Health and Social Care
Jackie Doyle-Price Excerpts(5 years, 3 months ago)
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Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
The Minister will know that the Health and Social Care Committee interrogated the Government’s plans on mental health for our young people. We found a massive gap: many schools that are passionate about their students’ mental health have had to cut the provision that they previously provided, including the educational psychologists, the councillors, the pastoral care workers and the peer mentors. Can she tell us—as the Education Minister could not tell us—what her plans will replace? We know that an army of those professionals are no longer working in our schools.
Jackie Doyle-Price
I know that the hon. Lady is very passionate about all this, and I can say to her that, in rolling out this additional support, we do not want to crowd out anything that is there already. It should genuinely be working in partnership with the provision that has already been undertaken, but we recognise that we need to be rolling out further investment. We are introducing a new workforce that will have 300,000 people when it is fully rolled out, but we must ensure that we invest in the training in such a way that it will be effective.
[Official Report, 15 January 2019, Vol. 652, c. 1004.]
Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price):
An error has been identified in the response I gave to the hon. Member for Liverpool, Wavertree (Luciana Berger).
The correct response should have been:
Jackie Doyle-Price
I know that the hon. Lady is very passionate about all this, and I can say to her that, in rolling out this additional support, we do not want to crowd out anything that is there already. It should genuinely be working in partnership with the provision that has already been undertaken, but we recognise that we need to be rolling out further investment. We are introducing a new workforce that will treat 300,000 people when it is fully rolled out, but we must ensure that we invest in the training in such a way that it will be effective.
Oral Answers to Questions
Jackie Doyle-Price Excerpts(5 years, 3 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
The new mental health support teams will deliver evidence-based interventions in or close to schools and colleges for children and young people with mild to moderate mental health issues. In December, we announced the first 25 trailblazer areas in England, and 12 sites will pilot a four-week waiting time to speed up children and young people’s access to NHS mental health services, including in Hertfordshire, serving my hon. Friend’s constituents.
Bim Afolami
I thank the Minister for that response. She will appreciate that the answer is not just spending more money on mental health—it is how that money is spent. Can the Minister explain in further detail the nature and scope of the research, scientific and otherwise, that has underpinned the Department’s response to the increase in poor mental health in our young people?
Jackie Doyle-Price
My hon. Friend is right: it is important that we get the best value from any investment we make in improving the nation’s mental health by making sure that it is evidence-based. On that basis, the Government engaged extensively with a range of expert organisations and individuals, including children and young people, to inform our proposals to improve mental health support, including through a consultation. We also commissioned academics to undertake a systematic review of the evidence which directly informed our proposals and we will, of course, learn from the trailblazers as we commission additional services later this year.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
The Minister will know that the Health and Social Care Committee interrogated the Government’s plans on mental health for our young people. We found a massive gap: many schools that are passionate about their students’ mental health have had to cut the provision that they previously provided, including the educational psychologists, the councillors, the pastoral care workers and the peer mentors. Can she tell us—as the Education Minister could not tell us—what her plans will replace? We know that an army of those professionals are no longer working in our schools.
Jackie Doyle-Price
I know that the hon. Lady is very passionate about all this, and I can say to her that, in rolling out this additional support, we do not want to crowd out anything that is there already. It should genuinely be working in partnership with the provision that has already been undertaken, but we recognise that we need to be rolling out further investment. We are introducing a new workforce that will have 300,000 people when it is fully rolled out, but we must ensure that we invest in the training in such a way that it will be effective.[Official Report, 16 January 2019, Vol. 652, c. 8MC.]
James Cartlidge (South Suffolk) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
Under the NHS long-term plan, there will be a comprehensive expansion of mental health services with an additional £2.3 billion in real terms by 2023-24. This will give 380,000 more adults access to psychological therapies and 345,000 more children and young people greater support in the next five years. The NHS will also roll out new waiting times to ensure rapid access to mental health services in the community and through the expansion of crisis care.
James Cartlidge
I thank my hon. Friend for her answer. She will be aware of the long-running and substantial problems that we have had in our main mental health trust, the Norfolk and Suffolk NHS Foundation Trust. Will she update the House on the latest position there, and in particular, will she tell us what steps the Government are taking to finally turn around this failing trust?
Jackie Doyle-Price
My hon. Friend is quite right: I have stood at this Dispatch Box a number of times to address concerns from all the local MPs in Norfolk and Suffolk. I can advise him and the House that the trust is receiving increased oversight and enhanced support from NHS Improvement. It is in special measures for quality reasons. It is also receiving peer support from the East London NHS Foundation Trust, which is an excellent and outstanding trust. We will continue to take a close interest in developments, but I can assure him that the trust is receiving every possible attention to improve its performance.
Nigel Mills
Will the Minister also set out what steps will be taken to ensure that care for someone experiencing a mental health crisis is available 24 hours a day, seven days a week?
Jackie Doyle-Price
I am grateful to my hon. Friend for his question, because this was top of my list of asks as we were developing the forward plan. The NHS has reiterated its commitment to ensure that a 24-hours-a-day, seven-days-a-week community-based mental health crisis response for all adults is in place across England by 2020-21. All adults experiencing a mental health crisis will be able to be directed to support via NHS 111. This is based on best practice as shown by the Cambridgeshire and Peterborough NHS Foundation Trust. I am grateful to my hon. Friend for his interest in this, and I can assure him that NHS England, all the commissioners and I are very much on it.
Dr Paul Williams (Stockton South) (Lab)
Half of all women who experience depression or anxiety in the perinatal period say that their problem was not asked about by health services. There are some genuinely positive things to say about the NHS long-term plan’s proposals for specialist services, but what is the point in having services if half the people with a problem do not have it diagnosed? What are we going to do about that?
Jackie Doyle-Price
The hon. Gentleman has quizzed me about this a number of times, and I know that he cares very deeply about it. One of the specific issues he has raised with me is the awareness of GPs and their involvement in diagnosing these problems. Obviously we are taking that forward as part of the GP contract. I can also advise him that there is a significant expansion in perinatal services. We are confident of achieving the national trajectory of 2,000 more women accessing specialist care this year, and more than 7,000 additional women accessed such care as of March 2018.
