Health and Care Bill

Sarah Olney Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Paul Bristow]

My hon. Friend speaks with much experience and makes a powerful point. I think he would agree that that core admin function is not what he went into medicine to do. He went into medicine to treat patients. I am grateful that the Minister laid out some of the plans that the Government have to deal with this issue. It is right that we should be looking to the long term, and the 15-year framework for future workforce is to be welcomed, but there also needs to be a much more regular reporting mechanism attached to that to ensure that we as Members are informed, but more importantly the NHS is informed, about how that challenge is going. The integration between NHS England and Health Education England—aligning the delivery arm and the workforce capacity arm—is probably also the right thing to do.

I end with this point: the challenges around workforce will be addressed not only by employing and training more NHS staff, although that is crucial—that is why I have some sympathy for amendment 10—but by ensuring that we work more productively by asking clinicians to operate at the top of their licence. It is also about ensuring that the NHS works smarter. We have created organisations such as Getting It Right First Time and NICE and asked them to go away and do the hard work of coming up with the most cost-effective and efficient ways of delivering care. If we ask those organisations to come up with the pathways and the ways of doing these things, surely it is only right that the NHS then adopts them instead of sitting there and saying, “These things will not necessarily work here.” We ask experts to come up with the right way of performing procedures; I suggest we go ahead and adopt them.

[Sarah Olney (Richmond Park) (LD)]

I rise to speak in support of amendment 10, tabled by the right hon. Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, because the amendment reflects the key issue facing the NHS and all our health and care services at this time: the workforce. Access to healthcare services is the No. 1 issue raised with me by constituents at the moment, and I know that concern is being echoed in other constituencies across the country.

People are experiencing the issue in many different ways. Some are struggling to get a GP appointment. I regularly speak to parents in great distress because of the lack of available help for their children’s mental health needs. The accident and emergency department at Kingston Hospital in my constituency has regularly had to ask patients to consider whether there are more appropriate sources of help for their needs. Patients waiting in the backlog of elective procedures are regularly having appointments rescheduled or cancelled. Ambulances do not always arrive when called.

The impacts are many and various, but when I speak to health service leaders in my local area, the answer is pretty much the same: there is a lack of available staff. Even in cases where lack of funds is not in itself a limiting factor, the lack of people with the relevant skills makes it impossible to fill all the vacancies they are able to pay for.

Many of these problems are covid-related. The current NHS waiting list is estimated to be over 6 million, and it is clear that much of that is because so many elective treatments were delayed during lockdown. Demand for mental health services has accelerated because of the impact of the lockdown, particularly on young people. Covid is still with us, of course, and workforces in every part of the economy are being impacted by the need for individuals to isolate when they have symptoms or test positive. Healthcare staff need to be more vigilant than the rest of us.

Many of these problems are also Brexit related. A lot of young Europeans decided to return to their home countries at the start of lockdown and have not since returned. Brexit has stymied our ability to recruit from the EU, shutting off an extremely important supply for all parts of the labour market, but the effect is being felt most markedly in health and social care, since it is having to manage the extraordinary demand of a global pandemic at the same time.

Many of these problems are also the result of a long-term failure to correctly predict or prepare for workforce demand. One of the huge advantages of a national health service is that it is possible to get clear data from right across the sector and to make appropriate plans and decisions. For some reason, that has not been done, and it is absolutely right that the Government should adopt amendment 10 to start to put that right.

I want to amplify a Backbench Business debate that I was able to bring to this Chamber a few weeks ago, in partnership with the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell). It was on the subject of giving every baby the best start in life, and it was the firm view of all who attended that debate that the health visiting workforce needs to be substantially boosted to enable all new parents to receive a home visit from a trained healthcare professional. During the course of that debate, we heard of the many ways in which a health visiting workforce can support new families and the critical role they play in supporting babies and their families. One estimate is that the cost of poor parental mental health in the first year of life is more than £8 billion. It is clear that the cost of boosting our health visiting workforce would more than pay for itself in a very short time.

I also want to reflect briefly on a conversation I had with a constituent in the street in Richmond town centre on Saturday. Despite having two degrees, she was working in the care sector, and she was talking to me about her terms and conditions of work. She is employed by an agency and is not allowed to engage with any other agency. She is on a zero-hours contract, so she has to sit at home and wait to hear how many hours she might be required to work the following week. For various reasons that suits her, but I feel that it underpins the recruitment crisis we are experiencing in our social care sector, because that is no way to retain skilled and committed staff.

[Mr Kevan Jones]

Does the hon. Lady agree that it is not just about levels of pay and uncertainty for those individuals, but ensuring that we nationally accredit the qualifications of those individuals and address the career paths that do not exist in those sectors at the moment?

[Sarah Olney]

The right hon. Gentleman is absolutely right, and that is the point I want to make: we need to boost the status of our care home staff and improve their terms and conditions. We need to improve their pay. This lady who I spoke to on Saturday was telling me that she gets paid for the hours she spends in people’s homes, but not the time spent travelling in between. It is clear to me that the crisis of staffing we are experiencing in our care sector—I think every one of us as MPs is hearing about it regularly from our constituents, who are at the sharp end of that—is as much about workforce planning and improving terms and conditions. The Government needs to give that the most urgent attention, and amendment 10 would go some way to resolving that, although it will not resolve it entirely.

