Health and Social Care

– in the House of Commons at 12:04 pm on 16 January 2020.

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Votes in this debate

  • Division number 15
    A majority of MPs voted against requiring a plan to end the crisis in social care and against at least a 4 per cent per year real terms increase in health spending.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care 12:06, 16 January 2020

I beg to move an amendment, at the end of the Question to add:

“but respectfully regrets that the Gracious Speech fails to ensure that the National Health Service and social care will be properly funded;
and calls for the Government to bring forward a plan and additional funding to end the crisis in social care and provide for at least a 4 per cent per year real terms increase in health spending.”.

Before I move on to the substance of my remarks, may I congratulate you, Mr Deputy Speaker? It is a pleasure to see you back in your place overseeing these proceedings. I will endeavour to be as brief as I can in my remarks, because I am aware that many Members hope to catch your eye to offer their maiden contributions. I am sure that every one of them will do their constituencies proud.

At the outset, I also wish to thank our hard-working NHS and social care staff who every day go beyond the call of duty and go the extra mile, especially over the Christmas period. We are forever in their debt. Our amendment, which we will put to the vote today, is essentially about backing up those hard-working NHS and social care staff, and sending a message to the Government that they should be given the resources that they need.

This is a motion about the 4.5 million people on waiting lists. This is a motion about the pregnant woman who waited so long for her glaucoma operation at a hospital in Southampton that she nearly lost her sight and has never seen the face of her child. This is a motion about the 34,000 people who wait more than two months for cancer treatment. This is a motion about those constituents, such as mine in Leicester, who had their bladder cancer operations cancelled twice. This is a motion about the 79,000 cancelled operations last year, and the 18,000 children’s cancelled operations. This is a motion about the 110,000 children denied mental health care, even though they are in the most desperate of circumstances. This is a motion about the 98,000 patients who waited on trolleys last month—a 65% increase on the previous year—many of them elderly, many of them in their 80s and 90s, languishing for hours and hours on trolleys in hospital corridors.

This is a motion about those hospitals that have been pushed to rack and ruin after years of cuts to capital budgets, including Hillingdon hospital in the Prime Minister’s own backyard, where children’s wards had to be closed because of subsidence. This is a motion about the Royal Cornwall hospital that is discharging patients early because it is so overwhelmed. This is a motion about the 1.5 million people, many of them with dementia, denied the social care support they need after years and years of swingeing cuts.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

Let me make a little bit of progress. I think Members on both sides would agree that I am usually generous in taking interventions, but I am aware that many colleagues want to make their maiden speeches today. I will take some interventions, but let me make a little bit of progress. I hope the right hon. Gentleman will give me a bit of leeway.

This motion is about giving the NHS the funding it needs. It is a motion that will test every newly elected Conservative Member of Parliament on their commitment to the NHS.

The Government are correct to signal in the Queen’s Speech, as they did indeed in the pre-election Queen’s Speech, that health and social care should be the priority. On that, at least, they have my agreement. Yesterday the Prime Minister promised to

“get those waiting lists down.”—[Official Report, 15 January 2020; Vol. 669, c. 1015.]

So the test that must be applied to the NHS and social care announcements in the Gracious Address is whether they add up to a strategy to drive waiting lists down and A&E performance up. The answer on that front is surely no. We have promises of 40 new hospitals, 50,000 new extra nurses, and 50 million more GP appointments, with 6,000 extra GPs. On each and every one of these commitments, we will keep track of progress and test Ministers on whether they deliver.

But we will also test Ministers on social—

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

I give way first to Sir Desmond Swayne and then I will make some progress because I know that many Members want to speak.

Photo of Desmond Swayne Desmond Swayne Conservative, New Forest West

The hon. Gentleman will recall that the Government accepted the Dilnot proposals and even put in place certain legislative provisions for them to be implemented in the next financial year. I never understood why, during the 2017 election campaign, they departed from that position—but what is the Opposition’s position on Dilnot?

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

We have long argued for a cap on care costs, but of course the Government, as the right hon. Gentleman says, dropped their support for this policy.

On the issue of social care, the Prime Minister said at the Dispatch Box yesterday that he wanted cross-party talks, although in his BBC interview the day before he said that he had a plan that he would bring forward in the next 12 months. The Government want a consensus. I say to the Government that the Labour party has proposed free personal care. We have a version of free personal care in Scotland. There is a similar version of it in Northern Ireland. There is a version of it in Wales. The House of Lords Economic Affairs Committee, which includes Thatcherites such as Michael Forsyth and Norman Lamont, alongside the former Labour Chancellor, Alistair Darling, has proposed free personal social care. There already is a political consensus. It is the Secretary of State and the Prime Minister who stand outside that consensus. If the Secretary of State wants to engage with us on that basis, then my hon. Friend Barbara Keeley is happy to do so. I will now take the intervention from the former Chief Whip.

Photo of Mark Harper Mark Harper Conservative, Forest of Dean

Given that the hon. Gentleman’s party is undergoing a leadership election and that will clearly mean—[Interruption.] No, I am trying to say this helpfully. If the Secretary of State has made a commitment to start the process of cross-party talks within the next 100 days, that will obviously be before that leadership election is concluded. So my serious point is that if we wish to engage on a cross-party basis on whether to implement the Dilnot proposals, as my right hon. Friend Sir Desmond Swayne mentioned, or on the basis that the hon. Gentleman just said, is he in a position to start that engagement with the support of his current party leader so that we can make progress urgently? The social care problems in the country are not going to wait, frankly, for another Leader of the Opposition to be elected. That is meant as a really serious and cross-party point.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

It is a serious point, and I am grateful for the way in which the right hon. Gentleman has put it. Of course, we are very happy to engage. My hon. Friend the Member for Worsley and Eccles South, who sits in the shadow Cabinet and leads on social care, is happy to sit down with Ministers at any point.

I am suggesting to the Secretary of State, rather gently, that there is a degree of political consensus on free adult personal social care. The House of Lords Committee, which includes Michael Forsyth and Norman Lamont, not socialists red in tooth and claw by any means, alongside Alistair Darling, has proposed it. We, as a Front-Bench team, have proposed it. There are forms of it in some of the devolved nations. It is the Secretary of State who is standing outside that consensus. If he wants to engage with us on those terms, and on the point about a cap as proposed by Dilnot, then of course we are prepared to have those levels of engagement.

There is also a degree of consensus around the need for better integration between health and social care, and better co-ordination of health and social care. That is why we are intrigued by the Secretary of State’s proposal to consult on the NHS Funding Bill.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

For the last time, because a lot of Members want to speak.

Photo of James Cartlidge James Cartlidge Conservative, South Suffolk

This is directly relevant. The hon. Gentleman made a point about the House of Lords Committee, but he will be aware that the House of Commons Committee recommended a social insurance system—perhaps along the lines of Germany’s, for example. Is he, in principle, supportive of that solution?

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

No, because we do not think it would work—it is not feasible. It is not just the Committee in the Lords that says that—plenty of think-tanks have said it is not feasible as well.

There is broad consensus about the principle of better integration between health and social care. We have long argued for it, and now the Government have come round to arguing for it as well. The Government are proposing an NHS Bill along the lines of what Simon Stevens of NHS England has proposed. We long warned that the Health and Social Care Act 2012, which was introduced by Andrew Lansley and supported by the many of the Ministers sat on the Front Bench, would lead not to the levels of integration and co-ordination of care that was needed but to a fragmented mess.

We also long warned that the compulsory competitive tendering provisions of the Act would lead to more contracts being handed to the private sector. About £9 billion-worth of contracts were handed to the private sector, despite the Secretary of State telling us that there would be no privatisation on his watch. If his Bill gets rid of those compulsory competitive tendering provisions—the so-called section 75 regulations—we would welcome that, but we want competitive tendering to be abolished completely. We do not want clinical services privatised. We do not want clinical services outsourced, such as pathology labs in London, as is happening on the Secretary of State’s watch. We do not want tinkering in the Bill: we want the Health and Social Care Act binned so that we can restore a universal public national health service. [Interruption.] The Secretary of State says that it is universal. He is clearly not aware of the rationing that is going on across the country because of austerity and the privatisation of the NHS that is his policy.

As I indicated in the debate on the Gracious Address before the election, we will work constructively with Ministers to ensure the speedy passage of the health service safety investigations Bill. We will look to strengthen the independence of medical examiners. We call on the Government to do more to roll out medical examiners across NHS trusts. It is disappointing that so far only about 50% of trusts have medical examiners. These are absolutely vital to improving patient safety, because we know that things do go wrong in the delivery of care. We have all been shocked by the revelations at Shrewsbury and Telford Hospital NHS Trust. This is the worst ever maternity scandal, with clinical malpractice apparently allowed to continue unchecked since the ’70s. It is absolutely horrific and astonishing. I cannot imagine the grief that the families affected must have had to endure. Will the Secretary of State update the House on what is happening at Shrewsbury and Telford? I appreciate that there was an Adjournment debate on that matter last night, but I think the House would appreciate his offering us some reflections on what is happening at Shrewsbury and Telford. Will he also commit to reinstating the maternity training fund to help to improve maternity safety in our hospitals?

I am sure that the Secretary of State will agree, more broadly, that the delivery of safe care depends on adequate staffing levels as well, so would he support enshrining safe staffing levels in legislation? We are short of 44,000 nurses in England. Community nurses have been cut by 6,000 since 2010. Learning disability nurses are being cut. Mental health nurses have been cut by 10%. Health visitor numbers are down. School nurses have been cut. We have been warning for years about the detrimental impact on safe care of these staffing shortages. That is why, for example, we fought the Government on the abolition of the training bursary. We welcome the fact that Ministers are now bringing back a partial version of the bursary in the form of a maintenance grant, but why not bring back the whole bursary? Without bringing back the whole bursary, many are sceptical that the Secretary of State will deliver on his commitment for 50,000 new nurses, because as quickly as—[Interruption.] Well, he is rather stretching the definition of the word “new”. He gave the impression in the general election campaign that there were going to be 50,000 new nurses, but that soon unravelled, because when he went on the media it turned out that he was including in his figures 19,000 nurses who already work in the national health service. I of course have some sympathy—

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

I am afraid that on this occasion I will not, because many Members want to make maiden speeches. There is nothing worse for a Member waiting to make a maiden speech than seeing the time ticking down because Front Benchers are taking lots of interventions.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

I will tell you who was talking rubbish, Mr Deputy Speaker: the Secretary of State when he said at the general election that he was delivering 50,000 extra nurses. That is why he avoided Piers Morgan during the election campaign. I do not know why the Secretary of State avoided Piers Morgan—he is a pussycat. I went on Piers Morgan’s show every week; why did the Secretary of State not go on?

I will give way once more, and then if Members will indulge me, I will not give way again, because a lot of Members want to make their maiden speeches in the debate.

Photo of Dr Caroline Johnson Dr Caroline Johnson Conservative, Sleaford and North Hykeham

I am grateful to the hon. Gentleman for giving way. He is using a lot of statistics and figures, and he talked about the definition of “more” and “new”. I want to ask him about the 44,000 vacancies that he talked about. Is it not right that when the Health Committee looked at that, it found that 38,000 of those places were actually occupied by nurses who work on the bank because they choose that working model?

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

As the hon. Lady knows from her work on the frontline in the NHS, the problem is that bank and agency staffing have contributed to many of the deficits that our trusts are dealing with. That is one of the problems with the way in which the workforce have been managed by the Government.

The Secretary of State says that his figures include 19,000 existing nurses. I have some sympathy for him, because we have been raising the issue of retention in the NHS for some time. That is why we were so vigorous in opposing the public sector pay cap, of which he was a great champion for many years as a Tory Minister, and it is why we were pleased that the Government got rid of it, following pressure from those on the Labour Front Bench. It is a laudable aim to improve retention in the NHS, but it is not the same as recruiting new nurses.

The Secretary of State expects to recruit 12,500 nurses internationally, while at the same time imposing a tax on those nurses through the immigration health surcharge, increasing it to more than £600 per family member per year of a nurse’s working visa. Does he really expect to recruit 12,500 nurses internationally while imposing this nurses’ tax on them?

The Secretary of State will also know that we are desperately short of nurses in the field of mental health services. We welcome the commitment to reform the Mental Health Act 1983, and we will work constructively with him on that, but we have had enough warm words and rhetoric on mental health services. It is now time to deliver the parity of esteem that patients deserve. We have a shortage of mental health beds, which means that too many people are sent hundreds of miles across the country to receive care, away from their family and friends, often in poor-quality private providers.

The Secretary of State likes to boast of hospital upgrades, but anyone who has been in a mental health trust, works in one or has visited one, as I have, knows that the mental health estate is, frankly, some of the worst estate in the NHS. It is unsafe. Mental health patients deserve so much better, yet there is still no credible plan in anything he has said to modernise and replace the 1,000 beds in old-style dormitory wards in mental health trusts across the country. Children are being particularly let down, with increasing rationing of mental health services and more than 130,000 referrals to specialist services turned down despite children showing signs of eating disorders, self-harm and abuse. Matters have become so desperate that there are even reports of GPs advising children to exaggerate problems, because otherwise they will not get any help. This is the chaos of the underfunded system, and it leads to an increasing number of children and young people presenting at A&E in mental health crisis. A&E is no place for someone in mental health crisis. This is a disgrace, and our mental health services now need investment.

That brings me to A&E more generally. The Secretary of State will say that there is increased demand on our A&E, and that is true. There is increased demand on our A&E because mental health services have been pushed to the brink; because years of cuts to social care are pushing more and more people to A&E; because public health prevention budgets have been hammered by years of cuts under this Conservative Government; because GP numbers in our communities have been cut and people cannot get appointments; because walk-in centres have closed under the Tories; and because pharmacies were cut back. More broadly, it is because decisions by this Government—whether it is their decisions on housing and universal credit or their cuts to children’s services, with Sure Start centres closing—and rising levels of poverty mean that health inequalities are widening. It all adds up to more people presenting at A&E because of 10 years of Tory austerity.

What is the Tories’ answer to the worst A&E performance figures on record? It is to scrap the four-hour A&E target. Abolishing the target will not magic away the problems in A&E. It will not suddenly fix a system that saw 100,000 people waiting on trolleys last December. That is why the president of the Royal College of Emergency Medicine said yesterday:

“Rather than focus on ways around the target, we need to get back to the business of delivering on it”.

But Ministers cannot get back to the business of delivering the target, because they will soon ask the House to approve legislation that will legally bake in the underfunding of our NHS. The NHS underfunding Bill effectively caps NHS spending way below the level that experts say our NHS will need. The last Labour Government did not need legislation to signal their support of and commitment to the NHS. The last Labour Government got on and delivered record investment in our NHS. They delivered a 6% increase in investment into the NHS, and they delivered the lowest waiting lists and the highest satisfaction ratings on record—and we did not need the gimmick of a Bill to do it. We got on and delivered it.

The Secretary of State is proposing a Bill that fails to reverse the £850 million of cuts to public health prevention services. This is at a time of rising drug deaths, rising presentations at A&E for alcohol abuse, rising STI infections and rising obesity among children. He is asking us to approve a Bill that does not reverse the raids on capital budgets or deal with the £6.5 billion backlog of repairs facing our hospitals, which has left hospitals with sewage pipes bursting, ceilings falling in and lifts not working. He is proposing a Bill that does not give the NHS the 4% uplift annually that many experts say it needs. That is why Labour has tabled an amendment today to give the NHS a 4% uplift, and every Tory MP who believes in the NHS should support it. The Secretary of State is enshrining in law four more years of underfunding of our national health service and four more years of capped expenditure in our national health service, but it does not have to be that way.

I congratulate the Government on securing election. I congratulate the Secretary of State and all the Ministers who have been reappointed to the Front Bench, and I pay tribute to my former shadow Ministers who lost their seat, Paula Sherriff and Julie Cooper. We will hold the Secretary of State to account. We will test him on whether he delivers 40 new hospitals, 50,000 new nurses and 6,000 new GPs. We will test him on whether he drives waiting lists down, as the Prime Minister promised yesterday. Where the Secretary of State is right, we will work constructively with him. Where he is wrong, we will argue our case forcefully.

The Secretary of State was elected on a promise to fix the NHS. With 4.5 million people on the waiting lists, 2.5 million people waiting beyond four hours in A&E and 34,000 people waiting beyond two months for cancer treatment, our constituents now expect him to fix the NHS. He could start by giving the NHS the level of investment it needs, which is a 4% uplift. He could start by voting for our amendment in the Division Lobby tonight.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care 12:28, 16 January 2020

This Queen’s Speech has health and social care at its heart. For the first time in the history of the NHS, we will enshrine into law our long-term funding settlement. Yesterday we brought forward the NHS Funding Bill, which makes a record financial commitment of £33.9 billion more each year—the largest cash injection since the NHS was founded. It will enable us to go further and faster in delivering better health and social care in this country over the next decade. We are already delivering on this Queen’s Speech. We are already delivering on our manifesto, and this Queen’s Speech sets out how we will deliver on the rest of our manifesto. How many new hospitals will there be over the next decade? Forty! That was even mentioned by Jonathan Ashworth.

Photo of Robert Halfon Robert Halfon Conservative, Harlow

I am delighted that my right hon. Friend has mentioned new hospitals because we have a new hospital coming in the Harlow constituency. Does he not agree that that shows the level of investment that this Government are putting into our national health service? Will he set out the plans for our new hospital—not a rebuild, not a reconfiguration, but a new hospital for Harlow?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is right, and of those 40 new hospitals over the next decade, one of the very first will be in Harlow. I pay tribute to my right hon. Friend, who has been a champion of Harlow for the last decade and has championed the need for a new hospital in Harlow. I am working very closely with the Harlow trust to make sure that that new hospital delivers what is needed for the people of Harlow. I very much look forward to working with him, and perhaps even being invited to cut a ribbon in due course.

Photo of Mike Amesbury Mike Amesbury Shadow Minister (Work and Pensions) (Employment)

The reality on the ground in the Halton part of my Weaver Vale constituency is somewhat different. Twice the Halton hospital campus has been turned down for capital investment. If the Secretary of State is true to his word on delivery for northern constituencies such as mine, will he please meet me? Let us have some progress there.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I am very happy to meet the hon. Gentleman. As well as the new hospitals, we also have upgrades going on that are very important. Some hospitals need to be completely rebuilt, we need some that are completely new and we also need to upgrade some. I am very happy to take that forward.

Photo of Steve Brine Steve Brine Conservative, Winchester

On the subject of the Secretary of State being true to his word—I welcome him back to his place—he will remember being robustly challenged on the NHS pensions issue when he came to Winchester hospital during the campaign. Can I thank him for what appears to be a very positive response to that conundrum, as reported this morning, and can I urge doctors’ leaders to recognise a compromise when they see one? However, does he recognise that there is a big job to be done now in rebuilding rotas? That could really have an impact on patient care in Winchester and across England.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

It is good to see that Mike Amesbury, having got the commitment to a meeting, is off—he’s done! That was quick. My right hon. Friend Robert Halfon is still here, but that is because there is so much more good news to come, and I am sure he wants to hear it.

The point about doctors’ pensions is very important. We have already delivered on the commitment in the manifesto to start a process to end the problems caused by the interaction of tax laws passed in the last Parliament but one and the NHS pension scheme. My hon. Friend the Minister for Health met Treasury Ministers, the royal colleges, the British Medical Association, NHS Employers and others to kick off this process, and we are working on it very urgently.

I absolutely take the point made by my hon. Friend Steve Brine that, as we resolve the tax issue, we also need to rebuild the rotas that have been reduced because of the high marginal rates of tax. I urge each and every NHS hospital to play its part in putting that right.

Photo of Steven Baker Steven Baker Conservative, Wycombe

I was a bit disappointed that the Secretary of State does not plan to build a new hospital in Wycombe, but I am glad to say that there is an opportunity to invest in a transformational digital project, bringing together healthcare, social care and council services. Does he agree with me that transforming the NHS, social care and council services for the 21st century is about more than buildings, and that we do need to put such resource into digital?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I was going to come on to that later in my speech, but my hon. Friend is absolutely right. I had an excellent visit to Wycombe during the general election campaign. He has a brilliantly led local hospital that is working incredibly hard. The use of modern technology is a critical part of the agenda for bringing forward the NHS. To make sure that we can address patients’ concerns and do more work more effectively, the technology has to work for the clinicians so that they can do their jobs better.

Several hon. Members:


Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I will continue to take some interventions, if the House will allow me, and then make some progress.

Photo of Ben Everitt Ben Everitt Conservative, Milton Keynes North

The Secretary of State is being very generous in giving way a number of times. I would like to thank him for his visit to Milton Keynes, and for his commitment to investing not only in extra capacity but in infrastructure improvements in our hospitals. Is the Secretary of State aware of the radiology and radiotherapy treatment situation in Milton Keynes, with patients having to travel to Oxford, temporarily, to receive their treatment? That is not the best situation for those patients. Is he aware of the situation?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I am, because Milton Keynes’s new MP has already been working with me to bring this concern to light. I can inform him that the new cancer unit will be handed over to Milton Keynes hospital at the end of next week. That problem is indeed temporary and it is being resolved, very much thanks to the hard work of the new MP for Milton Keynes.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

I thank the Secretary of State for his meeting the other evening. I am sure my right hon. Friend Robert Halfon is thrilled that he is one of the six to get a brand-new hospital.

In south-west Hertfordshire, as the Secretary of State knows, we are not happy about having a hospital in the middle of Watford, next to a football stadium. It is not right for my constituents or for many constituents of Members in the Chamber today. The Secretary of State has committed to me privately to look at whether we can have a new hospital elsewhere, and I know there is a review going on about the funding and how much that would cost. Would he like to reiterate that at the Dispatch Box?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, we are doing that work to make sure that, as we pump hundreds of millions of pounds into Hertfordshire to improve its healthcare, we get the exact locations right. I look forward to working with my right hon. Friend on that.

Photo of John Hayes John Hayes Conservative, South Holland and The Deepings

I am extremely grateful to the Secretary of State for giving way, and I know he will move seamlessly from new hospitals to new treatments. I have rushed here from a reception being held today in the House on the subject of tinnitus. Tinnitus affects numerous constituents of his and mine and people across this country, and it is urgent that we do more research and put more funding into the subject.

Will the Secretary of State give me news that I can rush back to the reception with—I am hosting it, while simultaneously being here—thereby giving good news to hundreds of thousands of our constituents?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I think that is an early warning that my right hon. Friend is going to leave immediately after his intervention. He is quite right to raise the subject. We are increasing the research budget, and I very much look forward to working with him on making sure that that research goes where it is needed. I am very happy to look specifically at the case for increased research funding into tinnitus and to work with him on it. If he were to meet the Lords Minister, who is responsible for the research budget, that would be the most productive way to take this forward.

Photo of Oliver Heald Oliver Heald Conservative, North East Hertfordshire

Does the Secretary of State agree with me that, in Hertfordshire, we have been fortunate to have extensive funding for new facilities at the hospital in Stevenage? Of course, my constituents further south also benefit from the improvements at the Princess Alexandra in Harlow. However, one thing that would help to relieve the hospitals of some of their burden would be to have more NHS hubs for social care and health together—that is, of course, for primary care. Does he agree with that, and is he able to say any more about Royston, which I have discussed with him in the past?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, I hope that we can make some progress on Royston, because Royston is an example of how the NHS needs to be formulated more in the future. The NHS needs to be both more specific and more local—more specialist and more local—with the high-quality, specialist, cutting-edge technologies in the most specialist of centres, such as the tertiary hospitals of this country. At the same time, it needs to get those services that can be as close to home as possible as close to home as possible, using the best of modern technology to be able to do it. That means that hubs that are somewhere between primary and secondary care are the future, because so often someone can go and have a scan at a hub and the scan can then be interpreted off-site in one of the specialist centres, which means that the patient does not have to travel as far. For instance, especially for an elderly patient, it can be incredibly helpful to be able to go just to the local health hub or walk-in centre to have such a diagnosis.

That is the future of the NHS: more local and more specialist at the same time. It is one of the reasons why I am such a fan of community hospitals, for instance. This is about making sure that we support the NHS where people live, and that we end the generation of putting more and more services into the really big hospitals and sucking them out of local community services. I will end that sucking out of local services, and in fact I will put more into local communities. I have talked about the technology agenda; one thing technology can do is empower the movement of the NHS to local communities. It is incredibly important that we do that.

Let me make some progress, Mr Deputy Speaker, in case you are unhappy with the amount of time I am taking. I mentioned that we will be having 40 new hospitals over the decade, and we will also have—how many more nurses? Fifty thousand more nurses! We will have 6,000 more doctors in primary care, and 50 million more GP appointments. In response to a point raised by the shadow Secretary of State, this Government will deliver on their promises. Given our ageing population, there is record demand on the NHS. I want to thank each and every one of the 1.4 million colleagues who work in the NHS, and the more than 1 million people who work in social care. We must support those people so that our health and care systems are always there for each and every one of us. With this Queen’s Speech, we will do that.