Paula Sherriff (Dewsbury) (Lab)
Recent analysis of NHS digital mental health workforce statistics reveals that NHS England is not on course to meet its targets of 21,000 additional mental health staff by 2021. This means that it is unlikely to meet the goals set in the five year forward view and the recent long-term plan. Mental health services are in real danger of further decline, so may we have an absolute guarantee from the Secretary of State that these targets will be met, and if they are not, will he resign?
Jackie Doyle-Price
I have to advise the hon. Lady that we are on course to meet the targets in the five year forward view, but she is right to raise concerns about the workforce. Frankly, that keeps me awake at night. We are investing in a significant expansion of mental health services and that requires appropriate staff to deliver them. I can assure her, however, that we are in productive discussions with clinical leads in NHS England. We need to be much more imaginative about how we deliver services, and we are seeing substantial gains and improvements in performance through the increased use of peer support workers, who provide the therapeutic care from which many can benefit. However, the hon. Lady is right to hold me to account.
John Howell (Henley) (Con)
Patient Rights and Responsibilities
Jackie Doyle-Price Excerpts(5 years, 3 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
I have today laid before Parliament a report on the effect of the NHS Constitution. The report has also been published on www.gov.uk, alongside an updated version of the handbook to the NHS Constitution.
The NHS Constitution, like the NHS, belongs to us all. It sets out the principles and values that underpin the NHS in England, and the rights to which patients, the public and staff are entitled, and pledges that the NHS has additionally made towards them. It also makes clear the responsibilities which we all have for supporting the NHS to operate fairly and effectively, and explanation of these has been strengthened in the handbook. We must all play our part in helping to make the NHS as good as it can be for ourselves, for our children, and for our grandchildren.
The report is based on an independent survey of staff, patients and the public. It describes how they view the impact of the Constitution, and its value in promoting and raising standards of care.
Many of us are increasingly turning to authoritative sources, such as the NHS website, for information on what they can expect from the NHS, how we can use it well, and how we can look after our own health.
In strengthening the patient and public responsibilities section in the Constitution handbook, which reflects our response to recommendations made in the House of Lords report on the long-term sustainability of the NHS and Adult Social Care, we have made clearer that patients and the public have a vital role to play in ensuring that the NHS remains sustainable, with its resources focused on those who need them most.
We have a dedicated NHS workforce, who work incredibly hard to deliver high quality care to all those who need it, when they need it. Despite the pressures they are under, they remain proud to be a part of the NHS, and firmly support the need for a Constitution. Awareness of the Constitution among staff is high, and among those who feel informed about the Constitution, more than ever said that it positively influences their day to day work. This highlights the Constitution’s ability to empower and enthuse staff to do their best for patients. As we work with the NHS to take forward its new long-term plan, published on 7 January 2019 and underpinned by a funding settlement that will see the NHS budget grow by £20.5billion in real terms by 2023-24, the Constitution continues to represent everything that the NHS stands for.
[HCWS1245]
Draft Human Fertilisation and Embryology (Amendment) (EU Exit) Regulations 2019
Draft Quality and Safety of Organs Intended for Transplantation (Amendment) (EU Exit) Regulations 2019
Draft Human Tissue (Quality and Safety for Human Application) (Amendment) (EU Exit) Regulations 2019
Jackie Doyle-Price Excerpts(5 years, 4 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
I beg to move,
That the Committee has considered the draft Human Fertilisation and Embryology (Amendment) (EU Exit) Regulations 2019.
The Chair
With this it will be convenient to consider the draft Quality and Safety of Organs Intended for Transplantation (Amendment) (EU Exit) Regulations 2019 and the draft Human Tissue (Quality and Safety for Human Application) (Amendment) (EU Exit) Regulations 2019.
Jackie Doyle-Price
It is a pleasure to serve under your chairmanship this morning, Mr Stringer—even though it is a bit early for some of us.
We are debating three sets of regulations that will be critical to maintaining patient safety in respect of organs, tissues and cells used to treat patients as we leave the European Union. They are no-deal statutory instruments: they have been developed as part of contingency planning and will be needed in the event that we leave the EU with no agreement in place. If the UK reaches a deal with the EU, the Department will revoke or amend the instruments to reflect the deal. The instruments will ensure that UK law on organs, tissues and cells functions effectively after exit day and maintains the same high standards of safety and quality. The instruments are being made under the European Union (Withdrawal) Act 2018. They make appropriate amendments and revocations to correct deficiencies in UK law and retained EU law.
I will go through the amendments in detail. First, in the event of no deal, the UK and the EU will consider each other to be third countries; the regulations redefine the term “third country” to include EU countries and Gibraltar. As a result, licensed establishments will need to make administrative changes to continue to import organs, tissues and cells from EU countries and Gibraltar.
A small number of organs are shared with EU and non-EU countries, with fewer than 30 organs on average being imported or exported each year. Despite the small numbers, we need to ensure that an appropriate legal regime is in place. Tissues and cells are imported from and exported to EU countries less often than they are imported from and exported to countries outside the EU. There are about 5,000 imports of tissues and cells from the EU in a typical year. That includes about 600 imports of stem cells and 3,000 imports of bone products. The UK imports donated sperm primarily from commercial sperm banks in the USA and Denmark.
Secondly, the regulations amend a number of references in current UK legislation that will no longer be appropriate once the UK withdraws from the EU. That includes references to obligations with which the UK must comply as an EU member state and some references to the EU, the European economic area, the European Commission and EU law. The regulations also modify how some of the requirements in the directives, which are referred to in domestic legislation, are to be read post exit.
Thirdly, these instruments propose a conferral of powers from the Commission to the Secretary of State and the devolved Administrations, where that is within devolved competence, permitting the Government to respond to emerging threats, changing safety and quality standards and technological advances. Legislative competence for the donation, processing and use in treatment of human reproductive cells—sperm, eggs and embryos—is reserved to Westminster. Competence in respect of all other human tissues, cells and organs is devolved; the relevant instruments are being made on a UK-wide basis, with the agreement of the devolved Administrations. The proposed amendments have been fully discussed with the Scottish, Welsh and Northern Irish devolved Administrations, and they have given formal consent to the draft statutory instruments.
The instruments are intended to maintain the current regulatory framework, so that UK organisations such as hospitals, stem cell laboratories, tissue banks and fertility clinics will continue to work to the same standards that they worked to prior to our leaving the EU. The impact of the instruments on businesses and public bodies will be low. Only establishments that import from or export to EU countries will be affected.