I know that Ministers will push back against the cost of boosting the workforce in all areas of the NHS, but they must surely realise the cost of failing to do so. The right hon. Member for South West Surrey. along with the hon. Member for Central Ayrshire (Dr Whitford), spoke about the cost of locum resource in the NHS. It is not just about the direct cost of locums or of worsening health outcomes as people wait longer for treatment; it is also about the lost productivity of days off sick, the cost of poor mental health as lives are put on hold and, as has been mentioned many times, the cost of exhausted and demoralised staff who are overwhelmed by the demands on the NHS. We cannot afford to continue to fail to effectively plan our healthcare workforce.

I am also very happy to support the amendments tabled by the hon. Member for North West Durham (Mr Holden) on virginity testing and hymenoplasty. I am delighted that the Government are adopting the provisions on virginity testing. We still have much to do to make this country a safe place for women and girls, but all progress is to be welcomed, and I am very glad that this opportunity to bring to an end the degrading practice of virginity testing has not been lost. I congratulate the hon. Member for North West Durham on all the work he has done and, although they may have left the Chamber, the representatives of the other charities referred to earlier. I hope in due course we will see the provisions for hymenoplasty as well, when the review has concluded.

[Mr Deputy Speaker (Mr Nigel Evans)]

I have three people indicating that they wish to speak. I ask people to make really short contributions, because I want to give the Minister six minutes to wind up and we will then go into the votes at half past.

Giving Every Baby the Best Start in Life

Sarah Olney Excerpts

Tuesday 9th November 2021 Commons Chamber

[Sarah Olney (Richmond Park) (LD)]

I beg to move,

That this House has considered the matter of giving every baby the best start in life.

I am grateful to the Backbench Business Committee for giving us time for the debate. Among all the turbulence created by the pandemic and the lockdown, I am pleased that we have the opportunity to debate at length the impact of those events on those who are likely to live with its after-effects the longest.

The building blocks for lifelong emotional and physical health are laid down in the period from conception to the age of two. Those first 1,001 days are a critical time for development, but they are also a time when babies are at their most vulnerable. Babies do not yet have the language skills to advocate for themselves, so carers and services must be equipped to do that on their behalf. During the first 1,001 days, babies are also uniquely susceptible to their environment. Chronic stress in early childhood, whether caused by maternal depression, poverty or ill health, has a negative impact on a baby’s development.

Early intervention and prevention to support the wellbeing of babies during this time is strongly linked to better outcomes in later life, including educational achievement, progress at work and mental health. Failing to invest in giving babies the best start in life delivers not only a human cost but an economic one. The total known cost of parental mental health problems per year’s births in the UK is estimated to stand at £8.1 billion.

[Chris Elmore (Ogmore) (Lab)]

I thank the hon. Lady for securing the debate on an issue that is close to my heart, having had a lockdown baby at the end of January—he is just over nine months now, and he is very happy and causing all sorts of chaos in my and his mother’s lives. The hon. Lady mentioned mental health, and my constituent Mark Williams has spent many years speaking publicly about the mental health issues he experienced after having his first child. It is extremely important that we wrap care around the mother and the baby after birth, but does the hon. Lady agree that we should also do more to allow fathers to get support with their mental health and to realise that becoming a father is a deeply profound thing and that there is nothing wrong with talking about our mental health as a father after having a child?

[Sarah Olney]

I congratulate the hon. Member on the birth of his baby, and I hope that all is progressing well. I am grateful to him for raising that point about fathers, and I will come to it later in my speech.

My interest in this topic arose from conversations I have had with constituents who gave birth during lockdown. They told me about the isolating experience of not being able to have their partners in the delivery room with them, not being able to share their new babies with the wider family and not being able to meet up with other new parents to support each other and share their experiences. Thinking back to my own experiences of early motherhood—12 years ago—I remember how much it meant to me to have all those people around me as I recovered from the birth and got used to my new life as a parent. My heart goes out to all those who struggled in isolation during those early months, and I am determined that young families should be prioritised for support as we emerge out of the other side of the pandemic.

The UK Government’s recent focus on investment in the first 1,001 days in their “Best Start for Life” vision and funding is very welcome and will undoubtedly make a significant difference to families. I pay tribute in particular to the efforts of the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), who has been unsparing in her work to bring the needs of our very youngest citizens to the forefront of public policy and funding.

One of the most important sources of support for new parents is a health visitor. Even for those who enjoyed the most robust mental health, having sudden responsibility for a tiny and vulnerable new baby who is entirely dependent on them is a source of great anxiety. Having a visit from a trained health care professional who can give them advice, answer their questions and, above all, reassure them is enormously helpful and can make all the difference to their early experience of parenthood.

Although the UK is no longer in lockdown, both access to services and working patterns have changed. Some support services, such as playgroups, have not survived, and some have closed altogether. Children’s centres have reopened, but numbers are limited and places need to be booked in advance, which may mean that the families with the least time on their hands will lose out. The co-ordinators and volunteers at Home-Start Richmond, Kingston & Hounslow have told me about the high levels of anxiety experienced by new mothers unable to access health visitor advice and reassurance. That is impacting new mothers’ confidence and their ability to meet their baby’s needs.

