Pregnant Then Screwed Campaign
I was sadly unable to attend the Westminster Hall debate on the cost and availability of childcare on 13th September due to a prior commitment. However, ensuring parents have access to affordable childcare so that they may work or even had some much-needed time to themselves is very important to me.
That is why I am pleased that more than one million disadvantaged two-year-olds have benefited from 15 hours of free childcare since it was introduced. In March 2020 the Government announced it would continue to pay funding to local authorities for early education entitlements for two, three and four year-olds during any periods of early education settings closures, or when a child could not attend due to coronavirus.
At the same time, the Government announced that non-local authority providers of childcare would pay no business rates in the 2020-21 financial year. At the March 2021 budget the Government stated that the 100 per cent business rates relief would continue from 1 April 2021 to 30 June 2021. This was followed by 66 per cent business rates relief which will continue until March 2022.
In June 2021 further investment of up to £153 million over the next three academic years was announced, including funding for early years staff. As well as this, data published by Ofsted shows that the number of childcare places available in providers on the Early Years Register as of August 2020 has remained broadly stable since August 2015.
Scavitex is licensed for certain uses in the UK, as it has recognised benefits for sufferers of multiple sclerosis. However, the guidance from NICE states that it is not a cost-effective treatment for the NHS to routinely offer. I know that NICE update their guidance regularly, and it will be for them to discuss with the manufacturers of Sativex to find a model of funding appropriate to the NHS.
Alzheimer's UK (Conservative Party Conference)
I believe that increasing public awareness and understanding of dementia among the wider public is vital to ensure that people are supported to live well with the condition. Unfortunately, due to my hectic Conference schedule, I will be unable to stop by the Alzheimer’s Society stand as you suggest. However, I am committed to improving Alzheimer’s research and it is an issue that I keep a very close eye on.
Research is crucial to understanding and tackling dementia. Under the Challenge on Dementia 2020 strategy, the Government's commitment to spend over £300 million on dementia research between 2015 and 2020 was met a year early, with £341 million being spent by March 2019. The Government is also supporting the £79 million Accelerating Detection of Disease challenge, a project bringing together the NHS, industry and leading charities to support research into the early diagnosis of disease, including dementia.
I know that the Government remains committed to research to combat dementia, and will shortly lay out plans for supporting people with dementia in England up to 2025 - I look forward to seeing these plans and funding commitments at the next Spending Review. I will work with my colleagues in the Department of Health and Social Care to ensure that the manifesto commitment to double research funding to over £160 million each year by 2030 is delivered as swiftly as is possible.
I am proud to support a Government that is committed to taking the difficult decisions and tackling these problems head on, creating a sustainable adult care system that is fit for the future. An extra £36 billion will be invested in the health and care system over the next three years, including £5.4 billion in adult social care, to ensure it has the resources it needs to recover from the pandemic. Further, the Government announced a landmark £33.9 billion for the NHS by 2023/24 to secure the long term future of our NHS.
This issue unfortunately affects many people, and I offer my sympathy to those who have suffered miscarriages, stillbirths, or the loss of child. I applaud my colleagues who have recounted this difficult experience in their lives in Parliament to raise awareness of baby loss and inspire changes in policy to reduce the number of stillbirths in the UK, which is higher than in other similar countries.
I am pleased that the UK is one of the safest places in the world to give birth, however the Government recognises that there is still more to be done. I know that the Department of Health and Social Care has set out a range of new measures to deliver its ambition to halve the rates of stillbirths, neonatal deaths and brain injuries that occur during or soon after labour, and maternal deaths by 2025, through the Saving Babies' Lives care bundle, an updated version of which was implemented in March last year.
I firmly agree that all parents who experience pregnancy and baby loss and would like specialist psychological support should be able to access it. In view of this, I particularly welcome the commitment through the NHS Long Term Plan to increase mental health support funding by £2.3 billion per year by 2023/24. As part of this I know that care provided by specialist perinatal mental health services will be available from preconception to 24 months after birth.
I welcome the debate on this issue which was held on 23 September which and focused on wellbeing and what further action can be taken to prevent baby loss. However, due to prior diary commitments I was unable to attend but I will be sure to follow this issue closely.
Heart Disease (British Heart Foundation Campaign)
Heart and circulatory disease, also known as cardiovascular disease (CVD), causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas. This is the single biggest area where the NHS can save lives over the next 10 years.
I welcome goals set out in the NHS Long Term Plan which seek to target this, including preventing up to 150,000 heart attacks, strokes, and dementia cases over the next 10 years, working with partners to improve community first response and build defibrillator networks to improve survival from out of hospital cardiac arrest, and working to ensure up to 85 per cent of those eligible are accessing cardiac rehabilitation care by 2028, among the best in Europe. NHS England and NHS Improvement are investing £4.5 million in 2012/22 to support whole pathway improvements in cardiac networks and to reduce variation in care across the service. Further, the NHS is supporting patients to better understand their condition, so that they can be supported to self-manage at home.
I know that, in 2010, the National Institute for Health and Care Excellence published guidelines which recommended that patients with suspected heart failure should be seen by a specialist, inside a fortnight in urgent cases. I agree that these targets are important, as part of the wider work to reduce deaths from cardiovascular conditions.
The NHS is facing unprecedented pressure as it faces down the pandemic. I know that my colleagues in the Department of Health and Social Care are doing all they can to support the health service, recognising the exceptional efforts being made by health and care staff. All work to raise awareness of symptoms, including by the British Heart Foundation, is vital as part of efforts to ensure early and rapid diagnosis and treatment.
Unfortunately, due to my hectic Conference schedule, I was unable to visit the British Heart Foundation stand. However, as we emerge from the pandemic, I will of course continue to work with my colleagues in the Department of Health and Social Care to ensure patients receive treatment as quickly as possible.
Introducing vaccine passports as a way of coercing younger people to get the vaccine is entirely inappropriate. We do need to increase uptake in some age groups however this should be through positive encouragement and education.
The Government has taken the right decision to trust people’s judgment since the 19th of July. We do still need to take precautions as cases are alarmingly high, however the success of the vaccines means mortality rates are now broadly in line with endemic viruses such as the flu. We should be planning ahead to how we can end measures in September once this wave is over, not ramping them up.
I can assure you I have already made this point to ministers and will continue to do so.
