NHS Dentistry: Recovery and Reform

Jonathan Edwards Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

I commend my hon. Friend for his excellent work as a constituency MP. It is exactly that sort of drive and ambition that will deliver results for his constituents. I would be delighted to meet him to discuss his plans, and I am pleased that our national dental recovery plan will fit well with his own local delivery plan.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I regret to inform the House that the situation in west Wales is quite catastrophic, and recent reforms by the Welsh Government have probably made matters far worse. However, my constituents and I would like to know how much of what the Secretary of State has announced today is new money, resulting in Barnett consequentials for the Welsh Government.

[Victoria Atkins]

The hon. Gentleman articulates the case against Labour-run Wales with great power. There is £200 million on top of the £3 billion that we already spend on NHS dentistry in England

NHS Strikes

Jonathan Edwards Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

I thank my hon. Friend for his question. We accepted in full the independent pay review body’s recommendation this year of 4.75%, which was over and above last year’s figure of 3% when the rest of the wider public sector was frozen. He asks about dialogue. Of course I am happy to have dialogue with the unions; my door has always been open and it will continue to be so. What I am not going to do is reopen this year’s pay review. We have the independent pay review body process and we accepted that recommendation in full. What I am willing and happy to do is to have that dialogue about next year’s independent pay review body recommendation. Let us not forget that it is in only two months’ time that the new financial year starts, and we have to get that right. I hope that he will encourage unions and others to take part in that process so that we can get it right, because we all want to ensure that NHS staff get the right pay rise that recognises the huge service they give.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

Half of the successful revised offer by the Welsh Government is in the format of a one-off payment. Will the British Government confirm that that element of the pay settlement will be recognised as cost of living support and not as income, and treat it as such for tax and benefit purposes?

[Will Quince]

Pay is a devolved matter and I understand that the full details of the Welsh offer are yet to be finalised. They will include a number of non-pay commitments, and I understand that the cost of those measures could be substantial. I will look carefully at what the hon. Gentleman says. In any event, it would not be a matter for me as a Health Minister but for the Treasury.

NHS Winter Pressures

Jonathan Edwards Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

I agree; I think that it is important that we maximise capacity in the independent sector. That is what we are committed to doing, and I very much agree with my hon. Friend.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

Over recent years, I have received sporadic correspondence from consultants based in my constituency complaining about the tax liabilities that they face as a result of their pension contributions, which force them to reduce their hours or to leave public health altogether. I understand that the Government are consulting on this issue and that this is probably a matter for the Treasury, but how close does the Secretary of State think we are to an innovative solution?

[Steve Barclay]

The hon. Gentleman mentions a matter that is raised with him. As he can imagine, it is also raised with me by many senior clinicians. He is right that it is a question for the Chancellor, because, as he knows, tax is a Treasury matter. I am happy to share that point though, as I know that it is under consideration by my right hon. Friend the Chancellor.

NHS Workforce

Jonathan Edwards Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

That is an excellent question that the Secretary of State is really well placed to answer. It is not as if people in Downing Street do not know what non-dom status is or how it is currently accessed. I do not know whether the Chancellor’s reluctance to abolish non-dom status is because he does not want bad relations with his next-door neighbour. We have all been in that situation—everybody needs good neighbours—but I think a little neighbourly discomfort on Downing Street is a price worth paying to improve the healthcare available to people on streets up and down the rest of the country.

We need to keep the staff we already have. On a visit to a hospital recently, I spoke to a nurse about whether she was planning to vote for industrial action. She said yes: pay was an issue, but what really motivated her decision was the stress, the burnout and going home at the end of the day with the moral injury of worrying that she had not delivered the care patients deserve because she was too overstretched. I asked her what would make the most difference. She said, “I just want to know that the cavalry is coming—that it is worth staying in the job because things are going to get better.” She knows how long it takes to train nurses—she has been through it herself—and how long it takes to train doctors. She can accept that, but what she cannot accept is a future in which, because we did not act today or because the incoming Government did not act after the general election, she is still working understaffed shifts in overstretched hospitals a decade down the line.

Labour’s message to NHS staff is that the cavalry is coming with Labour. We will train a new generation of doctors, nurses and midwives so that staff are not driven out of the service and patients are treated on time. Of course more can be done to keep staff from leaving. We have been calling on the Government for months to fix the perverse incentives in doctors’ pensions that are forcing them into early retirement. The Government have just launched a consultation that might lead to changes in spring 2023. What good is that when the NHS is on the cusp of the worst winter crisis in its history?