Health visitors are a skilled workforce of specialist public health nurses who have the expertise to provide holistic care to families. As the only professionals positioned to reach every young child before they start school, health visitors play a crucial role in child safety and early childhood development. They identify and manage developmental delay, as well as common and serious health problems. They also provide support around childhood immunisations and advice on infant feeding, safe sleeping and mental health, all of which relieves pressure on NHS emergency departments and specialist services.

However, there is currently no national plan to address falling health visiting workforce numbers. The Government's spending review stated that it

“maintains the Public Health Grant in real terms, enabling Local Authorities across the country to continue delivering frontline services like child health visits.”

In fact, the Government are maintaining the public health grant at a level that is too low for many local authorities to resource health visiting services that can deliver face-to-face visits and the support described in the healthy child programme and other national guidance.

Ahead of the spending review, 700 leading children’s sector organisations were united in their call for investment for 3,000 more health visitors over the next three years. However, I am concerned that £500 million over the next three years will not deliver the Government’s pledge to rebuild health visiting. It is of the most urgent importance that we restore face-to-face health visiting to every new mother as the most essential building block of support to families as they welcome their new babies.

The importance of early home visits by skilled healthcare professionals was highlighted to me by one constituent who wrote to me last summer. She said:

“My baby is now 6 months old and soon after birth he was diagnosed with SMA type 1. If you are not familiar with it, the full name is Spinal Muscular Atrophy and it’s a muscular wasting illness. There isn’t a cure for it and without treatments and proper care the life expectancy of a baby is less than 2 years. He is currently under treatment but, and here is the reason for this letter, every possible centre specialised in physiotherapy, hydrotherapy or other physical activities for disabled people is shut due to Covid-19.

My husband and I were the ones who had to notice something was not right with Peter because, due to Covid, no one came for home visits after birth to see the baby or me. I almost died in child birth and because we were left alone I had to endure 1 month bed ridden due to further complications, once again noticed by me. Only once I was able to walk again we saw something wasn’t right with the baby. If after 2 weeks the health visitor had been able to come home, my son would have started treatment sooner without losing the mobility of his legs.”

I want to talk a little more about the importance of diagnosing and treating perinatal mental health. Maternal suicide is the leading cause of direct deaths within a year of pregnancy. An estimated one in four women experience mental health problems in the first 1,001 days after pregnancy. While depression and anxiety are the most common perinatal mental health problems, other conditions include eating disorders, psychosis, bipolar disorder and schizophrenia. One in 10 fathers is also affected by perinatal mental health problems. Of the 241 families that Home-Start Richmond, Kingston & Hounslow supported during the most recent year, 66% were experiencing mental health difficulties, including post-natal depression, anxiety, depression and chronic mental health conditions.

I was privileged to be able to visit Springfield University Hospital in Tooting recently to meet the perinatal psychiatry team for the South West London and St George’s Mental Health NHS Trust. I was extremely pleased to hear about the work the trust is doing in successfully supporting new mothers who struggle with their mental health, and particularly that it was able to maintain its services during the lockdown and after. Akvinder Bola-Emerson, the clinical services lead for perinatal psychiatry, stressed in particular the need for peer support but also the importance of health visitors, whom she described as the “eyes and ears” of perinatal mental health services.

The visit highlighted for me that we also need better provision for new and expectant fathers. Currently only mothers can be formally diagnosed with a perinatal mental health problem. Springfield provides services for fathers, but it is currently able to identify mental health issues in fathers only when they accompany a mother who is attending the hospital for perinatal mental health issues.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I am extremely grateful to the hon. Lady for securing the debate, and she is making some very important points. Does she agree that one of the worst situations expectant parents can find themselves in is when there is a miscarriage and that parental leave for such parents would be a welcome reform?

[Sarah Olney]

I am grateful to the hon. Member for his intervention. He is absolutely right that there are a large number of events and incidents surrounding pregnancy and birth—as I know from my own experience—that can cause huge distress, and it is right that mothers and the people supporting them, and fathers as well, get the support they need, including statutory leave from employment for the time it takes to come to terms with the miscarriage. That is certainly something we should be looking at.

We know that impending fatherhood can be a cause of great anxiety for men, and more services need to be developed to support them. We also know that over a third of domestic violence starts or gets worse when a woman is pregnant. I would speculate that some of that is attributable to undiagnosed and untreated mental health conditions in expectant fathers, which underlines the need to do more to support them.

In addition to health visiting and perinatal psychiatry, support for children and their families throughout their early years is vital for enhancing children’s prospects at school and beyond. Evidence shows that effective integration of services in the earliest years can bring broad benefits. For example, Sure Start children’s centres are shown to decisively reduce hospitalisations during childhood. However, 1,300 children’s centres have closed since 2010, and recent research has shown that 82% of parents of young children have struggled to access early years services. I am pleased that the Government have now committed £80 million to introducing family hubs to 75 local authorities across England, and £50 million for parenting programmes. However, we need more information on what family hubs can provide, and I would particularly like to ensure that health visiting and mental health support are included.

