Edenfield Centre: Treatment of Patients

Rosena Allin-Khan Excerpts

Thursday 13th October 2022 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank my hon. Friend the Member for Bury South (Christian Wakeford) for his work with the families who have been affected.

I want to pick up on a point of clarification, if I may. The Minister mentioned in his response that the Government are putting an additional £2.3 billion into mental health. Over the last four years, 21 different Ministers have mentioned this same funding at that Dispatch Box on 67 different occasions as being spent in myriad different ways. I know that the Government are on the ropes, but this just shows that they are out of ideas and out of money.

Patients and their families rightly expect to be safe in in-patient settings. The footage of inappropriate use of restraint and seclusion, the bullying, dehumanisation and sexualisation of patients by staff, the verbal and physical abuse, mistakes over medication and falsification of records all made for extremely disturbing viewing. Each of these would be cause for significant concern, but together they point to a scandalous breach of patient safety. It should not have taken an undercover investigation to bring to light poor patient care. Why are the Government not across this?

Since “Panorama” aired, I too have received correspondence from families who have gone through similar experiences and from former staff at Edenfield who were bullied out of their jobs. What are the Government doing to tackle this toxic culture? The Government’s failure to learn from past failings, and to implement recommendations on reducing restraint, segregation and seclusion, is costing people their lives and traumatising too many patients, as evidenced in these reports. I sent a letter to the Secretary of State after “Panorama” aired. When will I receive a response? Is the Secretary of State even taking this seriously?



In 2019, the Government committed to reducing the need for restraint and restrictive intervention, yet the use of restraint has soared. Will the Government be conducting a rapid review into mental health in-patient services? What are the Government doing to tackle staff shortages, and what are they doing to ensure that patients’ complaints about their care are taken seriously? To have a “Dispatches” investigation into another trust less than two weeks after “Panorama” aired demonstrates that this is not a one-off. What are the Government doing? People are losing their lives.

[Mr Speaker]

Order. May I remind Front Benchers that we have set times? Please time your speech before you come to the Dispatch Box, otherwise it is not fair.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 19th July 2022 Commons Chamber

[Mr Speaker]

I call the shadow Minister, Dr Rosena Allin-Khan.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Thank you, Mr Speaker. A&E waiting times are through the roof, and we have people waiting without a bed—not even a trolley. This is removing the dignity that every patient deserves, but, sadly, it is not a one-off; this is commonplace up and down the country. It is not the Health Secretary who is on the receiving end of it, but staff, who are running from patient to patient trying to ease pain, diagnose illness and save lives—most importantly, it is of course the most vulnerable themselves. When the Minister hears reports such as this, does she not feel ashamed of the decisions her Government have made over the past 12 years?

[Maria Caulfield]

I say gently to the hon. Lady, who does amazing work on the frontline in A&E, that I have worked in A&E under the last Labour Government—I am showing my age now—and there were trolley waits and ambulance queues then as well, just as there are in Wales, where Labour is running the NHS, and in Scotland and in Northern Ireland. This is unprecedented pressure, because we are trying to live with covid and deal with a backlog of procedures and rising cases. The shadow Secretary of State was not here yesterday, so he may have missed some of the support that we are putting in. We are putting £150 million of extra funding into the ambulance service, £50 million into 111 to increase capacity, and £30 million into an auxiliary ambulance service to increase support. We are supporting the service, but we must recognise that it is facing unprecedented pressures.

[Dr Allin-Khan]

With respect, I will take no lectures from the Minister about working in A&E under a Labour Government and a Conservative Government. I have worked in the NHS under a Labour Government, when NHS waiting times hit record lows, and I have worked under a Tory Government, when NHS waiting lists hit record highs.

The Minister can use the pandemic, the heatwave, or even winter as justification. I have seen that emergencies do increase demand for services, but there is no excuse for not hitting the four-hour A&E waiting target for seven years. There is no defence for stroke and heart-attack victims waiting almost an hour for an ambulance. Undoubtedly, lives will be lost that could have been saved. Will the Minister apologise for those failings?

[Maria Caulfield]

The hon. Lady says there is no excuse for missing those waiting times, but perhaps she can explain why the Labour Government in Wales are also missing those times.

Ambulance Pressures

Rosena Allin-Khan Excerpts

Monday 18th July 2022 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank the Secretary of State for advance sight of the statement and welcome him to his new role. It would have been helpful if, ahead of the current temperatures, he had responded to our urgent question last week, but I am glad that he is here now.

The Secretary of State claims that everything is in hand, but I know from my own experience and that of colleagues across the country that that is far from the truth. We have already seen ambulance wait times soar and pressure on staff spiral, all while the NHS struggles to find the essential staff needed to deliver patient care. I am sure that everyone across the House will agree that our frontline workers are truly amazing. But if nurses and doctors are so overworked and do not have the time and resources to take care of themselves in this heat, the care that they can give patients will be impacted. The Government must step up and show the urgency that this crisis demands.

