Health and Social Care

Abortion (Northern Ireland) Regulations 2022

Selaine’s response:

I am very concerned that women and girls are still unable to access high-quality abortion and post-abortion care in Northern Ireland. The law changed more than two years ago, and abortion services should now be available as a healthcare service in Northern Ireland. Unfortunately, this is not the case. The Northern Ireland Office has extensively engaged with the Executive and Minister for Health, but they have failed to deliver.

I welcome the Government’s commitment that when establishing the legal framework for abortion that the services themselves would be delivered and overseen locally by the Department of Health and relevant health bodies in Northern Ireland, as a healthcare service. This is important as it will ensure that abortion services can be delivered in a sustainable way and become embedded into the health and social care system in Northern Ireland in the long term.

Although there has been a huge amount of pressure on health services in response to dealing with COVID-19, it does not absolve the responsibility on other important healthcare issues. As you may be aware 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, which were passed by the House of Commons on 22 June.

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.

June 2022

Assisted Dying Debate

Selaine’s response:

Thank you to those constituents who have contacted me about assisted dying, and for bringing to my attention a debate on this topic which will take place in Parliament on 4 July. I understand this follows an e-petition calling for assisted suicide to be legalised receiving over 140,000 signatures. Unfortunately, I was unable to attend this debate due to other Parliamentary duties.

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 Please be assured I will follow this debate closely, as I understand this is an important issue for many North Devon constituents.

June 2022

Breast Cancer

Selaine’s response:

Please be assured that every effort is being made to continue raising awareness of breast cancer and to improve the treatment of all those diagnosed with this disease.

I want to provide reassurance that reducing waiting times for cancer treatment, including for breast cancer, is an urgent priority for the Government. As part of the 2021 Spending Review, £2.3 billion was allocated to improve diagnostic capacity over the next three years.

The Government is committed to rolling out at least 100 Community Diagnostic Centres (CDCs), which will be new one-stop-shops for checks, scans and tests, helping those with suspected breast cancer to access earlier diagnostic tests closer to home.

In addition, NHS England and Improvement is asking local health services to focus on reducing the number of people waiting over 62 days on cancer pathways.

The Government is committed to ensuring that as many people are diagnosed to breast cancer within 28 days from GP referral. A new 10 Year Cancer Plan is being developed, with a key priority being to drive earlier diagnosis, including through meeting the FDS and joint awareness campaigns with patient groups like Breast Cancer Now.

June 2022

Carers’ Week

Selaine’s response:

Thank you to those constituents who have contacted me about Carers' Week which takes place between 6 and 12 June. I am grateful for their suggestions of a Recovery and Respite Plan for Unpaid Carers which I would be happy to discuss with my Parliamentary colleagues.

I recognise the valuable contribution made by all types carers: residential, domiciliary, paid, unpaid, many of whom spend a significant proportion of their life providing support to family members, friends and neighbours.

The Government is continuing to support the implementation of improved rights for carers, enshrined in the Care Act 2014. Carers can receive support through the Carer Element in Universal Credit and through Pension Credit and Carer's Allowance has been increased to £69.70 per week. Over the last twelve years successive changes will have provided an additional £800 a year for carers.

The Government’s Social Care White Paper outlined a number of measures to support carers including up to £25 million to kick start a change in the services provided to support unpaid carers. This could include respite, breaks and wellbeing support. The Department of Business, Energy and Industrial Strategy (BEIS) will also introduce a Carer’s Leave entitlement of five days of unpaid leave per year for eligible employees.

Local authorities are also required to undertake a Carer's Assessment for carers who require support. This may include recording a career's needs and the impact of providing care. Local authorities have a legal duty to meet a carer's needs if these are assessed as being eligible for support.

I believe that carers must receive the right support to help them carry out their caring roles. A tenth of adults in the UK provide unpaid care for a friend or family member, and these people should be supported in the invaluable work they do. Please be assured I will continue to follow this matter closely.

June 2022

Neglected Tropical Diseases

Selaine’s response:

There have been significant successes of the UK's past work to tackle Neglected Tropical Diseases (NTDs) worldwide, successes which the reception event on 8 June, ‘Ending the Neglect: Celebrating the role in beating NTDs’ is right to celebrate. It is of course important for the UK to consolidate past success with action going forward.

To this end, I am encouraged that the UK's new international development strategy, published in May, reaffirmed global health as a key priority for UK official development assistance spend. Efforts to tackle NTDs will no doubt continue to benefit from this overarching focus, as I am sure the ministerial representative from the FCDO will set out in detail at the event.

