Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Ms Dorries]

I wholeheartedly agree with my hon. Friend, and I would also like to pay tribute to Sir Simon and his co-chairs for their comprehensive work. The Secretary of State said in the House last year that

“the Wessely review is one of the finest pieces of work on the treatment of mental ill health that has been done anywhere in the world.”—[Official Report, 23 June 2020; Vol. 677, c. 1164.]

I know that the review was welcomed by hon. and right hon. Members across the House. We are taking forward the vast majority of Sir Simon’s 154 recommendations, either directly or by advancing the principles put forward by the review. The White Paper document contains the Government’s response to each of the recommendations.

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

The overhaul of the Mental Health Act has been long awaited. It is people who have to be at the heart of the legislation, and that includes staff. The promises that the Secretary of State has made rely on a workforce: our fantastic frontline mental health staff, of which there are simply too few at present. I asked him last month to outline when we would get the workforce settlement and what reassurance he could give on filling the training places. We are still waiting for an answer. Would the Minister like to answer now?

[Ms Dorries]

Work is under way; Health Education England is looking at proposals, particularly for the training of mental health workers. I wish to highlight one area where we can see that happening rapidly: in the mental health support teams that are going into schools. People are coming out of universities with their degree and going through a year’s training so that we can get them into schools faster to work with children and young people. The hon. Lady is right; the mental health workforce is at the heart of these reforms. I assure her that we have seen an increase in the number of people applying to be mental health nurses—and nurses across the healthcare estate—and that will have a knock-on effect on the number of people we have working on the wards with people who have severe mental illness.

Long Covid

Rosena Allin-Khan Excerpts

Thursday 14th January 2021 Commons Chamber

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

I would like to begin by thanking the hon. Members for Oxford West and Abingdon (Layla Moran) and for Central Suffolk and North Ipswich (Dr Poulter) and my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) for securing the debate, and I thank all Members for their very personal contributions.

For thousands, covid-19 is something neither succumbed to nor overcome in a matter of days. For many, it has lasting mental and physical impacts that affect the body many months after initial infection. It is nearly a year since the first case of coronavirus was recorded in the UK, and still very little is known about the debilitating post-covid syndrome. I pay tribute to the LongCovidSOS group and all the online support groups that work tirelessly to raise this issue and support one another.

At this stage, we cannot say with any real certainty what exactly long covid is. Nor we can accurately predict the true number of people suffering symptoms of long covid. The Office for National Statistics has published estimations suggesting that the proportion of people displaying symptoms for a period of over 12 weeks could be as many as one in 10. Let us be clear, this is not a syndrome being experienced by a small minority of people. There is also finite evidence on the best way to treat the condition, which has vastly varied symptoms. Without a clear understanding of exactly what the condition is, this makes it far more difficult for health professionals to manage and support those who are affected by it. With better data collection and further research, and by listening to those living with long covid, we can begin to effectively treat the condition. Will the Minister please outline what work the Government are doing to close this gap in knowledge?

What we do know for certain is that the symptoms of long covid can be severe, completely debilitating and utterly crippling, preventing people from living their normal lives. This impact can have a detrimental effect on people’s mental health, their wellbeing and, as we have heard today, their physical wellbeing. It leaves many unable to return to work months after their initial battle with the virus and causes a great deal of uncertainty in already anxious minds. It is crucial to understand that this stress and anxiety can cause relapses in the condition, as sufferers themselves have told me.

Many people with long covid do not know when or if they will return to work. Without action from the Government, the long-term social and economic consequences of this could be grave. Key workers have an increased risk of catching covid. NHS workers in particular are at least three times more likely to contract it than the general population, and this could wreak havoc on our frontline workforce. What steps are the Government taking not only to protect the NHS workforce further but to ensure that staffing levels are such that patients continue to be treated and the population continues to be vaccinated?

The availability of treatment and care for individuals experiencing long covid must be a matter of immediate concern to the Government, and I urge them to adopt a patient-led approach. Could the Minister please outline what progress has been made on setting up long covid clinics, and what plans the Government have to extend this programme in 2021? There simply cannot be a postcode lottery of service provision for long covid sufferers. No one person’s life is more valuable than another, and the Government must ensure that that is reflected in access to treatment.

Some long covid patients are being denied referral because they never had a positive covid test. For the many people who suffered with covid in the first wave back in March and April and were not eligible for testing at the time, that is proving incredibly frustrating. Will the Minister outline what measures the Government will take to ensure that people do not miss out on much needed treatment, particularly if they fall into the category of people who were unable to have a covid test in the first wave?

The Government have to step up and show leadership. There has to be clear messaging to the public to ensure that they are sufficiently informed about the condition and about where to seek help if they need it. That messaging needs to combat the misinformation about covid that is out there presenting it as a myth or similar to the flu. I would like to pay tribute to the former MP for Leigh, Jo Platt, who, along with LongCovidSOS and support groups on Facebook, is campaigning tirelessly on this issue. As Jo told me, there are no words to describe how covid deniers have made her feel. She said: “For people to seriously deny our experiences has been soul-destroying.” We have to get this right.

It is also essential that healthcare professionals at every level of the NHS are properly trained to treat long covid, distinguishing between the different conditions that fall under the term. This includes frontline mental health workers, as the mental health implications of long covid can be severe. Within an acute crisis, it is far too easy to push longer-term concerns to the periphery. Should the Government continue to do this with long covid, they do so at their peril.

Throughout this crisis, far too many people have felt that their voices have been silenced. For the sake of the health and wellbeing of all those living with long covid, please do not silence them. There is still so much that is unknown about this virus and how it affects us, but one thing that is certain is that long covid should be a matter of serious concern, and without concerted action by the Government we may be living with the consequences of this for many years to come. We are still learning so much more about the impact of covid-19 on our communities, our bodies and our wellbeing. There are thousands of people out there currently suffering with long covid. They are relying on us, and on the Government, to get it right for them.