There is no impact for organ transplant centres. NHS Blood and Transplant and the Human Tissue Authority are working together to ensure that the new arrangements are put in place properly. Licensed establishments that import tissues and cells will need to put in place new agreements, so that they can continue to import tissues and cells from EU countries. The draft regulations give a six-month transition period so that they can do so. UK regulators will continue to advise and support all tissue establishments in preparing for exit day.
The draft regulations will allow us to continue with business as usual while leaving the European Union. I commend the draft regulations to the Committee.
Jackie Doyle-Price
It is a pleasure to follow the right hon. Member for Don Valley. I do not think I disagreed with a word she said. I recognise that, for some Members, it is a matter of regret that we are leaving the European Union. None the less, we are committed to delivering the instruction given by the British people in the referendum. I think I speak for most people in the room when I say we would prefer to do that on the basis of an agreed deal with our European allies, but we need to be ready for the eventuality that we are not able to secure such a deal. That is why we introduced these SIs. I am grateful to Committee members for their pertinent questions. They are evidence—if only the public could see it—of how seriously we are taking the challenges of a no-deal Brexit, which of course we all wish to avoid as best we can.
A number of Members expressed concerns about whether affected establishments had been properly communicated with and were ready for the changes in these regulations, and about costs. We issued a technical notice to all affected parties in August to give them due notice to be able to prepare for the regulations. As was referred to, there is a six-month implementation period, but we expect that preparation to have been undertaken now. Given that it effectively will be business as usual, we expect that preparation to be relatively straightforward. Some of the things we have put in, such as the six-month transition period, are really just a sort of legal process to set deadlines, but we expect all those affected to be compliant almost immediately.
On the issue referred to in the technical notice of whether establishments might need to seek separate advice, we expect establishments just to engage with the regulators. Again, this will be business as usual, but the regulators stand ready to give all those affected as much advice as they need to be able to comply.
The hon. Member for Gedling is quite right that the updated information was not published in November, but it has now been published. It was published on 7 December, so it was slightly delayed—that is not unusual when it comes to things associated with Brexit—but it can be found online, and I will draw his attention to it.
Jackie Doyle-Price
Google has its limitations, it has to be said.
On whether costs need to be reimbursed, it is worth noting that we expect the costs incurred by establishments to be extremely low. The main impact of the draft regulations relates to agreements that establishments have to put in place with whomever they trade with, but most establishments already hold import licences and are well used to making and applying such agreements. We expect them simply to roll over their existing written agreements. Again, however, NHSBT and the Human Tissue Authority will work with and support establishments to put those agreements in place. There will be no impact on organ transplant centres, and in the case of non-reproductive cells we think all the establishments concerned will already have such agreements in place. On that basis, we do not expect any establishment to incur significant costs, so there will be no need for any reimbursement.
The right hon. Member for Don Valley and the hon. Member for Washington and Sunderland West mentioned organ donation. Clearly, the 30 organs that come in and out of the country every year are a matter of life and death. It is of considerable concern to me that we have sufficient provision in place to ensure that that can continue. Much of that movement is between the Republic of Ireland and the north, and at this stage we do not anticipate significant problems there, but there is good reason to worry about Dover-Calais.
We have all heard the concerns about whether things will be able to get into the UK through that entry point. We are working with the Department for Transport to ensure that things such as medical supplies, including organs, can get through if there is traffic congestion. We are making such provisions—contingency plans will be in place. I hope we do not get to the point of having no deal, but we are determined to ensure as best we can that, if we do, it will be business as usual and that, for example, couriers are escorted so they can navigate traffic more quickly. It is very much on our agenda to ensure that we can enable that to happen.
Question put and agreed to.
draft Quality and Safety of Organs Intended for Transplantation (Amendment) (EU Exit) Regulations 2019
Resolved,
That the Committee has considered the draft Quality and Safety of Organs Intended for Transplantation (Amendment) (EU Exit) Regulations 2019.—(Jackie Doyle-Price.)
draft Human Tissue (Quality and Safety for Human Application) (Amendment) (EU Exit) Regulations 2019
Resolved,
That the Committee has considered the draft Human Tissue (Quality and Safety for Human Application) (Amendment) (EU Exit) Regulations 2019.—(Jackie Doyle-Price.)
Draft Human Fertilisation and Emryology Act 2008 (Remedial) Order 2018
Draft Human Fertilisation and Emryology (Parental Orders) Regulations 2018
Jackie Doyle-Price Excerpts(5 years, 4 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
I beg to move,
That the Committee has considered the draft Human Fertilisation and Embryology Act 2008 (Remedial) Order 2018.
The Chair
With this it will be convenient to consider the draft Human Fertilisation and Embryology (Parental Orders) Regulations 2018.
Jackie Doyle-Price
It is a pleasure to serve under your chairmanship, Mr Evans, and to move the motion. Parental orders are an important mechanism that transfer the legal parenthood of a child born through a surrogacy arrangement from the surrogate and her partner, if she has one, to the intended parents. The effect of a parental order is that the child born to the surrogate is treated in law as the child of the applicants for the parental order and that any parental rights of the surrogate and her partner are extinguished. That confers legal certainty of parenthood, parental responsibility and decision making on behalf of the child to the intended parents. It is clearly a key legal underpinning of the new arrangements for surrogacy.
When the Human Fertilisation and Embryology Act 1990 laid down the legal foundations, parental orders were introduced for married heterosexual couples only. In the Human Fertilisation and Embryology Act 2008, that was extended to same-sex couples, civil partners and couples in long-term relationships where the relevant criteria were satisfied.
In 2015, there was a legal challenge by a father who had a child through a surrogacy arrangement in the USA. He could not apply for a parental order because he was single. The High Court found that the 2008 Act was in breach of article 14 of the European convention on human rights, combined with article 8. In May 2016, the Court made a declaration of incompatibility. The declaration related to the lack of any provision enabling a person in the position of the applicant—someone not in a long-term relationship—to apply for a parental order. The order addresses that case by removing any discrimination against single people being able to exercise their rights under the 2008 Act.
The Government made a commitment to rectify the incompatibility as soon as possible. That is why we are here today. I have been determined to see this through and get the law changed. I pay tribute to my hon. Friends the Members for East Renfrewshire and for Brigg and Goole, who have been my conscience in ensuring that we bring the arrangements to the House as soon as possible.
