NHS Staffing
May 2023
I stood on a manifesto that promised to deliver effective and sustainable workforce planning in our NHS. The Government is on track to deliver its manifesto commitment of 26,000 more primary care staff to help improve patient access to appointments and reduce the Covid-19 backlogs. Data for April 2023 shows there are more than 25,000 additional primary care staff, demonstrating that the Government remains on course to reach its target of 26,000 more staff in primary care by March 2024.
The Government is expanding routes into professional roles in the NHS, particularly apprenticeships. Apprenticeships allow people to earn as they learn, benefiting those for whom a full-time university course is not practical or preferred. There were around 20,900 new NHS apprenticeship starts in 2021/22, making the NHS the largest employer of apprentices in the public sector by number of starts. There has also been funding confirmed as part of a pilot scheme for up to 200 Medical Doctor Degree Apprentices. I fully support widening routes in to practicing medicine, so long as we do not lower standards.
Obviously, the standards required to practice medicine will remain the same.
Conversion Therapy
May 2023
The Government is committed to ensuring that everyone in the UK is free to live their lives and fulfil their potential regardless of their sex, sexual orientation or gender identity. The LGBT community must be free to proposer in modern Britain.
My colleagues in the Government Equalities Office have, over recent years, looked carefully and thoroughly into the gender recognition process, including considering potential changes to the Gender Recognition Act 2004. After careful consideration, it is their view that this existing legislation strikes the right balance between ensuring there are proper checks and balances in the system and ensuring there is support in place for people who want to change their legal sex.
I welcome that four new gender clinics were opened in 2021, which should see waiting lists reduce. This should provide transgender people with greater patient choice, shorter waiting times, better geographical coverage and, crucially, easier access. It will also make it easier to fulfil the medical requirements of obtaining a Gender Recognition Certificate.
The Government has now confirmed that transgender conversion therapy will be included in the ban on conversion therapy. The Bill will be published shortly, and will protect everyone including those targeted on the basis of their sexuality, or being transgender. I am aware that this is a complex area and legislation must not harm the growing number of children and young adults experiencing gender-related distress.
Nurses' Industrial Action
May 2023
I would like to start by saying that I am extremely grateful for the dedication of nursing staff in very difficult circumstances over the last three years. During the pandemic, nurses were on the frontline of caring and treating for patients affected by Covid-19, and we owe every nurse a debt of gratitude for the care they provided. I appreciate that the challenge of working in the NHS during the pandemic, and through the current period when the demand for patient care is very high, has taken a significant toll on nurses. I am also fully aware that the last few years have amplified existing challenges in the nursing workforce, such as the ability to retain experienced nursing staff to continue working in the NHS.
As a result of talks between the Government, NHS employers and the unions, an offer has been made for NHS staff (including nurses) to receive an additional pay rise of 2 per cent for 2022-23, on top of the 4 per cent increase recommended through the Independent Pay Review Body process.
A "Backlog Bonus" of at least £1,250 will also be paid in recognition of the dedication and efforts of NHS staff during the pandemic and their role in cutting waiting lists. The level of bonus will be determined by pay band and experience, so for example, the average nurse in pay band 5, will receive £1,350.
In 2023-24, the Government is offering NHS staff a 5 per cent consolidated increase in pay, worth at least £1,065. Alongside these proposals on pay, the Government will also introduce measures to ensure safer staffing in hospitals, make the pension abatement rules introduced during the pandemic permanent and identify ways to tackle violence against NHS staff.
In addition, I understand that Steve Barclay - the Health Secretary - has provided a commitment to the RCN to address specific challenges around recruitment, retention and professional development in nursing. The Government will also consider a separate pay spine exclusively for nursing staff in 2024-25.
I firmly believe that this agreement represents a fair and reasonable offer for NHS staff, as well as being a fair deal for taxpayers. To that end, I am pleased that Unison members have accepted this offer which can end the industrial dispute and the disruption that patients have faced in recent months. It is disappointing that members of the RCN and Unite have rejected this offer that was supported by their leadership.
The Government fully supports the right to strike. That being said, strike action has to be lawful. The Health Secretary chose to take action after being advised by employers at the NHS that the strikes were unlawful.
Andrew Bridgen's Vaccine Comments
May 2023
The vaccines that are authorised in the UK have been through rigorous clinical trials and safety checks. I am proud that the UK has some of the highest safety standards in the world. So far, millions of people have been given a Covid-19 vaccine and reports of serious side effects, such as allergic reactions, have been very rare. The vast majority of reported side effects are mild and all are in line with most types of vaccine, including the seasonal flu vaccine.
I did not attend Mr Bridgen’s debate. As a Member of Parliament, I have a number of responsibilities. It is therefore incumbent on me to determine how best to use my time to serve my constituents. I do not believe it best serves my constituents to listen to Mr Bridgen’s conspiracy theories.
Transgender Guidance in School
May 2023
The Government understands that this is a complex and sensitive subject for schools to navigate. This is why the Government is developing guidance to support schools both in relation to transgender pupils and those who are questioning their gender. The guidance will be clear that, apart from in exceptional circumstances, schools should involve parents in any decision about their child. To ensure the guidance is right, it is important that the Government is able to consider a wide range of views. The Government has committed to holding a full public consultation on the draft guidance prior to publication, to which anyone can respond. The consultation will be live in due course, allowing those who wish to respond to it time to do so.
Since the draft guidance has not yet been published and I have not seen it, I cannot comment on what is in it, or rather will be in it when it is published.
The Government has now confirmed that transgender conversion therapy will be included in the ban. The Bill will be published shortly, and will protect everyone including those targeted on the basis of their sexuality, or being transgender. I am aware that this is a complex area and legislation must not harm the growing number of children and young adults experiencing gender-related distress, through inadvertently criminalising or chilling legitimate conversations parents or clinicians may have with their children.
Alzheimer's Research UK Event
May 2023
I am proud to be the Member of Parliament for Alzheimer’s Research UK’s centre of operations and research centre. I have regularly met with representatives from the organisation and visited both of their sites in South Cambridgeshire.
I share your optimism about the potential of lecanemab to revolutionise treatment for dementia. I am aware of the challenges in administering the drug given the current issues with diagnosing Alzheimer’s in the UK.
Safety of Immunocompromised People at the Ballot Box
May 2023
A secure electoral system is vital to a healthy democracy, and the public must have confidence that our elections are secure and fit for the 21st century. I firmly believe that asking voters to bring photographic identification to their polling station is an important way of achieving this. I do, however, understand concerns about having to remove face coverings to allow polling station staff to check your photographic identification.
The Electoral Commission has said that anyone who wears a face covering for any reason, including for medical reasons, will only need to remove their face covering momentarily so polling staff can check that their photographic identification looks like them. I understand this can also be done at some distance; and also that you could also retain a transparent outer mask if you wanted to. Electors can request to have their photographic identification checked in private if it makes them feel more comfortable. Face coverings can be worn for the rest of the voting process.
I understand that the Electoral Commission has encouraged voters who have concerns about how their photographic identification will be checked to contact their local returning officer to understand what local arrangements are in place to support the voting process.
Saving Babies' Lives Report
April 2023
This issue unfortunately affects many people, and I offer my sympathy to those who have suffered miscarriages, stillbirths, or the loss of a child. I applaud my colleagues who have recounted this painful 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, I know that 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 relative to levels in 2010.
Since 2010, the stillbirth rate has reduced 19.3 per cent, the neonatal mortality rate for babies born over the 24-week gestational age of viability has reduced by 36 per cent, and the proportion of babies born preterm has reduced from 8 per cent in 2017 to 7.7 per cent in 2021. Where progress to reduce adverse outcomes has been slower, the Government has introduced several targeted interventions to accelerate progress, such as the introduction of the Saving Babies Lives Care Bundle and the Brain Injury Reduction Programme. Since 2016, the Government has provided more than £250,000 to SANDs, the stillbirth and neonatal death charity, to work with other baby loss charities and royal colleges to produce and support the rollout of a National Bereavement Care Pathway to reduce the variation in the quality of bereavement care provided by the NHS.