The Queen’s Speech commits us to six major legislative reforms that will help us to set fair the NHS and underpin our priorities across health and social care. The top priority is people. The NHS is nothing without the people who work in it, and as demand increases, we need more people—more GPs, more nurses, more mental health staff, and others—all better trained and better supported by the best technology. They must be better cared for by their employers, and work to the top of their capabilities—that is incredibly important, and we must get the most out of people. For instance, pharmacists can do so much more than the current contract allows, and I want them to do much, much more.

Photo of Bim Afolami Bim Afolami Conservative, Hitchin and Harpenden

Does the Secretary of State agree that this is not just about having more GPs, although we do need that, but about the way GP practices work, with managers using technology and other things to manage the demand for GP services? Will the Secretary of State further set out his plans in that regard?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

My hon. Friend is dead right. Pharmacies should be doing more to keep the pressure off GPs, because they are in the community and more accessible, and within a GP surgery not everything needs to be done by the GP. We are expanding the number of GPs by 6,000 over this Parliament, and increasing by 26,000 the number of other clinicians who work in primary care, supporting GPs. When someone goes to their primary care practice, they might see the GP, a practice nurse, a pharmacist, a physio or a geriatrician. The boundary that has existed since Lloyd George between primary and secondary care, where someone either sees a GP or goes to hospital, needs to become more porous so that we can have that care where it is right for patients.

My next point is that prevention is better than cure. Expanding primary care, allowing pharmacies to do more, growing our community teams—that is about driving prevention. My third priority is technology. That is not just because we stand at the cusp of a health tech revolution that has the potential to transform healthcare for the better, but because the first task is to drag the NHS out of the 20th century and into the 21st.

The next priority is infrastructure, much of which we have already started to discuss. Buildings have to be expanded and improved, and while we do that expansion, with upgrades to the 40 new hospitals, we will also repair the damage done by those terrible private finance initiative deals that have hamstrung hospitals—deals struck by the hon. Member for Leicester South and his friends: Mr PFI himself. When we hear from him about the challenges that the NHS faces, everyone should remember with every word he says that he was at the heart of the Treasury that was driving PFI, which has caused so many problems across our national health service. Our plan is for a more integrated NHS, with a culture that gives patients more control over their healthcare, and colleagues more control over their work.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

The Secretary of State is so pleased with himself and that attack line, he really is.

Photo of Eddie Hughes Eddie Hughes Conservative, Walsall North

He’s got good reason to be!

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

The hon. Gentleman says that he has good reason to be. I was at the Treasury as a young man in my twenties, signing off paper, when the Secretary of State was at the Bank of England, so by his logic, he would have been putting up interest rates for hardworking families. I was at the Treasury, but I was not responsible for any PFI contract. If he is going to say that I was responsible for every decision made by the Treasury when I was there in my mid-twenties, I will take responsibility for giving the NHS the biggest cash boost in its history, which meant the shortest waiting lists. That is a record I am proud of; that is a record he has not been able to match.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The cash boost that we are giving now is bigger. I think today is the anniversary of Prime Minister Tony Blair sitting on the couch of a TV show, talking about increasing funding for the NHS, which was opposed by Gordon Brown, who was Chancellor of the Exchequer at the time. We will not take any lectures.

I am thrilled that the public comprehensively rejected the Labour party’s baseless scaremongering, which was repeated through the election campaign and worried some of the most vulnerable people who rely on our NHS. I lost count of the amount of times I had to debunk some politicised nonsense put about by the Opposition across the country because they had nothing positive to say. The hon. Member for Leicester South was at it again yesterday and in his speech. He said that the settlement in the NHS Funding Bill is a cap, although clause 1 states that it is a minimum. Clause 1(1) states:

“In making an allotment to the health service in England for each financial year…the Secretary of State must allot an amount that is at least the amount specified”.

Did the hon. Gentleman even read the Bill? Did he get to clause 1? I am not sure he bothered reading it.

Let us look specifically at the amendment. It calls for reform to social care and for the Government to bring forward a plan, and that is precisely what the Queen’s Speech provides for. It also calls for additional funding for the NHS, which is what we are legislating for. The long-term plan is fully funded by the largest cash injection in the history of the NHS, and I urge Members across the House to support it fully. We can only fund the NHS with a strong economy, and that is exactly what we will do.

Photo of Mark Harper Mark Harper Conservative, Forest of Dean

The Secretary of State will have heard my earlier exchanges with the shadow Secretary of State, which I hope were helpful. He will be aware that more than half the budget for adult social care in England is spent not on older people, but on those of working age, as we try to enable people to be more independent and to work. Will he confirm that the social care plan that he plans to discuss with other parties, and which he will bring forward this year as committed to by the Prime Minister, will cover older people and those of working age, and will probably entail different solutions for those two groups?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The proposals that we are working on include solutions for the provision of social care for older and retired people as they decline in the latter years of their lives, and for people of working age. Part of the point about consensus building is that we must be open to options and look right across the piece. It was a disappointment that the Labour party proposals that came out in the autumn only covered older people and not working-age adults, and that point must be addressed. I hope we can do that in a spirit of cross-party discussion, and that those on the Opposition Front Bench will engage positively with that. We will engage right across the House when trying to bring forward a solution.

Photo of Kate Green Kate Green Labour, Stretford and Urmston

A few moments ago the Secretary of State spoke about scaremongering. Has he had a chance to look at early-day motion 56, which highlights one group of patients who are scared? Pregnant migrant women face charges for their maternity care, and it is believed that two or three women might even have died as a result of their fear of going for treatment, because they did not know how to pay for it. Will the Secretary of State consider suspending those charges and conduct a proper review of the public health impact of that charging regime?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I will have a look at that early-day motion. This is an incredibly important subject that we must get right. Of course it is fair for those who use the NHS to make a contribution to it, and we have made changes to ensure that those who give birth get the support they need. The point I think the hon. Lady is making is not only about the exact details of the rules, but ensuring that people are not put off because of a concern about what the rules may be. I am very happy to take up that point. On social care, I hope we can reach a broad consensus.

Photo of Barbara Keeley Barbara Keeley Shadow Minister (Mental Health and Social Care)

I want to give the Secretary of State a chance to be clear, following on from the question from Mr Harper, about what he intends to do. The Secretary of State will know that I raised with him, on the day of the previous Queen’s Speech in October, that we would be willing to sit down and talk about this issue. Three months have been lost with nothing happening. All we hear from the Prime Minister is that something will happen in this Parliament. Why does he not use this chance at the Dispatch Box to say where the plan is. We have proposals. Where is his plan? When is he going to produce it?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The Minister for Care, my hon. Friend Caroline Dinenage wrote to the hon. Lady after the election and has not had a reply. We are up for this conversation. The Prime Minister has been absolutely clear. We hope we can do it in a spirit of cross-party consensus. I hope we can have an approach to the health service that has some consensus. The truth is that I like the shadow Secretary of State. His politics are quite close to mine, although I do not agree with his approach on PFI. There has been good news for both of us recently. Both of us got the election result we wanted. [Laughter.] I did not want Jeremy Corbyn to be Prime Minister and we discovered from the hon. Gentleman’s friends that neither did he. So let us go forward in a spirit of as much co-operation as possible.

Let me, if I may, go through each of the six measures in the Queen’s Speech in turn. In addition to the NHS Funding Bill we announced yesterday, there will be our long-term plan Bill. The plan, created in consultation with NHS colleagues, sets out how the NHS will improve the prevention, detection, treatment of and recovery from major diseases including cancer, heart attack and stroke.

Photo of Henry Smith Henry Smith Conservative, Crawley

Blood cancer is this country’s fifth-most common cancer and the third-biggest cancer killer. May I have assurances from my right hon. Friend that that will also be a focus in the long-term plan on the cancer strategy?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes. My hon. Friend has been an assiduous campaigner to make sure that blood cancers are right at the top of the agenda. It is an incredibly important subject and it is very much in the long-term plan. We have managed to increase the survival rate faster than most countries in Europe for most cancers. We need to keep that drive going forward.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich

I want to bring the Secretary of State back to social care. We have a duty in this Parliament to resolve this issue, which for many decades has been kicked into the long grass. Does my right hon. Friend agree that it is not just about funding, but what service we want to deliver for people? The discussion about the future of social care should also be about service delivery, putting together not just a sustainable funding model but a model of delivery that is driven by integration of the health and social care services. We often talk about that, but it has not been delivered for patients and people on the ground.

Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

Before the Secretary of State answers that, may I just gently remind him that 40 people are trying to get in? It would be generous if he could at least keep that in mind as he takes interventions.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I will rattle through as fast as I can, Mr Deputy Speaker, but I also want to take as many interventions as I can, if that is okay. [Interruption.] No, okay, no interventions. That is an unusual request from the House, if I may say so. [Laughter.]

Putting social care on a sustainable footing, where everybody is treated with dignity and respect, is one of the biggest challenges we face as a society. The Prime Minister has said that we will bring forward a plan for social care this year. These are complex questions and the point my hon. Friend raises is very important.

The draft legislation on the long-term plan Bill aims to help us to: speed up the delivery of the long-term plan; reduce bureaucracy; and help to harness the potential of genomics and other new technologies. I hope the House will support it.

The third piece of proposed legislation is the medicines and medical devices Bill. We are at an important moment in the life sciences. This country can and will be at the forefront as the NHS gets access to new medicines and new treatments earlier, so patients can benefit from scientific breakthroughs sooner.

Photo of Liz Twist Liz Twist Labour, Blaydon

During the election campaign the Prime Minister promised a member of the public that the Government would look into the availability of Kuvan. Kuvan has been available for the treatment of PKU for 11 years. Will the Secretary of State commit to ensuring that that drug becomes available?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I can tell the hon. Lady that since the election I have been working on precisely that. I am very happy to meet her to see whether we can make a breakthrough.

Photo of Mike Wood Mike Wood Conservative, Dudley South

Increasing microbial resistance could have a devastating effect on the survival of people with sepsis. How will the medicines and medical devices Bill help to support new treatments to reduce antimicrobial resistance and support alternative ways of tackling infection?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The medicines and medical devices Bill is designed to make it easier for hospitals to take part in trials of cutting edge medicines, including personalised medicines, and allow us to be a part of an internationally competitive licensing and regulatory regime. This is all to improve patient safety right across the board. It is not condition-specific; it is right across the board.

Fourth is patient safety reform. Here, I want to pay tribute to my predecessor, my right hon. Friend Jeremy Hunt, for his work on patient safety. The Health Service Safety Investigations Bill was introduced in the House of Lords in the previous Parliament to improve patient safety and create a learning culture across the NHS. We will bring forward those proposals.

Photo of Duncan Baker Duncan Baker Conservative, North Norfolk

I thank the Secretary of State for giving way and for visiting me on my campaign to become the newly elected Member for North Norfolk. On patient safety, the wonderful constituency of North Norfolk has the oldest constituency demographic in the entire country and the worst ambulance response times in the beautiful picturesque town of Wells. We recently learnt that the nearest hospital, the Norfolk and Norwich University Hospital, has the worst accident and emergency unit. I think these matters are linked. Will my right hon. Friend commit to meeting me urgently to discuss these really serious matters?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes. I would be very happy to do that. I was struck by my hon. Friend’s enthusiasm for solving this problem when I visited during the election campaign. The problem is absolutely linked. The inability of ambulances to get off the ramps, so to speak, at the Norfolk and Norwich, is causing problems for ambulance response times. Many other hospitals have cracked this problem. I look forward to working with him and the Norfolk and Norwich, along with other local MPs whose constituents are affected, to try to solve that problem.

Photo of Sammy Wilson Sammy Wilson Shadow DUP Spokesperson (Treasury), Shadow DUP Spokesperson (Work and Pensions), Shadow DUP Spokesperson (Brexit)

May I first welcome the announcements the Secretary of State is making today? One of the benefits of being a part of the Union is that Northern Ireland, through the Barnett consequentials, will benefit from the huge influx of money into the health service. Northern Ireland has one of the longest waiting lists and we need many reforms to our health service. What work will he do with the newly appointed Minister in the Northern Ireland Assembly to ensure that the money is used effectively when it comes to the Northern Ireland Executive?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I look forward very much to speaking to and working with the new Health Minister in Northern Ireland. I am delighted that there is a ministerial team in Northern Ireland and I pay tribute to everybody who has worked so hard to make sure that that can happen. The right hon. Gentleman is right that the funding will increase. There are significant challenges in Northern Ireland, about which he knows all too well, and I look forward to trying to resolve them. The truth is that in Northern Ireland the number of people waiting more than a year for an operation is 10 times higher than in England, despite the much smaller population. It is four times higher in Wales, despite the fact that the Welsh population is smaller. We have to solve those problems and I look forward very much to working collaboratively across the Union to make sure that they are resolved.

Photo of Sarah Atherton Sarah Atherton Conservative, Wrexham

Many patients from north-east Wales attend hospitals over the border in Oswestry, Chester and Liverpool for general and specialist care. Last year there was a disagreement between the Welsh Labour Government and the Countess of Chester Hospital over paying for that care, and subsequently care treatment was delayed or cancelled as a result. Can the Secretary of State reassure the House that he will speak to the Welsh Labour Government to avoid a recurrence of that situation?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Absolutely. I am glad that we resolved the problems with the Countess of Chester Hospital serving patients who live in north Wales. I know that part of the world well, not least because I was born in the Countess of Chester Hospital and, for the first 18 years of my life, lived but a mile from my hon. Friend’s beautiful Wrexham constituency—I travelled through it every day on my way to school—so I know these cross-border issues intimately. It is ridiculous that we reached a position where the Countess of Chester Hospital was unable to take patients from north Wales because the Welsh NHS was unwilling to pay the relevant costs. We reached a good compromise, and we must ensure that it keeps working so that the problem does not happen again.

I will turn briefly to the fifth and sixth measures, Mr Deputy Speaker, which are very important. The fifth measure is mental health reform. Throughout the entire history of healthcare, mental health has been seen, treated and organised on a different basis from physical health. That is wrong. Over my generation the attitude that society takes towards mental health has fundamentally shifted. We are not there yet, but our mental health and physical health must be seen on an equal footing, and mental health must be treated as seriously as physical health.

As Health Secretary, I have made mental health a priority. Within the £33.9 billion of additional funding, mental health funding is increasing the fastest. We have a plan to improve mental health services across the nation. Just this week we opened a new gambling addiction clinic in Sunderland, and we will have 13 more across the country, in recognition of the unmet demand in our society. I fully support Claire Murdoch, the NHS mental health director, in her call today on gambling firms to act responsibly and prevent the loss of life.

We are making progress in how we treat all forms of mental ill health, but the legislation for mental health was written for a previous generation and we must bring it into the 21st century. The Mental Health Act 1983 is nearly 40 years old, and some of our legislation is still shaped by 19th-century views of mental illness. It is badly in need of modernisation. It is paramount that we ensure that people have greater control over their treatment, and that everyone receives the dignity and respect they deserve. We must get the legislation right. I pay tribute to Sir Simon Wessely for the work that he has done to set the parameters. We will publish a White Paper within months and then bring forward a new mental health Bill.

I want to say a word about the law governing the care of people with autism and learning disabilities, which concerns some of the most vulnerable people in our society. Again, parts of the law are antiquated. We are looking at this alongside the work on the Mental Health Act to ensure that the systems are appropriate and co-ordinated.

These are the six health and social care measures in the Queen’s Speech. It is central to this Government’s priorities that we meet the public’s expectations and deliver on our commitments. This Conservative Government made clear and solemn commitments in our manifesto. People in their millions placed their trust in us, many for the first time. People have entrusted us with the future of the NHS, and we will deliver on that trust.

Photo of Charles Walker Charles Walker Conservative, Broxbourne

Will my right hon. Friend give way just before he finishes his speech, because he is such a good egg?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I do not know how my hon. Friend knew that I was about to finish.

Photo of Charles Walker Charles Walker Conservative, Broxbourne

I thank my right hon. Friend for giving way, and I am sorry for arriving late in the Chamber, Mr Deputy Speaker. First, I thank my right hon. Friend for his action on mental health, which is fantastic news. Secondly, can we look at smoking cessation and public health? Smoking is simply an appalling thing to do. There are many products now on the market and we need to look at their efficacy, to see whether we can move people from smoking lit tobacco to a pathway to zero tobacco.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I want to see a pathway to zero tobacco too. I pay tribute to my hon. Friend for the work that he has done to draw attention to mental health and to change the national conversation about it, and indeed the global conversation.

We must meet each and every one of the commitments we made in our manifesto, because we are the party of the NHS, and that is the way it is going to stay.

Several hon. Members:


Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

Order. A substantial number of Members wish to speak in this debate, and we have a dozen maiden speeches. I am not imposing a controlled time limit, but Members should please take no longer than six minutes, to give those Members making their maiden speeches a fair crack of the whip.

Photo of Philippa Whitford Philippa Whitford Shadow SNP Spokesperson (Health and Social Care), Shadow SNP Spokesperson (Exiting the European Union) 1:05, 16 January 2020

As the Secretary of State has said, health and social care is delivered by people, and I would like to pay tribute to all my former colleagues across the UK who, regardless of system, are working their best to help patients.

All four UK national health services face the same challenges of increasing demand, workforce shortages and tight finances, but the NHS in England has faced almost 10 years of unprecedented austerity, with annual uplifts of about 1% for quite a significant part of the past decade.

The NHS Funding Bill will enshrine in law the Government’s plan to give £33 billion extra per year by 2023-24. Although that is a bit of a stunt, as the Government do not have to force themselves to act by law, I am sure that it will be very welcome after such a long drought. Of course, in real terms it represents £20 billion, and is therefore not additional new money but the extra funding already promised by the former Chancellor in 2018. It is claimed that it represents the biggest uplift ever for the NHS, but it amounts to 3.4% per year, which is actually still less than the average annual uplift across the NHS’s history. It should allow stabilisation of the NHS in England, but it is unlikely to provide enough money for major transformation projects.

The extra funding is again to be funnelled largely into the NHS itself, to make it sound like a bigger number, but it ignores the other responsibilities of what is actually called the Department of Health and Social Care. Public health funding has been cut by £850 million, with the 10 most deprived areas in England losing over a third of their central public health funding, while the least deprived areas lost only 20%. Prevention services, such as smoking cessation, which was mentioned by Sir Charles Walker, have been cut. That does not make sense, as £1 spent on helping someone to quit smoking saves £10 in treatment for lung and heart diseases later.

Similarly, although the plan includes an extra £1 billion for social care, the funding gap is currently estimated to be £6 billion. With cuts of up to 60% to their central budgets, councils simply cannot make up the difference. There is little point in pouring extra money into the NHS without also tackling social care—it is like trying to fill a bath without putting in the plug.

Although it was Labour that introduced private healthcare companies into the NHS and saddled all four UK health services with financially crippling private finance initiatives, it was the coalition Government’s Health and Social Care Act 2012 that created the full-blown healthcare “market” in NHS England. The NHS long-term plan proposes to unpick some of that, with legislation to remove the barriers to integration, such as by repealing section 75, which forces commissioning groups to put contracts out to tender, and getting rid of tariffs, which can act as a perverse incentive and encourage hospital admissions.

It was the competitive market that drove NHS trusts in England into debts totalling £2.5 billion within two years. That led to the closure of beds and to the downgrading and closure of A&E departments, and it has caused a marked decline in emergency care services, which have been consistently lagging about 10% behind NHS Scotland’s A&E performance since March 2015. It is important to focus on the data from type 1 emergency departments, as that is the most relevant definition—hospital-based A&E units that are open 24 hours a day, seven days a week. Diluting that with data from minor injury units and walk-in centres just masks the real situation.

Performance has deteriorated in all four nations this winter, but while one in six patients in Scotland are waiting longer, a third of those in England and Wales are waiting more than four hours in A&E. Unlike the three devolved nations, NHS England does not publish the total time spent in A&E by a patient. It restarts the clock to measure trolley waits for those needing beds. As was mentioned by the shadow Secretary of State, in December, nearly 100,000 patients waited over four hours, and often up to 12, for a bed. That time is on top of the original wait in A&E.

The Government’s plan seems to be to change the measure rather than dealing with the issue, but the four-hour target is the canary in the coalmine, warning of stress on the whole system—not just A&E, not just the flow through hospitals, but the assessment of what is happening in the community. Poor disease prevention rates and struggling primary care services lead to more patients going to A&E, while a lack of social care provision means that they can get stuck in hospital, which causes a lack of beds for emergencies. The Government list social care reform in their legislative programme, but the previously promised Green Paper is still nowhere to be seen, and no solution has been proposed.

The Scottish Government choose to invest £276 more per head in health and social care, because in a comprehensive health system a pre-emptive approach is more cost-effective. That provides significantly more GPs, nurses and beds per head of population. Free prescriptions ensure that people take their medication and control chronic conditions, while the fact that joint replacements and cataract surgery are not rationed helps older people to remain active and independent rather than needing more and more social care. Free personal care allows the elderly to stay in their own homes, rather than ending up in care homes or even hospital.

The workforce is the biggest single challenge facing health and social care services. That problem has been aggravated by Brexit, with a 90% drop in the number of EU nurses coming to the UK and a one-third increase in the number leaving it. As was mentioned earlier, the shortage of doctors has been acutely exacerbated by the Government’s changes in the annual pension tax allowance; some doctors are receiving tax bills for tens of thousands of pounds after working overtime. Many senior clinicians have been refusing to do extra shifts, for which they are financially punished. That is likely to have been a major contributor to this winter’s poor performance, as we have not experienced either a flu epidemic or severe weather. I wish the Government and the medical bodies well in sorting out an acute problem that will only make life for our patients worse.

We have been promised 50,000 extra nurses, but as only 31,500 will be new staff, that will not cover the 44,000 nursing vacancies in England, and as recruitment is spread over five years, the gap is unlikely to close. I am sure that the profession welcomes the Government’s U-turn on the nursing bursary—yet another disastrous Tory policy is having to be unpicked—but the promise is for only £5,000 a year, compared with £10,000 in Scotland, and nursing students here will still face tuition fees. The removal of the bursary led to a one-third drop in the number of nursing applications, and a 5% drop in the number of students starting each year. In contrast, 21% more nursing students have been starting each year in Scotland since 2016.

We have been promised 6,000 extra GPs to deliver 5 million extra appointments over the next five years, but we are still waiting for the 5,000 extra who were promised in the 2015 general election. There are actually 1,000 fewer GPs in England, so I will not hold my breath.

I welcome reform of the Mental Health Act—which is quite different from the legislation in Scotland—and, in particular, the focus on compulsory detention, but we need investment in mental health support and early intervention. It is good that we are talking much openly about mental health issues, including those of Members in this place, but we are still some way from achieving parity of esteem.

Having been a member of the pre-legislative Committee a year and a half ago, I welcome the Health Service Safety Investigations Bill. The aim is to copy the principles of air accident investigation, with a focus on learning lessons to prevent reoccurrence rather than apportioning blame to one person, particularly as “system failure” is nearly always a contributor and the chance to “design in” safety is then missed. While that will hopefully improve the learning from major incidents, it would be good to see more being done to prevent them from happening in the first place.

I was working as a surgeon in 2008, when the Scottish patient safety programme was set up. The first step was the introduction of a team approach to “pre-flight checks” in operating theatres to prevent surgical errors. As was reported in the British Journal of Surgery, that resulted in a 37% drop in the number of post-surgical deaths over approximately two years—among the largest reductions in surgical deaths ever documented. I was therefore surprised to hear from one of our Committee witnesses that the World Health Organisation pre-operative checklist was not standard practice in all surgical services in England.

The internationally acclaimed Scottish programme now extends to every aspect of healthcare and, despite dealing with increasing numbers of older and more complex patients, it has dramatically reduced hospital mortality by a quarter over the last 10 years. Reducing complications saves money, as well as being better for patients. For example, a one-third drop in bed sores since 2012 is estimated to be saving between £2 million and £5 million a year in Scotland.

The Government must accept that they got it wrong in 2012 with the Health and Social Care Act, and again in 2016 with the removal of the nursing bursary. They need to get rid of tuition fees, restore the bursary, and genuinely work to repair the fragmentation and damage done to the NHS in England by their “market” approach. The Prime Minister likes to attack the Scottish NHS. I gently suggest that he take the plank out of his own eye, read some statistics, and focus on sorting out the mess that his party has made of the health and social care system for which he is actually responsible.

Photo of Jeremy Hunt Jeremy Hunt Conservative, South West Surrey 1:17, 16 January 2020

Let me start by saying that it is wonderful to see you in the Chair, Mr Deputy Speaker, and that your presence there is a signal to every new Member that it is possible to undergo the ups and downs of politics and come through on the other side.

I thank the Health Secretary for his personal commitment to patient safety in including the Health Service Safety Investigations Bill in the Queen’s Speech, and I thank the Under-Secretary of State for Health and Social Care, my hon. Friend Ms Dorries, for her personal commitment in ensuring that it featured in both last year’s Queen’s Speech and the current one, despite many competing pressures. It is about patient safety that I wish to talk in my brief six minutes. When I became Health Secretary in 2012, I had not heard the phrase.