The Government announced in the autumn statement that, for the first time ever, they would count the number of staff the NHS need—a truly groundbreaking act! Counting the number of people we need is a good start, but Labour has committed to an independent workforce body that will look at retention and better professional development so that staff can build and progress their careers in the health service. With the number of care workers falling for the first time, where is the Government action to stop the exodus of care workers to places like Amazon? Providing fair pay and terms and conditions for care workers is not only the just thing to do, but one of the best things that the Government can do to ease pressure on the NHS.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

Is there not a need for urgent thinking about the impact of inflationary pressures on all the UK’s health systems in the UK? According to a report published yesterday by the Wales Governance Centre at Cardiff University, inflation will eat into the Welsh budget to the tune of £800 million next year and £600 million in 2024-25. Health is at the heart of the Welsh budget, and this will inevitably have a huge impact on health delivery in Wales. I am not sure what the English figures are, but the cash-terms increases in the autumn statement are highly unlikely to compensate for the inflationary pressures that will also affect the English health budget.

[Wes Streeting]

The hon. Gentleman is right: inflation is a big problem, and it is a problem made in Downing Street. We are all paying a very heavy price for more than a decade of Conservative mismanagement of the economy. Yes, we can all point to the spectacular success that was the mini-Budget, which crashed the economy and left everyone picking up the pieces, but even that does not explain more than a decade of low growth, low productivity and higher taxes. That is where the Conservative party has left us, and that is why it is not just a change of NHS policy we need, but a change of economic policy. Goodness me, the Conservatives have had enough goes at it. They have had enough Chancellors this year. Even The Spectator has lauded the shadow Chancellor as the Chancellor of the year, because she has the plan that the country needs. Business leaders know it, we know it, the country knows it, and I suspect that even Conservative Members know that it is true.

Let me now turn to our NHS workforce plan. When I say that it is a serious plan, the House should not just take my word for it. It has been endorsed by the Royal College of Physicians, the Royal College of Psychiatrists, and Universities UK. It has widespread and cross-party support. I was particularly pleased by the support expressed by one correspondent, who wrote in September:

“I very much hope the government adopts this on the basis that smart governments always nick the best ideas of their opponents. They also ditch the bad ones of their predecessors such as blocking an enlightened amendment to the Health Act that would have sorted out workforce planning”.

I should like to thank the Chancellor for his endorsement. I was with him in the Lobby to support that NHS workforce amendment when Conservative Members, no doubt including the Secretary of State, were voting the other way. May I invite the Secretary of State to use that quote in any future negotiations in which he engages at the Treasury? I am just trying to be helpful.

While the Secretary of State is there, perhaps he could suggest that the Treasury take a proper look at the non-dom tax status. The Chancellor admitted after the latest Budget that his team had not even calculated how much the tax status was costing the Treasury and how much scrapping it would raise, at the same time as expecting us to believe that it would not work and that the sums produced by independent academics would not add up, although he had not even bothered to commission Treasury sums of his own.

Politics is about choices. The Conservatives are choosing to protect non-dom tax status, benefiting a few wealthy individuals, while millions of people cannot get a GP appointment or an operation when they need one. The Conservatives are choosing to protect non-dom tax status, benefiting a few wealthy individuals, while millions of people are left waiting in agony on NHS waiting lists. And, of course, the Conservatives are choosing to protect non-dom tax status, benefiting a few wealthy individuals, when they know that it is not just the health of the nation that is being harmed by record NHS waiting lists, but the health of our economy. Patients need treatment more than the wealthiest need a tax break. Those who live in Britain should pay their taxes. The Labour party is clear about where we stand: we need nurses, not non-doms.

We have a plan. The Conservatives do not. We have a record of delivering in government. The Conservatives do not. It is not just the House that faces a choice today; at the next election, the country will face a choice between more of the same with the Conservatives and the fresh start that Britain needs with Labour.

Access to GP Services and NHS Dentistry

Jonathan Edwards Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

Let me first say in response to the final point the hon. Lady made that there is absolutely no excuse for abusing NHS staff whatsoever. Most people in this country do not blame NHS staff for the state of the NHS; they place the blame squarely where it belongs, with the Government who have been in power for the past 12 years. Her first point would be more powerful if we did not have 1,500 fewer full-time equivalent GPs now than we did when her party came to power. Her point would have been more powerful if her party had not whipped its MPs to vote against having a workforce plan for the NHS, but I am afraid that that is what it did. Conservative Members cannot run way from their choices and decisions, and from the fact that they have now been in government for 12 years and there is no one else to blame but themselves. In communities right across the country, we now see the consequences of their mismanagement.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I regret to inform the hon. Gentleman that the situation in Wales is not much better, but I do not want to make a party political point. Will he commend the potential role that pharmacists can play in alleviating pressure on GPs? I have an excellent pharmacist in my home village of Pen-y-Groes, which provides an invaluable service for the communities in my area.

[Wes Streeting]

I wholeheartedly agree with the hon. Gentleman’s point about the importance of looking at primary care as a whole and the really powerful and valuable contribution that community pharmacies can make, alleviating pressures on other parts of the primary care system, particularly general practice.