I welcomed the publication of the Women's Health Strategy in July 2022 that made several commitments related to baby loss and maternity care. This included a pledge to introduce a pregnancy loss certificate in England as recommended by the interim update of the independent Pregnancy Loss Review. The Government is working to deliver these commitments to make the NHS the best place in the world to give birth through personalised, individualised, and high-quality care.
Assisted Dying
April 2023
Coping with terminal illness is distressing and difficult both for the patient and their families. These cases are truly moving and evoke the highest degree of compassion and emotion. Currently 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, personally, believe that competent adults who are terminally ill should be provided at their request with specified assistance to end their own life, so long as there are robust safeguards to prevent any abuse.
Homes Not Hospitals
April 2023
The Government remains committed to significantly reducing the number of people with a learning disability and autistic people in mental health hospitals. However, I recognise that there is much more to be done to reach the target set for March 2024. In the meantime, I know that the Government is working with NHS England to implement the findings of the Action Plan, including work to check that people with a learning disability and autistic people in mental health inpatient care have received a safe and wellbeing review. It is the responsibility of Integrated Care Boards to commission services for their population, and to make their own decisions about spend on inpatient and community 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. Since 2015, the number of people in inpatient care has reduced by almost a fifth, which is welcome progress. The NHS Long Term Plan proposed key changes to inpatient units for those with learning disabilities and autism.
This includes commitments to reduce the number of admissions and decrease the amount of time spent in these units by 2024. I was also pleased to see these commitments renewed in the Autism Strategy (published in 2021). This will enable more people to receive personalised care in the community, closer to home, and reduce preventable admissions to inpatient services.
I fully share your concern that people with autism are still being admitted to these units. The Autism Strategy committed to improving the identification and diagnosis of autism when patients are admitted into inpatient care.
Changes are also being brought forward to the Mental Health Act 1983 to ensure that autistic people are only admitted to inpatient mental health settings if absolutely necessary. These changes would mean that autism alone is no longer a lawful basis for ongoing detention in inpatient care and would enable people in inpatient care to be discharged as soon as they are well enough to leave.
A draft Mental Health Bill, which contains these proposals, has recently completed pre-legislative scrutiny by backbench MPs. The Government is considering the recommendations made by MPs and will introduce the Bill when parliamentary time allows.
Epilepsy
April 2023
I absolutely understand the concerns and anguish of patients who suffer with epilepsy and are seeking treatments to ease their symptoms, and their families. The decision whether to prescribe an individual with medicinal cannabis is not a political or financial decision, but a decision by a medical expert, who will have considered whether it is the most effective treatment based on an individual’s particular condition.
To inform clinical decision making, more robust research will be required on higher numbers of patients to develop evidence on the impact of medical cannabis on outcomes.
I understand that the National Institute for Health and Care Research (NIHR) has issued two calls for proposals and a highlight notice on medicinal cannabis. Manufacturers are responsible for generating evidence to support the use of these products and to seek regulatory approval. The Government also offers scientific and research advice through the Medicines and Health Regulatory Agency and the NIHR.
At the present time, the licensed cannabis-based medicine Epidyolex is routinely prescribed on the NHS for two forms of epilepsy.
Access to IVF Treatments
April 2023
In England, decisions about local NHS fertility services are determined locally, taking account of National Institute for Health and Care Excellence (NICE) fertility guidelines. Local NHS 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. If this is the case, these couples are offered a further 6 cycles of unstimulated intrauterine insemination before proceeding to IVF. 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 NHS fertility treatment services. However, NICE has begun a review of these guidelines which will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. This is expected to be ready in 2024.
I wholeheartedly agree that no couple should face disproportionate or unequal costs in their efforts to overcome fertility issues. I am glad that NICE is reviewing the existing guidelines. The Department for Health and Social Care also undertook an internal review of access to NHS fertility services last year. The review informed the Government's Women’s Health Strategy published in July 2022.
In this, the Government committed to removing additional barriers to IVF for female same-sex couples. The Government committed to removing the requirement for them to pay for artificial insemination to prove their fertility status and NHS treatment for female same-sex couples will start with 6 cycles of artificial insemination, prior to accessing IVF services, if necessary. The Department is currently working with NHS England to implement this through local Integrated Care Board, with the intention that this change is made from April 2023.
The Women’s Health Strategy also outlined several ten-year ambitions including a commitment to work with NHS England to address the current geographical variation in access to NHS-funded fertility services across England. it also committed to ensuring that same-sex couples are able to access NHS-funded fertility services in a more equitable way.
Transgender Rights
April 2023
The Government is committed to ensuring that everyone in the UK is free to live their lives and fulfil their potential regardless of their sex, sexual orientation or gender identity. The LGBT community must be free to proposer in modern Britain. I agree that there are other issues that the political focus should be on. The recent debate on trans rights in Parliament was precipitated by the Gender Recognition Act in Scotland. The reality is that the SNP administration put forward an act of Government that covered non-devolved powers.
I do not know whether this was done without appropriate legal advice or whether it was deliberately pursued to orchestrate a conflict with the British Government. Either way, it was simply not workable to have different regimes on gender recognition in different parts of the United Kingdom. No section of society should be used as political footballs.
My colleagues in the Government Equalities Office have, over recent years, looked carefully and thoroughly into the gender recognition process, including considering potential changes to the Gender Recognition Act 2004. After careful consideration, it is their view that this existing legislation strikes the right balance between ensuring there are proper checks and balances in the system and ensuring there is support in place for people who want to change their legal sex.
I welcome that four new gender clinics were opened in 2021, which should see waiting lists reduce. This should provide transgender people with greater patient choice, shorter waiting times, better geographical coverage and, crucially, easier access. It will also make it easier to fulfil the medical requirements of obtaining a Gender Recognition Certificate.
The Government has now confirmed that transgender conversion therapy will be included in the ban on conversion therapy. The Bill will be published shortly, and will protect everyone including those targeted on the basis of their sexuality, or being transgender. I am aware that this is a complex area and legislation must not harm the growing number of children and young adults experiencing gender-related distress.
Andrew Bridgen's Vaccine Conspiracy Theories
April 2023
Andrew Bridgen lost the whip and was expelled from the Conservative Party for making wholly inappropriate remarks regarding the holocaust. The holocaust was the greatest act of evil in human history. To use it as an analogy in a bid to promote baseless conspiracy theories is an affront to human decency. Antisemitism is a scourge on our society and I therefore do not support Mr Bridgen’s reinstatement to the Conservative Party.
Vaccines are only deployed if they pass rigorous regulatory procedures to prove that they are safe and effective. Each of Covid vaccine candidate is assessed by a team of scientists and clinicians on a case-by-case basis, and it is only once a potential vaccine has met robust standards of effectiveness, safety and quality that it is approved for use. That is the case for all medicines, not just Covid vaccines. Extensive data shows that the vaccine is safe and highly effective in reducing the deaths that we sadly saw during the pandemic. That does not end when the vaccine is approved; surveillance of vaccines continues, as it does with any medicine, and any adverse reaction is recorded on a regular basis. That does not stop following approval.
NHS Privatisation
April 2023
The Government is clear that the NHS will always provide healthcare free at the point of delivery, regardless of ability to pay. The use of independent providers and the voluntary sector have historically played a role in the delivery of NHS services, including under the previous Labour government.
The most important way to support the delivery of care in the NHS is through investment. The Government is investing an extra £45.6 billion in funding for health and social care over the next three years, delivering better care for patients. As set out in the 2021 Spending Review, NHS England’s day-to-day budget is set to grow by 3.8 per cent on average up to 2024/25, supporting the NHS to tackle the elective backlog, deliver its Long Term Plan and ensure it has the resources needed to fight Covid-19. We now spend more on healthcare than ever before in British history, in cash terms, in real terms (taking inflation into account) and as a share of GDP. Around 10% of our GDP is now spent on the NHS, more than the average of rich countries across the world and of EU countries.