The importance of the right support in the early years was brought home to me after a recent meeting with primary headteachers in my constituency. I heard about how difficult it is for nursery and reception-age children to settle into class and to get used to spending time with other children and not spending all day at home with their parents. For adults, lockdown has been 18 months of inconvenience, after which we expect to be able to pick up the threads of our former life. However, some young children who started nursery this term will have spent up to a third of their life in lockdown, and we cannot yet know what the long-term impact will be.

[Wera Hobhouse (Bath) (LD)]

Is my hon. Friend alarmed, as I am, by the fact that domestic violence has increased during lockdown, which has particularly affected young or very young children? The Government need to look at the backlog of cases that have arisen through the lack of attention to domestic violence, or inability to look at it, during lockdown, as it did not really come to our attention.

[Sarah Olney]

My hon. Friend is absolutely right, and incidents of domestic violence during lockdown are a matter of grave concern. We know there is a clear link between domestic violence starting or worsening and a pregnancy in a family. That issue needs a huge amount of attention; more mental health support for both partners would help a great deal.

The lockdown will have increased disparities in educational outcomes between those from poorer backgrounds and their richer classmates, and I call on the Government to do more to provide catch-up funding to our schools, and allow them to spend it on a greater range of services. Local headteachers tell me that funding can be allocated only to academic tuition, and that they have identified many children, including the very youngest, who need mental and emotional support to help them in school.

I will conclude by saying thank you to everyone who has talked to me about their experiences in this area, but particularly our health visiting and perinatal mental health teams, who do so much good and valuable work for new families. I also acknowledge the huge contribution made by the voluntary sector in supporting new families, in particular the work of Home-Start, which provides an excellent network of support. It takes only a small amount of encouragement, a little word of advice or a sympathetic listening ear to give a new parent confidence, but it can make a world of difference to their children. A small investment in the beginning of life can reap huge rewards, not just for individual children and their families but for whole communities, and the right start can enhance not just individual educational achievement and wellbeing but reduce risky and antisocial behaviours. Few pounds could be better spent, or yield a more valuable return, than those invested in our youngest citizens.

--- Later in debate ---

[Sarah Olney]

Thank you, Madam Deputy Speaker. I thank all hon. Members who have spoken in our debate, which has been really interesting. I particularly thank the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) for all her work.

It was great to hear from the Minister about how much has already been delivered and the spending that has been announced. I thank the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for all her support in getting the debate together. She made some very interesting points about employment discrimination. I also want to pick up on what the hon. Member for Washington and Sunderland West (Mrs Hodgson) said about the importance of climate change.

The hon. Member for Penistone and Stocksbridge (Miriam Cates) made some very interesting comments about the economic impacts of motherhood. I was particularly struck by her comment that children are not an economic inconvenience; I agree 100%. I thank the hon. Member for East Worthing and Shoreham (Tim Loughton) for sharing his personal experience, which was really thought-provoking. I also thank my hon. Friend the Member for Bath (Wera Hobhouse) for mentioning trauma and adverse childhood experiences.

All hon. Members have added a really interesting dimension to the debate. I thank them all.

Question put and agreed to.

Resolved,

That this House has considered the matter of giving every baby the best start in life.

Oral Answers to Questions

Sarah Olney Excerpts

Tuesday 19th October 2021 Commons Chamber

[Gillian Keegan]

Yes, I completely agree. Some 95% of the jobs are with private providers, so it is important that they take care of their workforce. There is a lot of competition for labour and a lot of skills shortages in our country. Most workers are on just above the national living wage, but it worries me that a third are on zero-hours contracts, so there is a lot we can do to improve the terms and conditions of the social care workforce. My hon. Friend raises a good leadership example.

[Sarah Olney (Richmond Park) (LD)]

8. If he will make it his policy to keep prescriptions free for people aged over 60.

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

The Department’s consultation on aligning the age for free prescriptions with the state pension age closed on 3 September. The responses to the consultation are being reviewed, and we will outline the next steps in due course.

[Sarah Olney]

We know that low incomes are associated with worse healthcare outcomes and also that average prescription use is higher among those in more deprived areas. Will the Minister accept that increasing healthcare costs for those on low incomes will mean that health inequalities will widen, increasing the pressure on low-income families and the NHS this winter?

[Maria Caulfield]

I thank the hon. Lady for her question. I reassure her that around 90% of prescription items in the community are provided free of charge. Those who are vulnerable and on low incomes, such as those on universal credit, income support and jobseeker’s allowance, already qualify for free prescriptions. It is really important that those over the threshold can also apply for the prescription prepayment certificate, where all their items will cost just about £2 a week. We are making sure that costs are low for those on low incomes.

Covid Vaccine Passports

Sarah Olney Excerpts

Wednesday 8th September 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my hon. Friend’s work. He has been a champion of the vaccination programme and I am grateful to Medicare Pharmacy. We continue to have pop-ups at universities and walk-ins around the country, and incentives to young people to get vaccinated. We also continue to redouble our efforts to keep the vaccine evergreen for those who have not yet had their first dose.

[Sarah Olney (Richmond Park) (LD)]

Last week, I spoke to a constituent who is a widow with four children and has been working for the NHS on the frontline throughout the pandemic. One of her children has a range of very complex needs that can only be met by full-time residential care, and there is only one setting in the entire country that can meet his particular needs. She has been told that it cannot take him because of a shortage of care staff, and that the particular difficulty in recruiting at the moment is the requirement for care staff to have had two jabs. As the right hon. Member for Forest of Dean (Mr Harper), who is no longer in his place, highlighted, the vaccine does not prevent infection or the spread of covid. So why, given the crisis in recruitment of care staff, do we still have this requirement for two jabs when it is not effective and is depriving vulnerable people of the care they need?