I think all members of the Committee would recognise that since surrogacy was first introduced back in the 1980s, it has become increasingly common as a method for childless couples and individuals to address their wish to have a family. As such arrangements become more commonplace, it is important that we in Parliament ensure that the legal provisions underpinning them are safe for the child and for everyone whose rights need to be respected. The proposals have been considered by the Joint Committee on Human Rights. After its extensive and rigorous scrutiny, we have amended the order to get it into the shape that it is in now.
The regulations replace the Human Fertilisation and Embryology (Parental Orders) Regulations 2010 as a consequence of the changes made by the order that we are considering. The regulations will set the legal framework for parental orders by making provision for matters such as the legal status of a person who is the subject of a parental order, how the register functions and the factors that a court must take into account when considering an application for a parental order. It is worth emphasising that the issuing of a parental order still very much relies on the decision of the courts.
The regulations operate by applying, with modifications, adoption legislation to parental orders. For example, the regulations contain the requirement for the relevant Registrar General to hold and maintain a parental order register. When the child is born, the surrogate and her partner, if she has one, will record the child’s birth on the live birth register. Once the parental order has been granted, the court will send a copy of the order to the Registrar General and a new birth certificate will be issued. That is important when we satisfy ourselves about the legal rights and status of the parental order and how that will affect the child. This will be a certified copy of the entry in the parental order register.
Following the JCHR’s clear recommendations about the remedial order, we do not strictly need to debate the order, but the Government took the view that a joint debate with the parental order regulations would be more appropriate, and I am glad that this Committee has done so too. I hope that this debate has helped to illustrate the reason behind the regulations and explained the policy behind them, and I hope that we have been suitably transparent on an issue that many hon. Members will have very clear views about. I commend both statutory instruments to the Committee.
Jackie Doyle-Price
I thank hon. Members for their contributions. I particularly thank the hon. Member for Washington and Sunderland West for the constructive way in which she has approached this issue. We want to ensure that the law is fit for purpose in the 21st century, when surrogacy is becoming more common, and I look forward to having further conversations with her as the Law Commission continues its work. It is clear that the use of surrogacy arrangements has grown massively since the original legal framework was drawn up, and we really need to satisfy ourselves that the law is fit for purpose.
The hon. Lady asked when the measure will kick in. It will kick in 14 days after I sign off these statutory instruments following the approval of the House, so we can take action straightaway. Clearly, however, a lot of people have been waiting a considerable time for the change, so it will be possible to make retrospective applications going back six months. We kept that the same as in the previous legislation, but clearly the courts will be able to consider whether the change of law applies to a case and make judgments on that basis.
The hon. Lady also mentioned court fees. Those are of course primarily a Ministry of Justice issue. We are happy to follow up with the MOJ, but I am fairly confident that the fees will not be excessively burdensome, bearing in mind that parents have to go through the legal process of seeking a parental order as it is.
My hon. Friend the Member for Brigg and Goole showed his great passion for and interest in this subject. He is absolutely right that there are still issues with surrogacy law. It was without hesitation that I approved the grant to the Law Commission to have a good look at this whole area. He specifically mentioned parents with no genetic link to the child and the legal issues that follow from that. It is only when we think about these issues in the round that we realise just how vulnerable both parents and children are when the law is less than satisfactory. I can say to him categorically that the Law Commission absolutely is picking up the genetic link issues in its review, and I am sure it would welcome representations. I was interested to hear about his continuing work on this subject.
The Government recognise that there is a small but important number of individuals who have been waiting patiently for the law to be changed. No matter how small their number, it is essential that we in Parliament ensure that those people’s rights are protected and guaranteed, particularly given that we found such an obvious lacuna in our law. Those are people who are not currently recognised legally as the parent of their child, which is not good for the child, either. There are also people waiting to undertake a surrogacy arrangement with the support of a national surrogacy organisation who want the certainty of being able to apply for legal recognition of parenthood before embarking on their journey. That illustrates that people want the responsibility of exercising parenthood, and we absolutely must ensure that the legal framework enables them to make that choice and do it correctly.
Once again, I thank everyone for the spirit in which they approached these measures. We have corrected an injustice here, if I may say so, Mr Evans. I thank everyone for their contributions.
Question put and agreed to.
Draft Human Fertilisation and Embryology (Parental Orders) Regulations 2018
Resolved,
That the Committee has considered the draft Human Fertilisation and Embryology (Parental Orders) Regulations 2018.—(Jackie Doyle-Price.)
NHS: Hysteroscopies
Jackie Doyle-Price Excerpts(5 years, 5 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
It is a pleasure to serve under your chairmanship, Mr Howarth. It is an even bigger pleasure to respond to the hon. Member for West Ham (Lyn Brown). I pay tribute to the work she has done to highlight this issue, which has affected many women over many years who have been left to suffer in silence.
As the hon. Lady said, there were 47,000 signatures on the campaign petition, which is an indication of just how many women have been badly affected by what is actually a common procedure. It does not matter that it is only one in four, which is probably the most generous estimate. It could be as low as one in 10; it does not matter. We are talking about individuals who have been badly affected and who have been traumatised to the point where it effects their ability to look after themselves in the future. Frankly, it is no value to the NHS to leave those women suffering in silence, and I am very grateful to the hon. Lady for sharing the experiences of the women who have been brave enough to come forward.
The hon. Lady set me a challenge. She is quite right to demand swift action, because this has been going on for many years. She had four asks. On the first two, I will work with her and the campaign to make sure we can deliver them. They are extremely reasonable, to be brutally frank. On her third ask, we need to make sure that we have sufficient resource to enable women to exercise genuine, informed choice about how they take this procedure. On the fourth ask, about the tariff, notwithstanding the guidance about what might be best practice in most cases, we need to make sure that the tariff does not encourage perverse incentives that will disadvantage women. At the heart of all this, we need to ensure that running through every piece of treatment for women with gynaecological conditions is the ability to make informed and empowered choices—genuine choices. In that respect, I see the hon. Lady as a strong ally in working towards far better treatment for all women at the hands of the NHS.
The hon. Lady has given a great voice to people who have been through such terrible experiences. She again shared some of the distressing accounts of women for whom current practice has not been good enough. She is right that in the past not enough attention has been paid to a common procedure that generates harm to far too many women. I hope that the very fact of our debate today will shine a light on the situation, because the more we can do to spread awareness, the more women are empowered to look after themselves when facing treatment in the NHS. I hope that she will take some reassurance from the fact that I will continue to work with her to improve women’s health outcomes.