The Government is also making the largest health capital investment in a decade, making a real difference to the lives of NHS staff and patients, including the hospital rebuilding programme, new community diagnostic centres and mental health urgent and emergency care facilities.
Pandemic Preparedness Treaty
April 2023
Unfortunately, I was unable to attend the Westminster Hall Debate on 17 April regarding e-petition 614335, which calls for the UK Government to not sign any WHO Pandemic Treaty unless it is approved via public referendum, due to pre-existing commitments. The Covid-19 pandemic has been one of the greatest challenges to the established international order since the Second World War; a global threat that has required global solutions borne out of global cooperation. I pay tribute to people and nations across the world in confronting such a threat. International collaboration was immensely heartening to witness in the darkest of times. As in the late 1940s, where, to avert a repeat of the cataclysm of total war, world leaders united to establish the multilateral system we have today, I think it is reasonably fair to argue that a similar effort is required on the part of world leaders to strengthen preparedness for potential future pandemics.
As such, I welcome the suggestion of the former Prime Minister, writing with other world leaders in 2021, that the international community should commit to producing a new international treaty for pandemic preparedness and response. I understand that such a treaty would aim to foster greatly enhanced cooperation in order to better protect the UK from the health, social and economic impacts of pandemics.
Discussions are ongoing at the World Health Organisation to this end. The UK Government wants to reach agreement on its priority areas such as improving transparency, timely data sharing and supporting equitable access to vaccines and treatments. I appreciate your concerns about this; however, the Government will not support any treaty which compromises the UK's sovereignty. There is nothing in the proposed treaty that would impact our ability to take decisions about national lockdowns or associated measures at the national level. I would certainly not support one which gave the WHO powers to make such decisions, which are rightly the preserve of national governments. Once adopted, international treaties only become binding in the UK when ratified by Parliament in accordance with our constitutional process. No international treaty can by itself change UK law. If changes to the law are necessary, then a treaty could not be ratified until domestic legislation, agreed by Parliament, was put in place.
#Prescribingnow Campaign
April 2023
As stated in the campaign’s letter, my colleague Steve Barclay, the Health Secretary has an aspiration to reduce the workload on GPs, including by making greater use of the role pharmacists can provide.
However, I understand that a number of professional groups mentioned in the campaign’s letter already have powers to prescribe and supply medicines. My understanding is that dieticians and diagnostic radiographers can already supply medicines under Patient Group Directions and use supplementary prescribing. Furthermore, Orthoptists can already supply medicines under Patient Group Directions and exemption which permit certain medicines to be sold, supplied and/or administered to patients.
NHS England previously held a public consultation in 2015 on proposals to enable radiographers to practice as independent prescribers. This proposal was reconsidered by the Commission on Human Medicines in 2021, with advice given to Ministers to amend the Human Medicines Regulations 2012 to allow diagnostic radiographers to independently prescribe.
Healthcare providers are responsible for utilising the existing framework for independent prescribing provided by the Department of Health and Social Care to increase local capacity according to clinical need and the desired service configuration.
I understand the strength of view expressed in this campaign, but there are no current plans to extend medicines responsibilities further for the other professional groups.
M.E APPG Event
April 2023
I have known other people with ME and have seen directly how devastating it can be on people’s lives.
A cross-government delivery plan on ME/CFS in England will be developed with people living with the condition and, I understand that a draft version of this plan will be published by the end of this year. Three working groups have been established to provide input into this plan, focusing respectively on research, awareness and living with ME/CFS.
This delivery plan will align with other devolved nations where appropriate, for example the Scottish Government’s work on research into ME/CFS.
I understand that the delivery plan will build on the recently updated NICE guideline on ME/CFS and the comprehensive work of the All-Party Parliamentary Group on ME to date.
The Government has also announced a roundtable with the Department’s Chief Scientific Adviser – Professor Lucy Chappell – to bring together experts on ME/CFS to discuss ways of addressing the research priorities of people living with the condition. The Government is committed to funding research into ME/CFS, including through the National Institute for Health and Care Research (NIHR).
Boys Need Bins Campaign
April 2023
The Government recognises that tackling major conditions that cause ill-health - including prostate cancer - provides an opportunity to improve the lives of millions of people. That is why a Major Conditions Strategy will be developed and published over the next year to outline how outcomes in six major condition areas will be improved, including all cancers. Raising awareness of prostate cancer is key to driving earlier diagnosis and increasing survival rates, particularly for men at higher risk, such as those with a family history of prostate cancer. This is particularly important to addressing the variation in diagnosis times for prostate cancer between the north and south of England, as Prostate Cancer UK have recently highlighted.
In February and March 2022, an awareness campaign was run by NHS England and Improvement and Prostate Cancer UK to encourage men to use Prostate Cancer UK’s clinically approved risk checker to make an informed choice on further tests. Whilst there are no current plans to introduce an NHS screening programme for prostate cancer, I understand that the UK National Screening Programme is due to review the evidence for prostate screening in 2023. NHS England and NHS Improvement are implementing a best practice pathway for prostate cancer, including the use of MRI scanning prior to biopsy for a faster diagnosis.
New research is also vital to improving outcomes for those diagnosed with cancer. £75 million was announced in April 2018 to fund specific research into prostate cancer over the following five years. This is supporting over 40,000 men to participate in more than 60 prostate cancer studies, testing treatments including more precise radiotherapy, high-intensity focused ultrasound, and cryotherapy.
Surrogacy Recommendations
April 2023
Surrogacy offers an opportunity to parents who are unable to conceive or carry a child themselves; but I am aware that the legal process can be complex and, at times, worrying. As you may be aware, the Law Commission has reviewed all legislation concerning surrogacy, including the process of how intended parents become the child's legal parents. Their consultation closed in October 2019 and the final report with the Law Commission's recommendations, and a draft Bill, were published on 29 March 2023.
The Law Commission's proposals include creating a new surrogacy pathway to allow intended parents to be the legal parent from the moment of birth and introducing regulatory oversight for surrogacy arrangements and safeguards such as counselling and independent legal advice.
I note your concerns over the Law Commission’s proposals. I would like to reassure you that the Government will carefully consider the report and legislative proposals now they have been published.
Existing legislation in the UK ensures that the woman who gives birth is regarded as the child's mother until legal parenthood is transferred, and that surrogacy arrangements are not legally enforceable to avoid the situation of a newly-born child being taken away from its birth mother against her wishes. In the UK, if a surrogate is used, they will be the child's legal parent at birth. Legal parenthood can be transferred by parental order or adoption after the child is born, and if there is a disagreement, the courts will make a decision based on the best interests of the child.
Conversion Therapy
April 2023
I take this issue very seriously and I know that my colleagues in the Equalities Office remain committed to tackling conversion therapy in the UK. I am absolutely clear that this practice has no place in civilised society. Being lesbian, gay or bisexual is not an illness to be treated or cured.
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. We basically don’t know the extent of it in the UK.
The Government has delivered on its promise and introduced the Conversion Therapy Bill. The Bill will strengthen existing criminal law by ensuring that violent conversion therapy is recognised as a potential aggravating factor upon sentencing, as well as making sure those found guilty of conversion therapy offences have any profit obtained from those crimes removed. Further, it will protect freedom of speech, ensuring parents, clinicians and teachers can continue to have conversations with people seeking support. I have been assured that the legislation will not impact the existing professional frameworks that guide clinicians' ability to support people. As such, robust, exploratory and challenging conversations which are part of regulated care do not fall within the scope of the ban. It will protect under-18s regardless of circumstance and over-18s who do not consent and are forced or coerced to undergo conversion therapy practices.
The Government has now confirmed that transgender conversion therapy will be included in the ban. The Bill will be published shortly, and will protect everyone including those targeted on the basis of their sexuality, or being transgender. I am aware that this is a complex area and legislation must not harm harm the growing number of children and young adults experiencing gender-related distress, through inadvertently criminalising or chilling legitimate conversations parents or clinicians may have with their children.
