Oral Answers to Questions
Rosena Allin-Khan Excerpts(4 years ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I echo the words of solidarity with Ukraine that many colleagues have shared in recent days.
There are stark inequalities in children’s mental health services, from the postcode lottery of whether a child is ever seen after a referral to the luck-of-the-draw results of eating disorder treatment. Children from black and mixed-race backgrounds make up 11% of the population, but account for a staggering 36% of those detained in the highest-level mental health units. However, just 5% of those who access routine children’s mental health services are black. That is unacceptable—something clearly is not working.
Labour will put a mental health support hub in every community and a specialist mental health staff member in every school. What are the Government going to do?
Sajid Javid
I think we all agree, across the House, about the importance of mental health services, especially for younger people. As for what the Government are doing, before the pandemic there was already a commitment to increase funding for mental health services in the NHS’s long-term plan by an additional £2.3 billion a year. On top of that, there has been the response during the pandemic, with the mental health recovery action plan and the additional £500 million that I referred to a moment ago. When it comes to children’s mental health services, there is £79 million included, which will pay for an extra 22,500 referrals.
Children’s Mental Health
Rosena Allin-Khan Excerpts(4 years, 1 month ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I beg to move,
That this House recognises the importance of Children’s Mental Health Week; is concerned about the impact of the coronavirus pandemic on the mental health of young people and that there has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019; calls on the Government to guarantee mental health treatment within a month for all who need it and to provide specialist mental health support in every school, including a full-time mental health professional in every secondary school and a part-time professional in every primary school; and further calls for the Government to establish open access mental health hubs for children and young people in every community to ensure the best start to life for future generations.
This is Children’s Mental Health Week. I congratulate the children’s mental health charity Place2Be, which launched the first ever Children’s Mental Health Week in 2015. I also congratulate all the mental health charities and schools that are taking part in events this week.
The whole House will want to recognise the hard work and dedication of mental health professionals, campaigners, advocates, teachers, parents and guardians, especially over the past two years. So many mental health professionals have themselves suffered mental ill health, exhaustion and burnout. As we reach out to all the children and young people affected by poor mental health, we want them to know that we in this House are with them.
The pandemic has placed a huge weight on the shoulders of our children and young people. With schools closed, financial uncertainty at home, the exams fiasco and anxiety about the future, the pandemic has hit the poorest and most vulnerable children hardest. This highlights the inequalities in our society.
Children with chaotic home lives, children in overcrowded and noisy housing and children from black and ethnic minority communities suffer disproportionately from worse outcomes and worse mental health provision than white communities. Black children are much more likely to experience a mental health problem but far less likely to receive any support.
Tom Hunt (Ipswich) (Con)
I am interested in that comment because, of course, the Education Committee recently found that white kids from the most disadvantaged backgrounds have the worst educational outcomes. I would take issue with the hon. Lady’s point.
Dr Allin-Khan
I thank the hon. Gentleman for his intervention. Perhaps he would like to understand that some white groups from poor socioeconomic backgrounds have such outcomes but, by far and away, it is disproportionately weighted against black and minority ethnic groups as a whole in this country.
There was a crisis in child and adolescent mental health provision in this country even before the pandemic made it worse. The latest report by the Children’s Commissioner shows that demand for child and adolescent mental health services—CAMHS—increased in 2020-21, with one in six children likely to be suffering from a mental health condition, up from one in nine in 2017.
Mark Tami (Alyn and Deeside) (Lab)
Does my hon. Friend agree that children and young people who have suffered cancer and had long spells of cancer treatment need mental health support, too? That should be part of the package. It should not be an add-on or something they have to search for; it should be part and parcel of their treatment.
Dr Allin-Khan
My right hon. Friend is absolutely right. Some children endure unspeakable circumstances that unduly affect their mental health in a way that we can never comprehend. It affects not just them but their family—their siblings and parents. I thank him for his intervention.
Anna McMorrin (Cardiff North) (Lab)
My hon. Friend is making an excellent speech. Unlike the UK Government here, the Welsh Labour Government are adopting a whole-school approach, viewing this issue holistically and offering a package of measures, while the English approach has been described as shocking and despicable.
Dr Allin-Khan
My hon. Friend is always a powerful advocate when it comes to the importance of positive mental health for young people. I have visited Wales and seen at first hand the fantastic examples of what can be achieved when Labour is in power.
One in six children are suffering with probable mental health issues, but only about a third are able to access treatment. Now things are getting worse: the Conservative cost of living crisis is causing more misery, uncertainty and upheaval in the lives of millions of children and young people. For weeks the House has been witness to the impact of that Conservative cost of living crisis on people and their families across the country.
Children are going to bed cold and hungry, and their life chances are impacted because they are unable to concentrate at school. Many are watching their parents worry and cry about being unable to pay the bills. Dragging an electric heater around the house before jumping under the covers just to keep warm because there is no heating—that, for too many of us, feels far too familiar. It is how my brother and I grew up, and it will stay with me forever. I had hoped that that perpetual fear of insecurity that never leaves one was a thing of the past, but sadly not: it is alive and well in Tory Britain in 2022. This is a “cost of Johnson crisis”.
Layla Moran (Oxford West and Abingdon) (LD)
The hon. Lady is making a powerful speech that stems from her personal experience. One of the groups who seem to be falling off the cliff edge are 16 to 18-year-olds, because by the time they are referred to CAMHS, the waiting lists take them out of the range that CAMHS can deal with. Does the hon. Lady agree that that is awful, and is leaving far too many young people with nowhere to turn?
Dr Allin-Khan
The hon. Member is absolutely right. So many 16 to 18-year-olds find themselves on a waiting list for an extended period only to drop off it just as they turn 18, or else have one or two sessions, then turn 18 and find that there are no longer any services for them. That goes on to have a detrimental impact. This is not just a tragedy for today but a tragedy for tomorrow as well, because poor mental health in children is carried into adulthood. What happens today will impact demands for mental health services tomorrow. 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.
Janet Daby (Lewisham East) (Lab)
A GP with a surgery in my constituency contacted me recently about a serious incident of attempted suicide. The child involved is now on the waiting list, but must wait a whole year to be seen. Does my hon. Friend think that that is acceptable, or do the Government need to take action as a priority for children’s mental health and wellbeing?
Dr Allin-Khan
My hon. Friend is entirely right, and that is why we are here today. Our children deserve better; they cannot go on like this. That is why we are talking about measures that can help to ameliorate these difficulties so that no child has to wait that long, and their families do not have to wait that long for answers. This is not okay.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
Does my hon. Friend agree that among young people, black and minority ethnic young people often experience particular mental health pressures? There must be more analysis of the support that they and their families need.
Dr Allin-Khan
As always, my right hon. Friend is a powerful advocate for all groups, but particularly when it comes to black and minority ethnic groups. We do not have the data—we do not collect the data—even to understand the scale of the issue. I think that that is convenient for the Government, because it means they do not have to accept that there is a problem which needs to be dealt with.