The Secretary of State talks of creating additional space for new patients in hospitals. How will that happen—with what money, what resources and what staff? Will the Government try to call those new hospitals, too? Is not the reality that creating capacity elsewhere in hospital really means patients being left in corridors on trolleys or in car parks? Can he assure us today that that will not be the case?

Under the Conservatives, the NHS is simply struggling to cope. A record 6.6 million people are waiting for NHS treatment—and they are waiting longer than ever before, often in pain and discomfort. The people in our thoughts this afternoon are those waiting in queues outside hospitals in ambulances, with soaring temperatures and no air conditioning. If it were dogs or cattle, it would be against the law, but these are people in tropical heat unable to enter hospitals. People with conditions triggered by excessive heat are unable to get an ambulance, because ambulances are logjammed outside A&E. Will the Secretary of State apologise to them and their families?

This situation is impacting mental health, too. People attending A&E experiencing a mental health crisis cannot get a bed in a psychiatric hospital, so they wait in A&E, some of them for more than three days. Why? Because the Government have spent the past decade cutting a quarter of mental health beds.

I worked in A&E over this weekend and saw the amazing work being done by staff to prepare for the record heat. The heatwave and surge in covid cases are putting additional pressures on the NHS. I am glad that the Secretary of State recognised that in his statement. Without doubt, 12 years of Conservative mismanagement and underfunding have left our health service unable to cope, which not only has an impact on patients but hurts staff. Staff morale is at rock bottom. Is it any wonder that 5.7 million days were lost to mental ill health in the NHS last year?

Last week, the Minister of State claimed that the Government had procured a £30 million contract for an auxiliary ambulance service, but, moments later, it was revealed that it was yet to be awarded. Can the Health Secretary confirm whether the Minister of State has issued a correction yet?

On Wednesday, ambulance trusts were placed on their highest possible alert level. A national emergency was declared on Friday and, over the weekend, hospitals were scrambling to increase capacity. Why then has it taken until today for the Health Secretary to step up and show leadership? Can he tell us who he met over the weekend? I do not mean at Chequers; I mean from the NHS. Can he also tell us why the Prime Minister did not think it necessary to chair Cobra today? Just when we thought irony had reached a peak, the Prime Minister spent the weekend partying when he should have been dealing with a health emergency. Has the Secretary of State spoken to the Prime Minister today? The Health Secretary has been too slow. The Prime Minister has not even bothered to turn up and the Government have gone AWOL.

If the Government will not step up now, then Labour will. As temperatures reach a record high, all we are getting from the Government is more hot air. This is a crisis. The country has one message for Ministers: stop squabbling and plotting, do your jobs and get a grip.

[Steve Barclay]

Let me start with the area on which the hon. Lady was correct, which is that I recognise the increased pressure on ambulances and hospitals. That is why we put in place the long-established contingency plans. Since the heatwave in Paris in 2003, it is the case that each year in May, we put in place our heatwave plans. That is what has been activated. Those plans were refreshed as recently as two months ago and sit alongside the work that has been done on urgent and emergency care, including the 10-point action plan that was set out last September.

The hon. Lady is right: the House as a whole will recognise the significant pressure on the system, which is why we are taking the steps from our contingency plans. It is also why we have put in specific funding, such as: the additional £150 million of support targeted at the ambulance service; an additional £50 million for 111 calls to build capacity; and as she said, an additional £30 million for auxiliary ambulances, which is what the Minister of State, my hon. Friend the Member for Lewes (Maria Caulfield), was referring to in the House last week.

The Met Office and the UK Health Security Agency went to level 4 on Friday. As you will know, Madam Deputy Speaker, I updated the House on the first available sitting day after that. The irony will not be lost on the House that this issue is seen as so important that the shadow Secretary of State for Health and Social Care has failed to turn up to this statement in the middle of a heatwave. [Interruption.] Well, he is not here, which speaks for itself.

The hon. Lady also suggested that these challenges, which are being faced across Europe as a whole, were in some way due to the overall investment in the NHS. I remind the House that, to take the resource departmental expenditure limit alone, RDEL in 2010 was just under £99 billion and last year it was £150 billion. That is a good indication of the significant funding. We could also come on to capital investment, not least with the 40 hospitals programme, part of a £22 billion package to 2030, which underscores this Government’s commitment to investing in our NHS—an investment that, most recently, the Labour party voted against when we brought it to the House.

The hon. Lady asks about an apology for operational levels of performance. I do not know whether she is asking for that apology from the Welsh Government or just from the English Government. She may want to clarify that, given the performance of the Welsh ambulance service under the Welsh Government.

On the hon. Lady’s point about auxiliary, the Minister of State, Department for Health and Social Care, my hon. Friend the Member for Lewes, said in her statement that we had seen improvements in May. I referred to that as context, but on auxiliary in particular I can clarify for the House that a contract is being procured for auxiliary ambulance services and is expected to be concluded shortly.

