(3 years, 7 months ago)
Commons ChamberI suppose the facts will reveal themselves when the Minister shows us all the paperwork, leaves it in the Library and then we can go through the facts, the stats and the figures together. I look forward to that. We heard earlier today—[Interruption.] The Ministers are going through some figures now. I really think that, to resolve all of this, and to not even have this debate and conversation, they should put all the paperwork in the Library, we can all go through it together and that is what is needed.
My hon. Friend is making a powerful speech and she has spoken with incredible experience and heart on this subject throughout the last few years. Does she agree it is particularly galling that we are seeing the former Health Secretary write a book, the “Pandemic Diaries”, yet we are not able to scrutinise the facts and evidence of the decisions that were taken not just about the public’s money but about public safety?
My hon. Friend makes an extremely valid point. I spoke in Committee this morning. I am not going to read the book but I think we have to scrutinise it and cross-check the information that the Minister gave in Committee against what is in the book. The new Ministers who have come into post should be a little more humble, because what has happened is shocking. The cronyism and the corruption that has happened in the Government in plain sight is truly shocking. The Government are now spending £10 million burning PPE. It is like they are burning the evidence—we wonder why. [Interruption.] Sorry, the Minister said that I have just criticised the Minister for storing PPE. He is right. I would not want the Minister to spend nearly £1 million every day storing PPE. I also do not want him to burn PPE. He should be using the PPE—give it to people who are travelling on the tube. We are having a flu epidemic and it will help to resolve that, so don’t heckle me when this is your responsibility—[Interruption.] I mean the Minister. Sorry, Madam Deputy Speaker. The Government are incompetent as well as corrupt and it is not just cronyism. The situation is so ridiculous—[Interruption.] Am I not allowed to call it what it is, Madam Deputy Speaker? It smells like corruption to me.
(3 years, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The hon. Gentleman always makes constructive suggestions, and today is no exception. He knows that we have an ongoing inquiry into the lessons that can be learned and a dialogue with the Health and Social Care Committee about many of these issues. Given its heritage, Northern Ireland was an important supplier of textiles and PPE equipment. Inevitably, given the global balance of production, a lot of items did come from China, as he says, but as part of the lessons learned, we should be thinking about domestic supply.
We have all seen the shameful Guardian front page this morning, but the front page that sticks in my mind is the one showing nurses in bin bags—not PPE on the frontline, but bin bags. This was at a time when Luton Borough Council was facing another cut of £11 million. People are struggling, so why are this Government not lifting a finger to get our money back? They could start by releasing the records after the mediation process.
The hon. Lady’s question takes us back to that extraordinary moment when we had a huge crisis of PPE, and we were desperate and doing every conceivable thing we could to get the PPE that those nurses needed; that is what I have been referring to in my answers this morning. It is just not true that the Government are not lifting a finger to get the money back. We have a process, and there is a substantial team in the Department working on it right now.
(4 years ago)
Commons ChamberThat sounds like a very distressing constituency case. Obviously we are investing lots of money in research across the whole cancer spectrum, and I would be happy to meet my hon. Friend to discuss the issue he raises.
Unprotected exposure to the sun can leave someone vulnerable to skin cancer, but as my constituent Tina, who suffers with melanoma, knows, the sun is not the only risk factor for skin cancer—sunbeds continue to be used all year round at very high risk. Does the Minister agree that it is time we took the dangers of sunbeds seriously? Does he support Melanoma UK’s campaign to ban the use of sunbeds, and if not, why not?
(4 years, 1 month ago)
Commons ChamberFor many people living in Bradford, being unable to get an appointment with their GP for days or weeks, or being unable to see an NHS dentist at all, is one of the most depressing issues they face—if not the most depressing. Although such a scandal in our healthcare system is of course unacceptable anywhere, the harm that it is causing in Bradford, where we face especially stark health inequalities and where people are dying a decade earlier and facing a higher rate of preventable diseases, is particularly damaging.
It seems that the Government either do not understand or just do not care. Earlier, the Secretary of State opened for the Government. According to him, we have had record levels of investment, the Government are now planning many initiatives, and any concerns were entirely a result of the two years of covid. Of course, everybody in this Chamber would accept that the NHS, GPs, dentists and all the health services faced pressures during covid. I do not think anyone is denying that. The Secretary of State said to the shadow Minister, “You supported us during that period”. Of course we did. We were a responsible Opposition and of course we ensured that any pressures during a very difficult period could be alleviated. But to say that the issues have suddenly resulted from that period is simply untrue, and Ministers know that it is untrue.
