Conversion Therapy
March 2022
I take this issue very seriously and my colleagues in the Equalities Office remain committed to tackling conversion therapy in the UK. This practice has no place in civilised society.
This view is shared by the head of the NHS, the Royal College of Psychiatrists, the UK Council for Psychotherapy, the British Association for Counselling and Psychotherapy and the British Medical Association. Each of these bodies have concluded that such therapy is unethical and potentially harmful.
The Government Equalities’ Office commissioned a large-scale LGBT survey in 2017. Sadly, two per cent of respondents to the national LGBT survey said they had undergone conversion therapy in an attempt to ‘cure’ them of being LGBT. Unfortunately, in this survey, what conversion therapy entailed was not defined, nor were the respondents asked whether or not the conversion therapy referred to in their answer was offered in the UK.
The Government will legislate to ban conversion therapy to protect LGBT people from this harmful practice. The Government launched a consultation on how Ministers are planning to ban practices of so called 'conversion therapy'. The consultation was extended until February 2022 to allow for ample opportunity for all those to contribute their views including faith groups, LGBT organisations, counselling bodies and charities.
I have been assured that the Government is carrying out separate work on the issue of transgender conversion therapy, to ensure that any legislative measures brought forward will not have any unintended consequences. This is a legally complex area, and as such the Government have a responsibility that any of these unintended consequences are not written into legislation, particularly in the case of under eighteens. There is very active debate about this area with widely differing opinions and a growing evidence base, with mounting concern that extending the ban to transgender therapy could unintentionally stop or deter appropriate counselling and support for many different groups of vulnerable young people. In such circumstances, it is right that the Government considers the issues in more detail rather than legislating one approach. I would like to reassure you that the results will be analysed and will inform the Government's next steps in preparing legislation shortly.
Social Care Cap
March 2022
The Government is committed to facing up to difficult decisions and tackling longstanding problems within our social care system. This historic plan for adult social care will protect individuals and families from unpredictable and potentially catastrophic care costs.
From October 2023, no eligible person starting adult social care will have to pay more than £86,000 for personal care over their lifetime. To be clear, the cap is not a target to be hit, but a backstop protection to ensure people have certainty and avoid catastrophic costs. The reformed means test, which is the best way to ensure care is affordable, will increase the threshold above which people must meet the full cost of their care to £100,000. This is more than four times the current limit of £23,250, and the number of people receiving state support in the social care system will increase from around half to two thirds.
In designing these reforms, the priority has been the creating a more generous means testing system, which benefits those with low to moderate wealth. The nature of the means test will dramatically reduce the amount that less well-off users will have to spend on care. For example, someone who has £100,000 of assets would need to draw on care and support in a residential home for about ten years to spend the same amount as someone who entirely self-funds. Older adults have around a one-in-three chance of living in a residential home for three years and a one in 50 chance of doing so for ten years.
Only the amount that an individual contributes towards their personal care will count towards the cap, which ensures that those living in different parts of the country, but contributing the same amount, do not progress towards the cap at different rates because of differences in amounts paid by their local authorities. It is right that less well-off people in different parts of the country benefit to the same extent and that we do not see differences based simply on location.
The new social care reforms are clear, fair and reduce complexity. I am proud to support a Government that is seeking to significantly improve the sustainability and affordability of the provision of social care.
At-Home Abortions
March 2022
I understand that this can be an incredibly emotive issue, and I fully appreciate the strength of feeling that exists around this matter. There are strong arguments on both sides, and I have had extensive discussions with colleagues who have made the case for and against extension. This is not about abortion rights, which are not affected by this legislation, but access to chemical abortion without proper medical supervision.
Many of my female colleagues, who are pro-choice, were strongly opposed to extending the provision because of the risk of safe-guarding – teenage girls will be getting access to abortion without normal medical supervision, which could lead to abuse. For example, an uncle could rape and get pregnant his niece, and then co-erce her into an at-home abortion without her seeing any doctor or health care worker to assess the reality of the situation. There has also been a lot of concern about the number of women taking the abortion pill after 10 weeks, when it becomes a threat to their own health.
