Oral Answers to Questions

Priti Patel Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Victoria Atkins]

I am so glad that the hon. Gentleman has mentioned levelling up, because presumably he will know from his bid that the 12 levelling-up missions are mutually reinforcing. Conservative Members take the approach that in order to help people with their health—[Interruption.] The hon. Gentleman is shouting at me. I thought that this answer would be important to his constituents.

Levelling up is not just about health. It is about the impact of education, housing and other matters in our environment, which is why in the forthcoming major conditions strategy we will tie together the conditions that have the most impact on a healthy life. We will draw together a cross-Government strategy to help people who are living with those conditions to live longer but also healthier lives.

[Priti Patel (Witham) (Con)]

The Health Secretary will know about the health inequalities across the east of England, including in Maldon district, which will only be made worse if the NHS’s plans to close St Peter’s Hospital in Maldon proceed. Does she agree that the levelling-up funding that has been made available to Maldon District Council should be prioritised to facilitate investment in new localised health services, so that those inequalities can be tackled?

[Victoria Atkins]

My right hon. Friend makes an important point. The purpose of the levelling-up fund is to help local areas to address what they need locally, rather than respond to diktat from central London. I encourage her to work closely, as I know she will, with local agencies, the council and others making those important decisions, so that their levelling-up announcements include health, as an integral part of her mission to improve the lives of her constituents.

St Peter’s Hospital, Maldon

Priti Patel Excerpts

Thursday 14th March 2024 Commons Chamber

[Sir John Whittingdale (Maldon) (Con)]

It is a pleasure to have a fellow Essex Member in the Chair, Madam Deputy Speaker. I also welcome my hon. Friend the Minister, and I am glad to see my constituency neighbours, my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—on the opposite side of the River Crouch—and my right hon. Friend the Member for Witham (Priti Patel). She and I share the Maldon district between us, and we are working very closely on an issue that is of huge importance to both my constituents and hers.

St Peter’s Hospital in Maldon is a much-loved community hospital. It has been delivering care since the NHS was founded, but the building itself is a former workhouse and is more than 150 years old. We have known for some time that the building has significant problems, although, thanks to the dedication of the staff, the quality of care has been superb. There are significant challenges, which have become worse over time. The hallways are too narrow for stretchers, the floors have not been able to take the weight of the beds, the lift has repeatedly broken down, and there are leaking roofs, asbestos and potentially even a risk of legionnaires’ disease. While money has been spent over the years to maintain the building and keep it going, it has long been recognised that a new purpose-built facility is needed, either on the present site or in a different location. That has been the subject of debate and discussion for a number of years.

In 2003, the annual report of the Maldon and South Chelmsford Primary Care Trust stated that two preferred sites had been identified, that a provisional outline business case approval had been given, and that the new build was scheduled to open at some time towards the end of 2007. It never happened. There were difficulties with establishing ownership of part of the land off Limebrook Way, where it was due to be sited. Since then, we have had a succession of studies and debates about what a new hospital should offer and whether it should be a health hub. Most recently, plans were being drawn up for a new site to be developed to the west of Maldon, on Wycke Hill. However, this proposal became stuck due to the lack of sufficient funding for the access road, and a reduction in the contribution available from the developer and from the section 106 money for the housing being developed nearby.

To meet the anticipated winter pressures, it was announced in August last year that the in-patient beds would be relocated to Brentwood and Rochford, and the birthing unit transferred to St Michael’s Hospital in Braintree. We were told that these changes were only temporary while long-term solutions were found. Despite that, the Mid and South Essex integrated care board announced in January that it was proposing to make the changes permanent and that the out-patient services at St Peter’s would be relocated elsewhere, allowing the building to be eventually closed.

The proposals are subject to a consultation, which has recently been extended to 4 April. The ICB says that 2,600 of its surveys have already been returned. Over 400 people attended a public meeting that I organised with the mayor of Maldon, Councillor Andrew Lay, and another 100 had to be turned away. I have also received nearly 700 email responses to my own survey, and I am currently distributing across the constituency 25,000 leaflets containing a survey. It is already clear that my constituents are unanimous in wanting to see medical services continue in the town. They also believe that the consultation is a cosmetic exercise, with decisions already taken. I have to say that this belief is reinforced by the fact that the two alternative options presented for the in-patient beds currently in St Peter’s both involve closing the wards in the hospital and moving them elsewhere.

The Maldon district is growing steadily. We have something like 3,000 houses currently under construction in Maldon and Heybridge, with another 1,500 across the district. Demand for NHS services is rising steadily, with the GP to patient ratio already one of the worst in the country. Rather than closing NHS facilities, we need more. In addition, Maldon district is geographically spread, with some villages already half an hour’s travel time from Maldon. The travel time to Broomfield, Braintree or Brentwood can be up to an hour or more from villages such as Tillingham or Southminster in the Dengie peninsula, and the idea that an expectant mother in the early stages of giving birth should have to travel an hour is appalling.

The ICB suggested last year that there was an average of just six births per month at the maternity unit in St Peter’s, but the unit was actually closed for a large part of that time, because staff were sent to Chelmsford. Ten years ago, there were over 300 births per year, and the population has grown steadily since that time. As one of the midwives wrote in response to the survey that I am conducting:

“Our unit has seen 1000’s of births over its 75 years, over the past 5 years we have had over a 1000 postnatal stays, mothers who have birthed at Broomfield, then needed ongoing support coming to stay with us, we have taken readmissions from the community with baby’s not feeding well, which in turn warded off a remission to Broomfield where beds are always in short supply. We do in excess of 50 community visits weekly, 80+ clinic appointments weekly, over 20 new bookings a week, and anything between 5-10 appointments a day on our ward for anything extra…We are so much more than the ‘6 births a month’ that was widely reported and made us as a team so very angry and undervalued.”

The availability of in-patient services and a maternity unit are of huge importance to my constituents, but it is the out-patient services on which thousands depend. There are some 80,000 out-patient appointments each year, with a huge range of specialties such as X-rays, blood tests and ophthalmology. Although, unlike my right hon. Friend the Member for Witham, I have not used the birthing unit, I have received physiotherapy at the hospital and am due to have an abdominal aortic aneurysm screening there in the next few weeks.

I welcome the ICB’s assurance that out-patient services will be maintained at St Peter’s until alternative locations in the town are found, but it is essential that they are maintained in Maldon without a break or cessation of service. It is not good enough simply to divide up the different services and to try to slot them into buildings across the town. We need the new hospital or health hub that has been promised for so long. We have seen the new hospital at Braintree and the expansion of Broomfield and Southend, but Maldon has been consistently overlooked.

It was announced in last week’s Budget that the Maldon district is being allocated £5 million of levelling-up money for cultural projects, which I welcome, but what my constituents want is not cultural projects but a new hospital. Essex County Council and the district council have money set aside, but it is unlikely to be sufficient.

I applaud the Government’s continuing investment in the NHS, of which we saw further proof last week, but I ask the Minister to tell the Mid and South Essex ICB to think again and, rather than cutting services, to maintain and expand them so that my constituents have the high-quality, easily accessible healthcare they deserve.

[Priti Patel (Witham) (Con)]

rose—

[Madam Deputy Speaker (Dame Eleanor Laing)]

The right hon. Lady has not asked me, the Minister or the right hon. Member for Maldon (Sir John Whittingdale) whether she can take part in the debate, but she can ask now.

[Priti Patel]

May I take part in the debate?

[The Minister for Social Care (Helen Whately)]

indicated assent.

--- Later in debate ---

[Priti Patel (Witham) (Con)]

Thank you, Madam Deputy Speaker.

I congratulate my right hon. Friend the Member for Maldon (Sir John Whittingdale) on securing the debate, and I echo everything he said in illustrating the sorry and sad situation in which our constituents find themselves with regard to what is a much-loved local hospital. Naturally, we both speak from our personal experience, but it is fair to say that both he and my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) will have received hefty mailbags of angry correspondence from our constituents who believe that the ICB’s consultation is effectively a slippery slope to permanent closure and the running down of services after last summer’s announcement, which we clearly do not support. It is right that we stand up for our constituents.

I reiterate and echo the points raised by my right hon. Friend the Member for Maldon, particularly on the incredible maternity and birthing facility. Nurses from the facility were present at the public meeting held in Witham on Monday evening, and I emphasise the due diligence, care and compassion they provide not just in the birthing unit but in the wider community. The support that the facility gives to new mothers was echoed by everyone in that public meeting.

The reality is that Essex is a very large county, and relocating these services is simply not good enough because of the time it takes to travel to the alternative facilities, and public transport is not available. I emphasise that Maldon is a growing district in both our constituencies; the Westcombe Park development in Heybridge straddles my right hon. Friend’s constituency and mine, and it now has more than 1,000 homes under development.The current local plan runs until 2029 and will see the development of another 5,000 homes. It is simply unsustainable that we have a proposal to close St Peter’s Hospital and relocate services elsewhere in Essex, because we can guarantee that in future years there will be calls to stand up those local medical facilities again. That is why, as my right hon. Friend the Member for Maldon said, we must have new facilities in Maldon town, and they have to be future-proofed to meet growing need.

Finally, it is vital that we recognise the overall impact of an ageing and growing population. We have to provide the right kind of medical facilities and give our constituents the assurance that whatever happens with their health, they can have health provision on their doorstep.

Health and Wellbeing Services: Essex

Priti Patel Excerpts

Tuesday 12th March 2024 Westminster Hall

[Priti Patel (Witham) (Con)]

I beg to move,

That this House has considered health and wellbeing services in Essex.