The second assertion—those who were in the Chamber will recall that I pressed the Secretary of State about his record investment in the NHS—was that of course there was record investment, but let us look at that investment. Let me go to my district, to Bradford, and see the record investment that Ministers and the Secretary of State want to boast about. Frankly, they live in some parallel universe, because we do not see the effect that they come here and tell us about. In Bradford, one of the most deprived districts—more than 50% of the deprivation in my constituency is in all the top 10 deprivation indices—child poverty is now at a record high because of those on the Government Benches. Nearly 50% of children in my constituency today live in poverty because of the draconian, ideological cuts made by this Government over the past decade. I have said this in the Chamber many times: people who live in the inner cities are likely to live 10 years less than if they live in the leafy suburbs, which are far more affluent and, frankly, get more investment.
What does the record investment that the Secretary of State and Ministers tell us about equate to in Bradford terms? They tell us that, on average, we will get £4 per patient more than the rest of the country, even though we have the levels of deprivation, poverty and health inequalities that I have gone through. But actually the situation is worse, because even that £4 of investment that they tell us we are getting is fudged figures and smoke figures, because in real terms, if inflation was to be counted, we are getting £3 million less than we had before this Government came to power. On average, we have more than 2,800 patients per GP, whereas the national average is 2,100 patients per GP. If anywhere should be seeing this record investment, it should be in places such as Bradford, but are we seeing it? How does that equate? The hon. Member for St Albans (Daisy Cooper), who is no longer in her place, talked about the stark reality on the ground. This is why I say that Ministers are living in a parallel universe, because the stark reality on the ground is not as they see it. Most people simply cannot get GP appointments. People start ringing first thing in the morning and are on hold for hours on end. Many people will then have to wait until the next day. Getting through to a GP practice on the phone takes days on end.
When the Minister comes to her feet, I am sure she will say that X number of people have been able to access a GP, but have they been able to access their own GP? We have heard time and time again from health professionals how important continuity of care is. Does my hon. Friend agree that this is not just about seeing any old GP—it is about someone seeing their own GP?
I absolutely agree with my hon. Friend, who makes the point that I was coming on to raise. Her Luton constituency is not dissimilar to mine. With a single GP having 2,800 patients, it is obvious why those patients are not getting to see their GP. I could spend a long time in this Chamber going through constituency cases that I have recently dealt with. Indeed, I have done that in the past and those cases are on the record. Let me cite just one case today. An elderly lady in her 90s had to go to hospital and was then told to go to see her GP. Her son tried day after day to make a simple GP appointment for her. She had multiple health needs. My office had to intervene and even we were unable to secure a GP appointment for her. People are having to go through this ping-pong of not getting a GP appointment and then going to A&E as they have nowhere else to turn.
I am grateful because I did ask the Health Secretary about Bradford and urgent treatment centres, and he did favourably say that he would arrange a meeting with the Minister for Health, the hon. Member for Charnwood (Edward Argar), who joins us now, at precisely the right time. I look forward to that meeting because that is a way through and I am grateful for that offer. But the reality remains that the Government’s promise—or the points the Secretary of State made earlier today—is not apparent on the streets. People continue to suffer, they cannot get GP appointments and they have nowhere else to turn. That point has been made eloquently by a number of Members.
At least, after days and weeks of trying, people are able to get an appointment with a GP. Many Members have talking about issues with joining an NHS dentist. There is more chance of finding gold bricks on the street, or of finding the parallel universe that Government Ministers live in, than there is of getting on to the list of an NHS dentist. People simply cannot get NHS dentists, and we have heard accounts today of how they are being forced to carry out DIY operations at home, without anaesthetic or any medical care—I have come across such cases in my own constituency—because they have no other option. Frankly, as the fifth largest and richest economy in the world, it is shameful that people are having to resort to DIY treatment at home. Again, that is happening on this Government’s watch.