Communities across the country are experiencing those problems; let me take one place at random to illustrate the scale of the challenge. Today, after a decade of Conservative mismanagement, the city of Wakefield has 16 fewer GPs than in 2013. In fact, Wakefield has not seen a single additional GP since the Prime Minister promised 6,000 more at the last election, and since Wakefield has been served by a Conservative MP—albeit, thankfully, no longer—it has seen three GP practices close, with some surgeries so short-staffed that 2,600 patients are left to fight over one family doctor. Last month, patients in Wakefield were able to book 25,000 fewer GP appointments than in November 2019, the last month in which they were served by a Labour MP. The only good news for general practice in Wakefield in recent years has been that Simon Lightwood, an NHS worker and brilliant candidate in Thursday’s by-election, has successfully campaigned to save the King Street walk-in centre. [Interruption.] They don’t like it. Conservative Members shout in protest and point the finger at us, but they have been in government for 12 years.

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[Sajid Javid]

My right hon. Friend is absolutely right in his analysis, and I can give that undertaking. I will say a bit more about that in a moment.

If the hon. Member for Ilford North wants to talk about funding for the NHS, I am happy to oblige. Under the last NHS long-term plan, before the pandemic, we made a historic commitment of an extra £34 billion a year. Because of the pandemic, we then necessarily put in £92 billion of extra funding. At the last spending review, we increased funding still further so that the NHS budget will reach £162.6 billion by 2024-25, supported in part by the new health and social care levy.

We have made sure the NHS has the right level of resourcing to face the future with confidence, but we must also be alive to the consequences. The British people expect every pound spent to be spent well, and they expect us to be honest with them that every extra pound the hon. Gentleman calls for will be a pound less spent on education, infrastructure, housing and perhaps defence. I believe in a fair deal for the British people, and especially for our young people. We will be making plenty of changes alongside this funding.

[Jonathan Edwards]

One of the major problems we face in Wales and across the UK is the need to replace retiring GPs and dentists. There has been a welcome increase in the number of international medical graduates training in Wales, but the British Medical Association informs me that very few GP practices and dental practices in Wales are registered as skilled worker visa sponsors. Will the Secretary of State raise this with the Home Office to see what can be done to help GPs and primary care practitioners retain those international graduates to work in Wales and across the UK, if they so decide?

[Sajid Javid]

We are working with our colleagues in the Home Office on this and other skills and healthcare issues, so I can give the hon. Gentleman that assurance. He talks about the major problem he is facing in Wales, and that major problem is a Labour Government. I hope he agrees—[Interruption.] He is nodding.

Look at the performance of Labour in Wales, whether on health or education: the median waiting time for outpatients in Wales is almost double the median waiting time in England. People in Wales are waiting more than three years, whereas the longest wait in England is more than two years. Thanks to the covid recovery plan we set out in this House a few months ago, the number waiting more than two years has been slashed by more than two thirds in just four months, and it will be almost zero next month.

Thousands of people in Wales are waiting two or three years. In fact, one in four patients in Labour-run Wales are waiting longer than a year. In England it is one in 20, which is far too high and will be lowered, but in Wales it is one in four. It is not surprising the hon. Member for Ilford North had nothing to say about his colleagues in power in Wales.

Covid-19 Update

Jonathan Edwards Excerpts

Monday 6th December 2021 Commons Chamber

[Sajid Javid]

It is important that we do whatever we can through using the right communication channels. It is also important that we provide the easiest access possible. For example, some of the mobile vaccination units have had a disproportionately high success rate with younger people.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

Luckily, the omicron variant was picked up quite quickly in South Africa due to its genome sequencing capability; otherwise we could be in a worse position. What are the British Government doing to support international efforts to enhance genome sequencing capability across the world so that the next variant of concern is identified as quickly as possible, wherever it comes?

[Sajid Javid]

I think we can say that we are leading the way on this. The UK Health Security Agency has established a database that is open for all countries to access to post their data. Even the discovery of the omicron variant and its potential risks was done here in the UK.

Health and Care Bill

Jonathan Edwards Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Robin Millar (Aberconwy) (Con)]

I rise to speak to new clauses 60 and 61 in my name. Simply, they would put patients first. I am thankful to my right hon. Friend the Member for West Suffolk (Matt Hancock) for his comments on new clause 60, but as I do not seek to press it to a Division, I will mention no more of it now.

On new clause 61, let me simply say this: good data is needed for good services. Good data allows professionals and planners to assign resources and guide interventions where they are needed most. Good data allows patients to make informed decisions about where to be treated, or where to live. Good data allows politicians to be held to account when services fail. Therefore, new clause 61, at its simplest, is about collecting and comparing data. It would standardise the publication of a set of UK-wide NHS data and ensure the interoperability of that data.

In Wales, unfortunately, Welsh reporting standards mean that waiting list statistics are not available for most procedures. Before the pandemic, it took a journalistic investigation in north Wales to highlight that patients were waiting for more than two years for hip operations. Constituents now report that they are being told that they face a two-year wait just for a first out-patient clinical appointment. That is distressing and disappointing, and it is simply because data is not available.