That is one of the issues for the future. We have to understand the true scale of the issue when it comes to some minority groups, and tailor support that helps them specifically. When people from minority groups are seeking help, often it is so difficult for them to make a connection with people who understand some of the particular social pressures they live with at home and some of the societal issues they have to deal with that also contribute to mental ill health—for example, systemic racism. My right hon. Friend is absolutely right to bring that up.
We have a range of public health measures in place for children—check-ups for eyesight, hearing and growth—and vaccinations to protect against measles, mumps and rubella, yet we ignore the wisdom of the ages when it comes to children’s mental health. 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 having self-harmed or living with eating disorders. It is simply heartbreaking, and for parents it is absolutely agonising. Parents bring their children to A&E wondering why they are fainting repeatedly and are constantly exhausted.
Dr Rupa Huq (Ealing Central and Acton) (Lab)
Does my hon. Friend agree with me as a parent—we are both parents and many of us here are parents of school-age children—that the coronavirus crisis hit everyone with kids? I have 13 private schools within my constituency boundary, and I even have parents of children there emailing in that their kids, who were happy and outgoing children, are zonked in front of Teams meetings all day and have turned into blithering wrecks of what they used to be. Coronavirus exacerbated what was a problem with CAMHS all the way along and that has hit all children in this country, and the only people who will not recognise it are Conservative Members, who are in denial because they have their own internal problems to be dealing with.
Dr Allin-Khan
I thank my hon. Friend for her very powerful point. When it comes to mental ill health, no group is unaffected. It is really important that we acknowledge that, while some groups are disproportionately affected, mental ill health can affect anyone. Children can live in a £3 million house, and still feel they want to take their own life or want to self-harm. The pressure that puts on parents is extremely painful, and it causes many parents to give up their job to sit at home and care for their child, because they are so crippled and so worried about what may happen if they leave the house and go to work. That is why it is so important that we acknowledge the real difficulty we have with waiting times for CAMHS.
Esther McVey (Tatton) (Con)
Given that the hon. Lady and her party, unlike me, were enthusiastic supporters of lockdown measures and closing schools, and were not prepared to stand up to the teaching unions, does she accept any responsibility at all for this mental health crisis among young people, because those lockdowns have had such a negative impact on our young people’s mental health?
Dr Allin-Khan
Do the right hon. Lady’s Government take any responsibility for the tens of thousands of children who are now bereaved as a result of losing their parents because of this Government’s shocking handling of the pandemic? We shall take no lectures from the right hon. Member and her party when it comes to protecting children’s mental health. I shall move on.
When children come to A&E—[Interruption.] Please feel free to intervene: I will take interventions.
Edward Timpson (Eddisbury) (Con)
The fact is that we are all in this debate this afternoon because we all care about the mental health of children right across the country. For me, this is an opportunity for us to use this precious time in the Chamber to try to find some common ground between us, so that we can move forward in a positive way and people watching can understand that there are things we can do to make their lives better. In that spirit, can I suggest to the hon. Lady that she look at my report on school exclusions, particularly at how we can ensure that teachers are better prepared at school, including with the mental health leads that the Government are bringing in, so that they understand issues such as trauma and insecure attachment and can enable children to get the support they need at the time they need it? That is the premise on which we should all move forward.
Dr Allin-Khan
The hon. Member highlights the point that mental health should not be a political football, which is why we hope that he will support the Opposition’s recommendations. I should be delighted if he sent me his report; I will read it with interest.
It is crucial that when a child comes to A&E or a hospital, doctors and nurses take the time to build trust with them as a patient so that they feel safe talking about their condition, but with waiting lists growing and the staffing crisis deepening, it is becoming all too difficult to find the time to build the trust and respect that every patient needs and deserves. That is the human cost of more than a decade of decline caused by under-resourcing and under-investment in our NHS and by the lack of a proper NHS workforce plan for the future.
The impact on entire families is crushing. Time out of school affects a child’s ability to learn and their later life choices and chances. Parents have to take time off work and sometimes leave their jobs as a result, and siblings are deeply affected. 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.
Geraint Davies (Swansea West) (Lab/Co-op)
No doubt my hon. Friend is aware of the relationship between children’s mental health and air quality. Poor air quality can give rise to anxiety, depression, lesser focus and dementia, as well as mental health problems in unborn foetuses. Does she agree that more needs to be done, particularly in the most diverse and deprived areas where air pollution is worse? It is directly hitting children’s mental health.
Dr Allin-Khan
My hon. Friend is right to remind us that adverse childhood experiences and inequalities, including health inequalities, lead to worse mental health outcomes in later life and stop children from achieving their full potential.
Imagine being a mum or dad whose child is self-harming or presenting with symptoms of depression, anxiety or phobia, and being without specialist support for extended periods. We all agree that the pressure that that puts on families and parents is just so crippling. The number of children who needed specialist treatment for severe mental health crises between April 2021 and October 2021 was 77% higher than in the same period in 2019.
This is the UK in 2022. The bar to being seen by a specialist is high, the delays are long and three quarters of children were not seen within four weeks of referral. That time is one of anguish for them and their family. Does the Minister believe that making 369,000 children wait for vital mental health support is acceptable?
According to the latest report by the Children’s Commissioner, waiting times depend on where people live—so much for levelling up—and when they are eventually seen, services may be hundreds of miles away. It is making the situation so much worse. Ask any parent or any young person; they will tell us that the uncertainty and paucity of mental health services damages mental health, exacerbates mental health conditions, allows symptoms to persist and makes conditions harder to treat down the line. Ultimately, it also costs more.
Wera Hobhouse (Bath) (LD)
The mental health disorders with the highest mortality rate are eating disorders. What the hon. Member says is particularly true for eating disorders: the longer somebody waits for treatment, the longer the disorder persists, which makes it worse. We really need to look at prevention and early intervention in all our services. Does the hon. Member agree that instead of saving money at the wrong end, it makes absolute sense to put money into early intervention and, better still, prevention?
Dr Allin-Khan
I entirely agree. It has been a pleasure to work alongside the hon. Member in looking at eating disorder issues over the past couple of years; she is a powerful advocate. She reiterates my point that prevention is better than cure. We know that in the pandemic, eating disorders have increased. Young people who feel the loss of their sense of control through fear can, in trying to understand what is going on in their lives, develop habits that are unfortunately very difficult to break. We know that the earlier someone can intervene when there are such issues, the better the outcomes will be.