I have been in this place since 2015, and every time we have a debate about NHS dentists or GPs, Tory Members refer back to the Labour Government of 12 years ago. I remember that when I was growing up, under a Thatcher Government, GP practices were back-to-back houses on terraced rows without adequate facilities. The last Labour Government brought in record investment, gave us state-of-the-art health centres, and reduced health inequalities and child poverty. That was all under a Labour Government, but Tory Members cannot pretend that the Labour Government of 12 years ago are somehow responsible for the issues we face today. The Whips are not in their place, but I say to the Tory Whips, “Please do your Members justice and remove that line from the long-standing script you have for them”, because it is becoming embarrassing when Tory Members stand up and say, “12 years ago, there was a Labour Government, so it must be all their fault.” They can use that line for a year or two, but unfortunately, in nobody’s world can they use it for 12 years. Tory Members need to start understanding that.
Can we expect any more from this Government? This is a Government who believe people choose to be poor—they have said so in this very House and on TV. This is a Government who believe people should work extra hours and do more, and that those who are forced into poverty are not forced, but have chosen poverty. The reality is that this is a Government who could not care less about people in Bradford who continue to suffer. [Interruption.] The Minister chunters from the Front Bench; she will have time to address those points when she responds.
(4 years, 5 months ago)
Commons ChamberI hear your words loud and clear, Madam Deputy Speaker.
I am grateful to Opposition Members for providing the opportunity to debate the very important issue of children and young people’s mental health on the Floor of the House in Children’s Mental Health Week. As my hon. Friend the Member for Eddisbury (Edward Timpson) stated, this is such an important issue and I hope that we can use this debate to find common ground. I pay tribute to his work on this extremely important issue.
This year’s theme is “Growing Together” and I know that the past two years have been tough for many young people and their families. While some young people may have seen their mental wellbeing improve during lockdown, for many others, the disruption to their home lives and education has caused difficulties. We must support them to grow emotionally and find ways to help one another to grow.
We recognise that both the health and care and education sectors continue to face challenges caused by covid-related issues. I thank all staff across all sectors for their ongoing dedication to supporting children and young people in this vital period and for the support for their families, too.
Children and young people’s mental health and wellbeing are a priority, as is face-to-face education, so that children and young people feel supported in their education and on track with their learning and wider development. Around 12,000 schools and colleges across the country benefited from £17 million to improve mental health and wellbeing support in schools and colleges. I want to be clear that children and young people are not alone on this journey and that the onus is not on them to catch up; it is something that the whole school and whole education system is looking to achieve together, and it is our priority to support them to do so.
The Government are delivering record levels of investment in mental health services, but that was not always the case. Through the 2016 “The Five Year Forward View for Mental Health”, we now have a solid foundation on which we can build the necessary levels of care and support, but we know that we need to be more ambitious. That is why we published the Green Paper on transforming children and young people’s mental health provision in 2017 and the NHS long-term plan in 2019. Together, they set out a clear vision for ensuring that children and young people who need mental health support can get it when they need it.
The NHS long-term plan is backed by an additional £2.3 billion a year for mental health services by 2023-24. That will mean that an additional 345,000 children and young people will be able to access support.
I will make progress because we are short of time and I want to give plenty of time for Back Benchers to contribute.
More than 420,000 children and young people were treated through NHS-commissioned mental health community services in 2020-21, which was almost 100,000 more than three years ago. The NHS children and young people’s mental health workforce has seen growth of 40% from 11,000 whole-time equivalents in 2019 to 15,486 whole-time equivalents in 2021.
Early intervention and mental wellbeing support in schools and colleges can prevent poor mental wellbeing from developing into mental illness. We remain committed to the proposals set out in the Green Paper to roll out mental health support teams based in schools and colleges and staffed by mental health professionals. There are now more than 280 teams set up or in training, with 183 of those teams operational and ready to support young people in around 3,000 schools and colleges. I am really pleased that we have been able to accelerate that programme to meet our original target a year early and then reach around 35% of pupils through 399 mental health support teams by 2023.
(4 years, 7 months ago)
Commons ChamberI thank my right hon. Friend for his support. The UK has been supporting a new vaccines programme largely thanks to his efforts when he was in my position. That work continues. If it is necessary to procure new vaccines that we believe are safe and effective and will help with the new variant, we will do so.
