Oral Answers to Questions

Rachael Maskell Excerpts

Thursday 25th January 2024 Commons Chamber

[Ms Ghani]

The £28 billion that Labour is proposing has no plan behind it, and we are not told what hard workers across the country would have to pay to fill that black hole. Labour has asked for a transition to green steel. It would want us to protect steelworkers and obviously would want to protect advanced manufacturing in the UK. Customers want cleaner steel. Port Talbot could no longer function with its ageing blast furnaces, and our package will save 5,000 jobs at Port Talbot.

[Rachael Maskell (York Central) (Lab/Co-op)]

15. What steps she is taking to help support the growth of co-operatives and social enterprises.

[The Parliamentary Under-Secretary of State for Business and Trade (Kevin Hollinrake)]

This week, I spoke to a conference attended by building societies about how we can increase presence on the high street to help with access to cash and finance facilities. The Government provide extensive business support to all businesses, including social enterprises and co-operatives. The British Business Bank’s recovery loan scheme and start-up loans improve access to finance to help those kinds of businesses to invest and grow.

[Rachael Maskell]

Co-operatives and social enterprise businesses provide a fairer way of doing business, involve members in greater business decisions and provide economic growth for local areas. However, they are being held back by financial and regulatory constraints. Will the Government match the Labour party’s and the Co-operative party’s ambition of committing to address those challenges and doubling the size of the co-operatives sector?

[Kevin Hollinrake]

Personally, I am a big fan of co-operative movements and the regional mutual bank system in Germany, which I have spoken about many times in this place. Of course, the Government supported the Co-operatives, Mutuals and Friendly Societies Act 2023, which helps to maintain the status of co-operatives. Social enterprises and co-operatives can also access support via the business support helpline as well as help through our websites and our network of local growth hubs.

Horizon: Compensation and Convictions

Rachael Maskell Excerpts

Monday 8th January 2024 Commons Chamber

[Kevin Hollinrake]

I agree that accountability is key. I think it is fair to say that my Department has learned lessons on governance. I spend a lot of time meeting the Post Office and, indeed, the Government’s representative on the Post Office board, UK Government Investments, to make sure that we have proper oversight of this arm’s length body. My hon. Friend is probably referring to something wider than the Post Office—other arm’s length bodies—and he raises a very important point to which we should certainly give consideration.

[Rachael Maskell (York Central) (Lab/Co-op)]

I understand how complicated it is to calculate compensation for individuals. My constituent’s numbers disappeared off their screen as transactions were being put through. Will the Minister ensure that more resources are put into supporting the process so that compensation can be paid more expediently?

[Kevin Hollinrake]

The hon. Lady is absolutely right. These are complex matters, and there are two ends to the compensation journey. One is the compilation of a claim by the claimant, which may include legal advice and assessments of health conditions, for example, so it can take time to compile a claim.

Under the GLO scheme, which is the most recent scheme, we have committed to responding to 90% of claims within 40 days. We believe we have the right level of resources at our end to make sure we can respond fairly and quickly. The assessments are made on the compensation side by independent individuals and panels. We think it is a good process and we think it is resourced properly but, of course, we will continue to give it proper oversight.

Elderly and Vulnerable People: Loneliness and Isolation

Rachael Maskell Excerpts

Wednesday 6th December 2023 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to see you in the Chair, Mr Sharma. I congratulate the hon. Member for St Ives (Derek Thomas) on opening today’s debate and focusing on the digital economy.

We must remember that digital can be used as a positive, as well as a negative, and we need to focus. As we move at an even greater pace into a new age of AI and so many other technologies, we need to make sure that they work for everyone. The inequality that has been driven through the digital sphere has really shown itself, particularly among more marginalised groups.

It is a pleasure to follow the hon. Member for Westmorland and Lonsdale (Tim Farron), who focused on public services that have been withdrawn. Many of those services, such as post office and rail services, were once in public ownership, and the Government could drive the opportunities to enable connectivity. I think particularly of Royal Mail and the opportunities that we have there, if we see it not as a business, but as a public service that serves communities and checks in on individuals who are elderly or isolated; we know that would make a significant difference.

I thank the organisations that contribute so much, both locally in our communities and nationally. Age UK, the Marmalade Trust, the Jo Cox Foundation—it is a real pleasure to see my hon. Friend the Member for Batley and Spen (Kim Leadbeater) here—and the Red Cross do phenomenal work. My local community group, York Neighbours, helps with one-off projects, ensures that there are regular phone calls to individuals, and arranges connectivity groups and outings.

I take issue with the point that the hon. Member for St Ives made about needing a new national strategy. We have a very comprehensive national strategy. In fact, it is exhausting to read, because it covers every single Department in detail. We have that as a background, but the question is whether it delivers and meets the needs of people in our communities. I think we need to take a different approach, and to bring it into a public health framework. We should look at how we can deliver more locally. Ultimately, we can talk about grand plans, but this is about delivery. We have the structure; we know the problems; we have identified the need; we understand the causes; and we have definitions. We need to move beyond that now.

[Kim Leadbeater (Batley and Spen) (Lab)]

I thank my hon. Friend for giving way and for securing this important debate. Does she agree that we have achieved a great deal in this place on the issue of loneliness and, crucially, that that has been on a cross-party basis? I am extremely proud of the work of the Jo Cox Commission on Loneliness, which resulted in the world’s first Minister for loneliness, my good friend the hon. Member for Chatham and Aylesford (Tracey Crouch), and the first cross-Government loneliness strategy, which my hon. Friend referred to. Does she agree that, whoever forms the next Government, we must ensure that this issue is kept firmly on the agenda? We need to ensure that it is embedded in all Departments and across all sectors. My hon. Friend rightly paid tribute to the voluntary sector, which does a lot of the heavy lifting around loneliness, but every sector has a role to play. Will she also join me, as I hope everybody else in the House will, at the Tackling Loneliness Together festive fair at 2 pm next Monday in the Attlee Suite?

[Rachael Maskell]

I am grateful to my hon. Friend, who never misses an opportunity. I pay tribute not only to the incredible work she does in this place, but to Jo, who put this agenda on all our radars and did a phenomenal piece of work in raising its importance.

Another major point I want to make is about the interventions that we need—I have been reading a speech I made in this place two and a half years ago, and it feels like we have not moved the framework forward since that time. Recently, in the Health and Social Care Committee, we had some incredible witnesses, who talked about dealing with suicide among men, although there is a lot of cut-across and move-across. I was struck by a piece of data we were given showing that 45% of males who take their own lives live alone. That really brings out the pain and the isolation. People have not asked questions, so others are left very much in the margins.

