Health Protection (Coronavirus, Restrictions) (Steps etc.) (England) (Revocation and Amendment) Regulations 2021 Health Protection (Coronavirus, Restrictions) (Self-isolation) (England) (Amendment) Regulations 2021 Health Protection (Coronavirus, Restrictions) (Self-isolation) (England) (Amendment) (No. 2) Regulations 2021

Rosena Allin-Khan Excerpts

Monday 13th September 2021 General Committees

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

What a pleasure it is to serve under your chairwomanship, Ms McDonagh.

At the time of restrictions lifting, we opposed, and still oppose, the decision to remove the requirement to wear a face covering indoors and on public transport. Risk of transmission inside a crowded bus or train will be incredibly high. Last week, the Office for National Statistics believed that one in 70 of us in England had covid. The capacity of a double-decker bus is about 70, and a full tube or train carriage can carry up to 140 passengers, which means that last week each full carriage could have contained two infected passengers, with little ventilation and no legal requirement to wear a mask.

With no requirement to wear a mask coming from the Government, mask-wearing has dropped considerably. However, people learning to drive and their instructors are still required to wear a mask inside cars, although we do not require people to wear masks on a crowded bus. That makes no sense.

The explanatory memorandum to the statutory instrument states:

“The rationale for revoking these regulations is that the success of the vaccination programme means that at Step 4 we can move away from strict legal restrictions and towards personal responsibility and informed judgement.”

What assessment has been made of the rates of infection in areas where it is still compulsory to wear face coverings on public transport—for example, here in London?

We supported the removal of some restrictions on gatherings, but the Government did not have to go so far, so fast. The announcement that all limits were being removed again came too late, meaning that businesses were left to scramble owing to confusing and contradictory advice. Ministers have passed the buck to businesses and individuals with vague and unclear guidance encouraging, but not mandating, the use of masks, as well as the NHS covid pass.

The Government’s explanatory document states:

“Our assessment of the risks is not fundamentally changed by new Variants of Concern”,

but what about the rate of deaths and hospitalisations? There is talk of an October lockdown. What impact have these changes had on the rate of infection? Bars and restaurants have resumed service as normal, but what public health assessment has been made of transmission rates since social distancing was scrapped and face coverings were deemed not to be necessary?

Due to the unpredictability of the virus, it would be negligent completely to remove the ability to reinstate any restrictions if required locally, so we are pleased that regulation 3 powers for local authorities are being extended. However, the Government must back up local authorities with a proper package of support should they impose restrictions. Allowing local authorities to limit the capacity of venues and allowing them to mandate certain social distancing measures may become essential in preventing localised spreads. That may not have seemed necessary over recent weeks, but with cases, deaths and hospital admissions all rising, some local authorities might be forced to impose measures and the Government must—absolutely must—support those businesses and councils.

With contact tracing now voluntary, and with the requirement to book a table before entering premises removed, we are in the dangerously perilous position of not really knowing who is entering venues. During the summer, there has not as yet been a requirement for further restrictions, but with the winter months closing in, this type of contact tracing might become invaluable in battling a fourth wave if we are indeed to avoid lockdowns.

Removing that requirement altogether has meant that its importance has been lost to most people, and reapplying it would be an uphill task. It must also be said that while contact tracing in establishments could have been used effectively to target specific outbreaks of the virus, we know the Government did not really use the data and instead relied on the test and trace app. For a multi-billion pound test and trace system, I would have expected far more for my money.

There is no longer a need for people to check in at bars and restaurants, but is there contact tracing data that can be shared with us? How many new cases of covid have had their contacts successfully reached? One of the most important aspects of any contact tracing system is ensuring that anyone identified as a close contact of someone with the virus self-isolates as a precaution. However, the roll-out of the vaccine coinciding with the reopening of the economy requires that to be adapted.

We supported removing from people who were double-vaccinated and had come into contact with someone with covid the requirement to self-isolate, unless they returned a positive test, but that could have been done sooner. The Government had no real logic behind their chosen date in August and they still cannot explain why they chose 16 August when Wales and Scotland had removed the requirement a week earlier, enabling thousands of non-infected people to get to work. Someone who has been double-vaccinated is far less likely to get a serious infection from covid, and transmissibility is reduced as well.

Paragraph 7.7 of the explanatory note to the self-isolation statutory instrument stated that

“public health modelling suggests that the rise in case numbers we are experiencing will have peaked by mid-August so introducing this change then will reduce the risk of transmission, hospitalisations and deaths.”

However, that was not the case. Instead, cases continued to rise. What further assessment has been made of case rates? Following the scrapping of self-isolation among the vaccinated, what assessment has been made of the direction of travel of such cases? There is also an exemption from self-isolation for children. We are still early in the school year, but what assessment has so far been made of the spread of covid in schools this term?

Although we will not oppose the regulations, our concerns regarding certain aspects of them have been put on the record. I hope the Minister can provide answers to my questions. Fundamentally, these decisions must be driven by data and science, not pressure groups and lobbyists.

This has been an incredibly difficult time for everybody, and we understand how challenging it has been for people to self-isolate and to manage work with their children at home, but we must state that we know cases are on the rise. It is incredibly difficult to predict how case numbers will proceed over the winter months, so I would welcome answers to my questions so that we can ensure that the public are kept as safe as possible.

Covid-19: Immunology Research

Rosena Allin-Khan Excerpts

Thursday 9th September 2021 Westminster Hall

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

It is a pleasure to wind up for the Opposition with you in the Chair, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for securing this extremely important debate. I know he is hugely passionate about so many issues, and it has been wonderful to hear him set out exactly why this topic is so close to his heart.