Carers have a duty of care towards those that they look after and it is right that the Government is looking at taking robust action to protect those most vulnerable to COVID-19. It is already lawful for a care home to dismiss unvaccinated front line staff, (provided that certain conditions have been complied with) under statute and at common law. This is not a major change in the law, but a simplification. It is important to note that mandatory vaccination of those with a duty of care already exists elsewhere in the form of the requirement for surgeons to have a vaccine against hepatitis B.
The Government is launching a public consultation on whether or not to make COVID-19 and flu vaccination a condition of deployment in healthcare and wider social care settings as well. This is a complex issue and so it is right that the Government is looking for a wide range of perspectives from across the health and care sector about whether this should be introduced and how it could be implemented. I therefore would encourage you to take part in this consultation when it opens.
#EveryDoctor Briefing: Private Involvement in the NHS
I fully believe in our NHS and its values, which is why I welcome that the Government has guaranteed that the NHS will always provide healthcare free at the point of delivery, regardless of ability to pay. Let me be abundantly clear: the Government will never privatise the NHS.
The use of private providers and the voluntary sector in the delivery of NHS services is not a new concept, with the previous Labour Government introducing the independent sector and competition into the NHS between 1997 and 2010. Drugs and medical equipment are obviously supplied by private companies.
The NHS is something to be valued and protected which is why I support the commitment to properly funding the NHS. Since 2010 the NHS budget has increased every year, and I am happy to say that despite challenging financial circumstances, the annual budget of the NHS is being increased by £33.9 billion by 2023/24, which has been enshrined in law.
Abortion: The Diana Johnson Amendment
The Government is committed to protecting those selling sex from harm and enabling the police to target those who exploit vulnerable people involved in prostitution. It is also very important to ensure those who want to leave prostitution are given every opportunity to find routes out.
There are different approaches to prostitution around the world, including New Zealand and in Scandinavia, as well as recent legislative developments in Northern Ireland. The amendment tabled by Dame Diana Johnson to the Police, Crime Sentencing and Courts Bill, which would criminalise buying sex and decriminalises anyone offering sexual services.
The Government’s long-standing policy towards prostitution has been focused on tackling the exploitation associated with it and ensuring that those wishing to exit sex work are appropriately supported. I welcome the fact that the law around prostitution in England and Wales focuses on tackling harm and exploitation caused to those involved.
Ministers have assured me that they continue to meet and engage with experts, academics, the police and those who sell sex themselves to further their understanding on the issues around prostitution and this is all the more important during the Coronavirus outbreak. I will continue to press the Government to ensure those affected by the pandemic have access to the support they need.
EDM 151: Abortion
I completely understand what an incredibly emotive issue this is, and I appreciate the strength of feelings on both sides. It is for this reason that, as with other matters of conscience, the Government adopts a neutral stance on abortion, allowing Conservative MPs to vote freely according to their moral, ethical, or religious beliefs. This is a convention which I support wholeheartedly.
The approach to abortion in Great Britain is set out in the Abortion Act 1967, which states that two doctors must certify that, in their opinion, a request for an abortion meets at least one and the same ground laid out in the Act. These grounds include “risk to the life of the pregnant woman”, and “substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped”.
Not every pregnancy goes to plan and foetal abnormalities of varying degree of severity can occur. Women need support and information to reach an informed decision about how to proceed. Health professionals must adopt a supportive and non-judgemental approach regardless of whether the decision is to terminate or continue the pregnancy.
Baby Loss & Support
This issue affects many people, and I offer my sympathy to those who have suffered miscarriages, stillbirths, or the loss of child throughout their lives.
One of the key commitments in the NHS Long Term Plan published in 2019 is to make the NHS one of the safest places in the world to give birth. The Department of Health and Social Care has set out a range of new measures to deliver its ambition to halve the rates of stillbirths, neonatal deaths and brain injuries that occur during or soon after labour, and maternal deaths by 2025, through the Saving Babies' Lives care bundle, an updated version of which was implemented in March last year.
The Government has provided £2.45 million of new funding which will benefit NHS maternity staff and improve the safety of the women and babies they care for. The Royal College of Obstetricians and Gynaecologists (RCOG) has been awarded almost £2 million to lead the first phase of the Avoiding Brain injuries in Childbirth (ABC) collaboration and £450,000 to develop a new workforce planning tool to improve how maternity units calculate their medical staffing requirements, to better support families and babies.
I firmly agree that all parents who experience pregnancy and baby loss should be able to access specialist psychological support. In view of this, I particularly welcome the commitment through the NHS Long Term Plan to increase mental health support funding by £2.3bn per year by 2023/24. As part of this care provided by specialist perinatal mental health services will be available from preconception to 24 months after birth. I am encouraged by the Government’s collaboration with charities, such as Sands, Bliss, Tommy’s and others, to raise awareness of the preventative measures and to support people experiencing baby loss.
Diabetes is Serious Campaign
I, of course, understand the severity of diabetes; it is a leading cause of premature mortality, doubling an individual's risk of cardiovascular disease. With over 22,000 additional deaths each year, it costs over £10 billion every year to manage. It is right, therefore, that diabetes features prominently in the NHS Long Term Plan (LTP).
While Type 1 diabetes cannot be prevented and is not linked to lifestyle, Type 2 diabetes is largely preventable through lifestyle changes. That is why I am delighted that prevention is at the heart of the NHS Long Term Plan. One of the key commitments in the LTP is to double, to 200,000 people per year by 2024, the scale of the NHS Diabetes Prevention Programme which supports those identified as high risk of type 2 diabetes to reduce their risk.
To date NHS England has invested approximately £120 million of transformation funding into local services to target variation and improve performance in the treatment and care of people living with diabetes since 2017/18. This is focused on improving attendance at structured education to increase understanding, improving achievement of NICE targets and reducing variation across the country, reducing amputations through improved provision of multidisciplinary footcare teams, improving timelines of referrals from primary care for patients with diabetic food disease, and reducing lengths of stay for diabetic inpatients through specialist nursing services.
I absolutely agree that technology could, and should, provide vital support to people managing diabetes and I know that new treatments and technologies are being created all the time. I welcome the DHSC Research and Development Budget for 2021 of £1.3 billion, which underlines the commitment to ensure that the best possible treatments and technologies are available through the NHS at the earliest opportunity.