Mental Health Act Reform

Rosena Allin-Khan Excerpts

Wednesday 13th January 2021 Commons Chamber

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

I thank the Secretary of State for an advance copy of the statement. This overhaul of the Mental Health Act has been long-awaited, and we welcome the White Paper and the fact that the Government have accepted the majority of the recommendations from Sir Simon Wessely’s independent review of the Mental Health Act.

Without a doubt, people need to be at the heart of this legislation. Service users must be involved in framing the legislation going forward, and when we talk of numbers and statistics, we must remember that these are real people with real lives and real families. There is a web of individuals who are affected when things go wrong. Deprivation of liberty and the use of coercion can cause lasting trauma and distress. That is especially true for children and young people who find themselves in these most difficult of situations, whose voices often are not heard when decisions are being made. It is an important step that learning disabilities and autism will no longer be grounds for detention under the Act, and I am sure that we all welcome that. It is also very welcome that the recommendation on nominated persons has been included.

The best way to reduce coercion and detention is to have alternatives to admission. Will the Secretary of State please outline how that will be achieved? Community provision is vital for mental health services that are truly joined-up and, crucially, work well for patients, so will he also give reassurances on community care?

It is in our communities where we witness the harsh reality of health inequalities, which so desperately must be addressed. Social inequalities and adverse childhood experience are the drivers of mental ill health, and they cannot be ignored. Children from the poorest 20% of households are four times more likely than those from the wealthiest 20% to have serious mental health difficulties by the age of 11. That will not be solved simply by mental health legislative changes; there must be a commitment to addressing the vast chasm of health inequalities across the country.

At present, black people are over four times more likely to be detained. We need to advance the mental health equality framework, and there must be culturally appropriate services and freedom for local areas to look at their specific population in order to have the most suitable approaches.

Mental health staffing levels are crucial to ensuring that mental health services are fit for purpose. The proposals set out by the Secretary of State go well beyond what has been committed in the long-term plan. We need to see true understanding from the Government that mental health is not about promising fancy equipment; it is about people. The promises in the White Paper rely on the workforce—our fantastic frontline mental health staff, of whom there are simply too few at present. Will the Secretary of State please outline when we will get the workforce settlement? What reassurance can he give on filling training places?

It has already taken so long to get to this point—it was the former Prime Minister who started this process, back in 2016—so will the Secretary of State provide some clarity on the timeframe going forward? Given the complexities of the legislation and the need for it to be robust, what are the plans for a joint prelegislative Committee? It is vital that the blueprint that Sir Simon Wessely’s report sets out is implemented in full. I would like to take this opportunity to thank him and everyone involved for all the work they have done on this review.

We must act, and quickly. Covid has shown us how all the pressures on mental health are building. We need action now. We all know how rare these pieces of legislation are; this is a once-in-a-generation opportunity to get it right for some of the most vulnerable in our society. We simply must get this right for everyone who depends on these services.

[Matt Hancock]

I thank the shadow Minister for her thoughtful approach. I agree with the way that she described the challenge, and with her insistence that we must not just improve the legislation—and we will—but improve and continue to strengthen service provision, in particular community service provision, as an alternative to admission. That is how we turn legislation from dry words on a page into real action on the ground.

The shadow Minister is absolutely right, too, that service users must be at the heart of framing the legislation. If I may link that point to her question about the timeframe, the challenge of the timeframe is to ensure that we move fast enough to help people and get the new legislation on the statute book as quickly as reasonably possible, but at the same time continue with the consensus-based approach that we have taken.

I am very grateful, as I said, for the work of Sir Simon and the NHS team, and I am grateful that we have managed to develop this White Paper with broad consensus among those who provide mental health services and service users, and politically across the House. I think that is an important consensus to keep, and I want to try to keep it by ensuring that we take as open an approach as possible to the legislation. I am absolutely open to joint prelegislative scrutiny, and I am absolutely open to the publication of a draft Bill. Let us get the details right, and let us work together on this and keep it as consensual as possible.

I also agree with the hon. Member’s point about the need to tackle broader health inequalities, and covid has laid bare some of those. That is a core part of our levelling-up agenda, and it is an important consideration for both physical and mental health. I am glad to say that this landmark White Paper, which will lead to a once-in-a-generation Bill, is proceeding with the support of the Opposition. I am really pleased about that, because this is for everyone. It is to make sure that some of the most vulnerable people in our country get the support they need and deserve.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 12th January 2021 Commons Chamber

[Edward Argar]

The hon. Lady is absolutely right to highlight the pressure that the NHS and critical care are under in London and, indeed, more broadly. I pay tribute again to all those who are working in the NHS, including my shadow, who I suspect has been on the frontline in recent days—I pay tribute to her, too. The best way we can thank them is by following the advice to stay at home and to follow the rules. In respect of her specific point, yes, we are involving independent sector capacity, Nightingale capacity and increasing NHS capacity—all those, alongside other measures—to ensure our NHS continues to be able to treat those who need this care at this time.

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

Last night, I finished a shift in a busy east London hospital, sharing difficult news with hopeful families. The resilience of staff on the frontline can never be matched, but across the country morale is on a cliff edge. A decade of cuts to beds, services and staff, combined with pay freezes, has left NHS workers undermined and undervalued. Without our incredible staff, a hospital bed is just that —a bed. So does the Health Minister regret how the Government have made frontline workers feel and can he promise to change that?