Sometimes the damage, especially the damage done by waiting, is permanent. Imagine if we treated childhood cancer like we do children’s mental illness: waiting for symptoms to get worse before seeing a specialist, waiting for months or even years for treatment and leaving patients and parents to rely on charity. There would be an outcry, yet that is what the Government are doing with children’s mental health. When the Minister responds, I invite them to tell the House what new measures the Government are taking, what new money is being allocated to CAMHS, and where it is going. How many mental health staff will be recruited? How will they deal specifically with the impact of the pandemic on mental health? How will they tackle the deep-rooted mental health inequalities on the lines of place, race, class and income?
Matt Rodda (Reading East) (Lab)
My hon. Friend is making an excellent speech and showing her deep understanding of this important issue. She is absolutely right to mention the enormous pressure on families and on staff. Does she agree that there should be an important focus on the retention of skilled staff by the NHS and the Government?
Dr Allin-Khan
I absolutely agree with my hon. Friend. There has to be retention, and I will come on to focus on our plan to grow the workforce. I will make progress, because I appreciate that I have been talking for a long time, and I want as many Members as possible to be able to speak.
I would like the Minister to tell us how they will tackle mental health inequalities on the lines of place, race, class and income—not slogans, not rehashed announcements, but a real plan with real funding. I have no doubt, sadly, that they will rehash old announcements. This is all while the Department of Health and Social Care wrote off £8.7 billion on wasted PPE equipment.
Dr Allin-Khan
I am afraid I have to make some progress. Labour has a plan for children’s mental health, and the next Labour Government will implement it.
The next Labour Government will guarantee mental health treatment within a month for all who need it, setting a new NHS target to ensure that patients start receiving appropriate treatment—not simply an initial assessment of needs—within a month of referral. The next Labour Government 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. The next Labour Government will put an open-access mental health hub for children and every young person in the community, providing early intervention drop-in services. The next Labour Government will provide specialist mental health support in every school to support pupils and resolve problems before they escalate.
Labour’s plan will see a full-time mental health professional in every secondary school and a part-time professional in every primary school. The next Labour Government will make every week Children’s Mental Health Week, until every child has security, wellbeing and the support they need. Childhood should be a time of wonder and joy; a time to store up precious memories of friendship, holidays and play; and a time to experience the things that form us as adults, yet thousands of children are suffering from stress, anxiety or depression. We are failing them—failing on prevention, failing on access to treatment, failing on funding and failing on supporting their families—and the system is stretched to breaking point. The staff are exhausted. The children are suffering. It is all happening on the Government’s watch, and they are doing nothing about it. That is why I urge all Members across the House to support the motion.
Several hon. Members rose—
Covid-19 Update
Rosena Allin-Khan Excerpts(4 years, 4 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I start by sending my best wishes to the shadow Secretary of State, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), who cannot be here as he is off with covid; we all hope that he gets better soon.
I thank the Secretary of State for advance sight of his statement. This variant is a wake-up call: the pandemic is not over. We need to act with speed to bolster our defences and keep the virus at bay. It is also an important reminder that no one is safe until all of us are safe. Ministers have not met the commitments that were made at the G7 this summer to get the vaccine rolled out to other parts of the globe. What update can the Secretary of State give on the Government’s global commitments?
Given that omicron is already here, what we do at home truly matters. There are measures that we can put in place right now to keep infections down and ensure that the country has the best possible protection. Will the Secretary of State set out the rationale for not introducing pre-departure testing? Surely that would be an effective way of preventing people with covid from travelling into our country.
We support the decision to introduce measures on masks on public transport and in shops, but we believe that those requirements should never have been abandoned in the first place. Keeping in place requirements for masks would always have been our plan A. Will the Secretary of State extend measures on the use of masks to hospitality and other settings, or does covid not spread in pubs? Most importantly, what is the plan to enforce mask wearing? Shop workers have given so much during the last 20 months, alongside our emergency services. Asking shop workers to enforce mask wearing is yet another pressure that they do not need and do not deserve.
If masks had been mandatory, it would have been harder for this new variant to spread. A global study published in The BMJ argued that face mask wearing can bring transmission down by as much as 53%. This Government’s flip-flopping on masks has created confusion across schools, colleges and universities, so will the Secretary of State today confirm the new requirements across all education settings? The Prime Minister is not the best person to tell people to wear masks, when he cannot even be bothered to wear one himself when he goes into a hospital full of vulnerable patients—and may I ask the Secretary of State when Conservative Back Benchers will start wearing their masks?
Will the Secretary of State update the House on when he expects there to be a decision on vaccinations for younger children? The Government have fallen far short of their own target to offer all 12 to 15-year-olds the vaccine by October half-term, so can he say what action will be taken to speed up vaccine roll-out?
Our NHS has done us proud, and has done a fantastic job of delivering the vaccine, offering first, second, third and booster jabs, all at the same time as treating patients who are suffering from covid and trying to recover when it comes to elective procedures. I thank everyone who works in our NHS and care sector. We are putting even more demands on them at the moment. Our NHS has stepped up to the challenge; it is a shame that this Government simply have not.
Among those with mental illnesses, vaccine rates are low and mortality rates high. The Government need to stop weaponising mental health, and must instead recognise that good, clear, honest communication, which they have failed to have so far, is so important in a crisis. I know that I have mentioned this time and again, but the Government must acknowledge the trauma for people with severe covid and long covid, and for NHS staff, so where is their plan?
Labour has been clear throughout this pandemic that proper sick pay will help people to isolate. The Government have chosen to ignore us time and again, so I ask again: what support will be available to people who need to self-isolate? Is not this the time to finally fix sick pay? I would appreciate it if the Secretary of State updated the House on the new antivirals and how they will be used. Why are the Government not already giving antibody tests to the immunocompromised? The situation we find ourselves in was entirely predictable. Yet again, this Government have shown that they are incapable of protecting our communities, protecting our NHS and saving lives.
Sajid Javid
I, too, extend my best wishes to the shadow Health Secretary and wish him a speedy recovery.
I have to say that I think the hon. Lady has misjudged the tone of the House. This is a very serious matter. The whole country will be looking for all Members of this House to work together and support the nation. Surely she is not blaming the UK Government for the emergence of the new variant. Perhaps she was just auditioning for the reshuffle that is going on in her party right now.
The hon. Lady asked about international donations. The UK is leading the world on international donations—quite rightly. It is absolutely right that that be treated as a priority. We would like to see other countries step up as well. A few months back, the Prime Minister pledged 100 million donations by June 2022, 80% of which will go through COVAX, of which we are a huge supporter; 20% will be made bilaterally. So far, we have donated over 20 million doses—more than many other countries. COVAX, which we helped found, and which we support, has donated, I believe, some 537 million doses to 144 countries.
The hon. Lady asked about the rules on travel and masks, and other rules that I set out. I think I have addressed that. I believe that the measures are proportionate, and that this is a balanced response. We have just set out a huge expansion of the vaccine roll-out programme, and it is a shame that the hon. Lady could not find it in herself to welcome that. As I said, I will set out more details in coming days on exactly how we intend to meet the requirement to vaccinate more.