Covid-19:International Travel

Sarah Olney Excerpts

Monday 24th May 2021 Westminster Hall

[Sarah Olney (Richmond Park) (LD) [V]]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I congratulate the hon. Member for Don Valley (Nick Fletcher) on securing this important and timely debate.

I will stick to my five minutes by merely supporting what hon. Members have said already, in particular what was said by the right hon. Member for Exeter (Mr Bradshaw) and by the Chair of the Transport Committee, the hon. Member for Bexhill and Battle (Huw Merriman). I support many of their points.

There is no doubt that the Government have lots of difficult decisions to make about how we reopen our travel sector as we come out of the pandemic, which we all hope we are now doing thanks to the huge success of the vaccine roll-out. Many of my constituents are employed in or own businesses across the travel and tourism sectors. I hear from them huge frustration at the lack of clarity surrounding the overall strategy for allowing international travel and reopening the sector. Above all, we need a great deal more clarity on how decisions are being made, in particular with reference to which countries are on the green, amber and red lists.

I share the dismay of the Chair of the Transport Committee at the small number of countries that are on the green list; not knowing the criteria for the lists is causing a great deal of confusion. In recent weeks, we have heard a great deal about India, for example, not being on the red list despite its circumstances being more severe than those in other countries that were on the red list. It is important that we have clarity about why countries are on the red or amber lists.

What is most important for the travel industry is being able to plan and to predict, and to look at conditions prevailing in certain countries and think, “Are they on the way out? Have they got a vaccine programme that they are rolling out? What is the likelihood that we will be able to travel freely to that country in July, August or September?” If we had more clarity about why decisions are being made and when we might be allowed to travel to certain countries freely again, that would make a huge difference.

As the hon. Member for Bromley and Chislehurst (Sir Robert Neill) said, it is not just about the travel industry. We need clarity in order to provide certainty for many sectors that depend on travel. He highlighted in-bound tourism, which is a big issue for people in my constituency and the wider area. My former employer was Hampton Court Palace, and I know how much it depends on visitors from America and Europe, so it is suffering at the moment. It is about our broader economy, as travellers from our business and cultural sectors want to be able to plan for greater reopening in the autumn. Without much better understanding of how the Government are approaching the opening up, it is very difficult.

I want to highlight the issue with testing when people arrive in the country from an amber list country and need to test on day two and day eight. I was appalled to hear from a constituent about the cost of these tests. I had naively assumed that they would be free, as they are for every resident here who needs a test. I cannot understand why we are charging travellers up to £150 for each test. For a family of four who are travelling here and have to do tests on day two and day eight, that is an extra cost of £600.

This petition is about the needs of those who have family, friends and partners abroad. My heart goes out to people who have dying relatives in other countries, which is a situation in which far too many families find themselves. I have many constituents with family and friends in European countries—we have a lot of European nationals in Richmond Park—who are already finding it difficult to travel to those countries, but need to travel at this time because their families are struggling. To have the additional cost of the tests is inconceivable.

If we have a wider strategy to make international travel possible and safe again, it beggars belief that we are charging that extraordinary amount for those tests. I urge the Government to have another look at that. It is not just a barrier for people who are travelling for whatever reason they want to travel now, but it will continue to be a barrier. If it is going to be part of our strategy for opening up, it will be barrier to business, trade and tourism, and we must address that. As such, I urge the Government to look at providing greater clarity about how travel can be made possible, and particularly about the cost of tests.

Oral Answers to Questions

Sarah Olney Excerpts

Tuesday 13th April 2021 Commons Chamber

[Matt Hancock]

Yes. I think that through the pandemic we have seen an improvement in our ability to see what is happening in the NHS right across the UK, and that helps us all work together better to deliver for patients. One example of that is the vaccine programme. That is a UK-wide programme with UK-wide metrics but it is delivered, of course, by the local NHS wherever people are in the UK. There are lessons we can learn from that.

[Sarah Olney (Richmond Park) (LD)]

I am hearing increasingly difficult stories from constituents across my constituency whose children are suffering severe mental health problems and are regularly having to wait up to a year for a first appointment. In that year, their condition gets progressively worse, so by the time their appointment comes around, they already need a much greater level of treatment than they would have needed had they been seen earlier. That also has a disruptive impact on their education, on top of the disruption that they have all experienced over the last year. The situation is getting worse; we are seeing more and more young people needing mental health care in my constituency. What is the Secretary of State doing to increase resources in this very important area of child and adolescent mental health?

[Matt Hancock]

We are putting record resources in. Of the increase in the NHS budget, the fastest increase in the long-term plan settlement is for mental health services, and within that, for children’s mental health services. We have also increased support through the pandemic. There is an awful lot that we continue to need to do, and there is a very significant plan, as part of the long-term plan, for improving access to these vital services.

Maternal Mental Health

Sarah Olney Excerpts

Wednesday 10th March 2021 Westminster Hall

[Sarah Olney (Richmond Park) (LD)]

I beg to move,

That this House has considered maternal mental health.