[Edward Argar]

I reiterate, as I did earlier, my thanks to the hon. Lady and all her colleagues in the NHS for everything they are doing. I reassure her, as I do and as my right hon. Friend the Secretary of State does at every opportunity, just how valued and supported our NHS is. We have put in place just over 1,000 additional critical care bed capacity at this time—the right thing to do. In addition, in respect of supporting staff, we are investing about £15 million—just one example—for mental health hubs and mental health support for staff. I saw, from the hospital that she works in, or has worked in, in her constituency, a number of staff—it was on the BBC recently—setting out just how flat out they are. The best way we can thank them, alongside what we are doing—I make no apologies for reiterating it, Mr Speaker—is by all following the rules to stay at home to help to ease the pressure on those phenomenally hard-working and valued staff in our NHS hospitals.

Covid-19

Rosena Allin-Khan Excerpts

Monday 14th December 2020 Commons Chamber

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

I would like to start with a tribute to Dame Barbara Windsor. She holds a special place in the affections of the nation from her earliest days with the Joan Littlewood Theatre Workshop to being landlady of the Vic. Barbara Windsor asked us to make a stand against dementia, and we will. Our thoughts are with Dame Barbara’s friends and family.

It is now nine months since the first British patient contracted covid-19—nine months that have tested our national character, our national health service and our national leaders; and nine months of terrible grief for tens of thousands of families who face a Christmas with an empty chair at the family dining table. Torn apart with anguish and united in pain, those families were robbed of their chance to say goodbye and robbed of the last hug or kiss, and they are still unable to sleep at night.

Rates of depression doubled during the first wave, but referrals to mental health services dropped. Couple that with nine months of economic turmoil exacerbated by the Brexit shambles, with millions facing the dole or losing their homes and businesses, and people need assurances that their wellbeing will be protected. There are still 3 million freelancers and small business owners excluded from Government support and facing utter ruin, which takes a terrible toll on their mental wellbeing. Some of the 3 million excluded have even, tragically, taken their own lives. It is not too late for Ministers to do the right thing and support the 3 million excluded.

What a year it has been. When the British people were called upon to stand together against a common enemy and to rise to greatness, they were not found wanting. I am thinking of the people who queued down the street to volunteer to deliver food and medicine; people who donated to food banks and looked in on neighbours; and people such as Captain Sir Thomas Moore, who raised not just money, but our spirits and our sense of ambition. I am thinking of those who spearheaded the #WhatAboutWeddings campaign, supporting people whose wedding day plans were derailed and people in the wedding industry whose businesses disappeared. I am thinking of people in the Beauty Backed campaign, supporting workers—mostly women—in the multi-million pound beauty sector whose salons were closed and who could not work to feed their families.

I am thinking of our refuse collectors, delivery drivers, shop workers, shelf stackers, cleaners and others who kept the country running. I am thinking of workers in the social care sector—low paid and so often stigmatised—working at the sharp end of the pandemic in our care homes. These unsung heroes deserve real recognition. Perhaps next time we discuss low pay and minimum wage, we will remember how much we owe all these workers who make Britain tick. I want to give a special mention to Britain’s postal workers, who have played a special role in supporting our communities—not only delivering the post come rain or shine, but looking in on the vulnerable, raising the cheer of isolated and lonely people and being a friendly face amid uncertainty and fear. Britain’s posties, we salute you.

Of course, we praise the 1.4 million of us who work for our national health service. So many NHS workers risked their lives to fight the pandemic, and so many have tragically died. Many more are left with the trauma of dealing with mass casualties. The latest absence figures from the NHS show that just under half a million days were lost to mental ill health in just one month alone. With infections continuing to rise throughout the country and the Christmas easing of restrictions imminent, how will the Government ensure that the NHS has capacity to cope in January? Staff are already burned out and exhausted by the virus. What plans do the Government have to support our NHS to deliver the care that patients need throughout January and prevent the NHS from becoming so overwhelmed that the vaccination programme is affected?

Staff across our health service are struggling, and they know that the adversity is not over yet. I want to take this opportunity to praise workers across the NHS: our ambulance drivers, nurses, student nurses, doctors, health visitors, mental health professionals, midwives, pharmacists, porters, receptionists, radiographers, physiotherapists, admin staff and healthcare assistants. Not only that, but I want to praise the cleaners, the kitchen staff, the gardeners, the dispatch drivers, the record keepers, the chaplains, the volunteers and so many others.

When I turn up for my shifts at St George’s Tooting as an A&E doctor, I know that I am part of an NHS family in which every part relies on the others—a complex web of care and compassion. We as a country rely on them, so let us do more than offer them applause. Let us rebalance the system of wages and rewards in this country so that the most valuable people, such as care workers and nurses, are valued above shareholders and stockbrokers. I have mentioned our national character and our national health service. Both rose to the challenge admirably, but what about our national leadership? Her Majesty’s official Opposition have maintained a consistent position: we will support the Government in tackling this pandemic, but we reserve our right to scrutinise decisions and ask questions on behalf of the people. That is our proper constitutional role.

We will be demanding a full public inquiry into the Government’s response to covid-19, and one particular area that will require forensic dissection is ministerial decision making on procurement. On 18 March 2020, the Cabinet Office issued guidance on public procurement of personal protective equipment and other equipment to tackle the pandemic. That guidance noted that public bodies were permitted

“to procure goods, services and works with extreme urgency.”

By 31 July 2020, more than 8,600 contracts had been awarded, with a value of £18 billion.

Of course we recognise that there was a need for speed, but the National Audit Office reported that there is

“a high-priority lane to assess and process potential PPE leads from government officials, ministers’ offices, MPs and members of the House of Lords”.

Many suppliers with connections to the Government and Ministers obtained lucrative contracts. One such supplier was PestFix, a vermin control company valued at just over £19,000, which was given a contract worth £108 million for PPE that had not been properly tested. The House has heard of the case of Mr Gabriel González Andersson, who was awarded more than £20 million as a middleman between the UK Government and a PPE business founded as the pandemic took hold by Michael Saiger, a Florida-based jewellery designer. And the NAO showed that Stroud Conservative councillor Steve Dechan, who ran a small, loss-making firm, signed a £156 million deal to import PPE from China.