Whilst I am unfortunately unable to attend this event due to other Parliamentary duties, I will be sure to follow this matter closely.

June 2022

Dementia Action Week

Selaine’s response:

Due to the impact of the pandemic, the estimated dementia diagnosis rate fell below the national target for the first time since 2016.

While the rate has recovered slightly since the early part of the pandemic, there is more to do if we are to reach the national target for two thirds of people with dementia to be formally diagnosed.

Last year, £17 million was made available to Clinical Commissioning Groups to address dementia waiting lists and increase the number of diagnoses, which I hope will have an impact in North Devon.

May 2022

APPG Pro-Life Event - Fetal Viability

Selaine’s response:

Thank you to those constituents who invited me to the APPG Pro-Life event on fetal viability and the case for reducing the abortion time limit.

In response to a recent question in Parliament, my colleague Maggie Throup MP (Minister for Public Health) stated while that 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.

Unfortunately I was not able to attend the event due to my other parliamentary duties, but I noted the position being put forward by the speaker invited by the APPG, and would be interested in more information about the evidence being presented.

May 2022

Carers Week

Selaine’s response:

I am grateful for the suggestion of a Recovery and Respite Plan for Unpaid Carers by some constituents, which I would be happy to discuss with my Parliamentary colleagues.

I recognise the valuable contribution made by carers of all kinds, residential, domiciliary, paid, unpaid, many of whom spend a significant proportion of their life providing support to family members, friends and neighbours.

I completely agree that carers must receive the right support to help them carry out their caring roles. A tenth of adults in the UK provide unpaid care for a friend or family member, and these people should be supported in the invaluable work they do.

The Government’s Social Care White Paper outlined a number of measures to support carers including up to £25 million to kick start a change in the services provided to support unpaid carers. This could include respite, breaks and well-being support. The Department of Business, Energy and Industrial Strategy (BEIS) will also introduce a Carer’s Leave entitlement of five days of unpaid leave per year for eligible employees.

Going forward, NHS England at a national level and Integrated Care Boards at a local level will have a duty to involve carers when care is being commissioned for their loved one. The Department for Education (DfE) will be amending the School Census to include young carers.

May 2022

GBS3 Trial

Selaine’s response:

I know that this infection can have a devastating effect for some mothers and their babies.

I am aware that The Department for Health and Social Care is working with the National Institute for Health and Care Research (NIHR), the NIHR’s Clinical Research Network and NHS England and NHS Improvement to encourage trusts to participate in the trial and mitigate any challenges which might prevent trusts from doing so.

The Excess Treatment Cost (ETC) threshold, which forms part of the mechanism to fund non-commercial research in the National Health Service, has been cited as a barrier to participation by NHS organisations. Therefore from 1 April 2022, the organisational ETC threshold was lowered from 0.01% of operating budget to 0.001% to reduce the costs of undertaking research. I will continue to follow this closely and work with our local trust.
Maternity care is a priority for Government, and it has announced an ambition to reduce stillbirths, neonatal deaths, maternal deaths and neonatal brain injuries by 50 per cent by 2025. This includes harm and death caused by GBS.

May 2022

Women's Health Strategy – Miscarriage

Selaine’s response:

This issue unfortunately affects many people and I offer my sympathy to those who have suffered miscarriages. In March 2021, the public were asked for their views on the first ever government led, Women’s Health Strategy for England. The call for evidence was launched for two reasons: firstly, to improve the way in which the health and care system responds to women’s concerns and secondly, to improve women’s health outcomes all over England, regardless of where you live.

Nearly 100,000 responses from women across the country were submitted, informing the Government’s vision for a new healthcare system. Fertility, pregnancy, pregnancy loss and post-natal support were listed as one of the six priority areas and the second most selected topic 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 in full later this year and the Government’s ambitions will be set out in more detail with full delivery plans. Please be assured that I will be following developments closely.

May 2022

Endometriosis

Selaine’s response:

I understand that women might also have endometriosis elsewhere in the body, other than within the pelvic cavity. Feedback from topic experts, sought by NICE (National Institute for Health and Care Excellence, detailed that there is currently no evidence upon which to base recommendations on how to best diagnose and manage endometriosis outside the pelvis, including thoracic endometriosis. The experts explained that treatment in specialist centres may improve patient outcomes and facilitate evidence generation on how to manage endometriosis outside the pelvis.