Young people are now the group who experience the most loneliness in our society. What are schools doing to intervene and ensure that there is good socialisation? Children are so stressed at the moment because they are having to meet the requirements set down by the state, but are they confident individuals who can make social connections? How do we facilitate that to help them to navigate the ever more complex world in which they are growing up?

What about the GP and every other connection, such as the Department for Work and Pensions, for those who need support—not least the disabled people in our communities? What about local authorities? If a question was asked in every interaction to find out whether people were experiencing loneliness or isolation, we could start to put strategies in place to address those needs.

There is a real need to look at statutory services and to ask how we can build a framework, but also to look at what is happening across society. As we get older, these issues get more difficult. As we have heard, there are 7.8 million people on waiting lists. People are frailer and they get more withdrawn and isolated from communities and society, so it is harder and takes more effort to make those connections. It is important that we really look into that to find out not only the scale of what is happening locally and to ask those difficult questions, but to provide the necessary services, and particularly youth services. There used to be luncheon clubs for older people, but they have just gone. The funding crisis in local authorities is making things even more difficult, so my third request is that we invest in a public health strategy that enables pilot projects to move forward and to make those connections once again.

Draft Code of Practice on Reasonable Steps to be taken by a Trade Union (Minimum Service Levels)

Rachael Maskell Excerpts

Monday 27th November 2023 General Committees

[Kevin Hollinrake]

We did not think it necessary to develop a statutory code of practice for employers, but we are producing guidance for employers on how they can comply with their regulations and engage with their workforce in such situations.

To comply with section 234E of the 1992 Act, which was inserted by the 2023 Act, trade unions should take reasonable steps to ensure that their members who are identified in a work notice comply with that notice and do not take strike action during the periods in which the work notice requires them to work.

[Rachael Maskell (York Central) (Lab/Co-op)]

How will the employer be compliant with GDPR requirements in a multi-union environment where lists will be going to different unions and where the employer itself will not know which unions individuals belong to? How will the Minister ensure that the names of employees will not go to unions that do not organise those particular workers?

[Kevin Hollinrake]

The hon. Lady may be confusing two things. The employer and the unions both have a legitimate interest in the individual they are speaking to. The employer must speak to their workforce, and I am sure the unions will speak to their members. But this is all set out in both the statutory code of practice and guidance for employers. She will see more when she sees the guidance for employers.

[Rachael Maskell]

I am specifically talking about a multi-union environment. Where a number of trade unions are involved, how will the Minister ensure that GDPR requirements are met?

[Kevin Hollinrake]

It is not my responsibility to make sure that GDPR requirements are met.

[Rachael Maskell]

They can’t be!

--- Later in debate ---

[Chris Stephens]

That may very well be the case. The hon. Member makes an eloquent point.

[Rachael Maskell]

Every single day this Government are in office, they are unable to maintain minimum service levels across a vast array of our public services, so why does the hon. Gentleman think they are requiring more workers to attend work on strike days than the rest of the year?

[Chris Stephens]

That is a magnificent point. This has been debated on various occasions on which we have asked the Government—perhaps the Minister will rise to his feet; I will take his intervention right now—why minimum service levels are necessary on industrial action days, but not at any other time. If there were statutory guidance and a code of practice for employers, one would certainly ask the question: would employers demand that there be more workers on shift on days of industrial action than on a normal working day? The Minister knows this, because it has been raised consistently when we discuss these things that employers are always at it.

I was a proud trade union activist. I refer to my entry in the Register of Members’ Financial Interests: I am a proud member of the Glasgow city branch of Unison. We had to negotiate life-and-limb cover for strike days—yes, the legislation sets out that there has to be life-and-limb cover—and employers would ask for more people on shift on days of industrial action than on normal working days. I will take an intervention right now if the Minister can give us an assurance that no employer across these islands will ask more workers to be at work on days of industrial action than on normal working days. I am more than happy to take an intervention from the Minister right now.

I note for the record that the Minister has not risen to his feet.

Since the passage of the anti-strike Act, there have been suggestions that the Act’s provisions on minimum service levels would be similar to the norms of Europe. Well, no, they are not. I will not repeat all the clarifications that I and others have offered on what actually happens in Europe, as those fell on deaf ears. I will, however, repeat our warnings that this nasty legislation will prove to be severely counterproductive and damaging overall to society. Taking a negotiated, voluntary and successful approach to minimal service levels and mutating it into an imposed, coercive and ultimately failed system is very foolish, but it is unsurprising from those who choose not to listen or learn.

Let me comment in detail on one sector in particular: the health sector. I will do so by referring extensively to the TUC’s consultation response on minimum service levels for hospital services. I will also refer to the views of the British Medical Association and the Royal College of Nursing.

The TUC believes that the Act

“is unfair, undemocratic and likely in breach of our international legal commitments.”

Its view is that it is

“the fundamental right of a worker to take industrial action to defend their pay and conditions”

and that

“secretaries of state are to be given enormous power to define and introduce minimum service requirements”.

It says the Act is

“draconian: it could lead to individual workers being sacked for taking part in industrial action that was supported in a democratic process”,

with trade unions facing large damages if deemed to be non-compliant with this code of practice. Perhaps the Minister will answer the question with which he was challenged by the shadow Minister, the hon. Member for Ellesmere Port and Neston. The Minister was quoted as saying that no one would be dismissed as a result of this legislation, but where does it say that?

According to the TUC, the Act is “unnecessary”—it is “custom and practice” to agree “life-and-limb cover”—and “counter-productive”. That, however, is not the view of only the TUC, which points out that the Government’s own impact assessment suggests that

“industrial disputes are likely to become more protracted and prolonged as a result of introducing minimum service levels”.

In summary, the TUC believes the approach is unacceptable, anti-democratic, draconian and, ultimately, both unnecessary and counterproductive.

Given the purpose of this Delegated Legislation Committee, a further quote from the TUC might prove to be the undoing of the code of practice:

“Given the fact that the services subject to MSLs are to be determined by Secondary Legislation, there remains a number of uncertainties around (a) the extent to which the policy would restrict the right to strike, (b) the relationship between the ability to strike and the strength of workers’ ability to bargain on terms and conditions of employment through collective bargaining, and (c) the value workers place on collective bargaining relating to terms and conditions of employment.”