I am grateful that you are chairing the debate, Mr Henderson, and pleased to see that my right hon. Friend the Member for Pendle (Andrew Stephenson) is the Minister responding. He has been very good on many issues that I have taken to him thus far. I will cover a wide and diverse range of health-related issues affecting my constituents and people across Essex. I appreciate that some of those issues fall outside of the Minister’s portfolio, but I know he will take them on board and will feed back to colleagues. He is an excellent Minister, and I know he will respond in a helpful way. I am particularly pleased to welcome to the debate colleagues from neighbouring constituencies, my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince), because we care about the provision and quality of health and wellbeing services. It is important to our constituents, and it is important that our constituents know we will work together as neighbouring MPs on some of the issues.

As the Minister and colleagues will be aware, just over a year ago, in March 2023, we were in this very Chamber having a similar debate with a similar title—I think we stretched it to the east of England last time round—and this debate follows on from that one. Everyone here will know that Essex is an amazing county. Our residents, businesses and communities are hard-working, resilient, entrepreneurial, ambitious and aspirational. They obviously back all the Conservative values around lower taxes, being a county of entrepreneurs and the engine of economic growth. We are net contributors to the Exchequer. I never tire of saying that because, as net contributors, we in Essex do not always get our pound of flesh back from the Exchequer when it comes to investment in our public services. It is fair to say that our constituents expect that from the Exchequer, particularly the fact that we should be supported when it comes to our public services, including the NHS, but also wider health and wellbeing services that do not always require medical interventions or diagnostics.

Parts of our county—mid-Essex in particular—have experienced considerable population growth and demographic changes, and that covers the constituencies of Colchester and Maldon. For clarification, we share district boundaries, so our council boundaries are intertwined—we are effectively three integrated MPs, I think it is fair to say, on many of the issues that we stand up and speak for. Those living within Essex County Council’s boundary totalled more than 1.5 million at the 2021 census, up by more than 100,000 people on the 2011 census, which is more than 7% and above England’s average of 6.6% at the time. That includes areas such as Southend and Thurrock. When we include those areas, our county population totals just under two million, at 1.9 million. We are one of the fastest-growing counties in the country, and growth in the city of Colchester, which covers parts of my constituency, continues to grow. With that, demand on public services continues to grow. We see from the census that we have over 300,000 people aged 65 or over, which is 21% of our population. That is higher than the average in England of 18.6% and, by 2035, that number will grow by up to 27%, so just under 400,000 people in Essex. The number of those over 85 will rise by 60%, so we can see that the numbers are growing. We are an ageing not just county but country and, that impacts on the working-age population of 18 to 65-year-olds which, by contrast, is set to rise by only 4%.

We can see the counter-cyclical issues resulting from the fact that a greater part of our population will be elderly. Interestingly enough, with that ageing population we are seeing increasing numbers of young families coming to Essex, which will mean more house building. Our schools are rated good and outstanding, and we are commutable territory, so our towns are thriving and growing.

As I said in the debate last year, there are pressures on social care which have had a very significant impact on the integrated care systems that have been introduced, with further integration taking place. In particular, those pressures have had an impact on spending at the county, district and city council level. We have a number of integrated care boards that cover Essex: NHS Hertfordshire and West Essex; NHS Mid and South Essex, which predominantly covers mid-Essex; and NHS Suffolk and North East Essex, covering Colchester and Tendring.

We also have a number of hospitals, the biggest being Broomfield Hospital, Colchester Hospital, the Princess Alexandra Hospital, Basildon University Hospital and Southend University Hospital. Our emergency services are provided by the East of England Ambulance Service NHS Trust, and the South Essex Partnership NHS Foundation Trust provides mental health services. I am shortly going to discuss those areas, and those trusts in particular.

As hon. Members have heard, we have a range of trusts, hospitals and challenges in Essex. When I was first elected we had the old-fashioned primary care trusts and strategic health authorities. Those were deeply unpopular, hugely problematic and bureaucratic and massively resource-intensive, and the changes in structures we have seen now provide greater integration. What really matters to all my constituents and residents across Essex is not so much the configuration and structure of services, but how those services work together effectively to deliver what those people and their families need: primary care, appointments and access to health services.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Lady on the debate. It is clearly about health services in Essex, and is therefore not to do with Strangford. However, to add my support to what the right hon. Lady is saying, I note that the problems in Essex she has outlined are replicated across my constituency as well. They include the closure of the local minor injuries unit, which is integral to the local community. That means that constituents have to travel further to get their healthcare—the very thing that the right hon. Lady is referring to. Does she agree that health bodies must focus more on community health and wellbeing to ensure that all constituents have the local access they deserve to efficient health and care services? Again, I commend the right hon. Lady on introducing the debate.

--- Later in debate ---

[Priti Patel]

The hon. Gentleman is absolutely right, and he has teed up the issue I wanted to raise—community healthcare provision and localised services. I have just mentioned our big hospitals in Essex, but it is absolutely vital that we have localised healthcare provision.

That brings me on to a local issue that affects my right hon. Friend the Member for Maldon and me—the future of St Peter’s Hospital. I raised this issue in the House last week in Health questions, and my right hon. Friend the Member for Maldon has secured an Adjournment debate on Thursday to discuss it further. Last night I attended a public meeting hosted and organised in Witham by Witham Town Council on this matter.

I know that colleagues will say more about this issue later in this debate, but for context, to say that my right hon. Friend and I are receiving hefty mailbags on this issue would be an understatement. We are receiving unprecedented levels of correspondence and communication —emails and phone calls—from concerned and angry residents who are frustrated by the plans put forward by the integrated care board to remove services from St Peter’s hospital, which could lead to its closure under the proposed consultation. The Minister will know that the plans are subject to consultation; my right hon. Friend and I have called for it to be extended, and yesterday we were given confirmation that it has been.

The measures that we are discussing include the removal of stroke rehabilitation in-patient beds to Brentwood and Rochford, which are not local areas and require considerable travel, and making permanent the temporary removal of a midwife-led birthing unit. The ICB is also seeking views on the future removal of other services from the site, including out-patient services covering blood tests, ultrasound scans, X-rays, podiatry clinics and services to support mental health patients, with an average total of around 300 patients a day using the particular site.

I should add that this is a much-loved community site, and it is fair to say that across the generations everyone in our district would have had some kind of interaction or engagement with it. I myself have used St Peter’s and its maternity facilities. Last night, I met some of its maternity nurses, who kindly came to our public debate. They are remarkable ladies, who are wonderful in the care and compassion that they give to mothers, particularly new mothers who, quite frankly, struggle after the birth of their first child to adapt to some of the post-maternity services. The nurses are wonderful.

The hospital serves the town of Maldon and the wider rural area, including people in Maldon district who live in the Witham constituency. This part of Essex has experienced very considerable economic growth, particularly housing growth. My right hon. Friend the Member for Maldon cannot speak about small housing developments—we have significant housing developments in our constituencies. I will refer to the Westcombe Park development in Heybridge, which straddles both our constituencies. It is a development of over 1,000 homes, which speaks to the type of developments that we have locally. The current local plan runs up to 2029, and we will see the development of another 5,000 homes in that time. I recognise that we need more homes—people need homes to live in and we aspire to own our homes—but we also need to know that new housing and population growth will attract the infrastructure and public services to support them in the long run.

The consultation about St Peter’s is very important. The document covers a range of issues, but I have to say that it is not acceptable for us to say, “It’s fine for the services to go elsewhere and be relocated.” Our constituents would experience considerable travel times if services were relocated and there are issues with local public transport as well. I am afraid to say that trying to park a car at Broomfield Hospital is nigh-on impossible. We want to those services to remain local; that is absolutely pivotal. Importantly, they should remain within Maldon town and Maldon district.

Our constituents have serious reservations about these proposals and it is right that we, as local MPs, continue to support, champion and work with the integrated care board, and work with local authorities, Ministers and the Government to secure these services in Maldon town. We have to keep these services in our district. I know that the Minister cannot specifically intervene in matters being considered by the ICB, but I would welcome his views, and I think this issue is going to be very important going forward. This consultation also sets a benchmark for engagement with ICBs and future-proofing localised healthcare services, which we all want to see in our constituencies.

I have mentioned the need to enhance services and safeguard them in Maldon and Maldon district. The Department is very familiar with communication around Witham town and my calls over 14 years for a new health centre there. My correspondence file in the Department is large; I know that, and I thank Ministers for their forbearance and all the responses that they have sent to me. However, like Maldon, Witham has experienced huge amounts of housing growth, which means that the demand for primary care is outstripping supply.

We have four GP practices in the town and I will name them all: Fern House surgery has 16,500 patients; Douglas Grove surgery has 6,500 patients; Witham practice has 6,500 patients; and Collingwood Road practice, which I visited recently, has 2,500 patients. That is a total patient list of about 32,000 just in the town itself. The national patient to GP ratio average is around 1,700 patients per GP, but across those four surgeries there are around 13 full-time equivalent GPs, which means that the local patient to GP ratio is closer to 2,500. That is the tense situation that we have and the challenge that we face.

We also have the incredible Anglia Ruskin University medical facility. Many of us were part of the group making the business case that was made for that and we are very proud of it. In September 2023, we saw the first cohort of medical practitioners from that facility. We are desperate to make sure that we keep them all local; we absolutely want them to remain local.

However, we need to discuss the practicalities and how hard it is to get a GP appointment. That is why we need new facilities, more support for GPs and more primary care staff to improve health services in Witham. I am consistent in my campaigning for all of that.

I pay tribute to Braintree District Council, which has been on this journey with us. We have capital funding for a service, but the Minister will recognise that we need the GP practices to make the business case on how they can work together. I pay tribute also to the work of the local ICB and the NHS Alliance director for mid-Essex, Dan Doherty, who has undertaken to pursue this project with local councillors. For the first time in a decade, I feel that we have better collaboration and a stronger commitment to making this happen.