Finally, the hon. Lady asked what meetings I have held over the less than two weeks that I have been in post. I am happy to share with the House that I have been on visits to four different hospitals, in Whipps Cross, Hillingdon, King’s Lynn and Bedford; I have been out on two different ambulance shifts, been to three different ambulance centres, been out to see GPs to look at boosting access to their services and been to look at life sciences. I have been engaging, and that sits alongside, for example, the meeting with chief execs of ambulance trusts on Saturday, Cobra on Saturday and other such meetings that I have had in the course of my duties.

Finally, the hon. Lady asked about the Prime Minister’s engagement. Just as the Chancellor of the Duchy of Lancaster set out that he was engaging with the Prime Minister in his role chairing Cobra as Minister for the Cabinet Office, I am happy to confirm to the House that I also engaged with the Prime Minister over the weekend, updating him on the health plans we have put in place. He has been closely engaged on the contingency we have put in place.

Bereavement Charities

Rosena Allin-Khan Excerpts

Tuesday 5th July 2022 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It was approximately six years ago that you sat next to me when I made my maiden speech, Mr Davies, and today is the first time I have had the pleasure of serving under your chairmanship. I thank the hon. Member for North Devon (Selaine Saxby) for securing this important debate, and all hon. Members for their thoughtful contributions.

People, including us in this place, are growing more comfortable about sharing their own experiences of loss and grief. I thank the hon. Member for Strangford (Jim Shannon) for kindly mentioning my professional experience with those needing bereavement support. Last year I had the very painful personal experience of losing my father after a long, protracted, difficult and painful battle with dementia, which came on when he was very young. No one can prepare someone for how they will cope with the loss, and everyone will react incredibly differently. The only sure thing we know is that everyone will go through it at some point.

It is important to remember that everyone deals with loss differently. I threw myself into exercise and relied on a support network of my friends and family. Together, we mourned for the life lost and the experiences we were never able to have. Others require professional help.

I will take this opportunity to thank the palliative, neurological and bereavement support charity Sue Ryder, for the assistance it provides to so many families, and Lottie Tomlinson, who has done so much to break down the stigma that still exists around bereavement. Lottie speaks from the heart about navigating the loss of both her mother and her sister, and the different experiences she had in getting informal support from her family and professional support after the loss of her sister.

There is no one-size-fits-all approach to bereavement. Indeed, it is different for everyone, depending on whether they have lost a child or even, in the case of the hon. Member for North Devon, a grandmother—I am so sorry to hear about the hon. Lady’s loss. No amount of comments such as “She had a good innings” can take away from the pain and loss that she feels, because the family had her in their lives for 98 years and that really counts for something. All our love and support go to the hon. Lady’s family at this time.

The pandemic robbed so many families of the opportunity to say a final goodbye. That has had a profound impact on people’s ability to grieve. The mental health impact of that is enormous. Around one in 10 people bereaved will suffer from prolonged grief disorder, resulting in severe mental health conditions, such as post-traumatic stress disorder.

In the report released by Sue Ryder last week, 70% of respondents reported that they could not access the type of support they would have liked after a close bereavement. The most common barriers to accessing support were that it was not culturally specific, or not provided in the recipient’s language. That has to change. There is a postcode lottery on bereavement support, and that should not be the case. Some local authorities do a fantastic job with limited resources, but it should not have to be that way. So much for levelling up if some areas cannot even afford dignity in death.

Bereavement charities and local authorities should not be living hand to mouth when it comes to bereavement support. The Government must have a clear strategy that tackles the social isolation and loneliness that people often experience after a death. It must ensure that all family members are provided with information about bereavement support services in all appropriate languages.

In A&E, where I work, when a patient dies, there is all too often little joined-up working. I know local bereavement organisations and am able to signpost loved ones to them, but not everyone is able to do that. That is where the development of a specific bereavement pathway would be incredibly useful for frontline workers. It could ensure that relatives are given the information that they need at a time of crisis by hospitals, GPs and charity services. That would help healthcare professionals to find the right support for anyone who has experienced a bereavement, and should be supported by a public health campaign to promote awareness of the different services available.

I would again like to thank everyone who has shared their experiences in order to help to tackle the pernicious stigma still associated with bereavement. It is clear that there is a long way to go to ensure that bereavement services get the support they need to support all of our communities at their darkest hour. I urge the Minister to take the comments made today into account. I know that the UK Commission on Bereavement is currently working to analyse and understand all the evidence that it has received, and I look forward to its report this year.

Experiencing the death of a loved one is one of the hardest things a person will go through. Unfortunately, the last couple of years have made that an all too stark reality for too many people. The humanity was stripped out of grieving; it is high time that it was put back.

[Geraint Davies (in the Chair)]

Last but not least, I call the Minister.

Draft Mental Health Bill

Rosena Allin-Khan Excerpts

Monday 27th June 2022 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I thank the Secretary of State for an advance copy of the statement, and for sharing his family’s experiences over the weekend. I am so sorry to hear about the circumstances surrounding his brother’s tragic death.