I am positive about the steps that have been made so far in the UK to achieve LGBT equality, and am confident that this good work will continue.
Support for Pharmacies
April 2023
Unfortunately, I was unable to attend the APPG on Pharmacy event in Parliament due to prior commitments. I would like to acknowledge the valuable and skilled work undertaken by pharmacists throughout the country every day. Community pharmacies do much more than simply dispense medicine - they play a vital role in our communities, offering advice and care. I recently visited a pharmacy in South Cambridgeshire along with the Executive Development Officer of Cambridgeshire & Peterborough Pharmacies.
The Government is committed to sustainably funding community pharmacies. The Community Pharmacy Contractual Framework five-year deal commits £2.5 billion in each financial year between 2019 and 2024 for community pharmacies. On 22 September 2022, following discussions between the Department, NHS England and the Pharmaceutical Services Negotiating Committee, which represents pharmacy contractors in England, the Government announced an agreement for the remaining years of the Framework, including a one-off investment of £100 million.
Junior Doctor Remuneration
April 2023
I met with three junior doctors at Addenbrooke’s last Friday to better understand the issues that doctors face at that stage of their career. The passion, commitment, and specialist knowledge of our junior doctors is part of what makes our NHS so special. This is reflected in the pre-existing multi-year pay and contract reform deal agreed with the trade union in 2019 and due to end in March 2023. The upcoming pay round is the appropriate time to discuss pay when the multi-year deal ends.
By the end of the current deal, all junior doctor pay scales will have increased by 8.2 per cent. Around £90 million is being invested to reform the contract, including the creation of a new, higher pay point to recognise the most experienced doctors in training. This package also provides funding to enhance eligibility for night shift pay and increased allowances for those working the most frequently at weekends. In addition, a new £1,000 a year allowance will be available to support training for junior doctors working less than full time. It should also be noted that salaries for all trainee doctors were increased from 1 April 2022. While I note your comments around the inclusion of junior doctors in the pay review process, I understand the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) has not been asked to make a pay recommendation due to the current multi-year agreement in place.
I note the recent vote by BMA junior doctor members in support of industrial action. However, whilst I sympathise with the issues facing junior doctors, I do not support the BMA's calls for full pay restoration and cannot support the proposed industrial action because of the potential impact on patient care. I know that my colleague Steve Barclay, the Health Secretary, is committed to continuing discussions around what is fair and affordable around pay, as well as working conditions and workload.
On the 16th March, the Government agreed with unions representing staff including nurses, paramedics, 999 call handlers, midwives, security guards and cleaners, to find a fair and reasonable way forward on pay. This Government’s priority is to ensure that the NHS operates in a way that works for staff and for patients. I commend the Government and the Unions for reaching this agreement and I would urge other unions representing healthcare workers to take a similarly constructive approach.
Prescription Charges and Cystic Fibrosis Sufferers
April 2023
There is an extensive list of conditions exempted from prescription charges in addition to exemptions for children, pregnant women and people on certain benefits or through the NHS Low Income Scheme. Some people with cystic fibrosis may meet the eligibility criteria for prescription charge exemptions and may therefore be in receipt of free prescriptions.
The system of exemptions as a whole means that already 89 per cent of prescriptions are dispensed without charge. Additionally, patients who need more than one prescription each month can save a minimum of £20 every three months by purchasing a pre-payment certificate (PPC) from the NHS Business Authority. This covers an unlimited number of prescriptions for the length of the certificate, regardless of whether they specifically relate to the condition.
Income from prescription charges is put back into our NHS and generates a valuable source of funding for the NHS. Between 2015/16 and 2019/20, prescription charges generated over £2.8 billion for the NHS, which contributes to patient care and essential running costs for frontline services. This money would have to be found elsewhere if charges were abolished entirely.
GP Recruitment and Retention
April 2023
The Government remains committed to increasing the number of doctors in general practice and is determined to deliver this as soon as possible. The number of GP training places has increased, with 4,032 trainees accepting a place in 2022, compared to 2,671 in 2014.
Work is ongoing with NHS England, Health Education England and the profession to increase recruitment, address the reasons why doctors leave the profession and encourage them to return to practice. The updated GP Contract Framework announced a number of new retention schemes alongside continued support for existing schemes for the general practice workforce. In areas where there are GP vacancies, the Targeted Enhanced Recruitment Scheme provides a £20,000 salary supplement to attract GP trainees. The abolition of the pension lifetime savings allowance should help reduce the number of GPs and other doctors who retire early.
The Government is also taking steps to support the recruitment of GPs from overseas. In 2020, the Home Office launched the Health and Care Visa, with the aim of making it easier, cheaper and quicker for health workers – including GPs - to be recruited in the NHS. To increase the workforce further, GP surgeries are being encouraged to become approved Home Office approved sponsors, helping more international medical graduates to be retained as GPs.
As part of the Autumn Statement, I welcomed the Government's announcement that a NHS workforce plan will be developed to consider how many staff will be required over the next 15 years to meet patient need, including General Practice. The Government will launch a recovery plan for general practice in the coming weeks, which will focus on supporting GPs through providing them with the technology and tools that will help them deal with ever-increasing demand.
Emergency Care Services
March 2023
I recognise that A&E services are strained. It is disappointing to see the latest NHS figures showing that 68.9 per cent of patients in November 2022 were seen within four hours in A&E Departments across England, compared to 69.3 per cent in the previous month. Please be assured that the Government will make improving ambulance waiting times and reducing the backlog of care a key priority over the coming months. NHS England and Improvement announced steps to help the NHS prepare for Winter 2022/23, by increasing hospital bed space and increasing the number of NHS 111 and 999 call handlers. In particular, I want to highlight that the NHS will increase the number of general and acute beds by 7,000, which will include new hospital beds and virtual wards where patients will be treated at home with NHS equipment or assistance.
The Government has also committed to urgent action to free up beds and reduce long waits in accident and emergency through the £500 million Adult Social Care Discharge Fund. An additional £200 million has been allocated to help the NHS buy up beds in the community, so that thousands of patients can be safely discharged from hospital. This will help free up hospital beds so that people be admitted quicker from accident and emergency to wards, reducing pressure on emergency departments.
The Government has recently published its Urgent and Emergency Care Plan alongside an investment of £1 billion to deliver 5,000 more hospital beds compared to the numbers originally planned for 2022-23, and to put over 800 more ambulances on the road. This will speed up discharge from hospitals, free up beds for patients needing urgent and emergency care and, ultimately, reduce pressures on hospitals.
Palantir
March 2023
I note your concerns over media reports about the awarding of contracts for the proposed Federated Data Platform (FDP), a new data tool to connect and integrate patient and other data sources from across the health system. The FDP will be procured via open competition, in line with Public Contracts Regulations 2015. Once launched, the procurement process will be open to all suppliers and will abide by the core principles of the 2015 Regulations, including transparency, non-discrimination, equal treatment and proportionality. These principles apply to all suppliers bidding for the FDP.
NHS England is committed to transparency on the way data is used within the FDP to ensure that patients are informed of the choice to opt out, where applicable and how to do so. It is also committed to publishing information on who is accessing data and for what purpose. There must always be a valid lawful basis for the collection and processing of personal information, with transparency about the use of data within the FDP, as defined under the applicable legislation.
The Government published its strategy Data Saves Lives: Reshaping Health and Social Care with Data in June this year. This set out how digital capabilities will enable health and social care to be delivered in a much faster and more effective way, and with a greater emphasis on personalised care. This strategy is supported by the Government’s Plan for Digital Health and Social Care which outlined a £2 billion investment to digitise the NHS and at least £150 million to support digital transformation in social care.
The Government is also enabling frontline clinicians to deliver care efficiently, effectively and safely through Electronic Patient Record (EPR) systems. By December 2023, 90 per cent of NHS trusts should have EPRs in place and 100 per cent by March 2025. On 22 September 2022, the Government published its Our Plan for Patients strategy. This committed to using joined-up data and digital tools to increase patient choice and operational productivity. It also committed to freeing-up time to allow carers to care by using IT to reduce bureaucracy.