So many heroes have emerged from this pandemic: our frontline NHS staff, shopworkers, carers, posties, delivery drivers—the list goes on and on. It is absolutely right that these people’s efforts are recognised, but today we have the opportunity to express our gratitude to a different group of people—a group that is more often found behind the scenes in labs and research facilities up and down the country. Their commitment and dedication to understanding and then eradicating deadly diseases has saved millions of lives over the last two centuries. Immunologists and all their colleagues in biomedical research deserve all the gratitude we can offer.

It is through immunological research that we can treat and prevent the spread of diseases. Although it can be difficult to remember a time when we were not consumed by information surrounding covid, it is important to remember how we got here so quickly. Without this research, we would not be able to develop vaccines or even understand basic principles in reducing infection rates. This work allows us to identify who is most at risk of certain diseases and informs both public health messages and interventions to limit outbreaks.

The work of immunology researchers and scientists led to an almost immediate understanding of this virus. We understood how to limit its spread and, ultimately, how to develop a vaccine to stop it. Considering that very little was known about the coronavirus before it began to spread ferociously around the world, this achievement is even more remarkable. Without this work and dedication, the loss of life worldwide would be far greater. For that, we already owe a huge debt.

It is only right to begin my contribution today by paying my respects to those who work in this field. In particular, I pay respect to the British Society for Immunology and the Royal College of Pathologists. I am sure colleagues will join me in doing so. Those institutions refused to be fazed by covid-19, and the work of their members has been pivotal in delivering a route out of the pandemic. We have a long and proud tradition in this country of pushing advancements in medicine, especially on immunisation. The work of UK scientists has led to vaccines being developed for numerous infectious diseases.

Edward Jenner, often referred to as the father of immunology, discovered the first ever smallpox vaccine in 1796. It had been theorised that exposure to cowpox would protect against infection with the more lethal smallpox. Jenner tested this theory and it was a resounding success. A tribute to Blossom, the cow whose cowpox was used as the first vaccine, can still be found on the wall of the St George’s medical school library, which is attached to the hospital where I work. From that achievement in 1796 to covid vaccines today, we should be proud of this legacy.

The scientific community has always fully endorsed collaboration and working across borders and cultures to foster innovation. Let us be clear: the unsung heroes are our scientists, who went to work day and night throughout the pandemic, even though they were putting their own lives at risk and were concerned for their own families. They are the reason we have a vaccine today—a vaccine that has saved so many lives. For them, we are truly grateful. By collaborating with researchers all over the world, UK scientists have played their part in preventing deaths from some of history’s deadliest diseases. These efforts have resulted in no less than 26 vaccine-preventable diseases, and are estimated to prevent over 2 million premature deaths globally every year.

I am proud to be part of the UK scientific community—as, I am sure, are you, Dr Huq. I am truly honoured to have met so many of the specialists who have been relentless in their struggles to get a handle on covid-19. It is imperative that the Government do all they can to support this work and to facilitate as much international collaboration as they can during the final stretch of covid-19 and long beyond. Despite all we have learned about the virus, there is still so much we do not fully understand: exactly how long immunity lasts following vaccination and whether immunity completely prevents individuals from passing the virus on, or simply prevents them from developing symptoms. Research into those questions is, of course, ongoing, and as greater numbers are vaccinated we should be in a better position to answer them.

With the ongoing threat of new variants emerging, it is vital that we understand their potential effect on immunity. Closely monitoring new variants and their impact on our immune system will help get us to a position whereby we can begin to control the virus and exit the pandemic. It is easy to assume that, now that we have a vaccine, the hard work is over and life will inevitably return to normal. While that is what we all strive for, we cannot allow complacency to creep in. By continuing to support the work of immunologists, pathologists and the wider scientific community, we will be able to face any new emerging challenges and react accordingly.

The UK is a global leader in immunology and infectious disease research, both in the academic environment and in our industrial capabilities. We need to build on those strengths and invest in our workforce, who are the lifeblood of the discipline, to ensure that excellence continues to be recognised at home and abroad. I would be grateful if the Minister could commit to this and outline what support the Government will provide for this highly skilled workforce.

Now is the time to encourage people to take up careers in this field. We need to attract high levels of talent from around the world, while training and developing our own staff and encouraging them to forge long and successful careers here. We must continue to break down the barriers in STEM to ensure that immunology has a representative workforce who can inspire future generations, regardless of their gender, ethnicity or class.

The response from the research community to covid-19 has been immense, but it has also highlighted the need to be better prepared for the next pandemic, whatever it may be and whenever it may come. Governments around the world recognise that and must never lose sight of it. Here in the UK, we cannot afford to take our eyes off the ball. Doing so would jeopardise the results of the sacrifices we have all had to make over the past 18 months, including those in our scientific community. I implore the Government to continue to support our world-leading biomedical science sectors long after covid becomes a distant memory. We were not as prepared as we could have been for the virus’s onslaught. We must learn from that and ensure that we are better prepared for the next threat, even if we do not yet know what it will be.

[Dr Rupa Huq (in the Chair)]

Finally, from the Government, Nadhim Zahawi. It is good to see him in person, and not on a conference call on a Friday.

NHS Update

Rosena Allin-Khan Excerpts

Wednesday 21st July 2021 Commons Chamber

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

I declare an interest as an A&E frontline doctor who is working in our NHS.