This overhaul of the Mental Health Act 1983 is long awaited. We welcome the draft Bill, and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Act. It was interesting to hear, in the statement, of the Government’s focus on keeping people in crisis out of A&E, and of their plans to reduce the use of general ambulance call-outs for those experiencing a mental health crisis. In 2020, there were over 470,000 calls to 999 because someone was in a mental health crisis, which took up an estimated 66,000 hours of call time. In my email inbox, I have numerous examples from across the country of children being stuck in A&E for over 24 hours waiting for a mental health bed. One child waited over three days. When I work shifts in A&E, I see more and more people coming into hospital in crisis. The increased frequency is deeply concerning. Conditions are getting worse and illnesses are going untreated. We would not allow that in cancer treatment, so why is it allowed in mental health treatment?

Deprivation of liberty and the use of coercion can cause lasting trauma and distress. That is especially true for children and young people who find themselves in these most difficult situations and whose voices are often not heard when decisions are made. We are pleased that patients will have greater autonomy over their treatment in a mental health crisis, and we are glad that the Government have been working with organisations to listen to the experiences of those with learning disabilities or autism, but will the Secretary of State explain what safeguards will be put in place for people with learning disabilities or autism should the worst happen and they find themselves in prison? This is not a straightforward issue. Many people with learning disabilities or autism also live with serious mental illnesses, and we have to make sure that they have their rights protected and have dignity in their treatment.

In our communities, we witness the harsh reality of the health inequalities that so desperately need to be addressed. As the Secretary of State said, black people are over four times more likely to be detained under the Mental Health Act.

[Kim Johnson (Liverpool, Riverside) (Lab)]

Will my good friend give way?

--- Later in debate ---

[Mr Speaker]

Order. The shadow Minister cannot give way; this is a statement.

[Dr Allin-Khan]

We need to advance the mental health equality framework and there must be culturally appropriate services and the freedom for local areas to look at their specific populations in order to have the most suitable approaches. Culturally appropriate community provision is vital for mental health services that are truly joined-up and effective and that, crucially, work well for patients. Will the Secretary of State also provide reassurances on the future of community care and on how they will work with local authorities across the country to deliver community provision that works?

Mental health staffing levels are absolutely crucial to ensuring that mental health services are fit for purpose. More than a year and a half ago, I asked the Secretary of State’s predecessor about the future of mental health staffing. The proposals that have been set out today go well beyond what has been committed to in the long-term plan. Labour has a plan: to recruit an extra 8,500 mental health staff to treat 1 million additional patients a year by the end of our first term in office. Will the Secretary of State outline when we will get the workforce settlement? What reassurance can he give on filling training places?

For too long, the Government have had their head in the sand when it comes to mental health. They have failed on eradicating dormitories from mental health facilities, failed on cracking down on the use of restraint, and failed on getting on top of waiting times. We cannot have this kicked into the long grass and, if it gets lost in the political quagmire of Conservative in-fighting, should the Government call an early general election, people will suffer. We cannot have the Government fail on mental health legislation any longer. This is a once-in-a-generation opportunity; we simply must get this right for everyone who depends on these vital services.

[Sajid Javid]

I thank the hon. Lady, particularly for her remarks at the start of her response about my personal experience.

I think the hon. Lady agrees with me, as does everyone in this House, that the 1983 Act is outdated. Society has learned since then, rightly, that people’s mental and emotional wellbeing is as important as their physical wellbeing. That was recognised in the Health and Care Act 2022, which came before Parliament recently, and this draft Bill does a lot to change the situation as well.

The hon. Lady talked, rightly, about the importance of mental health services. The NHS is putting record funding into NHS services. Some 1.25 million people were seen through the NHS talking therapies service, despite the pressures of the pandemic, and an additional £500 million of resources was put into mental health services because of the pandemic.

On the workforce, today in the NHS, we have around 129,000 health professionals focused on mental health. That is the highest number ever, and the number has gone up by some 20,000 since March 2016. As for the NHS’s strategic workforce plan—the 15-year plan on which it is currently working—having the correct provision for mental health will, of course, be a very important part of that.

Infant Mental Health Awareness Week

Rosena Allin-Khan Excerpts

Thursday 16th June 2022 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to wind up for the Opposition with you in the Chair, Mrs Murray. I thank the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) for securing this extremely important debate for Infant Mental Health Awareness Week, and all hon. Members for their thoughtful contributions this afternoon.

I know I say this sometimes in Westminster Hall debates, but there really are some debates that unite us all. Infant mental health is one such issue. I am delighted to say that I have learned a lot and am filled with the powerful advocacy that has come out of every single wonderful contribution today. It is good to know that there are such powerful advocates in this room. I thank the right hon. Member for South Northamptonshire for all the work that she has done in this space.

We are all here today because we recognise that adverse childhood experiences are the key driver of mental illness in later life. We have many experts in the room today. The last two years have shone a light on the problem. The pandemic has hit the poorest and the most vulnerable children the hardest, highlighting the inequalities in our society that are very hard to escape—children with chaotic home lives; children in overcrowded, noisy housing; and children from black and ethnic minority communities who suffer disproportionately from worse outcomes and worse mental health provision than white communities.