Gordon Brown said yesterday that the chief medical officer urgently needs to teach the Prime Minister “some basic medical facts”, and I would say that that could probably be extended to some of those on the Government Back Benches as well, meaning that we are not going to stop the threat of variants—
Order. Mr Shelbrooke, I thought you might have been going on the NATO delegation, and I do not want to hear that you have missed out on it.
We are not going to stop the threat of variants derailing our progress until we vaccinate the world. Our country has enough vaccine to give at least three doses to everybody, yet of the 100 million doses that were pledged by the Prime Minister to the world’s poorest, less than 10% have actually been delivered. Can the Secretary of State tell us if the PM will meet his ambition to help vaccinate the world by the end of 2021, or is that yet another broken promise with catastrophic consequences?
I said earlier that, out of the 100 million commitment that the UK has made to international donations, over 20 million have already gone and been delivered, and another 10 million are about to go.
(4 years, 8 months ago)
Commons ChamberI reassure my hon. Friend that we always look at ways to make it easier for people to get their booster, as well as for people to get their first and second jabs and their flu jab. We are always open to looking at opening up further opportunities.
The Minister said earlier that she will not take any lessons from Labour on this issue but, given we have one of the highest death rates in Europe, perhaps she should.
I want to talk about one of the most vulnerable groups of people who have been left unprotected throughout this pandemic. One in six of the most critically ill covid patients in the UK are unvaccinated pregnant women. What are the Government doing to protect pregnant women now and throughout the ongoing pandemic?
The hon. Lady makes a very good point. I find it really concerning that one in six people in hospital with covid are unvaccinated pregnant women and it is an issue that I wholeheartedly want to address. I encourage every lady who is either looking to become or is pregnant to talk to their midwife and their GP and get reassurance that vaccines are safe for that cohort of ladies. The best thing they can do is to protect themselves and their babies.
(4 years, 8 months ago)
Public Bill CommitteesThe new clause would require ICBs to provide specialist domestic violence and abuse training, support and referral programmes to all GPs, with the aim of strengthening the health response to domestic abuse and improving links between the NHS and voluntary sector support for victims. We have concerns about the new clause, which is why we cannot accept it, but I hope that I can set out to the shadow Minister my reasoning.
Domestic abuse, as we discussed yesterday when considering another proposed new clause, is a terrible crime, and it can have a devastating impact on victims and survivors. It is also important that we remember that children are often just as much victims as the victims themselves, through the experiences that they have of domestic abuse and domestic violence. The Government are clear that there is absolutely no excuse for abuse. Tackling domestic abuse and supporting victims, survivors and their children is a key priority for Government, now more than ever.
The Domestic Abuse Act 2021 and the forthcoming domestic abuse strategy will help to provide a whole-system approach to protect and support victims and their children. The measures in the 2021 Act seek to promote awareness by introducing a statutory definition of domestic abuse, and to recognise children, as I alluded to, as victims in their own right, in order to protect and support both, tackle perpetrators, transform the justice response, and drive consistency and better performance in the response to domestic abuse.
The 2021 Act also sets out the convening of local domestic abuse partnership boards, with healthcare representation. We recognise the key role that healthcare services play within a whole-system approach to tackling domestic violence. Healthcare services must identify signs of risk and harm, enable victims and survivors to come forward, and provide timely integrated care and support. We know how important it is that statutory agencies and professionals properly understand and react to domestic abuse. However, I hope that I can reassure the Committee that placing in the Bill a formal duty on ICBs to ensure that specialist domestic violence and abuse training, support and referral programmes are universally available to all GPs is not necessary.
General practice is delivered by multidisciplinary teams, rather than just GPs, and existing Care Quality Commission registration requirements include a review of practices’ safeguarding processes. In addition, NHSEI’s ICS people guidance sets an expectation that ICBs will foster learning and continuing professional development. Going further, the Bill, in proposed new section 14Z41 of the National Health Service Act 2006, imposes a duty that each ICB
“must, in exercising its functions, have regard to the need to promote education and training for the persons mentioned in section 1F(1)”
of the 2006 Act.
Again, I break the convention that Whips do not speak, because this issue is close to my heart. I listened carefully to the discussions yesterday, and to what the shadow Minister, my hon. Friend the Member for Nottingham North, and the Minister have said on the new clause, but if we looked at domestic abuse as a disease or virus, given the fact that it kills women, it kills people in their homes, and has mental and economic impacts that affect people’s overall health, we would certainly ensure that GPs were trained on it. Why can we not do the same thing with domestic abuse?