Abortion Clinics
March 2023
As you might be aware, MPs agreed to add Clause 9 - which introduces areas around abortion clinics and hospitals (buffer zones) where interference with, and intimidation or harassment of, women accessing or people providing abortion services would be an offence - to the Public Order Bill. Matters related to abortion are a free vote for MPs, meaning the Government does not ask members to vote a certain way.
I chose to vote in favour of the clause. However, it is clearly not intended to apply to people doing silent prayer. I do appreciate that people have strong convictions both ways in this matter. Ultimately, however, undergoing an abortion is a tremendously traumatic experience for a woman. There are a great number of personal and health related reasons for abortions. I believe it is better to pursue an empathetic policy on this matter that treats the emotional wellbeing of those undergoing abortions as the priority.
NHS Privatisation
March 2023
It is not the intention of this Government or any previous Conservative Government to pursue privatisation of the National Health Service. I fully believe in our NHS and its values. The Government has guaranteed that the NHS will always provide healthcare free at the point of delivery, regardless of ability to pay. This 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 expanding the independent sector and competition in the NHS between 1997 and 2010.
The NHS is something to be valued and protected which is why I support the commitment to properly funding the NHS. Following the 2021 Spending Review, NHS England’s day-to-day budget is set to grow by 3.8 per cent on average up to 2024/25, supporting the NHS to tackle the elective backlog, deliver its Long-Term Plan and ensure it has the resources needed to fight Covid-19.
In fact, more money is spent on the NHS now that at any time in history, whether you measure it in cash terms, adjusted for inflation or as a share of GDP. The NHS budget is far bigger now than under the last Labour government, however you measure it. The UK Government now spends more on health than most other EU countries and indeed most other high-income countries around the world. Clearly, as we age as a society and develop new treatments, health demand rises rapidly, which is why spending has needed to rise.
Drug Resistant Infections
March 2023
The rise and spread of AMR is creating a new generation of medicine-resistant superbugs and, left unchecked, the impact of these superbugs would be wide ranging and highly damaging to global health and to socio-economic development. I agree with you that this issue should be taken extremely seriously and I particularly welcome the work of the All-Party Parliamentary Group on Antibiotics in this area. Parliament also debated this issue in Westminster Hall in 2021.
I know that my colleagues across government recognise the importance of addressing AMR. In 2019, the UK 20-Year Vision for AMR was published, outlining a range of targets and three key methods for tackling the issue. This included reducing the need for, and unintentional exposure to, antimicrobials; optimising the use of antimicrobials; and investing in innovation, supply and access.
Alongside this, a five-year national action plan was released in May 2022, aiming to build on achievements to date. The plan is now in its third year of delivery and changes were made to provide more specific and measurable commitments and reflect lessons learned from the Covid-19 pandemic. Amendments also reflect work towards new sector targets as well as the progress made in reducing antibiotic prescriptions in food-producing animals. The aim is to ensure that antimicrobial resistance is controlled and contained by 2040.
To this end, the Government recently launched a consultation to inform the next stage of tackling antimicrobial resistance, including the next 5-year national action plan to protect patients from deadly infections. The consultation was accepting evidence until 20 January 2023. The Government is analysing responses and will respond in due course. No new class of antibiotic has been developed since 1987, and I know the Government recognises that the market is broken. The development of antibiotics is not commercially attractive. It is linked to high costs and low returns because novel antibiotics are reserved for more serious and difficult-to-treat infections and so are not being used as much as other drugs.
To tackle this, the Government is testing a new subscription model for antibiotics with the NHS paying two pharmaceutical companies up-front for access to two antimicrobials. Instead of reimbursing pharmaceutical companies based on the quantity of antibiotics sold, guaranteed payments at fair rates will provide the life sciences sector with the security to develop new and effective drugs and ensure that medicines can be provided quickly for NHS patients. I await further developments with interest
Preconception Care Strategy
March 2023
I believe every woman should receive personalised, high-quality care to support maternal and child outcomes. The Women's Health Strategy, published last summer, committed to make the NHS the best place in the world to give birth through personalised, individualised, and high-quality care. The NHS Long Term Plan committed to implementing new measures to improve safety, quality and continuity of care from preconception to 24 months after birth.
This includes enabling an additional 24,000 women to access specialist perinatal mental health care by 2023/24. Within specialist perinatal mental health services, 33 new maternal mental health services will provide psychological therapy, maternity services and reproductive health for women with mental health needs following trauma or loss related to their maternity experience. These will be available across England by March 2024.
The Government is also investing £300 million in perinatal mental health and parent-infant relationship support by 2024/25, as part of the Start for Life and Family Hub programme for 75 upper tier local authorities in England. Thousands of families across England will be offered help and support with issues such as infant feeding, mental health and relationship building thanks to Family Hubs being rolled out in local communities. A Maternity Disparities Taskforce was established in February 2022 to explore the reasons for disparities in maternity care and address poor outcomes for women from ethnic minority communities and those living in deprived areas. In January this year, the Office for Health Improvement and Disparities published new analysis of factors affection preconception health in ethnic minority women.
The Department for Health and Social Care is working with the NHS to establish an independent working group to help guide the implementation of the recommendations from the Ockenden and East Kent reports on maternity services. The first working group meeting took place on 31 August 2022 and will inform the new NHS Maternity Development Plan.
YoungMinds Event
February 2023
The mental health of young people is a major concern. I will certainly look to attend the YoungMind event in Parliament if parliamentary time allows.
The NHS Long Term Plan increased investment in mental health services by at least £2.3 billion a year by 2023/24 so that an additional 345,000 children and young people are now able to get the necessary NHS-funded mental health support. In 2021/22, the Government provided an additional £79 million in response to the pandemic to expand children’s mental health services in the 2021/22 financial year. Over 689,000 children and young people under 18 were supported through NHS-funded mental health community services with at least one contact in the twelve months to July 2022, compared to 615,000 for the same period to July 2021. Mental health support teams now cover 26 per cent of pupils in schools, a year earlier than originally proposed in the Transforming Children and Young People’s Mental Health Provision Green Paper. This will increase to 399 teams, covering around 35 per cent of pupils by April 2023, with over 500 planned to be up and running by 2024. Rollout of further mental health support teams is being developed and will be confirmed in due course.
On average, each mental health support team will work with around 8,000 children across 10-20 schools and colleges. All schools involved will have a mental health lead. Each mental health support team is made up of education mental health practitioners and senior clinicians or higher-level therapists as well as a team manager and some admin support. The teams act as a link with local NHS children and young people’s mental health services.
In Our Plan for Patients published in September last year, the Government committed to expanding mental health support for children at school, given that half of mental health conditions take root by the age of 14. This included a commitment to boost the number of mental health practitioners in primary care and to strengthen mental health support in schools. Furthermore, the Department for Education has committed to offer all state schools and colleges a grant to train a senior mental health lead by 2025, and over 10,000 schools and colleges have taken up the training offer so far.
Hospice Support
February 2023
The Government is taking action to support hospices so they can continue to provide compassionate quality care to patients. My colleagues and I understand that hospices must be able to continue the incredible support and comfort they offer to those suffering from a terminal condition.
Hospices benefit from the Government's Energy Bill Relief Scheme (EBRS), which reduces expenditure on energy and offers certainty over their budgets. In April 2023, the EBRS will be replaced by the Energy Bill Discount Scheme (EBDS) which will run until March 2024. The EBDS will support hospices by providing a discount on gas and electricity unit prices.
Hospices will receive a per-unit discount to their energy bills from April 2023 to March 2024, subject to a maximum discount. The discount will be applied if wholesale prices are above a certain price threshold. For most non-domestic energy users in the UK these maximum discounts have been set at £19.61 per megawatt hour (MWh) with a price threshold of £302 per MWh for electricity, and at £6.97 per MWh with a price threshold of £107 per MWh for gas.