We must ask the question, if for want of a nail, the shoe was lost, what are we losing for the want of good data? If the Government are to bring digital transformation into the heart of the NHS, the Minister must know that that heart can only be animated when good data courses through its veins.

In the months I have worked with colleagues on new clause 61, we have heard overwhelming support from patients—they agree. Healthcare professionals, IT experts and administrators have told us that they agree. In fact, I do not believe that the clause would divide the House, in compassion or common sense. I accept, however, that there is a challenge in delivering it and I know that the Government are exploring ways to address that.

I note the Minister’s comments at the start of the debate about close working with the devolved Administrations, and I welcome that.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I do not question that the hon. Gentleman’s new clause is well intentioned. Does he believe that the standardisation would happen in conjunction with the four Governments working together or, in his view, would the process be driven solely from Westminster?

[Robin Millar]

I thank the hon. Gentleman for his question, which is a good and relevant one, and it speaks directly to the heart of what the Minister said in his opening comments. There is good collaboration and an emerging consensus on this, so I am optimistic that that will be the case. In fact, my concluding remark is to say that I will not press new clause 61 to a Division, but I will listen carefully to the Minister’s response.

Health and Care Bill

Jonathan Edwards Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

The hon. Lady will, of course, understand that one of our key aims must be to stop younger generations taking up smoking in the first place. Does she believe that her proposals—which I fully support—will help to achieve that key strategic aim?

[Mary Kelly Foy]

Most of my new clauses are indeed intended to prevent young people from starting to smoke in the first place.

--- Later in debate ---

[Edward Argar]

I am grateful to my hon. Friend. He will know that this Government have continued not only to highlight and promote parity of esteem between mental and physical health but to increase the funding available to mental health, reflecting that reality on the ground. He is right to highlight that issue.

We have announced a comprehensive set of reforms to alcohol duty in this year’s Budget which, taken with the steps we have put in place on a public health basis, have put in place a strong regime to tackle the consequences of alcohol misuse. We do not feel that this Bill is the place to legislate further on this issue but, as I have said, I am none the less grateful to the hon. Member for Liverpool, Walton for his amendments and for this opportunity to debate them.

On amendments 11, 12 and 13, this Bill would introduce a 9 pm TV watershed for less healthy food and drink products and a restriction on paid-for advertising of less healthy food and drink online. Those amendments, tabled by the hon. Member for Liverpool, Walton, would expand the definition of a less healthy product to include alcohol. This would have the effect of making alcohol advertising liable to the watershed proposed for TV programme services and the online restriction on paid-for advertising.

I reassure the hon. Gentleman, through Opposition Members, that the Government have existing measures in place to protect children and young people from alcohol advertising through the alcohol advertising code. Material in the broadcast code and the non-broadcast code relating to the advertising and marketing of alcohol products is already robust, recognising the social imperative of ensuring that alcohol advertising is responsible and, in particular, that children and young people are suitably protected. If new evidence emerges that clearly highlights major problems with the existing codes, the Advertising Standards Authority has a duty to revisit the codes and take appropriate action. Furthermore, the Government introduced additional restrictions last year on alcohol advertising on on-demand programme services, through amendments to the Communications Act 2003.

Clause 129 and schedule 16 are aimed at reducing the exposure of children to less healthy food and drink advertising and the impact of such advertising on child obesity. Less healthy food and drink products—

[Jonathan Edwards]

Will the Minister give way?

[Edward Argar]

I fear that I have only a few minutes left, and I have already taken a number of interventions on this. I want to conclude by covering the tobacco amendments as well, which I know that some colleagues are keen to see a response to. I apologise to the hon. Gentleman.

Less healthy food and drink products are not age restricted at the point of purchase, unlike alcohol. Finally, the 2019 and 2020 consultations on advertising restrictions for less healthy food and drink did not consult on alcohol within the restrictions, either online or on TV, so we cannot be sure of the impact these amendments would have on the industry more broadly.

Turning to tobacco in the time I have left, because I know the shadow Minister, the hon. Member for Nottingham North (Alex Norris) , has taken a close interest in the issue, I thank the hon. Member for City of Durham (Mary Kelly Foy) and others, including my hon. Friend the Member for Harrow East, who have tabled a number of amendments that seek to address the harm caused by smoking in this country. I reassure the hon. Member for City of Durham of the Government’s commitment to becoming smoke free by 2030.

We have successfully introduced many regulatory reforms over the past two decades, and the UK is a global leader in tobacco control. Our reforms include raising the age of sale from 16 to 18, the introduction of a tobacco display ban, standardised packaging and a ban on smoking in cars with children, which all place important barriers between young people and tobacco products. The Government are currently developing our new tobacco control plan, and I reassure the hon. Lady that that will reflect carefully on the APPG’s findings and report.

I am afraid I cannot be tempted to go further than the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), did in the recent Westminster Hall debate on this question, but I can reassure the hon. Member for City of Durham that we remain committed to bringing forward the tobacco control plan.