The first crisis with which I had to deal was the one at Mid Staffs. I remember the then chief executive of the NHS, Sir David Nicholson, taking me aside and saying, “You just need to understand, Jeremy, that in healthcare we harm 10% of patients. That is what happens all over the world.” I then asked the awkward question about how many people actually died because of mistakes in healthcare.

It is important to point out that this is not about the NHS; it is about how healthcare is practised everywhere. However, being the good old NHS, we have carried out endless academic studies on this. The Hogan and Black analysis shows that, at that time, 4% of hospital deaths had had a 50% or more chance of being preventable. If we do the maths, that works out at about 150 preventable deaths every single week—the equivalent of an aircraft falling out of the sky every single week.

Then I met a group of people who persuaded me that this issue should be my main focus as Health Secretary. I met Scott and Sue Morrish, a young couple from Devon who lost their son Sam to sepsis when he was three because it was not picked up early enough; James Titcombe, who lost his son Joshua at Morecambe Bay when he was nine days old; Deb Hazeldine, who lost her mother in a horrible death at Mid Staffs; Martin Bromiley, who lost his wife Elaine because of a surgery error at a hospital in Milton Keynes; and Melissa Mead, who lost her son William when he was just 12 months old—in December 2014, when I was Health Secretary—again because sepsis was not picked up.

Those people all did something that most of us would never do. Most of us, when we have a tragedy in our lives, want to close the chapter and move on, but they chose to relive their tragedy every single day because they wanted to tell their story and make the NHS change so that other families did not go through what they had been through. They paid a terrible price for doing that. James Titcombe had to write more than 400 emails over several years before we were prepared to admit why Joshua died. Martin Bromiley sacrifices 40% of his salary as an airline pilot so that he can go round the NHS talking in hospitals free of charge about what happened to Elaine. Melissa Mead carries William’s teddy everywhere. She goes into TV studios to try to alert people to the dangers of sepsis, and she brought it to her first meeting with me. Inside that teddy were William’s ashes. That is a meeting I will never forget as a Minister.

We must not let this blind us to the fact that the vast majority of NHS care is absolutely brilliant. I have three beautiful healthy children, thanks to the NHS. About a year before I was Health Secretary, I was in the Cabinet and I had a basal cell carcinoma removed from my head. A local anaesthetic was administered, and the surgeon had his scalpel out. The head nurse looked at me and said, “By the way, Mr Hunt, what is it you do for a living?” This was a time of austerity and cuts, and I froze before giving the answer to that question. But thanks to substantial additional funding by the last Labour Government and by this Government, the NHS has improved dramatically, and we now have record survival rates for every major disease category.

Photo of Yasmin Qureshi Yasmin Qureshi Shadow Minister (Justice)

I thank the right hon. Gentleman for giving way. Three years ago my mother died of sepsis, and sepsis is still a big problem that needs to be addressed in hospitals.

Photo of Jeremy Hunt Jeremy Hunt Conservative, South West Surrey

I thank the hon. Lady for raising that. We have made huge progress in sepsis care, and the vast majority of people who go to A&E now are checked for sepsis, but mistakes still happen, and I am sure that it affected her as it affected the families of the people I have talked about.

We must not be complacent about the things that go wrong. In the NHS, we talk about “never events”—the things that should never happen. Even now, after all the progress on patient safety, we operate on the wrong part of someone’s body four times a day. It is called wrong site surgery. When I was Health Secretary, we amputated someone’s wrong toe, and a lady had her ovary removed instead of her appendix.

Photo of Philippa Whitford Philippa Whitford Shadow SNP Spokesperson (Health and Social Care), Shadow SNP Spokesperson (Exiting the European Union)

I know that the right hon. Gentleman visited the Scottish patient safety programme to see in action the WHO checklist, which is designed precisely to prevent such events, so can he explain why the checklist was never introduced during his time as Secretary of State?

Photo of Jeremy Hunt Jeremy Hunt Conservative, South West Surrey

Actually, we do have WHO checklists throughout the NHS in England—I think they were introduced under Lord Darzi in the last Labour Government—but the truth is that even with those checklists, which are an important innovation, mistakes are still made because sometimes people read through lists and automatically give the answer they think people want to hear. This is why we have to be continually vigilant.

What is the solution? It is to ask ourselves honestly, when a mistake happens and when there is a tragedy, whether we really learn from that mistake or whether we brush it under the carpet. To understand how difficult an issue that is, we have to put ourselves in the shoes of the doctor or nurse when something terrible happens, such as a baby dying. It is incredibly traumatic for them, just as it is for the family. They want to do nothing more than to be completely open and transparent about what happened and to learn the lessons, but we make that practically impossible. People are terrified about being struck off by the Nursing and Midwifery Council or the General Medical Council. They are worried about the Care Quality Commission and about their professional reputation. They are worried about being fired. In order for a family whose child is disabled at birth to get compensation, they have to prove that the doctor was negligent, but any doctor is going to fight that.

The truth is that many of the mistakes that are made are not negligence, but we make it so difficult to be open about the ordinary human errors that any of us make in all our jobs. As we are not doctors and nurses, people do not generally die when we make mistakes. That shows the courage of entering that profession, and if we make it difficult for people to be open, we will not learn from those mistakes. That is why we need to change from a blame culture to a learning culture. That is also why, as we reflect on the devastating news that the Under-Secretary of State for Health and Social Care, my hon. Friend Ms Dorries gave the House last night that the Shrewsbury and Telford Hospital NHS Trust is now examining 900 cases dating back 40 years, we realise that the journey that the NHS has started on patient safety must continue. We should take pride in the fact that we are the only healthcare system in the world that is talking about this issue as much as we are, and if we get this right, we can be a beacon for safe healthcare across the world and really turn the NHS into the safest and highest-quality healthcare system anywhere.

Photo of Siobhain McDonagh Siobhain McDonagh Labour, Mitcham and Morden 1:26, 16 January 2020

This is my first contribution in the House in this new Parliament, and it is a pleasure to see you in the Chair, Mr Deputy Speaker.

Given that the subject of today’s debate is health and social care, I would like to start by expressing my sincere admiration for the selfless and dedicated staff who have kept our NHS operating this winter under the most testing of circumstances. It has been a period that has pushed A&E waiting times to their worst on record, but despite 10 years of austerity leaving our treasured NHS desperately short of staff, services and supplies, the biggest threat to my constituents is to be found far closer to home. Yes, it is back. From now until April fool’s day, of all days, my constituents are once again being consulted on the future of St Helier Hospital.

Under countless brands and titles, this consultation has been run time and again at a staggering cost of over £50 million. This latest consultation has been triggered thanks to the Government pledge of £500 million to Epsom and St Helier University Hospitals NHS Trust. This time it is branded as “Improving Healthcare Together”, and it builds on the unscrupulous foundation of its predecessors to determine how those funds will be used and where the acute hospitals in south-west London should be based: in St Helier or Belmont.

Of course I welcome any investment in our treasured NHS, but as ever, the devil is in the detail. These latest proposals push for both St Helier and Epsom hospitals to lose their key acute services, moving them south to Belmont. The reality is that St Helier would lose its major A&E, consultant-led maternity, acute medicine, critical care, emergency surgery, in-patient paediatric and children’s beds. That represents 62% of St Helier’s beds, and the move would leave a shell of a hospital that could more accurately be described as a walk-in centre. The consultation assumes that my constituents will travel to the new site regardless of where it is, but they will not. If St Helier is downgraded, my constituents will turn to either St George’s, where the A&E is already in the bottom quartile for space standards, or Croydon University Hospital, where bed occupancy is already at 99%. How can it possibly be a sensible idea to force even more people to rely on such overstretched services? The impact would be devastating.

I have pointed this out time and again to those running the consultation. Meanwhile, they have spent millions of pounds of taxpayers’ money on misleading impact reports with utterly astounding gaps in their analysis. Let us take Pollards Hill in my constituency. It would be considered deprived in comparison with much of Sutton or Epsom, but it was deemed by the consultation to be outside St Helier Hospital’s catchment area. However, the largest GP surgery in Pollards Hill directs 34% of its patients to the hospital. That matters, because areas that rely on St Helier were not even considered in the analysis, so how can the potential impact of moving acute services from the hospital be adequately assessed? I have pointed out such gaps, but they have not been rectified, and the health and deprivation figures in my constituency have been disguised by including the neighbouring constituency of Wimbledon and calculating the deprivation for Merton as a borough. This is not a political tool; it is a hospital, and it should be based where it is needed.

The situation gets even more unbelievable, because the deficient evidence was then assessed in behind-closed-doors workshops, with all those attending forced to sign a non-disclosure agreement before being allowed in. That brings us to the present day, with the latest consultation launched last week. The flawed analysis has been used to decide on Belmont as the preferred site for acute services in south-west London, and that preference is clearly stated on the consultation document itself. How can that possibly be acceptable?

Maybe I should just be grateful that these documents were actually delivered to all households this time around, rather than to the preferred target areas like last time. It is time for some accountability and for the Government to step in before St Helier Hospital’s future is thrown into jeopardy. I challenge every foundation that this programme has been built upon, and I appeal to Ministers to step in before another penny of taxpayers’ money is wasted on this bogus consultation. It is time for the madness to end. Leave these vital services where they are most needed: at Saint Helier hospital on its current site.

Photo of James Brokenshire James Brokenshire Conservative, Old Bexley and Sidcup 1:31, 16 January 2020

It is good to see you restored your place, Mr Deputy Speaker, and a particular privilege to take part in today’s debate on the Gracious Speech, with a particular focus on our precious NHS. It is also good to see the emphasis in the Government’s programme on funding, innovative medicines, safety and mental health, so that we can improve the services that our NHS delivers and improve the lives of those who needs its care.

The timing of today’s debate has some particular poignancy for me. I was struck by the comments of my right hon. Friend Jeremy Hunt about the ups and downs of politics. It is almost exactly two years to the day that I had surgery to remove the top part of my right lung and the cancerous tumour contained within it, but I am pleased to say that, in the immortal lyrics of Sir Elton John, “I’m still standing.” [Hon. Members: “Hear, hear.”] I count my blessings each day, and today provides me with a further opportunity to pay tribute to the incredible people in our NHS who saved my life and continue to save the lives of countless people up and down the country every single day.

I have learned so much over the past two years, and I am determined to use my experiences to act as an advocate for change, especially for less survivable cancers such as lung cancer. I have been heartened by the encouragement of colleagues across the House—even the colleague who upon my return to the Members’ Tea Room after surgery said, “Didn’t expect to see you back.” To this day, I am quite sure that the omission of the words “so speedily” was simply an unconscious oversight.

Over half of us will get cancer at some stage in our lives. That is why we need to be more open about and change the nature of the conversation around the disease. For many people, cancer is becoming the treatment of a chronic condition, and more and more people are living well with or beyond cancer.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I thank the right hon. Gentleman for giving way. I was pleased to see him back after his operation, and he is making a clear case on cancer-related issues. Just this week, I met representatives from the Teenage Cancer Trust who indicated that, for young people and teenagers, cancer is not just about the operation and other physical activities, but mental anxiety, too. The Government have set aside money to ensure that that anxiety is addressed, but only 61% of such services are taken up in hospitals and just 40% of the available assistance and help is taken up afterwards. I am sure that the Government response will be positive, but does he agree that now is the time to address those shortcomings for those who experience mental health anxiety due to cancer?

Photo of James Brokenshire James Brokenshire Conservative, Old Bexley and Sidcup

I commend the hon. Gentleman for his point about mental health issues and some of the stresses and strains, and there is a need for greater focus and attention on teenage cancer patients. That leads me on to my next point, which is about the need to overcome the fear that a diagnosis can bring. I know what that can feel like. Early diagnosis and speedier treatment are key, not least to reduce the worry and sleepless nights that result from knowing something is wrong by getting something done about it. It is great that the NHS long-term plan recognises that. By 2028, the plan commits to improving cancer survival dramatically, increasing the proportion of cancers diagnosed early from a half to three quarters. That is why the NHS Funding Bill, with its commitment to an extra £33.9 billion a year for the NHS, is especially important.

There is, however, a question around how we turn the increased investment and that intent into the reality of improved outcomes. That is why we need to focus on what I term the “SAS”: better screening for the disease, greater awareness of the disease, and a breaking of the stigma attached to the disease. By doing that, we can make a real step change. I welcome the introduction of the targeted lung cancer screening programme, which I championed, and which is being rolled out as we speak. I commend the charities and the regular campaign events to highlight the symptoms and, yes, the importance of getting things checked out—especially for us blokes, who can be pretty rubbish at actually going to the doctors and doing something about it. The stigmas are linked to that, and we need to talk about the big C, because it is the disease that dare not speak its name. False judgments can be made, especially with something like lung cancer, because people may make wrongful assumptions that it must be perhaps the sufferer’s fault as they must have smoked. However, as one leading clinician said so effectively and succinctly at a recent conference I attended, “If you have got lungs, you can get lung cancer.”

All this needs to be looked at in context. We need the right workforce in place with the right equipment and the right systems and processes to back it all up. I welcome the Government’s commitment to increased investment in CT scanners and to increasing the overall number of nurses, but we need to recognise the particular role of specialist nurses and the incredible difference that they make. I look forward to the publication of Baroness Harding’s workforce planning review, and I hope that it sees this special group of nurses strengthened and supported and that their numbers will be increased.

There can be no doubt about the pressures that exist within the system and the increasing demands that our NHS has to meet, but the overwhelming experience of most people who use and rely on our NHS is positive, with a real appreciation of just how special it is. We need to continue to stand up for it, to champion it and to be positive about what more it can achieve. I have every confidence that we will and, in doing so, that we will help improve the lives of people it serves and the people we are privileged to serve as Members of this House.

Several hon. Members:


Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

Order. I ask for the usual courtesies during maiden speeches, please. I call Sarah Owen.

Photo of Sarah Owen Sarah Owen Labour, Luton North 1:39, 16 January 2020

It is a pleasure to follow James Brokenshire, and I am pleased to see that the NHS has got him back on his feet.

I am grateful for this opportunity to speak on health and social care, as the issue is very close to my heart. I start by paying tribute to the wonderful, dedicated staff at the Luton and Dunstable Hospital in my constituency. We should all be grateful to every single person who works there, from porters to paramedics, from healthcare assistants to operating department practitioners, and from doctors to nurses. They are dedicated but often overstretched.

I declare my interest as a proud member, and former employee, of the GMB union. I support the ongoing campaign against the outsourcing of housekeeping and domestic services at the L&D.

I know the devastating impact of outsourcing. As a carer working for an outsourced care company, I witnessed at first hand a business that put profit before patients. It was then, standing in front of a patient who desperately needed more than the 15 minutes I had allotted for her, that I knew our social care system was broken—and it is still broken today. All parties in this House must have the political will to mend it, because the frustration of health workers should not be underestimated.

My mother came to this country from Malaysia 46 years ago, and she is still an NHS nurse today. She is just like many people who come to this country from across the world to work in our fantastic NHS, and we should never forget the debt we owe them.

Mum came to see me swear in just before Christmas, and we took pictures by the Christmas tree in Westminster Hall. Her face went from smiley to thunderous in a matter of seconds. Usually that look is reserved for when I have done something truly awful, but it turns out she was not scowling at me; she was looking at the person behind me, which happened to be none other than the Secretary of State for Health. Joking aside, when we see the latest proposal to scrap four-hour A&E targets, who, frankly, could blame my mum?

The NHS goes to the very heart of my party’s principles. My predecessor, Kelvin Hopkins, embodies those socialist Labour principles. He represented Luton North for 22 years and is beloved by many in the town. But for all his and his wife Pat’s dedication to the area, what I am most grateful to them for is their daughter, my amazing hon. Friend Rachel Hopkins.

Together we will represent the people of Luton with equal energy, commitment and dedication to the town, because we will need to. Every cut to local government and every cut to every service has an impact on an individual we represent. Early-years providers like the fantastic Gill Blowers nursery, which I visited last week, are facing a cut of a quarter of their budget. Firefighter numbers in Bedfordshire have been cut by 9%. Each child in Luton North is £576 a year worse off. There are fewer police on our streets. All that comes against the backdrop of a hostile environment.

Even in these challenging times, Luton has always punched above its weight. Together, the people of Luton make the town the fantastic place it is. The mosques, churches, businesses and wider community have come together to support Luton’s food bank, making sure the most vulnerable in our community are looked after.

The entire community came together to make the dream of the new Power Court stadium a reality and to deliver the regeneration Luton wants. The Labour council led by Hazel Simmons works with communities to continue building much-needed council housing while facing over £100 million-worth of cuts. Time and time again, Luton comes together to say no to the hatred and division of the far right.

I learned through the trade union movement that we are stronger together and that we should not let people divide us. That is sound advice for any workplace, but it is a lesson for our communities and our country, too. The people of Luton North know this to be true. Luton’s diversity is its strength, and I am proud to be bringing up this little one in a multicultural town that comes together.

Yes, in case Members have not noticed, I am pregnant—it is not just a good Christmas. She is, in every way, a little mix. A mix of east Asian, Irish and British. She is essentially Luton in a baby. And, yes, she will be donning a Luton Town shirt and going to games in a brand-new stadium that will be fit for her generation and future Lutonians. Judging by how she is kicking me right now, she might even try out for the team.

In the face of the hatred we saw in the past, we on these Benches will have to be staunch defenders of the equality and diversity I know run to our country’s core. Just over the road, in the Cabinet war rooms, my grandma worked under Churchill during the second world war, while my grandad fought overseas with the Royal Engineers. They fought against vile fascism then, just as we must all renew our fierce opposition to those who discriminate against or dehumanise others in every corner of the world, from Luton to Kashmir to Hong Kong.

It was not racism or hatred but the need for change that drove people to Brexit, and we must all hear that call for change. Luton has a proud manufacturing history, from Vauxhall to Electrolux, and it needs a future to be proud of, too—one that provides the decent housing, good schools, affordable transport and well-paid jobs that every Lutonian not only wants but richly deserves. As their MP, that is exactly what I will fight for in Luton North.

Photo of Fiona Bruce Fiona Bruce Conservative, Congleton 1:45, 16 January 2020

I congratulate Sarah Owen on her speech. It was a pleasure to listen to such a clearly articulated speech by a new Member, with humour thrown in. I am sure she will be a very caring and committed Member of Parliament for her constituency.

I am delighted that this one-nation Conservative Government want to level up opportunity across our country, particularly in areas like Burnley, where I grew up and where we now celebrate a new Conservative Member of Parliament. I welcome the words of Her Majesty in the Gracious Speech:

“A White Paper will be published to set out my Government’s ambitions for unleashing regional potential in England”.

In order to truly release the potential of all our communities—to promote healthy, caring and resilient communities—we need to strengthen families. Colleagues may not be surprised to hear me say that.

The Conservative manifesto said on page 14:

“A strong society needs strong families. We will improve the Troubled Families programme…to serve vulnerable families with the intensive…support they need to care for children—from the early years and throughout their lives.”

I believe we need to do much more than support troubled families, not that the news two weeks ago of a £165 million boost to extend the troubled families programme is unwelcome—it is welcome. We now need to build on the good work of the previous Conservative-led Government and broaden our commitment to help strengthen families. Indeed, why not rename the troubled families programme as the wider “strengthening families programme” that it should be? Every family goes through challenges, and every family needs support at some time.

I also welcome the Prime Minister’s commitment at last week’s PMQs to champion and support family hubs, which every Member of Parliament could similarly promote and champion locally. Family hubs are a practical way to help strengthen families, with a place in every local community offering help to families as and when they need it. More of that shortly.

Building a stronger, healthier society surely starts with the family, the basic building block of society. When we fall on hard times or become seriously ill, our family is often the first port of call. Our family, at best, teach us our values, shape our identity and nurture our sense of responsibility to society.

Weakness in our family units—when they are dysfunctional, when they disintegrate or when our closest relationships do not work and we become distressed about them—has repercussions in so many ways. It can increase children’s mental ill health and insecurity, preventing them from attaining their best education and employment potential. It puts pressure on GP surgeries through increased rates of depression, addiction and other ailments. It puts a strain on housing provision when families split up, and it increases work absenteeism, exacerbates loneliness in old age and makes state provision for elderly care completely unsustainable. In other words, it makes not just our families, but our wider communities less cohesive, less healthy, less productive and less resilient to the inevitable shocks that life throws at us all.

If we really mean what we say about levelling up those parts of our country that feel they have been neglected, we must realise that we will never achieve that simply by repairing neglected physical infrastructure, such as roads and bridges, good as that is. If we are really to make a local-lasting, generational difference in the lives of people who feel left behind, it must surely also mean helping them to strengthen local communities where relationships have fractured. That should mean, as a priority, strengthening families, so that they can not only flourish but contribute positively to those local communities going forward.

Family breakdown is serious, socially, culturally and economically, and this country has one of the highest rates of it among 30 OECD countries, yet successive Governments have shied away from accepting and addressing this. Let this Government be bold and different. Why? Because the young, the poorest and the most vulnerable pay the highest price when family life fractures, with children from fractured families being twice as likely to develop behavioural problems and being more likely to suffer depression, turn to drugs or alcohol, or perform worse at school and not achieve their job or life potential. There is an increased chance of their living in income poverty in the future and of their own relationships being less stable in adulthood.

It is not just children who suffer from family collapse. Divorce and separation have led to increasing estrangement between elderly parents and older children in later life, with growing loneliness among older people. More than a quarter of a million people over 75 in this country spent this Christmas day alone. This epidemic is causing widespread misery and impeding the life chances, health and wellbeing of millions of people. It is a national emergency that should warrant the same level of concern and attention as climate change. It should warrant the Government reshaping their Departments, for it affects almost all of them. It requires a Cobra-style committee to pull together across Government to champion families and not condemn another generation to the destructive effects of dysfunctional family relationships. At its worst, we see that in people’s involvement in county lines; reportedly, it involves as many as 10,000 young people, with many seeking the comfort of a gang to replace that of a family.

It is a tragedy that more than a million children in this country today have no meaningful contact with their father. The poorest and working-class families are bearing the brunt of family breakdown most. Such families are more prone to break up and they are less resilient when it happens. Greater financial security inevitably allows for insulation from some of the pressures that often drive poorer people apart or result from their splitting up.

What should be done? First, we need to champion the strengthening of families right across Government and as individual Members of Parliament. The public want us to do that. Recent polling by the Centre for Social Justice shows that 72% of adults believe that family breakdown is a serious problem in Britain and 81% think that strengthening families is important in order to address our current social problems. That should start with focusing on communities that feel they have been left behind and that feel dislocated, with a loss of belonging, where there has been a rise in poverty and street crime.

We should focus on places where people feel unequal and where there are high levels of children in care and a large proportion of isolated adults. Government must champion the family—that must be central to the way that every Department thinks, because family policy does not fit neatly into a single Department. There should be a Cabinet lead and an office for family policy, and every Department should develop a family strategy. The family impact assessment—also known as the “family test”—should be put on a statutory footing. We could do worse than to have one of the Members successful in last week’s ballot pick up the oven-ready Bill that I introduced on this issue in the last Parliament.

However, I am delighted that the Government are committed to championing family hubs, as those are one way in which we can all help to strengthen our local communities and family life within them. What are family hubs? I will not take much longer, Mr Deputy Speaker, but let me say that they are one-stop shops offering a range of support and specialist help to parents, couples and children, aged nought to 19 and beyond. That can include relationships counselling and mental health services, childcare, early-years healthcare and employment support. They provide help with a troubled teen or a carer, and much more. They are backed by the local authority but they work in conjunction with charities and local businesses. They bring together statutory and voluntary approaches and are currently developing in half a dozen towns across the country.

The hubs are proving that they can have significant outcomes, with children and young people feeling safer; families being helped to improve parenting and children’s behaviour; mothers and children having better emotional wellbeing; good lifestyle choices being made; and families being more resilient when shocks occur. We need more of these hubs. Let us avoid the trap of previous Governments, where families remained everyone’s concern but nobody’s responsibility. Let us take up our responsibility as a one-nation Government to fulfil our manifesto commitment to strengthen families and strengthen society.

Photo of James Murray James Murray Labour/Co-operative, Ealing North 1:56, 16 January 2020

Thank you, Mr Deputy Speaker, for calling me to give my maiden speech. I will begin by giving my heartfelt thanks to the people of Ealing North for putting their trust in me, and I would like to thank one resident of Ealing North in particular: Mr Steve Pound.

Every morning in the run-up to the election, Steve and I would drive to a primary school to speak to parents outside the school gates. Those car journeys were filled with stories about Ealing North and jokes that were as funny as they were often unrepeatable. The warmth and affection the parents showed toward Steve was awesome and inspiring, and it was typical of people across Ealing North and beyond. It could be a little intimidating too, as he leaves very large boots to fill, but I drew some comfort on that front from Steve’s own maiden speech. Using characteristically direct language, he said of one his predecessors:

“I am somewhat tired of constantly being told how I compare to the right hon. Gentleman.”—[Official Report, 10 November 1997; Vol. 300, c. 606.]