Those comments are also derived from the Government’s impact assessment.

Conservative Members may simply choose to disregard the findings of such an impact assessment. They would find interesting backers in doing so, as the Government’s own Regulatory Policy Committee judged the impact assessment of the Act

“red-rated as not fit-for-purpose”,

and found that the Government make

“use of assumptions in the analysis which are not supported by evidence”—

here is us thinking that the Boris Johnson days were gone. There are other, less parliamentary ways to describe making use of assumptions that are not supported by the evidence, which I will leave to the imagination of Members.

Let us now explore the views of the British Medical Association and the Royal College of Nursing. Agreement among health sector unions is clear, as the BMA also considers the proposals for minimum strike levels to be

“counterproductive, undemocratic, unworkable, and draconian”.

The legislation seems to be little more than a smokescreen. Instead of addressing the state of the NHS, which currently compromises patient safety on a daily basis, or the underlying reasons why doctors and other healthcare staff have been striking in some parts of the UK, if not in others, the Government are trying to paint healthcare workers as the villains of the piece, rather than the victims of governmental action and inaction. I specifically mention striking “in some parts of the UK,” because a different and more respectful approach to public service employees in Scotland has resulted in something closer to industrial harmony. Perhaps others should watch and learn from what the Scottish Government are achieving in public sector relations.

Throughout these islands, a long-standing history of constructive joint working between NHS employers and trade unions at a local level has patient safety at its heart. The introduction of minimum service levels in hospitals would poison those industrial relations. It would replace a system under which those who understand the local situation tailor their response to the needs of hospital service users with a national service level mandated from Whitehall and designed by those who arrogantly assume that they know better.

Although the Government’s consultation seemed to find that several critical incidents arose due to strike action, data from a freedom of information request suggests otherwise. It is unclear whether any were a direct result of action being called. Rather than demonstrating that patient safety was compromised due to industrial action, the data shows the importance of tackling the stresses that the NHS faces on a daily basis.

The BMA has repeatedly raised concerns that the “reasonable steps” that unions would be required to take to comply with the Act would force unions to act in a way that undermines their responsibility to represent their members. It is not “reasonable” to expect unions to take any steps that would undermine legitimate strike action, for which they will have passed a high threshold to have a lawful mandate under trade union legislation.

--- Later in debate ---

[Rachael Maskell]

Thank you, Ms Nokes; I will keep my comments incredibly short. I refer to my declaration in the Register of Members’ Financial Interests.

I am completely shocked and baffled as to why the Minister has brought forward these provisions today when he does not even understand the context of the impact that this will have on a multi-union workplace and the breaches of the GDPR that the employer will be subject to in sharing sensitive information about their employees with different trade unions. They will be able then to identify the people who are members of other trade unions. Therefore there will be a complete breach, which will clearly be challengeable in the courts. [Interruption.] The Minister shakes his head, but that will be the consequence.

I am also completely baffled in relation to the timetable. When it comes to balloting for industrial action, it takes months to organise an industrial action ballot. We are talking about complex public sector ballots on the whole. As a result, it is important to get the information accurate and permissible under the law. However, an anti-union employer will have only four days in which to provide the information to a trade union, and then it will be a case of cross-matching, getting a notice out by post, because obviously the union does not need to collect information on the email addresses of its members, and then giving the notification. It is an employer who has the responsibility for whether a worker goes to work or not. I say to the Minister that that obligation should not be placed on trade unions.

The Minister has not said what will happen to the worker’s protection if the worker does not receive the notice, and whether their protections will be removed and, as a result, they could end up with a dismissal, with no right of restitution at all. It is really important that the Minister brings clarity as to what will happen in those circumstances and, indeed, what will happen to the trade union if it makes efforts to comply with the legislation but is unable to do so because of the format and the way the data is provided. The Minister makes a lot of assumptions that the employer knows their workforces and who will be taking industrial action or not. I have to inform him that that is often not the case in these complex industrial environments.

The Minister is above this. I think the fact that he has brought this measure forward today just shows that he has not taken the time to understand the way industrial action ballots actually work and the consequences of this legislation.

World Sepsis Day

Rachael Maskell Excerpts

Wednesday 13th September 2023 Westminster Hall

[Christina Rees]

I agree with the hon. Gentleman. He must have seen my speech, because he has quoted some of the stats that I am going to come on to later.

What is sepsis? It is a life-threatening condition that arises when the body’s response to infection causes injury to its tissues and organs. It is a global health concern, but today I will focus on its prevalence, the challenges and some potential solutions in the UK. Sepsis is indiscriminate. While it primarily affects very young children and older adults and is more common in people with underlying health conditions, it can readily occur in those who are otherwise fit and healthy.

Sepsis can be triggered by an infection, including chest and urinary tract infections. It is not known why some people develop sepsis in response to those common infections whereas others do not. Sepsis is often referred to as “the silent killer” because of its ability to strike swiftly and unexpectedly. In the UK, sepsis is a significant public health problem. Each year around 240,000 cases are reported, leading to more than 48,000 deaths.

Sepsis is the leading cause of avoidable death in the UK, claiming more lives than breast, bowel and prostate cancer combined. Unlike data for heart attacks, strokes and cancer, sepsis data is imprecise, because it relies on coded administrative data rather than the granular clinical data of patient-level registries. Moreover, this striking deficit means that not only do we find it necessary to estimate the burden of disease, but we are decades away from precision medicine for sepsis. However, therein lies a paradox, as the UK’s unique healthcare infrastructure means that we are well placed to change that for the world.

Around 40% of people who develop sepsis are estimated to suffer physical, cognitive and/or psychological after-effects. For most people, those will only last a few weeks, but others can face a long road to recovery and develop post-sepsis syndrome. One of the biggest challenges in tackling sepsis is early diagnosis. Sepsis can mimic other common illnesses, making it difficult to spot in its early stages. Symptoms such as fever, increased heart rate, rapid breathing, confusion and extreme pain can be attributed to various conditions. This leads to delayed treatment, which significantly worsens the patient’s chance of survival.