Giving Every Baby the Best Start in Life

Jonathan Edwards Excerpts

Tuesday 9th November 2021 Commons Chamber

[Sarah Olney]

I congratulate the hon. Member on the birth of his baby, and I hope that all is progressing well. I am grateful to him for raising that point about fathers, and I will come to it later in my speech.

My interest in this topic arose from conversations I have had with constituents who gave birth during lockdown. They told me about the isolating experience of not being able to have their partners in the delivery room with them, not being able to share their new babies with the wider family and not being able to meet up with other new parents to support each other and share their experiences. Thinking back to my own experiences of early motherhood—12 years ago—I remember how much it meant to me to have all those people around me as I recovered from the birth and got used to my new life as a parent. My heart goes out to all those who struggled in isolation during those early months, and I am determined that young families should be prioritised for support as we emerge out of the other side of the pandemic.

The UK Government’s recent focus on investment in the first 1,001 days in their “Best Start for Life” vision and funding is very welcome and will undoubtedly make a significant difference to families. I pay tribute in particular to the efforts of the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), who has been unsparing in her work to bring the needs of our very youngest citizens to the forefront of public policy and funding.

One of the most important sources of support for new parents is a health visitor. Even for those who enjoyed the most robust mental health, having sudden responsibility for a tiny and vulnerable new baby who is entirely dependent on them is a source of great anxiety. Having a visit from a trained health care professional who can give them advice, answer their questions and, above all, reassure them is enormously helpful and can make all the difference to their early experience of parenthood.

Although the UK is no longer in lockdown, both access to services and working patterns have changed. Some support services, such as playgroups, have not survived, and some have closed altogether. Children’s centres have reopened, but numbers are limited and places need to be booked in advance, which may mean that the families with the least time on their hands will lose out. The co-ordinators and volunteers at Home-Start Richmond, Kingston & Hounslow have told me about the high levels of anxiety experienced by new mothers unable to access health visitor advice and reassurance. That is impacting new mothers’ confidence and their ability to meet their baby’s needs.

Health visitors are a skilled workforce of specialist public health nurses who have the expertise to provide holistic care to families. As the only professionals positioned to reach every young child before they start school, health visitors play a crucial role in child safety and early childhood development. They identify and manage developmental delay, as well as common and serious health problems. They also provide support around childhood immunisations and advice on infant feeding, safe sleeping and mental health, all of which relieves pressure on NHS emergency departments and specialist services.

However, there is currently no national plan to address falling health visiting workforce numbers. The Government's spending review stated that it

“maintains the Public Health Grant in real terms, enabling Local Authorities across the country to continue delivering frontline services like child health visits.”

In fact, the Government are maintaining the public health grant at a level that is too low for many local authorities to resource health visiting services that can deliver face-to-face visits and the support described in the healthy child programme and other national guidance.

Ahead of the spending review, 700 leading children’s sector organisations were united in their call for investment for 3,000 more health visitors over the next three years. However, I am concerned that £500 million over the next three years will not deliver the Government’s pledge to rebuild health visiting. It is of the most urgent importance that we restore face-to-face health visiting to every new mother as the most essential building block of support to families as they welcome their new babies.

The importance of early home visits by skilled healthcare professionals was highlighted to me by one constituent who wrote to me last summer. She said:

“My baby is now 6 months old and soon after birth he was diagnosed with SMA type 1. If you are not familiar with it, the full name is Spinal Muscular Atrophy and it’s a muscular wasting illness. There isn’t a cure for it and without treatments and proper care the life expectancy of a baby is less than 2 years. He is currently under treatment but, and here is the reason for this letter, every possible centre specialised in physiotherapy, hydrotherapy or other physical activities for disabled people is shut due to Covid-19.

My husband and I were the ones who had to notice something was not right with Peter because, due to Covid, no one came for home visits after birth to see the baby or me. I almost died in child birth and because we were left alone I had to endure 1 month bed ridden due to further complications, once again noticed by me. Only once I was able to walk again we saw something wasn’t right with the baby. If after 2 weeks the health visitor had been able to come home, my son would have started treatment sooner without losing the mobility of his legs.”

I want to talk a little more about the importance of diagnosing and treating perinatal mental health. Maternal suicide is the leading cause of direct deaths within a year of pregnancy. An estimated one in four women experience mental health problems in the first 1,001 days after pregnancy. While depression and anxiety are the most common perinatal mental health problems, other conditions include eating disorders, psychosis, bipolar disorder and schizophrenia. One in 10 fathers is also affected by perinatal mental health problems. Of the 241 families that Home-Start Richmond, Kingston & Hounslow supported during the most recent year, 66% were experiencing mental health difficulties, including post-natal depression, anxiety, depression and chronic mental health conditions.