I also want to put something else on the record: the hon. Lady talked about a complete lack of humanity in how those women were treated. I would not be the first to say this—I have spoken to many female colleagues across the House as well—but we often feel that, when our reproductive organs are not being used for the purpose of having children, they are just an inconvenience. The NHS needs to do better. She mentioned my women’s health taskforce, and it is very much at the heart of that. As we go through life, the virtue of having our reproductive organs brings morbidities which are not always treated well in the NHS. We need to do better.
Hysteroscopy, as the hon. Lady explained, is a useful tool in the diagnosis and treatment of a number of conditions, such as the investigation of heavy menstrual bleeding, which affects as many as one in four women between the ages of 15 and 50. That gives some indication of just how many women might consider the procedure. Hysteroscopy is also used to treat fibroids and polyps, which are conditions that can cause long-term symptoms of pain and discomfort. The procedure is without doubt useful in treating women, so hysteroscopies have a role, but as she illustrated beautifully, they can be invasive and traumatic. We need only think about what the procedure involves to understand how traumatic it can be when it becomes painful.
Women’s least expectation of going through the procedure—this is crucial—is that they should be treated with sympathy and respect. They should also have full understanding before undertaking such an experience. As the hon. Lady explained, however, often women find themselves in profound shock at what is happening, and it does not always take place in the most appropriate setting. We clearly need to do better. Information is crucial in that regard: we need to ensure that nothing comes as a surprise.
I encourage women to access the NHS webpage on hysteroscopy, which includes information on what the procedure involves, the likely recovery period and the alternative procedures available. It notes that experiences of pain during a hysteroscopy can vary considerably from one woman to another but—the hon. Lady highlighted this point—I do not think that it properly reflects that, for women who have never had children, the pain can be particularly acute. We should consider the question whether it is ever appropriate for women who have not had children to have the procedure. Clearly, from the evidence she has presented to me, that is where the highest risk is.
I also feel strongly that merely giving information is not enough. Not only is this about providing clarity about what will happen and whether there are decision points for patients—some women will experience little or no pain, but for others it can be severe. We should also remember that for some women the hysteroscopy might be a first encounter with gynaecological services and that some might need to confront past pain or trauma. The hon. Lady has illustrated that well today. It is concerning when medical professionals do not prepare patients for the treatment in a sensitive way.
I fully agree with the hon. Lady that when a woman is clearly suffering during the procedure, it should be stopped. In any case, consent means that at any point people should be able to request that a procedure is stopped. It horrified me to read some of the accounts that she shared, such as women being held down and told, in essence, “You’ve got to continue this treatment or it will be worse for you.” That sort of conversation does not belong in 21st-century Britain in our fantastic NHS. I think we would all agree, women need to be treated better in that regard.
I also agree that we need better training on pain relief and managing women who are to have what can be a traumatic procedure. For practitioners, gynaecological procedures might be an everyday thing, but us women who present ourselves for such a procedure might have to have an out-of-body experience to go through it, because it is not comfortable—[Interruption]—excuse me—to have people engaged in that. We need more sensitivity—[Interruption.] Excuse me, Chair, I have a terrible cold.
The Royal College of Obstetricians and Gynaecologists has produced a guideline to provide clinicians with evidence-based information regarding outpatient hysteroscopy—[Interruption.] Excuse me—[Interruption.]
Mr George Howarth (in the Chair)
Order. The Minister is clearly in some distress. She must feel that she has more to say, but it would be perfectly in order if she wished to conclude the debate at this point. How can I put this? In these troubled times, it is really nice to see the amount of co-operation taking place across the Chamber. We have established that there is a consensus, so if she feels that she is still in some distress, it is perfectly acceptable if she wishes me to put the question, or we can continue—it is her choice.
Lyn Brown
I am really grateful to the Minister for her response thus far. I have found her, to be honest, to be the only Minister I have been able to have proper conversations with about such issues who has understood them. I am grateful. However, I honestly believe that we need to do something about the fourth ask. I am a fairly strong woman, but even I was in such a position: I had requested a hysteroscopy with general anaesthetic, but the hospital spent an hour of its time trying to talk me into having one without anaesthetic. I am in a high-risk category of being an older woman and of not having had a child, but I had to beat off the medic who was trying to use every piece of emotional blackmail that she could to get me to agree—the cost to the NHS, taking up resources, the possibility that I had cancer or of a long wait, and so on. It was an uncomfortable conversation. If we do not get rid of the perverse financial incentives, even women as strong as me will be browbeaten.
Jackie Doyle-Price
I thank you, Mr Howarth, and the hon. Lady for the generosity of allowing me to recover myself. We can tell it is December, because we all have colds—thank you very much.
In the short time I have left, I will address the specific issue of the tariff and the possible incentives, which I know the hon. Lady is particularly concerned about. She is right that there is a best practice tariff that incentivises care in a day-case setting with no anaesthetic, just pain relief. That tariff is agreed with the Royal College of Obstetricians and Gynaecologists, but it is revising its guidance. I want to engage the hon. Lady and the campaign group in that process through the women’s health taskforce, so that we can all satisfy ourselves that the guidance is appropriate. She is absolutely right: if someone such as her or me—women Members of Parliament—cannot look after ourselves, neither can anyone else, and I have heard many tales of people often feeling diminished at the hands of the NHS. She and I have the opportunity to use our voices to ensure that women get a better deal.
I again thank the hon. Lady for all her work. I look forward to continuing to work with her to ensure that all women who face that procedure can do so with sensitive treatment and appropriate pain relief.
Question put and agreed to.
Oral Answers to Questions
Jackie Doyle-Price Excerpts(5 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
We know from recent trends reported to the public health outcomes framework that health inequalities persist in this country. We already have world-leading programmes to address the root causes of poor health, including programmes to deal with childhood obesity, control tobacco and prevent diabetes and heart disease. The Prime Minister has set an ambition to ensure that people can enjoy at least five extra healthy independent years of life by 2035, while narrowing the gap between the experiences of the richest and the poorest, and next year the Secretary of State will set out further plans to achieve that in his prevention Green Paper.