We have opportunities to redevelop locations. I cannot speak about them because some are commercially sensitive and are subject to the local councils and the ICB working together. We need the critical mass of our GPs to commit firmly to driving this proposal forward. The Minister knows that it cannot be achieved without them. We want to ensure that there is sustainability and a future business for them. For example, we are protecting prescribing, because one of the practices is a prescribing pharmacy. It is important that we give them the approach to do this.

With the game-changing dialogue that we hear in Government about localised health services, community pharmacies, and my right hon. Friend the Chancellor’s focus on improving efficiency in the NHS, if we can knit those strands together, this could develop and lead to great outcomes for Witham town. The frustration of my constituents in Witham town is palpable; they have been waiting decades for this. We as a Government must deliver for them, and I will continue to press the Government on this.

In addition to the growing demands in Witham, we have growing demand for primary care and GP services in other parts of my constituency. These are theoretically villages but their growth means they are not analogous with the old view of what a village looks like; they include Kelvedon and Feering. Stanway in its own right is no longer a village; it has become a town within the Colchester city footprint. The beautiful village of Tiptree is famous for Wilkin & Sons and some other wonderful businesses. The Tiptree medical centre now has 12,000 patients on its books, and there are concerns that that is too many for one practice to handle. I recently received a letter from the practice explaining that their clinical rooms are full to capacity, and that they may consider options to close their patient list to new patients, formally or informally, and to reduce their patient catchment area significantly, so as not to include patients who are registered in the CM postcode area.

That is worrying and deeply concerning. Action is needed to address concerns about the impact of population growth. That is something our local authorities should be doing as they develop their local plans—they have to be much more strategic. Six years ago, a very unpopular planning application was submitted for 200 dwellings in Tiptree. It was widely opposed, including on the basis of pressures on the local health services, the Tiptree medical practice in particular. Initially the application put aside land for a new medical facility; despite local opposition, the application was granted on appeal, but in the end no site for a medical facility was included, according to the decision issued. That said that the application originally included the provision of land for a medical facility but that that was removed from the proposal because Tiptree medical centre and North East Essex clinical commissioning group no longer required the land on the site, and instead requested a financial contribution towards the provision of medical facilities. That contribution has been incorporated into the section 106 agreement. As we can see from the correspondence I referred to from the medical practice, the new capacity is now not sufficient.

What we now have in Tiptree is an unwelcome development: a growing population but no significant new investment to meet the demands. Again, across Essex, planning contributions to health facilities are inadequate. They are not delivering on the improvements that have been promised, and that is totally unsustainable. I would like the Minister and the Department to review this and, in particular, look into the provision of GP services in Tiptree, and with the CCG look at how developer contributions are secured and issued.

As well as protecting and enhancing primary care facilities, we need to talk about GP training. I have already mentioned the facility at Anglia Ruskin University, which we are thrilled to have. I think that the Minister himself may have recently visited, and I will be heading there this week as well. It is an incredible facility that we need to grow at some stage, which I am already hinting to the Minister basically means expansion. We can then grow its capacity and have more locally trained medical practitioners.

On the subject of healthcare in our community, I thank the Minister and the Government for empowering pharmacies to deliver more services, which was long overdue. I have raised that issue in previous debates and I spoke about it when we had the announcement in January that pharmacies can now support patients with seven common conditions. That reportedly frees up something like an incredible 10 million GP appointments a year, while providing pharmacies with new business activities that importantly keep their footfall going.

Our local pharmacies are at the heart of our communities. That is pivotal, which is particularly in constituencies like mine and that that of my right hon. Friend the Member for Maldon, which as hon. Members will know, touch the coast. I urge the Minister to consider empowering pharmacies by giving them the opportunity to grow that provision around the wider conditions that they can treat. I am a great believer in social prescribing as well, and some of those pharmacies could even utilise their own buildings as social prescribing hubs, which we should all collectively look to expand.

The Minister has heard me touch on the importance of investment in primary care services, but the statistics I referenced in my opening remarks demonstrate the importance of prevention and social care services. I have to say that Essex County Council is blessed with the high-calibre leadership of Councillor Kevin Bentley and Councillor John Spence, who is the portfolio holder for health, adult social care and integrated care systems integration, and it has a strong record in supporting investment and service area improvements. I do not say that lightly because we were not there a decade ago, when none of us wanted to use the infamous term “bed-blocking” or say that it would take place in our hospitals, the implications of which we all know.

At any one time, the council is supporting around 16,000 people with social care, and 40,000 during the course of the year. Over 90% of people who use its services say that they are safe and secure, and the council is supporting increasing numbers with hospital discharges and reablement services. I visited an organisation called Medequip on Friday, based in Braintree district, that is contracted by Essex County Council. The innovation and the quality of care and equipment that it is providing for reablement services is phenomenal, and we really have to do much more to support that. For example, the Essex Wellbeing Service has helped 73% of people in Essex to quit smoking, which is an important intervention using preventative care, and it also supported the provision of 42,000 NHS health checks. We need to do much more on health checks, particularly cancer checks.

I will not repeat the numbers on the elderly population, but the population with learning disabilities and autism is also increasing. It is expected to grow by 3% by 2025—just next year—and the population of working-age adults with sensory impairments will grow by 5%. The council is spending around £500,000 a year on adult social care services, just over £200 million on people aged over 65 and just under £300 million on working age adults between 18 and 64. I welcome the funding that we have, but we definitely need much more.

I met parents yesterday in my constituency who are fighting for education, health and care plans—a common experience for all of us now. Since 2019, under Essex County Council, the number of EHCPs has increased from just under 9,000 to over 11,600 in 2023—a 29% increase in four years. Essex is doing very well at this compared with many authorities, but we are struggling to get these plans for children. That is a long-standing issue. The Minister will recognise that we are seeing greater demand from parents and that schools are raising this issue.

Another area of frontline health provision that will be familiar to the Minister is dentistry. In the east of England in particular—not just Essex—we have long-standing problems. The Library has shown that, in 2023, around 52.2% of children in Essex had seen a dentist in the past two years, which is just under the English average of 53%. Our figures are not good, and I would like to hear from the Minister how we are going to make progress in this area.

I thank the Minister for the time he gave us last week to discuss the mental health statutory inquiry. Colleagues in Essex are familiar with the concerns about this issue. When we debated health and wellbeing services last year, the inquiry was on a non-statutory footing. It was established back in 2021 to investigate 2,000 in-patient deaths that had occurred since 2000. I pay tribute to Geraldine Strathdee for her work in chairing that inquiry and for doing all she could to gather evidence and see the witnesses that participated in that work. She, families and colleagues in this place were frustrated that not enough progress was being made and, importantly, that not enough evidence was coming forward. Colleagues pressed for the inquiry to be converted to a statutory inquiry, and we now have Baroness Kate Lampard chairing it. Over the past few months, she has been consulting on the terms of reference. I thank Kate for the work that she is doing. Obviously, the Minister is familiar with this. We are waiting for the terms of reference to be finalised.

Our constituents have been incredible in their dignity, their courage and their bravery but also in their resilience. As human beings, they have been through a terrible ordeal—they really have. They want to see the statutory inquiry progress at pace. I pay tribute to my constituent Melanie Leahy, whose son Matthew died in 2012 while a patient in the Linden centre. My right hon. Friend the Member for Maldon will speak to this as well, as Melanie Leahy was at one stage his constituent. She is remarkable for the way in which she tackled what I call the institutional state failure of her son’s treatment. Importantly, she helped to get a statutory inquiry. The families must all get the answers that they need and see lessons learned from what happened. We owe it to those who lost their lives and to their families to change the system and to get answers. I look forward to the Minister’s comments on this in particular and on how we will come together to make time to meet the families and to work with them.

My final comments speak to the future of the NHS—the workforce plan, the growing demand for services and work on recruitment. I spoke about this in my last dialogue with the chief executive of Broomfield Hospital. I am interested in this, and I ask questions all the time. The House has heard the numbers and the statistics I put forward on how difficult it is to get an appointment and how pressed we are in terms of medical practitioners.

We should also recognise that we have an incredible international workforce locally. Our NHS would be in a much more difficult position if it was not for the staff from Botswana, India, Pakistan, Nigeria, Nepal, Sudan, India and Egypt who are working in our health and social care services and contributing to our public services, our economy and our tax system. They care for elderly and vulnerable residents across our constituencies, and they should be thanked for that.

There have been interesting debates on migration, immigration and on the skills and contributions of those coming to our country. Of course there is a need to control numbers, but we have to recognise that we rely on those skills and contributions because of workforce pressures and the fact that we have not done enough as an economy and a country to grow skillsets here. I encourage the Minister to ensure that, as part of the NHS long-term workforce plan, we do much more. We have Anglia Ruskin University and other universities across the country, but we must do more.

I want the Government to recognise that we need a wider labour market strategy that addresses these issues, which sometimes unnecessarily inflame debates around immigration. They must also recognise that many of those who come to our country through a skilled worker route pay thousands of pounds in immigration health surcharges, which contributes to the finances of the NHS. Many of them are also higher-rate taxpayers and contribute to our economy, our country and important sectors.

Of course, technology also has a role to play—it really does. We can do so much more using technology, and we must make sure that we absolutely grow the workforce locally going forward.

I have presented the Minister with a long list of health and wellbeing issues across Essex, and I thank him and his team for their patience—he is a great Minister, who is very considered, and I know he will respond accordingly. With investment, innovation and support, our health and wellbeing services across Essex could be so much better. Importantly, they could meet the needs of our constituents and ensure that we have not just a sustainable NHS service that meets the needs of our population, but a happier and healthier population.

--- Later in debate ---

[Priti Patel]

I am grateful for the opportunity to discuss these important health issues across Essex. I pay tribute to my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince) for joining the debate, and to the Minister for a concise series of well-considered remarks. We have touched on a range of issues, including the challenging demographics of the county of Essex and the needs of populations, and key areas covering primary care services, GP-patient ratios, our hospitals, the need to safeguard the facilities of Maldon St Peter’s Hospital, the need to secure a health centre in Witham town, the growing needs in Tiptree itself and the significant demands on social care.

