Oral Answers to Questions

Debate between Paul Williams and Caroline Dinenage

Tuesday 7th May 2019 Commons Chamber

[Caroline Dinenage]

My hon. Friend is absolutely right to raise this issue. Reasonable adjustments are critical for improving the experiences of health and care for autistic people. That is why the long-term plan commits to a digital flag in patient records, which will ensure that staff know whether a patient has a learning disability or autism. At the same time, we are looking at how we record where a diagnosis of autism has been made.

[Dr Paul Williams (Stockton South) (Lab)]

In 2017, more than 100 MPs wrote to the then Health Secretary demanding a national target of a three-month waiting time for autism diagnosis because waits were more than four years in some areas. Stockton clinical commissioning group and Stockton Council have reduced waits, but what do current figures show? Will the Government now set a target in line with National Institute for Health and Care Excellence guidance?

[Caroline Dinenage]

I am pleased the hon. Gentleman has raised this issue, because he is absolutely right that we need to drive up performance nationally on diagnosis for autistic people. It is only with diagnosis that people can get the support and help they need. We are collecting data for the first time. It will be published later this year for the first time. It will mean that each area can be held to account and given the help and support it needs to drive up those figures.

Mental Capacity (Amendment) Bill [ Lords ] (Fourth sitting)

Debate between Paul Williams and Caroline Dinenage

Thursday 17th January 2019 Public Bill Committees

[Caroline Dinenage]

I am grateful to the hon. Members who have raised this important issue. I will address each amendment in turn.

On amendment 35, I agree that the independence of the pre-authorisation reviewer is of the utmost importance for ensuring that there is no conflict of interest in the pre-authorisation review. The Bill provides for separation between those who will authorise arrangements and those who will carry them out. The Bill is clear that anyone involved in a person’s day-to-day care or treatment or with a prescribed connection to a care home cannot complete a pre-authorisation review. That was an amendment made to the Bill after discussion in the other place.

[Dr Paul Williams (Stockton South) (Lab)]

Even though somebody might not have a prescribed relationship, informal relationships can develop, as my hon. Friends said. Our concern is that the existence of those informal relationships—they have been described as “cosy”—may well not be precluded by the protections afforded in the Bill.

--- Later in debate ---

[Caroline Dinenage]

I might turn that point round on the hon. Gentleman: we are indeed including it in the code of practice. The Bill states that the AMCP will meet the cared-for person except in the very rare circumstances in which that is not practicable or appropriate. We will set out those rare exceptions, including case studies, in the code of practice—a much better place for them than the Bill, which cannot include such case studies to flesh out what we are trying to achieve.

[Dr Williams]

As the Minister describes it, the assessment will take place unless it is inappropriate or impractical, so perhaps the Bill ought to say that.

[Caroline Dinenage]

I thank the hon. Gentleman for that clarification, but we may be dancing on the head of a pin slightly. To my mind, the meaning of amendment 42 is that in all cases the AMCP should turn up and see the person, whereas we are saying that that should happen in all cases, with some very small exceptions. With that reassurance, I hope that the hon. Member for Worsley and Eccles South will withdraw the amendment.

Mental Capacity (Amendment) Bill [ Lords ] (Third sitting)

Debate between Paul Williams and Caroline Dinenage

Thursday 17th January 2019 Public Bill Committees

[Caroline Dinenage]

I start by welcoming the fact that we have just heard from the hon. Member for Dewsbury for the first time. It is a great pleasure to hear from her, not least because I can pronounce her constituency far better than Worsley and Eccles South.

I thank hon. Members for tabling the amendments, which I will take in the order in which the hon. Member for Dewsbury presented them. Amendment 32 would place the consideration of fluctuating capacity in the Bill. I agree that the likelihood of capacity to fluctuate should be very carefully assessed under the Mental Capacity Act. Fluctuating capacity should be considered in the authorisation, in the length of the authorisation and in the frequency of reviews. I am very tempted by the amendment, but the problem is, then what? It puts the provision in the Bill, but it does not describe what happens then. To my mind, that opens a whole can of worms.

As my hon. Friend the Member for Halesowen and Rowley Regis said, fluctuating capacity is incredibly complex to diagnose. It is a fact-specific matter that deserves great in-depth and detailed guidance. As such, I do not think it can be considered satisfactorily in one line in the Bill.

[Dr Williams]

I think there is an acknowledgment that whether or not someone has fluctuating capacity needs to be assessed. What is wrong with putting that in the Bill and then dealing with the complexity and the nuance and the “then what?” in the code of practice?

[Caroline Dinenage]

As I say, I am tempted by what hon. Members have said, so I will take this point away and look at it, but we have to consider this matter very carefully. We have to consider whether there are appropriate protections already in the Bill. That point relates to what I spoke quite a lot about on Tuesday—we have to be really careful about the unintended consequences of putting too much in the Bill, because if we then leave something out, we may create the sort of legal loopholes that caused so many problems with the previous DoLS legislation.

Mental Capacity (Amendment) Bill [ Lords ] (First sitting)

Debate between Paul Williams and Caroline Dinenage

Tuesday 15th January 2019 Public Bill Committees

[Caroline Dinenage]

Everybody is entitled to an AMCP if they are in an independent hospital. That is on the face of the Bill in terms of decision making, case studies and how we make sure people have the training and information to implement the Bill in the way it is intended. Let us not forget that we started with a well-intended Bill with DoLS, but because of the way it was worded and subsequent decisions by judges, we have now got a one-size-fits-all Bill. That is why we have a statutory code of practice, which runs alongside the Bill. It is a legal document and will be approved by both Houses. It will be put together with stakeholders and will set out very clearly the guidelines that dictate how and when action should be taken. It will include case studies and will be compiled very closely with stakeholders, who are on the frontline and deal with individuals.

[Dr Paul Williams (Stockton South) (Lab)]

I wonder whether the Minister can tell us what it is about independent hospitals that warrants an AMCP assessment, given that independent care homes do not warrant one?

Oral Answers to Questions

Debate between Paul Williams and Caroline Dinenage

Tuesday 24th July 2018 Commons Chamber

[Caroline Dinenage]

I completely understand my hon. Friend’s concerns. She has been an incredibly strong advocate and campaigner on this very issue. As she knows, no permanent changes will be made until the work is carried out by the independent review panel, which is looking at attempts to recruit obstetric staff for her local services. I thank her very much for the offer of a visit; I am sure the Secretary of State will look at it very closely.

[Dr Paul Williams (Stockton South) (Lab)]

Dr Neal Russell volunteered to help in the fight against Ebola. Today he has returned his Ebola medal in protest at the healthcare hostile environment for migrants caused by a new charging regime, which has led to vulnerable pregnant women here in the UK being too afraid to get maternity healthcare. Will the Minister suspend her Department’s charging regime, pending the completion of a thorough and independent public health assessment?

[Caroline Dinenage]

That is incredibly sad news. We hate to hear of anybody who has done such incredible service in the pursuit of great healthcare around the world taking such drastic steps. We have an incredibly strong departmental ambition for NHS maternity to provide the safest, highest quality care in the world. That is something we will continue to aspire towards.