I am glad that, in December 2021, NICE made an editorial amendment to the guideline section on referral for women with suspected or confirmed endometriosis to highlight that women with endometriosis outside the pelvic cavity should be referred to a specialist endometriosis centre. While I note your desire to see changes to the NICE guideline around thoracic endometriosis, I understand that NICE has said that while they do not expect to make further changes, the issue has been added to the issue log for the guideline for consideration in future surveillance, once more evidence is available

May 2022

Conversion Therapy

Selaine’s response:

I am determined that everyone in the UK should be 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 know for many in the LGBT community the issue of conversion therapy is a significant concern. I am absolutely clear that the practice of conversion therapy has no place in civilised society. Being lesbian, gay or bisexual is not an illness to be treated or cured. I understand that 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 am aware that the Government is proceeding with its legislative proposals to ban conversion therapy for lesbian, gay, and bi-sexual individuals. Alongside this, I have been assured that the Government is carrying out separate work on the issue of transgender conversion therapy, this is to ensure that any legislative measures brought forward will not have any unintended consequences. I understand that 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.

Internationally, the promotion and defence of human rights is an integral part of the UK’s foreign policy, including speaking up for gender equality and LGBT rights, and seeking an end to discrimination where it exists. The UK is clear that every country must fulfil its international human rights obligations.

As co-chair of the Equal Rights Coalition (ERC), the UK has launched the ERC's first Strategy and Five Year Implementation Plan that will increase international action to defend the rights of LGBT people around the world. Further information on the plan for 2021 to 2026 can be found at: https://www.gov.uk/government/publications/equal-rights-coalition-strategic-plan-2021-to-2026.

I am encouraged by the action of the Government to support the LGBT community in the UK and overseas. However, there is of course more that needs to be done and I will continue to press ministers to fulfil commitments made and provide further support.

May 2022

Early Medical Abortion (At Home)

Selaine’s response:

Thank you for contacting me about the provision of early medical abortion.

I completely understand that this can be an incredibly emotive issue, and can fully appreciate the strength of feeling on this matter. Given the sensitivities and 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.

In March 2020, the Government put in place a temporary measure in England, enabling women to take both pills for early medical abortion up to ten weeks (nine weeks and six days) gestation in their own homes, following a telephone or e-consultation with a clinician, without the need to first attend a hospital or clinic. This measure was put in place to reduce the risk of transmission of Covid-19 and ensure continued access to abortion services.

Following consultation, the Government announced a six-month extension to the temporary arrangements, with the intention of returning to pre-Covid arrangements on 29 August 2022.

However, an amendment was tabled to the Health and Care Bill, currently progressing through Parliament, to reverse the Government’s decision and make permanent these temporary measures. Following a free vote, MPs voted in favour of the amendment to make the provisions permanent.

For my part, I voted against this amendment. I believe that women should have access to support and care when making this difficult decision, and I feel there would have been better ways to ensure women were provided with the necessary support. This was temporary legislation, and my opinion is that instead of making this permanent through an amendment, that we should have taken more time to properly scrutinise these changes, even if this meant bringing forward specific legislation to address this issue. In the end, the amendment was passed, and I trust that women will take great care and personal consideration for any choice they make, but would always encourage anyone making such an important decision to seek advice.

The Health and Care Bill has now returned to the House of Lords for further scrutiny and I will follow its progress carefully.

April 2022

Health and Care Bill: Workforce

Selaine’s response:

Our NHS relies on effective workforce planning to ensure we can meet the health and care needs of local communities and I applaud the dedication of healthcare professionals across a range of professions.

Clause 35 of the Health and Care Bill would require the publication of a workforce report at least every five years - covering the whole of the NHS including primary, secondary and community care.

This report will increase transparency and accountability in the workforce planning process. For example, the report would set out the role and responsibilities of new Integrated Care Boards (ICBs) about how they would ensure the delivery of effective local workforce planning.

I recognise that people would like to go further, and the level of support that an amendment made to the Bill in the House of Lords has received from Peers, patient groups and professional bodies.

However, I disagree with this amendment because I believe that the Government's clause is sufficient and it is not necessary to add further or different reporting duties on that topic. There is common ground on the need to have effective workforce planning.

As my colleague Ed Argar, the Minister for Health has stated, we cannot predict all future workforce needs, which is why the report is required to be published at a minimum of every five years.

This flexibility will allow an updated report to be provided earlier than the statutory required period to reflect any changes to roles and responsibilities.

It should be kept in mind that in addition to Government measures in the Bill, the Department for Health and Social Care has already commissioned the development of a long term, 15 year strategic framework for the health and social care workforce. This is a welcome piece of work and I look forward to its publication, which I am told is expected later this year.

It is vital that workforce planning is closely integrated to the wider planning across health and social care. Two key NHS bodies will be merged to help put long term planning and strategy for healthcare staff recruitment and retention at the forefront of the national NHS agenda.