I thank everybody for their comments on the EPUT statutory mental health inquiry, which is particularly sensitive, difficult and challenging. I pay tribute to the Minister for meeting us last week, and his comments on meeting the families are crystal clear. I thank his private office, which contacted us MPs today—in less than a week—to ask for the specifics that we have discussed. It is important that we can go back to those families with the information that a meeting with the Secretary of State will take place very soon.

My final comment is to echo my right hon. Friend the Member for Maldon: the inquiry has been going on for too long. We need to find the right balance of redress and parity of esteem in the whole mental health debate. However, while the inquiry takes place, we also need to find the right services and support for the families and the lawyers in particular.

It has been a pleasure to secure this debate and raise these issues. I thank all hon, and right hon. Members for their important contributions. There is more to do, and we will be back to discuss the same issues again.

Question put and agreed to.

Resolved,

That this House has considered health and wellbeing services in Essex.

Oral Answers to Questions

Priti Patel Excerpts

Tuesday 5th March 2024 Commons Chamber

[Maria Caulfield]

I have a news flash for the hon. Lady: we are already doing all that work. Mental health support teams are being rolled out in schools—44% of pupils now have access to a mental health support team, rising to 50% shortly. Over 13,800 schools and colleges now have a trained senior mental health lead. Only last week we announced 24 early support hubs for 11 to 25-year-olds—they will not need a referral; they can drop in. There are 24/7 helplines available that can be accessed through 111. That is what we are doing.

[Priti Patel (Witham) (Con)]

Mid and South Essex integrated care board is seeking to remove vital community health services from St Peter’s Hospital in Maldon. Will the Minister meet me and our right hon. Friend the Member for Maldon (Sir John Whittingdale) to discuss the proposals? They will affect both our constituencies and are causing a great deal of concern.

[Helen Whately]

I would be very happy to meet my right hon. Friends to discuss those concerns.

Pharmacy First

Priti Patel Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

There has been a 61% increase in registered pharmacists since 2010, with plans to increase that number by 50% in the next few years.

[Priti Patel (Witham) (Con)]

I commend my right hon. Friend for her excellent statement, but how will she tackle the issue of funding for prescriptions? Community pharmacies are struggling, and she will understand that the NHS tariff does not pay them the full price of products. Will she look at that as she rolls out the scheme?

[Dame Andrea Leadsom]

The Government currently contribute £2.6 billion to community pharmacy, quite apart from the £645 million addition for Pharmacy First. We are about to start negotiations for the 2024-25 period.

Oral Answers to Questions

Priti Patel Excerpts

Tuesday 5th December 2023 Commons Chamber

[Dame Andrea Leadsom]

My hon. Friend is right; it is appalling that people book an appointment and then do not show up. In many GP surgeries now they post the numbers of patients who do not turn up for their appointments and urge people to make the effort to cancel. As part of our access to primary care, we are creating digital tools so that GP surgeries can notify patients that they have an upcoming appointment and say, “If you don’t need it, press here and it will cancel the appointment.” Measures such as that make it easier for people to cancel, but he is quite right that it is incumbent on us all, if we book that appointment, to turn up for it.

[Priti Patel (Witham) (Con)]

7. What funding her Department is providing to help tackle health inequalities in Essex.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

9. What steps she is taking to help reduce health inequalities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to reiterate to my right hon. Friend the Member for Witham (Priti Patel) that Essex is receiving funding from the National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, to promote research into health inequalities and support better health outcomes for her constituents and all residents in Essex.

[Priti Patel]

I thank the Secretary of State for her response and welcome her to her new role; it is a real pleasure to see her in her position today. My Witham constituents have one of the highest patient-GP ratios in the country. That brings many challenges in accessing the NHS, from primary care to dentistry, social care and hospital appointments, some of which have been exacerbated by industrial action. Will she give an update on the work she is leading to address some of those issues and will she support my work and campaign locally to get a new primary health centre in Witham town?

[Victoria Atkins]

I thank my right hon. Friend very much for her kind words. She will remember how much I enjoyed sitting on the Front Bench alongside her when we were in the Home Office. In terms of her work in Essex, she is a formidable campaigner and she will know that the decision on such a healthcare centre lies with her integrated care board, to which the Government have given some £183 million of capital funding between 2022 and 2025. I am sure she will make a compelling case to the ICB for such a centre in her constituency. Interestingly, the Mid and South Essex integrated care board is one of seven sites receiving additional support and funding from NHS England to address health inequalities, and I know she will pay close attention to how that is spent.

--- Later in debate ---

[Victoria Atkins]

As I said earlier, careful thought has gone into the announcements that were made in the autumn statement, and of course I will work with the Secretary of State and the Chancellor to ensure that the commitments we already have to people living with disabilities are maintained, and that we have their wellbeing at the heart of all our policy making.

[Priti Patel (Witham) (Con)]

T4. The Secretary of State’s predecessor took a strong interest in the deaths that took place in the Essex mental health trusts, and a statutory inquiry is now taking place. Will she meet me and our Essex colleagues, and the families, to discuss that important inquiry, so that they can have justice for the loved ones they have lost?

[Victoria Atkins]

I would be very pleased to meet my right hon. Friend, the families and other Essex MPs to discuss that important inquiry.

Countess of Chester Hospital Inquiry

Priti Patel Excerpts

Monday 4th September 2023 Commons Chamber

[Steve Barclay]

The hon. Gentleman raises an extremely important point. It is right that we focus on that and ensure that the concerns about the revolving door are addressed. On the decision taken by my predecessor, my understanding is that the recommendations accepted from Kark were viewed as effective in addressing that—obviously, the events to which this statement relates have happened since—but I have asked NHS England colleagues in the Department to look again at testing them further in the light of the evidence that has come through from the court case in particular.

[Priti Patel (Witham) (Con)]

My heartfelt prayers and thoughts are rightly with the families, whose heartbreak and suffering is just unimaginable. I really welcome the tone that the Secretary of State has taken on ensuring that no stone is unturned in the quest for justice. Likewise, I thank him for the support that he has given us in Essex through the Essex mental health trust statutory inquiry that he announced just before recess—we look forward to working with Baroness Lampard on the terms of reference. Can he some provide some assurance so that the 80-plus families who did not engage with the inquiry previously come forward, give evidence and have confidence that their evidence will lead to justice for the loved ones they are missing because of what happened at the mental health trust?

[Steve Barclay]

I am keen to give my right hon. Friend that assurance. I know that she has personally championed —as have a number of colleagues across the House—the interests of families in Essex to ensure that they get the answers they need. Indeed, she very effectively conveyed to me the concerns about the inquiry in Essex hitherto. Our focus—I think this is an area of consensus across the House—has to be on ensuring that families get the answers that they legitimately deserve. The reason that it was proportionate to shift the Essex inquiry from a non-statutory footing to a statutory footing was the concern of the chair that there was insufficient engagement, particularly from staff but also, as my right hon. Friend just said, from families who did not have confidence in the inquiry as it was. That is why that inquiry has been strengthened and we have put in a very senior chair with experience of the Savile inquiry. I know that my right hon. Friend will be at the forefront in ensuring that the families’ voices are heard moving forward.

Mental Health In-patient Services: Improving Safety

Priti Patel Excerpts

Wednesday 28th June 2023 Commons Chamber

[Steve Barclay]

It is a shame that the hon. Lady chose to conclude her remarks in such a way. Let me address that head-on. It is bizarre to accuse a Minister who is literally at the Dispatch Box of being missing, particularly when the shadow Health Secretary, having managed to turn up for Prime Minister’s Question Time, has failed to turn up for this statement. It is even more bizarre that, although we are constantly told that the Labour party sees parity between mental health and physical health as a key priority, when it actually comes to debating the issue, the contrary is clearly on show.

This debate is not about the issues normally raised during Prime Minister’s questions about the politics of the day; it is about the families who have tragically lost loved ones, about how we can learn the lessons from that, and about how we can ensure that we get the data right, get the support for staff right, and get the procedures right so that other families do not suffer loss. We have responded to the excellent points made by Dr Strathdee through her rapid review about data. There are two elements to that: there is data that is collected that does not add value, is often duplicative and takes staff away from giving care—that is somewhere that we can free up staff—but there is other data that is needed to better identify issues early, and we need to look at how we improve that data. Specific issues arose in respect of engagement by staff, and we have actively listened and responded to the concerns raised by families and by many Members of the House, particularly about the Essex inquiry. I will come on to those as I go through the wider issues.

The shadow Minister mentioned speed. Of course, there is a balance to be struck between the completeness of a statutory inquiry and the greater speed that is often offered by other independent inquiries. Indeed, the Paterson inquiry was a non-statutory inquiry commissioned through the Department, and that is another vehicle that is often successfully used. There are also inquiries commissioned through NHS England, such as the Donna Ockenden review. There is often a balance to be struck between those inquiries, given the speed at which they can proceed, and a statutory inquiry, which has wider powers but often takes longer.

It was because of our desire to move at pace to get answers to families that we initially commissioned a non-statutory inquiry, in common with Bill Kirkup’s inquiry into Morecambe Bay and inquiries into many other instances in the NHS. However, we have listened to families and to right hon. and hon. Members who have raised concerns about the process and, in particular, the engagement by staff, and decided to make it a statutory inquiry.

The shadow Minister asked about our commitment to transparency. The very reason that we set up the rapid review in January was to bring greater transparency to the data. That is why I will be placing in the Libraries of both Houses the outcome of the rapid review. That speaks to the importance of transparency as we learn the lessons of what went wrong in Essex and in other mental health in-patient facilities.