I was privileged to be able to visit Springfield University Hospital in Tooting recently to meet the perinatal psychiatry team for the South West London and St George’s Mental Health NHS Trust. I was extremely pleased to hear about the work the trust is doing in successfully supporting new mothers who struggle with their mental health, and particularly that it was able to maintain its services during the lockdown and after. Akvinder Bola-Emerson, the clinical services lead for perinatal psychiatry, stressed in particular the need for peer support but also the importance of health visitors, whom she described as the “eyes and ears” of perinatal mental health services.

The visit highlighted for me that we also need better provision for new and expectant fathers. Currently only mothers can be formally diagnosed with a perinatal mental health problem. Springfield provides services for fathers, but it is currently able to identify mental health issues in fathers only when they accompany a mother who is attending the hospital for perinatal mental health issues.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I am extremely grateful to the hon. Lady for securing the debate, and she is making some very important points. Does she agree that one of the worst situations expectant parents can find themselves in is when there is a miscarriage and that parental leave for such parents would be a welcome reform?

[Sarah Olney]

I am grateful to the hon. Member for his intervention. He is absolutely right that there are a large number of events and incidents surrounding pregnancy and birth—as I know from my own experience—that can cause huge distress, and it is right that mothers and the people supporting them, and fathers as well, get the support they need, including statutory leave from employment for the time it takes to come to terms with the miscarriage. That is certainly something we should be looking at.

We know that impending fatherhood can be a cause of great anxiety for men, and more services need to be developed to support them. We also know that over a third of domestic violence starts or gets worse when a woman is pregnant. I would speculate that some of that is attributable to undiagnosed and untreated mental health conditions in expectant fathers, which underlines the need to do more to support them.

In addition to health visiting and perinatal psychiatry, support for children and their families throughout their early years is vital for enhancing children’s prospects at school and beyond. Evidence shows that effective integration of services in the earliest years can bring broad benefits. For example, Sure Start children’s centres are shown to decisively reduce hospitalisations during childhood. However, 1,300 children’s centres have closed since 2010, and recent research has shown that 82% of parents of young children have struggled to access early years services. I am pleased that the Government have now committed £80 million to introducing family hubs to 75 local authorities across England, and £50 million for parenting programmes. However, we need more information on what family hubs can provide, and I would particularly like to ensure that health visiting and mental health support are included.

The importance of the right support in the early years was brought home to me after a recent meeting with primary headteachers in my constituency. I heard about how difficult it is for nursery and reception-age children to settle into class and to get used to spending time with other children and not spending all day at home with their parents. For adults, lockdown has been 18 months of inconvenience, after which we expect to be able to pick up the threads of our former life. However, some young children who started nursery this term will have spent up to a third of their life in lockdown, and we cannot yet know what the long-term impact will be.

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[Dame Andrea Leadsom (South Northamptonshire) (Con)]

It is a pleasure to follow the hon. Member for Richmond Park (Sarah Olney) in this important debate, and I congratulate her and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) as fellow co-sponsors and tireless fellow campaigners for giving every baby the best start in life.

Despite the rough and tumble of politics, there are times when colleagues from all parties in the House come together. Early years is one such cross-party issue. Over the past 11 years in Parliament, I have been proud to work with many colleagues on the early years. The hon. Members for Manchester Central (Lucy Powell) and for Washington and Sunderland West (Mrs Hodgson), my stalwart and long-standing hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), and my hon. Friends the Members for Eddisbury (Edward Timpson) and for Winchester (Steve Brine) have all been amazing campaigners for the earliest years, as has the hon. Member for Glasgow Central (Alison Thewliss). The former Member for Birkenhead, Lord Field, and the former Member for East Dunbartonshire, Jo Swinson, have been great allies, as have all those Members who supported the all-party group conception to age two: first 1,001 days, and Ministers on the inter-ministerial group on early years family support from 2018-19.

It is fantastic that since the 2019 general election, the early years agenda has received fresh support from new colleagues such as my hon. Friends the Members for Penistone and Stocksbridge (Miriam Cates), for Stroud (Siobhan Baillie), for Cities of London and Westminster (Nickie Aiken), for Truro and Falmouth (Cherilyn Mackrory), and for Ruislip, Northwood and Pinner (David Simmonds). I also pay tribute to the late Baroness Tessa Jowell. She and I worked together on the 1,001 critical days agenda, and she campaigned for it to be introduced as part of the sustainable development goals at the United Nations. I must also mention the superb work of the Royal Foundation and its Centre for Early Childhood. The commitment from Her Royal Highness the Duchess of Cambridge and her team has generated fresh attention for ensuring that every baby gets the best start in life.

This subject has been my personal passion for more than 20 years, from chairing the Oxford parent-infant project, to setting up the parent infant partnership UK, and the Northamptonshire parent infant partnership, establishing the 1,001 critical days manifesto and the all-party group conception to age two: first 1,001 days, and chairing the inter-ministerial group in the Government of my right hon. Friend the Member for Maidenhead (Mrs May). July 2020 marked a huge opportunity when the Prime Minister commissioned the early years healthy development review and invited me to chair it. Since then, we have been able to build on years of cross-party support, and a wealth of knowledge and expertise from the early years sector, to create a new vision for the 1,001 critical days initiative that was launched in March this year. The review has put the baby’s needs at the centre of all our work. Through meetings with parents and carers, virtual visits to local areas, and detailed discussions with parliamentarians, practitioners, academics and charities, we heard about the experience of early years services and support, and about what is going well and where change is needed.