The Government is delivering against its key pledges to increase the numbers of GPs and nurses and there are 1,200 more GPs and 27,000 more nurses compared to 2019.

I believe that the measures in the Health and Care Bill will help to clarify who is responsible for workforce planning and ensure NHS can provide the workforce needed to meet the health and care needs of the population.

April 2022

Social Care Cap (Means Test)

Selaine’s response:

I am proud to support a Government that is committed to taking the difficult decisions and tackling the problems in the social care system head on. 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 help make care 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 10 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 10 years.

Only the amount that an individual contributes towards their personal care will count towards the cap. This ensures that individuals 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 we do not see differences based simply on where someone lives.

The new social care reforms are clear, fair and reduce complexity. I am proud to support a Government that is tackling the issue of social care reform head on, significantly improving the sustainability and affordability of the provision of social care.

April 2022

Diabetes

Selaine’s response:

Diabetes is a leading cause of premature mortality, doubling an individual's risk of cardiovascular disease. With over 22,000 additional deaths each year, it costs over £10 billion every year to manage. That is why I believe it is important that high quality diabetes care is available. My grandfather developed late onset, type 1 diabetes so I do have personal experience of how difficult this condition is.

NHS England has invested approximately £120 million of funding into local services to improve performance in the treatment and care of people living with diabetes since 2017/18. This is focused on improving attendance at structured education to increase understanding, improving achievement of NICE targets, reducing amputations through improved provision of multidisciplinary footcare teams, improving timelines of referrals from primary care for patients with diabetic foot disease, and reducing lengths of stay for diabetic inpatients through specialist nursing services.

It is important that people with diabetes can access the routine care and support that they need, and am glad that the Government is committed to supporting the NHS to recover from the Covid-19 pandemic. An additional £23.3 billion has been announced to support the NHS in managing the ongoing impact of pandemic. I understand that the Government is also analysing the impact of the pandemic on health conditions like diabetes, to inform how to recover the provision of routine care. I await the findings of this with interest.

I was very interested to hear of the Diabetes is Serious reception, and I am planning to attend. I am glad of the opportunity to hear directly from people living with diabetes about the impact.

April 2022

Catch Up With Cancer Campaign

Selaine’s response:

Let me assure you that I share the commitment of the campaign to see waiting lists for cancer treatment and care to be reduced over the next few years and I have ensured that ministerial colleagues are aware of the campaign and its calls to action. I am also a member of the All Party Parliamentary Group for Radiotherapy.

In recent months, the Government has brought forward funding to help recover cancer services, and a plan that outlines how that funding will be spent effectively.

Last year it was announced that nearly £6 billion is being put towards capital investment for new beds, equipment and technology. This funding will contribute towards expanding mobile diagnostics for cancer and upgrading MRI and screening technology.

The expansion of elective capacity will focus on rolling out new and innovative forms of radiotherapy to deliver treatment in a more targeted and intensive way, meaning cancer patients spend less time in Hospital.

It is right that this funding comes with high expectations for reducing cancer waiting times. By March 2024, the NHS has set an ambition for 75% of patients who have been urgently referred by their GP for suspected cancer to be diagnosed or have cancer ruled out within 28 days.

April 2022

Carer’s Allowance

Selaine’s response:

I recognise and appreciate the vital role played by unpaid carers now more than ever, and I understand that this is an extremely important issue for many carers.

The primary purpose of Carer's Allowance is to provide a measure of financial support for people who give up the opportunity of full-time employment in order to care for a severely disabled person. It must be stressed that it is not a carer’s wage or a payment for the services of caring, nor is it intended to replace lost or forgone earnings in their entirety.

The Carer's Allowance earnings limit is not linked to the number of hours worked. Instead, it is set at a level that aims to encourage people to maintain a link with the labour market through part time work. The earnings limit for Carer's Allowance is a net figure, meaning it takes into account income tax, National Insurance contributions and half of any contributions to an occupational or personal pension, and there are also a number of other deductions which can be made. That means that people can earn significantly more than £128 per week gross and still be eligible for Carer's Allowance.

In the past decade, the rate of Carer’s Allowance has increased from £53.90 to £67.60 a week, meaning nearly an additional £700 a year for hundreds of thousands of carers. This will increase further to £69.70 per week from April.

April 2022

Dementia Research and Diagnosis

Selaine’s response:

Research is crucial to understanding and tackling dementia, and I was proud to stand on a manifesto that committed to making finding a cure for dementia one of the Government's biggest collective priorities. I look forward to the publication of the dementia strategy later this year, which will focus on the specific health and care needs of people living with dementia and their carers, including dementia diagnosis and research.