Those are just a few instances of a procurement scandal that will only grow as more of the truth emerges. The Prime Minister says over and again that any Government would have done the same. He is wrong. He must not judge others by his own standards. This is a Government who have stretched the procurement rules to breaking point, overseen a bonanza for chancers, spivs and Del Boys, and wasted millions on the cronies and chums of Government insiders. Doctors and nurses were sent to the frontline without working PPE while profiteers lined their pockets. The truth will come out. The public will get the answers they demand, and the guilty men and women—the hard-faced men who have done well out of the pandemic—will be called to justice.

Now, we face the first Christmas alongside covid-19. Ministers must do more to explain the science behind their current plans for the tier system and their plans to relax the rules during Christmas. The PM says we must be “jolly careful”, but are his Government? Is the Minister aware of the advice of Professor Andrew Hayward, director of the University College London Institute of Epidemiology and Health Care and a member of the Scientific Advisory Group for Emergencies, who told the BBC that allowing people to meet up over Christmas amounted to

“throwing fuel on the Covid fire”

and that it would

“definitely lead to increased transmission”

and was

“likely to lead to a third wave of infection, with hospitals being overrun, and more unnecessary deaths”?

Is the Minister confident that the Government have done everything possible to avoid a third wave in the new year?

With today’s announcement that London will be moved into tier 3 just a week before rules are relaxed, is the Minister confident that the Government can effectively communicate these three rule changes to the public in the next week? What assurance can she offer the millions living in London and the south-east of England who will be under the tier 3 rules on Wednesday that the measures taken will actually halt the spread of the virus and keep them and their families safe over Christmas?

[Steve Brine (Winchester) (Con)]

I have expressed my concerns in the House before about the Christmas policy. There is a lot of care going into looking at the data for the review of the tiers, and yet weeks ago, the Government announced a five-day relaxation starting on 23 December. What is the position of the official Opposition in respect of the Christmas firebreak? Do they now oppose that, are they still supportive of it, or are they abstaining?

--- Later in debate ---

[Dr Allin-Khan]

Everything has to be evidence based. We in the Opposition have been labouring under the misapprehension that the Government have control over the messaging that has been going out. The mixed messaging relayed day after day by this Government has left people utterly confused. That is why I am saying that we need assurances from the Minister and the Government that the millions of people living under these restrictions will in fact be safe over the Christmas period, were families still to mix.

Finally, we turn to the bright light at the end of the darkest of tunnels: the prospect of a vaccine. I welcome the news of new vaccines, and I praise all the teams who delivered them and the Medicines and Healthcare Products Regulatory Agency for its efficiency. We all have a duty now to explain that vaccines are safe, vaccines work, and if and when people are offered one, they must get vaccinated. When I am offered the vaccine, I will eagerly join the queue, not just because I am a doctor but because I have seen the tragic consequences of this disease up close. All of us in this House must speak up for the science and against irrational conspiracy theories and malign myth making, and we must get our people vaccinated.

Is the Minister satisfied that the Government are doing enough to build public confidence in the vaccine? Is she confident that we have the infrastructure to roll out the largest ever mass adult vaccination programme? What about those in tier 3—people in Derby, Leicester, Nottingham, Tyneside and Teesside, Lancashire, Manchester, Birmingham and the Black Country, Hull, Yorkshire, Bristol and, soon, London? Will they get the vaccine quickly and efficiently? What plans have the Government made to deliver the vaccine for tier 3? Can the Minister update us on the position of vaccinations for people in care homes? People were promised a vaccine, and they need reassurance that they were not given false hope.

As we near the end of a terrible year, let us reflect on the strength, resilience and genius of our constituents, on the communities that came together, on the values of solidarity and compassion that unite us and on our common resolve to make 2021 a better year for all—especially the bereaved, the lonely, the vulnerable and the people who saw their worlds turned upside down by this terrible disease. They deserve a Government on their side, yet millions feel let down and left on their own. In 2021, that must change.

Deaths in Mental Health Care

Rosena Allin-Khan Excerpts

Monday 30th November 2020 Westminster Hall

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

It is a real pleasure to serve under your chairmanship, Mr Stringer, and an honour to respond on behalf of the Opposition in this profoundly moving and powerful debate. I thank my hon. Friend the Member for Hartlepool (Mike Hill) for securing the debate, but it goes without saying that every contribution today has been extremely powerful. Everyone who has spoken has stood up for their constituents and represented the issues very well. The points have been made clearly and concisely, and hon. Members have done Melanie Leahy and the other families very proud.

We are here today because of a mother’s love for her son and her desire to receive some answers about his tragic and untimely death. It is fitting, then, that the debate should take place ahead of National Grief Awareness Week. Matthew Leahy was just 20 years old when he was admitted to the Linden Centre in November 2012 after being detained under the Mental Health Act 1983. While in the care of North Essex Partnership University Trust at the Linden Centre, Matthew phoned his parents on numerous occasions to express his unhappiness at being detained there. I know that I am speaking again of things that have already been mentioned, but it is important to give the details as many times as possible, to get what happened across as powerfully as is necessary to see the change we want.

Two days after being admitted, Matthew phoned his father to tell him that he had been drugged and raped on the ward. Following a 999 call made by Matthew, the Linden Centre staff gave assurances to the family that he was indeed safe in their care. Just days later, Matthew was found unresponsive and hanged, in his room. He was transferred to Broomfield Hospital, where he was pronounced dead. Matthew was in the Linden Centre for just seven days.

As a mother myself, I cannot comprehend what Melanie has had to contend with over the last eight years. Sadly for Melanie and the family, the struggle is not over. An inquest concluded with an open narrative verdict that Matthew was subject to multiple failings and missed opportunities over a prolonged period of time, by those entrusted with his care. Multiple investigations and reviews were carried out into the North Essex Partnership University NHS Foundation Trust, and into Matthew’s care, and they raised even more questions about the care that he received and the nature of his death. I want to raise some of the concerns that were found in the various reviews so that everyone here can get further understanding of the scale of the challenge that Melanie and her family have faced for the past eight years.