During the election Steve was unfailingly kind and generous when introducing me to people. He would tell them that I would be just as diligent an MP as he had been, but with more hair. I cannot guarantee my hairline after a few years in this place, but I know that nothing will recede about my determination to work tirelessly for the people of Ealing North.

It is the honour of my life to represent the place where I grew up. Before Christmas, I visited Perivale Brewery, on Horsenden Farm, just down from Horsenden Hill, where I used to fly my kite when I was a boy. Last year, I ran the Ealing half marathon, on behalf of the Ealing Churches Winter Night Shelter, through Pitshanger Park, where I used to collect conkers with my grandmother 30 years ago. Those places, and others along the River Brent, Northala Fields and many more besides make up Ealing North’s wonderful greenery. They offer a calmness to balance the pace of life in part of the greatest city in the world and, let us be honest, the stress of traffic on the A40. But Ealing North is defined not just by its physical highlights; it can also be described by the strength of its many overlapping communities.

Our part of London is home to communities from India, Pakistan, Poland, Ireland, Somalia, Sri Lanka, Armenia, Afghanistan, Iraq and Iran, and many more besides. It is home to LGBT+ people building their lives and their families. It is home to people of all faiths who have invited me in, at St Mary’s, St Barnabas, St Stephen’s, Ealing Gurdwara, Shree Jalaram Mandir, the Greenford Central and Bilal Masjid mosques, the Ealing Liberal Synagogue, All Hallows, Holy Cross and many more besides. Our community organisations also bring people together, whether at the Royal British Legion Club or at the Wood End Residents’ Association’s legendary Christmas party. Members of the community look out for each other. Just last Saturday, volunteers were busy running the Ealing Foodbank next to my surgery at Greenford Methodist Church. Those volunteers deserve our deepest thanks and, as their MP, I will do everything I can to end the injustice in our society that makes their work vital.

I will work day in, day out, for the people of Ealing North. We need investment in public services so that our young people are safe from getting involved with or becoming the victims of crime. We need investment in new, high-quality council homes to make sure that everyone has a decent and secure place that they can afford.

I will stand up for a foreign policy that always avoids the rush to war. At my surgery on Saturday, a woman spoke to me through tears about her parents’ desperate situation as Iraqi refugees in Jordan. It was heartbreaking, and those in power should never forget that our country’s mistakes around the world cast a very long shadow.

I will fight for the health and social care system that we need, which is something that the people I represent so clearly and dearly want. It is also very personal for me. In the late 2000s, I was diagnosed with a rare, long-term neurological condition called myasthenia gravis. It causes muscle weakness, which made it difficult, or sometimes impossible, for me to do things like go running, speak at length or smile. But the NHS came to my rescue. My wonderful consultant and all his colleagues got me through a major operation and on to a painstakingly calibrated set of medications. I have been symptom-free since the early 2010s, and I will fight every day for our NHS with the strength that it has given me back. [Hon. Members: “Hear, hear!”]

As the MP for Ealing North, I draw strength from local campaigners and their enormous determination to protect our NHS, and particularly local services that have been under threat. In 2015, the maternity unit at Ealing Hospital was closed. Since then, no babies have been born in hospital in Ealing. In 2016, the children’s A&E closed, too. Plans to close the main A&E were, in a triumph of public pressure, finally dropped after a seven-year fight, but across the London North West University Healthcare NHS Trust, waiting times in A&E last month were over four hours for 39% of patients.

Across the country, our beloved NHS is creaking, yet the promises made by the Government are, as the Health Foundation has said,

“simply not enough to address the fundamental challenges facing the NHS’.

The Government have also failed to offer the plan or funding needed to fix the crisis in social care.

We must win the battle for the NHS and the social care system that we need. That is what I will fight for on behalf of the people I represent, and I thank them again for the honour of allowing me to do so. They must know that I will never flinch from my determination to fight for a fairer future for Ealing North, for our country and for our world.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich 2:02, 16 January 2020

First, may I draw your attention, Mr Deputy Speaker, and that of all Members to my declaration in the Register of Members’ Financial Interests as a practising NHS psychiatrist?

Before I address the motion and speak in support of the Queen’s Speech and its focus on health and social care, I pay tribute to James Murray. I have no doubt that he will have the eloquence of his predecessor—somebody we in the House knew for his many jovial speeches. I also have no doubt that he will match the diligence that his predecessor showed as a constituency MP in fighting for the needs of his local residents, not least by standing up for his local NHS and maintaining a health service locally that meets the needs of people in Ealing. I wish the hon. Gentleman very well in all that he does in this place.

Many commendable and positive things can be recognised in the contribution by my right hon. Friend the Secretary of State. He rightly talked about the need for increased investment in the health service and about the need to support the staff who work on the frontline. He rightly identified the need to improve mental health provision and talked about the need to find political consensus on social care.

I intend to talk briefly about a couple of those issues, but before I do so it is worth observing that we now have a new Prime Minister and the Government have a strong mandate. That is an opportunity to reflect on what we could do as a Government to improve the legislation that we ourselves have passed that has perhaps had unintended consequences. There is a particular concern among patients and people who work in the NHS about the fragmentation of services, which has been the result of the sometimes market-driven approach to the delivery of healthcare and the encroachment of the private sector on the delivery of traditional NHS services.

As a clinician, what matters most to me is that we deliver the right services for patients. We need to recognise that the involvement of private sector provision has sometimes led to greater fragmentation and a lack of joined-up care for patients. In particular, if we look at how addiction services are commissioned, we see the impacts of that on increasing homelessness and people not getting treatment in a timely manner, or on the joined-up care with the NHS afterwards. If we look at how some sexual health services are now commissioned, we see that they are done in a fragmented way that often lets patients fall through the cracks. With a fresh mandate and a new Prime Minister, I hope we have an opportunity to look at that and be honest that the answer is not always in the market—that the answer is in well-funded, properly delivered public services that are free at the point of need and often run by the state. We have to be honest about that and recognise where we could do things better in future.

The second point I wish to make is on the need to value our staff. NHS staff have had a difficult period, with wage restraint and morale issues—for example, as a result of the junior doctor dispute. We also need to recognise the challenges relating to the NHS workforce that Brexit has brought into focus. We are very reliant, and have been historically, on the contributions made by members of the NHS who come from all over the world, from within the EU and from throughout the country, and frankly our NHS could not work without them. We are very grateful for those contributions and it is right that we support those people in our NHS.

Of course we need to focus on improving the number of British-trained graduates across the health service, but we also need to recognise that the staffing crisis is the biggest issue that we now face. If we want to realise the ambition to increase nursing numbers and GP appointments, we have to recognise that across the piece there is a need to take staff training, recruitment and retention seriously. We need to look at the fact that in different parts of the United Kingdom—for example, the north-west or the north-east—there are fundamental staffing challenges and a difficulty in recruiting and retaining staff that is much more acute than it may well be in the south of England. I know the Government want to look at that, but we need to come up with meaningful answers.

We need to look overseas at examples in Australia, where they have to cover a very large land mass. They have had challenges attracting staff to work in parts of rural Queensland and the Northern Territory; we need to take lessons from those healthcare systems and apply them here so that we can address workforce shortages on the frontline. Without the staff, we cannot deliver the care. It is all very well to talk about improvements in patient safety and other things, but unless we have the staff to do it, we cannot deliver it. I hope that there is now an opportunity for the Government to grip these issues. Staff planning takes more than just one parliamentary cycle until the next general election; it is a five or 10-year mission, but it is one that we need to grip now if we do not want to have lasting workforce shortages in many regions of this country.

In particular, I draw the attention of those on the Treasury Bench to the challenges that we face in mental health. It is absolutely right and commendable that we have focused on destigmatising mental health and on the importance of mental health liaison services. Professor Simon Wessely did a welcome review of the Mental Health Act 1983 that was long overdue. I am sure we will address those issues.

We have to recognise that community mental health services have been substantially the Cinderella of mental health services for far too long. If we want to improve care and prevent people with mental ill health from getting so unwell that they need to turn up at hospital, we need to recognise that the primary focus of investment in mental health services—indeed, one of the issues we face is a staffing crisis in mental health, with reducing numbers of frontline mental health nurses in the community—must be in community services. They have been hollowed out for too long and now need investment.

Photo of Eleanor Laing Eleanor Laing Deputy Speaker and Chairman of Ways and Means

Order. I hesitate to interrupt the hon. Gentleman, but he has now spoken for seven minutes and we are on a six-minute time limit, so I know that he will finish soon.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich

Thank you, Madam Deputy Speaker. I am sure that Members on the Treasury Bench will take away and look at the issue I just outlined.

The Government are rightly looking for political consensus on social care and on finding a sustainable funding formula. However, as part of that, they should also consider how social care services need to look. It is no good bringing in money when the mode of delivery is wrong. I hope that, as part of the consensual approach, there will be a renewed focus on delivering care in the community in an integrated way, thus joining up the health and social care systems. I hope that that will be part of the important review and the approach to political consensus that the Government are trying to deliver.

Several hon. Members:


Photo of Eleanor Laing Eleanor Laing Deputy Speaker and Chairman of Ways and Means

Order. The reason why we do not have a formal time limit is to try to help people who are making maiden speeches. It is difficult to make your maiden speech against the clock. It should not be difficult for people who have spoken in the Chamber many times to speak for six minutes, so when we get to six minutes, I will call “Order.” I call Julie Elliott.

Photo of Julie Elliott Julie Elliott Labour, Sunderland Central 2:10, 16 January 2020

Thank you, Madam Deputy Speaker, and I will take that amount of time.

I want to speak today on eating disorders, an issue that is important to me and many of my constituents and friends who have approached me about the subject. Awareness of mental health issues has been on the rise, with recent examples such as the Football Association’s Heads Up campaign encouraging people to take a minute out of their lives to think about their mental health. The ongoing work of organisations such as Mind and Beat has meant good progress on combating the stigma of mental health issues and informing the public about the importance of taking care of mental health.

There is undoubtedly still a lot of work to do on eating disorders. It is such an incredibly important and pressing issue, and at the same time so preventable with proper support, funding and attention, that I am disappointed that it was not named in the Gracious Speech as a subject on its own. The only mention of mental health is:

“My Ministers will continue work to reform the Mental Health Act.”

I very much hope that eating disorders will be part of the reform.

There is a major problem with the way eating disorders are dealt with in this country. From poor staffing levels to the way disorders are diagnosed and the wait to be treated, too many people who need treatment urgently do not get it. More than 1 million people in the UK suffer from an eating disorder and it is about time they got the services they deserve.

As Hope Virgo has shown in her excellent Dump The Scales campaign about the diagnosis of eating disorders, multitudes of people around the country are being turned away by their GPs as a result of their body mass index not being low enough. They are being refused treatment, not because of any psychological assessment, but because their weight is not low enough. Although National Institute for Health and Care Excellence guidelines advise against the use of single measures such as BMI to determine whether to offer treatment, that does not mean it does not happen. As much as I would like to present case study after case study of young people being turned away from treatment because they were not considered ill enough, only to go on to do more damage to their bodies in the hope of actually receiving treatment, time does not allow it. But it happens, and that has to change. It is shocking that it has happened once, but we are talking about hundreds of people being turned away from services they desperately need.

Those first connections with medical professionals are so important, not least because of the bravery shown by sufferers in seeking help and talking about their illness, but also because the earlier the treatment is administered, the more effective it can be. Identifying problems as early as possible does not just allow people to be treated quickly and more efficiently, but can mitigate the long-term effects of illness and decrease the chances of relapse. Early intervention is the key to proper treatment for those suffering from eating disorders. It might mean that the person seeking help no longer needs a hospital stay, or that they recover quicker, or that they feel stronger fighting their illness knowing they have the support behind them that they need. That is why the Government need to do a full review of treatment and care pathways for people who suffer from eating disorders and ensure that there are services that people can approach, and that they can be treated quickly and effectively.

However, there is also a big variety in quality and speed of treatment depending on where people live in the country. We need to see the end of the postcode lottery, which means that the quality and speed of care is based on where people live and what age they are, and sometimes ends in those lucky enough to be referred being sent to hospitals more than 200 miles from where they live. Only yesterday, I saw a letter to a young woman who, after an urgent referral, has been told she should expect an 18-month wait to be seen by a psychological therapist. That is truly shocking. I therefore fully agree with the calls on the Government by leading eating disorder charity Beat to hold the NHS to account for comprehensive implementation of the access and waiting time standard for children and young people in every region and community.

There is desperate need for direct investment in a fully supported NHS that does not need to divert the funds assigned to mental health to other areas to plug massive funding deficits in an attempt to continue to provide basic care.

We also need to ensure that our medical professionals understand the signs of eating disorders and the pathways available. Trainee doctors can receive as little as two hours’ training on eating disorders throughout their several years of training. We need to invest in services to get parity of esteem for mental and physical health, and there are simply not enough beds to deal with the growing demand from those suffering from eating disorders and those who need mental health treatment more generally.

We need more staff. Those who work for the NHS are stretched as it is, and we need more staff in frontline services to help ease the pressure and ensure that treatment is effective and quick. We need more and proper support in our schools. I implore the Government to act on those measures.

Photo of Laura Trott Laura Trott Conservative, Sevenoaks 2:16, 16 January 2020

Thank you, Madam Deputy Speaker. Politics has become something of a dirty word in recent years, but during the election campaign, thousands of activists from all parties throughout the country went out in the cold, the dark and the rain because they truly believe that their political viewpoint can make people’s lives better. Across the House we may disagree, often vigorously, on how to do that, but I truly believe that public service is why we are all here.

A true example of that public service was my predecessor, Sir Michael Fallon. I know Sir Michael was a friend to many in this place. He served my constituents in Sevenoaks and Swanley for 22 years, and those in Darlington before that. He served as a Minister under four Prime Ministers, first under Margaret Thatcher as schools Minister, a role he also played under John Major. He was responsible for setting up school league tables and Ofsted—huge leaps forward for the accountability and performance of schools in this country. Sir Michael also served under David Cameron and my right hon. Friend Mrs May. Despite his unofficial title as Minister for the “Today” programme, he was in fact a Minister in the Department for Business, Innovation and Skills and in the Department of Energy and Climate Change. He was latterly Secretary of State for Defence—a role that he both excelled at and relished, although I must say, as the person responsible for running the No. 10 grid at the time, it is possible that he did not always manage to run his announcements past No. 10.

Sir Michael was, above all, a strong voice for Sevenoaks and Swanley constituents, an example I am determined to follow. Sevenoaks is a wonderful constituency, with a vibrant community and excellent schools, and it is over 90% green belt—something we must maintain. It is an honour to represent the constituency that houses Chartwell—Winston Churchill’s former home—as well as Chevening, the Foreign Secretary’s residence. I am very much looking forward to an invitation to visit.

Although the constituency is known for both its greenery and transporting much of its population to work in London, there is significant entrepreneurship, with 7,000 businesses in Sevenoaks. We are also developing some fantastic expertise in wine and beer. Squerryes, Westerham Brewery and the Mount Vineyard are creating world-class produce and deserve to become international brands.

I also pay tribute to my brilliant local district council, led by Peter Fleming, who has won numerous awards for his stewardship, and at a time of great fiscal strain made Sevenoaks District Council financially independent. Equally, Roger Gough, the talented leader of Kent County Council, has done so much to deliver the excellent standard of schools throughout the constituency.

I should move on to the health service, which is the main topic of debate today. All of us here will have stories of how the NHS has helped us, and we have heard some incredibly moving ones from my hon. Friends today. My now thriving one-year-old twins were born six weeks early and needed help to breathe and to eat when they were born. I owe the neonatal teams in our NHS everything and I will be forever grateful.

I worked on maternity care and choice policy when I was a special adviser, and it is something that I will continue to speak up for in this place. We must, and I know that we will, ensure better care for women in maternity, ensure that pain relief is freely and readily available, give women a full choice of options on how and where they want to give birth, continue to improve outcomes for multiple births and deliver on our brilliant promise to extend maternity leave for mothers of premature babies.

It has been striking this week that the focus of maiden speeches has been on the importance of social mobility and education. In speeches by my hon. Friends the Members for Wantage (David Johnston), for Eastleigh (Paul Holmes), for East Surrey (Claire Coutinho) and for Stoke-on-Trent North (Jonathan Gullis), among others, it is truly heartening to witness the breadth of expertise, diversity and interest that our intake takes in these issues. I will add my own name to the list of those speaking out on this topic.

I went to a comprehensive and was the first in my family to go to university. My grandfather on one side was a milkman and, on the other, a doorman at The Sun. My grandmother was one of the smartest people I have met. She got a scholarship to a good school, but was not allowed to go as they could not afford the uniform. The thing that changed the fortunes of my family was the great education that my mum and dad received. That is why I am incredibly proud of the Conservative party’s legacy in delivering higher school standards, not just by putting money in with that reform, but by being fearless in demanding better for our children, calling out the soft bigotry of low expectations that my right hon. Friend Michael Gove so rightly addressed and that my right hon. Friend Gavin Williamson is continuing to work on.

The levelling up in funding that we have promised is the key next step, but equally important, as with all public services, will be the inspection regime making sure that this leads to higher standards being delivered. The true test of our system is whether we can improve the outcomes for those who need it the most. There are more than 2,000 children in care in Kent. We have taken huge steps forward in addressing their complex needs and improving their educational attainment, but we must do more, and I know that this is a Government who will do so.

I thank the House for listening. Politics done well is making people’s lives better and I am delighted to be part of this one nation Conservative Government, who I am certain will give so much to my constituency and to the country.

Photo of Liz Twist Liz Twist Labour, Blaydon 2:22, 16 January 2020

May I start by congratulating Laura Trott on an accomplished and thought-provoking speech? I am sure that she will represent her constituents well.

I am very pleased to be able to take part in this important debate on health and social care. Earlier this week, I chaired a breakfast roundtable organised by the Industry and Parliament Trust, bringing together industry representatives, third-sector organisations and parliamentarians to discuss the issue of suicide in the construction industry. As chair of the all-party group on suicide and self-harm prevention in the last Parliament, I am familiar with the statistics on the number of lives lost to suicide and the statistics that show that middle-aged men are particularly at risk. However, even I was shocked to hear that two construction workers each day die by suicide and that twice as many die by suicide as those who die falling from heights.

A huge amount of work has rightly been done on reducing the physical risks in the construction industry. I am glad that there are now moves by some employers and charities such as Mates in Mind to put the same focus on tackling mental health issues and preventing suicide in the construction workforce. There are issues and problems caused by job and financial insecurity, physical stress, working away from home and loneliness.

I want to speak about the wider issue of suicide prevention. I am glad that the Minister is in her place to hear this. Last year, the number of deaths by suicide in the UK rose significantly—an increase of more than 600 on the previous year. There were 6,507 deaths by suicide in 2018. The statistics show that middle-aged men remain the highest risk group, though rates among young people, too, are rising. This is at a time when there is increased talk of improving mental health services in the NHS plan and a focus on suicide prevention. Clearly, the Government need to be doing more for individual people and at policy and practice level to reduce those figures.

Suicide is a public health issue. It is startling to know, from work done by the University of Manchester in 2018, that two thirds of people who take their own lives are not in touch with mental health services in the year before they die. A way needs to be found of reaching out to these people. We know from work by the Samaritans and others that socioeconomic factors are often at the root of the desperation which many people feel. Low incomes, job insecurity, unemployment, housing problems and benefits issues all play their part. Although there is a cross-Government suicide prevention work plan, what needs to happen is for each Department to take clear actions to make a real difference. I understand that the Department for Work and Pensions, for example, has no concrete actions from the plan, but those of us dealing with constituents on a day-to-day basis will know that that Department has a real impact on people, especially when they are struggling.

Most local authorities do now have suicide prevention plans, but the Government must do more to make sure that those that do not, develop them as a matter of urgency, and that those that do, follow up the written plans with action and share experience and best practice. I have to say that reducing public health funding is tying the hands of those local authorities that are translating those plans into actions and real interventions.

Some £57 million has been made available for suicide prevention, but those of us who have tried to track it with our local health services have found it difficult to identify what specific actions that translates into when it is spread so thinly that it is almost invisible to see in the budget. Local NHS services need to make sure that the gaps in services, which too many people can fall through, are filled in. For example, there must be a way for people who are considered “too suicidal” for talking therapies to be able to access secondary mental healthcare more quickly, and non-clinical services need to be available, too.

I have already mentioned the fact that middle-aged men on low incomes have been the highest risk group for many years. Much more needs to be done to understand what really works to support this group when they are struggling. Research, again by the Samaritans, shows that the poorest men living in the most deprived areas are 10 times more likely to take their own lives than the wealthiest living in more affluent areas. We really need some concrete action to address that.

I wish to speak briefly about self-harm. Levels of self-harm among young people are rising. There is a real stigma around self-harm that stops people seeking help. Most people who self-harm do not go on to take their own life, but there is evidence that many people who do have self-harmed in the past. It is a sign of deep emotional distress and people who self-harm must have access to support to identify why they are feeling that distressed. Plans are needed in that area, too.

In summary, suicide prevention is a public health issue and should be tackled as such. Low-income middle-aged men are at the highest risk of suicide and we need to tackle and identify the causes of that and develop accessible services. Levels of self-harm are increasing and need to be tackled now. The Government need to do much more to address this issue and they need to put more resources into both the NHS and the local authorities to reduce the number of people dying by suicide.

Photo of Damian Green Damian Green Conservative, Ashford 2:28, 16 January 2020

It is always a pleasure to follow Liz Twist. As somebody who is in the early weeks of their seventh Parliament, I can say that I have therefore sat through many waves of maiden speeches over the years. The quality of the speeches that we have heard not just today—we have just heard from my hon. Friend Laura Trott and from several Members from the Labour Benches—but throughout this debate over the past few days has been breathtakingly high. As somebody who has been round the block a few times, I can say that that is not only very welcome, but slightly alarming.

What I want to do is concentrate specifically on the social care element of today’s debate. It is a hugely important part of the wider health agenda and also obviously vital in its own right. I welcome a number of elements in the Government’s approach. The first is the recognition of the urgency of the need to solve the issue of social care, which has been left on the backburner for far too long. The second is the desire to work on a cross-party basis. I appreciate that that is going to be challenging for the Opposition Front Benchers over the next three months, because they will have other things on their mind, but for the past 18 months I have been working from the Back Benches with both Labour and Lib Dem Members. Although none of them are here at the moment, there are Lib Dem Members who are interested in this issue. I think that that cross-party approach is the best one. The third element is the Government’s recognition that the system today is incredibly fragile and needs extra money to tide it over. I am glad that the Government are helping local authorities with £1 billion in the coming year, but although it may be the world’s most expensive sticking plaster, it is still a sticking plaster, and we all know that we need a much more wholesale approach.

Many aspects of the problem need solving. There is the question of where the workforce are going to come from. Home adaptations will be needed so that more people can live in their own homes for longer. We will need the provision of extra places in care homes, where a shortage is developing. There are also problems when it comes to dementia patients. I think the Alzheimer’s Society has sent many Members a briefing for this debate, and everything it says is very sensible, but beneath all these questions is the issue of money. Where is the extra money going to come from? If there were a simple solution, a Government would have adopted it a long time ago.

I warn Ministers against reaching for the simplest and easiest solution, because the easy solution is to say, “We’ll make it free and we’ll fund it out of general taxation.” That is easy and seductive, because many people think social care is free anyway, but that would be wrong and unfair. It would be wrong not just because of the public spending implications, but for intergenerational fairness. If we fund the solution from the taxation paid by working-age people, we would be telling 20, 30 or 40-somethings not only that we are going to tax them to pay for their own social care if they need it in the future, which would be fair enough, but that we are also taxing them to pay for the social care of their parents’ generation, which would not be fair. That would be particularly unfair in this country, where there is a preponderance of wealth among the baby boomer generation. So much of the wealth in this country is tied up in housing, and that generation are far more likely to own their own homes than their children’s generation.

Photo of James Cartlidge James Cartlidge Conservative, South Suffolk

My right hon. Friend is making a brilliant speech, with great passion. Surely the definition of “sustainable” here is someone in their 20s who is entering the workforce and being asked to pay into a new system believing that the same quality of care will be available when they reach their 70s or 80s. That will not be the case if the model is unsustainable.

Photo of Damian Green Damian Green Conservative, Ashford

My hon. Friend is exactly right, and I wanted to talk briefly about the various ways in which we can achieve a sustainable system. We could have a compulsory social care payment that is made by everyone of working age and, indeed, beyond working age. That has been recommended by Select Committees of this House. Alternatively, I would suggest that we could have not a tax, but a hugely desirable saving, based on the model of the pension system, whereby the vast majority of people are encouraged to—and do—subscribe to auto enrolment pensions, but it is not compulsory.