The contempt that the Government have for the House is unacceptable. I had advance sight of the statement only a few minutes ago. Once again, the Government have had to row back on a shoddy, ill-thought-through position, with their 1% pay rise—a real-terms pay cut—rejected by the independent pay body. What do they do? Nothing. Less than an hour ago, there were competing briefings on what the deal was going to be, but it turned out to be nothing. Our NHS staff deserve better than this. They have worked incredibly hard throughout the pandemic, and their personal sacrifice is astounding. Their hard work never stops, and that is not without consequences. Work-related stress has increased by nearly 10%, and mental health is consistently the most reported reason for staff absence in the NHS, accounting for approximately half a million days lost every single month.

Those issues preceded the pandemic, but the increased pressure, intensity and trauma experienced by staff has taken its toll. Reports published in January found that nearly half of frontline NHS staff were suffering with post-traumatic stress disorder symptoms and severe depression, with many drinking to numb the pain. It is hardly a surprise that a third of staff are considering leaving their job. With vacancies throughout the health service, retaining staff is absolutely vital, especially when the NHS is embarking on a vaccine booster campaign, tackling the coming wave of coronavirus hospitalisations, treating the growing number of long covid cases, and dealing with the ever-mounting backlog.

That is why a fair pay rise and conditions are important. It is not just a moral imperative—it is also about the future functioning of our NHS. By refusing to offer a pay rise, the Government risk workers leaving the health service, creating more vacancies, shortfalls in shifts and increased workloads for the staff who remain. It makes recruitment much harder, with huge gaps in crucial areas such as nursing. It makes the Government’s already insufficient pledge to recruit 50,000 more nurses by 2024 simply impossible. Healthcare staff are rightly angry that they have been treated in this way. We recognise that unions want to consult their members on all proposals, and we support them in that. The fact that even the unions have been kept in the dark is utterly unacceptable.

After the year we have had, there should not be so many unanswered questions, so I ask the Minister: is this really fair on NHS staff who have had to bury their colleagues, as well as their families? Is this really fair on NHS staff who have been sent like “lambs to the slaughter”, without appropriate personal protective equipment for work throughout the pandemic—I am using their words. Is this really fair on NHS staff who are sent to support us and our families, ill-equipped and with inappropriate PPE? Is this fair, when NHS staff nursed our loved ones when they died alone? Is this fair, when staff are exhausted and there is still no end in sight. Minister, this is quite simply an insult of the highest order. After everything our NHS staff have done for us, when will the Government finally make them feel valued and offer them something more than claps?

A statement on the NHS should have concrete plans on how the Government will support the NHS in tackling the summer crisis. If the Minister is so sure that she understands NHS staff and their pressures and workloads, I invite her to do a shift with me on the A&E frontline—she can shadow me for once.

National Health Service

Rosena Allin-Khan Excerpts

Tuesday 13th July 2021 Commons Chamber

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

Since the start of the pandemic, our lives have all been deeply affected. Our key workers have experienced more than their fair share of grief, strife and sacrifice. Our care staff have truly been the best of us during the past 16 months, nursing our loved ones at the end of their life, being the person who holds our relatives when they are scared and confused, and facilitating greetings through windows and fences and across roads. They have been family to our vulnerable relatives over the past year, and for that I will be forever grateful. I do not think we will ever be able to repay that debt.

These are not the words of a politician or even a doctor; they are the words of a daughter who had to say goodbye to her father during the pandemic. I am eternally grateful for the care my father received, which went above and beyond what I could have expected. Carers showed my family and me what humanity truly is: changing their shifts to be with him, being on the end of the phone whenever we needed them, and facilitating whatever they could for us to be with him in his last moments. I can never repay my father’s carers for the humanity that they showed him as his condition worsened while my family could not be by his bedside.

Carers were scared, and many still are. The idea of passing a deadly virus on to the people in their care tormented them, and that is why we are here today. The idea that care workers do not think about the day-to-day safety of the people they care about is an insult. From my own experience, I know that their residents are of the utmost importance to them. So often poorly paid, they put in the gruelling work because they truly care. To argue that they do not neglects their fears. We want everyone working in a care home to take up the vaccine, which is safe and effective, but we are not inclined to support these proposals or the case for compulsory vaccination.

There are serious warnings from the care sector that the Government’s plan could lead to staff shortages in already understaffed care homes. This would have disastrous consequences for the quality of care. It is vital that we examine the current reality of life on the frontline in care settings. During the pandemic, Unison surveyed its members, who shared that they were feeling more anxious and depressed than before owing to the fear of passing the virus on to their relatives and those under their care. Many felt that their management were not equipped to support their needs. Resoundingly, care workers just wanted people to listen to their experiences and the challenges they were experiencing without, and I quote, “fear of being singled out as a troublemaker”.

[Rachael Maskell]

I am really grateful for the speech that my hon. Friend is making and obviously pass on my condolences to her. Does she agree that after all that our care workers have been through, what they need at this time is not only supported conversation about how they can progress with their own vaccination, or not, but to have the right people in place giving them that supported conversation?

[Dr Allin-Khan]

It is almost as though my hon. Friend has read the rest of my speech. I could not agree more.

We have to listen to our care workers today. For the young, pregnant carers worried about their next pay cheque, will these proposals make them more secure? For all those carers from communities who have lost trust in authority, will the threat of losing their jobs instil more trust? For all those carers who have loved and cared for their residents but have concerns about the vaccine and have not had anyone answer their questions, are they being told that their dedication is suddenly irrelevant?