It is a real pleasure to serve under your chairmanship, Mr Robertson, and indeed to have Members participating virtually in this afternoon’s debate. Maternal mental health should be among our principal concerns. Pregnancy and birth can be the trigger for poor mental health among those who did not previously suffer from mental health problems, and they are a major factor in the escalation of existing ones. The first two years of a child’s life are vital in their development, and the right support and guidance for families at this time can make a big difference to their long-term outcomes.

For many women, becoming a mother presents psychological challenges. They might have experienced conflict or abuse in their own childhoods, which resurface when they contemplate the reality of becoming a parent themselves. They might be used to setting high standards for themselves and derive their sense of worth from their ability to meet them, but find that their baby does not comply with their drive to meet their parenting targets. They might simply be overwhelmed by the awesome responsibility of having another human being entirely dependent upon them, and fear that they do not have what it takes to be able to be an effective parent.

Because everybody has had a mother at some point in their lives, we all, knowingly and unknowingly, have formed a picture of what a mother is and what a mother should do. These assumptions about motherhood crowd around every new mother, complicating her own feelings about her new baby and her new role. New motherhood can be extremely lonely, especially in the dark, still hours of the early-morning feeds, and that loneliness creates a fertile space for doubts and anxieties.

Lockdown has exacerbated so many of these issues. I asked for today’s debate so that we can talk about the impact of covid on the mental health of new mothers, and to urge the Government to prioritise this as we come out of lockdown. Loneliness has been a major issue for almost all of us during the past year, but the lack of contact has been particularly acute for those who have had babies during this time. I am enormously grateful to the parliamentary digital engagement team for organising a survey in advance of this debate to ask members of the public for their experiences. We had more than 11,000 responses, with some extremely moving testimony among them. I thank everybody who took the time to share their experiences, but especially those whose experiences were difficult and painful.

The overwhelming theme of the responses was how difficult isolation had made the experience of giving birth and caring for a newborn. I was particularly struck by the experience of Zilia from the south-east when she told us:

“All appointments attended alone and in sterile conditions. Childbirth alone, no visitors in hospital, no family able to meet your newborn and help you out thereafter. Just the most isolating and lonely experience I have been through.”

Reflecting on my own experiences, I overcame the early challenges of motherhood with a combination of a supportive partner present at the birth, a delighted family who rallied round with practical help, professional health support delivered through home visits, and a peer group of other new mothers in the neighbourhood. To have been denied any one of those would have made the job of adjusting to motherhood considerably harder. We now have thousands of mothers battling through the early months of motherhood without having had any of those essential forms of support, and this has taken its toll on their mental health.

This is how Emily from Scotland describes the impact on her:

“My mental health is awful. I have never felt so lonely or isolated. I shielded from March until June last year and saw nobody for my second trimester other than my husband. My husband’s family are yet to meet our baby, who is our first, and he is coming up to six months old. I have developed post-natal OCD, which is horrendous, and I am still waiting for professional help to cope with this.”

Other covid-19 factors that have worsened the experience for new mothers in lockdown are financial uncertainty, lack of access to childcare, and bereavement. The industries worst hit by the lockdown employ a large proportion of females. Some 20% of mothers have lost their jobs during the pandemic, compared with 13% of fathers. The closure of schools has left many mothers trying to juggle home schooling for older children with looking after a newborn, and many families are dealing with the trauma of losing family members to covid.

The impact of the pandemic has changed the way that we all access healthcare, as resources are prioritised towards emergency admissions and efforts are made to reduce contact. In some parts of our healthcare system, it has led to an increase in digital and telephone consultations. In many parts of the country, this has included perinatal care. Many of the respondents to the survey reported receiving follow-up care in this way, including Jennifer in the west midlands, who reported:

“Very limited midwifery care. I didn’t see a midwife at all until I was 28 weeks. No health visitor service whatsoever. Apart from one very brief phone call, I have had no contact from a health visitor. My baby has not been weighed since 10 days old, and they are now almost six months. Overall, my pregnancy experience has been unnecessarily stressful and left me feeling constantly anxious and unsupported.”

In my conversations with new mothers in my constituency, many of them brought up how difficult they found the lack of professional support. They were unable to access guidance about breastfeeding or sleeping, and unable to ask questions or seek reassurance. Many of them found that they experienced much greater anxiety about their babies as a result. I have at least one case in my constituency where the lack of a physical examination led to a major genetic condition being missed—one in which, tragically, early intervention can make a significant difference to the quality of life.

The survey we conducted found that, of those mothers who had received an online consultation, 60% said they were not affected, compared with only 3% who said they were affected. I have spoken to the Institute of Health Visiting and the Royal College of Psychiatrists, and they have confirmed to me how vital such face-to-face support is for new mothers in the first weeks. The value of the home visit is that the mother does not need to identify the need for help and then go out and seek it for herself; someone comes to her and asks her how she is. A trained and experienced health visitor can observe mother and baby and identify whether additional support is needed. That kind of support cannot be replicated on Zoom or over the phone. Furthermore, as the Royal College of Psychiatrists has highlighted to me, it is much harder to identify whether there are issues of domestic violence or coercive control between a mother and her partner when contact is one-dimensional.