Debbie Abrahams
We have known for decades that poverty and economic inequality drive health inequalities. The richer people are, the longer they live, and the longer they live in good health. In addition to the economic analyses of the Prime Minister’s Brexit deal, what assessment has the Minister made of the deal’s impacts on health inequalities, and on life expectancy and healthy life expectancy, which we know are already falling in some parts of the country, and among some groups of people?
Jackie Doyle-Price
The reasons for health inequalities are complex, but obviously we encourage people to make the lifestyle changes that enable everyone to live longer. I simply do not accept that the direct causality that the hon. Lady has outlined is as clear as that. We will focus on programmes that help people to lead healthier lives with better diets; that tackle tobacco control; and that prevent diabetes.
Andrew Selous (South West Bedfordshire) (Con)
As it is the most deprived children who are most overweight, will the Minister call on Kellogg’s to follow the example of Nestlé and put traffic light colours on all its products so that people can make healthier choices?
Jackie Doyle-Price
My hon. Friend makes an excellent point. Clearly the more we can do to educate people to make informed choices to improve their diet, the better. He is absolutely right: poor health among children used to be indicated by being underweight, but now being overweight is very much an indicator. I congratulate any food manufacturer that is taking action to address the problem.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Minister and the ministerial team know that many working class people do not have good access to GPs, and that GPs treat them differently from more middle class people, as demonstrated by the number of people from poorer backgrounds with atrial fibrillation who are wrongly diagnosed. If they are diagnosed with an irregular heartbeat or pulse, they are given the wrong drugs. That happens to many ordinary people in this country: there are still all these wonderful GPs prescribing aspirin that will do no good at all. What is going on with GPs and poorer people?
Jackie Doyle-Price
Our NHS is full of people who are doing their best to deliver the best possible care for all their patients. It is important that GPs and any health practitioners consider the holistic needs of all their patients—
Jackie Doyle-Price
The hon. Gentleman says they are killing people; that is not the debate I want on the NHS.
Luke Graham (Ochil and South Perthshire) (Con)
Scotland has the lowest life expectancies of all parts of the United Kingdom, with the figures falling for the first time in 35 years. The average life expectancy in 2017 was 77 years for men and 81.1 for women, compared with 79.2 for men and 82.9 for women in the rest of the UK. What can my hon. Friend do to support the devolved Administration to ensure that Scotland is not left behind the rest of the United Kingdom?
Jackie Doyle-Price
My hon. Friend is right to draw attention to that. I am always very keen to work with the devolved nations to both learn from what they do well and to share our expertise and experience where we are doing better, and I hope we will all co-operate to do exactly that.
Alison Thewliss (Glasgow Central) (SNP)
Initiating breastfeeding at birth can help reduce to health inequalities. Due to the actions of the Scottish Government, breastfeeding rates in Scotland are at a record high, whereas in England they are falling back dramatically because of local cuts. What will the Minister do to increase breastfeeding rates in England?
Jackie Doyle-Price
I commend the hon. Lady for her leadership on the issue, and she is right that this is one of the most significant public health interventions we can make at the earliest point in life. I will happily line up with her to do more to champion breastfeeding, and there is certainly a lot further to go, not least in ensuring that society is more tolerant of the practice and that women really do enjoy their right to breastfeed.
Luke Hall (Thornbury and Yate) (Con)
Nick Smith (Blaenau Gwent) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
Since 2013, when local authorities took on responsibility for these services, attendance has increased from 2.9 million to 3.3 million. Tests for sexually transmitted infections and access to long-acting contraception have also increased, which shows that people are taking their sexual health seriously and that services are responding.
Nick Smith
Unfortunately, syphilis and gonorrhoea diagnoses are up 20% since 2016. What are the Government going to do to address this growing trend, given that sexual health services are at their limit?
Jackie Doyle-Price
The evidence I have is that sexually transmitted infection rates are stable, that rates of teen pregnancy are falling, that rates of abortion are stable and that rates of HIV testing are increasing. However, the hon. Gentleman raises an important point, and I will look into it. The most important thing is not necessarily where or how people access their services, because we want to make tests and long-term contraception available online too. We will keep the issue under review.
Diana Johnson (Kingston upon Hull North) (Lab)
Does the Minister agree with the chief medical officer, who said in her evidence to the Health and Social Care Committee that she thought the cuts to sexual health services had gone too far?
Jackie Doyle-Price
As I said in my previous answer, the important thing is to look at outcomes. We can see that levels of teen pregnancy and sexual infection are stable and that more people are accessing contraception. We need to ensure that people can access contraception in the most convenient way for them, and we can see that rates of access are on the increase.
Lisa Nandy (Wigan) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
The hon. Lady makes a very good point. When we last discussed this matter over the Dispatch Box, I said that it was my ambition to come back to her as soon as possible, but we have to agree a cross-Government response, which is imminent. However, she is quite right; we really need to respond as soon as possible.
Andrew Bridgen (North West Leicestershire) (Con)
Jackie Doyle-Price
My hon. Friend will be aware that we have brought forward proposals to have a mental health lead in all schools. We are also introducing a brand new workforce to support schools and improve mental health provision. The first wave of staff are being recruited for training now, and we have 210 applicants for the first wave of places.
Mr Ben Bradshaw (Exeter) (Lab)
Ruth George (High Peak) (Lab)
Today’s report on the amount of police time spent dealing with emergency mental health cases without support from mental health professionals is echoed by police in my constituency, who say that it takes up almost 40% of their time. Will the Government recognise that this crisis should not be dealt with by police officers, far less in cells, and sort it out?
Jackie Doyle-Price
First, I pay tribute to the work that the police do in dealing with people who are in mental health crisis. They view it as part of their core work, but clearly they should not be picking up the slack where services do not exist. I am working closely with the police service and other interested parties to ensure that we have sufficient crisis care, to enable the police to discharge their responsibilities adequately and in a safe way. We will continue to do that.
Kevin Foster (Torbay) (Con)
My constituent Alice Sloman died during what should have been a routine MRI scan, following complications with the general anaesthetic that had been administered to her. Will the Minister agree to meet me and Alice’s parents to discuss the possibility of people, particularly those with existing conditions, having routine heart checks before such procedures?
Hannah Bardell (Livingston) (SNP)
My constituents Kirsteen and Wilma Ord have had their lives blighted by the Primodos hormone pregnancy drug. The review that the Government undertook was a whitewash, and now the further review, led by Baroness Cumberlege, will focus only on people in England. She has said that she will consult groups in Scotland, but drug regulation is reserved. What will the Minister do to promise that my constituents will not be let down again?