To combat sepsis effectively, awareness is the key. The UK and devolved Governments, healthcare professionals, and organisations such as the UK Sepsis Trust have been working tirelessly to educate the public and healthcare providers about the signs and symptoms of sepsis. Public awareness campaigns and training for healthcare workers have been instrumental in improving early detection. Timely intervention is crucial in sepsis management. The UK Sepsis Trust’s “Sepsis 6” care bundle and treatment pathway includes administering antibiotics, providing fluids and monitoring vital signs, and has been implemented in 96% of hospitals across the UK and in 37 other countries worldwide to ensure rapid and effective treatment. Early recognition and swift action can save lives and reduce the severity of sepsis-related complications, but despite such work, there remain many cases of avoidable death every year.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to my hon. Friend for securing today’s debate, and for the very powerful speech she is making. My constituent, a teenager, tragically lost his life. Not only did he display so many signs, his parents were screaming for help, but those calls for help—for further investigation and better treatment and management—were just not heeded. Does my hon. Friend agree that it is now crucial that we introduce Martha’s law, so that parents can be granted a second opinion when they ask for one, in order to save lives?

[Christina Rees]

I am very grateful for my hon. Friend’s intervention. I think she must have been looking over my shoulder, because I am just about to come on to Martha’s law. As always, her timing is impeccable.

Over the past couple of weeks, significant media attention has been given to the tragic case of Martha Mills, who died of sepsis aged 13. Martha’s grieving parents have advocated for the establishment of Martha’s rule, which would empower patients to request an immediate second opinion if they feel that their medical concerns are not being addressed adequately. Other preventable deaths include UK Sepsis Trust ambassador Melissa Mead’s son William. The then Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), apologised to William’s family after a report found that clinicians missed four opportunities to save his life, and to Jason Watkins, who lost his daughter Maude when she was only two and a half years old.

In order to end these preventable deaths, parents need to feel empowered to advocate for their child—to just ask, “Could it be sepsis?”—and clinicians must be given clear guidance on the appropriate care pathway in cases of suspected sepsis. At the moment, there is room for improvement on the clinical side, because of the confusion created by delays in updating the National Institute for Health and Care Excellence clinical sepsis guideline, NICE guideline 51. In addition, research plays a pivotal role in understanding sepsis better and developing more effective treatments. The UK has a rich history of medical research, and ongoing studies are dedicated to improving our understanding of sepsis. Advances in genomics, microbiology and immunology are shedding light on the complexities of sepsis, paving the way for innovative therapies. Technology is also proving to be a game-changer in the fight against sepsis, with AI-powered algorithms being used to interpret patient data and identify sepsis risk factors early on.

The UK Sepsis Trust is a charity founded by an NHS consultant, Dr Ron Daniels BEM, in 2012. It has led the fight against sepsis after Ron witnessed the tragic and preventable death of Jem Abbots, a 37-year-old father of two. The UK Sepsis Trust aims to end preventable deaths from sepsis and improve outcomes for sepsis survivors. It also strives to raise public awareness of sepsis and works to support anyone affected by this devastating condition with its free, nurse-led support service. It raises awareness by educating healthcare professionals and by instigating political change.

The UK Sepsis Trust aims to protect people by enabling the prevention of severe infection and the treatment of sepsis, while helping to ensure that antibiotics are used responsibly. Its clinical tools are used by healthcare professionals across the country and have been formally endorsed by NICE.

The trust contributed to feedback on a draft update to the NICE clinical sepsis guideline—NG51—in March this year. The final version was due to be released in June, following a request by NHS England to update it in the wake of a statement from the Academy of Medical Royal Colleges about the timing of using antibiotics. However, the publication was pulled at the last minute without any obvious reason. The result is that we are left with a NICE guideline from 2016 that conflicts with the position statement from the Academy of Medical Royal Colleges. This has caused confusion among clinicians, which could lead to patient harm.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I start by thanking the hon. Member for Neath (Christina Rees) for introducing this important debate, which is taking place on World Sepsis Day; for her work as chair of the all-party parliamentary group; and especially for her tribute to Dame Cheryl Gillan, who did so much work in this space. I am sure that Dame Cheryl would have been delighted by the way the all-party parliamentary group has been taken forward under the leadership of the hon. Lady.

I was touched by how she shared her personal experience of sepsis because I think that will highlight to people listening or watching how difficult it sometimes is to diagnose sepsis and the very many circumstances in which sepsis can present. Sepsis is a devastating condition and, while many people who develop sepsis survive, every death is tragic. Patients rightly expect it to be recognised and treated promptly because very often they are feeling so poorly that they are not necessarily in a position to raise concerns themselves. Even as the hon. Member for Neath pointed out, just becoming unwell with sepsis has long-term consequences and it can take many months to recover from an episode. She put that extremely eloquently.

The many interventions have moved us all. Many of us will know people who have become worryingly ill or have died from sepsis. It is especially heartbreaking when the family of someone who has died from sepsis feel that more could have been done to save them. Those cases are hard to hear, but it is important for us to listen and learn at all levels of Government, from officials through to frontline clinical staff.

As has been mentioned, we have all been moved to hear about Martha Mills who was 13 when she tragically died from sepsis despite concerns being raised by her family about her care. On what would have been Martha’s 16th birthday last week, her mother spoke about her death and the need for patients and families to be listened to when they think that something is wrong. I echo the words of the hon. Member for Neath. We need to encourage more people to ask that question: could it be sepsis?

I am pleased to add my support to the announcement made by the Health Secretary that the NHS will be exploring the introduction of Martha’s rule in the United Kingdom. The Secretary of State is meeting Martha’s family later today and is looking at how this could be implemented. I am sure he will be updating the House and I am happy to update Members on the follow-up from that meeting and the work that is being done to look at this.

We anticipate that Martha’s rule will be similar to a system in Queensland, Australia, known as Ryan’s rule, which is a three-step process allowing patients and families to request a clinical review of a patient’s condition if they are deteriorating. Such a system would build on initiatives already being tested in the UK, including the Call 4 Concern scheme introduced in the Royal Berkshire Hospital. Evidence from the scheme suggests that patients and their families find it useful, and that it can make a real difference in outcomes for patient care.

[Rachael Maskell]

In the light of the fact that people suffering from sepsis can rapidly deteriorate, will the Minister ensure that a review of a patient could also be undertaken really quickly, without it becoming a bureaucratic process?

[Maria Caulfield]

Absolutely. That is the point: if families want a review, it needs to be done as quickly as possible. If we are going to look at Martha’s law, those processes will need to be looked at. It must not become bureaucratic to make a request. It must be a really practical process that makes a difference.