I hope this reassures you about the commitment to tackling diabetes as well as supporting those living with it to lead healthier lives.
Mental Health Services in South Cambridgeshire
While it is hugely welcome that we are on the road to parity of esteem, there is still more to do. That said, I am extremely encouraged by the news that, as part of the five-year funding offer that will see the annual NHS budget grow by over £33.9 billion, mental health services will receive budget growth of £2.3 billion over the five-year funding settlement, the fastest uplift in funding. This will enable further service expansion and faster access to community and crisis mental health services for both adults and particularly children and young people. Further, for the first time, in 2018/19, all clinical commissioning groups increased the amount spent on mental health by at least as much as their overall budget increases. I also welcome the Government's commitment of around £2 billion to address waiting times for mental health services, giving more people the mental health support they need, investing in the NHS workforce and helping to ease existing pressures in the NHS caused by COVID-19.
I am pleased that a new mental health crisis service with comprehensive mental health support will be available in every major A&E, alongside new children and young peoples’ crisis teams across the country. The additional funding will also deliver more mental health ambulances, “safe havens” in the community; and a 24-hour mental health crisis hotline when people are in urgent need of help.
I hope these new services help end the stigma surrounding mental health, offering crucial support to people suffering from crisis and those who have suffered in silence for too long.
British Sign Language
Deafness or being hard of hearing should not be a barrier to participating in society and I appreciate your desire to have BSL recognised in UK law. The Government formally recognised British Sign Language as a language in its own right in 2003 and provision for accessing services by users of BSL is covered by equalities legislation and by the Public Sector Equality Duty. Employers, service providers and public bodies must provide services in BSL when it is reasonable to do so.
It is clear to me that the Government and the public sector should lead by example in ensuring that important communication is accessible to all. That is why I am glad that public health information has been available in many alternative formats including BSL during the Covid-19 outbreak. Covid-19 press briefings with BSL have been available on the Downing Street social media channel and the BBC News channel has provided live BSL interpretation for the briefings.
BSL, more broadly, may also be offered in schools as part of the school curriculum. I understand that the Department for Education is working to develop draft content for a potential GCSE in BSL and that a consultation on the content is due to published this year.
Transforming Social Care
I absolutely agree that patient safety and care for those with autism and learning disabilities should be to the highest standard and I am deeply concerned at the abuse that patients in Winterbourne and other hospitals faced. Children, young people and adults with a learning disability, autism or both, with the most complex needs, have the same rights to live fulfilling lives. Since 2015, the number of people in inpatient care has reduced by almost a fifth, which is welcome progress.
The NHS Long Term Plan sets out key changes to inpatient units for those with learning disabilities and autism. This includes a commitment to reducing the number of admissions and decreasing the amount of time spent in these units. However, I do appreciate the need to do all we can to support the prevention of inpatient admission and so it is welcome that the Long Term Plan includes increased investment in intensive, crisis and forensic community support. This will enable more people to receive personalised care in the community, closer to home, and reduce preventable admissions to inpatient services. Local providers will also be able to take control of budgets to reduce avoidable admissions, enable shorter lengths of stay and end out of area placements.
I firmly support the four principles set out in the Government’s proposed changes to the Mental Health Act as an important measure for protecting patients, service users, and their loved ones. I understand that the Government is currently reviewing feedback from the consultation on reforming the Mental Health Act, which included consideration of the introduction of new duties on commissioners to ensure the adequate supply of community services for people with a learning disability and autistic people.
I recognise that changes with regard to this matter have enormous ramifications for you personally. I will of course continue to monitor this issue carefully, and I am very grateful that you have brought this to my attention. I will bear your comments in mind when I discuss the issue with ministers.
Diabetes is a leading cause of premature mortality, doubling an individual's risk of cardiovascular disease. With over 22,000 additional deaths each year, it costs over £10 billion every year to manage.
While Type 1 diabetes cannot be prevented and is not linked to lifestyle, Type 2 diabetes is largely preventable through lifestyle changes. That is why I am delighted that prevention is at the heart of the NHS Long Term Plan (LTP), launched in 2019. One of the key commitments in the LTP is to double, to 200,000 people per year by 2024, the scale of the NHS Diabetes Prevention Programme which supports those identified as high risk of type 2 diabetes to reduce their risk.
Further, medical research has shown that some people with type 2 diabetes can achieve remission through adoption of low-calorie diets: this is a non-invasive treatment allowing people with type 2 diabetes to tackle their diabetes as part of leading healthier lives. I warmly welcome the inclusion in the LTP of pioneering plans to test an NHS programme of low-calorie diets for overweight people with type 2 diabetes.
To date NHS England has invested approximately £120 million of transformation funding into local services to target variation and improve performance in the treatment and care of people living with diabetes since 2017/18. This is focused on improving attendance at structured education to increase understanding, improving achievement of NICE targets and reducing variation across the country, reducing amputations through improved provision of multidisciplinary footcare teams, improving timelines of referrals from primary care for patients with diabetic food disease, and reducing lengths of stay for diabetic inpatients through specialist nursing services. I look forward to reviewing updated data on the National Diabetes Treatment and Care Transformation Fund as soon as it is released.
While I was unfortunately unable to attend the event on 7th July, I will of course be happy to learn more about this issue so that I can represent my constituents living with diabetes in Parliament.
I hope this reassures you about the commitment to tackling diabetes as well as supporting those living with it to lead healthier lives.
Health & Disability Green Paper
I appreciate that there is frustration at the delay to the Health and Disability Green Paper, but it is my understanding that, given the necessary focus on the departmental response to Covid-19, Department for Work and Pensions (DWP) are working to a longer timescale than previously anticipated. The Minister for Disabled People is continuing to engage with disabled people and their representatives and is committed to publishing the formal consultation document in the coming months.
The Green Paper will consider how to improve the DWP’s current services so they are better and easier to use, explore how extra support can help people navigate the system as well as what can be done to better support disabled people into employment.
I know that DWP has run workshops across the country where local disability organisations and disabled people have shared their experiences and priorities for future change.
Additionally, the Government plans to publish a National Strategy for Disabled People, which will focus on issues that disabled people say affect them the most across all aspects of daily life.
