Mental Health In-patient Services: Improving Safety
James Duddridge Excerpts(10 months ago)
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Steve Barclay
The meaningfulness of those comments can be seen in the fact that we are putting this inquiry on a statutory basis; the £2.3 billion additional investment compared with what we had four years ago; the crisis cafés and the other schemes we have, as part of the 160 schemes we are bringing forward; and our willingness to innovate in mental health through the use of mental health digital apps. There is a whole range of initiatives because that is the right approach. Across the House, it has been recognised that in the past mental health did not get as much focus as physical health, which is why we are investing more. Again, the House recognises that covid has brought more focus to these issues, which is why this is a priority for the Government. Today’s statement is a further continuum in that effort.
Sir James Duddridge (Rochford and Southend East) (Con)
I thank the Secretary of State for his attitude to this issue and the time he has put in. I fully support the points he has made about non-statutory and statutory inquiries. It was right to start off non-statutory and to change when the situation changed and we were not getting what we wanted.
I reflect on the comments of my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) about, “Where did this go wrong?” Since I first visited Rochford Hospital, part of what is now EPUT, in my constituency, I believe we have had three Secretaries of State visit, as well as at least five Ministers responsible for these areas. What was the South Essex Mental Health Partnership grew to take in more of Essex, and it then reached across the border into Hertfordshire and, if I recall correctly, went further. It perhaps just got too big. Early on, the constituents I spoke to were concerned about getting in; they wanted their children to get in, but there were delays and this was about overall capacity. Now the issue is about the quality of what goes on. The hon. Member for St Albans (Daisy Cooper) mentioned beds and I can tell her that this is not a problem of beds, certainly in Rochford Hospital, where there are plenty of beds; it is about having the clinical psychiatrists specialised in children’s services and the supporting nurses to deliver. We should also pay attention to the fact that things are much better where people have simple mental health problems, but very few people have those. When these problems are combined with drug use or autism, particular challenges are presented while people are in these places and during discharge. I urge the Secretary of State to encourage the inquiry to look into all those issues.
Steve Barclay
My hon. Friend makes extremely important points, and I absolutely agree with him. Indeed, I will draw the inquiry’s attention to the points he raises. He is right about the trade-off between non-statutory inquiries giving speed and statutory inquiries having a wider range of powers. We have followed the evidence on that, which Dr Strathdee has shared. There is also a balance between the size of a facility and the quality of the care. Data is a key component within that and the rapid review was focused particularly on it. All of us are focused on, “How do we get the best patient outcomes? Where those have fallen short, how do we ensure the lessons of that?” That is what the statutory inquiry is absolutely focused on and it is important that families then engage with it.
Performance-enhancing Drugs and Body Image
James Duddridge Excerpts(1 year, 2 months ago)
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Dr Evans
The hon. Member is spot on. The advent of social media over the last 20 years has really brought home that idea of body image. With the likes of Instagram, if a man is interested in using a gym, they are sent hundreds of images in 30, 40 or 50 seconds. Each individual image in itself is not the issue, but the cumulative effect of repeatedly being sent such images is a problem.
I would argue that the way to solve the problem is through the social media companies’ algorithms, to ensure that there is transparency about what people are being sent. Facebook talked about diet pills aimed at young girls being a real problem. If we do not deal with male body image and body dysmorphia, this will be the next iteration of that problem.
As a doctor, over the last 10 to 15 years I have started to see more and more young men coming into my clinics and asking to be prescribed protein powders or creatine, and asking, “How do I bulk up?” I also started to see more and more men in their 20s, 30s and 40s who were using steroids and having side effects, including bad acne, scarring acne, mood problems and depression. I have even seen some men who have had strokes, heart attacks, liver problems, kidney problems and erectile dysfunction, none of which are really talked about when it comes to steroids.
The problem with steroids is that they work, so people use them and see a drastic improvement. People who want to build muscle will see that improvement, take the cycle of whatever substance it happens to be and then plateau, which is very hard for them to deal with because they no longer see the gains they were initially getting under their regime. They say, “Oh, I’ll only use it once”, but once becomes twice, twice becomes thrice, and so on.