The shadow Minister made a fair point about waiting times. We are committed to cutting waiting times, including in mental health. That is why we are spending £2.3 billion more on mental health this year than four years ago, we have commissioned 100 mental health ambulances, we have 160 different schemes looking at things such as crisis cafés to support people in A&E, and we have schemes such as the review through 111 and the funding the Chancellor announced in the Budget for mental health digital apps to give people early support. Of course, that sits alongside other mental health interventions, such as our programme to train more people to give mental health support in schools.

The shadow Minister made an important point about working with families. I agree with her about that. HSIB will be meeting families—indeed, Ministers have been doing likewise—and we are keen that that should feed into the terms of reference, both for the statutory inquiry and for the HSIB review.

We have touched on consultants, but let me make a final point on that. As far as I am aware, the Opposition do not support a 35% pay rise, whether for junior doctors or for consultants, but if that is their position, perhaps they will tell us whether this is yet another area that the stretchable non-dom contribution will reach to. Exactly how will it be funded?

This is a serious issue. The measures that we are taking address the concerns of families who have suffered the most tragic loss. It is important that we learn the lessons, both in Essex and more widely. We have actively listened to the points raised by Dr Strathdee, who has done a fantastic job. It is right that the work moves on to a statutory footing, but it is also right that we look more widely at the lessons from other mental health in-patient facilities. That is exactly what we intend to do.

[Priti Patel (Witham) (Con)]

First, let me put on the record my personal thanks to the Secretary of State and Ministers for their honest and frank engagement with colleagues and with bereaved families, whose concerns they have listened to. It was my constituent Melanie Leahy, who was at one stage a constituent of my right hon. Friend the Member for Maldon (Sir John Whittingdale), who brought the issue to our attention and to the attention of the Secretary of State. She deserves a lot of support for the way she has conducted herself. None of us would want to go through the sheer anguish and personal trauma that she has experienced. We owe a lot to her and to others who have come forward.

There are still 80-plus families who did not engage with the inquiry led by Dr Strathdee, to whom I pay tribute. The statutory inquiry will give them the confidence and courage to come forward, speak up and share what will be—we should be frank about this—deeply harrowing evidence. Will the Secretary of State expand on how evidence received by Dr Strathdee’s inquiry will be treated? I know that he said he will come back to the House on the processes. We are interested, in particular, in the inquiry’s terms of reference. Importantly for bereaved families, what measures will be in place to support people to come forward and give evidence? There have been too many barriers in that regard for families and, if I may say so, those who have been employed by EPUT. What involvement will the families have in drawing up the terms of reference? They are the ones that need confidence in the process. Again, I thank Dr Strathdee, and I thank the Secretary of State and Ministers for their engagement.

[Steve Barclay]

In my discussions with my right hon. Friend and colleagues, I found the compassion that they showed and the way they championed the family voice compelling. I absolutely agree that it is important that families take confidence from the decision to move the inquiry on to a statutory footing and come forward with their evidence. I know that she plays an active part in that. Of course, we want families to be part of the discussion on the terms of reference. I know that, with her significant experience, my right hon. Friend is keen to be part of that too, and we are keen to engage with her on it.

My right hon. Friend is right to highlight the evidence that has already been gathered through the excellent work of Dr Strathdee. I had a meeting with her yesterday to ensure that we capture that as part of the work that is moving forward. I hope—I reinforce my right hon. Friend’s point—that families will take confidence from today’s announcement and that those families who have not come forward to date will be able to do so. I know that in my right hon. Friend they will have a resolute champion supporting them to do so.

Health and Wellbeing Services: East of England

Priti Patel Excerpts

Wednesday 1st March 2023 Westminster Hall

[Priti Patel (Witham) (Con)]

I beg to move,

That this House has considered health and wellbeing services in the East of England.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful to have secured this important debate, and to be joined by my colleagues from the east of England across all parties to highlight and discuss the many substantive issues relating to health and wellbeing in the east of England. I welcome my hon. Friend the Minister for Social Care, who will be familiar with some of these issues from the deluge of correspondence she has no doubt been receiving and the recent debates in this Chamber.

This debate follows the excellent one secured by my hon. Friend the Member for Waveney (Peter Aldous) on 31 January on the progress towards the Government’s levelling-up missions in the east of England. He cannot join us for this debate, but I thank him for championing the levelling-up agenda in our region and other colleagues who have supported this, particularly those on the all-party parliamentary group for the east of England.

Today I will speak about some of the regional issues and the specific health and wellbeing issues that are relevant to Essex and my Witham constituency. The Minister will be familiar with the “Levelling up the East of England: 2023-2030” report and its commentary on health and wellbeing matters. The report highlights that, while many areas in the region excel, there is a significant number of places and communities where deprivation is affecting outcomes and opportunities and where we need to focus our efforts.

With the 2021 census data showing the east of England to be the fastest growing region in terms of population—up by 8.7% or just under 500,000 to 6.3 million people—it will come as no great surprise to Members that our region is, frankly, pressed. It faces challenges from the health and wellbeing pressures associated with a growing and ageing population. The Office for National Statistics projects that by 2041, the number of people in the region aged over 65 will have increased by more than 450,000.

In particular, the report highlights the data on healthy life expectancy. Both men and women are spending over one fifth of their lives in less than good health. In 2018 to 2020, average healthy life expectancy for men in the region was 64.6 years, compared with average life expectancy of 80.2 years; and for women, average healthy life expectancy was 65 years of an average 83.3 years. The challenge speaks for itself. Some of the figures are gradually improving, but this is a significant concern across the region. The scale and beauty of our region masks a number of health inequalities.

[Vicky Ford (Chelmsford) (Con)]

I thank my right hon. Friend for leading the debate. One of the challenges we have had in my part of Essex for many decades is the difficulty of recruiting doctors, in part because no doctors were ever trained in Essex. It was fantastic news when, five years ago, thanks to the Conservative Government’s policy and support, a new medical school opened in Chelmsford, training doctors in Essex for the first time. The first doctors will graduate in just a few weeks, and I am delighted to tell my right hon. Friend that the drop-out rate on that course is only 3%—the average across the country is 8%—and many of those new doctors want to stay working locally in our area, which is fantastic. Will she and the Minister join me in supporting Anglia Ruskin University’s campaign to double the size of the medical school in Chelmsford?

[Priti Patel]

My right hon. Friend is correct. I remember having the opportunity to support the business case for the medical school around seven years ago, and I pay tribute to everyone who was involved in establishing that amazing medical school. In Essex in particular and in the east of England region, we are very proud to have the Anglia Ruskin University medical school. I have seen the campus—the size, the scale, the facilities—but also the enthusiasm of the students there. My right hon. Friend makes an incredibly important point, which is that we have to grow our own in Essex, and in the eastern region, and we need those students to be placed locally in GP practices to grow the footprint locally. I will come to that, particularly when I speak about primary care.

The point about the medical school, healthy life expectancy and the delivery of good health outcomes speak to the challenges we face in the region, which include heart disease, lung disease, diabetes, lung cancer, stroke, depressive disorders, falls and drug-related deaths. As our population grows, on top of the age profile changes that we are experiencing and will continue to experience, we will need more qualified GPs, but also medical specialists to serve those individuals and to support the community. The difficulties that we face comprise not only demographics, but the scale of the health challenges and, I say to the Minister, the issue of geography. The east of England is a diverse part of the country, and its rurality and coastal nature put pressure on services.

[Giles Watling (Clacton) (Con)]

Does my right hon. Friend agree that since we have been devolving powers and money to local integrated care systems, centralised NHS England appears deeply inefficient in many ways? In Clacton, we have private dentists up and ready to serve with the NHS, but they are unable to do so. The integrated care boards are going to absorb new commissioning powers, but without flexibility in NHS England rules, will we not just be shuffling a deck of cards?

[Priti Patel]

My hon. Friend is the voice of common sense on this. He will recall that we covered some of those issues in the debate we held here on, I think, 31 January. I spoke about the state being very inflexible and centralising too many resources, which need to be cascaded downwards to meet the needs of patient care.

My views on the size of the state are well known, but on this issue I think that, yet again, the centralised approach is wrong. It is simply not delivering the patient outcomes and the care that we need. We need more flexibility. ICBs are brand new, and they are finding their feet right now. We as Members of Parliament have to support them so that they can establish themselves and work with us to understand the needs of our constituents and communities. There is nothing worse than central Government funnelling cash to another centralised organisation and bureaucracy within a region, and that money going on, for example, NHS managers and bureaucracy, not the healthcare that is needed.

[Daniel Zeichner (Cambridge) (Lab)]

Let me pick up the point about NHS dentistry, the commissioning of which, I am told, is about to be transferred to the ICBs. We probably all have a pretty grim constituency experience of people trying to access NHS dentistry. Does the right hon. Lady agree that it might have been a good idea to hand that power back to local areas quite a long time ago?

[Priti Patel]

The hon. Gentleman is right. For years, I have spoken about local healthcare provision. Practitioners know best, and it is not for central structures to dictate the needs of a local community. With that, there is the issue of access to services that matter so much. Dentistry has been controversial for too long. As a result, children are not accessing dentistry in the way they should, and health outcomes are absolutely shocking and appalling, particularly in young children.

[Mr Richard Bacon (South Norfolk) (Con)]

I congratulate my right hon. Friend on securing this debate. I recently had a meeting with Dr Nick Stolls, who for 20 years ran the local dentistry committee in Norfolk and Suffolk and is now the professional lead for dentistry and wellbeing for the integrated care board. He described work done by the British Dental Association that points out that Norfolk is almost a dental desert, with no dentists able to take contracts, in some cases because of NHS England’s inflexibility. Does my right hon. Friend agree that reform is needed? Will she invite the Minister to agree that, as the British Dental Association said, fundamental reform of the NHS dental contract is urgently required to truly address the challenges that patients, dentists and the wider NHS are experiencing?