I am grateful to the hon. Lady. In part, the reason is because this is sadly not a well drafted new clause. It is very narrowly drafted to GPs, not recognising the multidisciplinary nature of how healthcare is delivered in GP practices. I suspect that we all have correspondence from constituents—whether happy or unhappy—going to doctor associates, practice nurses and others. That is one of my key concerns, but let me articulate a little more what is already being done. I see where she is coming from. As I mentioned yesterday, I was the Minister with responsibility for victims of domestic violence, and of crime in general, when I was in the Ministry of Justice, so it is something that I am very familiar with. It is about raising awareness not just with GPs, but within the police and a range of agencies. My challenge, just before she intervened, was partly about the way the new clause is drawn, but let me articulate a little further our views on it. I am keen to do so before the business possibly collapses early in the House, and we have to adjourn in order that I can respond to the Adjournment debate.
Section 1F of the 2006 Act defines a wide group of people, covering persons who are employed, or who are considering becoming employed, in an activity that involves or is connected with the provision of services as part of the health service in England. That duty on ICBs would already cover general practitioners, but it goes wider. I appreciate that the new clause goes beyond training, so I will also discuss the support and referral elements that the hon. Member for Nottingham North talked about.
The NHS provides care and support to victims of domestic abuse through a range of healthcare services. This response is centred around ensuring that healthcare professionals are trained to spot the signs of domestic abuse and those at risk; to make safe and sensitive enquiry of the issue; to know where to refer people to get further support, and to know when and how to share information appropriately with colleagues and other organisations.
All NHS staff must undertake annual mandatory safeguarding training, which includes focus on domestic abuse. NHS England, NHS Improvement and Health Education England are reviewing mandatory safeguarding training for all health professionals to ensure that they are fully equipped with the key skills, knowledge and principles to protect all citizens. The Government published an online domestic abuse resource for health professionals and have developed a number of training modules with the Institute of Health Professionals, the Royal College of Nursing and the Royal College of General Practitioners.
From 2018 to 2020, the Department managed £2 million of funding for the domestic abuse pathfinder programme, which created a model health response for survivors of domestic violence and abuse in acute, community and mental health services. The pathfinder toolkit was published in 2020 as the result of emerging promising practice at our pilot sites, coupled with the expertise of the pathfinder consortium of specialist domestic abuse organisations, to encourage best practice across the health system. Pathfinder has given us a model for our response to domestic abuse in healthcare. It is a model for integrated, joined-up and trauma-informed care and support, with healthcare settings and the voluntary sector working together.
As the shadow Minister mentioned, the Department of Health and Social Care has also funded the IRIS programme, to which I pay tribute. IRIS is a training, referral and advocacy model to support clinicians in better supporting patients who are affected by domestic violence and abuse, and to increase the awareness of domestic violence and abuse within general practice. IRIS is recognised by the DHSC as good practice, and via the National Institute for Health Research we funded a study that demonstrated the effectiveness of the IRIS programme at scale. I am delighted to note that the study won the 2020 Royal College of General Practitioners research paper of the year award.
I am proud that the Government have championed the building of that evidence base. I believe that it would not be best or appropriate, however, for the legislation to require local health and care systems to adopt specific programmes. Indeed, such detailed requirements would reduce local health and care partners’ flexibility to meet the needs of their local populations or to engage with particular local organisations and expertise in delivering their programmes.
Beyond ICBs, I see a huge opportunity for integrated care partnerships to support improved services for victims of domestic abuse, sexual violence and other forms of harm, through better partnership working and joint planning of services. The Government have also developed a cross-Government strategy for tackling violence against women and girls, and will develop a cross-Government domestic abuse strategy.
As committed to in the tackling violence against women and girls strategy, the DHSC will continue to work closely with NHS England and NHS Improvement to promote evidence-based approaches to tackling violence and abuse through guidance and engagement with the new system.