On antivirals, we are one of few countries in the world to have procured the two leading antivirals. Our independent regulator, the Medicines and Healthcare products Regulatory Agency, was the first in the world to approve one of those antivirals. I am pleased with the over 700,000 courses that we have for citizens across the United Kingdom, but of course, given the emergence of the new variant, we will be reviewing that and seeing if more needs to be done.
Oral Answers to Questions
Rosena Allin-Khan Excerpts(4 years, 4 months ago)
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Gillian Keegan
I share my hon. Friend’s concern that waits for autism assessments and diagnosis are often way too long, and that is why we are investing an additional £13 million of funding this year. That funding will allow local systems to test different diagnostic pathways—including working on a multi-disciplinary basis, which will shorten the diagnosis time—and to find new solutions for addressing long waits. The precise allocation of funding for diagnostic pathways are decisions made at the local level, and those should be compliant with National Institute for Health and Care Excellence guidance. NHS England is working with local systems to evaluate what works well. Since November 2019, we have been reporting on waiting times between referral and first assessment, and that is important, because we use that to drive up local performance. I would be very happy to meet my hon. Friend to discuss this further.
Dr Rosena Allin-Khan (Tooting) (Lab)
When the Government talk about waiting times, they refer to how long it takes simply to get an assessment, and not to when treatment may start. Most children face an incredibly long wait after that first step, or even have their referral closed. The real truth is revealed when we look at how long it takes for children to complete treatment. In Yorkshire and the Humber, it took one child more than 13 years to complete treatment for their anxiety. In the north-west, some children took three years to complete treatment for eating disorders. In the midlands, it is not uncommon for treatment completion to take five years. Will the Minister commit, as we have, to the provision of a counsellor in every school, a mental health access hub in every single community and regular mental health assessments for children in all key stages?
Gillian Keegan
We know that the prevalence of children and young people with a mental health condition has increased—in some cases, it has increased massively. That is why we remain committed to increasing investment through the long-term plan. Also, we have consulted on the potential to introduce five new waiting times standards, including for children and young people and their families and carers presenting to community-based mental health services. In addition, NHS England and NHS Improvement have announced an additional £40 million to address the impact of covid on children and young people’s mental health, including for eating disorders. Since 2014, extra funding has been going into children and young people’s community eating disorder services every year, but we know that we have more to do. This extra funding will enhance the development of more than 70 new and improved community eating disorder teams, but there is no doubt that there is much to catch up on. We are also introducing services into schools for young people.
Covid-19 Vaccinations
Rosena Allin-Khan Excerpts(4 years, 4 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I thank the Minister for giving me advance sight of the statement and take this opportunity say a huge thank you to our NHS. Frontline staff are doing a fantastic job continuing to deliver the vaccine programme, which is especially complex and fraught with challenges as they deliver first, second and third doses as well as jabs for 12 to 15-year-olds. They are coping with numerous pressures in the system, but continue to work flat out to get the UK through this pandemic.
Winter is coming, though, and frankly the Government just do not have a handle on covid, going into the busiest season for our NHS. The Government must get a grip on the stalling vaccination programme. Plan B, which contains measures that we already support, such as mask wearing and allowing working from home, is simply not enough on its own. Yes, we support it, but it is not enough on its own. We must turbocharge vaccine boosters, fix sick pay and improve ventilation.
The clinically vulnerable are simply not getting the jabs they need. Local residents are contacting us saying that they cannot get the boosters they so desperately need. One lady in her 70s who has underlying health conditions went to her pharmacy and called 119, just to be told that she was not eligible for her booster. She has now finally got one booked for December, but she had to rely on her daughter to book the appointment for her because she does not use the internet. The system simply is not working, particularly for many of those who need it most.
The Government had a deadline of 1 November for offering booster jabs to all care home residents. Right now, only 23% of care home residents in Leicester have had their booster jab, and the picture across the country is extremely patchy. To be clear, just promoting pop-up vaccine clinics does not help care home residents. We must use all the resources we have, including community pharmacists, retired medics and trained volunteers, to go into care homes and vaccinate residents. The Government are failing and this is putting people’s lives at risk.
In my borough of Wandsworth, the two-dose rate is only 67%, which means that almost 100,000 people do not have the recommended level of vaccination, but this is not an isolated example—people in Wandsworth are working very hard to get the vaccine out—and it is replicated across the country. What are the Government doing to increase the uptake?
Let us be honest, it is largely less affluent areas that have the lowest take-up, proving that vaccine inequalities are alive and kicking. Covid has shone a spotlight on the health inequalities that exist across the country. Why are the Government ignoring them again now? We are tired of issuing the same warnings time and again.
Our rate of child vaccination is shamefully low and slowed during half-term—the rate is still only around 20%. There were almost 250,000 children out of school in the days before half-term. Where is the plan?
On current trends, we will not complete the booster programme until spring 2022. The Government need to get a grip and set a target of 500,000 boosters a day. At the moment, the figure is less than 300,000 a day, which is why we are calling for more pop-up vaccine clinics, greater use of community pharmacies and the mobilisation of retired medics.
As we approach a difficult winter, Ministers have failed to put in place measures such as improved ventilation, proper sick pay and fully resourced local contact-tracing teams, all of which would help to reduce the spread of the virus. We must get the balance right and ensure flu vaccines, covid vaccines and boosters are all delivered at a high pace from now until the end of winter. While the booster scheme is so slow, the Government should never have scrapped mask wearing and working from home. The Prime Minister should never have abandoned those measures.
The Government have failed to plan yet again, and they are putting the country at risk going into winter. We need less bluster from this Government, who seem to spend more time planning to protect their mates than the lives of people up and down the country. We need action now.
Maggie Throup
Ninety per cent. of the adult population have had their first dose, and 8 million people have taken up the opportunity to have a booster jab. That is a successful vaccination programme, so I will take no lessons from the hon. Lady.
The hon. Lady talks about care homes and, from a personal point of view, I know how important it is to make sure our most vulnerable are vaccinated, which is why I am delighted that nine out of 10 care homes have had their jabs either delivered or booked. That is a great success.
This Government have already recognised that covid has exposed the disparities across the nation, which is why on 1 October we launched the Office for Health Improvement and Disparities to understand what is important and how we can make real change in our communities that need the most help.
The hon. Lady talks about bringing back retired medics and volunteers, but they are already back. They have been playing their part for months, and I take this opportunity to thank them for all their efforts. Just last week, I met a retired medic who had come back to St Thomas’ Hospital, and he was relishing his role in this amazing vaccination programme. The hon. Lady does those volunteers and returners a huge disservice.
I am always grateful to the hon. Lady and the right hon. Member for Leicester South (Jonathan Ashworth), because throughout this pandemic they have usually been co-operative, helpful and in agreement with us, but the hon. Lady’s remarks today give too little credit to the phenomenal role that the NHS and community pharmacies are already playing in the roll-out of our vaccination programme. They are delivering a booster programme of third doses while delivering the largest flu programme ever, with 35 million people now eligible for a flu jab. I call on people to come forward as soon as they can.