At post-mortem, traces of the drug GHB were found in Matthew’s system. He had bruises just above both ankles and four to five unexplained needle wounds in his groin. Matthew’s paperwork was incomplete and a key worker was not assigned to him. Staff at the Linden Centre had not issued Matthew with a care plan, but after his death they falsified one and backdated it. A number of ligature points in the Linden Centre previously identified for removal were still there. Essex police dropped a corporate manslaughter investigation into the deaths of 25 patients who were in the care of the North Essex partnership trust at nine separate establishments since 2000. The ombudsman investigated, and agreed that Matthew had not been responded to appropriately after reporting a rape, as well as that the Essex partnership’s investigation of Matthew’s death was inadequate. All this in eight years—the toll it has taken on this family. That is before we consider the prosecution of the Essex Partnership University NHS Foundation Trust by the Health and Safety Executive following the deaths of 11 patients in its care between 2004 and 2015.

The loss of multiple lives and the tearing apart of families were devastating and, most tragically, utterly preventable. We have to learn from those tragic losses so that no other families are affected. I ask the Minister if she will please work with Melanie Leahy on this matter directly, as her predecessor promised to do. I had the honour of speaking to Melanie ahead of the debate. This is her day, Matthew’s day and a day for all who are still seeking answers about their loved ones’ deaths.

The strength it takes to continue this fight after eight long years is commendable. My heart goes out to Melanie’s family and to all who have lost loved ones in similar circumstances, not just at the Linden Centre but in care settings across the country where they were meant to be safe. Many of those people have been mentioned in today’s debate, and I thank Members again for their contributions.

A system is not working properly if it takes so long to investigate such a tragedy, and yet answers are still not forthcoming. A grieving mother should not have to plead with people to sign a petition to get answers surrounding her son’s death. There should be no barriers to the truth. Inquiries and investigations should not be reserved for the most privileged and those who are most familiar with the system.

On the point about time, I highlight that it has taken over a year to have this debate following Melanie’s successful petition. We all understand the mitigating factors that this year has brought, but I would like everyone to consider how every step of the process has been slow. Barriers have been put in place for the family at every single turn.

[James Cartlidge]

Does the hon. Lady agree that, that being so, it would be very much in the interests of all stakeholders if the inquiry took place, ideally, as soon as possible?

[Dr Allin-Khan]

Yes, of course it would be in everyone’s best interests for the inquiry to take place as soon as possible. After all this time, Melanie deserves some answers. I support her call for a statutory public inquiry into Essex mental health services and for the appointment of an independent chair. It is crucial that lessons are learned from Matthew’s case.

I will take this moment to read a few words from Melanie about why a statutory public inquiry is so important to her:

“To come this far and then get fobbed off with a review or general inquiry…would simply take…us all back to square one.”

She goes on to ask that the Minister do something real and meaningful that paves the way for truth, justice, accountability and change. There is an opportunity here for the Minister to commit to providing a grieving mother with answers about her son’s death, and to learning lessons so that other families do not suffer in this way. We cannot, and must not, delay any further.

[Graham Stringer (in the Chair)]

We have plenty of time, but I ask the Minister to leave enough time for the wind-up at the end.

Draft Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020

Rosena Allin-Khan Excerpts

Wednesday 18th November 2020 General Committees

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

It is a pleasure to serve under your chairmanship, Mr Davies.

The removal of these provisions from the Coronavirus Act is, of course, extremely welcome, and Labour Members will not seek to oppose it. When the Coronavirus Act was hastily drafted and enacted in light of the threat our country was facing in March, we accepted the inclusion of these regulations, to be used only as a last resort. It is a relief that the provisions have never had to be used, and we are pleased to see them dropped.

The legislation represented a significant reduction in the safeguarding of individuals subject to the Mental Health Act, and I am sure that the expiration of the provisions will be gladly received by those who are living with mental ill health and by their families. I thank all health and care staff for their hard work, and I am grateful for the work of the CQC and NHS England, whose response to the virus was robust enough that the provisions were never turned on.

Although the mental health provisions in the Coronavirus Act were never activated, that does not mean that the coronavirus has not had a significant impact on the mental health system in England. In March, at the very beginning of the pandemic, an additional 2,441 people were discharged from mental health hospitals. Compared with February, that is an increase of 26%. At that time, increasing bed capacity was a priority. Although it was necessary to take that step where it was safe to do so, it was vital that discharged patients continued to receive the care they needed.

Inevitably, the redeployment of staff to concentrate efforts on tackling the virus led to disruption to existing mental health services, with surveys from charities such as Rethink Mental Illness and Mind showing that many struggled to access support during the pandemic. That was especially true for those with existing mental health conditions, including many who were abruptly discharged. The needs of people who are living with severe mental illnesses are complex, and it is vital that they receive appropriate care in all settings.

As the number of cases and hospital admissions related to covid-19 continue to rise, so too does the prospect of having to empty beds again. In August, the Government announced a £588 million fund to support the safe discharge of patients in the event that it becomes necessary to free up space for coronavirus patients. That money is essential to prevent a repeat of the mistakes that were made in March, but I had it confirmed to me last week that mental health trusts are unable to access that funding. Similarly, alongside the announcement of that money guidance was published outlining the correct procedure for safely discharging patients from hospital settings. Again, mental health trusts were excluded from that, and there is currently no equivalent guidance for them. Will the Minister please outline why mental health trusts are excluded from this vital funding, and will she confirm what resources are being made available to trusts to support the safe discharge of patients and ensure that they receive ongoing care in the community?