Sepsis is not a single disease and it cannot be diagnosed with a single test. It varies in presentation depending on the source of infection and the individual. I pay tribute to the UK Sepsis Trust, which today has reiterated the signs and symptoms for people to look out for, including: fatigue; not passing urine; breathlessness; skin being discoloured, which is particularly important for ethnically diverse communities, because the skin colour may be different in different communities; fits and shakes; confusion; and shivers. All those symptoms are signs of potential sepsis, so it is really important that people understand to look out for them. We will never fully eliminate the risk of sepsis or other forms of acute deterioration, but we must do everything we can to ensure that clinicians and other NHS staff working on the frontline can recognise a very sick patient.

As many Members know, 100% of ambulance trusts and 99% of acute trusts in England screen for sepsis using the national early warning score or NEW score, which is carried out in clinical care. Following recommendations from the Academy of Medical Royal Colleges and the National Institute of Health and Care Excellence, we are working to update national guidance on sepsis. I very much take the point made by the hon. Member for Neath about the importance of ensuring that that information is all in step and aligned with guidance across the board, so that there is one clear narrative about recognition of sepsis and the targeted use of appropriate treatment.

Research is key to improving outcomes the detection of sepsis and finding more effective treatments. We are committed to driving the evidence base to improve our understanding, and the Department is providing funding of over £1 billion a year through the National Institute of Health and Care Research to drive forward research studies in these areas. Since 2017, the national institute has funded 14 research projects on sepsis, with a combined total funding value of £27 million, but further applications will be welcomed, so if there people out there want to undertake research studies, please encourage them to come forward and put in applications.

It is important that I touch on antimicrobial resistance, as the issue is inextricably linked to sepsis. It is critical that we conserve our antibiotics so that if an infection occurs, they remain as effective as possible when they are really needed, including for sepsis. In line with the asks of the declaration, the Government are delivering a five-year national action plan and a 20-year vision to contain and control antimicrobial resistance by 2040.

I am pleased to say that we are working collectively, across the UK, with our counterparts in Northern Ireland, Scotland and Wales on that antimicrobial resistance national action plan. Hon. Members have touched on international collaboration, because no country or Government can tackle this issue alone. A study published last year by the Global Research on Antimicrobial Resistance Project shows that resistance was associated with the deaths of 4.95 million people worldwide, and many of those cases will be because of sepsis related to antimicrobial resistance. By working together with international partners, we can protect ourselves and help to treat sepsis more quickly and easily.

World Sepsis Day is an important reminder that there is more work to be done. In recognition of that and as a reminder of the importance of the issue, the Department is lit up in pink today. Once again, I thank the hon. Member for Neath. I am happy to meet her and anyone she wants to bring with her, because there is still work to be done. We have made great progress, and she is touched on work that is being done, including on Martha’s rule, but I am happy to meet her and the APPG to ensure that, by next World Sepsis Day, we have made further progress with this significant condition.

Question put and agreed to.

Non-disclosure Agreements in the Workplace

Rachael Maskell Excerpts

Tuesday 5th September 2023 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under your leadership, Ms Ali. I congratulate the right hon. Member for Basingstoke (Dame Maria Miller) on eloquently opening the debate and making all the pertinent points as to why NDAs should be outlawed. It is very evident from what we have heard so far how they are used to hide discrimination and bad practice in the workplace. That is why I fully support her proposal and all the comments made across the Floor today.

I think we have learned, particularly in the last week, that creating secrecy in the workplace creates closed cultures and they can be incredibly dangerous environments. We heard yesterday in a debate in the main Chamber about seven consultants who blew the whistle. It would have been so easy to have silenced them with an NDA, and we have seen that right across the NHS. I will bring to this debate my experience from the health service, but also as a trade union official for many years, as to how NDAs have been used to silence people who are raising a concern and trying to speak truth to power, because ultimately this is all about power and control, and therefore we need to ensure that justice can be served in every environment and particularly in the workplace. We know that many people forced to sign NDAs are being forced out of organisations because they have had the nerve to raise concerns about what they have seen around them in order to make the work environment safer for themselves and others. They have shared those observations to see improvements in their organisation. It is not vexatious to raise concerns; it is the right thing to do and it should be encouraged. Not having laws to protect those individuals exposes them and brings about further risk.

As the Minister will know, I am bringing forward a Bill about bullying in the workplace and the cultures developed there—cultures of secrecy and of bad conduct and behaviour. There is certainly much to be done. Those people who experience the signing of an NDA are seeing a slamming of the door on not only their career but often their lives, leading to serious mental health challenges for many years. They have to live with the injustice they have been served for what is often a small sum of money to pay them off and buy that silence. We have to create open work places where we can have honesty, and raise concerns and see them resolved. Without that, we will enforce the negative cultures that we see in work practices today.

I refer to my entry in the Register of Members’ Interests—I should have said that earlier. When I was a union official, I saw many times how compromise agreements were a cheap option to try to buy people off, to move an issue sideways and to protect the perpetrator in the workplace. Even if people brought a case to an employment tribunal, a COT3 agreement would often be signed to bring a case to a conclusion. We have to look at that within the system as well. The purpose of such agreements is merely to shut down debate and move on, leaving a legacy for other people—the discrimination, poor conduct, assaults, harassment or discrimination that have already been experienced.

We should create an open culture so that no one fears raising concerns and people know they are working in a safe environment. A closed environment, as we have known in many contexts, is an unsafe environment. What we are discussing would make workplaces safer for everyone, not least those people who have experienced the most pernicious assaults as a result of the NDA process.

I look at what has happened across University Hospital Birmingham, where silence has been bought off individuals, and at the mental health trusts. There are questions across the piece at the moment about what is going on in those organisations, which are often very closed cultures in themselves. When concern is raised, individuals are invariably on sick leave as a result of the response that they get, and then they are bought—told that they cannot return, or their sickness brings them to that point. When someone is so weak and powerless because of what the organisation has done to their voice and agency, they will take a little scrap to try and rebuild and move forward.

Whether it is in healthcare, local government—we know it happens there—education or the police and justice system, we know that the issue is pretty prevalent. I ask the Minister: where is the data and the scrutiny over what is happening? Do we know the reasons why all those NDAs have been signed? Do we know the numbers in every sector? Do we know which employers are the perpetrators issuing NDAs? We need the data to legislate and to understand, but also to call out those employers using NDAs as part of their suite of employment policies. I also ask the Minister to dig deep into all sectors—not only the private sector, but the charitable sector and what goes on there. Some of the statistics may well surprise him.