In addition to the Government’s support for energy bills, NHS England is supporting palliative and end-of-life care across the country. For example, palliative and end-of-life care for children and young people is being supported through the Children and Young People’s hospice grant, providing £21 million in 2022/23, rising to £25 million in 2023/24. Furthermore, as part of the NHS Long Term Plan, up to £5 million in 2022/23 of match funding has been made available to commissioners who increase their overall level of investment in local children’s palliative and end-of-life care services, rising to up to £7 million in 2023/24.
Allegations of NHS Privatisation
February 2023
I fully believe in our NHS and its values. 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 clear: the Government has not privatised the NHS, and will never privatise the NHS.
The NHS is something to be valued and protected which is why I support the commitment to properly funding the NHS. Following the 2021 Spending Review, NHS England’s day-to-day budget is set to grow by 3.8 per cent on average up to 2024/25, supporting the NHS to tackle the elective backlog, deliver its Long Term Plan and ensure it has the resources needed to fight Covid-19.
Far from being starved of funds, spending on the NHS is now bigger in cash terms, adjusted for inflation and as a proportion of the economy than it has ever been in history. The UK government now spends more on health than most other developed countries, and spends far more than it did under the last Labour government.
Sue Ryder Exhibition
February 2023
We must ensure that people receive the most appropriate care personalised to their individual needs as they approach the end of their life. The NHS Long Term Plan, prepared by the NHS and published in 2019, builds on previous commitments made by the Government to personalise care through informed conversations between healthcare professionals and dying people.
Part of this is a commitment to help people to live independently for longer, as well as a promise to give more people more say about the care they receive and where they receive it, particularly towards the end of their lives. I believe empowering people with terminal conditions in this way will better enable them to access palliative care when and where they most need it. The establishment of the Personalised Care Institute has made training available to help staff identify and support patients and to introduce personalised care planning for everyone identified as being in their last year of life. Importantly, this enables meaningful conversations to take place and allows staff to help patients and families, address their concerns and to explain the breadth of services available in the local area.
On the funding of hospices, NHS England and NHS Improvement have recently provided funding to support seven strategic clinical networks to deliver palliative and end of life care. The Health and Care Act will also require Integrated Care Boards (ICBs) to commission palliative care and end of life services.
Baby Loss APPG
February 2023
I am afraid I cannot commit to joining the APPG at the moment due to full commitments elsewhere, but I know some of my colleagues are energetically involved, and I will certainly keep an eye out for their events and look to attend when possible. The APPG on Baby Loss and Sands do tremendously important work to raise awareness in Parliament and elsewhere on this crucially important issue.
The UK is one of the safest places in the world to give birth, although I know that 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 relative to levels in 2010.
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 36 per cent reduction in neonatal mortality rates for babies born after 24 weeks gestation.
Since 2016, the Government has provided more than £250,000 to Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and Royal Colleges to produce and support the rollout of a National Bereavement Care Pathway to reduce the variation in the quality of bereavement care provided by the NHS.
I welcomed the publication of the Women's Health Strategy in July this year that made several commitments related to baby loss and maternity care. This included a pledge to introduce a pregnancy loss certificate in England as recommended by the interim update of the independent Pregnancy Loss Review. The Government is working to deliver these commitments to make the NHS the best place in the world to give birth through personalised, individualised, and high-quality care.
Gambling Review
February 2023
For many, gambling can be fun but I recognise that, for others, it can become a serious problem. While we all want a healthy gambling industry that makes an important economic contribution, we must also protect those that use it from harm. The Government recognises the unique contribution that horse racing makes to the UK's sporting culture and in particular to the rural economy.
I appreciate your concerns over the impact of the Gambling Commission’s consultation, specifically in regard to affordability checks. I want to stress that the proposals focused on more prescriptive requirements for operators to identify and intervene with customers who may be at risk of harm. This included a specific process for assessing affordability and particular consideration will be given to the spending/loss threshold at which it might be proportionate to require operators to complete affordability checks.
In response to evidence showing some gamblers may be at greater risk of harm during lockdown, the Commission published new guidance for online operators to help reduce the risk of harm in these unprecedented circumstances. You may also welcome that the Government committed to striking the right balance between freedom of choice and protection from harm while reviewing the Gambling Act 2005. I will be sure to scrutinise whether this commitment has been delivered on when the Government sets out its findings in due course.
Accident and Emergency
February 2023
The current situation at Accident and Emergency is simply not acceptable and not sustainable.
The Government is aware that there are significant issues with emergency care at the moment. NHS England and Improvement recently announced steps to help the NHS cope with Winter 2022/23, by increasing hospital bed space and increasing the number of NHS 111 and 999 call handlers. In particular, I want to highlight that the NHS will increase the number of general and acute beds by 7,000, which will include new hospital beds and vizzrtual wards where patients will be treated at home with NHS equipment or assistance.
The Government has also committed to urgent action to free up beds and reduce long waits in accident and emergency through the £500 million Adult Social Care Discharge Fund. An additional £200 million has been allocated to help the NHS buy up beds in the community, so that thousands of patients can be safely discharged from hospital. This will help free up hospital beds so that people be admitted quicker from accident and emergency to wards, reducing pressure on emergency departments. The Government has recently published its Urgent and Emergency Care Plan alongside an investment of £1 billion to deliver 5,000 more hospital beds compared to the numbers originally planned for 2022-23, and to put over 800 more ambulances on the road. This will speed up discharge from hospitals, free up beds for patients needing urgent and emergency care and, ultimately, reduce pressures on hospitals.
Nurses' Remuneration
February 2023
I do believe that recruitment and retention problems within the NHS could be somewhat assuaged by salary adjustments. Over the last twelve months, I have held regular meetings with local NHS and trade union leaders regarding a high-cost-of-living supplement for Cambridge. I am acutely aware that we live in one of the most expensive parts of the country. Where Cambridge’s NHS staff are paid according to national standards, in London staff receive between 5% (fringe) and 20% (inner London) supplements. I therefore held meetings with Sajid Javid when he was Health Secretary, and I was encouraged by his response. It is a priority of mine to discuss this matter with Steve Barclay as soon as possible.
On a national level, the independent pay review bodies provide a recommendation on the level of pay for NHS staff, doctors and dentists and the Government has accepted their recommendation in full. This means that over a million NHS staff benefitted from another pay rise last year on top of the three per cent increase they received in 2020 when pay was frozen in the wider public sector. Staff including nurses, paramedics and midwives, received a pay rise of at least £1,400 with the lowest earners receiving an increase of up to 9.3 per cent. Doctors and dentists received a 4.5 per cent pay rise.
I believe that pay should deliver value for the taxpayer and be careful not to drive inflation even higher. In formulating its recommendations, the Pay Review Bodies consider evidence from a range of stakeholders, including NHS system partners and trade unions and factors such as recruitment, retention, morale, motivation, affordability and the economic context, including inflation and the labour market. The Secretary of State for Health and Social Care has formally commenced the 2023-24 pay round and wrote to the Chair of the NHS Pay Review Body on 16 November 2022 to ask for recommendations for the Agenda for Change workforce from April 2023.
Adult Social Care
February 2023
I am proud to support a government that is committed to taking the difficult decisions and tackling the problems in adult social care head on, creating a sustainable adult care system that is fit for the future.
As you may be aware, the Government has announced a cap on care costs and more generous means testing for care, which will benefit all adults. From October 2025, the amount anyone in England will need to spend on their personal care over their lifetime will be capped at £86,000. Those who have assets below £20,000 will not have to pay anything for their care from their assets, however may still need to make a contribution towards their care costs from their income.
In assessing what someone can afford to pay for care, a local authority must ensure that in addition to the minimum guaranteed income, people retain enough of their income so they have sufficient funds to meet those needs not being met by the local authority. At present, some people face real financial pressures each week or month after paying for their care.