Concerns have also been raised about patients who were not discharged. Many mental health estates were not built with social distancing in mind, and that has affected treatment and access to visits on and off site. Reduced contact with family and friends has undoubtedly had an effect on in-patients. Staying in a mental health ward can already be an extremely lonely experience, but the extra restrictions on social contact mean that it can feel truly, devastatingly isolating. Although many people accept that digital solutions are necessary, their success in such settings has been mixed. In-patients have stated that when social contact was facilitated virtually, it made a positive difference to their experience; however, when treatment was provided through digital means, many felt that the standard of care dropped.

It is important to remember that a large number of those who have lived in mental health wards throughout the pandemic are children who are living with severe mental health disorders, such as eating disorders or severe depression. They need a more intense level of care than would be possible in the community, but that does not make the experience any less traumatic for a child. The Children’s Commissioner found that there was a great deal of resilience on those wards throughout the pandemic, with staff working exceptionally hard to ensure that the standard of care and support provided to the children did not drop, but significant challenges remained. Although staffing rates stood firm in many children’s wards, visits from external professionals dropped alarmingly throughout the pandemic. The disruption to mainstream education filtered its way into hospitals, with many teachers stopping all face-to-face teaching on the wards, which left untrained hospital staff to deliver teaching in addition to caring for patients.

During this second spike of the virus, it is crucial that all mental health in-patients receive appropriate, high-quality care. Will the Minister outline the measures that are in place to ensure that people in mental health hospitals will receive the best care available to them, despite ongoing pressures from the coronavirus?

Entrenched inequalities in mental health treatment and access to services have existed for many years, but they are undoubtedly being deepened during the pandemic. The disproportionate impact of the virus on black, Asian and ethnic minority communities has put them at greater risk of developing mental health problems. That is especially concerning, because historical racism and experiences of inappropriate support have left many individuals from BAME communities distrustful of mainstream health services, highlighting the need for support in the community. Distrust should not come as a surprise to the Government, considering that in 2019-20 the rate of detentions in England under the Mental Health Act was more than four times higher for black or black British people than it was for white people. The racial disparity in detentions under the Mental Health Act underlines the need to address health inequalities and to ensure that provision is widely accessible and that support is suitable for all. I would be grateful if the Minister outlined what work is being done to address the inequality.

We need to be clear that for many people, community support is the most effective way to improve their wellbeing, and that has to be a priority as we look to the recovery period. What work is being done to strengthen mental health support in the community at this time?

The impact that covid-19 has had on the wellbeing of the nation has been profound. The Centre for Mental Health found that approximately 10 million additional people will require some form of mental health support as a result of the pandemic. It is important that the Government recognise the additional need and have a strategy to address it during winter and beyond. We know that the best mental health strategies are proactive and preventive. Early intervention is key to addressing mental health concerns before they develop into something more insidious. The Government must ensure that services are prepared and have the resources to cope with any rise in demand.

The expiration of the provisions today is a small but welcome step in ensuring that patients who rely on safeguards in the Mental Health Act are adequately protected. I urge the Government to not stop there. The next step must be to publish the long-awaited White Paper on the Mental Health Act and to stand by their commitment to reform the legislation to better support people who are subject to it. Only then can we be confident that those living with severe mental ill health will be properly supported by the system that is designed to protect them.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 17th November 2020 Commons Chamber

[Jo Churchill]

I would like to thank the hon. Gentleman. In the main, many of our frontline operators are getting it free—social care, general practice, dentistry, optometry and so on. The relief was designed specifically to relieve the burden of VAT on sectors particularly affected by coronavirus while supply did not match demand. Now the Government are able to supply covid-related PPE across all sectors, the burden of VAT will still not fall on frontline providers for all covid-related PPE and demand will be met. Most businesses that make taxable supplies can recover the VAT that they incur on purchases of PPE as business expenses. They will therefore be able to reclaim all VAT after the 31st. But I reiterate: for the majority of frontline healthcare, it is free.

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

The price of an FFP2 mask bought by the Government increased by 1,400% in just six weeks to the end of May and gowns by 350%. I welcome all efforts by the Government to procure PPE, but I have concerns that we may not be getting a fair price. One company, PPE Medpro Ltd, was given Government contracts worth over £190 million. PPE Medpro Ltd had no previous experience and coincidentally was only set up on 12 May 2020. Reports have suggested that the company has substantial links to Conservative party donors, so can the Secretary of State or the Minister categorically assure the country that no Conservative party donors are profiteering from the pandemic?

[Jo Churchill]

Our plan on PPE has to be to stabilise the system and build resilience. That was outlined in the PPE strategy published on 28 September. [Interruption.] Children! Thank you.

Covid-19

Rosena Allin-Khan Excerpts

Wednesday 11th November 2020 Commons Chamber

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

On this day of remembrance, I pay tribute to all those who made the ultimate sacrifice so that we can stand here today with the freedoms we hold dear. And I would like to formally put on the record my congratulations to President-elect Joe Biden and Vice-President-elect Kamala Harris. We look forward to working together to tackle this global pandemic.

We have heard today that the UK has tragically become the first country in Europe to pass 50,000 covid-19 deaths. It speaks to why we are all here today to discuss the greatest challenge of our time. We have heard some superb speeches in the debate. I pay a special tribute to Mary Hutchins, the nan of my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy), who does her community proud. I also pay tribute to the hon. Member for Beaconsfield (Joy Morrissey), who was incredibly powerful in speaking up for Jamie and his family.

My hon. Friends the Members for Sefton Central (Bill Esterson), for Nottingham East (Nadia Whittome) and for Brentford and Isleworth (Ruth Cadbury) all rightly raised the murky world of procurement and the complete lack of transparency. My hon. Friend the Member for Warwick and Leamington (Matt Western) spoke movingly about the need to do better for those in care homes.