In 2018 it was estimated that 50,000 children aged zero to five lived in homes where domestic violence, adult drug or alcohol dependency and adult mental illness were all present. Children and adults living in households in the lowest 20% income bracket are two to three times more likely to develop mental health problems than those in the highest.

There was already a crisis in child and adolescent mental health provision in this country, even before the pandemic, and the virus has undoubtedly made it worse. The latest report by the Children’s Commissioner shows that demand for child and adolescent mental health services increased, with one in six children suffering from a probable mental health condition, up from one in nine in just 2017—that is one in six. Yet only a third of children were able to actually access treatment, and 42% of child and adolescent mental health services in England do not accept referrals for children aged two and under.

Why should someone’s ability to access preventative services or treatment be determined by where they live? Poor mental health in childhood is carried into adulthood. As we have heard many times, what happens today will impact on demand for mental health services tomorrow. As the old saying goes, prevention is better than cure. That is why we have a range of public health measures in place for children—check-ups for eyesight, hearing and growth; vaccinations to protect against measles, mumps, and rubella. Yet we ignore the wisdom of the ages when it comes to children’s mental health.

Improving infant mental health is all about prevention. With early intervention in those critical 1,001 days, families and infants can be supported. As a doctor, I know that adverse childhood experiences are a key contributing factor to poor mental health in adulthood. In A&E, I see increasingly younger children coming in who have self-harmed or who are living with eating disorders. It is simply heartbreaking. For parents, it is absolutely agonizing.

It should be a badge of shame for the Government that three quarters of children were not seen within four weeks of being referred to children’s mental health services. Imagine being a mum or dad whose child is self-harming or presenting with symptoms of depression, anxiety or phobias, and being without special support for more than a month.

There has been a 77% rise in the number of children needing specialist treatment for a severe mental health crisis between April 2021 and October 2021 compared with the same period in 2019. According to the latest report from the Children’s Commissioner, waiting times depend on where someone lives. When they eventually are seen, services may be hundreds of miles away.

I invite the Minister to please tell the House what new measures the Government are taking in relation to infants and their parents—I am looking for new measures. What new money is being allocated to child and adolescent mental health services, and where is it going? How many new mental health staff will be recruited? Are there plans for specialised parent-infant relationship teams for the infants most at risk? How will they tackle mental health inequalities along the lines of place, race, class and income? With respect, in every mental health debate we hear about the £2.3 billion allocated to mental health, but it seems to get spent five to 10 times over. I would like specific answers to my specific questions.

The Labour Government are committed to improving infant and child mental health. We will guarantee mental health treatment within a month for all who need it, ensuring that patients start receiving appropriate treatment—not simply an initial assessment of needs—within a month of referral. We will recruit 8,500 new staff so that 1 million additional people can access treatment every year by the end of Labour’s first term in office, and we will provide specialist mental health support in every school and put an open-access mental health hub for children and young people in every single community, ensuring that every child has somewhere safe and secure to talk about their mental health.

As it stands, our children are being failed on prevention, on access to treatment and on funding, and we are failing to support their families. The system is stretched to breaking point. The staff are exhausted, the children are suffering, and parents do not know where to turn. I plead with the Minister today to take action before it is too late for another generation of children.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 14th June 2022 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Working a shift in A&E just two days ago, I could not have felt prouder of the teams of nurses who form the foundation of our NHS. As the Minister is so gushing about the Government’s track record, will he explain why specialist food banks are being opened up in hospitals? Will he explain why, in a report by the Royal College of Nursing, 83% said that staffing levels on their last shift were not sufficient to meet patients’ needs safely and effectively? These lifesavers need a Government who are on their side. Only Labour will deliver for the NHS workforce and ensure that nurses and patients get what they rightly deserve.

[Edward Argar]

I think that I detected the hint of a question in there. On a serious point, I pay tribute to the hon. Lady, as I often do on such occasions, notwithstanding the challenges that she throws at us, for the work that she does in the NHS and the work that she did before she was elected to the House. Through her, I also pay tribute to NHS workers up and down the country for their work.

The Government have put in place record support for our NHS, including nurses, which is about supporting those already on the frontline in the profession—that is absolutely right—and about growing that workforce to ensure that the work that needs to be done is spread among more people. That is exactly what we have done. We have record numbers in our NHS workforce, and we are well on target to meet our manifesto commitment on more nurses.

Government Action on Suicide Prevention

Rosena Allin-Khan Excerpts

Wednesday 8th June 2022 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to wind up for the Opposition with you in the Chair, Mr Bone.

I first thank those of you in the Public Gallery. It cannot be easy to be here today, and you are a testament to the love you hold for the ones you have lost. You are incredibly brave, and I want you to know how much we value your presence here and how important you are to our discussion. Part of our fight to make this better for people around the country is thanks to your work and your never-ending belief that things can get better. Thank you so much for being here. We see you. We recognise your pain and we send all our love and condolences to you.