To understand why there may be hesitancy among care home workers to take up the vaccine, it is important to understand the health inequalities that much of the workforce face. Ethnic minorities are over-represented in the adult social care workforce, with 21% of all care staff coming from a minority ethnic background. Negative experiences of a culturally insensitive health service, the higher rates of death from covid for people from black and south Asian communities, and a lack of representation of minority groups in vaccine trials and wider health research all serve to build distrust in the health system. These are some of the communities that have been hit the hardest during the pandemic.

The disproportionate use of coercive and restrictive practices on minority communities also, importantly, erodes trust in the system. Black people are four times more likely to be detained under the Mental Health Act 1983 than white people, despite making up a much smaller percentage of the overall population. With trust so low, that creates hesitancy, but this can be overcome through effective communication and an understanding of the issues that have created it. Further coercion and punishment through the threat of being dismissed from employment only reinforces the reasons for hesitancy in the first place.

[Steve Brine (Winchester) (Con)]

I hear what the hon. Lady is saying. My first instinct on persuasion, months and months ago, was exactly the same, but more than seven months on, it has not happened. I am tempted to ask, “If not now, when?”, to coin a phrase. What is her response to that?

[Dr Allin-Khan]

My response is that the Government have not gone far enough to have these conversations. A real effort has not been made to engage with the communities that have been hit the hardest and for whom vaccine hesitancy is at its highest. Trust being so low creates the hesitancy that I have just spoken of. This hesitancy can be overcome through effective communication, but that has not yet happened under this Government’s watch.

[Several hon. Members rose—]

[Dr Allin-Khan]

I am going to make progress, thank you.

These measures will disproportionately punish groups whose needs are already rarely reflected in mainstream health services or the labour market. Respectfully listening to concerns and offering practical support would not only tackle vaccine hesitancy; it would also help to rebuild trust in health services, which in turn could eventually lead to reduced health inequalities for all minority groups.

Let us be clear: vaccine hesitancy is entirely different from being an anti-vaxxer. Vaccine hesitancy is a challenge for the Government to tackle. It is harder work. There is no quick fix. The Government are trying to make an incredibly complex issue into a black and white one, and that does nothing to pay respect to the sacrifices that care workers have made since the start of the pandemic. More must be done to encourage uptake of the vaccine.

[Dr Luke Evans]

Will the hon. Lady give way?

[Dr Allin-Khan]

I am going to make progress, please.

The UK Government should learn from the fantastic work of the Labour-led Welsh Government, who are running the fastest vaccine programme in the world and have vaccinated a far greater proportion of their staff than England; yesterday’s figures showed that almost 95% of care home residents and 88% of care home staff are double vaccinated. Wales has rejected compulsory vaccinations and instead chosen to work closely with the care sector to drive take-up, as well as valuing the workforce with a proper pay rise. That is the sort of leadership that is needed here.

A failure of leadership here will place the care sector in an even more precarious situation, with even fewer staff than at present. There are serious warnings from the care sector that the Government’s plan could lead to staff shortages in already understaffed care homes. That would have disastrous consequences on the quality of care. More than 100,000 posts in the care sector are currently unfilled, with recruitment and retention already extremely difficult due to low wage levels for difficult and demanding jobs. Not only could this plan have a disastrous impact on those relying on care, but the stress and trauma placed on their relatives will affect so many across the country. We already have a social care crisis. Let us not deepen it.

These proposals are at odds with the Government’s decision to throw caution to the wind by making social distancing and mask wearing optional and up to individuals to decide on. It makes no sense. Surely forcing workers to receive a vaccine is at odds with the individualism that the Government seek to promote at every opportunity. It seems odd that care workers are being singled out. Why is there a different rule for them? Are the Government hoping that the public will simply forget about their failure to protect care homes over the past year? Is that what is going on here?

Forcing carers to choose between losing their job and taking a vaccine that they are afraid of is inhumane. These are people who often work for less than the minimum wage. They are incredibly vulnerable people and their voices must be heard. Many of these people have lost multiple family members during the pandemic. They are being asked to put their faith in a vaccine that they are afraid of. The Government need to be doing more to tackle misinformation, promote the positive benefits of taking up the vaccine and support care home staff to do so. They have not been doing enough to support care workers who have done so much during the crisis. They should be focused on driving up standards and staff retention by treating care workers as the professionals they are, with improved pay, terms and conditions and training.

We have a moral imperative not to force people to take a vaccine that they are afraid of, so I urge the Government to listen to our care workforce. Surely they deserve at least that after the last year.

[Madam Deputy Speaker (Dame Rosie Winterton)]

This debate finishes at 7.19 pm and I need to bring the Minister in at the end. That means that if colleagues speak for between four and five minutes, everybody will get in. If colleagues do not speak for between four and five minutes, everybody will not get in.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 13th July 2021 Commons Chamber

[Sajid Javid]

We have put more and more capital into the NHS. There are always representations from hon. Members, including you, Mr Speaker, for even more capital. My hon. Friend is right to raise the issue of the importance of local healthcare systems, which will need more capital funding as we progress. She will know that we set out our capital plans for this financial year, 2021-22, but she is right to say that multi-year funding will mean that trusts can plan better, and that is a priority; we want the spending review to have more sight and better planning for capital.

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

Let us consider these words about mental health services:

“prior to 2017, no government invested in or prioritised MH services.”