The 2021 Spending Review saw £5 billion committed to health-related research and development and I understand that work is ongoing to finalise outcomes from the spending review and to identify ways to significantly boost research on dementia, which is encouraging. I was delighted by the Government's announcement in November of a £375 million investment, over the next five years, to improve understanding and treatment for a range of neurodegenerative diseases, including different types of dementia.

It is disappointing that, due to the impact of the pandemic, the estimated dementia diagnosis rate fell below the national target for the first time since 2016. While the rate has recovered slightly since the early part of the pandemic, there is more to do if we are to reach the national target for two thirds of people with dementia to be formally diagnosed. Last year, £17 million was made available to clinical commissioning groups to address dementia waiting lists and increase the number of diagnoses, which I hope will have an impact in our local area.

March 2022

Health and Care Bill: Workforce

Selaine’s response:

Clause 35 of the Health and Care Bill would require the production of a workforce accountability report at least every five years. This report will increase transparency and accountability in the workforce planning process. For example, the report would set out the role and responsibilities of new Integrated Care Boards (ICBs) about how they would ensure the delivery of effective local and national workforce planning.

I recognise that people would like to go further, but there is common ground on the need to have effective workforce planning.

As my colleague Ed Argar, the Minister for Health, has stated, we cannot predict all future workforce needs, which is why the report is required to be published at a minimum of every five years.

This flexibility will allow an updated report to be provided earlier than the statutory required period to reflect any changes to roles and responsibilities .

I also recognise the level of support an amendment made to the Bill in the House of Lords has received from Peers, patient groups and professional bodies. I look forward to giving further consideration to workforce planning when the Bill returns to the House of Commons later this month.

It should be kept in mind that in addition to Government measures in the Bill, the Department for Health and Social Care has already commissioned the development of a long-term 15-year strategic framework for the health and social care workforce. This is a welcome piece of work and I look forward to its publication, which I am told is expected later this year.

It is vital that workforce planning is closely integrated to the wider planning across health and social care. Two key NHS bodies will be merged to help put long-term planning and strategy for healthcare staff recruitment and retention at the forefront of the national NHS agenda.

The Government is delivering against its key pledges to increase the numbers of GPs and nurse, there are 1,200 more GPs and 27,000 more nurses compared to 2019.

March 2022

Water Fluoridation

Selaine’s response:

While I note some constituent’s concerns about fluoride in our water supply, fluoridation programmes in our country are common practice, and have been in place for nearly 60 years. I am aware that currently, around 5.8 million people in England already consume fluoridated water. I would like to reassure constituents that there have been no cases of water fluoridation causing any ill effects.

I understand that a report from Public Health England, now the Office for Health Improvement and Disparities, on improving oral health, published in 2020, found that water fluoridation significantly reduces tooth decay, especially in children. It found that, in deprived areas where water fluoridation occurs, there were 55% fewer hospital admissions for tooth decay among children aged one to four.

This scheme is effective and safe and I am reassured that there is no evidence of health harms from the levels of fluoride used in English schemes, nor the slightly higher levels allowed naturally. Further, the Government is required to monitor the effects of water fluoridation and produce reports on this every four-years, which I hope you find reassuring. The last report was published in 2018 which means that there will be a new report, which is due to be published in 2022.

While this is a government-supported programme, local authorities are responsible for any consultations on fluoridation schemes. You will be encouraged to know that ministers have published a toolkit for local authorities to aid them in carrying out these consultations. However, it is worth noting that the new Health and Care Bill proposes to return responsibility for the fluoridation of water in England from local authorities to central government, making it easier to expand water fluoridation schemes so that more of the population can benefit from it.

I know that some are concerned by previous suggestions of adverse effects from fluoridated drinking water, such as a rare form of bone cancer (osteosarcoma), Down’s syndrome or effects on the kidney. I am, however, reassured that evidence does not support this and that various authoritative expert evaluations from different international organisations all agree that there is no convincing evidence that fluoride in drinking water at levels used in fluoridation schemes or at concentrations below the regulatory drinking water limit is harmful to general health.

March 2022

Care Home Visits

Selaine’s response:

I know that throughout the pandemic, the Government has done everything it can to protect people receiving care and staff and it is vital that this continues. While the vast majority of people cared for in care homes and at home are vaccinated, the risk of transmission and hospitalisation from Covid-19 remains higher than in the general population. I am told that current protections in social care will remain and the Government continues to review all Covid-19 measures for social care in line with the latest scientific advice.