[Priti Patel]

I thank my hon. Friend for making that point. The British Dental Association has been pressing for reform probably for as long as I have been in Parliament, and I am very familiar with its case. My hon. Friend speaks very clearly about access and inflexibility. Importantly, if there is no flexibility in the system, there is no opportunity to provide services to meet local need accessibly and in a way that means people do not think they will be charged or subject to barriers to access.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Lady. She was a very effective Home Secretary and it is good to see her just as active on the Back Benches—well done. This subject does not affect me personally, but I want to ask her about a similar issue: face-to-face GP appointments. It is vital for a GP to assess what they see as well as the words they hear. My constituents wish to have face-to-face appointments, but they seem to be restricted. Is the right hon. Lady experiencing the same problems? What would she suggest should be done to solve them?

--- Later in debate ---

[Priti Patel]

I thank the hon. Gentleman for his comments. I have a whole section of my speech on GP access, particularly in the Witham constituency. That has been a contentious issue throughout my entire time as a Member of Parliament. He is absolutely right, and I have no doubt that his constituents and constituents in the east of England and across the country are facing the same challenges. There is a range of reasons for that, which I will touch on.

I think the Minister will be interested to know that in the east of England—this relates to facilities and access to care—per capita spend is £2,889, which is the lowest of any region and below the national average of £3,236. Like so much of the rest of the country, we face challenges. Ours is an ageing part of the country—our population is getting older—so we face disproportionate health and social care challenges and workforce demands. The east of England has the smallest number of nurses per 1,000 people of any region in the country. I urge Ministers to review not just the flexibility of dentistry contracts, but the east of England’s metrics on healthy life expectancy—this comes back to the levelling-up report—and provide more certainty to the region to address the disparities, which affect constituents across the board.

I also ask the Minister to look at what can be done to reduce ill health and early death, particularly as a result of preventable factors. Prevention is rightly a significant feature of the NHS, but we have serious issues in the east of England. Health providers and local authorities across the region would be really keen to engage with the Government on that. I am going to volunteer them all, because they offer themselves up constantly for new pilots and initiatives; we are very proactive. I pay tribute to Essex County Council, which has done a great deal of work on this issue, and other key providers that have the ability, capacity and capability to provide services.

As well as support for the region’s levelling-up ambition on healthy life expectancy, we are very keen to see improvements in wellbeing, where social prescribing comes into the mix. I say to the Minister and all our colleagues here today and people across the region that it is incumbent upon us to start to narrow that gap from top-performing areas. We need to start closing the gap, so that we start to see equity across these big challenges. As the levelling-up report has demonstrated, this is a difficult health indicator and target to measure, but we have the opportunity now to be innovative, and to work with new providers as well as our county council in the way that my hon. Friend the Member for Clacton (Giles Watling) has spoken about—a less bureaucratic and more flexible way that helps to drive local outcomes with our partners.

[Vicky Ford]

In my part of Essex, great work is already being done on levelling up. For example, it was never possible for people to get IVF in Mid Essex due to lower levels of funding, but that has now been levelled up, so that from 1 April, women will be able to get IVF treatment on the NHS in Mid Essex, which is really important to so many women who want to start a family

[Priti Patel]

I thank my right hon. Friend for her comments.

I have some very specific Witham issues. The Minister and the Department will be familiar with my bundles of correspondence on the Witham health centre. One of the most important ways that health and wellbeing in Witham, in Essex and across the East of England can be improved is by strengthening accessible services that are delivered within the local community. We have already touched on this point. That applies to the provision of health services in Witham.

I never tire of raising the needs of my constituents across the constituency and in Witham town; it is growing as a constituency and a community, and we are very proud of that. We have seen some amazing outcomes—for example, in education, in our rail services and in the infrastructure that we have been pursuing—but there is more to do. We have seen hundreds of new homes being granted planning consent and thousands of homes being built, with more residents coming to my constituency. Ours is a fantastic part of Essex—I do believe that the only way is Essex. Importantly, we now have a blend of new families and families who have lived in Witham for many generations. Like many towns, we have a growing population of elderly residents living in care homes and homes around the town, and of young people as well—we are a commuter town—with young families. With that blend and that increase, we need a new health centre.

Since the start of the pandemic three years ago, the four GP surgeries in the town have seen their patient lists increase by nearly 3% to almost 32,000 people. Between the four surgeries, there are just 13 full-time equivalent GPs, giving an average patient to GP ratio across the town of about 2,440. That is about 50% greater than the national average. The patients to GPs ratios across those four surgeries range from 2,045 patients per GP to 3,150 patients per GP, and each surgery is well above the national average.

With so many patients—in fact, this has been the case throughout my entire time as Member of Parliament for the Witham constituency—many constituents regularly report not getting appointments, and far too many are unable to take action when it comes to dealing with their own health concerns. Cancer risks are being picked up too late. In the light of the health disparities that I have already raised, serious and debilitating health conditions will not be serviced and attended to in a timely manner.

This will be no great surprise to the Minister or anyone in the Department, and I apologise to no one for the vigorous way in which I keep on raising the need for a health centre. It is one of the key projects that I have campaigned for during my time as Member of Parliament. The money has to come directly to Witham town. With four GP surgeries and more than 30,000 patients, there is a clear and compelling business case. I have offered to write the business case for the GPs myself. I have done everything to facilitate the GPs coming together, which has been rather challenging; the Minister will be well aware of the business models that mean that GPs do not always want to reach agreement and work together. I am sorry to report that those models have been a major underlying problem.

Having a new facility—this is the key point—would mean more specialist treatments and services delivered locally. It would give local constituents the greatest assurance that, whether they have young children or they are elderly, their needs will be taken care of within the town itself, and that there will be medical practitioners, therapists, nurses and others who can absolutely ensure that care is there for them. We should also bring in new providers and do much more on social prescribing. I am a great advocate of that, and we have to have a blended approach when it comes to access to primary care.

[Giles Watling]

On that point, I would like to bring up Clacton. We have a new community diagnostic centre, which is absolutely brilliant. I thank the Minister for that, but there was supposed to be a primary care hub, too. I had a meeting recently with one of our local GPs, and the primary care hub is not forthcoming at the moment. Hospitals such as the one in Clacton are very important because they take pressure off the bigger hospitals locally, such as those in Ipswich and Colchester. It is very important that we have a primary care hub, so I ask the Minister to respond to that.

[Priti Patel]

I thank my hon. Friend for his comments about his beautiful constituency and the healthcare needs.

I want to press the Minister. For too long, my constituents and the residents of Witham have been waiting for a medical facility—a new health hub, as we have dubbed it—and I am afraid that there has been inertia in the way that people have come together locally to drive this outcome. I give credit to the new ICB and to one of our NHS colleagues heading up the ICB, Dan Doherty, who is trying to get GPs to come together. We are looking at a new practice centre and locations are being discussed, but enough is enough. We need this to come together, and it needs central leadership. We have spoken about the centralisation of money and resources. The one thing that central Government could do that would actually make a difference is to say that the project needs to go ahead, and then to tell the local ICB and GPs, “You will get the resources, the help and the support, because it is your job and your responsibility to deliver for local constituents and residents.” That is key.

We are, proudly, a growing constituency, and Tiptree is another major population centre where there are challenges in health provision. Tiptree is a very famous village, although its village status is sometimes questioned because it is growing and growing. The village is famous for its legendary jam-making business, which has a royal warrant, and we are very proud of Wilkin & Sons. The medical practice there has 12,000 patients registered but has just two practising GPs, so although the practice has a range of healthcare professionals working there, the level of GP provision is too low.

To come back to the point made by my hon. Friend the Member for Clacton, if we are to stop the pressures on A&E—for my constituency, the pressures are on Colchester Hospital, which is where Tiptree faces, and the pressures on the Witham side are on Broomfield Hospital, towards Chelmsford—we have to ensure that our local practices are supported and that we increase our GP ratios. That also speaks to the point made by my right hon. Friend the Member for Chelmsford (Vicky Ford) about the need to bolster the medical school and ensure that its graduates come to work in our GP practices. That is hugely important, and we in Essex absolutely believe that there is a great opportunity to increase GP provision. The medical school is outstanding. We want that link to be made and we need more GPs to come through from Anglia Ruskin. I will put in a shameless plug: come to Witham and Tiptree, and use the area as a network, through a new hub in Witham town, to then go further.

There have been interventions about dentistry, and I reiterate the point about the BDA’s statistics: around 93% of dentists in the east of England are not accepting any new NHS outpatients, and the proportion for children is 81%. We should pause and reflect on those statistics, which I find astonishing because of the health and wellbeing implications. We see poor dental hygiene and tooth decay in children, which is simply unacceptable. The Government announced a package of measures to improve dental health and access to NHS dentists in November, but the issue seems to be deteriorating for lots of reasons.

I know that the Government are doing much more on prevention, but we need what we have seen from the Suffolk and North East Essex ICB, which provided funds for children aged between two and eight to experience supervised brushing in early years and school settings. I am a big believer in our schools, which can do so much for children’s health and wellbeing. I said that we were all for innovation and pilots, and initiatives such as that should be supported across other schools to improve health and wellbeing with regard to dental care, and to show children what can be done and how to look after themselves. If we cannot get it right in the early years, frankly, we end up picking up the pieces later in life. This is about not just costs, but the wider health implications. There is so much preventive work we can do at the outset.

I will also take this opportunity to comment on our ambulance services across the east of England. I am sure that all of us here today—including you, Mr Hollobone, with Kettering Hospital—are all too familiar with the challenges for our ambulance services. Ten years ago, in 2013—I am sorry to say that I remember this too well—the East of England Ambulance Service was in crisis. There was a lack of investment in ambulances and paramedics, devastating concerns over patient care and appalling mismanagement of the board.