GP Appointment Availability
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Dr Rosena Allin-Khan (Tooting) (Lab)
It is a pleasure to serve under your chairmanship, Mr Robertson. I thank all hon. Members for their contributions this afternoon and the hon. Member for Beaconsfield (Joy Morrissey) for securing this debate on an extremely important issue as we recover from the pandemic. This issue is close to all our hearts and to the hearts of the people whom we service.
GPs play an essential role in our communities. They are often the first port of call for people accessing a wide variety of health services, and their hard work and dedication to serving their communities ensure that we can always obtain advice, medicine and referral to other services.
When we discuss GPs, it is important to remember that they are more than just nameless public servants doing a job. They do not just serve communities; they are an integral part of them. I myself have had the same GP for my whole life, if people can believe that. I am slightly giving my age away to say that she has been my GP for over 40 years.
GPs are the foundations of our national health service, and without access to them our whole health system would collapse. Chronic illnesses would not be caught in time, mental illnesses would go unchecked and life-saving medication would simply not be prescribed. From our birth to our death, a GP is there for us all, and everyone in this country should have access to their GP.
However, like much of the NHS, GPs are overstretched and under-resourced. Even prior to the pandemic, GP surgeries had to contend with a double hit of fewer doctors in the workforce and a rising ageing population. Demand simply outweighs supply. We need more GPs, pharmacists, physiotherapists and community health workers. But instead of supporting GPs during this challenging time, the Government prefer to blame them, making their jobs even more difficult at the time of greatest pressure for our NHS.
We have looked for virtual solutions so often during this pandemic, and for the most part their effectiveness cannot be disputed. They have allowed our economy to keep going and our public services to continue functioning, and also allowed a small degree of normality in what has been an extremely challenging and turbulent 20 months. I know from my own experience on the A&E frontline, especially early on in the pandemic, that infection protocols and social distancing made many elements of delivering compassionate care very challenging.
Digital solutions have worked well, but we know that they are not appropriate in every setting and they do not work for everyone; we have heard ample example of that today in this debate. However, we need to be careful not to conflate two separate issues. Digital solutions in practices were not just necessary for infection control. The sheer demand for appointments is through the roof. GPs have been offering telephone consultations and online appointments for some time now, even prior to covid. There were 2.2 million more appointments in August this year compared with August 2019. The percentage of appointments being delivered face to face is also rising. That shows that GPs are striving to see as many patients as they can, but to increase that number even further they need more support from the Government.
The Conservatives have promised more GPs in every one of their manifestos since 2015. However, we have approximately 2,000 fewer GPs now than we had in 2015. It seems like a simple fix for Government—deliver on manifesto commitments and expand the GP workforce. That will allow for even more appointments and it will help to reduce the burden on existing staff, leading to less burnout and less fatigue.
The British Medical Association conducted a survey of GPs in July. Half the respondents said that they are currently suffering from depression, anxiety, stress, burnout, emotional distress or other mental health conditions. I repeat—half the respondents said that. That is a huge percentage. Around the same proportion of respondents said they now plan to work fewer hours after the pandemic. When a workforce are supported, their absence rates come down and their productivity goes up; it is pretty basic. Ensuring that staff are supported not only benefits the workforce but the patients, through more effective and timely care. It is a virtuous cycle, which surely even the cynics would support, as it ultimately leads to more patients being seen and better care being provided.
We have heard about the trickle-down effect of not being able to see GPs and the knock-on impact that has on the rest of the NHS. Yet instead of delivering on their manifesto pledges, this Government would rather stoke the flames of division, by attempting to shift the blame to GPs and encouraging local residents to vent their frustrations at them rather than at the Government. The Health and Social Care Secretary has resorted to attempts to name and shame GP practices that were unable to guarantee face-to-face appointments. The Government will then deny additional essential funding to the practices they deem to be performing poorly. That provocation does nothing to improve patient care; it serves only to deflect anger away from the Government and towards the health service. I know from colleagues in GP surgeries across England that it has already resulted in abuse both online and in person. That leaves so many practitioners considering their career choices, and will lead only to further shortages in future.
Fundamentally, the Government need to make good on their manifesto pledge of an additional 6,000 GPs. Without that, there will be a detrimental impact on the workforce and, crucially, on patient care. That has a knock-on impact on how much time GPs are able to spend with patients. Patients are understandably frustrated, as the backlog of care due to covid continues to pile up, with a knock-on impact on waiting times throughout the NHS. At a time when case numbers are soaring again and the booster programme is faltering due to Government inaction, people are anxious about their health and the health of their local community.
Dr Allin-Khan
No; I want to make some progress. The imminent arrival of winter is also a great cause for concern. Winter is always an extremely challenging time for the health service. GPs will be the first point of contact for the majority suffering from winter respiratory illnesses. However, GP surgeries cannot be blamed for being unable to fill vacancies as a result of wider workforce and funding issues. It is simply not acceptable. The Government are purposefully turning communities against one another, risking the health and wellbeing of patients and staff simply because they are unwilling to put forward a sustainable plan to support GPs to manage their workloads. GPs’ needs and patients’ needs are one and the same. It is a failure of Government that has led us here.
Chris Green
The Labour party voted against compulsory vaccination in the care setting, presumably because they sensed that it would have an impact on carers and their ability to carry on in the sector. Does the hon. Lady think that it would also have an impact on the NHS, with perhaps up to 100,000 people leaving, and GP surgeries?
Dr Allin-Khan
That is beyond the scope of this debate, but I am very happy to have a discussion with the hon. Gentleman afterwards. I do not believe it is appropriate to mandate vaccinations for NHS staff, forcing them to leave their jobs if they do not accept vaccination, as I put forward in the Labour party’s position on the care sector.
Let us be clear: GPs are being scapegoated for a failure of this Government to act and put people’s health first. The war against GPs that is being propagated by the Government does nothing to serve patient needs or to serve GPs, who are exhausted and unable to fulfil the commitments that they trained hard to carry out, because of a failure of this Government. I see that the hon. Gentleman feels rather pleased with himself for his intervention on me. Forcing people to have vaccinations in the communities that have been hardest hit, for whom trust has been completed eroded by this Government, does nothing to serve our collective aim, which is to ensure that the communities that we all serve have the treatment that they need and timely and respectful surgeries and appointments. That is the very thing that will keep our communities alive and well this winter.
Will the Minister, whom I welcome to her place, please outline what steps the Government will take to tackle the workforce shortages in GP surgeries? Will she outline what resources will be provided to ease the intense workload that GPs are already contending with? Will she outline why additional funding is all directed to secondary care, while our primary services are left to crumble?