There is a clear sense of hope about the prospect of a vaccine. It has come at the end of a particularly bleak year that has left none untouched by the effects of the virus, but we need to ensure that this is not false hope. There must be a clear plan for manufacture and distribution. With little time to get that right, can the Minister please outline how the Government will ensure that those deemed a priority to receive the initial dose will be able to access it?

On the topic of priority groups, in June, the Health and Social Care Secretary said that the Government would consider black, Asian and minority ethnic groups as a priority for a vaccine, but that does not seem to be the case now. Why? I have seen at first hand patients in intensive care fighting for their lives because of this virus. I was overwhelmed by how many of them were from our BAME communities. Is it not possible for the Joint Committee on Vaccination and Immunisation to consider multiple risk factors when rolling out the vaccine? What about all those adults who have been shielding for months? Throughout the summer they urged the Government not to forget them. What is the Government’s message for them today?

Finally on a potential vaccine, I sincerely hope that we are successful, but if there are setbacks that mean that the vaccine is not rolled out until later in 2021 the Government must have a plan in place that is communicated effectively to the public and which outlines what restrictions may look like. I hope to see the Government planning for that scenario, so that as a nation we are not caught off-guard again by the virus.

Sadly, people feel left behind. They need to feel that they have a Government on their side. The feeling of isolation and loneliness needs urgent attention from the Government this winter. The Minister for Patient Safety, Mental Health and Suicide Prevention tweeted only a couple of days ago that mental health services have never closed, and have continued throughout, but for many, especially those who rely on group therapies, that has not been the reality.

It is important that we do not forget those who need to access mental health services for the first time and simply do not know where to turn. Our wedding industry, talented people involved in the arts, musicians, photographers and small family-run businesses feel as if no one is listening to them. The Government did them a great disservice by describing their careers as unviable—that cut to the core of who they are, the talents that they have and the way in which they give back to our economy. I have heard from people in the industries that I have mentioned who felt that the Government were questioning their viability not just in the workplace but as husbands, wives and parents. That has affected their mental health greatly. When Ministers come to the House they must take responsibility for the language that they use and understand the detrimental knock-on effects that it can have on people’s mental health. Artists, creatives and entrepreneurs need a Government who are on their side, showing them that they care not only about their livelihood but about their mental health. How will they be supported through the winter?

As the days become shorter at a time when people are missing their families and way of life, what provisions are in place for anyone who needs help with their mental ill health? What support will be offered to organisations and communities across the country that are lifelines to people who rely on them for a bit of brightness in their day? On suicide, is there a plan for a comprehensive national real-time monitoring system for suspected suicides that will allow us to monitor and respond to new concerns among particular groups of people or in particular areas of the country? I am sure, whatever side of the House we are on, we agree that this is important.

What is the Government’s suicide prevention strategy in the light of covid-19? Many people with serious mental illnesses have been feeling left out of the Government’s strategy to tackle covid-19, with research finding that people with a pre-existing mental health diagnosis were 65% more likely to be diagnosed with covid-19 than those without such a diagnosis. Will the Minister outline any work that the Government are conducting to provide assistance for people with schizophrenia, psychosis or borderline personality disorder?

Members have raised many times in the Chamber the fact that expectant mothers are suffering immeasurably because they cannot bring a birthing partner with them into hospital, whether to accompany them to tests to check on their unborn baby, or when they are giving birth. What support has been offered to those suffering from post-natal depression? Some expectant mothers and fathers have had to endure the worst and find out that they are miscarrying. What support is available to mothers who have to be told that alone, and break down on the phone trying to tell their partner or a loved one? We have to do better for those people.

What support has been offered to mental health trusts for the winter? Are they able to access funding to support the safe discharge of patients from hospital in the light of the second spike? It is crucial that this is given the attention it deserves.

I welcome the announcement of routine testing for frontline NHS staff. We have been requesting that for months, and it is an important development for not only protecting staff but infection control in healthcare settings. There have been other changes to testing, and I would like to take this opportunity to pick up on plans for the mass distribution of lateral flow tests. What resources are being allocated to the local councils that are getting access to 10,000 lateral flow tests, including in my borough of Wandsworth, to make this a success? For areas with a disproportionately high number of vulnerable groups, how will the Government address any strain on council resources?

After weeks of unnecessary delay, the Government have now addressed the need to get students home safely over Christmas, and tests will be made available. Could the Government outline how they plan to work with universities and local councils to ensure that rapid and accurate testing is available for all students who need it? How will the tests be administered, and are the Government prepared to comment on what students should do in January?

We must understand that our students have endured a particularly difficult time, with the exams fiasco, being told it was safe to go to university, arriving at university only to be made to feel responsible for the second spike of covid-19 and then being trapped in dormitories with strangers, unable to leave to do their shopping or see their families. We have to get it right for our students, who we are allowing to go home over the Christmas holidays.

We have a long road ahead, and we cannot lose hope. The Government need to get their response to this crisis right, and they do not have to spend taxpayers’ money on PR consultants to do so. For many months, brave people across the country have played their part in fighting this virus. We cannot let them down now.

Baby Loss: Covid-19

Rosena Allin-Khan Excerpts

Thursday 5th November 2020 Westminster Hall

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

It is an absolute pleasure to serve under your chairwomanship, Ms Eagle. It is an honour and a privilege to respond on behalf of the Opposition to this profoundly moving and powerful debate, which I thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for securing. Bravery comes in all forms, and today she has shown the very best of us and done Lily proud. Lily’s honour and name will be timeless in the records of the discussions that we have had today. The hon. Member is incredible.

This is the fifth year running in which we have had such a debate during Baby Loss Awareness Week. It is becoming a very welcome tradition and long may it continue, although obviously we have heard today of the importance of ensuring that we prevent as many deaths as possible. I pay tribute to every Member who has had the courage and conviction to share their experiences on an issue as devastating as baby loss. To live through it is one thing, but to speak about it in a bid to help others is another altogether. After what we have seen today, I have never been more proud to be in this place and to stand among all Members present, regardless of party, political persuasion or geography. It is an honour to hear their stories first hand.