The impact of perinatal mental illness can have long-lasting impacts on families. Stephanie from the east midlands told our survey:

“I have previously not had any mental health issues, but I have really struggled with my mental health since having my baby. I have severe anxiety and now perinatal OCD. I have intense fear and stress about leaving my child, and I am not receiving anywhere near enough support.”

The long-term societal cost of perinatal mental ill health is estimated at £8.1 billion annually for each one-year cohort of births, and about three quarters of that is the cost of the impact on children. The financial value of early interventions to support struggling families is clear, and there is also the very human value of building loving and supportive families.

We already have the structures and mechanisms to provide support through the health visiting service. I should declare an interest here: my mother was a health visitor for many years, so I have learned at first hand from her about the times when a friendly knock on the door made all the difference to an overwhelmed new mother. However, it is a service that was already chronically underfunded and understaffed before the pandemic took hold. There has been a 31% decrease in the health visiting workforce since 2015, and many local authorities target their scarce resources at those deemed most at risk.

I believe that only a universal health visiting service can properly identify and support mothers who are suffering from poor perinatal mental health, and that the Government should allocate sufficient resources to enable this to happen. We need better mental health support for all ages and stages, and better training throughout our health service to identify and support those who are struggling, but providing support to new mothers should be a priority, because of the long-term impacts that their poor mental health can have on the development of their children and on the rest of their family.

The first step is to address the shortage of health visitors. There cannot be quality service provision when 65% of health visitors have case loads of more than 500 children each. We also need to urgently address the staffing shortage among midwives, who have a critical role to play in supporting women’s emotional wellbeing during pregnancy, childbirth and beyond. The Royal College of Midwives has found that there is currently a shortage of 3,000 midwives. Alongside that, we need to increase training and specialist mental health support for midwives, so they are well equipped to deliver the necessary support.

The pandemic has forced us to use digital tools in every area of our lives. We may find that we continue to use some of them even after face-to-face contact is possible again. If I could make one plea to the Minister, however, it would be that we should not allow digital and telephone perinatal check-ups to become the new accepted standard. The Government should fund and resource home visits by health visitors to all new mothers so that we can properly address the issue of maternal mental health.

--- Later in debate ---

[Sarah Olney]

This has been a really fantastic debate, and I am so grateful for the contributions from Members, both in the room and on Zoom. I welcome the contribution from the hon. Member for East Worthing and Shoreham (Tim Loughton) and all the work that he has done, particularly as the chair of the APPG for the first 1,001 days. He has highlighted the work of the right hon. Member for South Northamptonshire (Andrea Leadsom), and I am very much looking forward to reading her review, which will be really interesting. He also highlighted the importance of fathers, and I am really grateful to him for raising that important aspect of the debate.

I am grateful to the hon. Member for Strangford (Jim Shannon) for mentioning grandparents. Some of the most distressing correspondence I have had during this pandemic has been from grandparents who have been unable to see and hold their new grandchildren, so I thank him for raising that issue. I congratulate the Minister on her impending grandmotherhood and hope that all goes well.

I am particularly grateful to Members who have shared their own experiences throughout the debate. I thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory), whose experience highlights what I was saying about the inadequacy of telephone and digital follow-up appointments. She spoke of her experience of post-natal depression, and I am really grateful to her for sharing that. If I could stretch out a virtual hand, I would like to say to her that we share the experience of baby loss, and I know what that is like.

I am grateful to the hon. Member for City of Durham (Mary Kelly Foy) for highlighting another really important aspect: babies who are born with additional needs, the particular needs of their families and how they have been affected during this pandemic. I really hope that their needs can be prioritised going forward. I also want to mention the right hon. Member for Basingstoke (Mrs Miller). It feels as if a mother’s financial experience is almost an additional thing, but she is absolutely right in saying it is central to mothers’ mental health to know that they have economic stability. I thank her for raising that.

I want to pick up on the Minister’s comments. I am really pleased to hear about the call for evidence. As I say, I am looking forward to the early years review. I want to push her on the point about not allowing digital and telephone consultations to become the norm in perinatal mental health, because those face-to-face visits are so important to mothers everywhere, and I really hope that can be embedded. I thank everyone for their time this afternoon, and thank you, Sir Edward, for your chairing.

[Sir Edward Leigh (in the Chair)]

Speaking as a grandfather, it has been a very interesting debate.

Question put and agreed to.

Resolved,

That this House has considered maternal mental health.

Covid-19

Sarah Olney Excerpts

Wednesday 18th November 2020 Commons Chamber

[Sarah Olney (Richmond Park) (LD)]

I appreciate this opportunity to pay tribute to some of my constituents who have had such a tough time during this pandemic and during the lockdowns and restrictions. The businesses in Richmond Park have had a really difficult time, but I have been so impressed by how they have responded to the challenge, made themselves covid-secure and continued to deliver for my local constituents in whatever sector they are in. I pay tribute to those who have gone above and beyond and made a difference to the community. I am thinking of my favourite pizza restaurant in north Kingston, Peppe, which has been providing pizzas to NHS staff every time someone has bought a pizza from it.