In that pensions model, we would have the equivalent of a state pension—a universal care entitlement—which would have to be better than the current provision of care. On top of that, we would urge millions of people voluntarily to save for a care supplement, as they do for a private pension. That would guarantee them the quality of care that they would want in their old age. Of course, not everyone will be able to make those savings, and the system needs to be better for those who cannot contribute towards their own care if they need it in old age, but it is essential that we use this massive wealth, particularly among those who are 60 and above; a small sliver could help us to achieve these aims.

At the moment, the equity in housing of those over the age of 65 is £1.7 trillion. Just a small sliver of that would provide a much greater sum of money and therefore a much more sustainable system. The Prime Minister is absolutely right when he says that nobody should be forced to sell their own home to pay for care. People have worked for that, and will want to give some of it to future generations, but a small sliver saved into the sort of insurance system that I am suggesting would make a huge difference and would put the social care system on a sustainable level.

I have a final thought, which puts these ideas in the wider context of today’s debate. If we do not sort this issue out, the long-term plan for the NHS will not work. The 2020s need to be a decade of hope for the NHS, and every one nation Conservative will want that to happen, but to make that real we need to solve the social care crisis. I wish Ministers well in achieving this, and urge the House to reject the Opposition amendment.

Photo of Feryal Clark Feryal Clark Labour, Enfield North 2:35, 16 January 2020

I am grateful for the opportunity to make my maiden speech in this important debate, and deeply honoured and humbled to stand in this great Chamber. As a child refugee who arrived in Britain with her family 30 years ago, I could never have dreamed that I would have the privilege and responsibility to serve my adopted country as a Member of Parliament. I would like again to express my thanks to the people of Enfield North for putting their trust in me. I am steadfastly committed to being their voice and their champion.

I pay tribute to my predecessor Joan Ryan, who served Enfield North diligently from 1997, with only a brief gap. Joan was a dedicated public servant, committed to representing local issues, and a brave and outspoken advocate for causes close to her heart. We share a passion for local government, having both served as councillors and then as deputy leaders. We both have concerns over the cuts to our health service, and a determination to reduce the harmful impact on constituents in Enfield North. I am sure that the whole House will join me in wishing Joan well in her future endeavours.

I am the first MP of Turkish Kurdish heritage to be elected to Parliament. I am also the first MP of the Alevi religion; although there are between 300,000 and half a million believers in the UK, they are underrepresented in public office. I also thought I might be arriving as the shortest MP but I am assured that, at 5 feet, I am a whole half inch taller than my hon. Friend Tulip Siddiq. I hope that we can be an inspiration to vertically challenged women everywhere.

My constituency is varied in every sense of the word. It is diverse in culture and privilege, and has contrasting landscapes. Enfield is a bustling market town with rural spots of natural beauty, and a place where people from across the world have found their home. We are proudly home to Forty Hall vineyard, which produces delicious, organic English wine, which I can wholeheartedly recommend to my colleagues who are so inclined. We host Enfield Town football club, which is fan-owned and an example to local football clubs across the UK. I am personally delighted to boast about having the Tottenham Hotspur academy in my constituency; it truly trains the cream of the football crop, as I am sure the whole House will agree.

I am extremely proud of the diverse population of Enfield North. Our diversity is our strength. I am committed to representing all the communities who live alongside each other in support and solidarity. Some 6.8% of my constituents hail from other parts of the EU, and they can be assured that I will stand up for them during every step of the Brexit process, fighting for their rights to be protected and for promises made to them to be kept.

There seems to be a tradition in the House of emphasising the contrasts in our constituencies, but Enfield North really is a tale of two cities. On the west side, we have the beautiful greenbelt land, numerous golf courses and the prosperous town centre. On the east of the borough, however, it is a different story. The A10 is the dividing line of wealth in my constituency. We all know that poverty has a knock-on effect on health, and when you cross the A10, you sadly find that the life expectancy there is significantly reduced. The rates of child poverty in the east of the borough are among the highest in the country, as are the levels of homelessness. The east is crying out for more investment, but Enfield Council’s budget has been cut by more than £100 million since 2010, leaving vital services wanting.

My constituency also faces significant challenges from crime. Cuts to youth service budgets and the loss of 240 police officers over the past 10 years have culminated in far too many tragedies of young lives being lost or ruined, to the extent that groups of parents are now taking it upon themselves to patrol the streets in the hope of keeping their children safe. How has it come to that? The Government have made much of their pledge to restore 20,000 police officers, and I will campaign for my borough to get its fair share.

By far the biggest issue for my constituents is the topic of this debate. Already my constituency has seen a steep decline in healthcare over the past 10 years, and the forecast is no brighter for the next. Some 10% of GP practices have been recorded as closing since 2013. GPs are desperately overworked, with the number of patients having risen by 23,000 since 2015, but with no rise in the number of GPs to treat them. Parts of my constituency, such as Enfield Chase ward, do not have a single GP surgery.

In 2010, Chase Farm Hospital was downgraded, leading to the loss of its A&E facility, maternity unit and other specialist departments. My constituents now have to go elsewhere for medical emergencies, leading to pressure on neighbouring hospitals in Barnet and on North Middlesex Hospital. Spending per head on healthcare in Enfield has reduced by 16% since 2015, which puts the symptoms of dereliction in our health service into context.

The last bastion of support locally is the urgent care centre in Chase Farm Hospital, but its survival is not certain. I hope the Minister can assure me that the urgent care centre in Chase Farm Hospital will not have its hours reduced, and that my constituents will not experience any further decline in healthcare.

I hope that I have managed to shed a small amount of light on my constituency in all of its glory and challenge. I am ambitious for Enfield, and I believe it has great things to come, but we need the support of our Government to see our young people flourish, our businesses thrive and our healthcare system repaired. I pledge to my constituents to be their persistent champion, and what I lack in height, I will make up for in voice.

Photo of Jackie Doyle-Price Jackie Doyle-Price Conservative, Thurrock 2:42, 16 January 2020

It is a pleasure to follow the maiden speech of Feryal Clark. She has just proved that what she lacks in height she makes up for in her energetic performance, and I have no doubt that she will give the Treasury Bench considerable challenge in the future. So many firsts, but I must congratulate her specifically on being the first refugee Member of Parliament. Does not that show that this country is open and liberal, and welcomes those from all parts of the world, whatever their circumstances, who want to make a contribution and do the right thing? I congratulate the hon. Lady. When I go around schools, I give the message to everyone that if they work hard and take advantage of every opportunity that comes to them, they will get on in life. I now have a new poster girl, and I look forward to hearing more contributions from her.

I was struck by the opening speeches, because it is getting a bit boring that all we hear is, “We’re spending this much money” and “Well, it’s not enough and we would spend more than you.” That will not get the best for our NHS. The truth is that whichever side of the House we sit on, we all want our NHS to be the best it can be. Every Government, of whatever colour, will always make the NHS a priority when it comes to the Budget. Let us not make this debate all about money. When we do, we let those areas in which we are not doing as well as we should off the hook. Getting the best out of the NHS is not just about money; it is about leadership and about behaviour—on the part not just of medical professionals, but of patients too. We need to make sure that we have honest discussions about outcomes, what we need to do better, what we expect from everyone and what patients can legitimately expect from the NHS.

That was very much part of the discussion during the general election. I remember knocking on doors and being asked, “But can we trust you on the NHS?” I would reply, “Conservatives are not aliens from the planet Zog who never get ill. We depend on the NHS as much as anyone else. Why would we ever engage in an act of self-harm by not doing our best for it?” We can be clear that under this Government the NHS will have the investment that the country can best afford, and we will focus on making sure that it delivers the best service possible.

The biggest challenge facing the NHS is not money. The workforce remains a considerable challenge. While we carry on talking about imports and the need for more doctors and nurses, we will continue to feed perverse behaviours and make the labour market in the NHS dysfunctional. Medical staff know that they can earn more as locums, so we have a massive vacancy rate and sky-rocketing salary bills, because of the choices people make. We need to do more to address that issue.

Much healthcare can be delivered by those who are not medical professionals. We need to look at where the NHS can commission services from the voluntary sector and how that could work. It is not just about doctors and nurses: it is about a more holistic approach to wellbeing. I would really welcome it if we could move the political debate away from pounds towards patients.

My right hon. Friend Jeremy Hunt spoke passionately about patient safety. Again, we need to focus on outcomes, and no one did more than he did to meet that challenge. When he became Secretary of State for Health, my constituency had a failing hospital, but thanks to the measures that he put in to improve performance, we now have a hospital that provides the service that we deserve. We should not be shy about challenging poor performance. The excellent doctors, nurses and others delivering medical services know when things are failing and would welcome the challenge to the leadership of their institutions to make them better.

We need to do more to help more vulnerable patients. The public services do very well for the pointy-elbowed middle classes who are able to fight for what they want, but the test of a society is how we treat the most vulnerable. In that regard, I welcome the commitment to reform the Mental Health Act 1983. That Act was a product of an era in which people with mental ill-health were an inconvenience to be managed. I am pleased to say that we have moved on very far from that, and we will introduce reforms that will empower patients to look after their own recovery. We should be grateful to people who have been through detention and shared their distressing experiences to make things better.

I can see that you are rightly looking at the clock, Madam Deputy Speaker, but I want to mention one final challenge in an area where, as a Minister, I was disappointed not to be able to do more—the issue of people with autism and learning disabilities being detained in institutions that, frankly, are doing them harm. I was horrified to see a report on “Sky News” only this week that showed that we have lost 10 people in the past year in those institutions. That is a mark of failure of the state: families entrusted their loved ones to that care and then lost them. I hope very much that we will redouble our efforts to make sure that we are not putting people into inappropriate care settings and are giving them the tools to be able to live outside those institutions.

Photo of Florence Eshalomi Florence Eshalomi Labour/Co-operative, Vauxhall 2:48, 16 January 2020

Thank you, Madam Deputy Speaker. I am pleased to stand here, and feel humbled, to make my maiden speech as the new Member of Parliament for the area that I have called home all my life. I want to thank the constituents in Vauxhall for voting for me and placing their trust in me.

My predecessor represented Vauxhall for 30 years. As many right hon. and hon. Members in this House will know, she was one of the most vocal supporters of Brexit. But Kate was much more than just a vocal Brexiteer—she was a diligent, hard-working constituency MP who fought very hard for her constituents. I hope to build on her work locally and I pledge to represent the residents of Vauxhall to the best of my ability.

My constituency is home to a diverse community. Across our schools in Vauxhall, including my old primary school of St Helen’s in Brixton, there are over 50 languages spoken by children of migrants from all parts of the world who have made this area their home. We have vibrant Portuguese, Jamaican, Ghanaian, Ecuadorian and Italian communities who run a number of small businesses and restaurants in the area. Vauxhall also has a proud history of an active LGBTQ community. I would like to place on the record my thanks for the contribution of the Royal Vauxhall Tavern in supporting and providing a safe space for our friends there. I am also proud to highlight the work of the 1997 Labour Government, who broke the Thatcherite legacy that hurt so many men and women in Vauxhall so badly through section 28. My constituency also has many famous national landmarks and buildings, including the London Eye, the National Theatre, the Young Vic, the Southbank Centre, the Kia Oval cricket ground, and the home of MI6.

I am pleased to be making my maiden speech today in this part of the debate on the Queen’s Speech because, like many hon. Members in this House, health and social care is very close to my heart. My late mother suffered from a disease called sickle cell anaemia, and in later life she developed renal failure and had to attend dialysis three times a week. The average life expectancy for sickle patients is between 42 and 47 years old, and many experience complications with childbirth. My mother was a fighter and she instilled in my sisters and me the values of standing up for what you believe in.

My mother also taught me how to make jollof rice. For any of you who have not tasted that, I want to put on the record now that Nigerian jollof rice is the best. As a young girl, I would watch my mother in pain going through a sickle crisis, but somehow she would still find the strength to help my sisters and me get ready for school and support us with our homework. I know the real value of the NHS. Without the amazing care of the haematology and renal team at King’s College Hospital, and my mother’s faith in God, she would not have lived to the age of 60.

St Thomas’s Hospital in my constituency is also close to my heart. I never imagined that almost five years to the day, as I was literally pacing up and down the maternity ward, looking over the river, trying to coerce my daughter to come out, I would now be sat in this Parliament fighting for funding for our hard-working doctors and nurses.

The NHS is struggling to cope with the increase in demand for health and social care. The A&E department at St Thomas’s is treating more patients than ever before. Attendance has risen by two thirds since 2018. The staff are now seeing 600 patients on their busiest days compared with an average of 420 when the new emergency department opened in 2018. So what is driving this increase? A significant number of patients are presenting with serious mental health problems, there is a high number of homeless people with complex health needs, and the number of children attending the Evelina Hospital A&E continues to rise. In November and December, it had a record attendance, with 130 children seen in one single day—more than double the number seen in four years. With an ageing population and more complex needs adding so many cost pressures to the budgets, I hope that this Government will make sure that increasing funding to the NHS is a top priority. That is why I will be voting to support Labour’s amendment later this afternoon.

I got involved in politics to give a voice to people who feel that politics is not for them or that politics does not matter. I have spent a large part of my career working with young people, including the young people who society is quick to demonise and stereotype. Last Tuesday, I was one of the first people on the scene following a stabbing incident that took place just over the border of my constituency. I made the frantic phone call to the emergency services, as I and two other members of the public tried to stem the flow of blood from the young boy who had been stabbed. I later found out that that young boy was 15 years old. I was scared. I was sad, because some members of the public walked past. We cannot allow ourselves to become desensitised to the issue of knife crime. Young people in my constituency are being groomed for violence, and there has been an increase in fatal stabbings over recent years.

I firmly believe that, to tackle this issue, we need to understand the root causes of the problem. Evidence from various commissions, including the recent work led by my hon. Friends the Members for Croydon Central (Sarah Jones) and for Lewisham, Deptford (Vicky Foxcroft), shows that the vast majority of young people involved in knife crime have suffered childhood trauma. Mental health services for our young people have not been adequately funded, and I hope that the Government will make a commitment to reverse the cuts and support our young people at risk.

In this Parliament, I will continue to speak up for investment in youth services and creating positive opportunities for our young people, so that they do not see selling drugs as a way to make money. I will continue to speak up and challenge the Home Office to invest in our police service, so that it has the resources to catch the people who continue to exploit our vulnerable young people. And I will continue to champion and speak up for the young women and girls who are facing sexual exploitation. The people of Vauxhall have placed their trust in me, and I pledge to represent their interests and concerns to the best of my ability for as long as I am in this House.

Photo of Anne Marie Morris Anne Marie Morris Conservative, Newton Abbot 2:56, 16 January 2020

That was a very thought-provoking, emotional and personal contribution from Florence Eshalomi, who I very much welcome to this place. She made some very important points about the NHS and knife crime, and I look forward to her working with all of us in this House to deliver exactly what she rightly says we must. I congratulate her.

It is right that health and care are a substantial part of this Gracious Speech, but it must be about action, not just words and promises. Across the House, whichever party we represent, we must deliver on what our constituents need and want and what we have promised them. I welcome the inquiry into social care. My concern is that this has been promised by Governments for years, and it seems to be taking forever and a day. This is urgent—it cannot wait. We must talk cross-party and look at the work that has been done, rather than do it all over again. Let us look at what works and does not work, take the good and move forward. I would like to see a Bill on social care in this Parliament.

Integration is another key issue. Members across the House have pushed for integration, and we need to make it happen. NHS England has proposed legislation to unblock the things preventing this from working. I am pleased to see the Bill to implement the NHS long-term plan, but I would like it to be more ambitious. It is right to address the commissioning challenge, but the Bill does not address the overlapping regulatory system, the conflicting accountability between health and social care or any of the legal relationships. Where are we with sustainability and transformation partnerships and integrated care systems? They have no legal status, yet we look to them to deliver a solution on integration. More must be done, and we must be bold.

Across the Chamber, we agree that mental health is a priority, but again, where is the ambition? Dealing with detention is crucial, but we must also look at parity of esteem. It is not defined. We talk about mental health representing something like 23% of the burden on the NHS, but how is that measured? Is that really the totality of the issue? We need to define parity of esteem, be clear how we will measure the need and address that need as a matter of urgency. We talk about achieving parity of esteem over the next 10 years, but that seems an incredibly long time. I would like to see a proper plan, and I would like to see parity considerably sooner than 10 years from now.

There was an extremely well-made speech a little earlier about wellbeing. For so long, we have talked about the NHS and health, but actually we talk about illness, not about wellness. When we talk about Public Health England, that is not the only part of trying to ensure wellbeing. Professor Dame Sally Davies, the former chief medical officer, has said that wellness is as important as dealing with illness. I would like to see that fully addressed, and I very much hope that those on the Front Bench are listening and will take that seriously.

The assets that we have to address our problems are not infinite. We have some wonderful people, we have some wonderful infrastructure—buildings and hospitals—and we have some wonderful technology.

Photo of Neil Parish Neil Parish Conservative, Tiverton and Honiton

My hon. Friend is making a really strong speech. Talking of assets, in my constituency we have community hospitals in Honiton, Axminster and Seaton, which could be used to much greater effect to take some of the pressures off the acute hospitals. Honiton does good work with Ottery St Mary and others in the neighbouring seat of East Devon. Can we actually get these assets working better for us? I welcome what the Secretary of State said in his speech earlier.

Photo of Anne Marie Morris Anne Marie Morris Conservative, Newton Abbot

My hon. Friend makes a very good point, and I was very pleased to hear the Secretary of State say that community hospitals were valuable. We must have a fundamental rethink of the infrastructure and look at what we really need. In rural areas, where we cannot get to the best stroke centre, say, we must think seriously about how we use or reuse such facilities.

Photo of Philippa Whitford Philippa Whitford Shadow SNP Spokesperson (Health and Social Care), Shadow SNP Spokesperson (Exiting the European Union)

Talking about assets, do we not also need to sweat the assets that are in the community? In Scotland, we have had community pharmacies with minor ailment services since 2005, and we now have the same for optometrists, to the point that only a tiny percentage of people ever need to go to A&E if they have an eye injury, a red eye or another problem.

Photo of Anne Marie Morris Anne Marie Morris Conservative, Newton Abbot

The hon. Lady—I almost said my hon. Friend because we share some common issues, and she is a great spokesman from the SNP Benches—is absolutely right. I think we would actually all agree that we need to look at the people who deliver these services and at the breadth we have, and involve them all appropriately.

We must also look at the new professions with the new associate levels. Physician associates take a huge part of the burden, and have a great career across the whole of primary and secondary care. Let us be innovative and creative, and provide the training, the financial support and the respect that I think many people working in our health system feel they do not necessarily receive from this place, although clearly they feel they have it from their patients. IT has always been the call of the Secretary of State, but again, let us be more imaginative. It is not just about communication; it is also about diagnosis and the delivery of care. There is much that can be done.

The Queen’s Speech refers to a medicines and medical devices Bill, which is absolutely critical to get right. I am very keen to look at the speed of getting medicines to patients, but we need to do more than deal with clinical trials. There is much that has to be done with regard to the Medicines and Healthcare Products Regulatory Agency and NICE and their systems. I would like to see the approach to access to medicines be more ambitious.

Finally—I am getting the evil eye, I think, Madam Deputy Speaker—I am very pleased that in the NHS Funding Bill we are now committing to enshrine increased spending in law. My concern is: do we have the right level of spending, how will we be measuring need and is that spending matching the increase in demand? That is a good promise, but it needs considerably more work.

This Government have done a good job in setting out some of the key issues and priorities that we as a House need to address, but we must look at the detail, we must implement this and we must deliver.

Photo of Emma Hardy Emma Hardy Labour, Kingston upon Hull West and Hessle 3:03, 16 January 2020

I think all of us here have had those moments when the injustice of what we see continues to haunt us ever afterwards. Last October, I had such an experience when I visited the vascular service at Hull Royal Infirmary and spoke to NHS staff as well as amputee patients with vascular disease and their families. Hon. Members may not know much about vascular disease, so forgive me while I explain briefly. This disease results from the build-up of fatty deposits in people’s arteries, which interrupts the flow of blood around the body. Vascular disease in the legs causes pain and muscle wastage, and the dead leg tissue can leave unhealable wounds that become ulcerous. My horror at learning about the pain suffered by patients of vascular disease, as the tissue in their legs slowly dies through lack of oxygenated blood, cannot be understated. When I was younger, someone very close to me suffered from the same disease and an amputation, and I grew up seeing not only their suffering, but that of their loved ones and family around them.

During my visit to the hospital I was shown images of foot ulcers, and the surgeon explained, in a phrase that has stayed in my mind ever since, that “time is tissue”, and that the development of a foot ulcer from something so small into something that requires amputation can be as short as 48 hours. My horror only increased when I learned of the north-south divide, with major amputation rates being 30% higher in the north of England than the south. The situation in Hull is even worse. Overall, people in Hull are 46% more likely to need a major amputation, and 16% more likely to need a partial amputation, compared with the all-England average.

Staff at Hull Royal Infirmary are incredible. They are hardworking and dedicated, and I am in awe of their work. I particularly wish to mention Dr Dan Carradice and the work done by his department on this disease. They are fighting vascular disease with their hands tied behind their backs. They are battling staffing shortages, increased demand for services and funding restraints, and all without the updated critical equipment and facilities that they need. It cannot be right that vascular disease patients who live in Scotland have access to more advanced equipment than people who live in England. We are at a critical junction, and the Government need to take action quickly.

I therefore have two simple asks, the first of which goes to every Member of this Parliament. I am proud to be taking over from Derek Thomas as chair of the all-party group on vascular and venous disease. I invite Members from across the House to join that all-party group, and to find out about the disease and how it impacts on their constituents. Together we can make the strongest possible case to the Government for more funding, and a better staffing plan to deal with this crisis.

Secondly, will the Minister meet me and Dr Dan Carradice to discuss the particular challenges at Hull Royal Infirmary, and the workforce requirements, equipment and funding that is needed to prevent the crisis in vascular disease from becoming even deeper? The Government must make this an urgent priority because as the doctor said, time is tissue, and we must act before it is too late.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead 3:07, 16 January 2020

When I sat in the Chamber earlier, I was not certain that I was in the right place. As you will know, Madam Deputy Speaker, we are not used to so many people listening to speeches—and what brilliant speeches they have been, particularly from the new entrants in the House. I say to newly elected Members of Parliament: this will not last. As we get further into the Session, trust me, it will not last.

I thought back to my maiden speech in 2005, when I made a promise to my constituents that I would go on and on and on about the acute problems at the hospital in my constituency. There was a bit of politics. I am not making a maiden speech, so I can be a little more controversial than some of my colleagues here today. The Labour party made the decision—in those days it was the Minister’s decision—to close the acute facilities at Hemel Hempstead Hospital. Acute facilities at St Albans had already been closed, and promises were made that those facilities would always be looked after at Hemel Hempstead Hospital, which was fairly new. We are a new town, so this was not about dilapidation. It was a fairly new hospital, but the decision was made to move those facilities to the centre of Watford, next to Watford football club.

I have nothing against Watford football club. As you may have heard, Madam Deputy Speaker, I am an ardent Spurs supporter, so this weekend will be very difficult for me as the Spurs play Watford. I want every success for the local clubs, but we have a Victorian hospital next to that football club, in a very difficult traffic area of Watford, and it is well over 100 years old. In the modern world we live in, would we dream of building a hospital in the middle of a town, next to a football club? Of course we would not. So I was simply thrilled—this is where I am going to get controversial on my own Treasury Front Bench—when it was announced that in south-west Hertfordshire, in my part of the world, we would get one the first six new hospitals—six new hospitals were announced; five new hospitals and one refurbishment—guess where, Madam Deputy Speaker: next to Watford Hospital.

We can moan and moan at Ministers, but the difficulty these days is that we have devolved so much power to local health authorities. That sounds good on the tin, but having oversight from local, democratically elected people is really very difficult. The clinical commissioning groups should listen and in our community they are not particularly listening. West Hertfordshire Hospitals NHS Trust is absolutely determined that this is where they want to build £400 million of new facilities: in the middle of Watford, nowhere near the community it should be serving—apart from the people of Watford, to be fair.

We continue to campaign. We have not given up. We do not want to reopen the facilities at Hemel Hempstead Hospital and we do not really have the land available in St Albans. What we have said is this: let us build a new hospital for south-west Hertfordshire. That is what we would do today; that is what the money in the new hospitals plan would do. To be fair, the Secretary of State has seen me and he has asked his officials to look into what the cost-evaluation would be. We have had costings of £1 billion for a greenfield site put out on local radio, interestingly by the Mayor of Watford, and we have had costings from other parts of the country as low as £375 million. So something is seriously going wrong between the costings.