After careful consideration, the Government also came to the view that the provision of early medical abortion should return to pre-Covid arrangements. However, as it was about abortion, it was a free vote, and MPs were free to vote (or abstain) as they please. In the end, having listened to both sides, I decided to vote against the amendment. The reason for this is that I believe it is wrong to introduce such an important piece of legislation as an emergency measure and then make it permanent without any proper scrutiny. On issues like this, there should be a public consultation, so all groups can feed in their views, a public debate so all issues can be discussed openly, and if necessary protections put in place to reduce the risk of abuse. You will be aware that the amendment did pass, and so the provision of at home abortion pills without proper medical oversight has been extended. That is democracy. But it means none of the normal proper consultation or debate has happened, or possible mitigations put in place to stop any potential abuses. I very much hope that this does not lead to the safe-guarding issues that many of my female colleagues are worried about, and that such worries prove to be unfounded.
Baby Loss Campaign
February 2022
I thank the APPG on Baby Loss and charities such as Sands for their work to raise awareness in Parliament about the impact of pregnancy or baby loss on thousands of parents every year. 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.
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. The Department of Health and Social Care has set out a range of 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. It is encouraging that good progress has been made on achieving these ambitions. Since 2010, there has been a reduction of 25 per cent in stillbirth rates and a 29 per cent reduction in neonatal mortality rates for babies born after 24 weeks gestation. Of course, there is still work to be done and I welcome the Government’s keen focus on achieving its important ambitions.
Personal Independence Payment assessments and the Work Capability Assessment
February 2022
I firmly believe that the welfare system should protect the most vulnerable in society. The Personal Independence Payment is assessed on the basis of the needs arising from a health condition or disability, rather than the health condition or disability itself.
PIP and work capability assessments look at an individual's ability to carry out a series of key everyday activities which are fundamental to living an independent life, such as their ability to prepare, cook and eat food, dress and undress and make budgeting decisions. This ensures that the greatest level of support goes to those least able to carry out such activities in order to contribute towards the increased costs they are likely to incur.
The health professionals carrying out PIP and work capability assessments have training in multiple and complex conditions and have specific guidance available to them on the effects of a range of conditions.
My colleagues at the DWP are committed to supporting disabled people and people with health conditions, and understand that DWP is forecast to spend over £57 billion this year on health and disability benefits – which is around 2.5 per cent of GDP. The Health and Disability Green Paper, meanwhile, explored how the benefits system could better meet the needs of claimants now and in the future by improving claimant experience of DWP services, enabling independent living and improving employment outcomes. The consultation closed in October and a White Paper is expected next year. I will follow developments closely.
Motor Neurone Disease
February 2022
I am grateful to the MND Association for their work to highlight the importance of access to aids and adaptations in the home to people affected by Motor Neurone Disease.
As part of the Social Care White Paper, I was pleased to see that the Government has committed £570 million to delivering the Disabled Facilities Grant from 2022-23 to 2024-25, and has pledged to consult on proposals to increase the upper limit for the Grant.
NHS Staff Meals
February 2022
I would like to thank our NHS staff for their tireless work to support patients through day and night, and I appreciate the commitment of campaigners to ensure they have access to good catering and self-catering facilities.
I am assured by the actions the Government is taking to increase standards and improve facilities for NHS staff for catering and self-catering. The Independent Hospital Food Review – published in October 2020 – made a number of recommendations to improve standards of catering in Hospitals in England. This included that Hospitals should provide “appropriate facilities to support patients and staff to eat well 24/7 when in the hospital environment.”
In addition, the Review recommended that if it is not possible for Hospitals to provide catering or restaurant facilities over 24 hours, staff must still have access to appropriate facilities to safely store, prepare and eat their own meals and hot drinks at any time of day and night.