Sir James Duddridge (Rochford and Southend East) (Con)
My hon. Friend listed symptoms, but I do not think that he mentioned swelling of the brain. Matt Dear, a 17-year-old from Essex, tried to build himself up by taking bodybuilding pills, because he was committed to a career serving in the armed forces. He took pills that he had bought for £30, his brain swelled up and, tragically, he died. The memory of Matt has helped to educate children in the community. Is my hon. Friend concerned that even taking these things once can be terminal?
Essex Mental Health Independent Inquiry
James Duddridge Excerpts(1 year, 2 months ago)
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Vicky Ford (Chelmsford) (Con)
I beg to move,
That this House has considered the Essex Mental Health Independent Inquiry.
It is a pleasure to serve under your chairmanship, Mr Davies. Today’s debate is important for the future of mental health services across the country and ensuring that the tragic stories that I and many of my Essex colleagues have heard from the families affected by the failings in mental health services in Essex are not repeated. This is not the first time that mental health in Essex has been debated, and I pay tribute to my hon. Friend the Member for South Suffolk (James Cartlidge) for his previous Adjournment debate. Before I start, I ask everyone to take a moment to think about all those who have died, those who have suffered, those who love them and those who care for them.
As well as other in-patient facilities, many concerns have been raised about the Linden Centre in Chelmsford, where there have been a significant number of in-patient deaths, both on the wards and while vulnerable patients were on section 17 leave or had absconded. The Linden Centre lies just outside the boundary of my constituency, but the patients treated there come from across Chelmsford and, indeed, Essex. For example, Jayden Booroff was suffering from acute psychosis and known to be at high risk of absconding. In October 2020, he was killed by a train just a few hours after he had been able to tailgate a staff member out of the Linden Centre. The inquest concluded that Jayden died following inconsistencies in care at the Linden Centre run by Essex Partnership University NHS Foundation Trust, or EPUT. Jayden’s mother, Michelle, is one of my constituents. She has told me of her wish to achieve accountability, for responsibility to be accepted and for long-term lasting improvements to services.
I and many of my Essex colleagues represent family members of mental health in-patients who have died under the care of EPUT, which is responsible for the provision of adult NHS mental health services in Essex. Many inquests and investigations have taken place, but it has been very clear for a long time that a fuller inquiry was necessary to understand why so many deaths have occurred and to try to prevent future tragedies.
In January 2021, the Government set up an independent inquiry, to be chaired by Dr Geraldine Strathdee, to investigate matters surrounding the deaths of mental health in-patients in Essex between 2000 and 2020. At the time, when local MPs were briefed on the issues, Ministers believed that a non-statutory inquiry was more appropriate, more likely to get to the truth and more likely to make recommendations for improvement in a timely manner, whereas a statutory inquiry was likely to take much longer to set up and report. It was made clear that, while the inquiry did not have statutory powers, witnesses were expected and would be encouraged to come forward and give evidence.
On 12 January 2023, I and many other Essex MPs were deeply concerned to receive the open letter published by the inquiry chair, Dr Strathdee, stating that she felt that the non-statutory inquiry into EPUT was unable to fulfil the terms of reference due to the extremely low engagement of EPUT staff. We also heard that rather than the 1,500 deaths we had been informed of, close to 2,000 fall within the scope of the inquiry. It is incredibly disappointing that, of the 14,000 members of EPUT staff whom the inquiry had written to, only 11 had agreed to give evidence. In the specific cases that the inquiry is investigating, only one in four responded. That is a shockingly low figure. It is abundantly clear that, with this extremely small pool of staff witnesses, it is highly unlikely that the full truth would be heard.
Upon receipt of Dr Strathdee’s letter, my right hon. Friends the Members for Maldon (Sir John Whittingdale) and for Witham (Priti Patel) immediately wrote to the Health Secretary to raise their serious concerns that the powers available to the inquiry did not go far enough. I have also written to the Health Secretary to underline my agreement with all the points they raised. Dr Strathdee’s unequivocal view, as stated in her open letter, is that the inquiry will not be able to meet its terms of reference with a non-statutory status. I want to put it on the parliamentary record that I join those calls for this to be converted into a statutory inquiry, which will compel witnesses to give evidence, to ensure full transparency and greater public scrutiny of its progress.