We have got into a situation where the only way we can fight this, believe it or not, is to take the trust to court. There is a lack of accountability—I have called for debates in this House on that for years now. The only way we can fight the fact that the trust has only put in a bid for refurbishment of the Watford site is to take it to court and challenge it under judicial review. I have a fantastic community. We have raised the money. We will go to court. But is it not crazy that here I am praising, and I will be voting for, the Queen’s Speech and against Labour’s amendment, when I am saying that the £400 million being offered by the Government is going to the wrong place?

I listened deeply to the former Secretary of State, my right hon. Friend Jeremy Hunt, when he said that we have to admit it sometimes when we make mistakes in the NHS, whether they are clinical mistakes, mistakes on Primodos—another thing I like going on about in the Chamber, although I do not have the time to do so this evening—or the fact that we do not have prescribed medical cannabis free at the point of delivery to our children when a consultant says it should be prescribed. The only way we can fight this at the moment is to go to the courts. I am pleased with the Secretary of State on this, and I know that this will all be fed back. There was supposed to be a letter to me in the last couple of days from the people looking at the funding. That has not arrived yet, so—hint, hint, Front Bench—let us get the letter to me.

I do not want to go to court and the community do not want to go to court, but I was sent here to fight for something. The biggest issue in my constituency is the future of my hospital and the future provision of care in my constituency. We want a new hospital on a greenfield site. This Government, I believe, could fund that.

Photo of Marion Fellows Marion Fellows SNP Whip, Shadow SNP Spokesperson (Disabilities) 3:13, 16 January 2020

It will come as no surprise to you, Madam Deputy Speaker, that I intend to dwell on health and social care issues as they relate to my constituents in my own country of Scotland.

Before I do so, however, I should like to remind the House that just because edicts and statements are issued from the Government Benches, it does not mean that they are factually correct. Indeed, I must say that the pejorative language used by Conservative Members, including those representing Scottish seats, when discussing Scotland and its SNP Government, is unjust, mostly fallacious and paints a picture of healthcare in Scotland that neither I, my family nor my constituents recognise. In Scotland, the SNP Government are carrying on with the day job and have abolished prescription charges, which helps many folk in Scotland. To know that they can have the medication they need without worry is a fine thing, and it can save precious NHS resources further down the line.

Satisfaction with the NHS in Scotland remains high. In 2018, 95% of patients rated their overall experience of cancer care positively. [Interruption.] The hon. Member on the Government Front Bench may shake his head, but I can vouch for that, as my husband had cancer treatment in Scotland. Some 86% of patients rated their full in-patient experience positively, and 83% rated the overall care provided by their GP surgery as good or excellent. Scotland’s patient safety record is among the best in the world. Over the past five years there has been a decreasing year-on-year trend in the rate of MRSA and C. diff infection.

Scotland led the UK by introducing a mental health waiting times target. In the Scottish Government’s 2019-20 programme, the budget for mental health increased by £15.3 million, up by nearly 22%. This is the first Government in Scotland to have a ministerial post dedicated to mental health. The SNP is always looking to improve services for all Scots, which is why the Government are undertaking a review of mental health legislation in Scotland. The review aims to improve the rights and protections of persons who may be subject to existing legislation, and to remove barriers to those caring for their health and welfare.

This Tory Government aim to emulate Scotland by abolishing parking charges at hospitals. Since 2008, when the SNP Government abolished charges in NHS car parks, patients, visitors and staff have saved over £39 million.

The Nuffield Trust, an independent health think-tank, has said that although the 3.2% increase in NHS England’s budget is welcome, it must not detract from the reality that the English health service cannot adequately function or improve without significant investment in NHS capital and the workforce. Perhaps NHS England, through adequate Government funding, could emulate NHS Scotland and offer the same bursary to student nurses as we do in Scotland, where from next September nursing students will benefit from a £10,000 bursary, which is double the proposal for nurses training in England.

Of course, nursing students receive free tuition in Scotland. The benefits of this policy are easy to see, with nursing student numbers in Scotland increasing for seven years in a row. Compare that with a 30% drop in applications in England. How difficult will it be for this Government to achieve their promise of 50,000 extra nurses, or is it actually 19,000 fewer nurses? I am not sure; I am a bit confused about that figure. Perhaps I am not the only one.

On the question of social care, in 2011, the Scottish Government became the first in the UK to pay the real living wage to staff, including all NHS workers. In 2002, free personal care for the elderly was introduced by the Labour-Lib Dem Executive, and I give them credit for that, but that was against the wishes of the Westminster parties, which used it to cut social security funding for older people in Scotland—as ever, Westminster never misses an opportunity to cut Scotland’s budget. [Interruption.] Now the SNP, in government, has extended free personal care to all those under 65 who need it, and from the next Parliament the Scottish Government will work to abolish social care charges. [Interruption.]

Photo of Eleanor Laing Eleanor Laing Deputy Speaker and Chairman of Ways and Means

Order. The hon. Lady must be heard. There are indeed a lot of Members here this afternoon, but we will have no noise.

Photo of Marion Fellows Marion Fellows SNP Whip, Shadow SNP Spokesperson (Disabilities)

Thank you, Madam Deputy Speaker.

The Westminster Government would do well to look at and emulate many of the forward-looking, fair, equitable and progressive policies that originate in Scotland. One example is that, through the Social Care (Self-directed Support) (Scotland) Act 2013, everyone who uses social care services can now control their individual care budget.

The Prime Minister promised to

“fix the crisis in social care once and for all … with a clear plan we have prepared”.

The UK Government have failed to propose a Bill, a clear timetable or costings in their manifesto to address the social care crisis in England. The Tories have been in government for a decade and overseen the social care crisis. According to Age UK, there has been a £160 million cut in public spending on older people’s care in the last five years, despite rapidly rising demand. About 1.2 million people over the age of 65 did not receive the care support that they needed, and cuts have increased the pressure on unpaid carers.

I encourage the Secretary of State to look to and adopt the innovative measures that the Scottish Government have introduced in Scotland, to benefit those who live in England and use its NHS and social care provision.

Photo of Dehenna Davison Dehenna Davison Conservative, Bishop Auckland 3:20, 16 January 2020

Let me start by paying tribute to my incredible new colleagues, who have made some inspiring speeches and have set the bar so incredibly high. No pressure there, then!

There is only one word that sums up how I feel about being on these green Benches, and that word is “chuffed”. I am chuffed to be here, and to have been granted the opportunity to be the Bishop Auckland constituency’s champion. My predecessor served the constituency well for 14 years, and I thank her particularly for her good work on maintenance fees for new build estates.

All 650 MPs in this place are convinced that they represent the best, most beautiful constituency, and I am incredibly happy to be the one who is right. The home of the Prince Bishops, with over 70 communities across 365 square miles, we have a proud history of railways, mining, farming, and football. I hope to add to the latter by joining my hon. Friend Tracey Crouch on the parliamentary women’s football team. With 10 amateur cup wins, Bishop Auckland football club also stepped in to help Manchester United to fulfil its fixtures following the heartbreaking Munich air disaster in 1958, proving that when we work together, we work best. West Auckland, just down the hill from where I live, even represented Great Britain at the inaugural world cup in 1909—and in 1909, the Sir Thomas Lipton trophy was indeed coming home. As we will prove on the 31st of this month, that was not the last time we went to Europe and got the result that we wanted.

As in football, the Bishop Auckland constituency is a tale of two halves: the beautiful rolling landscapes of rural life to the west in Teesdale, and the grafting industrial towns and villages to the east. The diversity in landscape is matched by the diversity in the challenges faced by the different communities. In Teesdale we need to protect our rural communities, with an emphasis on the farming heroes who help to feed our nation and preserve our environment. I will work even more closely with Upper Teesdale Agricultural Support Services to be a true champion for our farmers and to create a thriving rural economy.

I will also be campaigning to improve our rural broadband and 4G coverage, and I am delighted that the Government have committed themselves to eradicating notspots. Connectivity, in every sense, is at the centre of my local plan, and at the centre of Government.

In the east of the constituency, in an all too familiar story, our high streets are under pressure, but the Government are listening, and I am chuffed once more that Bishop Auckland will benefit from both the towns fund and the future high streets fund. Local transport is also an issue, and I have been nagging my right hon. Friend the Secretary of State for Transport incessantly about the long-awaited Toft Hill bypass. We must also secure the repair work that is needed on Whorlton Bridge, not least because the community faces a dramatic detour which has forced the closure of the local pub, but also because of its cultural value in being the oldest suspension bridge in Britain that still relies on its original chainwork.

One issue that unites the whole constituency is our local healthcare provision. My local priority is fighting for improved health services at Bishop Auckland Hospital, with the ultimate goal of restoring our A&E. I have been banging that drum here in Parliament non-stop since I was elected, and I have no plans to let up just yet. So I say to my right hon. Friend the Secretary of State for Health and Social Care: I am sorry, but he will be seeing an awful lot more of me. Despite the rhetoric from many Opposition Members, the NHS is at the very heart of the Conservative party, and I welcome the record NHS funding from this Government and the bold step to enshrine that funding in law.

The NHS has a special place in my heart, although unfortunately my best experiences of it were in times of great sadness. It was the incredible NHS staff who helped to bring smiles to my nan’s face during the last days of her battle with cancer, and it was NHS paramedics and doctors who fought valiantly to save my dad’s life. If any of those staff are watching today, I thank you from the bottom of my heart. I was 13 years old when a man who later admitted to being high on drink and drugs walked across a pub and ended my dad’s life in seconds with one single punch. As a result, I spent my early teenage years in and out of court cases, tribunals, and meetings with lawyers and the police. While I was insistent that I would not let a dark event in my past negatively determine what happened to my future, that is a life that I would not want other young people to have. Here in this place, I want to champion policy that helps to reduce violence by educating disadvantaged young people, rehabilitating offenders and giving our police the resources they need to do their job. The police officers that I encountered as a young teenager were exemplary, particularly Karen Cocker, our family liaison officer, who I am proud to say I am still in touch with today.

Losing my dad had a profound impact on me. He was an incredible source of inspiration. In many ways, he was the very embodiment of blue collar Conservative values. He was a grafter, a self-employed stonemason who taught me the value of small enterprise as a force for good. He was incredibly aspirational, often jokingly citing Del Boy’s great line:

“This time next year, Rodney, we’ll be millionaires!”

He believed that, above all else, a person’s duty was to leave a better world for future generations, delivering that through nothing short of hard work. Growing up with my dad’s values, I became the first in my family to go to university and, weirdly enough, the first in my family to take a seat in this place as well. I was one of the lucky ones, but a child’s opportunities should not be determined by luck or by their postcode.

I am proud to be a member of this Conservative party, which has levelling up and spreading opportunity at the very core of its ethos. Improving social mobility is not only a passion of mine; it feels to me that it is my very duty to my constituents and to my country. That is why one of my key local priorities is improving job opportunities by setting up a youth employment champions scheme. A wise man called Dumbledore said:

“It matters not what someone is born, but what they grow to be.”

Grafting as hard as I can to help my constituents to grow to their full potential is not just a priority; it is my duty.

Photo of Catherine McKinnell Catherine McKinnell Labour, Newcastle upon Tyne North 3:28, 16 January 2020

I congratulate Dehenna Davison on her excellent and powerful maiden speech. As a fellow MP representing the north-east and as an advocate of the One Punch Can Kill campaign, I am sure there are many challenges that we will face together.

I rise to talk about the NHS and social care, but I will also talk about other aspects of this Gracious Speech that will either affect, or not affect enough, the community that I represent in Newcastle. Any additional funding that is to be enshrined in law as part of the multi-year funding settlement is of course welcome. However, I worry that the gesture might be more about politics than about dealing with the real challenges that our NHS faces. Many of us agree that one area in which we need substantial answers is social care. NHS leaders warn us that hospitals are being overwhelmed by people who have nowhere else to go, and any additional funding risks being wasted because of this issue.

The Conservative manifesto has pledged to build cross-party consensus on a long-term solution, and if the Government are serious about doing that, I absolutely welcome it because I believe that that is where the solution lies. There are good reasons to be optimistic. There is already broad agreement on what a deal would look like, and we all know how important social care is to our constituents. Indeed, if we cannot put adult social care on a sustainable financial footing, then the frail, the elderly, and the most vulnerable and their families will pay the price, and the public will not forgive us. Let us make a start on building that consensus to fix social care now.

Moving on to education, the idea of levelling up school funding by increasing minimum per-pupil funding will in fact disproportionately benefit schools with less challenging intakes. Because they benefit less from the disadvantage elements in the funding formula, most disadvantaged schools are already over the new threshold. Some beneficiaries no doubt need extra funding, but there must be a better way of ensuring that it reaches them than the regressive method designed by the Government. I note that the Education Policy Institute said that the north-east will benefit the least of any region outside London despite the fact that we have consistently had the lowest performance in England on the Department for Education’s attainment 8 and progress 8 outcome measures. Our children’s potential is being wasted, and we cannot let that happen.

The north of England, the north-east in particular, also suffers from a persistent and growing productivity gap with the rest of the UK. I have long made my concerns known that leaving the EU will make the gap more difficult to close given that the evidence indicates that the north-east will be hardest hit by any form of Brexit. However, an important part of the answer for tackling the north-south productivity gap while also tackling the climate crisis lies in having the best transport connectivity. The inclusion of HS2 phase 2a in the Queens Speech is therefore good news, and I hope we can now make progress on getting HS2’s benefits to the north.

I take a special interest in the east coast main line, which I travel up and down every week, but my interest is not purely self-motivated. Upgrading it is essential for the north-east, not least to ensure that it also benefits from HS2, which is why I established the all-party parliamentary group on the east coast main line. The group will be re-established, and I encourage new Members to join it. We urgently need to improve capacity, so we need HS2 and Northern Powerhouse Rail, and I completely reject any suggestion that this is an either/or choice. I call on HS2 Ltd, the Government, Network Rail and Transport for the North to work together to produce credible, timely and properly funded plans to upgrade the east coast main line so that the north-east can fully benefit from the introduction of high-speed rail. After decades of under-investment, we have an opportunity to transform rail capacity and connectivity in the north-east and attract investment, boost skills and opportunity, level up communities across the north, and create sustainable transport infrastructure. We need to take it.

Overall, the Gracious Speech was light on detail, but there are some causes for celebration. I welcome the domestic abuse Bill, which is an opportunity to drive cultural change, and, as the TUC said, transform

“domestic abuse from a criminal justice issue to one that is ‘everyone's business’, tackled by health and social care, housing, education and employers”.

I also welcome the inclusion of the animal welfare and sentencing Bill and pay tribute to the work of Anna Turley, the former Member for Redcar, who campaigned tirelessly on the issue after a particularly horrific case in her constituency came to light. There are some great opportunities for the north east if the Government make good on their promises, and I for one will be watching closely to see that they follow through.

Several hon. Members:


Photo of Dean Russell Dean Russell Conservative, Watford 3:33, 16 January 2020

Thank you, Madam Deputy Speaker. It is wonderful to see you in the Chair. I am incredibly humbled to be here. As a working-class lad, to be sitting on these Benches is an enormous honour, but to be sat among so many other working-class Conservatives is just as fabulous. I must thank the people of Watford for putting me in this wonderful place and for giving me the honour and the opportunity to hopefully make a change in this country.

First, however, I want to pay tribute to my predecessor. Everyone who knows him will know that he works tirelessly and is a true gentleman: Mr Richard Harrington. When I first became a candidate, people would say to me, “Dean, you’ve got big shoes to fill.” At first I thought it was a dig at my height, but I soon found it was because of Richard’s amazing legacy and the work he has done for the people of Watford. Today’s debate focuses on health, and there are so many things I could talk about—from his jobs fairs to the work he has done on social housing and tenancies—but I will specifically pay tribute to his work to ensure that Watford General Hospital and the local NHS got additional funding. I am proud that Watford will get one of the six new hospitals in the coming months and years, as was alluded to in a previous speech. Richard was a true champion for Watford, and I hope I can fill his shoes in the coming years. I will work tirelessly to do so, although my height may not change.

As you know, Madam Deputy Speaker, Watford General is on Vicarage Road, right next to the legendary, most fabulous Watford football club, which famously once had Elton John as its chairman. I would like to steal one of his song titles and say that I would like to be the first rocket man of Watford as we soar to the stars.

Sadly, to be totally honest, Elton John was not actually born in Watford—I cannot do anything about that—but we do have an incredible wealth of world-famous Watfordians. We have our very own Spice Girl in Geri Halliwell. [Hon. Members: “Hear, hear!”] You have to give a whoop for that. We have our own boxing heavyweight champion of the world in Anthony Joshua. We have our own political heavyweight, too, in the dearly departed Mo Mowlam. And we have the England football manager with the best waistcoats in the world, Mr Gareth Southgate.

As a science fiction fan myself, it is particularly exciting that we have our very own member of Doctor Who’s time-travelling Tardis team in Mr Bradley Walsh. Many Members will know that Bradley Walsh hosts a famous game show called “The Chase”, in which he battles with “The BeastMark Labbett. As a Conservative, I feel that in this election we battled our own “Chase” and our own beast—the beast of socialism—and we won. We defeated that beast.

One of the most world-famous parts of Watford is a magical place, and it was mentioned earlier in a brilliant maiden speech: Warner Brothers studio and the Harry Potter tour. Given his love of buses, I would like to invite the Prime Minister to visit the studio, because we have neither a boring single-decker bus nor a boring double-decker bus; we have the world-famous Harry Potter triple-decker “Knight Bus.” Who can beat that?

Watford is not just a hub for entertainment. We are also a massive magnet for investment and business. We have several UK headquarters. We have Hilton hotels, so people have somewhere to sleep. We have TJX, the home of TK Maxx—looking around the Chamber, I am sure everyone has recently bought their clothes from there. We have a place to drink in JD Wetherspoon, and we have a place to win millions and to help millions more in Camelot and the lottery. We also have our very own pharmacy, a fabulous business called Sigma Pharma. Of course, every Member will want to visit our incredible market, our high street and the Intu centre for a most delectable day out.

Madam Speaker—sorry, Madam Deputy Speaker; I promoted you—at heart I am really just a family man, and it is my family who inspire me. My working-class roots may have defined who I am, but my family are the ones who drive me forward. I give credit to my parents and my sister for all the work they have done over the years and for the support they have given me. I am sure it is the same for many Members. Our families make such a difference to our lives and keep us grounded. In that sense, my wife and my daughter truly are my beating heart and soul.

However, not everyone in society has a family or even friends to support them, and, through no fault of their own, they may feel that they are on their own. That is where community comes into play. Let us all be role models to support people who feel as though they have no one. That is the role of a Member of Parliament: not just to make laws, but to help those around us. We must let everyone know that opportunity has no gender. Opportunity should have no race and it should have no age. Whoever someone is, wherever they are, they should be able to be the best version of themselves. I believe that my party is helping to represent that.

Community is very important to me, which is why I worry about modern times. Mental health has been a big issue today, but so, too, is loneliness. We used to talk about being lonely in a crowd, but today there are so many who are lonely in the cloud. The digital world, modern life and social media mean that probably more people are aware of the names of the Kardashian family than they are of those of the neighbours on their own street.

For many years, I have felt that we need to bring the world back together, to be less divisive and to try to tie those threads together. I have had a daily philosophy for many years, and it goes like this: HOPE is an acronym and it stands for Help One Person Everyday. If we all do that in our own lives, in a way that changes people’s lives, we will have a better world. I feel honoured to be in this place as a Conservative, to enable that on a much bigger scale. We may be able to effect laws and change legislation, but changing people’s lives is surely why we are here.

In the past few years, we have seen lots of divisiveness, but let us have an age of decisiveness. Let’s not just get Brexit done—let’s get stuff done, to make people’s lives better. I believe that our manifesto and the Queen’s Speech have shown that that is our goal. As we enter 2020, let us lead the world in relentless positivity, optimism and can-do-ism, and turn this into the soaring 20s. As I complete my speech—I may be going over time; I apologise—I just want to thank people for electing me to be on this Bench and tell them that I will work tirelessly for the people of Watford, and with all Members here, to make the world a better place.

Photo of Eleanor Laing Eleanor Laing Deputy Speaker and Chairman of Ways and Means

I thank everyone who is speaking today but not making a maiden speech for their kindness towards the maiden speech makers, who are being given a lot more leeway. That means that we will now have to impose a time limit of four minutes on people who are not making maiden speeches and still one of six minutes or so for maiden speeches. There is no point in people looking shocked; there are only so many hours in a day and that is where we are.

Photo of Helen Hayes Helen Hayes Labour, Dulwich and West Norwood 3:43, 16 January 2020

Thank you, Madam Deputy Speaker. May I congratulate all the Members who have made their excellent maiden speeches in the House today?

Across the country there is a clear and urgent need to reform the social care system. A vast unsustainable gap exists between the current funding levels and the reality on the ground. Local authorities, including Tory-run councils such as Somerset, are stretched to breaking point, facing impossible daily decisions to cut care packages or raise the threshold for qualification for support. The Local Government Association estimates that the shortfall between funding and need in social care is £1.5 billion in the current financial year, with that set to grow to £3.5 billion by 2024-25.

The Government funding announcement on social care is playing a very disingenuous game with the public across the country who rely on social care. An announcement that falls far short of meeting the current funding gap is simply not remotely close to a solution to the long-problems of social care. The failures of this Government on social care can be seen in the inbox of every Member of this House. I see it in the case of my constituent who is being made ill by the anxiety provoked by the care home bills she has received for her mother’s care, in the distress of dementia patients forced to sell their homes and in the anguish of the sibling of an autistic man who is living in supported accommodation where the staff are too busy, poorly paid and undertrained to safely manage the behaviour of other residents. When we talk about social care, we are talking about individual lives—about my constituents, and millions like them, whose present day-to-day is intolerable.

The Tories offer nothing but prevarication and delay. During the previous Parliament, the Government delayed publishing the social care Green Paper eight times, and they went into the general election offering only a vague commitment to cross-party talks. Yet extensive cross-party work has already been done by Andrew Dilnot and Select Committees in both Houses. The menu of options available to deliver a social care system in which everyone who needs support can live with dignity is clear: there is a broad consensus that care should be free at the point of need and there is a clear understanding that additional taxation must be raised to fund it. There is simply no excuse for the disgraceful delay in bringing forward detailed proposals. The message it sends is that the Tories just do not care about the daily misery that so many people are experiencing right now because social care is broken.

Finally, the Government must address the scandal of their utter failure to deliver the transforming care programme. Winterbourne View should never have happened, but once that disgraceful scandal had come to light, it should never, ever have happened again. Yet, on this Secretary of State’s watch, horrific abuses took place at Whorlton Hall and the NHS continues to pay for patients to be placed in the private hospital at St Andrew’s in Northampton, which was recently failed again by the Care Quality Commission. Autistic people and people with learning disabilities should be able to live with dignity in homes, not hospitals—in regulated community provision, supported by well-trained, properly paid staff.

The Government have a decade of failure on social care under their belt. They simply cannot be trusted. We will hold them to account on behalf of our most vulnerable constituents, who desperately need a radically different approach.

Photo of Paul Beresford Paul Beresford Conservative, Mole Valley 3:46, 16 January 2020

I thought, Madam Deputy Speaker, that immediately I stood up you would announce that the time limit was down to three minutes.

The number of medically trained professionals who have come into the House has apparently risen dramatically. I am one of them, but I have been here a wee while. I warn the new ones that their profession will lean on them to put the case until they are driven to it, as I am today.

I wish to pick on child dental health in particular. For decades, the statistics have been absolutely appalling. Deciduous teeth—baby teeth—are particularly susceptible to decay: their enamel is much thinner than that of permanent teeth. Before SNP Members stand up to tell me about it, I should say that action has been taken on care and education, particularly in schools, and to some degree it is working, but those children for whom it does not work, or works only partially, will require extractions. I can remember looking at little kids in east London with appalling mouths—broken-down teeth, abscesses—who were crying and having sleepless nights, and having to refer them to hospital for a general anaesthetic.

The statistics today are terrible. Last year, more than 45,000 children and young people aged up to 19 were admitted to hospital because of tooth decay. They included 26,000 five to nine-year-olds, making tooth decay the leading cause of hospital admissions for that age group. Last year, there were more than 40,000 hospital operations and extractions for children and young people. That is 160 a day. It is a complete waste of money, it is completely preventable and it is occupying space in our national health service.

Education is starting to make a difference, but far and away the best-proven method to reduce tooth decay among children, and even more so among adults, is fluoridation of the water supply. In the United Kingdom, approximately 330,000 people have naturally occurring fluoride in their water supply. In addition, another 5.8 million in different parts of the country are supplied with fluoridated water. But that covers only 10% of the total population. The percentage covered in the United States is 74% and rising; in Canada it is 44% and rising; in Australia it is 80% and rising; and even little New Zealand has managed 70%. We have fluoridation legislation, but it is left for local authorities to instigate and compel companies to fluoridate their water supplies. There is no financial advantage for the local authorities, but the savings to the NHS would be considerable.