Those are not my words but the words of the Minister for Patient Safety, Suicide Prevention and Mental Health, the hon. Member for Mid Bedfordshire (Ms Dorries). Indeed, the new Secretary of State was the architect of these cuts, during his time as a Treasury Minister. The unparalleled devastation he left behind has been simply staggering, so does he agree with his Minister? Can he explain to us why 140,000 children were turned away from mental health services last year? Can he explain why a quarter of mental health beds have been cut since 2010? Is he ashamed of his track record?

[Sajid Javid]

The hon. Lady will know that the NHS long-term plan that has been set out by this Government is committed to a transformation in mental health services and mental health spending; some £2.3 billion extra is being invested by 2023-24. In addition, she will be aware of the mental healthcare White Paper and the mental health recovery action plan. I hope these are all initiatives she will support.

Children and Young People’s Mental Health

Rosena Allin-Khan Excerpts

Wednesday 16th June 2021 Westminster Hall

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

It is such a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Twickenham (Munira Wilson) for securing extremely important debate and all hon. Members for their thoughtful contributions.

My speech is full of stats. We have heard stats and real-life stories. We know what has been unfolding in our communities. Today, we have a choice to do something about it. The Government have a choice to do something about it. What are we going to do? We are going to make our interventions, state our cases, speak the numbers. The Government will respond and then we will go back to normal, with children attempting to throw themselves off bridges; a reality where parents have to take time off work or give up work because they are so worried about their children who are self-harming. We are going to go back to teachers who would walk over broken glass for their students, desperately telling me that they cannot get their children on to CAMHS waiting lists. Even if they are lucky enough to tick those boxes and get on a list, it is far too long until they are seen.

Today, we have the choice to do something about this. Demand for mental health support is at an all-time high, yet access to services is simply not keeping up. For over a year, Labour has warned that children’s mental health should not be forgotten in this crisis, but it is easy to blame the coronavirus pandemic for what we are seeing playing out in our communities—every single community. This issue cuts across the class and socio-economic divide. It can affect any child or young person. Prior to the pandemic, access thresholds in many places were so high that they created unacceptable waits and led to children having their referrals cancelled without treatment.

The former Children’s Commissioner outlined in her 2021 annual report that over half a million children and young children were referred to CAMHS in 2019 and 2020. Of those, approximately 3,500 either had their referral closed or were still on the waiting list by the end of the reporting period. This simply is not good enough.

The pandemic has pushed services that were once stretched to breaking point over the edge. The Minister does not need to take my word for that, but she should certainly heed the warning from the NHS mental health trust leaders surveyed in May this year. The survey, carried out by NHS Providers, found that two thirds of trust leaders said they were unable to meet demand for CAMHS. Every leader surveyed stated that demand for children’s and young people’s services is higher now compared with last year. Some 78% said they were extremely or moderately concerned about their local system’s ability to meet the level of demand over the next 12 to 18 months, and 84% of trust leaders said children were waiting longer for treatment than they were six months ago.

The Government know all these stats. The Minister knows all these stats. What is she going to do about it? Is she going to recycle yet more money in a new announcement? Is she going to spend £2.3 billion over and over again in every debate that we have, depending on exactly which mental health topic we are talking about? The NHS does an incredible job with limited resources. However, it needs the political will to close the gap, now more than ever, and workforce capacity is often cited as the biggest barrier to scaling up provision.

That has been known for some time, with not enough being done to rectify it. Failure to resolve the issue before the pandemic is now having disastrous consequences. Mental health trusts had to give money to local hospital trusts to plug gaps, leaving them with even less of the money that they needed. This, on top of 11 years of an austerity-driven agenda, means the money is simply not in the system, and anything put back into the system will simply not cut it.

Staff have been grappling with a health emergency for more than a year, under enormous pressure, resulting in the acceleration of burnout and exhaustion. They are in desperate need of a reprieve, but the mental health fallout from covid means that waiting lists continue to pile up. Without urgent action, that gap in access will only continue to grow, leaving thousands of children to fall through the cracks.

National and crisis provision are extremely important, but more must be done to ensure that support is proactive, holistic and community-led. The biggest driver of poor mental health in children is adverse childhood experiences —I can see colleagues nodding. That is a well-known fact. When I do a shift in accident and emergency, and a child comes in with mental health issues—a child I have seen multiple times in the previous year, living in mouldy housing, in multi-occupancy homes, with parents who cannot access jobs—it is no surprise to me that they are suffering with their mental health.

What will the Government do about that? In areas of deprivation, it is not uncommon for parents to resist answering calls from withheld numbers or opening letters labelled private and confidential, but that is the main way in which CAHMS appointments are communicated to parents. Many miss the appointments, despite them and local advocates having pushed for treatment for many months and even years. Those children, the poorest and the hardest hit by other Government measures, then get dropped, which unfairly creates the impression that parents simply do not care. Those same parents are often grappling with many children suffering with mental ill health as a result of their life experiences.

Advocates out there would give the shirts off their back and, as I said, walk across broken glass to get those children to appointments. A fully holistic approach would include in a child’s referral the GP and school, where necessary. In areas where mental health is less understood, or cultural or language barriers exist, many children will attend a CAMHS appointment with mum and dad after the school has referred them, but because of a lack of understanding, mum and dad cannot explain the issues that their child is facing, so no course of treatment is started and the child is taken off the list.

These are our most vulnerable children, and often the children who need our help the most. What will the Government do to make services accessible for such children and their families? The scars that children live with forever means that those with the best English and a better understanding get the treatment they need, while others fall through the cracks. Many of us serve communities where that is the case, and it is no surprise that, despite being four times more likely to have a mental health problem than their affluent peers, children from the poorest backgrounds are much less likely to access services. A more joined-up, proactive approach between education, health and local authorities is needed, with greater focus on prevention and early intervention.