Our cultural organisations, which we value so highly in Richmond Park, have had a really tough time. They were all opening up again and having record demand for tickets during October. Then, of course, we had the current lockdown, and we are hoping against hope that they can still open in December. I am particularly looking forward to going to see “Rapunzel” at the OSO Arts Centre in Barnes in December. It is billing it as “The Original Isolation Story”, so I think that is something we are all looking forward to.

I want to take this opportunity to draw attention to people who have been without financial support during the lockdown. I welcome all the Government’s efforts on furlough, and there is absolutely no doubt that that has been critical to the survival of many businesses not just in my constituency but elsewhere. However, I want to highlight the lack of support for those on contracts and the self-employed, which we raised in the Public Accounts Committee hearing with Her Majesty’s Revenue and Customs on Monday. That is a big issue in my constituency. We have lots of people who are employed by the live events sector, which of course has been really badly hit during the lockdown, and it struggled to come back before the second lockdown. I just do not understand why we cannot do more for this particular group of people who have been paying taxes for years. All the records are at HMRC, and there is absolutely no reason why more could not have been done for them.

The children in my constituency have suffered huge disruption throughout the summer. I am so pleased to see them all back in school. I was speaking to year 6 at the Vineyard School in Richmond just this morning, and it was wonderful to see them all there. I very much look forward to being able to visit them in person soon. I would also ask the Government for some clarity on what will happen with exams next summer. That is what headteachers are asking for, and they need a decision now. Are exams going to be cancelled, as they have been in Wales by the Lib Dem Minister for Education there, or will there be a different source of assessment? Something needs to be done, and teachers ideally need to know before Christmas, so that they have time to prepare.

I was speaking to the management team at my local hospital, Kingston Hospital, last week, and that reminded me why we are doing this lockdown. They have had a big increase in hospitalisations, which, at the end of the day, are what we need to be careful of. I want to reiterate what the Minister and my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) said earlier, and it is the message from my local hospital too: “Please, please, please continue to attend”. I have heard some distressing tales of cancer sufferers whose conditions have worsened through not being able to access health services during the first lockdown, and I really do not want to hear any more.

I pay tribute to all the voluntary organisations in Richmond Park. I was speaking to FiSH, which looks after the elderly residents of Barnes. Its particular issue has been isolation, and I am so pleased about all the work that it and all the other excellent neighbourhood charities in Richmond Park have done, with befriending calls and so on.

Finally, it is such welcome news about the vaccine. We are all very excited about that, but there is an urgent need for clarity about how we get from here to where we have all been vaccinated and can operate safely again. I urge the Government to bring forward announcements on that as soon as they possibly can.

Oral Answers to Questions

Sarah Olney Excerpts

Tuesday 17th November 2020 Commons Chamber

[Edward Argar]

I am grateful to the hon. Gentleman. He is quite right to highlight the amazing work that our NHS and social care workforce have done throughout this pandemic, as they do every year, and I pay tribute to them for that. As he will know, the NHS agrees with its staff multi-year pay deals set by independent recommendations, and we continue with that process.

[Sarah Olney (Richmond Park) (LD)]

If he will allocate additional funding to local authorities to support the roll-out of lateral flow covid-19 testing.

[The Secretary of State for Health and Social Care (Matt Hancock)]

In addition to giving local directors of public health access to tests, NHS Test and Trace will provide access to training, clinical, operational and service design guidance, and communication and engagement support. In addition, all local authorities have funding available up to £8 per head of population to support the roll-out.

[Sarah Olney]

I welcome the allocation of lateral flow tests to both Kingston and Richmond in my constituency to allow for mass testing. Can the Secretary of State confirm whether, in addition to the support he has just outlined for the testing, there will be additional resources to support local tracing efforts and to support those who are found to need to isolate?

[Matt Hancock]

Absolutely, the funding to support people who need to isolate is in addition to the funding I just outlined, which supports both the roll-out of mass testing and local contact tracing, and we always keep these things under review.

Covid-19 Response

Sarah Olney Excerpts

Tuesday 2nd June 2020 Commons Chamber

[Matt Hancock]

The hon. Gentleman is right to ask that question in the sensitive manner in which he does. Of course, I have had discussions with my colleague the Secretary of State for Education, and both of us have taken clinical advice on the decisions around schools. I would not support the changes and the reopening of schools if I did not think they were safe. One of the reasons to bring in three years in the first instance in primary school is to ensure that there is the physical space that my hon. Friend the Member for West Worcestershire (Harriett Baldwin) spoke about earlier. We have got to be careful, cautious and sensitive, especially to the needs of those who might be disproportionately affected, and we have got to do the research to get to the bottom of why.

[Sarah Olney (Richmond Park) (LD)]

A great deal of work has been done by local policing teams in Richmond and Kingston to inform my elderly constituents about the risk of scams both online and over the telephone. What shall I tell my constituents to look for, if they are contacted by a contact tracer, before disclosing personal data?

[Matt Hancock]

The hon. Lady is absolutely right to raise that. It appals me that people would try to raise a scam in response to this mission-critical national project of NHS Test and Trace. NHS contact tracers will never ask for your personal financial information. They will never ask you to pay for anything, and they will never disclose your personal medical information. If any of those things start to happen on a call, it is not a call from NHS Test and Trace. We have worked closely with the National Cyber Security Centre to ensure that we get the scripts right and that we protect against these risks, and she is right to raise it.