Sir James Duddridge (Rochford and Southend East) (Con)
My hon. Friend knows that I did not support a public inquiry—I thought it would take a long time and be an expensive distraction from spending money on the service—but the approach we have taken simply has not worked. Unless the Department and EPUT transform miraculously over the next four weeks, the only real option is a statutory inquiry, for which she has our full support.
Vicky Ford
I thank my hon. Friend for his words, which are absolutely spot on, and for emphasising the support among Essex colleagues on this matter.
Having said that, I also recognise the points made to MPs in a letter from the chief executive of EPUT on 19 January. He points out that a public inquiry could bring consequent delays and costs, and the trust needs to be focused on continued improvement to services at a time of rising demand, both in numbers and complexity of cases.
He made a number of recommendations, including an increase in resources and expertise available to the inquiry chair, and ensuring appropriate information-sharing protocols. He also suggested a number of practical steps to drive better staff engagement with the inquiry. He has informed me that, since 2019, absconsions have decreased by more than 60%, the use of prone restraint has reduced by 88% and fixed ligature incidents have reduced by 32%. He has told me that many staff are scared to come forward, and that all board members will come forward now, as an example to others.
Given that, I can understand that Ministers might be tempted to give those suggestions a short period of time, to see if they bring improvements. However, I make two points. First, it is two years since the independent inquiry was announced. EPUT has already had a long time to take action and to support staff to engage. Secondly, given how incredibly low the engagement has been to date, I have serious doubts about whether the process would be effective. Therefore, I suggest that, if Ministers decide to take this option, they should set a deadline of no more than one month, making it clear that if there is not a massive material change in staff engagement, the statutory route will be actioned. They should also make it clear that the statutory route is likely to include some staff being named, and being compelled to give evidence in public.
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)
It is a pleasure to serve under your chairmanship, Mr Davies. I thank my right hon. Friend the Member for Chelmsford (Vicky Ford) for securing this important debate, and I thank her and all the local MPs—my right hon. Friend the Member for Witham (Priti Patel), my hon. Friend the Member for Rochford and Southend East (Sir James Duddridge) and my right hon. Friend the Member for Maldon (Sir John Whittingdale)—for their dogged work over a long period in trying to get justice both for those in the Public Gallery and for all the others who are unable to be present this morning.
I know that Members have raised a lot of concerns about the progress of the inquiry, and I want to take this opportunity to make clear our strong commitment to this absolutely vital work. The speech made by my right hon. Friend the Member for Chelmsford was stark, and I know that some of the victims, survivors, and friends and families of people who have been affected are in the Public Gallery. It is a powerful reminder of why the inquiry is so important: it has to get to the truth.
The Government are committed to improving mental health services across the country, which is why we launched the independent inquiry in January 2021, covering a 20-year period from 2000 to 2020. Obviously, it is a complex inquiry. Like Members present, I am pleased with the hard work of Dr Geraldine Strathdee, the inquiry chair, since the inquiry started its work. However, I am concerned about the level of co-operation that the inquiry has received, which was set out clearly by my right hon. Friend the Member for Chelmsford. It is not good enough, and Dr Strathdee has recently raised concerns about this. She met the Secretary of State and has since published an open letter in which she stated that
“in the event that staff engagement remains very poor, it is my view that the inquiry will not be able to meets its terms of reference with a non-statutory status.”
We take those concerns very seriously.
Dr Strathdee has raised two particular concerns. The first is about the participation of current and former staff, and the second is about the availability of documents for the inquiry. As a result of Dr Strathdee’s concerns, the Secretary of State met Paul Scott, the chief executive of Essex Partnership University NHS Foundation Trust, to better understand how the trust will support the inquiry. The Secretary of State sought assurance on two key issues. The first is what actions the trust will take to encourage more staff engagement with the inquiry, and the second is assurance that the trust will provide all the evidence and information requested by the inquiry, to enable it to fulfil its terms of reference. I know that Mr Scott has also written to local MPs setting out the steps that he thinks necessary to improve engagement, and he feels confident that progress can be made.
On staff participation, I remind the House that it is incumbent on all holders of public office and all health professionals to demonstrate their fitness for office by voluntarily co-operating with independent inquiries. In their guidance on the duty of candour, professional regulators advise that health and care professionals must be open and honest with their colleagues, employers and relevant organisations, and take part in reviews and investigations when requested. Similarly, they must support and encourage each other to be open and honest. I therefore hope that anybody who is asked to contribute evidence will co-operate fully with the inquiry in the public interest and in fulfilment of their professional obligations. The Department is also working closely with the inquiry and NHS England to look at what more can be done.