COVID-19: Booster Jab for Asthma Sufferers
The Joint Committee on Vaccination and Immunisation (JCVI) concluded that only those with more severe forms of asthma are at clinically high risk from COVID-19. This group are defined as adults with asthma who require continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission and will have been eligible for vaccination as part of priority group six. An individual with a more severe case of asthma may have been included in the clinically extremely vulnerable group, in which case they will have been eligible as part of priority group four.
To assist GPs in identifying patients eligible for a vaccine in each priority cohort, NHS Digital aligned specifications for the identification of patients via their medical records with GP system suppliers. Asthma sufferers were identified through this system and invited to make an appointment when the vaccination programme reached their priority cohort. I urge anyone who thinks they should be in these categories to get in touch with their GP to discuss.
While the programme of first and second doses continues, the Government has confirmed that a booster shot programme will happen in the Autumn for over 50s and those who would usually get the flu vaccination, and steps are being taken to prepare for this. Of course, some logistical matters remain to be resolved, but it is anticipated that the booster programme will be rolled out in a similar way to the current programme albeit with some differences.
Continuity of Care
I agree that every woman and their baby should receive personalised, high-quality care. One of the key commitments in the NHS Long Term Plan (LTP) published in January 2019 is to make the NHS one of the safest places in the world to give birth. The Government has set out a range of new measures to deliver its ambition to halve the rates of stillbirths, neonatal deaths and brain injuries that occur during or soon after labour, and maternal deaths by 2025. To help meet this target, I welcome the Government’s announcement that it will recruit 3,000 more midwives.
I firmly agree that the continuity of carer model is extremely important, and is associated with reduced pre-term births, hospital admissions, reduced need for intervention during labour, and an improved experience of care. Local maternity units are rolling out a standard continuity of carer model and the NHS Planning Guidance 2019/20 stated that that they should prioritise women who could be at higher risk. I know that work is ongoing to roll out this model, though that has been slightly more difficult during the 12 months of the COVID-19 pandemic.
While it is welcome that the target to reduce neonatal stillbirth and neonatal mortality rates by 20 per cent by 2020 was met, with almost a 25 per cent reduction reported, more work is being done in this area to further reduce these rates. Losing a baby is devastating, and it is vital we do everything possible to ensure that parents who have previously lost a baby are properly and consistently supported through any future pregnancies.
Support for Mental Health Services
It is incredibly important to protect and support the health of children and young people in our society. In recent years we have made huge progress in understanding mental health issues, and I support efforts to transform children and young people’s mental health for the better. Approximately 10 per cent of 5 to 16 year olds have a clinically diagnosable mental health problem. Since 2015, an additional £1.4 billion has been invested to transform children and young people’s mental health services.
The Children and Young People’s Mental Health Green Paper sets out ambitious proposals to improve mental health services for children and young people, together with over £300 million of funding. This will incentivise and support schools and colleges to train designated leaders for their pupils’ mental health, and introduce new mental health teams, both of which will ease pressure on NHS mental health services.
The NHS Long Term Plan makes a commitment to offering children and young people the best start in life. As part of this, there is an additional commitment to deliver on the promises made in the Five Year Forward View for Mental Health so that 70,000 more children and young people will access treatment each year by April 2021. Moreover, by 2023/2024 at least an additional 345,000 children and young people aged 0-25 will be able to access support via NHS funded mental health services and school or college-based Mental Health Support Teams. In particular, I welcome the Secretary of State's announcement that £79 million from the additional £500 million for mental health announced at the 2021 Spending Review will be allocated to accelerate the commitment to expand these services.
Early intervention is absolutely vital in the fight against eating disorders and everyone with an eating disorder must have access to timely treatment. That is why I am glad that an ambitious new access standard has been introduced, aiming for 95 per cent of children (up to 19 years old) with eating disorders to receive treatment within a week for urgent cases and four weeks for routine cases by the end of 2020. While in view of the coronavirus pandemic I know that this has been a particularly challenging year, and I share your disappointment that this target was not met, I know that NHS staff have been working extremely hard to refer people as quickly as possible: I am certain that services will continue to improve, particularly as NHS services return to normal following the disruption of the past year.
Joint Replacement Surgery
I am so grateful to everyone who has worked so hard to stay at home throughout the pandemic: your efforts have undoubtedly saved lives, and enabled our NHS to provide urgent treatment like cancer and emergency care. However, I understand that 4.7 million people in England are now waiting for care, with around 380,000 of those having been waiting more than a year, in addition to people who have not contacted their GP when, in ordinary times, they would have reached out for help. I agree that we must act urgently to tackle this problem.
As a result, I welcome that the Government is already working with the NHS to accelerate service recovery: in March 2021, an additional £7 billion of funding was announced for healthcare services, including £1 billion to target backlogs in elective services. As part of the commitment to recovery of non-urgent services and to address elective backlogs, £325 million has been provided for new investment in diagnostics equipment to improve clinical outcomes.
I know that staff throughout the NHS are working extremely hard to tackle the backlog: in January and February 2021 NHS staff completed almost 2 million operations and other elective care while also providing treatment to 140,000 COVID-19 patients in England. However, I agree that there is more work to be done in this area over the coming months
Including Calories on Menus
My colleagues in the Department of Health and Social Care recognise concerns people with eating disorders may have on measures to reduce obesity, and I support their commitment to striking a careful balance between enabling people to make healthier food and drink choices whilst not negatively impacting on those with or recovering from an eating disorder.
I understand your concerns about calorie labelling at large out-of-home businesses with 250 or more employees. Alongside work to develop the obesity strategy, an equality assessment was undertaken to understand the impact of these proposals, including on people with eating disorders. The study determined that, although some research has shown that label use on packaged foods was related to engagement in some unhealthy weight behaviours, there is a larger likelihood of participants engaging with healthy weight control behaviours.
More than a third of children leave primary school overweight or obese, and nearly two-thirds of adults are overweight, it is vital that we equip people with the information to make decisions about their food intake. Information on the energy content of food and drink is already widely available in supermarkets through mandatory nutrition labelling requirements on pre-packaged foods and some restaurants.
The Government is committed to striking a careful balance between informing and educating people to make healthier choices, while not negatively impacting people with eating disorders or those in recovery from eating disorders. This issue will, of course, require careful monitoring, and I will certainly keep a close eye on it going forwards.