We have to understand that the issue is about the impact on individuals as well as organisations. The right hon. Member for Basingstoke made a powerful point about the cost to organisations of being able to mismanage their staff in such a catastrophic way, but we also have to realise that that has an impact on not only the individual but their colleagues as well. Ultimately, it silences them, because they know what is coming next: their job will be on the line, and they will be managed out of the organisation one way or another.

This closed-culture mentality must be prised open by the Government and we must do everything we can. We are in a space where organisations fear the reputational damage and fear what is happening at the moment. Let us get the data and the legislation in place to ensure that we are not only tackling poor conduct but advancing good conduct in the workplace, so that every worker can be safe.

[Several hon. Members rose—]

Strikes (Minimum Service Levels) Bill

Rachael Maskell Excerpts

Consideration of Lords message
Monday 17th July 2023 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

Will the Minister spell out exactly how trade unions are to comply with and enforce a code that is outwith their jurisdictions in making workers go into work?

[Kevin Hollinrake]

The code of practice will be consulted on so that all parties are clear about what the obligations of the unions will be. We expect them to be quite straightforward. They have been debated at length, along with various ideas about how this might operate.

[Rachael Maskell]

rose—

[Kevin Hollinrake]

I want to end my speech shortly, but I will give the hon. Lady one last chance to intervene.

[Rachael Maskell]

As has been pointed out on numerous occasions, the measures that the Minister is trying to introduce are outside the jurisdictions of trade unions, which therefore do not have the powers to implement them.

[Kevin Hollinrake]

As I have said, we intend to consult with all parties to make sure that they have a chance to comment on what reasonable obligations a union might be required to take. I think that it is pretty straightforward, and, indeed, unions will be familiar with the code of practice on picketing that was issued under section 203 of the 1992 Act. This code will be subject to statutory consultation, including consultation with ACAS, and to the approval of Parliament. The consultation will give trade unions, employers and any other interested parties an opportunity to contribute to practical guidance on the steps that a union must take in order to make it as practicable, durable and effective as possible.

--- Later in debate ---

[Justin Madders]

That is a very good question. My understanding—no doubt the Minister can correct me if I am wrong—is that it is still up to the employer to determine what work notices it issues, which makes the Bill a little ludicrous.

All these consultation papers, all these impact assessments, and we are still legislating in the dark.

[Rachael Maskell]

My hon. Friend has just made a valid point, because when NHS Employers and the NHS Confederation came before the Select Committee on Health and Social Care, they said that they did not want any of this legislation. Presumably, following that logic, they will not have to issue minimum service level terms for a strike.

[Justin Madders]

I thank my hon. Friend for her intervention. That is why it would have been so interesting to see what the consultation responses were to the draft regulations, because those might have told us whether employers were saying, “Don’t do this; we don’t think it is going to work.” We know that a long list of employers’ organisations are opposed to this Bill, and I will come on to that in a moment. They understand that, ultimately, it is not going to help industrial relations but will sour them.

In summary, the Bill’s impact assessment turns up late and is inadequate; no pre-legislative scrutiny or evidence sessions for the Bill took place; the Committee stage is rushed through in one day; and subsequent consultations are incomplete and leave many questions unanswered. Yet the Government still say that this Lords amendment is not necessary. The evidence to date and the opinion of the ILO say otherwise. I referred to the fact that the ILO is not alone in expressing concerns about the Bill. Many organisations have expressed alarm, including the Equality and Human Rights Commission, the Joint Committee on Human Rights, NHS Providers, the rail industry, the Chartered Institute of Personnel and Development, the TUC, and the Welsh and Scottish Governments. The Transport Secretary and the Education Secretary have also done so, and I could give more names, but I have only an hour for this debate and so I will leave it there.

When we have the shameful spectacle of the ILO calling this Bill out, Members need to think again. By rejecting this Lords amendment, the Government are, in effect, saying one of two things: either they do not know whether they break international law; or they do know but they just do not care. We ought to care, we ought not to be trailing behind in workplace protections, and we ought not to be mentioned in the same breath as Turkmenistan. We ought to be leading from the front, as an exemplar for other countries to follow and a leader on the international stage that says, “Yes, good workplace rights and strong trade unions are a key component in any prospering modem economy, and the right to withdraw your labour is a fundamental one.” However, this Bill is the hallmark of a weak Government who have run out of steam, have nothing left to offer but division and want to silence the very people who keep this country going—shame on them.

Local Radio: BBC Proposals

Rachael Maskell Excerpts

Thursday 22nd June 2023 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

I, too, congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) on securing this debate.

Having engaged with constituents and those impacted by the change who have been supported by their trade union, the NUJ, and having met regional and national management, my clear conclusion is that BBC local management has failed in the process and in the decision. It has failed to consult and it has been insensitive to listeners and staff—this shameful episode has left them ignored and hurt. The BBC must apologise. All this for the sake of less than £200,000 across the whole of North Yorkshire—25p per person, or tuppence a month. The BBC could more than fund that from its licence fee. If the BBC saw itself as social prescribing—which it is—that would be value for money. However, licence fee payers have never been asked. I say to the BBC, “Never forget who you are there for.” I say to Ofcom, “Do your job.”

In writing to the BBC, Ofcom highlighted that over-65s would be impacted the most. Why is that okay? It is not. The House clearly believes that older members of our communities—the frailest and the most isolated—matter, although I have to say that the Government have not helped by taking away free licences for older people. Ofcom went on to say,

“We question how shared programming which will cover such large areas will still be relevant to audiences.”

Ofcom has to act. It is not a bystander but a regulator. With more people becoming isolated and 9 million people experiencing loneliness, having a friend—that reliable voice just down the road—matters. My goodness, it matters. Through covid, we learned what many people live through every day of their lives. That local connection is the thing that makes us belong. It gives us value, identity and hope. That has now been stolen.

This debate it is not just about community interest. Power, politics and decision making are shifting away from the Westminster bubble to local areas: not to Yorkshire, but to North Yorkshire, South Yorkshire, West Yorkshire—each one distinct. The new area will cover a distance of 150 miles. That is the length of a quarter of the country, so do not tell me that that is local. Digitalisation is all about diversification, not centralisation. The BBC local teams around the country understand that, because they are not in the London BBC bubble but integrated and immersed in our communities with their listeners. Well BBC, today we are here to speak up for our communities, so stop laughing at us and start listening.