I thank my hon. Friend the Member for Bristol East (Kerry McCarthy) for securing this extremely important debate and all hon. Members for their thoughtful contributions. Shadow Ministers often attend debates in which we have to make the closing remarks, and we do that because it is part of our job, but sometimes, although people might not know it, we have a personal and deeply vested interest in the subject matter. Today’s debate is of great importance to me for many private and professional reasons.

Many of us were together a few weeks ago in the Speaker’s chambers thanks to the hard work of my hon. Friend the Member for Bristol East, who put together a heartfelt event to mark the 42nd anniversary of the death of Ian Curtis. I applaud my hon. Friend for placing the issue of suicide at the heart of Parliament, bringing together parliamentarians, metro Mayors, staffers and musicians, and encouraging people to talk of their own experiences, which is never easy.

I thank my hon. Friend for sharing her personal experience of a loved one passing from suicide last year. We all send our condolences and are sorry for my hon. Friend’s loss. She did not share that experience in order for us to do so, but I would like her to know that we send our condolences.

My hon. Friend the Member for Blaydon (Liz Twist)—eloquent and insightful as always—highlighted the issue of self-harm, in a safe and supportive way and rightly placed particular importance on combating stigma around the issue. I thank her for all the work she does in that space.

The hon. Member for Richmond Park (Sarah Olney) was such a powerful advocate for Tom, Philip and their whole family. My hon. Friend the Member for Bradford West (Naz Shah), whom I am proud to call a friend, was so honest about her own experience and emphasised the scandal—that is what it is—of the postcode lottery for people seeking child and adolescent mental health services in Bradford. Unfortunately, the people of Bradford are not alone in what they face because it is rife across the country. That has to be addressed.

The hon. Member for Strangford (Jim Shannon) characteristically made many heartfelt points, and we always value his contributions to such debates.

I say to my hon. Friend the Member for Liverpool, Walton (Dan Carden) that I would be delighted to visit Paul’s Place, and I will set that up with him at the first opportunity. I thank him deeply for his comments on LGBT mental health, especially as June is Pride Month. It takes a certain bravery for someone to put their head above the parapet and talk about multiple personal experiences in a way that can effect change. My hon. Friend is testament to the fact that we can use the most painful parts of our lives to change the lives of others.

I want to draw on my personal professional experience as an A&E doctor in addressing the point made by the SNP spokeswoman—the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), with whom I love sharing a platform—about addiction and mental health services. I cannot stand to have another night shift in A&E when I yet again have to tell someone who has come in while intoxicated with alcohol or following a drug overdose that I cannot plug them into mental health services because they tick the addiction box. I cannot stand another shift begging the drug and alcohol liaison team to come to see somebody who has also admitted that they have mental health issues. This is a deeply flawed system, Minister. I know her to care about the issue greatly, but it absolutely has to be addressed because lives are being lost as a result.

We have a duty in this place to break down barriers and improve people’s lives, and breaking down the stigma around suicide and mental illness is an area in which there is still so much more work that needs to be done. It is a tribute to people’s hard work that we are hosting events and debates in Parliament to break down the stigma, and we are getting fantastic coverage such as that in NME so as to reach more and more people, but four decades on from the tragic death of Ian Curtis, there should not still be so much work to be done to tackle suicide rates.

Over the past decade, it has been incredibly welcome to see the strides taken to tackle suicide and mental illness at a parliamentary level, to hear talk of parity of esteem and to hear colleagues open up about their own struggles, but since the publication of the national suicide prevention strategy a decade ago, what progress can the Government genuinely be proud of? We are talking about a life or death issue here: we need more than warm words while people are still losing their lives, and there are things we can tangibly do to resolve it.

A commitment was made in 2016 to reduce the rate of suicide in England by 10% by 2020, but by 2020 the rate was almost the same. In 2018, the Health Secretary announced a zero-suicide ambition for mental health patients being treated in hospital. That has still not been met. If the Government are genuinely serious about achieving their zero-suicide ambition, they need to look at the impact that social factors such as debt, employment, housing and benefits have on mental health. It is evident that insecure housing and employment, racism and discrimination, being pushed into debt and poverty because of cuts to universal credit or to other benefits, and loneliness and isolation have a considerable impact on a person’s mental health. We know that and must do something about it.

Three quarters of suicides are of men, and the rates of suicide in England are significantly higher in the north-east, Yorkshire and the Humber than in London. Those figures cannot be ignored. We must have the data to ensure that there is not simply a one-size-fits-all approach. That is a crucial point that must be addressed if the Government are serious about tackling the issues once and for all. I am proud to back the Samaritans’ call for the Government to launch a national real-time suicide surveillance system, in line with what is in place in Wales. We need to understand what is happening now, not two years down the line. How is anyone supposed to tackle a problem that they simply cannot see?