To allow people receiving means-tested support to keep more of their own income, it is welcome that, following the last review, from 6 April 2022 the MIG was unfrozen and was increased in line with inflation. The level of the Minimum Income Guarantee is reviewed annually with the next review ongoing. Any revised rates will be published in a Local Authority Circular.
Gender Recognition Reform
February 2023
The Government is committed to ensuring that everyone in the UK is free to live their lives and fulfil their potential regardless of their sex, sexual orientation or gender identity. The LGBT community must be free to proposer in modern Britain. I agree that there are other issues that the political focus should be on. The recent debate on trans rights in Parliament was precipitated by the Gender Recognition Act in Scotland. The reality is that the SNP administration put forward an act of Government that covered non-devolved powers. I do not know whether this was done without appropriate legal advice or whether it was deliberately pursued to orchestrate a conflict with the British Government. Either way, it was simply not workable to have different regimes on gender recognition in different parts of the United Kingdom. No section of society, particularly vulnerable sections, should be used as political footballs.
My colleagues in the Government Equalities Office have, over recent years, looked carefully and thoroughly into the gender recognition process, including considering potential changes to the Gender Recognition Act 2004. After careful consideration, it is their view that this existing legislation strikes the right balance between ensuring there are proper checks and balances in the system and ensuring there is support in place for people who want to change their legal sex. I welcome that four new gender clinics were opened in 2021, which should see waiting lists reduce. This should provide transgender people with greater patient choice, shorter waiting times, better geographical coverage and, crucially, easier access. It will also make it easier to fulfil the medical requirements of obtaining a Gender Recognition Certificate.
Conversion Therapy
January 2023
The suggestion that being gay can be “cured” is both morally and medically wrong and the concept of conversion therapy has no place in our society. Being lesbian, gay or bisexual is not an illness to be cured.
It is right that this issue is tackled through legislation and I therefore welcome the announcement that the Government will publish a draft Bill which will set out a proposed approach to ban conversion practices. The Bill, which will apply to England and Wales, will protect everyone, including those targeted on the basis of their sexuality, or being transgender.
The Government will ask for pre-legislative scrutiny by a Joint Committee, to help ensure that the Bill does not cause unintended consequences. It will also ensure that the Bill benefits from stakeholder expertise and input from parliamentarians.
The Government has now confirmed that transgender conversion therapy will be included in the ban. The Bill will be published shortly, and will protect everyone including those targeted on the basis of their sexuality, or being transgender. It is important that the legislation must not, through a lack of clarity, harm the growing number of children and young adults experiencing gender related distress, through inadvertently criminalising or chilling legitimate conversations parents or clinicians may have with their children. It would obviously be wrong if parents were prevented from reaffirming their children’s birth gender, and I am assured this legislation will not do that.
Clean Water and Hygiene
January 2023
Safe water and adequate sanitation are basic human needs. It is a regrettable fact that for so many on our planet these needs remain unmet, particularly in developing and conflict affected states. Indeed, as UNICEF reports, three billion people do not have a hand-washing facility with water and soap at home, in addition to almost half of all schools lacking such facilities, affecting some 818 million school-age children. I am sure you will welcome, therefore, that improving access to WASH services, including in healthcare facilities, is a global health priority for the FCDO. It forms a core part of the UK's Ending Preventable Deaths of mothers, babies and children strategy, published in December 2021, and is critical to the FCDO's wider global health objectives. I am proud of the UK's action on promoting safe water, sanitation and hygiene - or UN Sustainable Development Goal (SDG) 6. Indeed, HM Government (HMG) pledged to provide 60 million people with improved water and sanitation between 2015 and 2020, and exceeded this target in August 2020, helping 62.6 million people access clean water and sanitation, of which 26.2 million were based in fragile states.
To deliver on such an ambitious target, HMG developed substantial bilateral WASH programmes and entered into a £57.3 million partnership with UNICEF to provide sustainable WASH services to 3.8 million people in ten countries, through the Sanitation, Water and Hygiene for the Rural Poor programme (2017-2022). The UK is now prioritising spend on hand hygiene as part of our approach to tackling Covid-19; strengthening the climate resilience of WASH services; and reinforcing accountability for the delivery of WASH services. The UK is also continuing to promote the importance of WASH through our membership of the "WASH In Healthcare Facilities" international taskforce, through bilateral programming such as our innovative hand hygiene partnership with Unilever, and through core multilateral funding, including to the World Bank and the World Health Organisation. This includes funding to the WHO-UNICEF Joint Monitoring Programme, which tracks progress against water and sanitation global targets and supporting the Global Water Partnership to promote climate resilient WASH.
Gender Recognition Reform (Scotland) Bill
January 2023
It is the assessment of the UK Government that the Gender Recognition Reform (Scotland) Bill will have significantly adverse effects, including the impact on the operation of the Equality Act 2010. In particular, the Government has said it shares the concerns of many experts and civil society groups regarding the potential impact of the Bill on the safety of women and children. I can assure you that this decision has not been taken lightly, and the UK Government fully respects the Scottish Parliament's competency to make decisions within devolved areas but it cannot ignore the significant consequences of this Bill for reserved areas.
The Minister for Equalities is making progress with implementing the Government's 2020 response to the Gender Recognition Act 2004 consultation. The Government has confirmed that it will be updating the list of approved overseas countries and territories to make sure it does not compromise the integrity of the GRA. The list of approved overseas countries and territories was last updated in 2011 and a commitment was made to keeping the list under review. There are now some countries and territories on the list who have made changes to their systems since then and would not now be considered to have equivalently rigorous systems. It should not be possible for a person who would not satisfy the criteria to obtain UK legal gender recognition to use the overseas recognition route to obtain a UK Gender Recognition Certificate. This would damage the integrity and credibility of the process of the GRA. The Government is now finalising the details of overseas countries and territories to be removed from the list via an affirmative Statutory Instrument. These compromise countries and territories where there is a clear indication that the country now no longer has a system at least as rigorous as those in the Gender Recognition Act 2004. We are undertaking a thorough checking system to verify our understanding of each overseas system in question. That the Minister for Equalities will engage with colleagues and Ministers from devolved governments in advance of laying the Statutory Instrument. The Government is committed to ensuring that this outcome of the GRA consultation is followed through and upheld and the overseas list will be updated via Statutory Instrument more regularly in future.
Revive the NHS Campaign
November 2022
I completely recognise the urgency behind Every Doctor’s campaign and the challenges facing NHS staff on the frontline. Whilst I cannot commit to signing the #ReviveTheNHS pledge, I know that the Government is taking steps to address the issues highlighted by the campaign to improve the experience of staff and patients in the NHS. Given the pressures that NHS staff face daily, it is vital that everyone has access to comprehensive mental health support in their workplace.
Over the last few years, 40 dedicated support hubs have been established across the country to offer staff access to mental health services. Through the Energy Bill Relief Scheme, hospitals across England will be able to receive support with energy bills this winter. It is my understanding that the support will be automatically applied to all eligible businesses, but if there are healthcare settings in our local area struggling to access this support, please provide further details and I would be happy to follow this issue up with the Department of Business, Energy and Industrial Strategy. While the Government does not support removing the locum cap and providing ringfenced funding for locums in secondary care, Trusts can override rules on agency staffing on exceptional patient safety grounds. Caps on locum pay rates do not apply in primary care and Integrated Care Systems are able to access up to £120,000 to support their recruitment in general practice. The contribution of healthcare professionals from overseas will be crucial to expanding the NHS workforce and improving access to primary and secondary care. Since the Health and Care Visa was introduced in 2020, the Government has expanded the number of occupations to help make it quicker and cheaper for healthcare professionals to work in the NHS.
I do agree that NHS pensions need to be reformed as a matter of urgency. I have made this case to the Chancellor and to the Health Secretary. I do believe that it is sensible to review areas with a high cost of living to support current staff and attract employees moving forward. That is why I am committed to achieving a high cost of living supplement for Cambridgeshire. To that end I met with the previous Health Secretary, and it is one of my top priorities to discuss this matter with Stephen Barclay.