Further details of any changes will be provided in due course, and I await this with interest. I have ensured that ministers are aware of the concerns that you have raised with me.

March 2022

‘At home’ Abortions

Selaine’s response:

I completely understand what an incredibly emotive issue this is, and I appreciate the strength of feelings around this matter. It is for this reason that, as with other matters of conscience, the Government adopts a neutral stance on abortion, allowing Conservative MPs to vote freely according to their moral, ethical, or religious beliefs. This is a convention which I support wholeheartedly.

In February, the Government announced a six month extension to temporary arrangements put in place at the beginning of the pandemic that mean women can take both pills for early medical abortion at home.

The temporary approval will end at midnight on 29 August and, from this point, the pre-Covid regulatory requirements for the provision of early medical abortion will be reinstated.

These measures were put in place as part of the public health emergency, in order to address a specific and acute medical need, reducing the risk of transmission of Covid-19, and to ensure that abortion services could continue to be accessed during this unprecedented time. Like many of the other measures brought in around this time they were temporary, and time-limited to two years.

I know that the Government recognises the sensitivities around abortion, and so I am glad that they consulted thoroughly on whether to make these temporary arrangements permanent, giving everyone an opportunity to input views, evidence and data. I am told that, after careful consideration, the Government has come to the view that the provision of early medical abortion should return to pre-Covid arrangements. I am also assured that the wellbeing and safety of women requiring access to abortion services has been, and will continue to be, the first and foremost priority.

Thanks to the success of the vaccination programme, we are in a very different position compared to the beginning of the pandemic, however health services have been under increased pressure in recent months. For this reason, the six month extension has been approved to enable a safe and reliable return to pre-pandemic arrangements and continued access to services.

February 2022

Bite Back Better

Selaine’s response:

It is fantastic to see the passion of the young people who are part of the Bite Back Better campaign to promote healthier lifestyles and to reduce childhood obesity.

The Government is committed to implementing its promise to ban pre-9pm TV advertising of food high in sugar, salt and fat across the UK. Recognising that a growing number of young people consume media online, I am also delighted that the Government will also restrict paid-for-advertising online.

These restrictions are being included as part of the Health and Care Bill that is going through Parliament at the moment. I am confident that such measures will help us to reach the Prime Minister's goal of halving childhood obesity by 2030 and help adults to reach a healthy weight.

I am also pleased that the Government's Levelling Up White Paper has recognised the role of obesity in driving poor health outcomes in communities across the UK. As part of the White Paper, the Government has promised to take forward recommendations from Henry Dimbleby’s independent review towards a National Food Strategy including piloting Community Eatwell and a school cooking revolution.

February 2022

Dementia Research

Selaine’s response:

I entirely agree that research is crucial to understanding and tackling dementia, and was proud to stand on a manifesto that committed to making finding a cure for dementia one of the Government's biggest collective priorities through the dementia moonshot.

As part of the 2020 Challenge on Dementia, £344 million was spent on dementia research in the past five years and I know that the Government is strongly committed to continuing to support research into dementia, having made a number of welcome funding commitments. At the 2021 Spending Review, £5 billion was committed to health-related research and development over the Spending Review period and I hope to see dementia research benefit from this funding. Additionally, I was delighted by the Government's announcement in November of a £375 million investment, over the next five years, to improve understanding and treatment for a range of neurodegenerative diseases. This includes Fronto-temporal dementia, Parkinson’s disease dementia, Lewy Body dementia and Alzheimer’s disease, among others.

I understand the Government is currently working on ways to significantly boost further research on dementia and I am told that a new dementia strategy is expected to be published this year. The strategy will include ambitions for dementia research and increasing dementia research funding and I look forward to its publication, particularly as I am a Dementia Friend.

I welcome the opportunity for Parliament to discuss this important issue and I am sure it will be a very compelling discussion. While I am unable to speak in the debate due to prior commitments, I will ensure that ministers are aware of the points you have shared with me.

February 2022

Assisted Dying (Update)

Selaine’s response:

As a general principle, I believe that individuals should have as much control as possible over their own lives. This leads me to be broadly supportive of a change in the law to allow assisted dying for those who are terminally ill and mentally competent. We must be incredibly careful to ensure that any change in the law does not encourage anybody to make the decision to end their life. New or amended legislation should only allow those who are already determined to end their lives to do so without their loved ones having to endure difficult legal processes afterwards.