Talent is everywhere, but sadly opportunity is not. That is why the Labour party announced a children’s recovery plan to ensure that children can continue to play, learn and develop in the post-covid period, no matter where they are from, or what school they go to. That programme is meant to support children and young people throughout their education, and to recognise that positive mental health and wellbeing can be pivotal for children to reach their fullest potential. By tackling food poverty in schools, guaranteeing quality mental health support for pupils and fully funding extracurricular clubs and tutoring, each child would have an equal chance to succeed.

The Government know we are facing a mental health crisis. That is not news. We have whole communities full of people who are desperate for support—parents, teachers, families, children, desperate for support. They are counting on us to use the debating time today to make real, effective change. They do not want just rhetoric—just empty words and gestures, the same old recycled announcements time and again—but an acknowledgement that the Minister has today listened: listened to the pleas from those with eating disorders; listened to those who are suicidal; listened to those unable to access CAMHS services; listened to those who have waited far too long for the help they need and deserve; and listened to people who are unable to reach their fullest potential because they have a Government that do not understand the scale of the issue.

The time for dither and delay is over. I look forward to the Government announcing some real, tangible change.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 8th June 2021 Commons Chamber

[Ms Dorries]

The short answer to that question is no, and that is why we have committed an additional £500 million to address some of the issues that the hon. Gentleman highlights. However, I must reiterate that the majority of our targets, where they have been set, are being met. Sadly, in eating disorders—I hold my hands up—we are not meeting the targets that we want to, but as he may be aware, we are trialling four-week waiting targets for children and young people. The results of that review and pilot will be available soon.

We continue to look at ways in which we can increase access to services for children and young people. Children and young people have told me themselves, via organisations such as Barnardo’s, that they want their mental health services delivered in a different way. They do not want to go and sit in a village hall or a hospital, or wherever they may receive their services from community practitioners; they want some of their services delivered via their phones, laptops or computers. Obviously, one-to-one services have to be available where they are needed, but children and young people are demanding a change, and we are going through that change now.

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

My hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) raises a very important point and, frankly, I am shocked that the Minister seems so relaxed about it. Across the country, there are numerous children who have waited more than 400 days for help with autism; 280 days for post-traumatic stress disorder; 217 days for suicidal ideation; 195 days for treatment after an overdose—I could go on and on. Children should not have to wait so long for treatment. That will have a scarring impact on their development. These waiting times simply are not acceptable, so will the Minister apologise to these children, and can she explain where it went so wrong?

[Ms Dorries]

I do not believe that meeting almost all our targets for NHS waiting times for mental health services, with £2.3 billion a year of investment into our NHS and no NHS mental health service closing during the entire pandemic, has been a failure. Of course I am sorry for those children and young people who cannot get access to services as quickly as they want; that is exactly why we committed an additional £500 million and established a mental health recovery plan: so that we can put community services in place to reach those who have been impacted most by the pandemic over the past 15 months. We have a long-term plan in place, with the investment that the NHS tells us that that long-term plan needs to provide the very services that we want to provide. The mental health of children and young people is this Government’s priority. We will continue to invest, and are proving to continue to invest, to make sure that those children and young people access the services they need.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 13th April 2021 Commons Chamber

[Ms Dorries]

I thank the hon. Lady for her important question. The mental health and wellbeing recovery action plan published on 27 March this year aims to respond to the impact of the pandemic on people’s mental health, specifically targeting groups that have been most impacted. She mentioned the Good Grief Trust, and I mentioned the £10.2 million of funding that we have allocated recently. That is on top of the £2.3 billion a year for general mental health, which includes bereavement counselling, and the £500 million additional spending that we received in the spending review. Some of that money did go to the Good Grief Trust, which has done a fantastic job. It has been signposting services by putting cards in doctors’ surgeries and in A&E departments in hospitals so that people have immediate access to a line, but there are 700 other charities across the UK that are providing bereavement and grief counselling services to many members of the public. We recognise that the demand is high, but the services are there and available.

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

With your permission, Mr Speaker, I will pay a tribute to my father, Mohammad Aslam Khan, who passed away a few days ago. Not only was he a keen cricketer and an amazing dancer, he was also a champion of equality. He was incredibly strong and brave until his very last breath and he shall be missed beyond measure. I extend a huge thank you to all the team at St George’s, especially the marvellous team on Dalby ward, also to Victor and the incredible staff and carers at Ronald Gibson House and to a wonderful nurse called Anne Wheeler. My brother and I saw at first hand that not all angels have wings.

Covid-19 has stripped the humanity out of grieving, with millions being unable to attend funerals, say final goodbyes, or be with loved ones following a death. Last year, the Government provided £10.2 million to mental health organisations to ensure that services could continue during the pandemic. Many people have been relying on the support of dedicated bereavement organisations to help them cope, yet the extra financial support ended on 1 April. Will the Minister please consider reviewing this vital funding immediately to ensure that no one has to go through bereavement alone?

[Ms Dorries]

I pay tribute to my hon. Friend and her brave words about her much missed father. Politics divides us, but grief, for many reasons, unites us across this House. I have personally declared to my hon. Friend that I am here should she need me. I pay tribute to her for her bravery, being here today so soon after the loss of her wonderful father. I hear her request; it is constantly under review. Bereavement services are incredibly important to me personally and to many of us. She mentioned the £10.2 million. There are 700 bereavement charities, including the Good Grief Trust. We monitor carefully how people access bereavement services. We know that there is an increased need at the moment and that is being watched very carefully. My hon. Friend is incredibly brave.