I pay tribute to colleagues across the east of England back then, because we came together, spoke with one voice and campaigned, to the extent that we forced the board of directors to resign and brought in new management—such was the scale of what was going on; it was appalling. The trust was turned around and I pay particular tribute to my noble Friend Earl Howe, who was a Health Minister at the time. Not only was he supportive, but he would sit in on meetings, come to the constituencies and sit with the ambulance trust. I also pay tribute to the successive chief executives at the trust who have improved plans and increased investment in ambulances and paramedics. It has been a slog, but we cannot overlook the hard work that has taken place over the past decade. I pay tribute to all those, in public service in particular, who gave up time with the trust to turn things around.

In January, I met the current chief executive of the trust, Tom Abell, and visited the call-handling centre in Broomfield, which my right hon. Friend the Member for Chelmsford will know. They are changing things. The call handlers are first class and I pay tribute to them; they are dynamic and so engaged. They are also smart, agile and triaging calls, which makes a tremendous difference. We want to support that and the right kind of patient outcomes, and they really care about patient outcomes.

We have to recognise that our paramedics and ambulances continue to face delays. That is preventing them from being out in the communities and reaching medical emergencies and injuries, so we still have complaints. I would welcome the Minister’s thoughts and insights on the east of England, and where further actions can be undertaken to improve services. I mentioned Broomfield Hospital in Chelmsford and Colchester Hospital for emergency care treatments. Importantly, those hospitals are part of the infrastructure and need to be reassured that the golden thread of integration reaches them, so that we do not see the appalling days of stacking that we saw many years ago and patients facing unnecessary delays.

Alongside that, we need reassurance and commitment from the Government to invest in and support hospitals, particularly in acute care settings in Essex and the east of England. I know that other colleagues will want to touch on that. An ageing population has more complex needs and our hospitals must be equipped to support that. Just as our ambulance service has been on a journey of improvement, the two hospitals have been on quite a journey of improvement. Broomfield was burdened with the most ridiculous private finance initiative costs when I became the Member of Parliament for Witham. I am afraid that those PFI costs—it was subjected to them by the previous Labour Government—were eye-watering, and the most horrendous debt had been put on the hospital at the time.

Colchester General Hospital has had one of the most interesting journeys. It spent long periods in special measures and required improvements, and it has now become integrated into the East Suffolk and North Essex NHS Foundation Trust. Many of the old issues have been resolved and there has been tremendous leadership there as well, notwithstanding the pressures faced during the covid pandemic. I pay tribute to everyone working at the hospitals who were involved in the turnaround plans. We have had periods pre and post pandemic with long waiting times.

Before the pandemic, Colchester hospital had a £44 million plan, which included the rebuilding of the day surgery unit and investment in a new orthopaedic centre. Those are important developments that we want to see come together. I look forward to hearing from the Minister, who is welcome to come to the constituency—or the region, I should say—at any time to see the panoply of issues that we have. Services need investment. There are improvements, but at the same time we need to get that golden thread, the integrated care, totally integrated.

As well as speaking about GP surgeries and hospitals, I will also mention our pharmacies, which play a vital role in providing health services to our residents. Pharmacies are located in the heart of communities. I have many brilliant pharmacies, and there are fantastic pharmacists around the country. They are the unsung heroes in our communities. We should recognise that they are desperate to play a stronger role in primary care. They want to help people to get treatments and help with prescriptions. I urge the Minister to speak to community pharmacists. I was concerned when I recently met a community pharmacist in the wonderful village of Tollesbury, where I was informed that the funding that they had received over the past seven years has been squeezed by 30%. I have been in touch with the Department about that.

Community pharmacists say that without urgent intervention, pharmacies will close, because of pressures on funding associated with prescription drugs and the NHS tariff. Pharmacies are to a certain extent subsidising the prescriptions that they issue in the community. The concerns are such that we are now moving towards a large number of permanent pharmacy closures, putting the safe supply of prescription medicines at risk. I have also heard that there are opportunities for the Government to empower pharmacies to do more by providing a blueprint for the future of community pharmacy, but that has to be backed by investment, which we are not yet seeing—we are seeing a continuing squeeze.

This issue is a no-brainer. In any village, constituency or community that has a community pharmacy, people can go there to be reassured if they feel unwell and want advice, rather than putting pressure on local GPs or, worse still, hospitals. With the son of a pharmacist now our Prime Minister, there is a great opportunity for the pharmacy agenda to take greater precedence and priority across the NHS and in our communities, so I want to press the Minister on that.

As my Essex colleagues are still here, it would be remiss of me not to raise one of the most contentious subjects that we face in Essex: the pressures of mental health services in our county, which has been raised in this Chamber before. I am sorry to say this, but we have seen families left devastated when loved ones in the care of mental health services have lost their lives, and families are now frustrated when they seek answers from the bureaucratic side because of the lack of accountability and transparency in the NHS trust.

On 31 January, my right hon. Friend the Member for Chelmsford held a debate on the Essex mental health independent inquiry, and our concerns are not being allayed at all. The inquiry’s chair, Dr Geraldine Strathdee, has raised many concerns. I pay tribute to her for her diligent work and boldness in speaking out and raising concerns about the lack of transparency and people not providing evidence to the inquiry. Both she and the current chief exec of the Essex Partnership University NHS Foundation Trust are encouraging and supporting staff to come forward to participate in this inquiry.

The Secretary of State, to his credit, has shown strong interest. He is trying to give us assurances that the inquiry may be put on a statutory footing, and we welcome that. However—I say this as a former Home Secretary who has been involved in setting up public inquiries into some of the most devastating issues—we would prefer evidence and information for the inquiry to come forward as soon as possible. I am conscious that—and I have said this to many of the families and victims—when inquiries are put on a statutory footing, it sometimes becomes harder for people to feel that they can come forward. The disclosure of names and personal details can become subject to some contention.

The point is that, for too long, families have been fobbed off with excuses and have had a lack of support. They have not been treated with respect and seriousness when they have raised concerns about their loved ones. Many are victims that have experienced the most horrific abuse at the hands of the trust. We now need the inquiry to deliver the answers that everyone is seeking. I would like the Minister to give an update on where we are on that.

Let me turn to another important point that is linked to the inquiry. We are experiencing too many mental health issues across society, and that is devastating. There is much more that we can do now with a focus on mental health and wellbeing in our schools, colleges and universities. We must put a particular focus on our young people. I am deeply concerned to hear of young people self-harming. That is not the subject of this debate, but it has been a subject in the House around online safety, the forthcoming Online Safety Bill and the roles and responsibilities relating to the type of information that is put out on social media networks and things of that nature. This comes back to prevention, but there is more that we can do on education and awareness. However, we must have specialist practitioners locally and in the community to provide the essential support. I would welcome some insights from the Minister on what education providers are doing in this area.

As a former Home Secretary, I will take the liberty of raising the issue of policing and mental health. In the police and crime plan, the Government that I was involved in made it abundantly clear that the police should not be the automatic backstop and default in dealing with mental health cases and patients. That therefore uses valuable police resources and means hours spent sitting in hospitals and A&E because mental health facilities were just not accessible. That is changing thanks to the Government and the initiative that I and the former Policing Ministers put in place, but it speaks to the mental health ecosystem and the numerous pressures on it.

On education providers and schools, constituents have raised concerns with me about how the health services are supporting children with special educational needs and disabilities. The Minister will be aware that health partners have a role to play in education, health and care plans for young students. However, the delays are not just cumbersome, but deeply stressful for pupils, families, parents and households. I am sure that all Members present can wax lyrical about the challenges in securing services, including speech and language therapy, to help young people and support them with their needs.

I go on about this a lot, but I believe that the money must follow the student. I still think we do not see enough of that. I have a terrible case of a youngster with very specific needs—high needs—as part of his education, health and care plan. However, the money that has gone to the school is just not following him in the way that it should for outcomes. We all know about delays in securing autism assessments. That is simply not good enough. We know it has been exacerbated by the pandemic, but we must do more to address the issue.

I will come to a near-conclusion by touching on a few other areas. I have already mentioned Essex County Council, which—all credit to it—has a strong record on investing in health, social care and wellbeing. I know that it would welcome details of its public health grant; it is that time of the calendar year when funding allocations come up. The council is also involved in piloting Active Essex, exploring what more can be done through prevention and enablement in health and social care systems to improve independence and health through increased physical activity.

On health and social care, I pay tribute to Essex County Council and Councillor John Spence. He is a remarkable individual who is really championing this area. If I may say so, central Government should spend some time with us in Essex to look at the innovative ways in which we are driving outcomes. The council has also transformed day services. It has established the “Meaningful Lives Matter” programme, and it is working with local employers to support adults with learning disabilities and autism. As a former employment Minister, I believe the more we can do to support people to get them into meaningful work, the better. It has great outcomes for health and wellbeing. We want more of that.

The council has a care technology service, which was launched in 2021 and is supporting 5,200 people. Of course, we all believe in making use of technology, and technology to improve health outcomes and independence is crucial. People do not want to be centralised or institutionalised; they want to be able to access services and live their lives. We are seeing good outcomes for people experiencing memory loss.

The council is working with the three integrated care systems that cover the county and supporting hospitals with discharges, which is obviously important from the social care perspective. The Essex Wellbeing Service has evolved. I emphasise that it is using both statutory and community service resources to support health and wellbeing outcomes. I invite the Minister to come to Essex to meet our colleagues—not just John Spence but the leader of the county council, Councillor Kevin Bentley. We are on the cusp of a good degree of innovation.