Prioritising Women's Health
I was extremely pleased by the Government’s announcement that to mark International Women’s Day 2021, Ministers are launching a 12-week call for evidence to form the basis of the new Women’s Health Strategy. This aims to understand and improve the health and wellbeing of women across England. While our NHS is outstanding, the Government knows it can be improved to better suit the needs of women.
The Strategy will focus on six key themes: placing women’s voices at the centre of their health and care; improving the quality and accessibility of high-quality information and education on women’s health; ensuring the health and care system understands and is responsive to women’s needs throughout their lives; understanding how women’s physical and mental health can affect them in the workplace; ensuring that research, evidence and data support improvements in women’s health; and finally understanding and responding to the effects of the coronavirus pandemic on women’s health.
The call for evidence is about giving women, from all backgrounds, a voice and autonomy about their health. Ministers will also be taking evidence from organisations and researchers to produce a landmark strategy that will radically improve the health of women.
You can find more information, and respond to the survey or submit written evidence, here:
Cancer remains a high priority for the Government and despite survival rates being at a record high, too many people continue to die from it, leaving many devastated by the loss of loved ones. In the past decade, rates of survival from cancer have increased year-on-year. Around 7,000 people are alive today who would not have been had mortality rates stayed the same as then.
The NHS Long Term Plan (LTP), published during 2019, outlined a number of new measures for catching cancer early and providing treatment, with the aim that from 2028, 55,000 more people each year will survive their cancer for at least five years after diagnosis. One of the measures outlined in the plan is safer and more precise treatment, including advanced radiotherapy techniques and immunotherapies to continue to support improvements in survival rates. This will be supported by a £130 million upgrade of radiotherapy machines across England, as well as commissioning the NHS new state-of-the-art Proton Beam facilities in London and Manchester.
In addition, the LTP commits to reforms to the specialised commissioning payments for radiotherapy hypofractionation to support further equipment upgrades. Faster, smarter and more effective radiotherapy, supported by greater networking of specialised expertise, will mean more patients are offered curative treatment, with fewer side effects and shorter treatment times. Starting with ovarian cancer, the NHS will ensure greater access to specialist expertise and knowledge in the treatment of cancers where there are fewer or more risky treatment options.
I hope that this provides reassurance that providing adequate support for a widely used and effective treatment for cancer is absolutely a priority for the Department of Health and Social Care and across the NHS.
I believe that we must all receive dignified care in old age. With an ageing population, this is one of the biggest challenges that our country faces. I stand by the Government’s commitment to ensure that the most vulnerable in society are given the support that they need. While it is important to note that more than four of every five people in care are looked after by good and outstanding organisations, more needs to be done to tackle this serious challenge, crucially by securing a long-term funding solution. I’m delighted that the Prime Minister has spoken of his determination to tackle this, stating in his first speech as Prime Minister that “we will fix the crisis in social care once and for all with a clear plan we have prepared, to give every older person the dignity and security they deserve”.
At the Spending Review in November 2020, local authorities were enabled to access over £1 billion of spending for social care, through £300 millions of social care grant, and the ability to levy a three per cent adult social care precept. This is in addition to the £1 billion social care grant announced during 2019, and the £3 billion provided to local authorities to address COVID-19 pressures, including in adult social care. I know that this Government is committed to sustainable improvement of the adult social care system.
Money alone will not fix the problem and reform is needed to encourage high standards across the whole country. It is vital for us to consider ways of encouraging collaboration between health and care services, such as the Better Care Fund which assists local government and the NHS with the implementation of integrated services.
In the Conservative Manifesto, on which I was proud to stand, we set out our aim to build the same level of consensus on social care that we have already built on the NHS, across political parties, so that an answer can be brought forward that solves the problem, commands the widest possible support, and stands the test of time. I firmly support the renewed commitment in the Queen's Speech to bring forward proposals to reform social care during this Parliament, and eagerly anticipate taking part in a conversation about establishing a care system fit for the 21st century.
HIV Action Plan
The UK is a world leader on this issue, as demonstrated our commitment of £1.4 billion to the Global Fund to Fight AIDS, TB & Malaria. This is our largest commitment to date and makes us the second largest donor (behind the US) to the current replenishment (2020-22) of the Fund.
Thanks in part to the UK's consistent and generous support, since 2002, the Global Fund has achieved what was once considered impossible. From the peak of the HIV crisis in the late 1990s and early 2000s, annual AIDS-related deaths and new infections have been cut by half. Of the 38 million people living with HIV, 25.4 million are on antiretroviral therapy today – 20.1 million in the countries where the Global Fund invests. I am assured that the UK will continue to support the Global Fund in its vital effort on this issue.
In recognition of the critical role that civil society organisations play in the AIDS response to address inequalities and hold governments to account the UK is also supporting the Robert Carr Fund, of which it was a founding member. The UK has committed £15 million to this Fund since its inception, and I am told that future investments will be announced later this year.
Ministers are also engaged with preparations for the upcoming UN High-Level Meeting on HIV and AIDS.
More broadly, I welcome that the Foreign Secretary has confirmed that investing in global health is one of seven key ODA priorities going forward, on which approximately £1.3 billion will be spent in 2021.
Coping with terminal illness is distressing and difficult both for the patient and their families. These cases are truly moving.
Assisting or encouraging suicide is a criminal offence under Section 2 of the Suicide Act 1961 for which the maximum penalty is 14 years’ imprisonment. I am aware that the Director of Public Prosecutions (DPP) published guidelines primarily concerned with advising the Crown Prosecution Service (CPS) prosecutors about the factors which they need to consider when deciding whether it is in the public interest to prosecute a person for assisting or encouraging another to commit suicide.
The House of Commons has discussed the DPP’s guidelines and these were unanimously commended as being a compassionate and measured way of dealing with one of the most emotionally charged crimes in the statute book. However, they do not change the law; assisting or encouraging suicide has not been decriminalised.
The DPP further clarified the CPS Policy on the likelihood of prosecution of health care professionals, to specify that the relationship of care will be the important aspect and it will be necessary to consider whether the suspect may have been in a position to exert some influence on the victim.
I believe the application of the law should be flexible enough to distinguish the facts and the circumstances of one case from another. To this end, the DPP’s policy offers important and sensitive guidance.