I thank all the GPs out there serving our communities. I hope that the Government have listened to our points on the support that GPs, patients and communities need.
World Menopause Month
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Dr Rosena Allin-Khan (Tooting) (Lab)
I am proud of everyone who has spoken today. I thank my hon. Friend the Member for Swansea East (Carolyn Harris) for all her work on this important topic. She never ceases to amaze me with her tireless campaigning, which has earned her a formidable reputation across all our nations. Many issues divide us in this place, but we have seen the best of the House in this debate. We are here only because of the work of fantastic campaigners. In a short time, we have moved from hearing whispers of “the change” in people’s living rooms to addressing what real change is needed to support women. We are doing that here in such an important way.
It is only possible to reduce the stigma around the menopause by talking and listening as we have today. I thank all hon. Members who have contributed—men and women—on both sides, because they and their solidarity matter. Along with the many accounts we have heard, it has been incredibly important to read accounts of high-profile women realising that they are experiencing the menopause.
We have heard a heady mix of humour and heartfelt tributes today, but it is a daunting space to navigate. As a woman who has not yet entered the menopausal phase of her life, but who has been through starting a period, worrying about having children, having children and understanding her body, after today’s debate I feel less anxious than ever about a topic that many women find extremely worrying to talk about. We have celebrities to thank for raising awareness.
How many of us have never had those much-needed conversations with our families? For how many of us is it too taboo to even start discussing our periods, let alone have conversations about the menopause? It is damaging to our society that far too many women simply do not know what to look out for. More and more women are learning about the menopause from celebrity accounts. There is still far too much mystery around our bodies, despite making up 51% of the population, and that simply has to change.
It is our duty to tackle the misinformation about the menopause and HRT. I hope that this debate goes some way to addressing some of those myths. Better information about the menopause and HRT would likely mean that more women would receive treatment before their symptoms became debilitating. For example, we have heard about osteoporosis, as well as moving accounts of people living with serious mental illness and wondering why they do not feel like themselves. For many women, that lasts more than a decade.
It is important that we recognise GPs’ essential work and pay due thanks for it, but it is also important to address the lack of understanding that some GPs demonstrate. I have heard accounts of GPs refusing to diagnose women as menopausal, resulting in a frustratingly long drawn-out process that has led far too many women to give up and suffer in silence.
Karin Smyth (Bristol South) (Lab)
My hon. Friend is making excellent points. I first encountered the issue as a young woman writing a draft women’s strategy for a regional health authority in 1989, in which it did not feature. We hear much about strategies and the education of medics, but actually they have not transformed and changed in that time. Does she agree that they are important?
Evidence shows that osteoporosis disproportionately affects women with lower incomes and that there is huge variability of services across the country. Does my hon. Friend agree that that also needs to be addressed?
Dr Allin-Khan
I wholeheartedly agree with both of my hon. Friend’s points. In fact, we have heard today the statistics about just how much there is a lack of education about the menopause in medical school. It was something that we did not really talk very much about when I was at medical school. It is also really important to highlight the fact that we live in a very diverse country and a diverse society, where information has to be available in a number of languages and where there has to be proper outreach to communities in which people certainly would not think of speaking about it at home.
As I have touched on, the effect that the menopause can have on women’s mental health must not be ignored. It should not be underestimated. How many of us throughout our lives have been dismissed as hormonal, hysterical even, or too emotional? The hon. Member for Stourbridge (Suzanne Webb) spoke about her ex-ex, and I am glad to hear he is such, but unfortunately we do get labelled—women get labelled—as hysterical or hormonal as an excuse. I have actually experienced it at first hand right here at the Dispatch Box. Is it any wonder then that women are scared to speak about what is happening to their bodies?
Women who experience mood changes during menopause are often not taken seriously. The symptoms of mental ill health are often condescendingly brushed aside as simple mood swings or unnecessary aggression as a result of the menopause. The reinforcement of women as hysterical or highly emotional is incredibly damaging. No wonder some women feel they are unable to reach out for support. So many hon. Members have mentioned, so importantly, the workplace, and for so many women, support simply is not available. They are often forced to suffer in silence for fear of repercussions. This is at a time when women should be reaching their professional peaks in their careers—the heady heights of what it means to be a CEO, run a hospital, run a business or sit here in Parliament—but, instead, women are forced to make up excuses about why they are taking days off or feel that they have to take early retirement. Well, this has to end, because women are a powerful force and able to achieve anything at any point in their life, and it has been wonderful to have reminders of that today.
Besides a seismic change in attitude and an eradication of stigma, what action do we need to ensure real change to support women undergoing the menopause? We need menopause awareness training for employers to help reduce stigma and to ensure that women are getting appropriate support and advice. This not only benefits those with menopausal symptoms, but has economic benefits for employers and wider society by helping to improve productivity and reduce absenteeism. We need to ensure that medical professionals are able to recognise when women are menopausal so that HRT can be prescribed, eradicating the lengthy waits, and women must be able to access accurate information on menopause to dispel the myths once and for all.
I would like to end by again thanking every Member for their contribution today, and I eagerly await to hear from the Minister how the Government plan to tackle the stigma surrounding menopause and offer real support for women once and for all.
Oral Answers to Questions
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Sajid Javid
We are hugely grateful for the tireless efforts of GPs and their teams throughout the pandemic. In our comprehensive new plan, which we announced last week, we are including a £250 million winter access fund to support GPs and make it easier for them to see and speak to their patients. A record number of GPs began training in 2021, and we are committed to increasing the number to 4,000 each year.
Dr Rosena Allin-Khan (Tooting) (Lab)
I start by paying my respects to Sir David Amess and James Brokenshire, who were sadly taken from us far too soon.
I welcome the Minister for Care and Mental Health, the hon. Member for Chichester (Gillian Keegan), to her new brief. I look forward to working with her.
We are all too aware of the growing demand for support across the NHS, but all too often mental health treatment is forgotten. With up to 10 million more people thought to require treatment as a result of the pandemic, with waiting lists soaring and with beds being cut, we need more than just warm words from the Government. Labour will guarantee treatment, not just an assessment, starting within a month, and we will recruit 8,500 new staff so that 1 million additional people can receive the timely treatment they so deserve. That is what came out of our conference from our party leader. There was nothing of equal value from the Prime Minister, bar recycled old pledges and money spent four times over. Why?
Baby Loss Awareness Week
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Dr Rosena Allin-Khan (Tooting) (Lab)
There is nothing that fills me with more pride than having the honour of following all the incredible speeches that have been made from both sides of the House today. There are so many things that divide us in this place, but is it not wonderful that this is not one of them? I thank everyone who has spoken today for their courage.
This annual debate is about having voices heard, and all who have spoken today have said incredibly moving things, but I want to pay tribute to a few people. I thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for moving this debate. In you, Lily lives on, and she will always continue to do so.