An expert panel of NHS caterers, dieticians and nurses are currently leading work to review to implement the recommendations for tastier, more nutritious food for patients, staff and visitors.
#CatchUpWithCancer Campaign
February 2022
As you point out, the Covid-19 pandemic has had a significant impact on waiting times for cancer diagnosis and treatment over the past two years.
Let me assure you that I share the commitment of the campaign to see waiting lists for cancer treatment and care to be reduced over the next few years [Optional: and I have ensured that Ministerial colleagues are aware of the campaign and its calls to action.]
In recent months, the Government has brought forward funding to help recover cancer services, and a plan that outlines how that funding will be spent effectively.
Last year it was announced that nearly £6 billion is being put towards capital investment for new beds, equipment and technology. This funding will contribute towards expanding mobile diagnostics for cancer and upgrading MRI and screening technology.
The expansion of elective capacity will focus on rolling out new and innovative forms of radiotherapy to deliver treatment in a more targeted and intensive way, meaning cancer patients spend less time in Hospital.
It is right that this funding comes with high expectations for reducing cancer waiting times. By March 2024, the NHS has set an ambition for 75 per cent of patients who have been urgently referred by their GP for suspected cancer to be diagnosed or have cancer ruled out within 28 days.
Equal Access to IVF for LGBTQ+ People
February 2022
Thank you for your letter of 13th February regarding access to fertility treatment for LGBTQ+ people.
In England, decisions about local NHS fertility services are determined by clinical commissioning groups, taking account of National Institute for Health and Care Excellence (NICE) fertility guidelines. Local National Health Service bodies are expected to commission fertility services in line with the NICE guidelines so that there is equal access across England.
The existing NICE fertility guidelines include provisions for same sex couples who have demonstrated their clinical infertility through six failed cycles of artificial insemination. The criteria in the guidelines were developed as a way of achieving equivalence between opposite-sex and same-sex couples in establishing clinical infertility and accessing National Health Service fertility treatment services. NICE has begun a scoping process for the review of these guidelines.
I wholeheartedly agree that no couple should face disproportionate or unequal costs in their efforts to overcome fertility issues. NICE is looking at reviewing the existing guidelines. I want to reassure you that I will work with colleagues at the Department of Health and Social Care to ensure they are aware of the importance of this issue. Thank you for raising it with me.
Junk Food Advertising
February 2022
Childhood obesity is one of the biggest health problems this nation faces, with one in every three children in England leaving primary school overweight or living with obesity. Obesity is also associated with reduced life expectancy, and it is a risk factor for a range of chronic diseases including cardiovascular disease, type 2 diabetes, at least 12 types of cancer, liver, and respiratory disease.
I am therefore delighted that the Government is taking action to tackle this important issue with a UK-wide pre-9pm ban on TV and UK-On Demand Programme Services (ODPS) advertising food high in sugar, salt and fat (HFSS), alongside a restriction of paid-for advertising online. As you might be aware, in 2018, the Government set the ambition to halve childhood obesity by 2030 and help adults reach a healthier weight. Furthermore, in July 2020, as part of the ‘Tackling Obesity’ strategy and following two separate consultations, the Government announced its intention to implement a 9pm watershed for advertising HFSS.
Currently being legislated for in the Health and Care Bill, the enforcement approach will mirror current frameworks with broadcasters and ODPS. Ofcom will be appointed as the appropriate regulatory authority for these restrictions and will be able to appoint a day-to-day regulator to carry out frontline regulation. The Government expects the Advertising Standards Authority to fulfil this role. Covid-19 has brought the dangers of obesity into sharp focus and highlighted that as a country we need to address the risks obesity presents. I am delighted with the measures put forward which I am confident will help support a fitter, healthier nation, making us more resilient to diseases in the future.