I fully accept that suicide, assisting or encouraging suicide, assisted dying and euthanasia are all subjects on which it is entirely possible for people to hold widely different but defensible opinions. This is why the substance of the law in this area is not a matter of party politics but of conscience, and any vote would be a free one should the law in this area ever be altered.
I believe that competent adults who are terminally ill should be provided at their request with specified assistance to end their own life, with sufficient checks in place to guarantee that vulnerable people are not taken advantage of.
Centene Involvement in the NHS
I fully believe in our NHS and its values, which is why I welcome that the Government has guaranteed that the NHS will always provide healthcare free at the point of delivery, regardless of ability to pay. Let me be abundantly clear: the Government will never privatise the NHS. The NHS is not for sale.
The use of private providers and the voluntary sector in the delivery of NHS services is not a new concept, with the previous Labour Government introducing the independent sector and competition into the NHS between 1997 and 2010. Most general practitioner (GP) practices are private partnerships that hold contracts with NHS England and NHS Improvement to provide primary medical services. Almost all the suppliers to the NHS, from pharmaceutical companies to medical equipment manufacturers, have always been private companies.
Centene Corporation does not own any GP surgeries in England. Centene is the owner of Operose Health Ltd.’s holding companies. It is Operose Health Ltd that holds the GP practice contracts.
While I acknowledge your concern about their involvement in GP surgeries, patient care will not be affected, and all services remain free at the point of delivery. As with all GP services, those for which Operose Health is responsible will continue to be regulated and inspected by the Care Quality Commission. I understand that the CCGs where this has happened have followed the appropriate and robust processes prior to transfer of responsibility. The NHS has always involved a mixture of public and private provision, and it is absolutely not for sale to private providers.
Report on Race & Ethnic Disparities
The Government’s commitment to building a fairer Britain and putting an end to racism is unwavering. That is why the independent Commission on Race and Ethnic Disparities was established in the aftermath of the outpouring of emotion last summer. It has examined outcomes across the population on education, employment, health and crime and policing.
The commission’s work is clearly extensive and covered some very difficult and contentious issues with delicacy and sensitivity. I am encouraged that the Commission has taken an evidence led approach and making recommendation based on what works to promote equality of opportunity.
The findings in the report have sparked a national conversation about race which will undoubtedly shed light on important issues across education, employment, health and the criminal justice system. For example, the report found that, while the UK is not yet a post-racial country, it has made considerable progress in addressing racial disparities in education and, to a lesser extent, the economy. I am encouraged to see that diversity has increased in professions such as law and medicine and that the ethnic pay gap has shrunk to 2.3 per cent. Many communities, in particular British Indians and British Chinese, now have considerably better educational outcomes than the national average.
While there has been great progress made in the past 50 years, Ministers recognise that there are areas which need our immediate attention. The report sets out 24 recommendations within four key themes that address the aspects the Commission believes will catalyse the most effective and meaningful change. The areas of focus are building trust, promoting fairness, creating agency and achieving inclusivity. For a full list of the recommendations, please visit: https://www.gov.uk/government/publications/the-report-of-the-commission-on-race-and-ethnic-disparities/foreword-introduction-and-full-recommendations
The Prime Minister supports the work of the Commission and the Government will consider its recommendations in detail and will respond in due course. I will closely follow the implementation of the recommendations.
Endometriosis and Polycystic Ovary Syndrome (PCOS)
These are common long-term conditions that can have a significant impact on a woman’s life. I believe it is important to raise awareness of the impact on women worldwide.
To provide support, all obstetricians and gynaecologists have been trained in the diagnosis and treatment of these conditions; it is a core part of their training. The NHS has published clinical guidelines on the management of endometriosis, and PCOS, to assist doctors.
Through its mandate to NHS England, the Government has set out ambitions to improve the care and support of people with long-term conditions in order to help them to live healthily and independently, with much better control over the care they receive.
I agree that swift diagnosis helps to ensure women are able to access the treatment and support that they need as quickly as possible. However, I understand that there are currently no plans to reduce the diagnosis time for endometriosis. Given the highly invasive nature of the diagnostic procedure and the varying degree to which women experience symptoms, it can be more appropriate to treat mild symptoms on clinical grounds and reserve a laparoscopy with its inherent risks for women with more significant symptoms. However, NHS England has developed a service specification for severe endometriosis under the specialised commissioning area of complex gynaecology, ensuring that specialist training is available to support diagnosis. While I know that this will not be what you were hoping for, I would certainly be happy to work to raise awareness of the condition and its symptoms to ensure women are empowered to seek help when they experience endometriosis.
I welcome the work of Endometriosis UK and Verity, the UK PCOS Charity, to raise awareness of these conditions, as well as providing sufferers with further information and access to clinical trials and the latest research. In addition, I know that the Government already provides £1 billion funding each year to the National Institute for Health Research, an organisation which invites scientific researchers to apply for funding support, across all fields, including for conditions like endometriosis and PCOS.
Alongside this, I support the Government’s commitment to increase NHS spending by £33.9 billion by 2024/25. This will enable the NHS to fund its own plan for the future, the NHS Long Term Plan. In addition, I know that the APPG on Endometriosis has recently published a report following an inquiry into the impact of the condition, which my colleagues in the Department of Health and Social Care will carefully consider as part of their ongoing work to support women's health.
I completely understand what an incredibly emotive issue this is, and I appreciate the strength of feelings around this matter. It is for this reason that, as with other matters of conscience, the Government adopts a neutral stance on abortion, allowing Conservative MPs to vote freely according to their moral, ethical, or religious beliefs. This is a convention which I support wholeheartedly.
Abortion care is an essential part of care for women, and safeguarding measures are still in place as part of care during the pandemic. The Royal College of Obstetricians and Gynaecologists has offered guidance on this issue which can be found here:
Guidelines have been issued which enable women to take both Mifepristone and Misoprostol at home for the duration of the outbreak, so that they do not have to visit a medical practice and risk exposure to the virus, and to enable doctors to prescribe medicines from home via telephone or video consultations without consulting a second practitioner, so that abortion care can be provided even in the case of staff shortages. I have been assured this alteration will last only as long as the temporary provisions enacted by the Coronavirus Act 2020 to protect women seeking care endure. The medicines must still be instigated prior to nine weeks and six days into the pregnancy. I am aware of data that indicates an increase in the number of abortions carried out in April 2020 by comparison with April 2019; I am also aware that the same dataset shows lower abortion rates during May and June 2020 compared with the same months in 2019. The pandemic has had an impact on many aspects of daily life, the full picture of which may not be clear for some time to come. I will, of course, continue to monitor this sensitive issue.