Dr Strathdee has expressed her concern that an additional 600 cases were recently sent to the inquiry. The trust has advised that they were identified during a validation process. I appreciate that this is not ideal, but I understand that the trust has allocated appropriate staffing and resource to ensure the thoroughness of the searches requested by the inquiry.
As Members have mentioned, the participation of families is equally important to the work of the inquiry, and I am grateful to all who have provided evidence to date. I am disappointed that a number of families who have tragically lost loved ones have chosen not to participate and get their voices heard. I urge them to reconsider, so that the inquiry can be as thorough as possible.
Our view is that a non-statutory inquiry, if it is possible, remains the most effective way to get to the truth of what happens. It is quicker, and potentially involves not having to drag clinicians through the public processes of a statutory inquiry. When my right hon. Friend the Member for Witham was Home Secretary, she used the non-statutory process to protect those who did not want to be named and dragged through a statutory process. It is faster and more flexible, which is why it was chosen in the first place. Although statutory inquiries can compel witnesses to give evidence under oath, that does not necessarily mean that it will be easier to obtain the evidence we want. However, all that turns on people co-operating with a non-statutory inquiry, and we now need to see a quantum leap in the level of co-operation. We will not hesitate to move to a statutory inquiry if we do not see a dramatic increase in the level of co-operation. Given how long this has gone on, we cannot wait for a long period for a transformation in the level of engagement. While the approach remains non-statutory for now, we will not hesitate to change that approach if we do not see the change we need rapidly.
Sir James Duddridge
I have visited Essex Partnership University NHS Foundation Trust in Rochford a number of times and have been incredibly impressed with its work, notwithstanding its very real problems. What I cannot get over is why people have not come forward to give evidence in a non-statutory environment, because these are caring individuals who want to improve the service. I do not understand why only 11 people have come forward.
Neil O’Brien
That is a vital question. There is an excellent chair, and many publicly spirited individuals are already co-operating to get to the truth and improve services for the long-term. We are currently in this environment of the non-statutory inquiry, which allows an informal approach. People do not have to give evidence in the way they would if we went to a statutory approach. There is an opportunity for people to co-operate more with the inquiry, exactly as my hon. Friend says.
NHS Funding: Essex
James Duddridge Excerpts(5 years, 2 months ago)
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Robert Halfon
My hon. Friend has been an incredible supporter; his constituents will know the work he has done to lobby the Government for our new health campus. He makes an incredibly important point: this is about not just a Harlow hospital, but a hospital for the surrounding area that will serve the people of Hertfordshire and Essex, and I am pleased that my hon. Friend the Member for Rochford and Southend East (James Duddridge) is also here.
James Duddridge (Rochford and Southend East) (Con)
May I take the opportunity to add my support and that of colleagues in south Essex for the excellent campaign work on the additional provision in Harlow? I wonder whether my right hon. Friend will touch more broadly on the sustainability and transformation plans, particularly in south Essex. If we encourage the Secretary of State to press ahead with those plans, although there are some reservations, that will release capital expenditure in the south and further release pressure. That will not alleviate the problem completely, but it will help the issue across the county.
Diabetes
James Duddridge Excerpts(5 years, 3 months ago)
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James Duddridge (Rochford and Southend East) (Con)
I too congratulate my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) on this excellent debate. The contributions have shown that we could have spoken at much greater length, given the breadth of issues faced.
I will talk from a personal perspective. Two years ago I received a phone call from my doctor’s receptionist, who said that the doctor would see me at 4 o’clock. Not catching on, I thought that was somewhat strange as I had not requested an appointment. I explained that I was in the House of Commons and very busy. She said, “Well, how about 9 o’clock tomorrow morning?” I agreed to go along on Friday, thinking that perhaps there was some issue that was going to be raised with me as a Member of Parliament.