The hon. Member for North Ayrshire and Arran (Patricia Gibson) did Kenneth proud, and I know that 15 October will prove incredibly difficult for you, as I am sure it does every single year, but you hold him in your heart and we hold him in all our hearts. We will be thinking of him on that day. In bringing your passion to this debate, you are ensuring that the other mothers, fathers and partners who go through this do not feel alone.
The right hon. Member for South West Surrey (Jeremy Hunt), with his honesty, reminded us that grief is a lifelong process. The honesty in the words of my hon. Friend the Member for Pontypridd (Alex Davies-Jones) truly highlighted that the journey to parenthood can be fraught with challenges. It is often not easy to admit some of our dark thoughts about other people’s happiness or about the failures we may see in ourselves if we feel that we do not fall into the social construct that society has created for women.
I am going to answer the rhetorical question that the hon. Member for Bracknell (James Sunderland) posed about the validity of his being here and speaking today: yes, you should be speaking. It is important to represent everybody who has gone through the same lived experiences, and you brought them to the Floor of the House.
Turning to the hon. Member for Guildford (Angela Richardson)—my goodness—the guilt surrounding parenthood is so rife, and we must be kinder to each other in society. There is nothing worse than sitting in an NCT group full of people who delivered their wonderful babies in a water bath when you went through a crash C-section and feel like a failure, crying into your cake as you wonder what is wrong with your body that meant that you could not give birth in a bath with some whale music. What you highlighted today shows us the importance of understanding that the journey through the birth process does not end once you have given birth. We have to look after each other and keep an eye on people’s mental health.
It is so important that we talk about stigma. I know about this from my work as a doctor in the emergency department over the last 16 years. I have seen countless parents come into that department. I have seen a mother, bleeding, pleading with me to tell her whether she is losing her baby, and I have known the heartbreak of performing the examination and either confirming her very worst fears or sometimes, even worse, saying, “I do not know—and I am really sorry, but it is Friday afternoon and you will have to wait for your scan on Monday morning to find out.” I see mothers who ask, “Did I eat the wrong cheese? Did I exercise too much? Should I have given up work and just stayed at home? Have I done this, doctor, have I done this?” No, you have not.
I say to every mother who is watching the debate today and asking herself if she has done something wrong, “You have not done anything wrong. Your baby was loved; your baby was wanted; you did everything right.” It is so important that we support mothers on this journey—mothers who are living with the guilt, living with the stigma, wondering if people are thinking to themselves, “Well, she clearly did not read the rules properly. We seem to have managed just fine.” To every mother who worries about that, I say, “You are not alone.” I thank all the charities that are out there doing such incredible work to eradicate the stigma, but there is still so much more to do.
To all the partners—supportive partners—who are told not to share their emotions, and told that their emotions are not as valid because they were not carrying the child, I say, “That is rubbish.” They are told not to acknowledge their grief, and are encouraged just to go back to work. It is a case of “Stiff upper lip—these things happen.” I say to them, “You are entitled to grieve. You are entitled to feel every single emotion that is due to you, because these are your emotions and that is your right.” Everyone does it differently: there is no one-size-fits-all model. We have to understand, and our health services have to be built to have a capacity that understands the nature of grief and understands that it is different for everyone. However, when we are doing this together here today, we are already going some way towards breaking down that stigma, and we are breaking it down every year when we have this debate.
It has been an incredibly difficult 18 months, and people’s experiences of baby loss during this time have been incredibly heartbreaking. During the pandemic there has been reduced access to face-to-face appointments, and when appointments have taken place in person, partners have been excluded, leaving women to receive the very worst of news on their own. Expectant fathers pace the car park, wondering when they will be allowed in to hear that very worst of news. Women are often forced to take decisions alone. I want to thank the NHS staff who have worked tirelessly throughout the pandemic, and have had to go above and beyond when visitors were not allowed into hospitals following a loss. However, I also want to highlight the important fact that there are babies that are lost when the loss could have been avoided. In the House we discuss many cases in which loss cannot be avoided, but this is not one of them.
That leads me on to the importance of inequalities in this debate. It is the saddest fact of all that where a family live and how socioeconomically well off they are can determine the likelihood of their baby’s surviving or not. Black and ethnic minority women are more likely to deliver by emergency caesarean section and less likely to have pain relief during labour, and receive fewer home visits from midwives. Stillbirth rates for black babies, including black British babies, were over twice those for white babies, while neonatal death rates were 45% higher. Black women are still four times more likely than white women to die in pregnancy or childbirth in the UK. With an ongoing inquiry into systemic racism in NHS maternity services, we must ensure that action is taken to eradicate these gross disparities. We need change now: women cannot and should not wait any longer. It is not acceptable, and these families deserve better. Many of us will have heard stories of women who were told that they needed an extra scan between the 20-week scan and giving birth, but professionals were concerned that because they were Muslim they might want to sex-select, and they were therefore denied the scan. That is atrocious. Preventable deaths have occurred because of such practices, and they must be eradicated.
Research published last week found persistent inequalities for ethnic minority women accessing mental health care after giving birth. It found that 98% of women were willing to be treated for their mental health, but one third had not received any treatment. including talking therapies such as cognitive behavioural therapy or counselling. About one third of the women surveyed felt that
“receiving treatment for emotional or mental problems carries social stigma.”
We have to understand, in our multicultural society, that everyone deals differently with mental health matters, particularly in relation to having children. We must have services that are able to handle the differences in our communities.
The major treatment stigma-related barriers to accessing services were found to be women’s concerns that they might be seen as “a bad parent”; not wanting mental health problems to be on medical records; concern that their children might be taken into care; and concern that they might be seen as “weak”. Those are the voices that we need to recognise today. We are in a place of privilege. We can stand here and talk about our experiences, people can learn from them, and we can feel that we are doing our bit to deal with our grief, but what about all those thousands of women’s voices across the country that are not heard? Today we are speaking for all of them as well.
Post-natal depression or anxiety in black, Asian and ethnic minority mothers is 13% higher than in white mothers. A 2011 study found that black women are the group least likely to initiate treatment for post-natal mental illness, and the least likely to receive follow-up treatment. We must do better, we can do better, and I truly believe that there is a collective will across the House to do better.
Let me ask a few questions of the Minister, whom I welcome to her place. Will bereavement support after the loss of a baby be standardised to avoid the postcode lottery that too many families experience? No one should have to lose three babies to receive miscarriage support; what are the Government doing to ensure that people have the support they need when they need it, not after miscarriages? Has data begun to be collected on miscarriage, stillbirth and pre-term rates, and if not, will the Government commit themselves to that? What is the current progress on the women’s health strategy, and who from the Government will be taking this forward following the reshuffle?