I urge the Government to work with the mental health sector, and consult on what is truly needed to drive down suicide figures. There is a looming mental health crisis in the wake of the pandemic. The backlog for treatment was already huge before covid. Now, with the sheer rise in referrals, the NHS is at risk of being completely overwhelmed and patients are unable to receive treatment.

That is why Labour is committed to improving access to mental health services. We will guarantee access to treatment within a month for all who need it, and expand the workforce, recruiting 8,500 additional staff to ensure a million more people can be seen. Crucially, we understand the need for prevention, reaching people before they hit crisis point. That is why the next Labour Government would ensure that every school had access to a mental health professional, and every community would have an open access mental health hub to ensure that every young person could access the support they need, safely and securely.

It is about offering people respect and dignity in their treatment. As it stands, two thirds of people who take their own lives are not in touch with mental health services in the year before they die. We have heard that this morning. Services need to reach out to people; they have to be accessible and be designed with the service user and families in mind. At a time of economic turmoil and after two incredibly difficult years, it is so vital to have this conversation, but please let us not lose any more lives needlessly to suicide. I urge the Government to act on what has been said today, and make real change in memory of those lives lost.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 19th April 2022 Commons Chamber

[Mr Speaker]

We now come to the shadow Minister, Dr Rosena Allin-Khan.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Our veterans have risked their lives for our country and deserve excellent mental health support. We must go even further: from the military frontline to frontline workers who have kept us safe, everyone deserves proper mental health provision. People have stepped up to protect our country and save lives during the pandemic, so is it any wonder that teachers and NHS staff are so furious with the comments made by the hon. Member for Lichfield (Michael Fabricant), about how they would go back to the staffroom and have a “quiet drink”, in an attempt to justify the indefensible actions of the Prime Minister? What does this say about the effect of mental health on our frontline staff? Will the Minister please condemn those comments and apologise for the hurt caused by those remarks?

[Gillian Keegan]

I am very happy to say that we of course thank very much all the staff who have been on the frontline, whether veterans or teachers, and involved in everything that kept us going throughout the pandemic. We are of course very much aware of the impact of those stresses and strains on mental health. There is additional support for mental health, and there will continue to be additional support for young people’s mental health and for adult mental health. That is one reason why I launched a call for evidence last week to inform a new 10-year cross-departmental mental health vision, and I urge everybody to input into that process before it closes on 5 July.

Health and Care Bill

Rosena Allin-Khan Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I would not suggest for a moment that Wales or Scotland should follow England or that England should follow Scotland and Wales. They are devolved competences. Each devolved Administration will rightly form their own view of the balance of benefits, the pros and cons, and that is right. That is what our devolution settlement is for. This House is considering the amendment that was brought here from the Lords and this is an opportunity for Members to express their view on what should happen in this country.

The Government remain of the view that the provision of early medical abortion should return to pre-covid arrangements, and face-to-face services should resume, given that the temporary change was based on a specific set of emergency circumstances. However, we recognise that their lordships have made an amendment in that respect and it is therefore right that this House considers it.

In normal times, we prefer and believe that decisions about the provision of health services are more appropriately dealt with through the usual processes, rather than through primary legislation. We have a number of concerns about the approach taken in the amendment. Parliament has already given the Secretary of State a power to issue approvals under the Abortion Act. That allows the Secretary of State flexibility to make decisions about how healthcare in this area is provided, which can be adapted quickly and easily to respond to changes in service provision or other external circumstances, as was the case with the temporary approval in response to concern about the risk to services from covid-19.

From a process perspective, it is not appropriate, in our view, to insert into primary legislation the intended detail regarding home use of both pills. That would mean that should any issues arise, there would no longer be scope to react quickly, as the Secretary of State did during the pandemic. However, we recognise that that is now a matter for debate and decision by this House.

In addition, Lords amendment 92, as drafted by my noble Friend Baroness Sugg, would not have the intended effect. If agreed to, it would create legal uncertainty for women and medical professionals by including wording on the statute book that does not, in fact, change the law in the way it appears to. On a procedural point, we therefore urge all right hon. and hon. Members to disagree with the Lords in their amendment.

All Members have the opportunity, however, to vote on our amendment (a) in lieu, which we have drafted to ensure, irrespective of colleagues’ views, that the provision does the job it was intended to do. We all agree that it is crucial that the law is clear in this area and does not create any uncertainty for those who rely on it. That is why we have tabled our legally robust amendment in lieu, which stands in my name and which would achieve the intended purpose of Baroness Sugg’s amendment.

It is for right hon. and hon. Members, in a free vote, to judge how they wish to vote on the amendment in lieu. I encourage them to reflect and make their decision when the amendment is pressed to a Division.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

The Opposition congratulate the Lords on their hard work on the Bill, which is much improved from when it left the Commons. We support the Lords amendments, which are sensible and proportionate and will go some way to tackling health inequalities that are still sadly far too prevalent.