I understand that a consultation has been announced to explore whether these temporary changes should be enacted long term. You can find more information on that here:
I have been distressed to read news reports of cases where abortions had been sought and enacted after the ten week legal limit for taking the medicines at home, and have caused further illness and even death. I understand that these instances are being investigated to ensure that women are accessing safe care, and that clinicians are properly supported through the consultation process. While it would be inappropriate for me to pre-empt the outcome of these investigations, I will continue to support all efforts to ensure safety is a paramount consideration for any amendments to regulations, however temporary. I will continue to monitor this issue closely.
I know that making a decision regarding abortion care can be an extremely difficult time, and I believe that we must do all we can to support women to make an informed decision, taking into consideration all their options, with medical professionals offering impartial advice. I will continue to do all I can to ensure plenty of information is available to women making enquiries relating to abortion care including all options available to them.
COVID-19: Access to Public Toilets
I know many people in the constituency with certain medical conditions greatly value being able to use public toilets. As we live with this virus, I understand some people would like to avail of these facilities to wash their hands.
During this difficult time, I welcome that billions have been made available to local authorities to address pressures they are facing in response to the Covid-19 pandemic, including improving the provision of public lavatories.
Guidance on ways that public spaces such as lavatories can be opened has been provided to local authorities. It is up to your local council to provide this service where possible and in accordance with the latest scientific advice, and I will continue to liaise with them on this issue.
You may also be interested to know that the Non-Domestic Rating (Public Lavatories) Bill is making its way through Parliament. This will legislate to provide 100 per cent business rates relief for public lavatories, alongside over £6 million in compensation for lost income to local councils in England and Wales.
COVID-19: Vaccine Prioritisation - Teachers and School Staff
I am delighted that three vaccines - Pfizer/BioNTech, Oxford/ AstraZeneca and Moderna - have been approved for use in the UK. We have been making great progress with our vaccination programme, giving us all clear hope that the end of the pandemic is in sight.
The Joint Committee on Vaccination and Immunisation (JCVI) has set out guidance on priority groups for Covid-19 vaccination. The Committee has considered evidence on the risk of exposure and mortality by occupation, and decided that everyone aged over 50, including teachers, are eligible for vaccination within the first phase of the programme. In addition, anyone who is under 50, but has an underlying health condition which puts them at higher risk of serious disease and mortality, including teachers, will be eligible for vaccination within group six of the first phase. I welcome that the Prime Minister has set a new target for all adults to have been offered a first vaccine dose by the end of July.
The JCVI has recommended that the vaccine programme proceed into phase two on the basis of age groups, with those aged 40 - 49 invited first once the initial priority phase has been completed. I understand your concerns about the vaccination of teachers, but rapid vaccine deployment is the most important way of increasing public health benefits against severe outcomes from Covid-19. As such, a strategy centred specifically on occupational groups would be more complex to deliver and may require new vaccine deployment structures which would slow down vaccine delivery. Various studies have also shown that teachers are at no higher risk from Coronovirus than the general population, and so prioritising them over groups at greater medical risk would cost lives. I therefore support the committee's recommendation to proceed with the vaccine programme based on age groups. I also would not support the Government over-riding the JCVI’s medically-based decisions on the roll-out.
COVID-19: Vaccination Passports
I am incredibly proud of the progress that the UK is making in vaccinating the population, with one in three adults receiving their first dose, and I am delighted that the Government reached the goal of offering a vaccine to priority groups 1-4, over 15 million people, by 15 February.
While I understand that a range of options are being considered to encourage people to receive the vaccine, the Government does not plan to make the COVID-19 vaccination mandatory.
As set out in the Government’s Roadmap towards easing restrictions, four programmes of work have been established to consider different aspects of how the UK should handle COVID-19 from summer onwards. One of these is a review into whether COVID-status certification could play a role in reopening our economy, reducing restrictions on social contact and improving safety.
Of course, COVID-status certificates raise complex ethical and discriminatory issues that would need to be worked through. This is something I know the Government and the Prime Minister are conscious of and I welcome the fact that the Government is considering these issues fully as part of the review.
The Government does not intend to introduce a vaccine passport for its own use, but many other countries are considering only admitting people who have been vaccinated, and it would be unfair not to provide British holidaymakers with proof of vaccine so they could travel. There are many private venues (such as care homes) that have similar plans, which I understand are legal if proportionate to the risk. For all their faults, I think the development of vaccine passports of some form is inevitable internationally. It is not new – I myself have a yellow fever vaccination passport which must be shown travelling to certain countries.
COVID-19: FFP3 Masks for NHS Staff
I would like to reassure you that continuing to ensure our frontline staff are properly protected is of paramount importance to me, and to my colleagues on all sides of Parliament.
I am encouraged that over 3 billion items of PPE have been delivered since the start of the outbreak to 58,000 health and care settings. Almost 28 billion items of PPE have been ordered overall from United Kingdom-based manufacturers and international partners to provide a continuous supply in the coming months and the Government is confident in the stocks and sources of supply of PPE to meet the needs of health and social care over the coming months.
FFP3 face masks are designed for use when carrying out potentially infectious aerosol generating procedures. Risk assessments in the workplace establish when different PPE is appropriate: FFP2 respirators may be more appropriate and deliver the required level of safety for the care a member of staff is delivering, FFP3 masks are not always necessary. I know that the Government has worked with the NHS and with a range of suppliers to ensure that health and care facilities have plenty of PPE of the correct standard.
Support for those with Motor Neurone Disease (MND)
I know that MND can have a devastating impact on a person’s quality of everyday life and be a real struggle for patients and their loved ones. Please allow me to assure you that ensuring early diagnosis and support for those living with MND remains a key priority of the NHS.
With early diagnosis key to treating the symptoms of MND, I am glad that the National Institute for Health and Care Excellence (NICE) has published new guidelines for clinicians on the assessment and management of MND. These set out the signs and symptoms of the disease and recommend that patients suspected of having MND should be referred without delay. The Royal College of GPs and the MND Association have also worked together to produce a ‘Red Flag Tool’ which sets out key signs of MND to help GPs to identify suspected cases and ensure prompt referral.