The second problem with the current legislation is that few local authority boundaries are coterminous with the boundaries of the water companies. That makes direction and implementation complex. The sensible answer is for legislation to apply nationwide. That is not in the Queen’s Speech. It could be put into a Queen’s Speech, but it will take a brave Government, I hope supported by the Opposition, to include and implement that. I warn that whenever I speak about fluoridation, the green ink letters fly and broomsticks whizz around my house as people complain. However, it works for child dental health care, which is deplorable in this country.

Photo of Amy Callaghan Amy Callaghan Shadow SNP Spokesperson (Pensions and Inter-Generational) 3:50, 16 January 2020

Thank you, Madam Deputy Speaker, for giving me the opportunity to make my first speech in this place on such an important topic. It is my honour to stand before you all as the new SNP representative for East Dunbartonshire. I cannot begin to describe how grateful I am to all those who have put their faith in me. To my family who are here today, to my outstanding campaign team, and to every single person who showed up at the ballot box on 12 December and entrusted me with their vote—and those who did not—together we have made history.

It is my promise that I shall fight tooth and nail at every turn to ensure that the people of East Dunbartonshire, and indeed the people of Scotland, never feel left behind or ignored by their representative again. I can only hope that by the time my tenure in this seat draws to a close—sooner rather than later in a progressive, independent Scotland—I will have repaid the faith that voters showed in me.

I also stand here with the unenviable task of following the maiden speeches of my predecessors, not least my good friend and now colleague, my hon. Friend John Nicolson. I am sure he remembers fondly the eloquent and articulate way in which the history and beauty of my constituency has been described in this House. Not only is East Dunbartonshire one of the most prosperous places to live in the country, given its array of excellent state schools and the unshakeable community spirit in areas like Bishopbriggs, Kirkintilloch, Bearsden and Milngavie, but it is a constituency that is steeped in history in more ways than one.

First, if people visited today, they would find the remains of the Antonine wall— the northernmost point of the Roman empire—still running through the area. As any history buff would tell them—I am sure there are many in this House—it is thought that this UNESCO world heritage site was built by the Romans to defend their mighty armies from the tenacity of the locals. Others say the case could equally be made that the Romans became so enamoured of the sheer beauty of the countryside and the Campsies that they simply decided to stop and take in the view. They certainly would not have been the last. Regardless of the reason for the wall’s construction, I find it rather fitting, given the political climate we find ourselves in, that such a vast and seemingly unstoppable empire was halted in my Scottish constituency after said empire had conquered Europe. Perhaps there is a lesson to be learned there about ignoring the will of the people of East Dunbartonshire, let alone the people of Scotland.

As per tradition, I pay tribute to my predecessor, Jo Swinson, both as the former MP for East Dunbartonshire and the former leader of the Liberal Democrats. In her time as the MP for East Dunbartonshire, Jo achieved a great deal in encouraging young women into politics and indeed to reach their potential in all walks of life. I think what both Jo and I can bring to the table is showing young women right across the United Kingdom that although there are still barriers in place, we can smash them. We should show people that there are no limitations to our worth.

That brings me nicely to my next point about the unique history of my constituency—one that Jo Swinson rightfully highlighted in her maiden speech in 2005. East Dunbartonshire has a history of electing strong and ambitious women in their 20s. In particular, I would like to pay homage to the late but inspirational Margaret Ewing. She won this “unwinnable” seat in 1974 at the age of 29 with a majority of just 22 votes. Ms Ewing entered the Commons under the name of Margaret Bain with a tenacious desire to get the very best for the people of Scotland and to defend the rights of those less fortunate than ourselves. It is a damning indictment of the state of this Parliament that that is exactly what I plan to do with the platform I have been given. Nevertheless, these women have paved the way for young female politicians like me, and it is my hope that I too can serve as an example to young women in East Dunbartonshire, and indeed across the country, and show them that they can make a difference, and that no door is—or should be—closed to them regardless of their circumstances.

I am delighted to be making my maiden speech on the topic of health and social care. I was not shy during my campaign in highlighting the profound impact the NHS has had on my life. I certainly would not be standing here as the newly elected MP for East Dunbartonshire, just shy of being six years cancer free, had it not been for our NHS in Scotland. To the surgeon, Mr John Scott, who saved my life not just once, but twice, I thank you from the bottom of my heart. To organisations such as the Teenage Cancer Trust, which guided me throughout my cancer journey and are an immeasurable support to young people facing a cancer diagnosis across the UK, I thank them for the unparalleled support that they gave to me and to so many other young people.

The issue that I should like to highlight most in respect of teenage and young adult cancer is its mental health impact—an area on which I have done considerable personal work. As a society, there is an ingrained assumption that once someone has the all clear from a cancer diagnosis, they should return to normal. I could not be clearer that normal does not exist after a cancer diagnosis—much less for a young person whose world has been turned upside down. They have had the harsh realisation that they are not invincible and they could also be facing fertility issues and the loss of a family that they never yet knew they wanted to have.

I considered myself unlucky for a long time for having to face this diagnosis so young, but I am now at the point in my journey where I can put this behind me and use the platform that I have to achieve great things for young cancer patients across the United Kingdom. My journey resonated with the good people of East Dunbartonshire who put their trust in me to come down to this place and best represent them. I can tell them that that is exactly what I will do. My clear message to those on the Government Benches is to keep their hands off Scotland’s NHS.

I have watched many of my colleagues’ maiden speeches and have noticed that they like to quote Rabbie Burns. In the same spirit, I thought it only fitting to quote a newer generation of Scots poet whose writing could not be more apt to the situation in which the people of Scotland find themselves. Gerry Cinnamon wrote:

“Are you happy that nuclear weapons are dumped on the Clyde?

Fighting wars for the wealth of the few, how many have died?

You can bury my bones but the truth of it can’t be denied.

Will you stand and be counted coz I’ll be there stood by your side.

Hope over fear;
don't be afraid.

Tell Westminster Tories that Scotland’s no longer your slave.”

That brings me to why I am here and why my colleagues were elected and re-elected as SNP MPs by voters across Scotland. After 60 years of not voting for the UK Governments that we end up with, it is hardly a surprise that support for independence is at an all-time high. It has nothing to do with the so-called wave of nationalism that those outwith my party claim is sweeping Scotland, and instead everything to do with the fact that we offer hope. Hope in the face of adversity. Hope in the face of soaring food bank use. Hope in the face of nuclear weapons on our waters. And hope for the people of Scotland that this is not the best that is out there.

Photo of James Davies James Davies Conservative, Vale of Clwyd 3:57, 16 January 2020

It is a pleasure to follow Amy Callaghan. Indeed, I congratulate her on her maiden speech. She spoke with striking personal elements as well as a very clear affection for her constituency. She clearly has strong views, and in that respect she evidently follows on in the long line of strong women representing her area, so I congratulate her wholeheartedly.

It is a privilege to be back here again representing my home constituency of the Vale of Clwyd following an unwelcome and enforced couple of years away. I am, of course, generously termed a retread.

I must start by placing on record my true thanks to all my constituents who voted for me, many of whom voted for my party for the first time ever. It is my ambition to live up to their hopes and aspirations, as well as to the hopes and aspirations of everybody else who did not vote for me. As I did in 2015, I pay tribute to my predecessor, Chris Ruane, who was well respected and represented the constituency very ably for more than 20 years in total.

On the doorsteps in November and December, there was no bigger domestic issue than health. I must declare an interest, as I am an NHS doctor and I am also married to an NHS nurse. Between 2017 and 2019, I worked full-time as a GP in my constituency in Rhyl and in other parts of north-east Wales and west Cheshire. This has given me a unique insight into the state of the NHS in north Wales and further afield. Health matters were transferred to Cardiff, almost in their entirety, 20 years ago. That includes the organisation, structure and basic terms of functioning of the NHS. The reality, though, is that there is still much confusion among the electorate about where powers lie, and my inbox has been inundated with NHS issues since my re-election.

The north Wales health board—the Betsi Cadwaladr University Health Board—has been in special measures for more than four and a half years, which my constituents and I find totally unacceptable. As yet, there is still no evidence of a turnaround, and my constituents are being let down by a systemic failure in the north Wales NHS. I am extremely limited for time today due to the number of speakers, but in future debates I hope to expand in detail on the issues that I have come across over the last two years in particular. Let me just emphasise that comparable and meaningful data to highlight the extent of this state of affairs is often lacking—if I am honest, I think that may be deliberate—especially given that one of the benefits of devolution was meant to be that we could compare performance of different policies across different parts of the UK. I will expand on the causes behind the problems that I have come across on another occasion, but let me say now that workforce is a key issue, including poor recruitment and retention of staff.

To conclude—in the 40 seconds or so I have left—I have outlined not only interesting statistics, but sadly an indication of unnecessary loss of life and of harm to real patients. At the very least, there is a need for UK-wide patient safety mechanisms and rigorous inspection regimes, underpinned by comparable statistical data on performance and outcomes. I urge the Secretary of State seriously to consider that when progressing the initiatives outlined in the Queen’s Speech.

Photo of Munira Wilson Munira Wilson Liberal Democrat Spokesperson (Transport), Liberal Democrat Spokesperson (Health and Social Care) 4:01, 16 January 2020

It is a pleasure—and slightly daunting—to follow so many powerful and emotive maiden speeches. I thought that the hon. Members for Luton North (Sarah Owen), for Vauxhall (Florence Eshalomi) and for Bishop Auckland (Dehenna Davison) made particularly moving speeches. It is an honour to give my maiden speech, and I am especially proud that my five-year-old daughter is in the Gallery to witness this moment. With a record number of female and BAME MPs elected in this Parliament, I hope that I and others will be an inspiration to girls like her and other young women as we strive towards a more diverse Parliament that truly reflects British society.

As the new Member of Parliament for Twickenham, I follow in the illustrious footsteps—or should I say dancing shoes—of the right hon. Sir Vincent Cable. After all, he did get a 10 from Len on “Strictly”! Vince earned the respect of Members of all parties in this House, not just for his economic prowess, but for his dry sense of humour. Who can forget his infamous “from Stalin to Mr Bean” put-down of Prime Minister Gordon Brown?

Vince served Twickenham assiduously for 20 years. I have always been struck by how many people have told me that they or someone close to them have been helped by Vince when they have had a problem, and this is the work of which I know he is rightly most proud. Among his many local achievements, I thought it apt today—while we are debating health and social care—to highlight his work with a local vicar in establishing Homelink in Whitton, which is a day respite care centre for dementia patients. He has also been a patron and champion, since its inception, of Shooting Star Children’s Hospice in Hampton and its work in palliative care. The National Physical Laboratory in Teddington employs some 1,000 scientists, engineers and skilled professionals. Vince was particularly proud of supporting the NPL to secure long-term funding and become a global leader in metrology. Both Vince and his Conservative predecessor, the late Toby Jessell, campaigned hard locally to try to protect the Royal Military School of Music. Kneller Hall, which was founded in 1857, is sadly being sold by the Ministry of Defence and is set to close later this year. It is a huge loss to the local community.

All my predecessors, including the former Conservative Member Tania Mathias, were united in opposing the expansion of Heathrow airport, and I will continue that fight. As Heathrow is the biggest single source of greenhouse gas emissions in this country, regularly breaching statutory air pollution limits, building a third runway would be an immensely regressive step in tackling the climate emergency, and would have a significant impact on the health and wellbeing of tens of thousands of local residents. I invite the Prime Minister to keep his promise to lie down in front of the bulldozers.

As well as planes, trains are a constant source of frustration for my constituents. The Hampton and Shepperton line via Strawberry Hill was built in 1864, and local residents may be forgiven for questioning whether the service has seen any improvement since then. It is the first service to be cut when there is any disruption. The South Western Railway franchise has been disastrous from the start, with constant cancellations and delays—my constituents suffered 27 days of strikes in December. With big question marks over its future viability, the Transport Secretary must urgently review the franchise.

We are extremely proud to have Teddington Memorial Hospital, which was opened in 1875, with just four beds, and which now provides important community services. The amazing League of Friends has raised tens of thousands of pounds to modernise parts of the hospital, and that jewel of a facility is rightly jealously guarded by local residents.

We have a moral obligation to ensure that every child and young person has the opportunity to flourish, but many have shared with me their frustration in accessing child and adolescent mental health services when they most need that support. Just last week, the mother of a 10-year-old with tier 3 needs in my constituency wrote to tell me how her child had been waiting four months for an appointment and would be waiting months more for treatment. My local mental health trust has seen demand explode fifty-fold in the space of four years for tier 3 treatment. Off the Record is an outstanding charity in my constituency working tirelessly with children and young people in this area. It provides a vital service under immense pressure, and I look forward to supporting its work.

My constituents are known for being an active bunch, and while Twickenham is the home of English rugby and Harlequins, it is also the home of Parkrun, founded in the stunning Bushy Park. I look forward to welcoming the officers and members of the Parkrun all-party parliamentary group to join me in Bushy Park one Saturday morning for a run.

I came into politics driven by a desire to tackle inequality, protect our environment and promote internationalist values. It is an immense privilege to have been granted the opportunity to serve both my local community and my country as a Member of Parliament, in order to champion those values. Twickenham, Teddington, Whitton, St Margarets and the Hamptons form a very special constituency, and I look forward, as Whitton’s woman in Westminster, to championing their interests first and foremost in this place.

Photo of Paul Bristow Paul Bristow Conservative, Peterborough 4:08, 16 January 2020

Thank you for the opportunity to give my maiden speech, Madam Deputy Speaker. It is an honour to follow Munira Wilson, who mentioned that her five-year-old daughter is in the Gallery. I would like to give a shout out to my four-week-old daughter who is also in the Gallery today—[Hon. Members: “Hear, hear.”]

It seems right to make my maiden speech in the debate on health and social care. Those services—both our care and NHS services—have been part of my life and part of my career, and they are now part of how I intend to serve the people of Peterborough as their Member of Parliament. That is partly because Peterborough is a growing city. It is my city, and we need more resources for our local NHS. Now we finally have a majority Government, I am confident we will get them.

If someone had to pick one constituency to illustrate the political chaos before the general election, they might well choose mine. I am the fourth MP for Peterborough in less than three years. Local people were crying out for the same political stability that our country needed and, now they have elected me, I would like to modestly suggest that they can achieve this by returning the same MP for a considerable period of time—20 or 30 years perhaps.

Each of my three immediate predecessors left their mark, and each, to be fair, cared about our local NHS services. Although Fiona Onasanya will inevitably be remembered for the manner of her departure, our city should be proud that we elected our first black MP in 2017—as should she.

I stood in last year’s by-election with Lisa Forbes, so we have a shared experience. Lisa was gracious in victory and gracious in defeat. She did not have much time in this House, but I respect the way she conducted herself during that campaign, and I know that her commitment to Peterborough was sincere. She should also be congratulated on her campaign on affordable school uniforms.

Finally, but not least, I would like to pay tribute to Stewart Jackson. I have known Stewart since I was a teenager; I am increasingly aware that was some time ago. As many here will know, he was a great champion for Peterborough. He has been a great friend to me, and served my constituents with distinction for 12 years. If I can begin to match his dedication, I will not have gone far wrong.

Peterborough deserves that, because it is a special city—an ancient city with a proud history. We have one of finest Norman cathedrals in Europe, where Mary, Queen of Scots lay after her death, and where Catherine of Aragon is buried. The cathedral holds the Hedda stone—just one part of our Anglo-Saxon heritage—and its wooden ceiling dates back to 1250. Yet that was a relatively late part of our past, because recent excavations at Must farm mean that Peterborough museum now hosts a stupendous display of bronze age artefacts. The area has even been dubbed Britain’s answer to Pompeii. The former residents of Pompeii spent centuries huddled together in small groups, covered in ash. Having known Peterborough’s nightclubs before the smoking ban, I can confirm that our nightlife felt no different.

Although Peterborough’s history is special, our potential is yet more exciting. We can build on our status as a working city. We have world-class manufacturers at Perkins Engines and Peter Brotherhood. We can seize on our new trading opportunities to become a national centre of excellence in engineering and agritech. The plans for a specialist university are crucial, and I will be lobbying for the investment that this university needs.

Far too many people think negatively about my city, not helped by bogus surveys naming Peterborough as the worst place to live in the UK. Fake polling does not harm us, but a negative mindset does. I am unashamed to continually say that I am proud of Peterborough. We are a great city. We have fantastic transport links. The east coast mainline puts us just 45 minutes from London, while the A1 puts us on one of the north-south road arteries. The A47 connects us east to west, which it will do far better when the Government finally agree to dual it through my constituency. As a long-suffering York City football club fan, I can confidently claim that Peterborough has a successful football team.

We have a talented and hard-working population from across the world. Many Italians arrived after the second world war, and eastern Europeans more recently, joined in between by large parts of the Indian and Pakistani diaspora. Striving for peace and respect for the rights of my constituents’ families in Kashmir is one of my priorities in this House.

The future should be ours in Peterborough; it just takes a bit of help. I will be reminding Ministers that the characteristics of northern towns and cities are shared by my constituency. Like the north and like the midlands, Peterborough expects.

On the subject of this debate, care and the NHS, we must deliver. For me, this is personal, because it was the NHS that brought me to Peterborough as a five-year-old. My parents moved to the area to work in the city’s national health service. I should also declare another interest, and have literally done so in the Register of Members’ Financial Interests, because until recently I owned a communications business specialising in health and social care. It is from this background that I intend to approach our NHS and social care system.

We need a service that focuses relentlessly on patient outcomes. There is an opportunity for the UK to lead the world in healthcare outcomes, healthcare research and jobs in the life sciences and health technology industry. I want to mention just three things that we should perhaps do about that: the first is to deliver on NHS capacity, the second is to maintain our ambition on life sciences research and manufacturing, and the third is to do what works—what the evidence shows makes a difference to patients. I understand that that is not always easy, and new technology is often expensive, but simple compliance with the National Institute of Health and Care Excellence guidelines on medicines and technology would make an enormous difference. With the £33 billion-a-year determination shown by this Government in the NHS long-term funding plan, I am confident for the future.

Photo of Mohammad Yasin Mohammad Yasin Labour, Bedford 4:14, 16 January 2020

It is an honour to follow Paul Bristow, who made important points about the need in our health and social care system. I look forward to working together to make this Government realise how important health and social care are for the people of this country.

The NHS is in crisis. Trusts across the country are under considerable strain as they seek to absorb additional demands for care, caused largely by the cuts that this Government have made since 2010 and the more than 100,000 vacancies in the NHS workforce. In December, we learned that A&E performance had dropped to 79.8% against the four-hour standard—the worst figures since records began. The Government’s response was not to fix the problem but to scrap the target, which could lead to a near-catastrophic impact on patient safety.

Health and social care provision have been decimated by this Government. We hear the Prime Minister and the Health Secretary crowing about making the “biggest ever cash investment” in the NHS in England. It is too little, too late—and I do not believe that it is true. The Prime Minister announced that 40 new hospitals would be built, and then we found out that there would be only six. It is nowhere near the biggest funding injection into the NHS in real terms when inflation is taken into account. The truth is that, prior to 2010, the long-term funding increases in the NHS were 4% per year. The Tories’ commitment is an increase of just 3.1%, and there have been huge cuts to social care.

We were promised a new plan for social care in December 2016, but still we have nothing. The Prime Minister previously said that he had prepared a “clear plan” to fix the social care crisis. Now we know that there is no plan, let alone a clear one. Last year, 34,860 people died while waiting for a decision on their application for social care. To think that social care could be fobbed off for up to another five years is a disaster for the 1.5 million people who cannot get the care they need today, a disaster for those in my constituency who must travel tens of miles to access in-patient mental health care, and a disaster for patients in my constituency who struggle to access GP services.

The NHS is seeing the first sustained fall in GP numbers in the UK for 50 years. Large workloads and feelings of demoralisation are behind a surge in the number of GPs wanting to quit. It is clear that the Government must be more ambitious on their GP training plans, because right now, eight out of 10 GPs feel unable to deliver safe care. Patients are waiting weeks to get an appointment and are being put at risk.

The investment promised by this Government may well keep our health service on life support, but the service needs real investment to meet the needs of the future and deliver the improvements we want to see to keep our patients safe.

Several hon. Members:


Photo of James Wild James Wild Conservative, North West Norfolk 4:18, 16 January 2020

It is a huge privilege, as someone born and bred in Norfolk, to stand here having been elected to represent the people of North West Norfolk. I thank them for putting their trust in me, which I will do my very best to repay.

I have many auspicious predecessors, including Sir Robert Walpole, our first Prime Minister. However, I want to pay particular tribute to my immediate predecessor, Sir Henry Bellingham. Henry was a great constituency MP who represented the area for over 30 years. He is rightly recognised locally as an assiduous champion for his constituents, regardless of how they voted. Indeed, such is his commitment that I was delighted to speak alongside him at a planning inquiry on Tuesday this week. I am sure the House will agree that, as a Member of Parliament and a Minister, he more than met the aim that he expressed in his maiden speech: to remove some of the “blemish” of a family member who assassinated a British Prime Minister. Echoing my hon. Friend Dean Russell, I know that I have big shoes to fill.

King’s Lynn is at the centre of my constituency, and its rich heritage dates from the 13th century, when it was one of the country’s main ports. Today, it continues to make a significant contribution to our local economy. This month saw the 575th anniversary of the first play performed at St George’s Guildhall, the oldest working theatre in the UK and the only one that can claim that Shakespeare performed there. The guild was founded, incidentally, by another of my predecessors, John Brandon, known as Britain’s greatest pirate. Channelling his spirit, I want to secure some of the treasure of the towns fund, the future high streets fund and the other investment coming from this Government for North West Norfolk.

Beyond King’s Lynn, my constituency is blessed with a beautiful coastline from Hunstanton to Holme and Brancaster to the Burnhams. To the west are the villages in the marshland—from Clenchwarton to Walpole St Peter. It is an area with a diverse economy, with much to offer, but it needs the infrastructure investment to help it thrive and take full advantage of the opportunities of Brexit. We also have a wealth of excellent pubs in the constituency: the Dabbling Duck in Great Massingham, the Rose & Crown in Snettisham and the Black Horse Inn in Castle Rising. As you can tell, Madam Deputy Speaker, I have been working hard to find the best, and I hope that the Budget will have good news for beer drinkers in all of them.

The Love West Norfolk campaign is doing a great job to promote all the good things about the constituency, but there are challenges—rural bus services, broadband, flood risk, educational outcomes—that I will want to help tackle in my time in this House. Healthcare is at the top of my constituents’ list of concerns, so I strongly support putting into legislation this record investment in the NHS. Similarly, our manifesto pledge to have 15 million more GP appointments has been widely welcomed, as has the excellent Pharmacy First initiative. During the election, I saw where that investment was going when I visited the site of the new surgery coming to Burnham Market, which will serve surrounding villages and also, importantly in my constituency, will have a dementia suite. Tomorrow, I will be meeting constituents who are concerned, as am I, about plans to close the GP surgery in Fairstead.

More than one constituent looking to find an NHS dentist has commented to me on the absurdity of the advice on the NHS website, recommending that they go to Skegness as the nearest practice. Flying across the Wash may be practical for the migrating pink-footed geese that are a great sight in the big skies of Norfolk, but it is not very practical advice for my constituents, so dental provision is an issue that I will be working on in this Parliament.

As well as the need to improve mental health services and social care, the Queen Elizabeth Hospital—the QEH—in King’s Lynn is extremely important to my constituents. Although it is in special measures, there is new leadership there, and on Friday I went to see for myself the improvements that are taking place, so the opportunity to speak in this debate is very timely. My visit came after an intense period in A&E, with a tenfold increase in the number of flu cases. Pam, the matron of A&E, was a great ambassador for the hospital—committed to delivering for patients and, despite all the challenges, she was still smiling. I met a dedicated maternity team, improving the service for new parents and supporting those who, sadly, suffer bereavements. I was glad to speak to the porters, cleaners, infection teams and security guards—the people who do not get the recognition they deserve, for they are the ones who can tell you what is really going on in the hospital. What came across to me was the passion of the staff: people proud of the improvements they have delivered for their patients, but who want to continue that journey and take the hospital out of special measures. As their MP, I pledge my support for them.

This year marks the 40th anniversary of the Queen Elizabeth Hospital. However, it was built with a life expectancy of 30 years, and its age is showing. The design does not lend itself to current clinical practices, care pathways or patient flows. A&E is too cramped to meet demand, and the roof has major structural issues. So, in this decade of renewal—with the infrastructure plan and the biggest cash investment in the NHS—I spy an opportunity not just to fix the roof, but to do more. I have spoken to my right hon. Friend the Secretary of State during the election campaign and since about the Queen Elizabeth Hospital. I know he will consider carefully proposals from the trust for capital investment—proposals that also harness digital technology. The QEH currently languishes near the bottom of the digital league, when it aspires to be like King’s Lynn FC, which is riding high at the top of the Vanarama National League North. The QEH is up for change, and it is up for innovation. My right hon. Friend has previously accepted an invitation to come to the hospital, and I would be delighted if he will join me in the near future to come and see how we can make the real improvements that the people of North West Norfolk deserve.