Baby Loss
February 2022
I thank the APPG on Baby Loss and charities such as Sands for their work to raise awareness in Parliament about the impact of pregnancy or baby loss on thousands of parents every year. 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.
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. The Department of Health and Social Care has set out a range of 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. It is encouraging that good progress has been made on achieving these ambitions. Since 2010, there has been a reduction of 25 per cent in stillbirth rates and a 29 per cent reduction in neonatal mortality rates for babies born after 24 weeks gestation. Of course, there is still work to be done and I welcome the Government’s keen focus on achieving its important ambitions.
Health & Social Care Bill
January 2022
I completely agree with you that the unprecedented threat of the COVID-19 pandemic reminded us how vital our health and care system is to all of us. I want to assure you that the NHS will always be free at the point of use, and any proposed reforms will aim to continue to improve the quality of these services and patient outcomes.
As we build back better from this pandemic, it is right and necessary that our health and care services are at the forefront. The pandemic underlined not only the dedication and skill of those in this sector, but also the necessity of a broader, more integrated health and care system. I welcome the intention to develop more integrated care between the NHS, Local Government and other partners including the voluntary and community sector, which will be vital in tackling the factors that affect the long-term sustainability of patient services. The Bill will make permanent some of the innovations brought about by the pandemic. I understand that these proposed reforms will also include proper accountability mechanisms and give patients and the public the confidence that they are receiving the best care from their healthcare system.
The measures set out in the Health and Care Bill deliver on the NHS’s own proposals for reform in its Long Term Plan. I believe these proposals have been developed in consultation with key stakeholders in this sector, and I am encouraged by the preliminary positive feedback received. In particular, the comments from the former Chief Executive of NHS England, who said that this Bill “will support our health and care services to be more integrated and innovative so the NHS can thrive in the decades to come”, are reassuring.
Vaccine Equity
January 2022
The Government is committed to ensuring that people in the poorest countries receive vaccines. The UK was a leader in setting up the international COVAX facility, which is providing equitable access for 92 lower and middle-income countries, and we champion equitable access through our G7 presidency. Our commitment of £548 million makes us one of COVAX’s largest donors. COVAX has delivered more than 475 million vaccine doses to the poorest countries, and that figure will rise to 1.8 billion by mid-2022. There are three limiting factors on distributing the vaccine globally. The first issue is supply, the second is the ability of local healthcare services to administer the vaccine and the third is the issue of vaccine hesitancy in countries across the world. There is now actually concern that in many African countries, the barrier to raising vaccination rates is not shortage of supply of vaccines, but that the vaccines are not being administered but rather stockpiled, and may soon pass their use-by dates. This is clearly also unacceptable.
Mandatory Vaccination for NHS Staff
January 2022
Nowhere is vaccination more important than in our health and social care system. It has always been the expectation that everyone gets the Covid-19 vaccine, especially those working in health and care settings who have a professional duty to do so.
All Covid-19 measures are kept under constant review and vaccination as a condition deployment in health and care settings is no exception. When this was consulted on, evidence showed that vaccine effectiveness against infection from the dominant, and more severe, Delta variant was between 65 and 80 per cent. It was clear that vaccination was the best way to keep vulnerable people safe. Given this, I believe it was the right policy at the right time, supported by clinical evidence and I was pleased to vote in favour of this measure. Indeed, we have seen a net increase of 127,000 NHS workers and 32,000 social care workers being vaccinated.
However, given that Delta has been replaced by Omicron, it is welcome that this policy has been reviewed. With the population as a whole better protected against hospitalisation, and Omicron being intrinsically less severe, the Government has concluded that it is no longer proportionate to require vaccination as a condition of deployment through statute.
Following a successful booster rollout and with workforce challenges remaining, the balance of opportunities and risks of this policy have now changed. Subject to consultation and parliamentary approval, the legal requirement for health and social care staff to be vaccinated will be removed. Those working in these sectors still have an important professional duty to get vaccinated and it is welcome that so many have taken the decision to do so.
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