The fact that we cannot provide comfort to one another when talking about this, though we are compelled to, illustrates how hard it must for people going through it not to be able to have the comfort of the ones they love the most, and for some parents to have to hear the very worst news that they will ever receive in a car park or down a phone. Such debates hopefully go some way towards breaking down the stigma that sadly persists. I am sure that having the bravery to speak out on this will bring a great deal of comfort to many who have been affected by baby loss.

I wish to reflect on a few of the compelling contributions. My hon. Friend the Member for Luton North (Sarah Owen) spoke so movingly about the experience of multiple loss and was a powerful advocate for the importance of having a loved one there. She was able to draw a stark comparison between the experience of not having someone there and having someone there. We must pay attention to that powerful contribution. The hon. Member for North Ayrshire and Arran (Patricia Gibson) is no longer present, but baby Ken will be immortalised in this place through the story that she shared. I do not know how she delivered that speech, to be honest. Most people I know would not have even been able to speak those words.

I am sure that all of us send our love and best wishes to Donna, who has a powerful advocate in the hon. Member for North Antrim (Ian Paisley). I thank him for bringing her story and lived experience to this place—he has done her proud. When my hon. Friend the Member for Sheffield, Hallam (Olivia Blake) spoke, I was lost for words. That she lived through the very worst of experiences in August, in the very worst of ways and in the most difficult of circumstances and yet is here now, not even three months later, telling her story in a bid to help others represents a strength rarely found in this world. I thank her so much for all the good she is doing and the voice she is for all those who cannot have one at this time. [Hon. Members: “Hear, hear!]

The hon. Member for Strangford (Jim Shannon) showed, through his emotion, the power of the need to have something to cling on to. He has his faith. However, as he rightly explained, people also need a loved one to be there. I turn to speech of the hon. Member for Guildford (Angela Richardson)—wow. It is so important that she raised the issue of what an infection at this time could do to a woman’s body and to the ability to carry a pregnancy. Given how the hon. Member for Guildford—I want to say her name, because this feels like the sort of debate where we should—went through a horrific experience not even in her own home or own environment while having a young child and went on to experience three subsequent losses, I cannot imagine what it took to talk about that today.

The hon. Member for Meriden (Saqib Bhatti) is no longer in his place, but it was great to hear about his incredible work to raise awareness. Jumping out of a plane is testing at the best of times. The chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), spoke powerfully, as always.

As we have heard, losing a baby is one of the most harrowing experiences a person can go through. It is painful, it is devastating, and it is ultimately cruel. It feels like the cruellest of circumstances. We know that, unfortunately, it is all too common and can happen to anyone at any time.

I am often the doctor in A&E who meets the mum when she is coming in. We have heard powerful contributions about stigma and guilt. For me, the take-home is always the overpowering sense from a mother that there is something she could have done. I want to put on the record, and say to those who may be watching, that she has done nothing wrong; she has done everything right. We must do all that we can to fight against the stigma and shame that so many women feel, going through pages and pages of internet sites, wondering, “Did I eat something wrong? Did I lie the wrong way? Should I have gone for that jog?” She did nothing wrong; she did everything right. Her baby was loved.

It is heartbreaking to have conversations like that without a partner, a parent or a best friend present. The first step supporting those affected is drawing attention to this tragic event. I am so proud of the fantastic work of the Baby Loss Awareness Alliance, a collection of more than 90 charities who work relentlessly to ensure that this is on the agenda during Baby Loss Awareness Week and beyond.

In 2020, it would be remiss not to return our attention to the effects of covid-19 when we discuss baby loss. This year of social isolation, solitude and sacrifice has made such tragic occurrences even more tragic. The coronavirus has stripped the humanity out of grieving, with a mother unable to get a hug from her mum and bad news delivered in personal protective equipment while unable to hug a grieving mother or father. We are unable to do what is so instinctively natural to us: to share our grief with those who love us as we lose someone we love.

During the pandemic, there has been reduced access to face-to-face appointments. When appointments do take place in person, partners have been excluded, leaving women to receive the worst news or make the most difficult decisions alone. That has been deeply isolating not only for mothers but for fathers as well. They have that helpless feeling of waiting on the other end of the phone, pacing the room, waiting for it to ring, and then wondering whether they are allowed to show grief, because they are not carrying the baby but they feel the loss equally. They try to be strong for their partner while a part of them dies inside. Virtual appointments just do not carry the same compassion and assurance as seeing someone in person, and as we have heard it can be especially difficult for parents who have already suffered a previous loss. There are challenges in hospital settings, too.

We cannot underestimate the impact that this has on expectant parents. I do not doubt that the Minister will talk about the work that the Government are doing to try to make this more bearable for parents who undergo such a loss. To support bereaved families, it is absolutely crucial that they receive immediate care. There is a direct correlation between when the person going through grief receives the package of mental health support and how long the need for intervention and mental health support continues. The sooner they get it, the better it is for them. Access to bereavement support varies across the country at the best of times, but the redeployment of many NHS staff in the wake of the pandemic has resulted in even greater challenges in accessing that vital support.

This is the most difficult of journeys. Very often, we cannot change the outcome, but we can influence the journey and make it more bearable. The NHS is here for parents going through this. Maternity and neonatal care must not be curtailed during the second wave of covid-19.

I thank all hon. Members for bravely sharing their experiences. I am sorry that I have spoken for so long; I did not even finish what I had planned to say, but sometimes we have to go with the moment. I could not be more proud of the contributions and to call all hon. Members here colleagues.

[Ms Angela Eagle (in the Chair)]

Minister, could you leave a couple of minutes before the end so that I can call the mover of the motion to reply?