Photo of Preet Kaur Gill Preet Kaur Gill Shadow Minister (International Development) 4:24, 16 January 2020

It is an honour to follow James Wild who, along with many hon. Members this afternoon, made an excellent maiden speech. I wish him well and look forward to working with him and all new Members.

Two months ago, I stood in this Chamber and spoke of my disappointment that the Queen’s Speech included only one reference to mental health, and even that was a reference to the Mental Health Act 1983, rather than a systematic programme to tackle mental health across all demographics. According to research by the Children’s Society, of the 22,365 children in Birmingham, Edgbaston, an estimated 2,733 five to 19-year-olds are struggling with mental ill-health. That is more than 10%. At the same time, the money available for local services for children and young people has fallen by 38%. Is it any wonder that just last week, research by the Education Policy Institute revealed that more than a quarter of child referrals for children and young people’s mental health services in England last year were rejected? Even when a referral was accepted, many children had to wait for an average of two months to begin treatment in 2019—double the Government’s four-week target. Birmingham Women’s and Children’s Hospital has a median wait time of 112 days. That is almost four months.

A decade of neglect in early intervention care, and an under-resourced mental health services sector, has meant that many more young people are turning up to A&E. I had hoped that the Government would have listened when I raised the issue in the debate on the previous Queen’s Speech, but given a second chance, the Prime Minister has failed once again to show that he is serious about tackling mental ill health. Yes, reform of the Mental Health Act 1983 is important and desperately needed, but the Government also need properly to fund vital preventive services.

For the many new Members of Parliament, I will repeat the shocking statistic that failed to elicit any action last time: for the whole of Birmingham there is only one early intervention counselling service for young people. The most recent waiting list has 400 young people and their families who are waiting desperately for treatment and support. The only conclusion I can draw is that the Conservative Government are knowingly and willingly failing our children and young people.

We know what we need. We need genuine parity of esteem. We must use the standards that we expect for physical health treatment as a template, and apply them to mental health patients. We need mental health services that are truly responsive to the complex conditions with which our young people frequently present. We must listen to young people when making decisions about the mental health services they use. I will ask the Minister once again: will he listen to those of us who are calling for the Government to do more for young people with mental ill-health, and deliver on the promises that his party has been making—promises that it has so far been breaking?

As a former social worker, I was surprised that the Queen’s Speech failed to commit to a review of children’s social care—the vital system that is designed to protect some of the most vulnerable in our society. That total and utter dereliction of duty follows cuts of almost a third in services for children and young people since the Conservatives came to power. Children’s social care is coming apart, despite the best efforts of hardworking councils around the country.

It should not be just about this; it should not just be firefighting. Social care should be about providing a system to support every child. We must give children the opportunity for the best start in life, whether that is in the form of late intervention such as safeguarding teams that step in in instances of abuse or neglect, or whether it is early intervention such as children’s centres and programmes that support parents and youth services. Children’s services are not only about looking after children in care; they provide effective family support services that help more children to stay in their homes if it is safe to do so. The Conservative party manifesto recognises the underfunding of children’s social care. Does the Minister agree that local authorities still do not have sufficient resources to address rising demand, even if his Government deliver on their manifesto commitment?

Photo of Elliot Colburn Elliot Colburn Conservative, Carshalton and Wallington 4:28, 16 January 2020

Thank you, Madam Deputy Speaker. It is a pleasure to make my maiden speech as the new Member of Parliament for Carshalton and Wallington. First, I wish to thank the people in my constituency who sent me to this, the mother of all Parliaments. I also thank all hon. Members who have made their maiden speeches today and throughout the week. They have set the bar incredibly high, but I will do my best.

Before I go on, I must pay tribute to the man who came before me and who represented Carshalton and Wallington for 22 years: Tom Brake. He had served in the House since 1997, holding many positions in his party and the coalition Government. Although we did not agree on everything, as an LGBT+ person, I will always be grateful to him for voting in favour of same-sex marriage in 2012.

To many people, Carshalton and Wallington seems nothing more than a suburban commuter town with not much history. However, hon. Members who like their history will be delighted to know that there is a tale to tell, and like all good TV dramas it involves power, intrigue, and even a royal fall-out. Carshalton itself was rumoured to have been called Ceashorton, or Caesar’s Town, in ancient times, because of the belief that the Roman Emperor once pitched up camp there. However, during an excavation of what is now the Beddington sewerage farm, it was discovered that instead of a hoard from Roman legions it was, rather, a Roman bath house that occupied the site.

If we fast-forward to the Tudor period—I know my right hon. Friend the Leader of the House will be very excited to hear this section—we find that Carshalton and Wallington was home to the Carew family. Carew Manor, the only grade 1 listed building in my constituency, remains on the site today. It was home to Sir Nicholas Carew, who was a favourite of Henry VIII until he was executed for treason in 1539. It was here that the then king spent time with Ann Boleyn while awaiting his first divorce. Their daughter walked the same trail—Sir Walter Raleigh is rumoured to have walked there with Queen Elizabeth. Unfortunately, he was beheaded by James I in 1618. It is rumoured that his severed head was kept by his wife and, to this day, is buried somewhere under Beddington Park. However, hon. Members will be pleased to know that my favourite memory of our fabulously beautiful local park is when my other half, Jed, who is in the Public Gallery, asked me to marry him. I was reliably informed that I may have met the same fate as Sir Walter had I said anything but yes.

Turning back to the subject of today’s debate, I am delighted, as a former NHS worker, to be talking about health and social care. It is incredibly important to me and my constituents. Hon. Members were lucky to hear about our local hospital, St Helier, from a very early contribution in this debate, so they should know all about it. After decades of warnings about potential downgrading and even the threat of total closure, now, thanks to the Conservatives in government, we have the go-ahead for over £500 million of investment in St Helier and Epsom hospitals. That is half a billion pounds to shore up both hospitals, bring all usable parts back into use, and, most excitingly, build a third brand new hospital in our area to provide acute services. That is incredible news for local patients and something for which my hon. Friends the Members for Sutton and Cheam (Paul Scully), for Reigate (Crispin Blunt) and for Wimbledon (Stephen Hammond), and my right hon. Friend Chris Grayling, have been campaigning for a very long time.

However, the funding is not certain. The consultation on the site of the new hospital has just been launched, but unfortunately there is still a group locally who seem to think that the hospitals do not need any funding; that for some reason £500 million means the hospital will be closed and that actually all those services are going to go in the next couple of months. Madam Deputy Speaker, nothing could be further from the truth, and nothing puts our hospitals more at risk than irresponsible scaremongering about our health service. I make the pledge to my constituents, and every constituency covered by our local NHS trust, that I will work with constituency neighbours, when they are willing, to ensure that the investment gets delivered and that we fight off the scaremongers to finally put to bed a political football that has been raging for over 50 years.

Health is about much more than just hospital buildings. As a former NHS worker, I know, and those of us in this Chamber who have backgrounds in the health service will know, that a person’s overall health and wellbeing is down to so much more than the quality of, and access to, an A&E hospital. It also depends on your housing, where you went to school, the work you have and the local environment. I am glad to see that, in the Queen’s Speech, the Government have recognised those factors. In other words, every single part of our lives affects our overall health and wellbeing in some way. Every single Government Department, I hope, will bear that in mind when they make decisions. Investing in the NHS is not just the right thing to do; it underpins the very ability of our country to reach its full potential. By looking after the health of our people, we are looking after the health of our nation and giving all of us the chance to prosper in the modern world.

St Helier is just one of many campaign issues on which I was elected to serve as the Member of Parliament for Carshalton and Wallington a few short weeks ago. Other issues include local train services, opposition to the council’s poor decision on parking, providing first-rate education and protecting air quality. I will get to work immediately to deliver on those promises to move our country forward. Madam Deputy Speaker, it is time to get to work.

Photo of Yasmin Qureshi Yasmin Qureshi Shadow Minister (Justice) 4:34, 16 January 2020

When Labour came to power in 1997, there were 1.3 million people on a waiting list—the highest number since the NHS was created in 1948. The Labour Government used targeted and sufficient funding to bring all those figures down, to the point where A&E waiting times were down to four hours and waiting lists were down to 18 weeks. It is regrettable that the Government now want to abolish the A&E waiting time target. Is that simply to spare Ministers’ blushes? Since last October, 320,034 people waited more than four hours at A&E, whereas in 2010 the figure was just 41,231.

My constituents have to wait three weeks to see a GP, and many cannot find an NHS dentist at all. In relation to targets, one of the things that helped, of course, was treating cancer patients. In my constituency, 60% of patients received treatment within 62 days of their GP referral, but 40% did not get the treatment they wanted in time.

One of the main problems is the abolition of nursing bursaries, which has led to difficulties recruiting and training nurses. As we have heard, there are 100,000-odd nursing vacancies still to be filled. In relation to the doctors contract, the abolition of the golden pension meant that many doctors took retirement at age 60, which led to an acute shortage. I therefore ask the Government please to return the 6,000 GP contracts that they abolished, so that my constituents can see a GP when they need to, rather than having to wait three weeks.

Many hon. Members have spoken today about social care provision, but there is one further aspect that I would like Ministers to consider. Many care workers provide home visits of 30 or 45 minutes throughout the day. Their paid work might be for only four hours in total, but often they spend six or seven hours travelling between visits. They have to pay for their transport and are on low incomes, so often they travel by public transport. They might do only four hours of paid work each day, but they will have spent six hours travelling. I know that Ministers are looking into the whole issue of financing care for elderly and vulnerable people, but this is an immediate problem that needs to be resolved. I hope that the Minister, when he responds, will set out what he plans to do about that.

My hon. Friend Preet Kaur Gill referred to the provision of mental health facilities for young people. Young people in my constituency are having to wait around 10 weeks to be seen by child and adolescent mental health services, which help young people in schools who have mental health and psychological issues. The services are much needed but very underfunded. This is important, because at the moment we are hearing not just about loneliness, but about serious issues such as bullying, and the fact that many young people are very distressed, and some are taking their own lives. Proper funding for the provision of mental health services for young people is really important.

Finally, may we please have more provision within the funding for dentists? It really is appalling that across the country, but especially in the north, it takes people months to find an NHS dentist.

Several hon. Members:


Photo of Rosie Winterton Rosie Winterton Deputy Speaker (First Deputy Chairman of Ways and Means)

Order. The final two speakers have three minutes each.

Photo of Dr Caroline Johnson Dr Caroline Johnson Conservative, Sleaford and North Hykeham 4:38, 16 January 2020

It is an honour to speak on a Queen’s Speech that has set out such a fantastic programme for government, and from a Conservative majority Government. As a consultant paediatrician, it is particularly special for me to be able to speak in a debate on health.

I want to talk about the importance of engineers. My daddy is very fond of telling me that engineers have saved more people’s lives than doctors have; it will perhaps not surprise Members to know that daddy is an engineer. To some extent he is right, because improvements in water, sanitation, investigatory tools such as CT and MRI, and ventilating machines have saved many lives. That is why I am really pleased that the Government are bringing forward the medicines and medical devices Bill: it is by investing in research and increasing the number of people in clinical trials, and investing in research and development generally—the Government are committed to increasing investment in R and D to 2.4% of GDP—that we will be able to improve people’s lives. This is not all about increasing the NHS budget, although I am also pleased to see that we are giving the NHS its biggest ever cash injection, at £33 billion by 2023.

In my last minute, I want to talk about diagnostic centres. Grantham Hospital is very important to me and to my constituents, and to the constituents of my new neighbour, my hon. Friend Gareth Davies. I was pleased that earlier this week we were able to meet the Health Secretary to talk about the hospital’s future—a positive and excellent future, in a growing town.

As a doctor, I have seen a progressive move towards greater centralisation, with services becoming increasingly remote from the people whom they serve. That makes sense for low-volume, high-complexity work, because it improves outcomes for the patients who need such treatment, but it does not make sense for high-volume, low-complexity work, which should be delivered closer to home. I was pleased to hear the Health Secretary say essentially just that in his speech earlier today, when he suggested that diagnostics and investigations would move closer to home, which would mean a positive future for Grantham Hospital and the people there.

However, my first priority—and, no doubt, that of my hon. Friend the Member for Grantham and Stamford —is to ensure that the hospital’s A&E department reopens as a 24-hour, round-the-clock service. That is no more than my constituents deserve.

Photo of Richard Graham Richard Graham Conservative, Gloucester 4:41, 16 January 2020

It is a huge pleasure to be the tail-end Charlie of this massive debate on the Queen’s Speech. Every single Member who made a maiden speech today—and they were all outstanding—referred to health in considerable detail, which only goes to show that the Health Secretary already knows that we are all probably more concerned about our hospitals, nurses and GPs than about anything else. In these last few minutes, I want to focus on two issues. I will speak first about the workforce and people, because ultimately our great health service depends on people. Secondly, if I have the time, I will speak very briefly about national insurance.

As the Prime Minister has announced, we will have to recruit a great many more nurses from abroad, but there are issues there. First, the NHS visa is very welcome, but the mooted earnings threshold of £30,000 needs considerable thought, as does the application of the immigration health surcharge to those who are being recruited to work specifically for the NHS. There are also anecdotal issues about family visas. My own suggestion to the Health Secretary is that we could look at whether long-term partnerships between British universities and universities abroad in countries such as the Philippines might generate highly qualified nurses with British nursing qualifications and a good standard of English, ready to be recruited by the NHS and to come and work here. That would help to resolve some of our problems.

Even more important than our foreign nurses, however, is the regrowth of our home-grown nurses. That has been helped by this Government’s creation of nursing associates through a higher apprenticeship scheme. The “but” is that although work in, for example, Gloucestershire Royal Hospital is valid for the purposes of the higher apprenticeship scheme, the Nursing and Midwifery Council does not consider those employees to be eligible for the BSc course. I urge Ministers to think about how the apprenticeship levy could be used creatively to resolve the issue between NHS employers and the NMC. That would provide a clear pathway for healthcare assistants to go all the way to the status of a full nurse, which would help us to realise the goal of 50,000 more nurses.

As for national insurance—which does not insure anyone, let alone the nation—may I encourage the Health Secretary to look again at how we might use it as a ring-fenced source of funds for both health and social care, thus turning it into national health insurance, as a King’s Fund study recommended so strongly earlier this year? I believe that, sooner or later, that could be used for an even more precious cause: helping to fund our future health and social care needs.

Photo of Barbara Keeley Barbara Keeley Shadow Minister (Mental Health and Social Care) 4:44, 16 January 2020

Today’s debate has shown how important the NHS and social care are to Members on both sides of the House, and has been wide-ranging. It has been great to listen to contributions from, I think, 32 Back Benchers, but, because we are short of time, I will focus on paying a special tribute to the 12 who spoke for the first time.

I congratulate my hon. Friends the Members for Luton North (Sarah Owen), for Ealing North (James Murray), for Enfield North (Feryal Clark) and for Vauxhall (Florence Eshalomi), as well as the hon. Members for Sevenoaks (Laura Trott), for Bishop Auckland (Dehenna Davison), for Watford (Dean Russell), for East Dunbartonshire (Amy Callaghan), for Peterborough (Paul Bristow), for Twickenham (Munira Wilson), for North West Norfolk (James Wild) and for Carshalton and Wallington (Elliot Colburn). As Damian Green said earlier, the standard of maiden speeches we have been hearing is breathtakingly high. They all made excellent speeches, and reminded us of the qualities and commitment to public service of their predecessors. They also highlighted their own commitment to health and social care, and we heard of much personal experience of the wonderful job being done by our staff in the NHS and social care. Earlier, my hon. Friend Jonathan Ashworth, the shadow Health and Social Care Secretary, mentioned the loss of our colleagues Paula Sherriff and Julie Cooper, whom we miss. It was also good to hear kind words about our former Labour colleagues Helen Goodman, Lisa Forbes and Stephen Pound, whom we also miss.

Last month’s performance figures show the NHS struggling to cope with demand, unable to provide beds for patients and leaving them languishing on trolleys in A&E departments. More than 1,400 patients were left stranded in hospital each day last November. They were patients who were well enough to leave but unable to do so because of a lack of social care. The Government’s failure to address the crisis in social care is having a profound impact on the lives of people who need care, and on our struggling NHS. The Health Foundation said last week:

“No plan for the NHS will work while social care remains the Cinderella service. Long overdue action on social care is needed to…reduce the pressures on the NHS.”

Proposing a solution to the crisis in care should be the Government’s top priority, as we have heard in many of the speeches this afternoon. However, despite the Prime Minister’s earlier pledge to

“fix the crisis in social care once and for all, and with a clear plan we have prepared”, he now says only that he will do something “in this Parliament”. After 10 years of inaction, is that the best the Prime Minister can say, alongside a vague offer of cross-party talks?

There are four key areas where action is needed to ensure that people have access to a functioning social care service that meets their needs. Labour has plans for a national care service, and we have made it clear how we would have addressed these four key areas. The first is funding. The Association of Directors of Adult Social Services tells us that, since 2010, £7.7 billion has been cut from budgets for adult social care. Councils just do not have the funding required to deliver the care that people need. The second area is access to publicly funded care. Age UK estimates that 1.5 million older people are going without the social care and support they need every day, and that number is increasing year after year while the Government fail to act.

The third area is capping care costs. Too many people are faced with catastrophic costs for their care. In 2014, the Government proposed to introduce a cap to limit the amount people must pay for their care, but they dropped that in 2017. In the past three years, 9,000 people who have been paying for their own care have completely depleted their savings or assets and approached their local authority for help with their care. The people who face the highest costs are those with dementia. So just how will the Government deliver on their promise that no one will be forced to sell their home to pay for care? Will they introduce a cap on care costs, as Labour would do?

The final area is the care workforce. Skills for Care tells us that there are 122,000 vacant care jobs. Care staff do not get the pay, working conditions or access to training that they deserve, meaning that many of them leave working in care for better-paying jobs in retail or hospitality. We need to pay care staff the real living wage, provide them with training to develop their careers and end the use of zero-hours contracts.

But it is not just in social care that there is a workforce crisis, as we have just heard from Richard Graham. More than half of mental health professionals have said that they are too busy to provide the level of care they would like to give to their patients. We need more mental health nurses and more psychiatrists to meet demand. Three out of four children with a mental health condition do not get the support they need, and others wait months to be seen. Mental health patients continue to be sent hundreds of miles from home because their local NHS does not have the beds or the staff to provide the care they need. Placements are sometimes in private hospitals that provide inadequate care, and that includes the 2,200 autistic people and people with learning disabilities trapped in inappropriate institutions. Last week, the Prime Minister stated that that number was falling rapidly, but the Secretary of State for Health and Social Care, who is now sitting here with us, knows that that is not the case.

Eight years after a Conservative Prime Minister promised to end the use of such institutions, the speed of change has been glacial. It took the Health and Social Care Secretary 14 months to resolve the case of Bethany, a young woman with autism held in a series of inappropriate placements, and I remind him—I notice that he is not listening—that there are 2,200 more Bethanys who are too often subject to inappropriate seclusion and restraint, as she was. I was glad to hear Jackie Doyle-Price raise the matter of early deaths at in-patient units and to hear from my hon. Friend Helen Hayes on the need for homes, not hospitals.

From older people left without the care they need to children waiting months to see a mental health professional, we have seen people across the NHS and social care let down by this Government. Disappointingly, the Queen’s Speech did not set out measures to fund the NHS and social care properly. The Government must provide the necessary funding for both services and, importantly, must now put forward plans to fix the crisis in social care once and for all, as has been promised. I urge right hon. and hon. Members to support our amendment to guarantee that both the NHS and social care get the resources they need.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care) 4:51, 16 January 2020

It is a pleasure to wind up a debate on such an important issue as our NHS and social care, and it was marked by the many well-informed contributions from hon. Members on both sides of the House. Those contributions reflect the pride we all feel in our NHS and how important it is to our constituents.

Before moving on to the maiden speeches, I want to highlight the powerful contributions from my right hon. Friends the Members for Old Bexley and Sidcup (James Brokenshire) and for South West Surrey (Jeremy Hunt) and Emma Hardy. I can tell the hon. Lady that I believe we already have a date in the diary for February, so I look forward to meeting her and discussing the issues she raised.

Given the short time remaining, I intend to focus on today’s maiden speeches, so I hope the House will forgive me if I do not take interventions on this one occasion. All the maiden speeches we heard today were of an incredibly high quality, and all those who have spoken will play a full role in keeping both Front-Bench teams on their mettle in the months and years ahead.

I will start with my hon. Friend Dehenna Davison. She spoke deeply movingly about her father and what drives her politics. I congratulate her on already bringing the same passion and determination to ensure that her constituents’ views are heard that she demonstrated in her fantastically successful election campaign. I suspect that we shall all hear a lot more from her in the months ahead.

My hon. Friend Dean Russell mentioned that he had never really thought he would be here, but having heard him I can see exactly why he is here and why the people of Watford put their trust in him. In response to one of his comments, I say that one’s height—I look at you Madam Deputy Speaker, and I think of the Lord Chancellor and my old friend the former Member for Rutland and Melton—does not directly correlate to the influence that one can have in this place.

Amy Callaghan made an eloquent speech setting out passionately the principles that govern her politics and that she brings to representing her constituents. Her dedication to her constituency and to Scotland was clear in her remarks.

Florence Eshalomi showed that she will be as strong a voice for her constituents as her predecessor. She spoke very movingly about her mother, and I hope she will let me say that I suspect her mother would have been deeply and rightly proud if she could have seen and heard her speech in the House today.

My hon. Friend Elliot Colburn spoke powerfully on behalf of his constituents. He fought an excellent campaign, and he spoke charmingly and well about his predecessor. He spoke up for his hospital, and I know he will continue to do so, but he was also clear in informing his constituents of why they should ignore the scaremongering they may have heard over many years. In him, they have a strong local champion.

Munira Wilson steps into big shoes—indeed, big dancing shoes—and, judging by her speech today, I think she will have no trouble filling them. I hope her contribution today will be the first of many from her on health-related matters.

There may be something about Members for Ealing North, but James Murray demonstrated that they all display a good sense of humour in this place, and he is continuing that tradition. He was active as a deputy Mayor of London, and I am sure he will bring that experience, expertise and commitment to his new role. I welcome him to the House.

Feryal Clark spoke movingly and powerfully about the diversity of her seat. She spoke about the importance of that diversity, and of how we should all protect, encourage and champion such diversity. I am sure she will be a diligent and determined champion not only for that but for all her constituents.

Sarah Owen spoke powerfully of the importance of social care and getting it right. Again, she demonstrated a sense of humour in her remarks, which I am sure will mark her future contributions. We look forward to hearing more from her.

Finally, I have known my hon. Friends the Members for Sevenoaks (Laura Trott), for North West Norfolk (James Wild) and for Peterborough (Paul Bristow) as friends over many years, and they have served at the heart of Government and in this place in previous roles. They bring that same dedication and talent to serving their constituents. They spoke incredibly well, demonstrating their experience and passion, and I suspect we will be hearing a lot more from all three of them in this House and in national politics.

The election has broken the deadlock in this House, giving our country a majority Government who are not just getting Brexit done but repaying the trust placed in us by the public to deliver the people’s priorities. The Opposition Front Bench may speak about their commitment to the NHS, but this Government and this Secretary of State for Health and Social Care are actually delivering on our commitments. They are ambitious commitments, but they are the right commitments.

We are delivering the longest and largest cash settlement in the history of the NHS, and we are providing the investment that the NHS itself said it needed. We are delivering the biggest and boldest hospital building programme in a generation. We are delivering new treatments and new technologies to deliver world-class, world-leading and safer care. We are working to find consensus to address the injustices in social care and the inequalities in mental health. For too long, Governments of all shades have not given those issues the priority that this Government will now give them.

It is clear that the Conservative party is the party of the NHS. We have protected and prioritised the NHS for 44 years of its 71-year history when we have been in government. Under this Conservative one nation Government, under this Conservative one nation Prime Minister and with this Queen’s Speech, we will continue to do so. These legislative reforms will strengthen our NHS and put it on a secure and stable footing for the future.

We will ensure a publicly funded NHS, free at the point of use and accessible according to need not ability to pay, and an NHS that is not for sale and never will be; an NHS true to its founding principles but, crucially, an NHS that is ready for the challenges of the future. It is there not only for our generation but for future generations. The NHS belongs to all of us; it is the people’s NHS and this Government are there for it. I commend this Queen’s Speech to the House.

Question put, That the amendment be made.

Division number 15 Queen's Speech — Programme for Government — Health and Social Care

A majority of MPs voted against requiring a plan to end the crisis in social care and against at least a 4 per cent per year real terms increase in health spending.

Aye: 222 MPs

No: 313 MPs

Aye: A-Z by last name


No: A-Z by last name


Absent: 111 MPs

Absent: A-Z by last name

The House divided: Ayes 222, Noes 313.

Question accordingly negatived.

The debate stood adjourned (Standing Order No. 9(3)).

Ordered, That the debate be resumed Monday 20 January.