First and foremost, we learnt from every parent and carer of their strong desire to be the best parent they can be, but we also learnt that new prospective parents often struggle to find the support they need. We heard from many parents who had deep concerns about their own or their partner’s mental health, and struggled to get timely support. We heard from many mums who desperately wanted to breastfeed but gave up because the support was not there. Parents told us how frustrating it was to keep telling their story over and over again to different people. Their cry was, “Why don’t you people ever speak to each other?” Equally, we heard from professionals and volunteers who said it would have been so helpful for them if they had known before meeting a new parent or carer about previous trauma or health challenges.

We heard from many dads about how excluded they felt from what they saw as “mum-centric” services. Some felt that they should not ask for any support for themselves, while others just felt sidelined and, in some cases, traumatised by what their partner had gone through in childbirth. We heard from foster carers of babies how little information came their way when caring for a vulnerable baby. More specifically, in 40 cases of babies who went into foster care, only two arrived with their red book. Those carers had no formal information about that baby’s early traumas that had caused them to be taken away from their birth family.

We heard from same-sex couples about unhelpful assumptions by early years professionals about their relationship and parenting roles. We heard from black mums about how particular cultural and health issues can be overlooked by busy staff. We heard from single mums and single dads about how they can feel isolated, and sometimes stigmatised, at such a life-changing time. We heard from many parents with particular challenges, such as not speaking English well, concerns about possible disabilities, experiencing violence in their lives, or other significant challenges. We heard that support is inconsistent and sometimes hard to access.

It comes as no surprise that the covid pandemic has been an extraordinarily difficult time for new families who, through no fault of their own, have not been able to access services or support in the normal way. The “Babies in Lockdown” report from the Parent-Infant Foundation, Best Beginnings and Home-Start reveals that nearly seven in 10 parents felt that changes brought about by covid were affecting their unborn baby, their baby, or their young child, and that 35% of parents would like help with their concerns about their relationship with their baby. The report also found that nine out of 10 parents and carers experienced higher levels of anxiety during lockdown.

Despite the many stories of difficulties, we also heard fantastic examples of good support for families. Many health visitors went the extra mile to keep in contact with families who were struggling, and many families found it incredibly reassuring to be able to text or Zoom their health visitor at short notice. Parenting programmes have been a huge support to many families, and we virtually visited Camden’s Bump to Baby programme, where classes continued online throughout the pandemic, and have proved incredibly popular with new parents and carers who are also helped to make friendships outside the programme. Dads gave us positive feedback on services that gave them space to share their experiences, without worrying about whether they were taking the focus away from the other partner’s health and wellbeing.

In lockdown, we also heard about excellent online and virtual services, and how they came into their own. One such service, Parent Talk, provided by Action for Children, reported a 430% increase in the number of parents seeking advice online during the pandemic. The Baby Buddy app, produced by Best Beginnings, has seen a huge take-up of its digital and virtual advice for everything from breastfeeding to nappy changing, and from sleep management to mental health concerns. Many local authorities are now determined to improve their joined-up offer to new parents and carers, so I certainly feel that we are pushing against an open door.

Our report, “The Best Start for Life: A Vision for the 1,001 Critical Days”, was launched by the Prime Minister in March this year. It contains six action areas. The first is that every local area should publish its own joined-up set of start for life services so that every parent and carer knows where to go for help.

The second is a welcoming hub for every family, in the form of family hubs. Those will build on the excellent work done by the late Baroness Tessa Jowell and others on creating Sure Starts, but the benefit of family hubs is that they will be the place where every family goes for support and advice, including from midwives, health visitors, mental health support workers and breastfeeding advisers within their walls. Not only will those services be physically available but they will be virtually available through the family hub model.

The third action area is a digital version of the red book, which will provide parents and carers with a record of their baby’s earliest life, from lovely moments such as their first tooth and their first steps, all the way to records of immunisations and professional support interventions.

The fourth action area is about the workforce. We all know that health visitors provide critical support for new parents and carers, but we also know that their case load can be very heavy, and parents and carers have told us that they really want more continuity of care and more frequent contact in the earliest years. We are therefore working with health visitors and local areas to consider resourcing levels and training needs, and whether a mixed-skill workforce can provide that greater continuity of care.

The fifth action area is to continually improve the start for life offer. A key action will be to establish parent and carer panels in every local area to ensure that the voices of families are heard when services are designed and improved. We are looking at improving the collection of data, at the evaluation of different interventions and at the need for proportionate inspection of the start for life offer in each area. A final but critical action area is to ensure that there is sound leadership, both locally and nationally, to drive the ambition to give every baby the best start for life.