In writing to the BBC, Ofcom expected the

“BBC to review the impact of its changes to local radio in England as they are implemented to ensure they are meeting audience needs”.

How can it do that if it is not talking to its audiences—audiences who are never consulted and never included? There is no baseline. In 2011, BBC local failed to consult its audiences on its “Delivering Quality First” proposals. However, it was ordered to and it must be ordered to again.

As for the presenters, many are very experienced, at the top of their profession and choose to remain in local radio because they care more about journalism, their communities and telling real stories than following the circus in Westminster or climbing the tree in London. They have been put to the test. The process determined that those journalists had to make demo tapes and talk about themselves. How utterly humiliating. Some just walked and we lost brilliant people from BBC Radio York’s family, notably Jonathan Cowap and Adam Tomlinson. I pay tribute to them today and trust that they will be back once this charade is behind us. Whoever thought up such a crass, insensitive process has no idea how to run a people-centred service. It is not a gameshow; this is about livelihoods and careers. It is not good enough for the BBC to just press on. It has got to stop.

The BBC breaches its responsibilities, ignores its listeners and insults its employees. With a 93% loss of confidence in the director general, it is seriously time for those responsible for this fiasco to consider their future. I say to Ofcom, “Do your job”; to the BBC, “Sort this out”; to the Government, “Act”; and to all who work in BBC local in York and beyond, “Solidarity”.

Strikes (Minimum Service Levels) Bill

Rachael Maskell Excerpts

Consideration of Lords message
Wednesday 21st June 2023 Commons Chamber

[Kevin Hollinrake]

If there is anybody whom the hon. Gentleman thinks was not able to contribute to the consultation, I ask him to please let me know, but it was open to anybody to make a submission to the consultation, and all those submissions will be properly assessed by Ministers and officials.

I turn now to the Lords amendments that would restrict the ways in which we can ensure that minimum service levels are achieved, Lords amendment 4B still leaves employers powerless to manage instances of non-compliance when workers strike contrary to being named on a work notice.

[Rachael Maskell (York Central) (Lab/Co-op)]

Could the Minister set out the timescale for the consultation and how he intends to carry it out?

[Kevin Hollinrake]

As the hon. Lady may know, our initial consultations closed around the middle of May—9 May to 11 May. Those submissions will now be considered, and we will report back to the House accordingly.

--- Later in debate ---

[Rachael Maskell]

I should refer to my entry in the Register of Members’ Financial Interests.

My hon. Friend makes a very good point about the jurisdiction of trade unions. I have said this in the House before, but Government Members just do not seem to understand it. It is the members of the trade union who determine what happens within a trade union—it is not a general secretary or even an executive, but the members—so how are they, as individual members, going to instruct workers to attend work?

[Justin Madders]

That is really a question for the Minister, and one that I think the Government have failed to answer adequately. I think the point my hon. Friend makes is a good one. When Conservative Members traduce the union barons, they actually traduce every single member of the trade union who has voted in support of industrial action, and I am afraid that that is no way for any Government to operate.

I would ask Conservative Members, not that there are many here, to consider what the Bill actually means. Representatives of trade unions will be required to encourage, cajole, advise, pressurise or even demand that their members cross a picket line. They will be asking trade unions to actively go against the very thing they were set up to do. I would say that it is a bit like asking a Conservative MP to vote in support of higher taxes, but I guess that, with the highest tax burden in over half a century, we may have to drop that particular analogy.

--- Later in debate ---

[Chris Stephens]

I, too, refer the House to my entry in the Register of Members’ Financial Interests. In opening the debate, the Minister skirted round amendment 4B and just said that the Government were opposed to it. A number of us intervened at the time, but I really do think that he needs to consider the Government’s position carefully, particularly on that amendment, because it gets to the heart of the Bill and why so many of us are expressing concerns about the attacks on natural justice and on human rights.

Lords amendment 4B asks that employees receive a work notice in good time. It seems fairly uncontroversial that a work notice should be issued to a worker in good time if they are to attend their work. If we do not accept the amendment, we will end up with a scenario where someone returns to work after a day of industrial action and is told they are being dismissed with no evidence whatsoever that they have been given a work notice. Of course, the Government do not want to give the responsibility for the work notice to the employer, so the employer will have no obligation at all to serve an employee with a work notice, but they could dismiss them the very next day after industrial action.

Let me emphasise that the employee would have no recourse to an employment tribunal. Surely it is a fundamental human right, and fundamental to natural justice, that if a worker is dismissed, they have recourse to a tribunal to challenge that decision. That, to me, seems fairly self-evident and obvious, but the Government are allowing a situation where rogue employers will be able to dismiss a worker for taking part in industrial action with no recourse to a tribunal, and they will not need to evidence the fact that that worker was served with a work notice.

The Government find themselves in a preposterous situation by opposing Lords amendment 4B, so I hope that the Minister will be able to answer some of these questions. Is it really the Government’s position, as I have outlined, that it is okay for an employer to dismiss those on strike and that they will not need to provide evidence that the employee was obliged to go into work? It is ludicrous.

[Rachael Maskell]

While the Government clearly do not want workers to have access to justice through the employment tribunal, of course those workers’ human rights will have been infringed, so will they not have access to other courts to challenge this egregious legislation?

[Chris Stephens]

Hopefully the Minister will answer that question.

The Minister did say in answer to my intervention that it happens in other countries. Yes, it happens in Russia and Hungary. Are Government Members really going to justify the Bill by saying, “It happens in other countries like Hungary and Russia”? Is that the Government’s example? Let me name another country—Italy, where workers can be disciplined but short of dismissal. But the Government do not want to follow the Italian model; they want to be in line with Hungary and Russia. It is incredible that the Government have found themselves in that position.

Strikes (Minimum Service Levels) Bill

Rachael Maskell Excerpts

Consideration of Lords amendments
Monday 22nd May 2023 Commons Chamber

[Kevin Hollinrake]

That is not what has been said, and I disagree with that perspective. The fact that other jurisdictions and other nations use this approach to making sure there are minimum service levels to protect the public, their lives and their livelihoods is indicative that it is the right thing to do. Indeed, as the hon. Gentleman knows, derogations exist in parts of our public services that do exactly what we are requiring services to do with minimum service levels; it is just that they do not work effectively all the time.