By talking about these issues so openly and honestly, we work to remove the stigma surrounding them. The pandemic has undoubtedly brought additional barriers that make the experience of losing a baby even more isolating, but it is stigma and the lack of understanding that can make people feel most alone. I will finish, as the hon. Member for Cities of London and Westminster (Nickie Aiken) did, by saying to anyone watching today: you are not alone.
Future of the National Health Service
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Dr Rosena Allin-Khan (Tooting) (Lab)
It is such a pleasure to serve under your chairwomanship today, Ms Bardell. I want to declare an interest: I am proudly an NHS doctor and have been for 16 years.
It is an absolute pleasure to wind up today for the Opposition. I thank my hon. Friend the Member for Leeds East (Richard Burgon) for securing this hugely important debate, and I thank all hon. Members for their thoughtful contributions and suggestions. My hon. Friend the Member for York Central (Rachael Maskell) reminded us of the inequalities that are already deeply rooted in our society, and my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) spoke movingly about residential care. My hon. Friend the Member for Rhondda (Chris Bryant) spoke about the value of our NHS staff, and my hon. Friend the Member for Wirral West (Margaret Greenwood) reminded us in no uncertain terms how life looks without the NHS. My hon. Friend and neighbour the Member for Streatham (Bell Ribeiro-Addy) spoke of the privatisation by stealth that she already sees in her community and the detrimental impact that it will have.
There is no institution that unites us quite like our NHS, and it represents the very best of our values: collective, compassionate and co-operative. Our health service was once the envy of the world and laid the blueprint for publicly run, universally free healthcare for the modern age. The outbreak of coronavirus reinforced the need not only for a universal health service, but for health services to be properly funded and fully resourced. I am in no doubt that we lost more lives than we needed to because of the drastic and protracted underfunding of our NHS over the last decade. The pandemic reminds us of the risks of Conservative underfunding and undervaluing of our NHS, leaving it ill-prepared to handle winter, let alone a global pandemic.
Despite our unwavering pride in our NHS, it has suffered a decade of decline under consecutive Conservative Governments, and we have already lived through a botched reorganisation in 2012, which was supposed to cut down bureaucracy and deliver better care for patients. Instead, the Lansley reforms had the opposite effect, by complicating processes and increasing the reliance on private providers. The reforms introduced market elements, putting shareholders and companies ahead of patients. Shame! The changes meant that services went out to tender to anyone, resulting in private companies competing against public ones to deliver care at a local level. Those changes completely fragmented our health service, creating a route for private companies to make a profit on community services.
The damage of that reorganisation is still being felt profoundly today. Waiting lists are skyrocketing and people are finding themselves stuck in A&E. Routine operations are being cancelled and cancer waiting times are not being met. Operations are being postponed at an alarming rate, and the backlog in mental healthcare is reaching an all-time high. We are letting down a whole generation of young people, who are so reliant on timely access to mental healthcare services.
Like my medical colleagues across the country, I have been in A&E to comfort young people with eating disorders, who are stuck there because there are no appropriate beds for them. They feel that they cannot trust anyone, because they continue to be passed from pillar to post. I have been with families who hope that their elderly relatives get discharged so that they can spend their final days at home. What must it feel like for a family who are waiting for the person they love to be discharged, just so that person can die with dignity at home and in the arms of those they love? Because of fundamental flaws in social care, however, they find that they cannot be reunited with and cared for by the ones they love. Shame!
We have seen a rise in the use of more expensive agency staff throughout the last 10 years, while nurses, doctors and porters have had their pay squeezed. During this decade of decline, we have also had the first doctors’ strike in the history of the NHS, with junior doctors forced to take industrial action because of contract disputes. The Government expect doctors to work longer for less. The last thing that we frontline NHS staff want to do is to strike. We want to be serving our patients but, sadly, the Government have given us no choice but to know that the best thing that we can do for our patients is to demand better pay and working conditions.
Our NHS staff have worked incredibly hard throughout the pandemic. Through each lockdown, each wave and each new variant, NHS staff have kept going, putting themselves at risk in order to keep us safe. The personal sacrifice is astounding, and we know that so many have paid the ultimate price with their lives. Staff are exhausted, burnt out and in desperate need of respite, and yet they are not receiving sufficient support from the Government. Throughout the pandemic, I have had medics, nurses and colleagues from all around the country messaging me in the middle of the night, unable to sleep from the stress that they have been put under and the amount of death that they experienced in such a short period of time. They were not trained for such conditions.
As hon. Members have said, it is no wonder that around a third of NHS staff stated in the most recent survey that they were considering leaving their jobs. With vacancies already high throughout the healthcare service, losing more staff would be absolutely catastrophic and would definitely impact on patient care. Healthcare staff need to feel valued and appreciated by the Government, but despite the sacrifices they have made and continue to make, their only rewards so far have been empty claps and a real-terms pay cut. If the Government truly appreciated the efforts of NHS staff, they would offer those staff a fair pay rise. The Government might also consider taking up my offer to work with them on a cross-party basis to address the mental health crisis among NHS and care staff. There is nothing I would like more than to work with the Government to deliver what our frontline NHS and care workers need.
On the subject of pay, fair pay is not simply a moral imperative; it is about the future functioning of our NHS. The NHS is one of the single largest employers in the world, but it is in the midst of a workforce crisis. By refusing to offer a fair pay rise, the Government risk causing workers to leave the health service. That would create more vacancies, further shortfalls of staff during shifts and increased workload for the staff who remain. We know that 56% of NHS staff already work unpaid additional hours, and that percentage will only increase if the workforce becomes even more stretched. It is a cycle that will lead only to further burnout among staff and eventually to more staff looking to leave. The Government have known for years that further action must be taken to recruit, retain and train more staff, yet nothing is being done at a fast enough pace to ensure that future demand will be kept up with.
Despite the mishandling of the NHS since 2010, it seems the Conservatives have not learned their lessons, because they are forcing through another reorganisation. The Health and Care Bill, like the Lansley reforms before it, fails to grasp the real challenges facing the NHS. It will only serve to create more problems, rather than solutions, and it will put our entire health service at risk. It does nothing to stifle the market forces present in NHS services, meaning that we will have more private companies running vital community services. A modern NHS has to take a whole-society approach, working closely with local authorities and other public services to reduce the inequalities that drive poor health. A joined-up approach would better serve communities, but the new Bill fails to outline how such an approach would be achieved, and that will result in more fragmented services and worse outcomes for patients. Instead of adopting such an approach, the Conservatives are more interested in consolidating power and guaranteeing private providers a voice in how local services are run.
As we look ahead to the future of the NHS, it is important that we never forget the principles on which it was founded: free at the point of delivery, publicly funded and publicly run, universally available and based on clinical need, not the ability to pay. The Conservatives, who voted against the creation of the NHS 22 times, have been working hard ever since to slowly erode the collective foundations on which it was built. We cannot let that happen. We must never, ever lose sight of the founding principles of the NHS, and we must never let the market control healthcare in this country.