I want to say a huge thank you to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), and to all the review’s sponsoring Ministers, past and present, for their support for the review. I am sure that it was their commitment, combined with the support of the Prime Minister and the Chancellor, that ensured such a positive spending review settlement for the earliest years, with £82 million for family hubs, £50 million for parenting programmes, £10 million for the start for life offer, £50 million for breastfeeding support, £100 million for infant and perinatal mental health support, £10 million for new workforce pilots, and a £200 million uplift for the supporting families programme. I believe that £500 million is a transformational sum that will allow many more parents and carers access to the vital help they need to give their baby the best start for life.

Why does this matter so much to our society? Well, we know that it is in the period from conception to the age of two when the building blocks for physical and emotional health are laid down. Babies born into secure and supportive homes will usually go on to become happy children who do well at school and grow into adults who cope well with life’s ups and downs and are more likely to hold down a job, have better health outcomes and form healthy relationships themselves. On the other hand, we know that in families under pressure, particularly where there is partner conflict, substance misuse, poor mental health or deprivation, the consequences for a baby’s developing mind in that critical early period can be far-reaching and very harmful.

Prevention is not just kinder; it is also significantly cheaper than cure. For example, the NHS has estimated that for every one-year cohort of births in England, the long-term cost of lack of timely access to quality perinatal mental health care is £1.2 billion to the NHS and social services and more than £8 billion to society. That is for every year’s cohort. We also know that up to 30% of domestic violence begins during pregnancy, and that health issues such as tooth decay and childhood obesity cost hundreds of millions of pounds every year in health-related expenses. We believe that those things could be significantly reduced by better education and support for new families.

With these six action areas, I think we can transform our approach to early years support and services, improving the health outcomes and life chances of the youngest in our society. Just as we need to level up economic opportunity across the country, we must also focus on where it begins—that critical period of human life from conception to the age of two.

[Jonathan Edwards]

The right hon. Member is giving a very comprehensive speech. Does she also agree that the Government should look at the issue of shared parental leave? The stats seem to indicate that fewer than 4% of eligible fathers take up the Government’s current policy. The Government need to look at that, and the forthcoming employment Bill may be an opportunity to strengthen those provisions.

[Dame Andrea Leadsom]

I completely agree with the hon. Gentleman that it would be fantastic for families and babies if more dads took up shared parental leave. Of course, as he will know, that has been legislated for. Unfortunately, as he points out, far too few fathers have taken it up to date. I certainly wish that more would have the confidence to do so.

I believe that all colleagues across the House would agree that the world in which we all want to live is one where every baby is nurtured to fulfil their potential, where good lifelong emotional wellbeing is the norm, where our society is productive and co-operative, and where every one of our citizens has the chance to be the very best that they can be.

Covid-19: Contracts and Public Inquiry

Jonathan Edwards Excerpts

Wednesday 7th July 2021 Commons Chamber

[Ian Blackford]

I will be generous to colleagues and the Prime Minister and for the purposes of this place I will respectfully do so.

The court cases highlighted that the covid contracts were not published on time, and poor records left big unknowns, such as why some companies won multi-million-pound contracts and others did not. Clarity on the latter has been provided through the revelation that civil servants were requested to triage contract proposals into high-priority lanes. That means that proposals from a supplier recommended by Ministers, Government officials, or MPs and Members of the House of Lords were given preferential treatment. That was crucial to the success of those seeking procurement deals: a National Audit Office report found that up to July 2020, one in 10 suppliers that had been put in the high-priority lane were awarded a contract, while the figure was less than one in 100 for those outside that lane. It is not what you know, or what you can provide: it is who you know in Government. These priority lanes created a tale of friends and family fortunes.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I am extremely grateful to my right hon. Friend for giving way, and for outlining his case forensically. What does this so-called VIP lane indicate about the priorities of the British Government, when we compare it with the fact that when the Welsh Government, the Scottish Government and the Northern Irish Government together asked for extra borrowing capacity to deal with the covid crisis, they were turned down? What does that say about the priorities of the British Government, and—more to the point, perhaps—what does it say about the nature of the relationships among Governments within the British state?

[Ian Blackford]

My hon. Friend is quite correct. There have been a number of occasions on which all the devolved Administrations have sought support from the UK Government for borrowing, and have been frustrated in that, but for friends of the UK Government, it is a case of “Come in, there are contracts to be had.”

Let me give a few examples. There was the neighbour and local pub landlord of the former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), who supplied tens of millions of vials for covid-19 tests despite not having had any previous experience of providing medical supplies: off the street, no experience whatsoever, but he was a friend of the Government. There was the small Stroud-based company which, despite making a loss in 2019, was awarded a £156 million contract for PPE. Wait for it: the company was run by a Tory councillor, and no evidence—none whatsoever—was ever found of its supplying PPE previously.