[Rachael Maskell (York Central) (Lab/Co-op)]

The Minister finds himself in an isolated position. At the Health and Social Care Committee on 9 May, NHS Providers, NHS Employers and NHS Confederation all said that the Bill was incredibly unhelpful and that additional legislation could make things more difficult, rather than improving the situation. Sir Julian Hartley, the chief executive officer of NHS Providers, said so. Why is the Minister going against the employers, not just the trade unions?

[Kevin Hollinrake]

We do not see that as being the case and we do not agree with that position. We think the Bill is effective and that it is the right thing to do to make sure that people can go about their daily lives unhindered, without fear or concerns about not being able to access vital public services.

I turn next to Lords amendment 1, which changes the application of the Bill from the whole of Great Britain to England only. The amendment would mean that strike action would continue to have disproportionate impacts on the public in Wales and Scotland. As the Government have always maintained, the purpose and substance of the Bill is to regulate employment rights and duties and industrial relations in specified services. Industrial relations is clearly a reserved matter and therefore we consider it right and appropriate to apply the legislation to the whole of Great Britain.

I also point out that the employer has statutory discretion on whether to issue a work notice ahead of the strike, specifying the workforce required to achieve the minimum service level. We hope that all employers will issue work notices to ensure that minimum service levels are achieved where it is necessary to do so. Employers must consider any contractual, public law or other legal duties that they have.

--- Later in debate ---

[Sam Tarry]

The Minister shakes his head, but that is a fact. If he does not believe me, I will take him to my local hospital to see that and to have discussions with the union reps, who regard the safety of their patients as their outright priority.

[Rachael Maskell]

I am grateful to my hon. Friend for giving way on that very point, because I used to negotiate those deals with employers when I was head of health at Unite. Those negotiations are about the relationship that we build between the employer and the worker, but that will not be possible under the Bill, which is why employers have asked that it does not proceed.

[Sam Tarry]

My hon. Friend makes a very good point. When we cast around for anybody actually supporting the Bill who is not a Minister or on the Conservative Benches, we struggle to find anyone. In fact, the Rail Safety and Standards Board chief executive has said nobody thinks this is workable and that it will worsen industrial action. The chief executive of Greater Anglia, who is obviously involved in the railway industry, has said nobody —nobody—in the whole of the rail industry has even asked for this. Then, as we heard from my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner) and many other Members who have spoken, there are the condemnations from the ILO general secretary.

This attack on rights is making our country an international laughing stock. The Government have said many times that the Bill matches or is very similar to some of the minimum service level processes in many other countries, but there is not a single person in Europe saying this is good idea, because it is not anything like what is in place in comparable countries around the world—not at all. One in five workers could be covered by this Bill’s provisions. They are the nurses, firefighters, teachers, paramedics, rail workers, civil servants and key workers the Government praised during the pandemic, who are all at risk of arbitrary dismissal. What a slap in the face for the heroes we clapped for weeks on end during the pandemic.

Let me turn to Lords amendment 4, on unfair dismissal. Currently, workers who are on strike are automatically deemed to be unfairly dismissed if they are sacked when taking part in an official, lawful strike. The Bill as introduced would remove that protection for those named by an employer in a work notice. It would mean that someone disciplined for not following a work notice could lose their job and then their livelihood. Lords amendment 4 is much fairer. It would reverse that measure and prevent the failure to comply with a work notice from being regarded as a breach of contract or constituting lawful grounds for dismissal. To be fair to the Government, I have not heard even them say that people should be sacked for trying to enact democratic rights. That would be a U-turn on what the Government said when minimum service level legislation was first brought forward. It was pledged in the 2019 Queen’s speech that

“sanctions are not directed at individual workers.”

The Bill clearly does do that, but the Lords amendment would help the Government to develop the policy set out in their own manifesto, so why not go ahead and back it tonight?

--- Later in debate ---

[Ian Lavery]

Absolutely. I fully agree with those sentiments.

When employers are considering who they might wish to give the work notice to, Lords amendment 3 suggests that when deciding whether to identify a person in a work notice, an employer cannot consider whether the person “has or has not” taken part in trade union activities, made use of their services or had a trade union raise issues on their behalf. That amendment should not be needed in the UK in 2023, because everybody clearly understands that if bosses give work notices, they have a clear idea who they will give them to: the trade union reps and the people who do not have a fantastic employment record. That is why that Lords amendment about who the company identifies for a work notice is really important.

In reality, this legislation is simply a battering ram against ordinary working people. I have mentioned the resistance that will be shown in this country if we start sacking the nurses, the teachers and the posties. Blaming the posties for breaking the universal service obligation; blaming the teachers for education in their classes; blaming the nurses for the backlog—you name it, that is what the bosses will do. That will start under this legislation, as they will have the power to sack people. This is a sackers charter, no doubt about that, criminalising our heroic workers.

There will be resistance like we have never seen before. The difference is that the public are on the side of the workers on this one, so be ready. I raise a stark warning: be ready. When the bosses have the books out, ready to sack individuals, and when the Government are telling them who to sack and what the reasons might be, they should be ready for the resistance, because there will be huge issues. How can the Government expect a trade union to take responsibility for individuals who might not want to accept a basic human right? It is bizarre. It is absolutely crazy. I am trying to explain it, but it is very difficult; it is not simple. The trade unions have a huge role to play.

The Bill not only escalates an already febrile atmosphere in this country; it is a vicious attempt the pin the problems that we have on trade unions, from a party that has completely run out of steam. When will the Government start doing their job, for heaven’s sake? How many more hospital appointments need to be set back? How many teachers need to be made redundant or letters and parcels be delivered late before they stop making excuses and demonising workers, and get on with the job that they were elected to do?

[Rachael Maskell]

My hon. Friend is making an outstanding speech about the reality of industrial relations. Does he agree that trade unions do not have any jurisdiction over their members; it is the members who have the jurisdiction over the trade unions? Therefore, it is for the members to decide what action they take or do not take. The Government do not seem to get it.

[Ian Lavery]

My hon. Friend makes a good and valid point that the trade unions are the workers themselves. It is as simple as that.

In conclusion, will Government Members tell us why we are not having a minimum service Bill for non-strike days? In the past year or so, in particular when the paramedics and ambulance workers have gone on strike, efficiency has increased and has been first class on strike days. On non-strike days, like the 360-odd days other than those strike days, unfortunately what we see is people lying on pavements or having heart attacks who cannot get an ambulance. Let us look at a Bill for non-striking days so we can enhance the efficiency of all of the services outlined tonight. If the Minister did that, he would get our support.