Over the past two years, we have seen the very best of our NHS. Publicly owned and free at the point of use, it is the best of us and has protected our families for generations; I hope it will continue to do so for many years to come. Unfortunately, the Government are set on a power grab, and refuse to act to tackle workforce shortages and ever-growing waiting lists. Waiting times for cancer care are now the longest on record, patients with serious mental illnesses are being sent hundreds of miles away for treatment, and one in four mental health beds have been cut since 2010. We deserve better. Our NHS deserves better.

We can all agree that the amendments in this group are wide-ranging, so I will be covering a range of subjects. A number of amendments in the group speak to women’s health. We have seen time and again that the Government are dismissive of women’s health and have ignored the needs of half the population. In its original form, the Bill was far too scant on tackling health inequalities; it is only because of colleagues in the other place and Labour votes that we are making ground on tackling them at all.

Along with the rest of our health team, I am proud to support the continued provision of telemedical abortion services in England. Maintaining the existing provision of at-home early medical abortion following a telephone or video consultation with a clinician is crucial for women’s healthcare. Not only did that preserve access to a vital service during the pandemic; it enabled thousands of women to gain access to urgently needed care more quickly, more safely and more effectively. Women’s healthcare must reflect the needs of those whom it serves. Scrapping telemedical abortion services would drastically reduce access to that vital service, and would simply serve to increase the number of later-term abortions. Everyone should have access to safe and timely healthcare. I say to Ministers: please do not ignore clinical best practice and the expert opinions of organisations and royal colleges.

We welcome provisions to ban hymenoplasty, and the power to create a licensing regime for non-surgical cosmetic procedures. Those too were a result of Labour votes, because the original Bill did not even mention them. Ministers must stop treating women as an afterthought in healthcare provision. However, we are glad to see that the Government have accepted the Lords amendment to remove coroners’ access to material held by the Health Service Safety Investigations Body.

On the NHS frontlines, I see at first hand the pressure placed on staff. Staff must feel protected, and must be encouraged to come forward. It is crucial for the Bill to promote a learning culture, so that any investigation can establish what training and procedures need to change in order to prevent any future mistakes. Only by enshrining that culture can we ensure that staff will feel comfortable about coming forward.

We welcome Baroness Hollins’s amendment to introduce mandatory training on learning disabilities and autism for all regulated health and care staff, and we are pleased to see that the Government support it. Everyone deserves access to safe, informed, individual care, and hopefully the amendment will go some way towards reducing health inequalities that are faced all too regularly by people with learning disabilities and autism.

[Barry Gardiner (Brent North) (Lab)]

I agree with much of what my hon. Friend is saying. For instance, I too believe that it is a woman’s right to choose. One of the features of a physical consultation was that it gave the woman an opportunity to do so in a free environment. Does my hon. Friend share the concern that I know exists among many of our constituents that if the consultation is done by telephone, it is possible that a woman who is being coerced will not be understood to be being coerced by the consultant who is dealing with her? It is important that, in preserving the right to choose for the woman, we do not allow a situation in which that woman could be coerced, by a coercive partner, into making a choice that is not her own.

[Dr Allin-Khan]

I thank my hon. Friend for his intervention. There are widely held variations in views across the House, but I stand by the principle that everyone should have access to safe and timely healthcare, and that scrapping telemedical abortion services would drastically reduce access to a service that is incredibly important for women, and, as I have said, would simply increase the number of later-term abortions, which can have physical and mental impacts on the mother herself.

As for Lords amendments 85 to 88, it is disappointing to see the Government going against their own ambitions and targets. The consultation referred to in Lords amendment 83 would be on a statutory “polluter pays” scheme to make tobacco manufacturers fund measures to reduce smoking prevalence and improve public health. Smoking is responsible for half the difference in life expectancy between the richest and the poorest in society. Will the Minister please explain why we are still waiting to see the Government’s tobacco control plan, which we were promised by the end of 2021? The Government need to stop kicking public health matters into the long grass. They say that they recognise the stark health inequalities associated with tobacco use, but delays will do nothing to level the playing field and eradicate health disparities.

Ministers need to make sure they listen to the Lords, whose amendments go a long way towards eradicating the vast health inequalities that exist across society today. Rather than wasting time trying to overturn the changes, Ministers should now focus relentlessly on bringing waiting times down.

[Fiona Bruce (Congleton) (Con)]

I rise to speak to Lords amendment 92 and the Government motion to disagree, and to the amendment in lieu. A few months ago, in my role as the co-chair of the all-party parliamentary pro-life group, I wrote to the Health Secretary, supported by more than 60 parliamentarians—not an insignificant number—urging him to discontinue the temporary provision to allow for the taking of both sets of abortion pills at home. We said that we were deeply concerned about reports that taking both sets of abortion pills at home without direct medical supervision had led to a number of deeply concerning, unacceptable health and safety risks to women and girls in this country. These included a lack of basic checks by abortion providers before sending abortion pills, and the occurrence of severe complications and later-term abortions due to the lack of in-person assessment. We were also, notably, concerned about the greater risk of coercion by a partner or family member where the doctor does not see the woman in person.