This is an incredibly difficult issue and the case studies which many constituents have highlighted are deeply saddening. However, I completely understand why other people feel equally strongly against assisted dying and their views are to be respected. It is good that these sorts of issues are almost always considered to be 'issues of conscience' when Parliament votes on them and so MPs are free from political constraints in deciding their views. Assisted dying is regularly considered by Parliament and I am sure that this Parliament will be no exception. In the case of me voting on the matter, I would take into account the stories I have heard from constituents, who too feel strongly about this emotive issue.

Thank you to those constituents who have invited me to the briefing meeting on 19th October. Unfortunately, I am unable to attend the meeting on this occasion, but I will always continue to review emerging research in this area.

Unfortunately, I am unable to attend the meeting on this occasion, but I will always continue to review emerging research in this area as I understand this is an important issue for many constituents.

February 2022

Radiotherapy

Selaine’s response:

Cancer remains a high priority for the Government and despite survival rates being at a record high, too many people continue to die from it, leaving many devastated by the loss of loved ones. In the past decade, rates of survival from cancer have increased year-on-year. Around 7,000 people are alive today who would not have been had mortality rates stayed the same as then.

The NHS Long Term Plan (LTP), published during 2019, outlined a number of new measures for catching cancer early and providing treatment, with the aim that from 2028, 55,000 more people each year will survive their cancer for at least five years after diagnosis.

One of the measures outlined in the plan is safer and more precise treatment, including advanced radiotherapy techniques and immunotherapies to continue to support improvements in survival rates.

This will be supported by a £130 million upgrade of radiotherapy machines across England, including £32 million to replace 17 Linear Accelerators aged over 10 years by the end of March 2022, as well as commissioning the NHS new state-of-the-art Proton Beam facilities in London and Manchester.

In addition, the LTP commits to reforms to the specialised commissioning payments for radiotherapy hypofractionation to support further equipment upgrades. Faster, smarter and more effective radiotherapy, supported by greater networking of specialised expertise, will mean more patients are offered curative treatment, with fewer side effects and shorter treatment times.

Starting with ovarian cancer, the NHS will ensure greater access to specialist expertise and knowledge in the treatment of cancers where there are fewer or more risky treatment options.

I hope that this provides reassurance that providing adequate support for a widely used and effective treatment for cancer is absolutely a priority for the Department of Health and Social Care and across the NHS.

January 2022

NHS Winter Preparedness

Selaine’s response:

I am reassured by the measures being put in place by the NHS, which focuses on increasing protection of the population through vaccination. This includes actions to accelerate the Covid-19 booster vaccine roll out and making sure that everyone who is eligible for a flu vaccination is able to get one.

NHS England and NHS Improvement are working with NHS providers to ensure appropriate plans are in place, including meeting potential increases in the demand for emergency care driven by seasonal flu and Covid-19.

It is welcome that the NHS will receive an extra £5.4 billion over the next six months to support its response to Covid-19. This includes £2.8 billion to cover related costs such as enhanced infection control measures and £478 million to continue the enhanced hospital discharge programme, to maintain capacity.

The Government is also taking action to increase NHS capacity so that the health service is well equipped to reduce waiting lists for operations such as hip and knee replacements. Alongside the £8 billion funding announced in the Spending Review 2021, a plan for recovering elective care will shortly be published by NHS England and Improvement.

December 2021

Conversion Therapy

Selaine’s response:

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.

The Government Equalities’ Office commissioned a large-scale LGBT survey in 2017. Sadly, 2% 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.

I very much welcome the fact that the Government is delivering on its promise and will legislate to ban conversion therapy to protect LGBT people from this harmful practice.

The Government launched a six-week consultation on how ministers plan to ban practices of so called 'conversion therapy'. The consultation was due to close on 10th December but has now been extended by eight weeks, this is to ensure that the widest possible views are being taken into account. I understand that the consultation has already taken views from members of the public, victims of conversion therapy, LGBT organisations, faith groups, psychiatric and counselling bodies, charities and other interested stakeholders to ensure we hear from all voices in shaping the ban on conversion therapy. However, the consultation will now close on 4 February, in order to allow ample opportunity for those to contribute who have not yet been able to do so. As such, I would therefore encourage you to take part at the following link:

https://www.gov.uk/government/consultations/banning-conversion-therapy

The Government's proposals include the creation of a new criminal offence and we will also ensure that conversion therapy is considered by judges as a potential aggravating factor upon sentencing for existing violent criminal offences.

Ministers further propose a range of other supportive measures including the introduction of statutory Conversion Therapy Protection Orders to protect individuals facing imminent risk, such as forced travel abroad to receive conversion therapy.

The results will be analysed and will inform the Government's next steps in preparing legislation for spring 2022.