Maternal Mental Health

Rosena Allin-Khan Excerpts

Wednesday 10th March 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Edward, and it is an honour to respond on behalf of the Opposition in this vital and incredibly moving debate. I thank the hon. Member for Richmond Park (Sarah Olney) for securing the debate. All contributions have been incredibly valuable and have highlighted the urgency of focusing attention on maternal health. Debates such as these can go some way towards breaking down the stigma that still persists around mental health and the often harsh reality of pregnancy, birth and motherhood. It is simply heartbreaking that suicide is the leading cause of maternal death. More people are starting to speak up publicly about their experiences, but we need action from the Government.

The coronavirus crisis has had a disastrous impact on many women. I was honoured to listen to colleagues sharing their heartbreaking experiences of baby loss in a recent debate. My heart breaks for all the women who have had to go through that alone at any time, especially during the pandemic. It is simply inhumane. Will the Minister outline what mental health support will be offered to women who have experienced baby loss without their partner by their side? Such tragedies have a long-term impact on partners and families, too. Will any support be extended to families? We heard described today, very eloquently, the importance of also considering fathers and other partners in such circumstances.

Within maternity services, there are huge inequalities. Black women are four times more likely than white women to die in pregnancy or childbirth. Pakistani women are more likely to have a premature baby or a neonatal death in the UK compared with their country of origin. Women from all ethnic minority groups in the UK receive fewer home visits from midwives and are more likely to give birth by emergency caesarean sections. What are the Government doing to address those discrepancies and to ensure that culturally appropriate mental health support is provided? Such racial inequalities are deep rooted and are further entrenched by covid-19. People from ethnic minority backgrounds are more likely to be adversely impacted financially by the pandemic, and the risk of death is much greater.

The Government’s only response so far to those shocking statistics has been to commission further research, but we need action now. The evidence is already clear that there are persistent inequalities in maternity outcomes and experiences, and that discrimination bias and a lack of cultural understanding are driving that. What action are the Government taking to eradicate these gross examples of health inequality? The five-year forward view for mental health made a recommendation that by 2020-21 in England 30,000 more women each year should be able to access evidence-based specialist mental health care during the perinatal period. During Monday’s statement on women’s health, I asked the Minister if she could tell us whether that target had been met. We did not get an answer, so will she provide one today?

Furthermore, the NHS long-term plan outlined that an additional 24,000 women per year with moderate to severe perinatal mental health difficulties and a personality disorder diagnosis would benefit from evidence-based care by 2023-24. Will the Minister please outline how many women are now benefiting from that? We also know that Health Education England was provided with £1.2 million of funding to increase skills and awareness around perinatal mental health. Will the Minister outline the progress on that and tell us where training initiatives might have been hampered by the pandemic?

The pandemic has had a profound effect on people’s mental health. We know how difficult and stressful pregnancy and birth can be at the best of times. Even outside of covid-19 it is vital that perinatal mental health services should promote prevention, early detection and diagnosis of mental health problems. Many women have been struggling to access the services they need during pregnancy, leaving them having to go through A&E. That is hugely distressing and can cause a great deal of anxiety for expectant mothers and their partners. It is therefore vital that those most at risk get the support they need now. Will the Minister outline what delays there have been during the pandemic in accessing perinatal services?

Working in a hospital, I have seen the fear that so many people present with: fear of contracting the virus, fear of taking the virus home and fear of wasting NHS time. Preventive measures around mental illness are crucial, especially now, for those most at risk. With more than half of new mothers having reported feeling down, lonely or irritable, and 71% reporting feeling worried since the beginning of the first lockdown, what steps is the Minister taking to ensure that new mothers know where to go to seek help?

A University College London report found that, during the pandemic, there was a redeployment of up to 80% of health visitors in some areas. That prevents the much-needed visits that we heard about earlier. Face-to-face visits are crucial in recognising issues early and in providing assistance. Will the Minister tell me what delays families have faced at this time and whether any additional resources will be offered to those who missed out on face-to-face visits?

As a mother of two under two at one point, I know how desperately stressful it can feel to have one baby already and have a new one arrive. I know what it is like to feel as though you are failing at motherhood and at being a working mother. I know just how challenging it can be, but I cannot imagine for a moment what it would have felt like to do that through the pandemic. We rely so much on being in playgroups, having other mothers and fathers telling us we are doing okay, and phoning the breastfeeding helpline at 2 am worried that you cannot make enough milk for your baby and having someone say, “Don’t worry. We can get a health visitor to come and see you tomorrow.” These are normal things, but for so many mothers they have been lacking throughout the pandemic. I fear for the effect that that will have on them, their families and their children in the long term.

My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) asked last year about the additional counselling and support being provided for those who gave birth during lockdown. I noted that there was no clear answer on the proactive work that the Government have done to provide support to new parents. I ask the Minister whether that was because no additional resources have been provided. Does she recognise that maternal mental health has been overlooked in this crisis?

Pregnancy and childbirth can be such a beautiful time in people’s lives, but I know what it can feel like when it goes wrong. I know the fear of stepping into a hospital afterwards—the memories come flooding back. Your heart rate goes up, and you cannot even imagine what it would be like to be pregnant and to go through childbirth again. These things can be overcome, but not without the specialist help that people really rely on. I cannot imagine what it must be like for women going through this during covid, and yet it is another barrier in the way of getting the help that they and their families desperately need.