Jackie Doyle-Price
I met Baroness Cumberlege just last week, and I know she would be open to hearing representations from constituents in Scotland, to add to her understanding of this issue. We are determined to make full use of that review, so that we can learn lessons from this tragedy.
Several hon. Members rose—
Health and Social Care Committee
Jackie Doyle-Price Excerpts(5 years, 6 months ago)
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Sir Henry Bellingham (in the Chair)
Would the Minister like to say anything?
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
Thank you, Sir Henry. I really welcome the report. My hon. Friend the Member for Totnes (Dr Wollaston) alluded to the fact that this issue lies within the bailiwicks of both the Department of Health and Social Care and the Ministry of Justice; I am glad that the Under-Secretary of State for Justice, my hon. Friend the Member for Charnwood (Edward Argar), is here beside me. We are seized of the importance of this issue and recognise that silo culture is often the enemy of good policy making. Rest assured that we will take away the report and reflect on it. We are very grateful for the interest that the Health and Social Care Committee has shown in this very important subject, because we do need to do a whole lot better.
Sir Henry Bellingham (in the Chair)
I am very grateful to the Minister for those words.
Organ Donation (Deemed Consent) Bill
Jackie Doyle-Price ExcerptsFriday 26th October 2018
(5 years, 6 months ago)
Commons ChamberRead Full debate Organ Donation (Deemed Consent) Act 2019 View all Organ Donation (Deemed Consent) Act 2019 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 12 September 2018 - (12 Sep 2018)
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
It really is a pleasure to confirm the Government’s support for this important measure from the Dispatch Box today. I join other Members in sending my good wishes to the hon. Member for Coventry North West (Mr Robinson), who has been the driving force behind the Bill, and I am grateful to him for choosing this as the subject of his private Member’s Bill, because it will save lives. I also want to thank the hon. Member for Barnsley Central (Dan Jarvis), who actually began this journey for me with his Westminster Hall debate on the subject, which took place before we launched the campaign to take this Bill ahead. This has been quite a journey for us, and it has been a pleasure to work with him and the hon. Member for Coventry North West. They have made it very easy for me to work with them; we were all very focused on the outcome that we were trying to achieve, which was to save more lives, and we have approached the matter practically and pragmatically. I wish the Bill Godspeed to the other place, from where I hope it will emerge unscathed to take its place on the statute book very soon. I shall certainly be saying my prayers to ensure that it does so.
Lots of colleagues mentioned the debt that we owe to Trinity Mirror for a campaign that captured the public’s imagination, and we are grateful to Max and his family for their role in it. However, we cannot thank the family of Keira Ball enough, and my hon. Friend the Member for North Devon (Peter Heaton-Jones) has been fantastic at telling their story. One of the joys of doing this job—I always feel inadequate and utterly humbled—is meeting donor families. It is great to have the hon. Member for Birmingham, Perry Barr (Mr Mahmood) here, because we should not forget live donors and their altruism. It is incredible that people will make such donations voluntarily and, it must be said, at great personal risk. Giving the gift of life is something that donors and their families should be proud of, and I never fail to be inspired by those stories. We think today not only of those who benefit from organ transplants and those on the waiting list—we hope to be able to save more of them—but of donors and their families, without whom we would not be having this debate. I thank them all.
The real objective of this Bill is to ensure that we improve the chances of the thousands of people who are desperately waiting for a transplant. Again, I totally associate myself with the comments of the hon. Member for Barnsley Central when he introduced the Bill, because it will not achieve the degree of change that we want on its own, but one of the happy advantages of this Bill and of the Daily Mirror’s campaign is that we have raised awareness of organ donation. Such things were rare 40 years ago, but donation has almost become so commonplace that people may think, “That is somebody else’s problem. I don’t need to worry about registering my preference. Somebody else will do it. There isn’t the need.” Well, there is a huge need. We also need to remind people that dialysis is a life-saving process, but it is not nice. We have become desensitised to just how challenging such illnesses are.
The Bill provides us with a fantastic opportunity to raise awareness of the whole organ donation issue, which I have been pushing NHSBT to take full advantage of, and I am pleased to say that it has. We will obviously have to build on that progress as the Bill moves forward. My hon. Friend the Member for North Devon pressed me on that, and if the hon. Member for Coventry North West was here, he would have done the same. I can tell the House that we will be investing £18 million over the next three years to raise awareness of the new scheme and to encourage people to register their wishes and have conversations with their families, which is by far the most important thing. There will be £18 million over the first three years, but ongoing communication to raise awareness will very much be part of how we take things forward.
If Members and anyone watching today have not had that conversation with loved ones about their wishes in the event of their death, please have it. The last thing we want is for loved ones, in the unhappy event of a loss of a life, to be put into a position where they have to make a judgment not knowing the true wishes. We have heard how people have approached that and doing so is immensely brave. I sometimes hear from donor families that the decision was easy because they had had that conversation, and I cannot repeat that message often enough.
I associate myself with the comments of the hon. Member for Barnsley Central when he said that the Bill is not about the state taking control of people’s organs. Organ donation is a gift, and that is a fundamental principle of the Bill. We are altering the basis on which people’s wishes can be expressed, which will have the effect of altering the conversation at the bedside when it most needs to take place. However, we will continue to invest in the specialist nurses who are trained to have those conversations in the most sensitive way. It is important that they are specialists, because the surgeons and medical staff who are emotionally invested in trying hard to save a life should not be the ones who then must have that conversation with the family—that clearly would not work.
I totally endorse the argument that, in addition to the new system, the accompanying measures relating to all support staff and communication will contribute to an increase in the number of organs available for transplant. It is only by taking those measures together, rather than in isolation, that the scheme will be successful.
In the time remaining, I want to address some issues that have arisen. There is a lot of nervousness. People are inhibited from signing up to organ donation mostly by a sense of mistrust—of institutions of the state and of medical professionals—and because they do not really know what happens. I want to put some points on the record to calm the situation and provide reassurance.
We have talked extensively about the need for more donors from black and Asian communities because they are more likely to suffer from conditions that require a transplant. Obviously, the most successful transplants are those with a strong genetic match, so we need more of those donors.