Abortion in Northern Ireland
July 2022
The deadline for abortion services to be fully commissioned in Northern Ireland passed on 31 March 2022 and I support the Government’s response which has been to introduce the Abortion (Northern Ireland) Regulations 2022. These regulations place a further duty on the Department of Health to make abortion services available as soon as is reasonably practicable and remove the need for Executive Committee approval before services can be commissioned.
This is not a more liberal regime than that in England and Wales in practice. Although Northern Ireland has a different starting point to the rest of the UK given abortion was decriminalised through repeal of sections 58 and 59 Offences Against the Person Act, where appropriate, the Government has mirrored provisions under the Abortion Act 1967, to ensure consistency in provision of services across the UK. Abortion does remain a devolved issue and the Assembly can of course legislate on this issue.
Assisted Dying
June 2022
Coping with terminal illness is distressing and difficult both for the patient and their families. These cases are truly moving and evoke the highest degree of compassion and emotion. Currently 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, personally, believe that competent adults who are terminally ill should be provided at their request with specified assistance to end their own life, so long as there are robust safeguards to prevent any abuse.
Foetal Viability
May 2022
In response to a recent question in Parliament, my colleague Maggie Throup MP (Minister for Public Health) stated that while officials keep evidence on fetal viability under review, there is currently no clear consensus from the medical profession that the age of viability has reduced below 24 weeks.
Ultimately, it is a question for Parliament whether to propose any changes to the law on abortion such as gestational time limits.
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.
I know that making a decision regarding abortion can be extremely difficult, 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.
Junk Food Advertising and Multi-Buy Deals
May 2022
The Government has taken action to tackle this important issue and will implement a UK-wide pre-9pm ban on TV and UK-On Demand Programme Services advertising food high in sugar, salt and fat. It was interesting to note that the Obesity Health Alliance reported that 74 per cent of the UK public supported the idea of a TV watershed and online ban on less healthy food and drink marketing. Furthermore, 9 in 10 parents taking part in Children's Food Campaign's Parents' Jury backed a TV watershed on junk food marketing.
The Health and Care Act 2022 introduced the 9pm advertising ban and the policies are due to come into effect on 1 January 2024. The measures had been intended to come into effect in 2023 but, due to a delay to the Health and Care Bill receiving Royal Assent, as well as a growing recognition that the industry needs more time to prepare, they have been postponed by a year.
With regard to the ban on multi-buy deals, officials have delayed introduction to allow time to consider the impact upon household finances in light of the increased cost-of-living. The Government is committed to tackling the issue of childhood obesity however it is essential we consider the wider implications of specific policy changes.
NHS Bursary
May 2022
First time students on standard five or six year undergraduate medical and dental courses are eligible to apply for support on the same terms as other full-time students for the first four years. This allows medical students to access the tuition fee loan, living cost loan and targeted grants. Students can also apply to Student Finance England for the non-income assessed reduced living cost loans for these years. For years five onwards, students on a standard five or six year undergraduate medical and dental courses enter a bursary year whereby those eligible receive the NHS Bursary.
Students benefit from having their tuition fees paid for by Health Education England and a non-means award of £1,000. Additionally, there is a means-tested award of up to £3,191. In addition, there is also a reduced rate maintenance loan available via Student Finance England. Furthermore, it is positive that maximum grants and loans for living and other costs for undergraduate courses and grants and loans for postgraduate courses will be increased by 2.3 per cent for 2022/23.
This will mean that the support available for students on the lowest incomes will reach record levels in cash terms. In addition, many providers have had hardship funds that students can apply to for assistance should the Covid-19 outbreak affect individuals’ finances in the academic year 2021/22. The Government is committed to keeping funding arrangements for all NHS healthcare professionals’ education under review to ensure that students are appropriately supported.
Having said all this, I will raise with ministers so they are aware with the strength of feeling.
Women's Health Strategy
May 2022
Sadly, an estimated one in four pregnancies end in miscarriage and I offer my sympathy to anyone who has experienced this. In recent years, MPs on both sides of the House have noted Baby Loss Awareness Week and have made very moving contributions to debates. I hope that these debates have emphasised the focus on this issue in Parliament, the Department of Health and Social Care, as well as the NHS, and moreover have also sent a message to bereaved families - that Parliament truly does understand the impact of miscarriage.
In March 2021, the public were asked for their views on the first-ever government-led Women’s Health Strategy for England. Nearly 100,000 responses from women across the country were submitted, informing the Government’s vision for a new healthcare system. The category, "fertility, pregnancy, pregnancy loss and post-natal support" was listed as a priority area and a key theme that respondents picked for inclusion in the Women’s Health Strategy.
As part of its response, the Government indicated that it would consider how to strengthen healthcare support for women and their partners affected by pregnancy loss and consider the recommendations of the forthcoming Pregnancy Loss Review. The Government has also announced that the Women’s Health Strategy would include data on miscarriages, as well as the 24/7 availability of emergency miscarriage services.
The Strategy will be published later this year after which the Government’s ambitions will be set out in more detail.
Disability and Day Care
May 2022
The significant impact that the Covid-19 pandemic had on society and the mental health of people across the country is well documented. I fully appreciate your concern about its effect on people with learning disabilities and the role that day centres can play in helping people reconnect with each other and with society.
Local authorities have a duty of care under the Care Act 2014 to provide or arrange services to meet the social care needs of local residents. In its winter plan for adult social care published last year, the Government was clear about the need to understand the degree to which day care services have reopened and what further action may be required in support of this.
Decisions about the opening, closing and delivery of care are the responsibility of the local authority. If you have any particular concerns about specific local services that you want me to help with, please don’t hesitate to contact me.
Conversion Therapy
May 2022
The issue around conversion therapy and the gender identity of children is a complex area that requires sensitive thought. It is important that we do not inadvertently bring about legislation that has the potential to be harmful to children.
Although the Government has included a ban on conversion therapy for sexual orientation in the Queen’s Speech, it has excluded a ban on conversion therapy for gender identity. 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 18s.
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.
Pancreatic Cancer
April 2022
Every effort is being made to improve early diagnosis and to drive up survival rates for pancreatic cancer.
I fully agree that more must be done to reduce the survival gap between pancreatic cancer and other cancers. The development of the 10 Year Cancer Plan provides an important opportunity to focus on improving outcomes for less survivable cancers such as pancreatic cancer. Key priorities in the Plan will include supporting earlier diagnosis of cancer and increasing survival rates to match the best in Europe.
The input of patient groups like Pancreatic Cancer UK will be invaluable to help develop the 10 Year Cancer Plan by highlighting the lived experience of people with pancreatic cancer. I understand that the Plan will be published later this Summer and that the Government is currently reviewing the responses to the recent call for evidence.
Research into less survivable cancers such as pancreatic cancer is also important to improving outcomes. The UK Government invests £1 billion per year in health and care research through the NIHR. I also recognise the indispensable contribution made by charities in driving forward research into cancer, with Cancer Research UK alone spending £17 million on pancreatic cancer over the last financial year.
I have sent a letter to the Secretary of State on this matter.
Suicide Safer Internet
April 2022
As part of the Online Safety Bill, companies will be required to remove and limit the spread of illegal content which encourages or incites suicide online. Digital Secretary Nadine Dorries has also prioritised additional illegal offences to be written on the face of the Bill. This removes the need for them to be set out in secondary legislation, allowing faster enforcement action against tech firms which fail to remove the named illegal content. These offences include the promotion or facilitation of suicide.
A recent strengthening of the proposed legislation will mean that firms must remove harmful content that has been reported to them and must prevent people being exposed to it in the first place. Ofcom, the UK’s independent communications regulator, will oversee the regulatory regime, backed up by mandatory reporting requirements and strong enforcement powers to deal with non-compliance. These powers include issuing fines of up to ten per cent of annual worldwide turnover to non-compliant sites or blocking them from being accessible in the UK.
I will discuss this matter with the Secretary of State to ensure she is aware of the strength of feeling.
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.
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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