Women’s Health Strategy

Rosena Allin-Khan Excerpts

Monday 8th March 2021 Commons Chamber

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

I thank the Minister for the advance copy of the statement. I wish every woman in the House and throughout the country a very happy International Women’s Day.

It is welcome that the Government want to understand the plight of women throughout the country, but although the Minister said that this strategy is the first of its kind, in reality it is not. We heard much that was in this announcement when the Government launched the women’s mental health taskforce in 2017. If the Government took this matter seriously, it would be a first. The Minister responsible for mental health at the time, the hon. Member for Thurrock (Jackie Doyle-Price), said:

“This report is a call to action for all providers, commissioners and practitioners across the health care system to drive forward the ethos of trauma- and gender-informed mental health care.”

That echoes what the Minister just said, so why are the Government asking the exact same questions four years later?

A multitude of health concerns are unique to women and are often overlooked. In hospital, I hold the hands of women in their darkest times: young women and girls presenting with eating disorders; trans women admitted after suicide attempts and substance abuse because they had been made to feel as though they do not belong; and women of colour presenting far too late with conditions that could have been easily treatable if they had found healthcare more accessible. I meet many women victims of domestic violence. They use healthcare services more than non-abused women, so I hope to see the Government’s upcoming violence against women and girls strategy address their needs.

The coronavirus crisis has had a disastrous impact on many women, and I have been honoured to listen to colleagues share their heartbreaking experiences of baby loss. My heart breaks for all those women who have had to go through that alone during the pandemic. What support will be offered to women who experience baby loss without their partners by their side? Within maternity services there are huge inequalities. The Minister is right to highlight the fact that black women are four times more likely to die in pregnancy or childbirth, and I welcome the launch of the forum, but the Government have known about these inequalities for years, so why has there not been action sooner? The Government are running a separate sexual and reproductive health strategy; would it not have made more sense to bring it, as part of that working, into this? A part of this which is widely stigmatised is the menopause. How will the Government be seeking to engage women who have to go through difficulties throughout the menopause?

The “Five Year Forward View for Mental Health” recommended that by 2020-21, in England, 30,000 more women each year would be able

“to access evidence-based specialist mental health care during the perinatal period”

and said that that was important. Can the Minister tell us whether that target has been met? Today, it is huge news that a woman of colour has spoken about her mental health struggles during pregnancy. Many women face difficulties but stay silent, afraid to seek help. With stigma attached to mental illness, the Government must ensure that evidence is collected from all of our ethnically diverse communities.

Women are still being misdiagnosed in 2021. With male bodies being seen as the default body, there is a huge historical data gap in understanding women’s health needs. It is shocking that women are 50% more likely to be misdiagnosed following a heart attack simply because our symptoms differ from those of men. What research will the Government commission to bridge that divide?

Finally, pay is a gendered issue. Women are 82% of the social care workforce and 90% of the nurses. Can the Minister justify the real-terms pay cut to our frontline NHS staff? Will she end poverty wages in social care? We need healthcare to work for every woman across the UK—young and old, white and women of colour, cisgender and transgender. We cannot wait any longer. Women’s health and wellbeing should not be an annual PR exercise. We need action and we need action now.

[Ms Dorries]

I join the hon. Lady in wishing every woman across the world a happy International Women’s Day. She opened by talking about the mental health taskforce and saying it is not the first of its kind, but it absolutely is. It was a five-year project that the NHS used to bring together women and organisations from across the healthcare sector to develop a mental health plan—a five-year view—which it did and reported on. As she knows, partly as a result of that, we now have the long-term plan in mental health.

The hon. Lady also spoke passionately, as she always does, about the patients she meets as part of her work and the women who are suffering from eating disorders—sadly, that has been a tragic cost of covid. We know that two groups have been affected by the past 12 months in the mental health sphere: people, including women, with pre-existing mental illness; and, in particular, young women aged 15 to 26, in whom we have seen an explosion in the number of referrals—I believe the figure is 22% for young women seeking help with eating disorders. We have committed funding during the spending review, when £500 million was announced, and I announced £79 million on Friday. Part of that is going to deal with the problems that we have as a result of the pandemic, and with young women and girls—and in some cases young men—who are suffering from eating disorders.

The hon. Lady talked about the stillbirth and neonatal target of halving the number of stillbirths by 2025. We are way ahead of our target on that. The Office for National Statistics published new data last week, and I believe we are looking towards a 30% figure already. We are way ahead of target, and that is a result of the measures that have been put in place in the maternity safety arena, including the saving babies’ lives care bundle and the early notification scheme.

I reiterate that what we are announcing today is a call for evidence from women everywhere in the UK: from every organisation and every friend, every partner, every family of every woman.[Official Report, 12 March 2021, Vol. 690, c. 5MC.] The link has been published today. I published it on the Government website and it is on the Department of Health and Social Care website and on my Twitter feed. It is a link that women can easily access using their phones or their laptops, and it takes a few minutes to complete. We want to develop the first ever women’s health strategy within the Department of Health and Social Care that will deal with all the issues—there are too many for me to talk about now—and all the ways in which women have been affected. These will include research funding and cohorts of trials not using women, using all the information that we have from Paterson and Cumberlege and from women stating clearly that women are not listened to in the healthcare sector. To address that, we need to hear not just from the Paterson women and the mesh women who spoke to Cumberlege; we need to hear from all women everywhere, and that is why we have launched this call for evidence today, to develop this strategy before the end of the year.