(4 years, 10 months ago)
Commons Chamber
Nickie Aiken (Cities of London and Westminster) (Con)
I thank my dear friend, my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory), for having the bravery we have seen here today, but also for how, throughout her time in this place, she has fought and campaigned very bravely for those who have experienced the loss that she has experienced. I think we see this place at its very best when we come together, put politics aside and discuss the issues that are so important and affect so many thousands of families across our country. I also pay tribute to the former Minister for patient safety, suicide prevention and mental health, my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who has certainly put campaigning for women’s health at the front of her Government’s priorities.
I, too, have experienced baby loss, and I remember it as if it was yesterday. It was my first pregnancy with my husband and, sadly, at eight weeks it did not continue. It is something that stays with me even today; this is the first time I have actually spoken about it publicly. However, I was very fortunate in that, within five months, I was pregnant again and I had my rainbow baby. Until Mrs Johnson, the Prime Minister’s wife, used that term I had never heard of a rainbow baby, but it is a fantastic term because it is about the positiveness that can come after the dreadful experience of losing a baby. My rainbow baby is now 17 years of age, in her last year of school and about to begin her life adventure.
It was not until I had my miscarriage that I realised that one in four pregnancies can be lost in this country, usually early—before 12 weeks. More than this, estimates from St Mary’s Hospital in Paddington in my constituency suggest that there are about a quarter of a million miscarriages every year in the UK, and about 11,000 emergency admissions for ectopic pregnancies, which always, sadly, result in pregnancy loss.
I think the theme of wellbeing for the forthcoming Baby Loss Awareness Week this year is so important. On this, I am very proud to highlight the work of the brilliant maternity wards at St Mary’s Hospital, which were the first in London to receive an outstanding rating from the Care Quality Commission. I invite the Minister to join me on a future visit to see their work at first hand, with, I hope, my hon. Friend the Member for Truro and Falmouth.
I note that patients from St Mary’s, which is part of the Imperial College Healthcare NHS Trust, have been taking part in a new study showing that one in six women experience long-term post-traumatic stress following baby loss.
I congratulate the hon. Member on having a rainbow baby, as I do myself. We know that the road to pregnancy is not always smooth, and the numbers she has just highlighted show how frequently this happens. Is it not now time that we reviewed the cruel requirement for three miscarriages or baby losses before medical intervention is offered to families?
Nickie Aiken
I thank the hon. Member for her intervention, and I think it is clear from the debate today that there needs to be more support for women and their partners when they experience miscarriage. I will never forget, when I became pregnant with my daughter, how terrified I was of going for the 12-week scan, because my first experience had been one of baby loss and I had been told at that scan that the baby was not viable. I think I would have benefited from some counselling and some support when I was going for that scan for the second baby.
My right hon. Friend is right that there has to be a whole family, cross-departmental approach, which I hope we can take forward.
The partners of expectant new mothers also face the stigma that many hon. Members have mentioned this afternoon, and I hope we can improve the situation by offering a range of help, such as peer support, behavioural couples therapy sessions and other family and parental interventions. I will focus on that.
This year, unlike in our previous debates on Baby Loss Awareness Week, we have to consider covid. This year, more than most, has been particularly difficult for those facing the loss of a baby. The covid pandemic means measures have been put in place to protect healthcare workers, patients and the general public, and it has been particularly difficult for those who have suffered baby loss during this period.
Specifically on preventing maternal death and morbidity due to covid, recent findings from a national perinatal study show that of 742 women admitted to hospital since vaccination data has been collected, four had received a single vaccine dose and none had received both doses. This means that more than 99% of pregnant women admitted to hospital with symptomatic covid-19 are unvaccinated, and one message I want to get across today is that it is hugely important that mothers and their families are vaccinated to improve their safety.
We have been pushing the Joint Committee on Vaccination and Immunisation to make sure that pregnant women are a priority group. Will the Minister give a commitment today that pregnant women will be a priority group in any booster programme?
I take the hon. Lady’s point. There was a lot of misinformation earlier in the year that made pregnant women reluctant to come forward, and there is a lot of work we can do to improve that communication.
(4 years, 10 months ago)
Public Bill CommitteesI know it is not the done thing for Whips to contribute to debates, but because I have been a care worker, this part of the Bill is close to home for me. I wanted to touch on the word that the Minister used when he spoke about “assumptions” about workforce planning. Does he agree that actual independence takes away the need for Ministers to make assumptions, and that is why the amendment is important? Otherwise, Ministers are in danger of marking their own homework when it comes to whether they have met the workforce projections that they say they have met.