We know that the issue is taboo in some communities. Some people believe that there are reasons of faith for not supporting transplantation. We have been working with various faith leaders to develop messages and materials to reassure people that the practice is consistent with their beliefs. I am grateful to my hon. Friend the Member for Torbay (Kevin Foster) for mentioning that the Board of Deputies of British Jews supports the Bill. We have had similar conversations with representatives of the Hindu faith, the Sikh faith and the Muslim faith, as well as with Christian Churches.
That dialogue needs to continue. It is clear that people will respond to messages from people whom they trust and respect, so it is very important that we continue to engage with faith communities. It cannot all be done at once; we need to keep chipping away and sending messages. I hope Members will use the toolkits I have circulated today. They are designed to equip Members of Parliament, who are trusted in their communities and are good advocates for the proposal, with the material to engage directly with communities.
Much reference has been made to the role of families at the bedside. There is concern that families often overrule the wishes of people who want to donate, but we need to protect the family’s ability to have that final consent. It is very easy for us to imagine situations in which we would want our wishes to be respected, but we do not know the circumstances when it comes to matters of life and death. It is very important that families have that final consent, and I emphasise that that will remain the case. I cannot emphasise enough that if people have that conversation with loved ones, their wishes are less likely to be overruled.
I remind the House that guidance on the current system of consent is detailed in a series of codes owned by the Human Tissue Authority. We will update those codes and people will have the opportunity to make representations. The idea is to have a complete, up-to-date document providing information on the approach taken in England. The guidance will cover how consent can be expressed; how people can register their wish to opt out; the role of the organ donor; and how specialist nurses will interact with families. It will also give people the opportunity to record that their faith is important, if they wish that to be an issue of consideration.
It is also worth noting that as we develop technological solutions to addressing things in the NHS, people will be able to amend their views on donation regularly by direct interface with an app. They will be able to change their mind. One day they might decide that they are happy to give their corneas and then on another decide that they are not. People will be able to make that selection and make anything that they would wish to be considered clear.
On timing, we hope that the Bill will receive Royal Assent by March, in which case the HTA is all set to go to produce a first draft of the code by May. That will be followed by a 12-week consultation on the draft guidance with stakeholders, including faith groups, so there will be another opportunity for us to address any concerns properly at that time. We expect to lay that guidance before Parliament next September. I can therefore assure the House that we intend to make use of this Bill speedily once it has received Royal Assent.
I wish to make a point about children. Obviously, children below the age of 18 will be exempt from the Bill, as they are not at the age of majority in order to make their choices known. As before, the family will be fully consulted. The safeguard will be as it is now, and children are always dealt with extremely sensitively.
I have mentioned that we will continue to engage with faith groups. I wish to emphasise that NHSBT is updating and extending its faith training, so that as we can expect more conversations to be taking place on the part of specialist nurses following this change, people will be kept fully up to date with any religious and cultural issues that might need to be considered.
Finally, I wish to say something about an issue that Members may have been lobbied about: novel transplants. We have all talked a lot today about kidney, liver, heart and lung transplants, and these are the organs we are all used to talking about. Clearly, medical advances being what they are, other things will materialise; I have heard evidence of hand, face and uterine transplants. They will not be covered by the Bill. They will be exempted by our introducing regulations that exempt certain organs from the deemed consent procedure. We have done it that way because this Bill needs to be able to have a life and to respond to medical advances, so it is better to have regulations that enable us to exclude rather than to have a list of organs that are covered. In that way, it is easier to keep this law in date.
Andrew Bowie (West Aberdeenshire and Kincardine) (Con)
Does my hon. Friend know whether the proposals she has set out on protecting parts of the body such as hands and the other things she mentioned will be marrying up with legislation going through the devolved legislatures now? Will we therefore have a similar code of practice across the entire UK?
Jackie Doyle-Price
Just as this Bill has progressed with good will from those in all parts of this House, so it has progressed with good will from all nations. We have all been sharing our experience to make sure that we get this right. So I am sure that that will be taking place in a consistent way.
In conclusion, as I said at the beginning, I am so proud that I have been able to play my part in taking this Bill forward. I am so grateful for the good will from both sides of the House in taking this forward. It has been a fantastic piece of cross-party working. It has made the process quick and speedy, and we have all been focused on what we are trying to achieve, which is to save more lives. I am very confident that Max’s and Keira’s law will have a very positive impact on how we treat people with organ failure and that it will also kick-start a cultural change in how we address these issues. In fact, it already has: people are talking about organ donation much more and joining the organ donor register at increased rates. I hope that the House will give the Bill its wholehearted endorsement.
Child Death Review
Jackie Doyle-Price Excerpts(5 years, 6 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
Today I am publishing, on behalf of the Government, the statutory and operational guidance “Child Death Review” which outlines the framework which all practitioners involved in a review of a child’s death should follow. Clinical Commissioning Groups and Local Authorities, as the new child death review partners, must make local arrangements for the review of all child deaths, in England.
The policy of child death reviews has, until recently, been the responsibility of the Department for Education. I welcome the Prime Minister’s decision on the transfer of policy for child death review set out in her written statement to the House on 18 July. This change will result in child deaths becoming part of the national Learning from Deaths Programme and its aim is to learn lessons to save more children’s lives and ensure that the way the NHS engages with the bereaved, continuously improves.
Related areas that remain the responsibility of the Department for Education include children’s social care including safeguarding children and child protection.
The revisions to the child death review process have been necessary to reflect the legislative changes introduced through the Children and Social Work Act 2017. The reforms underpin a stronger but more flexible statutory framework—one that will support local partners to work together more effectively to review the deaths of children in order to try to prevent deaths recurring by the same cause.
The findings from local reviews will be reported to the National Child Mortality Database (from April 2019), where the information, for the first time will be analysed centrally and will provide additional learning beyond what can be achieved by local systems. The data will be analysed at the Child Mortality Data Unit at the University of Bristol and will be used to inform strategic improvements in health and social care for children, and to help health and social care providers to learn about how they can reduce child deaths.
NHS England plan to publish shortly “When a Child Dies - A Guide for Parents and Carers”. The guide has been developed by a group of bereaved parents, and support organisations and professionals.
Child Death review is an important piece of guidance for agencies, organisations and practitioners to know what they must do individually and collectively to robustly and thoroughly review and learn from every child death.
[HCWS998]