I am also keen to support new schemes that can help physical and mental health and wellbeing. I have touched on social prescribing, but I am also about to launch a new initiative with schools called “Get Witham Growing”. Among other things, I will involve schools in growing cosmos seeds from the national plant collection, as well as food seeds. We can get much more holistic outcomes, as well as the education, health and wellbeing benefits. Frankly, we can plant them now for future generations. I encourage other hon. Members to pick that up as well.

My right hon. Friend the Member for Chelmsford mentioned IVF support. Hormone replacement therapy treatments are also in the news. It is important to raise that point, because constituents have expressed concerns; people across the country would like reassurance from the Minister on that issue. I have already spoken about the health hub in Witham town, but phlebotomy services are something that we have raised consistently for over a decade. Access to blood tests is crucial; we want to see much more support in that area, both locally and across the region.

My final point is quite topical. I raise it because my constituency is growing. In fact, Essex is growing—not just from planting seeds; our population continues to grow. We have a lot of house building, with developments across Chelmsford, Clacton and Witham. They are not small. My right hon. Friend the Member for Chelmsford has Beaulieu Park, which is a massive development in various phases. I have Tollgate, which consists of thousands and thousands of new homes. In Witham town we have phased development, which used to be the old Witham Lodge development. However, something is missing when it comes to planning.

That is the whole issue when we speak about pressures on local health services. We are not seeing developer contributions stack up to meet the needs of the growing local population when it comes to the moneys going to local councils, whether through the community infrastructure levy or section 106, to get long-term, sustainable investments. Currently, we see developers offer cash amounts based on a formula relating to the number of new dwellings being constructed. It is impossible to refuse applications on these grounds—that is a planning point. However, we need to ensure that the cash amounts made available to councils and the NHS for new facilities actually materialise, because the money is currently not following people and outcomes.

[Vicky Ford]

My right hon. Friend is absolutely right that the money for infrastructure that comes from developments needs to go to every sort of infrastructure that our households need. I was deeply shocked to learn that over the past four years, Chelmsford City Council, under Lib Dem leadership, has not allocated a single penny to the NHS. Indeed, neither of the two projects approved by the previous Conservative leadership—the Beaulieu Park and Sutherland Lodge medical centres—has moved forward under Lib Dem leadership. Does my right hon. Friend agree that that is shocking, and yet another reason why we need to take back Conservative control of Chelmsford City Council this May?

[Priti Patel]

I absolutely agree. If I remember rightly, both my right hon. Friend and I have been involved in meetings with one particular health provider, which I will not name but which was totally inadequate, about Sutherland Lodge and another practice in my constituency.

The situation is untenable and totally unsustainable. I have pressed this point many times, but I would really welcome the Minister’s working with Ministers in the Department for Levelling Up, Housing and Communities to secure those health contributions. It is a bone of contention—one that our constituents and their Members of Parliament are angry about. That Department used to be called the Ministry of Housing, Communities and Local Government. My constituency has been subject to proposals for a garden community on which millions of pounds were wasted, when money from central Government—from the old MHCLG—could have gone, via new homes, into our community to give us a health hub in Witham, which would have bolstered health services across the constituency and across Essex, because we are growing.

I have deliberately referenced many parts of the NHS and the challenges around health and wellbeing in the region. I hope that I have shown how interconnected many of these issues are; none of them sits in isolation. That speaks to a wider point raised in a previous debate. While the size of the state grows and grows, the lack of integration in our communities and at the grassroots is a sticking point. It is very challenging.

I thank colleagues for their contributions. Importantly, this is a real moment for the Government to start to integrate our statutory service delivery, not just through the integrated care boards, but across local councils, and hopefully drive better outcomes in health and wellbeing across Witham, Essex and the east of England.

--- Later in debate ---

[Priti Patel]

I thank you, Mr Hollobone, for chairing the debate, and all colleagues who have contributed today: my right hon. Friend the Member for Chelmsford (Vicky Ford), my hon. Friends the Members for South Norfolk (Mr Bacon) and for Clacton (Giles Watling), and the hon. Members for Strangford (Jim Shannon), for Bedford (Mohammad Yasin), for Enfield North (Feryal Clark) and for Cambridge (Daniel Zeichner). I want to reflect on the wide-ranging nature of the debate, including in my remarks. The NHS is enormous and covers a range of matters and the east of England is a very large part of the country. I thank the Minister for her comments, support and encouragement. The debate was very much premised on the “Levelling Up the East of England” report and the Government have to start addressing the fundamental disparities and issues.

I want to touch on a few points made by the Minister and a couple of other colleagues. It would be helpful to have some follow-up from other Ministers with direct responsibility. I mentioned the report on levelling up and there is more for the Department for Levelling Up, Housing and Communities to do in this space. Producing reports is one thing, but we have to drive outcomes. We want less centralisation and more integration. We have the ICBs, but a role for local government and specialist health providers is essential. The state cannot do everything. No disrespect to Labour colleagues, but if money were the answer, we would have all the best outcomes right now. There is no doubt about that. We have to have integration.

The hon. Member for Enfield North mentioned the fair funding formula. In the east of England, devolution is taking place in Norfolk and Suffolk. Cambridge has already gone through it. That could change outcomes tremendously through NHS integration and addressing the disparities that the report mentions. I want to emphasise the need for the Minister to go back to DLUHC and challenge it, because it needs to be on the hook for a lot of this. All colleagues in her Department have been helpful. I pay tribute to everyone in the NHS as well.

The hon. Member for Bedford touched on something very particular to me: the number of practitioners in the NHS, which we have raised in this Chamber before. Broomfield Hospital has told me that it is going overseas to recruit doctors and nurses. As a former Home Secretary who bolstered the NHS health and care visa, I think that we have to stand firm and stand by that as well as growing our own talent. We definitely need that in our medical hospitals as well. The NHS is becoming more and more blended, but we have to ensure that the skills are fit for purpose and meet the demographics of our local communities and our region, as well as the challenges of the report on levelling up health.

Every Member who has contributed to the debate, including the shadow Front-Bench spokesperson and the Minister, recognise the interconnectedness of driving outcomes, but there is a greater role to play at a local level. As a participant and an observer for 12 years as the Member of Parliament for Witham, I genuinely believe now that although the funding comes from the centre, the centre has to do much more to follow the money, people and outcomes. It is driving the outcomes that Ministers, the Department and central Government must be obsessed with, because there is too much of a lack of transparency and accountability. Given the billions of pounds that goes into the NHS, we in the Witham constituency in Essex and across the east of England are simply not seeing the outcomes that match the large sums of funding, so I hope that will change, and I hope we will be back in this Chamber—and the main Chamber —to keep pursuing this agenda across Government.

Question put and agreed to.

Resolved,

That this House has considered health and wellbeing services in the East of England.

Essex Mental Health Independent Inquiry

Priti Patel Excerpts

Tuesday 31st January 2023 Westminster Hall

[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.

[Priti Patel (Witham) (Con)]

I thank my hon. Friend for securing this debate and for her contribution. I also want to pay tribute to the families who are here today. We support the point she makes about a statutory inquiry. I want to thank the Minister for his engagement on that. Alongside that, does my hon. Friend have any thoughts on the role of an independent public advocate for family members? Perhaps the Minister could also comment on that. Their voices are simply not being heard. At the end of the day, we are here to represent them against institutional state failure. Duty of candour for stuff to come forward is important, but the time has now come for an independent public advocate for family members.

[Vicky Ford]

I thank my right hon. Friend for making that point. It is important that the voices of the families are heard. I am about to come on to the point that it is also important that the voices of the survivors are heard. Anything we can do to help to ensure that those voices are heard is vital. In calling for a statutory inquiry, I am not just supporting the calls of the bereaved families, but those of the group that I strongly feel has not, until now, been mentioned often enough. That is the group who, although they did not lose their lives, have been victims of appalling care: they are the survivors. That group also falls within the scope of the inquiry, which is investigating issues beyond in-patient deaths, including the management of self-harm and suicide attempts, sexual safety on the wards, the use of restraint and restrictive practices with in-patient units, medication practices and management, and various other issues, as outlined in the inquiry terms of reference, which were published in May 2021.

One of my constituents shared with me the testimony that she has given to the inquiry. She describes how during her time at the Linden Centre in the mid-2000s, she was raped by another patient, and when she asked for support, she was laughed at by staff members. She describes being able to make suicide attempts, including absconding from the ward and overdosing, as well as being able to ligature on the ward. She has told me of times when staff refused to treat her self-harm injuries and how she herself treated her own serious injuries and the injuries of others. She has also described to me how she was repeatedly restrained, often held on the floor by a number of staff, and forcibly injected.

This survivor reflected to me that she had hoped things might have changed in the years since she was an in-patient, but the recent “Dispatches” documentary suggests to her and many others that that is not the case. This is just one of the appalling stories shared by survivors of the horrific treatment they suffered while in the care of mental health services in Essex. This survivor is absolutely clear about the need to establish answers and uncover the truth of the situation to ensure that nobody else has to suffer the trauma she faced, which will live with her for the rest of her life. This survivor and others who have worked with the inquiry simply want to ensure that this never happens again.

Before Christmas, I spoke in the Chamber of the House of Commons about my own lived experience. I explained that it is very hard to talk about one’s own experiences of mental illness. It brings back all the horrors. The survivors who have shared their testimony are extraordinarily brave. I have asked what support is available for them, and I understand a contract is in place with Hertfordshire Partnership University NHS Foundation Trust, while psychological support is available to anyone involved in the inquiry. I understand also that some survivors might not be aware of that. EPUT has promised to publicise it, and I will ask the inquiry to ensure that it publicises it too.

Based on all that I have said, the words of the chair of the inquiry herself, and the devastating testimony of bereaved families and survivors, I believe that there is an urgent need to revisit the powers available to the inquiry and reconvene it on a statutory footing to ensure accountability and learning, and, most importantly, to embed long-lasting changes to safeguard lives in the future.