I had forgotten entirely that I had had a regular blood test following quite a serious illness. A few years ago, I was in hospital for the best part of a year, in and out, and at one point none of my internal organs, including my pancreas, was working. I was obviously on quite a lot of painkillers. One of the many things the doctor had evidently said was that I could be diagnosed as diabetic in the future but, to be honest, during that period of my life I was pretty much out of it on painkillers, so I did not listen particularly.
I was completely aghast when I turned up at the doctor’s and he said, “You’re diabetic, and at the end of this meeting I will probably have to inject you with some insulin and you may be on insulin for the rest of your life, but there are other options.” In the end, he decided that he would try to manage it through other drugs initially and I never went on to an injection regime, but it was quite scary.
It was also, I thought, quite embarrassing. I felt rather guilty and perhaps stupid for having been obese. Ironically, because of my illness, I was quite thin having come out of hospital. I had lost about five stone in total, so I was not a typical case, but I had eaten too much and not exercised enough. I am now getting back on track and staying on track, but when, as Members of Parliament, something happens to us, we have an insight into what our constituents are suffering from and their experiences.
There was a call in the debate for the best possible solutions. I would argue that we need a lot more diversity and that there is no one-size-fits-all solution. Diabetes is complex. A distinction has rightly been made between type 1, type 2 and juvenile diabetes, and while I have not spent the time on it that others have, there is a medical case for making further divisions in diabetes, particularly within type 2, for reasons that I suspect we do not fully understand.
On prevention, if I could have talked to my younger self and continued to exercise through my late 20s and 30s as I had as a child, I would perhaps not have the problems I have now. My diabetes is very much under control, and I praise the work of diabetes nurses around the UK, who have a little more time than the doctors and can coach people and point them in the right direction. For example, they mentioned a book to me, “Carbs & Cals”, which has pictures of typical meals and typical sizes and goes through the grams of carbs and the calorie intake—exactly like the type of poster that my hon. Friend the Member for South West Bedfordshire (Andrew Selous) wanted to see in doctors’ surgeries.
We should have diversity because some things have worked for me and some things have not. The shock of being diagnosed as diabetic made me change my ways. For months I would not touch chocolate and I would have no carbohydrates whatsoever. I went on a course about diet for diabetics that took a slightly different approach, which I went on to adopt, counting carbs and managing things precisely. Personally, that did not work for me and abstinence from sugar or carbohydrates worked better, but maybe for others it is different.
Exercise, for me, has worked well. I am hoping to run the London marathon, but whenever I do something such as that I question it. If I speak to anyone who has run a marathon, they talk about the big meal beforehand and say, “Make sure you have plenty of carbs the night before—lots of pasta and so forth that will release slowly.” One of the benefits I find in doing that is that I understand a little more about how carbohydrates are broken down, not just theoretically, but personally, and how my body reacts to carbohydrates and sugar.
When I left the doctor’s surgery I had the prick test for glucose. I ended up having three different machines, one of which eventually linked up to my iPhone. I do not now need to do a prick test on a regular basis, but I find it useful as a way of understanding my short-term glucose as well as the six-monthly blood test that I do. Personally, as a type 2 diabetic, while I do not need to monitor my glucose on an hour-by-hour basis, I would find it useful to have something on me for a week so that I could see the effect of having a tiny bit of cereal this morning, or the difference in my glucose if I have had two glasses of wine the night before. What is the difference between running five miles and 10 miles? How many carbohydrates should I have to compensate? We need a lot more diversity in provision over time.
Having outed myself as a diabetic—as I said, one should not feel shame about it, but I did for quite a while—and spoken about it in the House of Commons, I hope that I, like a number of hon. Members, can be an advocate for diabetics across the country, understand not only my condition but those of others, and help to improve the situation over time. I thank my right hon. Friend the Member for South Holland and The Deepings for raising this incredibly important issue in the House.
Oral Answers to Questions
James Duddridge Excerpts(5 years, 6 months ago)
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Matt Hancock
Yes, of course I will make sure the appropriate action is taken in this case. It is a sensitive matter, and I look forward to discussing it with the hon. Lady.
James Duddridge (Rochford and Southend East) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
We certainly will. I do not wish to pre-empt what the long-term plan will say, but it is an excellent opportunity for us to look at how the NHS can best support people who have or are at risk of developing diabetes, and that includes transformation funding beyond next spring and how technology can be used to help people better manage that long-term condition.