I also recognise the valuable contribution made by carers of people with MND, many of whom spend a significant proportion of their life providing support to family members, friends and neighbours. I agree that carers must receive the right support to help them carry out their caring roles and a new cross-Government National Carers Strategy is being introduced to look at what more can be done to support existing and future carers.
I was extremely interested to read about the research undertaken by the University of Edinburgh which identified an issue with MND patients' nerve cells, suggesting that this damage could be repaired by improving the energy levels in mitochondria. While I understand that this research is still in early stages, it is a most welcome step forward, and I will certainly follow this closely.
I am aware of the February 2020 Meeting of the APPG for MND, while I am unfortunately unable to attend due to a prior longstanding commitment, I will continue to follow this issue closely.
COVID-19: Support for Alzheimer's Patients
I imagine how challenging it must be for families caring for loved ones with Alzheimer’s during this difficult time, particularly those who have needed to take on extra responsibilities. I know that the Government is working closely with system partners, stakeholders, local authorities and the care sector to monitor the impact of COVID-19 on people with dementia and to identify what additional actions may be required to ensure safety, and access to the right support and care.
In addition, research through the National Institute for Health Research was commissioned on how to manage or mitigate the impact of COVID-19 on people with dementia and their carers living in the community. The research has considered the best ways to support people to stay well during the outbreak, including help to manage the psychological and social impacts of social distancing, self-isolation, and lockdown. You can find more information, including summary leaflets, here: http://www.idealproject.org.uk/covid/
I agree that we should do everything we can to offer support to people with long term health conditions, as well as those who support them, throughout this difficult time, and I will certainly continue to monitor this issue closely.
COVID-19: Self-Isolation Payments
The introduction of the £500 Test and Trace Support Payment is for people on low incomes who are unable to work from home while self-isolating.
I believe it is right that we both encourage compliance with the duty to self-isolate and support those who have lost vital earnings opportunities from having to self-isolate. It is important that any potentially fraudulent payments or payments made in error are investigated and that when administering the scheme, local authorities work to ensure that misappropriated funds are clawed back.
The introduction of a legal duty to self-isolate from 28th September 2020, a system of fines for those in breach of this duty and the Test and Trace Support Payment will help ensure that self-isolation is properly adhered to and we are better placed to protect communities from Covid-19.
I welcome the additional £20 million which the Government is making available to local authorities to support the operation of the system of Test and Trace Support Payments in addition to a further £10 million for discretionary payments to those who could face hardship as a result of self-isolation.
COVID-19 Vaccine: Gaps Between Dosage
Moving to a 12-week gap between vaccinations is a public health approach centred on doing as much good for as many people in the shortest possible timeframe. The short term efficacy for the Pfizer vaccine is around 90 per cent, and around 70 per cent for the Oxford vaccine.
I am aware the British Medical Association has released a statement questioning the decision to delay the second dose, however they are not supported by the Joint Committee on Vaccination and Immunology, the British Society on Immunology or the Medicines and Health Products and Regulatory Authority in this. Those three bodies are in agreement with the Government’s decision and dispute the scientific claims being made by the BMA about the reduced efficacy of the second dose due to the delay.
Exploratory analysis has shown that a longer dose interval may actually increase immunity from the Oxford vaccine, and while Pfizer has not evaluated an alternative dosing schedule, the Moderna vaccine, which uses the same mRNA technology, has data to support high efficacy up to 108 days after the first dose. This has since been highlighted by both the Chief Medical Officers and by the Chief Executive of AstraZeneca himself, who has emphasised that the prioritisation of the first dose is ‘absolutely the right approach’.
Due to this, many other countries are carefully monitoring the progress of the UK’s vaccination operation and considering adopting the delayed second dose themselves.
COVID-19 Vaccine: Ensuring accessibility for the blind, deaf & disabled
I can assure you that I take the issue of vaccine take-up incredibly seriously and I welcome the Government's commitment to move the UK's vaccine programme forward with pace. I am sure you will agree that when offered a vaccine everyone should take this up and get vaccinated.
I also firmly believe that accessibility is a key priority, and so I welcome that the Department of Health and Social Care has been working to ensure information is provided about the vaccine in audio, Braille, large print, easy read and British Sign Language.
The framework for rolling out the vaccine outlines that providers are responsible for ensuring that their vaccination centres are accessible to all members of their community and take steps to improve access and reduce potential inequalities for people eligible to receive vaccinations. Patients booking vaccination appointments can choose a site that meets their accessibility needs and transport requirements and will be informed of the distance of the site from the postcode they have entered.
I will be happy to work with vaccination hubs in and around South Cambridgeshire to ensure that everybody can access this vaccine as soon as they are invited to do so.
COVID-19 Vaccine: Prioritising those with ADHD & Autism
I know this has been an incredibly difficult and worrying time for people with learning disabilities and autism. As your MP, I am absolutely committed to supporting people with learning disabilities and autism through every stage of the pandemic, as I know my ministerial colleagues in Government are.
I understand that the Joint Committee on Vaccination and Immunisation (JCVI) has carefully considered the prioritisation of those with learning disabilities and autism. Current evidence strongly indicates however that the single greatest risk of mortality from COVID-19 is increasing age and that the risk increases exponentially with age. When compared to persons without underlying health conditions, the absolute increased risk in those with underlying health conditions is considered generally to be lower than the increased risk in persons over the age of 65. The exception to this is the clinically extremely vulnerable. JCVI's advice is therefore to offer vaccination to those aged 65 years and over followed by those in clinical risk groups aged 16 years and over. This includes those with severe and profound learning disabilities.
It is important to note also that while the JCVI has given its recommendations on the first phase of prioritisation (groups 1-9), JCVI is still due to come forward with further recommendations of further prioritisation. I will make representations to ministers to seek assurance that people with learning disabilities are carefully considered again by JCVI.
I know that the JCVI is in the process of considering the next phase of the vaccination programme and they have said that the points raised with them regarding the wider numbers of persons with mild and moderate learning disabilities and autism will be taken into account in the relevant discussions and considerations ahead. I will be following developments closely.
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