The hon. Lady alludes to it not being normal form for a Whip to intervene, but her contribution is, as ever, extremely valuable in this context—particularly given the work that she did before she became a Member of this House—and I am grateful to her. My counterpoint would be that we need to be cautious about a separation of projections and planning from the reality of day-to-day delivery. The system, as envisaged, will bring together an actual knowledge of what is going on on the ground with those projections and data delivery.
I suspect that I will not convince the hon. Lady, but I recognise and acknowledge the expertise that she brings to the area. Back in my days as a councillor, I was a cabinet member for adult social care and saw at first hand the amazing work done by care professionals and by volunteers in the care sector. Notwithstanding any political disagreements we might have, I pay tribute to her for that.
Finally, regarding the consultation requirements in amendments 94 and 41, I assure the Committee that consultation already happens throughout the workforce planning and delivery process. To give a recent example of such engagement, HEE completed a call for evidence as part of its refreshed “Framework 15”. That call for evidence closed on 6 September and received responses from a wide variety of bodies. Between October and April of next year, engagement and consultation will continue through various events led by HEE. I am sure that as I assume my new responsibilities, I will occasionally be questioned on those by the shadow Minister, either across the Dispatch Box or in written questions and letters, as is his wont and, indeed, his right.
At local level, ICBs will be under various workforce-related responsibilities and obligations, as I have set out. As part of that work, we can expect ICBs to work with local stakeholders in their area. We expect all this stakeholder consultation to continue, but we want engagement to be flexible, in keeping with one of the principles—the permissive principle—behind the Bill.
Let me turn to the issue of safe staffing. Amendment 42 would significantly amend our proposed workforce accountability report so that it would have to cover an assessment by the Secretary of State of safe staffing levels for the health service in England and whether those were being met. The effect of the amendment in reality would be to require the Secretary of State to make such an assessment but, in so doing, risk detracting from the responsibility of clinical and other leaders at local level for ensuring safe staffing, reflecting their expertise and local knowledge, supported by guidance and regulated by the Care Quality Commission. We do not support the amendment as drafted, for various reasons.
First, there is no single ratio or formula that can calculate the answer to what represents safe staffing in a particular context, and therefore against which the Secretary of State could make an objective assessment. It will, as we have seen over the past year and a half, differ across and within an organisation. Reaching the right mix, for the right circumstances and the right clinical outcomes, requires the use of evidence-based tools, the exercise of professional judgment and a multi-professional approach. Consequently, in England, we think that the responsibility for staffing levels should remain with clinical and other leaders at local level, responding to local needs, utilising their expertise, supported by guidelines from national bodies and professional organisations, and all overseen and regulated by the CQC.
Secondly, the amendment would require the formulation of safe staffing levels against which the NHS workforce could be assessed. I fear that that would be a retrograde step, as it would inhibit the development of the more productive skill mixes that are needed for a more innovative and flexible workforce for the future. That new workforce is crucial to successful implementation of the new models of integrated care that the Bill is intended to support.
The specific wording of the amendment is incredibly broad and would require the Secretary of State to assess safe staffing levels across all healthcare settings, across the whole of England, for all medical and clinical staff. Such a duty would be burdensome not only for the national system but, potentially, locally—for local clinical leaders. It would move us away from that local accountability and expertise.
I assure the Committee that we will continue to engage with stakeholders and hon. Members, including my right hon. Friend the Member for Kingswood, to look closely at this area. I want to reassure Members, including Opposition Members, that we have heard their concerns and the views that they have expressed in relation to workforce in today’s debate and reflecting the evidence of witnesses. I am grateful, as ever, for the tone in which the shadow Minister has raised his concerns and put his points. We will carefully consider these issues and continue to ensure, and to reflect on ensuring, that we work to address them through the Department’s wider work on workforce.
Let me just say, before concluding, that while we were doing the changeover between clauses, I did a very quick check and I believe I was correct in my answer to the shadow Minister that no applications were currently pending for foundation trusts. I wanted to clarify that it turns out I was right—I suspect he thinks he was right in his assumption as well.
For the reasons that I have set out, I encourage hon. Members not to push these amendments to a Division but to continue engaging with me and other Ministers.