Stroke Services
James Duddridge Excerpts(6 years, 4 months ago)
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Sir David Amess (Southend West) (Con)
I am grateful to you, Mr Speaker, for allowing me the opportunity to raise the crucial subject of the provision of stroke services throughout the United Kingdom. Every Member of Parliament will have a relative or friend who at some stage has suffered from stroke, so we all appreciate at first hand what the outcome of stroke can be. It can sometimes be halted and a recovery can be made, but that is not always the outcome for people who are not so fortunate. We can all recall the former Member for the Isle of Wight, Andrew Turner, who suffered a stroke recently, and there have been many others.
On Thursday 26 October, I chaired a roundtable on stroke solutions and the revolutionary potential of mechanical thrombectomy for stroke patients. The facts about stroke are as follows: more than 100,000 strokes occur in the UK each year; there are more than 1.2 million stroke survivors in the UK; and almost two thirds of stroke survivors leave hospital with some sort of disability.
James Duddridge (Rochford and Southend East) (Con)
I understand that this debate is very much about the UK and stroke units, but is my hon. Friend and parliamentary neighbour aware that today I met the Stroke Association, which is prepared to come to Southend to discuss changes in the stroke unit with the public? It will also have discussions with the wellbeing board, specifically to talk about the experience of reorganising acute and hyper-acute stroke units to give better outcomes, fewer deaths and fewer disabilities. This is good news for Southend, and the Stroke Association is happy to come to speak to us in Southend.
Sir David Amess
I very much welcome that news. I think that the two of us will look forward to meeting the Stroke Association and working with it to enhance the already excellent facilities at Southend Hospital.
The costs of stroke to the NHS and social care are about £1.7 billion a year, which is a huge amount. If I may be biased for a moment, let me say to the Minister that since 2013, the Government whom I support have contributed to significant advances in the treatment of stroke victims all over the country. The percentage of patients scanned within one hour of arrival in hospital has risen from 42% in 2013 to 51% last year, and the figure for those scanned within 12 hours has increased from 85% to 94%. I think the whole House will welcome that improvement, and I am grateful to Members on both sides of the House who are in the Chamber to listen to this Adjournment debate. I hope that their constituents will recognise the fact that they have stayed here.
Oral Answers to Questions
James Duddridge Excerpts(7 years, 2 months ago)
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Mr Dunne
We have already accepted one of Sir Robert Naylor’s recommendations ahead of the publication of his report, which is to look into bringing together NHS Property Services and other estates services in the NHS. With regard to allocations to the clinical commissioning group, the Department of Health has provided £127 million to CCGs precisely to contribute towards increases in the move towards market rents for property.
James Duddridge (Rochford and Southend East) (Con)
Oral Answers to Questions
James Duddridge Excerpts(9 years, 9 months ago)
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Dr Poulter
The hon. Lady makes a very important point. We know the importance of good perinatal mental health not just for the mother but for the life chances of the child. That is very important if we are to ensure that we get the commissioning of maternity services right in the future. There is a commitment in the Health Education England mandate that by 2017 all maternity units will have specialist perinatal mental health staff available to support mums with perinatal mental health problems.
James Duddridge (Rochford and Southend East) (Con)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Health (Mr Jeremy Hunt)
I am pleased to tell the House that on 19 June the Prime Minister hosted a very successful global dementia summit as a follow-up to the G8 dementia summit. We are currently diagnosing and treating 70,000 more people every year with dementia, but the big challenge is, as he set out at the G8 summit, finding a cure or disease-modifying therapy by 2025. We had useful discussions on what barriers need to be eliminated to ensure that the research happens to find such a cure.
James Duddridge
What assessment has the Secretary of State made of the need for a single hyper-acute stroke unit in south Essex?
Mr Hunt
I know that discussions are going on on that very topic and the CCGs are very interested in putting a hyper-acute stroke service at Southend hospital, which I know has excellent stroke services. We still need further improvements in the ambulance services for the east of England if we are going to do that and that is what we are currently discussing.
Health
James Duddridge Excerpts(9 years, 10 months ago)
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James Duddridge (Rochford and Southend East) (Con)
Sometimes we in Westminster get obsessed with the minutiae and detail of Bills and Committees, but our constituents do not have the same obsessions. As the Institute of Directors has argued, it is better to focus on a small number of Bills. A Volkswagen car salesman gets obsessed with the latest VW model, but the general public just appreciate better, cheaper cars. An engineer gets obsessed with a new widget, but the general public just want the machines to work. Our constituents do not get obsessed with Bills, how many of them there are, or whether they are nuanced towards the left or right. What they care about is that we get things right—and we are getting things right. One could argue that things are not happening quickly enough, but 1.5 million new private sector jobs is a darn good start. Is the reduction of the budget deficit by a third enough? No, it is not, but it is a darn good start.
This debate is a little bizarre, in that it is on health, even though health was not in the Queen’s Speech. The people on the doorsteps of Rochford and Southend East have not said to me, “Mr Duddridge, what we need is a new Bill on the health service.” In fact, I would wager that one or two constituents in every constituency would say that we have had far too many Bills on the national health service over the years, including recently. Having set out on this strategic direction in the NHS, it is right that we stick to it, bringing GPs closer to the broader care of individuals and bringing together social services and more traditional NHS care.
The NHS is a great British institution. When I was a teenager I attended religious education classes with a vicar, who asked: “If you didn’t know whether you were going to be born to a rich or a poor country or to a rich or a poor family, whether you were going to be fully able or disabled, or whether you were going to be healthy or suffer from ill health, where would you want to be born?” I say to this House that I would want to be born here in the United Kingdom, and one of the reasons for that is the national health service. When my son and grandparents were ill, they would not have received care anywhere near as good elsewhere. Yes, one or two places might have a slightly flasher health service—at double the cost—with shinier bells and whistles, but when a member of my family was ill I remember being told: “Internationally, the hospital in the States is very good, but the hospital your family member needs is the one they are going to, because it is the best in the world.” I think we are all grateful for that.
My hon. Friend the Member for Bracknell (Dr Lee) made an eloquent speech and he knows far more about the health service than I do, but he seemed to want politicians to coalesce and form a view that one Member’s hospital should close and another’s should be extended. That is part of a responsible debate in the House, but we truly need to trust health professionals. Southend has a particular problem with its stroke unit, which has historically been very good. The Basildon stroke unit started off from a lower base point, but stroke doctors across south Essex tell me that what south Essex needs is a single, hyper-acute stroke unit. We need to trust health professionals across the board.
I was going to make a speech about pensions on Wednesday, but I am making a speech about health today because I am going to meet the chief executive of Southend hospital on Wednesday. Despite health being one of the two ring-fenced areas, there are serious pressures. My hon. Friend talked about changes in pain threshold and people’s demands, but we cannot meet all those expectations. We need to have a balanced national debate about what we can do and the best way to do it.
Turning to other provisions, I welcome the private pensions Bill. If the Whip on duty is listening, I would very much like to serve on the Committee. I cannot imagine that many Members will volunteer and suspect I have already secured my place. More than 12 million people have underfunded pensions. It is a serious issue. The Chancellor has made some useful first moves on annuities, allowing greater choice for people coming out of pensions, but greater clarity is needed for those going into pensions.
Having previously worked in the investment and pensions industry, I know that all too often Government tinkered with the system and layered in cost for people who had only a small amount of money to invest. People often discuss the pensions of those on fat cat salaries, but most people’s pensions amount to managing only thousands or tens of thousands. A clearer, collective instrument that shares risk—greater risk can be taken when shared by a number of people—will be worthwhile.
I am not going to rewrite the Queen’s Speech like the hon. Member for Blyth Valley (Mr Campbell). I am not sure whether he was being real Labour, old Labour or a socialist, but I saw Members on the Opposition Front Bench give him welcome looks when he said that his speech was not Labour party policy. It would in many ways have helped Conservative Members if it had been Labour party policy.
One small change that I would have liked is a help to rent Bill. There are 15 million spare rooms in the United Kingdom. I am not talking about Opposition Members’ incorrect use of the term, but of spare rooms in houses that are owner-occupied and perhaps under mortgage. Not everyone wants to rent out a spare room to somebody, but the spare room relief of £4,250 has not been changed since 1997. Rather as we are doing with council and housing association property, we could release some of the spare rooms in owner-occupied houses by making it more financially advisable to rent out a room. There is nothing wrong in taking in a lodger—