The Equality Hub is engaging with a wide range of stakeholders who hold different views in relation to conversion therapy. Ministers have been clear that the recently launched consultation is looking into how, not whether, to ban conversion therapy. I welcome this approach to engage with everyone who has an interest in this area. I will continue to follow this closely and look forward to reviewing the Government's final proposals when they are released.

December 2021

APPG Pro-Life Event 14.12.2021 - Crisis Pregnancy Care

Selaine’s response:

Thank you to those constituents who invited me to the upcoming All-Party Parliamentary Pro-Life Group meeting on crisis pregnancy care.

According to a study in the Lancet, 45% of pregnancies and one third of births in England are unplanned or associated with feelings of ambivalence. Public Health England has previously highlighted the impact of unplanned pregnancies on the mental and physical health of both women and children.

Improving access to information, advice and services are crucial to helping women to make an informed decision around pregnancy, and supporting good reproductive health.

Unfortunately, I am unable to attend the meeting due to my other parliamentary duties, but thank you for inviting me to this event and bringing these issues to my attention.

December 2021

Abortion ('DIY Abortions')

Selaine’s response:

Guidelines have been issued which enable women to take both Mifepristone and Misoprostol at home for the duration of the pandemic, so that they do not have to visit a medical practice and risk exposure to the virus, and to enable doctors to prescribe medicines from home via telephone or video consultations without consulting a second practitioner, so that abortion care can be provided even in the case of staff shortages.

The medicines must still be instigated prior to nine weeks and six days into the pregnancy. I am aware of data that indicates an increase in the number of abortions carried out in 2020. The pandemic has had an impact on many aspects of daily life, the full picture of which may not be clear for some time to come. I will, of course, continue to monitor this sensitive issue.

A consultation has recently been held on the home use of both pills for early medical abortion up to 10 weeks gestation. The Government is currently reviewing the evidence received and will publish a response in due course. More information can be found here:

https://www.gov.uk/government/consultations/home-use-of-both-pills-for-early-medical-abortion

I have been distressed to read news reports of cases where abortions had been sought and enacted after the ten week legal limit for taking the medicines at home, and have caused further illness and even death. I understand that these instances are being investigated to ensure that women are accessing safe care, and that clinicians are properly supported through the consultation process. I will continue to support all efforts to ensure safety is a paramount consideration for any amendments to regulations, however temporary. I will continue to monitor this issue closely.

A decision regarding abortion care can be an extremely difficult time, and I believe that we must do all we can to support women to make an informed decision.

As my colleague Maggie Throup MP (Minister for Public Health) recently said in response to a parliamentary question, "It is important that women receive accurate and evidence-based information on abortion. The Department’s Required Standard Operating Procedures set out that women must be given impartial, accurate and evidence-based information both verbal and written, delivered neutrally by all abortion providers."

I will continue to do all I can to ensure plenty of information is available to women making enquiries relating to abortion care including all options available to them.

December 2021

Health and Care Bill

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.

Health and Care Bill: Workforce

The workforce is the beating heart of the NHS and I pay tribute to all those who work so hard in our health service.

Clause 34 of the Health and Care Bill would require the production of a workforce accountability report at least every five years. This report will increase transparency and accountability in the workforce planning process, putting in place the proper structures.

Additionally, the Department for Health and Social Care has already commissioned Health Education England to work with partners to develop a long-term 15-year strategic framework for the health and social care workforce. This will look at the key drivers of workforce demand and supply over the longer term and will set out how they impact on the future workforce. This is a welcome piece of work and I look forward to its publication, which I am told is expected to be published in the spring.

It is vital that workforce planning is closely integrated to the wider planning across health and social care. Health Education England will be merged with NHS England, putting long-term planning and strategy for healthcare staff recruitment and retention at the forefront of the national NHS agenda.

Health and Care Bill: Palliative Care

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 NHS must meet these commitments, and new measures are being developed to ensure local health and care leaders are meeting the high standards expected of them. There is existing guidance from the National Institute of Health and Care Excellence, which includes specific reference to maintaining comfort in dignity in a person’s last days of life. It is right that clinicians continue to utilise this guidance.

The establishment of the Personalised Care Institute has made training available to help staff identify and support patients and to introduce proactive and 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.

I am encouraged that the Department for Health and Social Care and the NHS proactively engage with the whole sector to understand the issues they face. Most hospices are independent, charitable organisations but do received some funding, mainly from clinical commissioning groups (CCGs), for providing local services. CCGs will have an understanding of future demand and associated funding requirements. There are seven regional Palliative and End of Life Care Strategic Clinical Networks working closely with CCGs and integrated care systems to understand the needs, sustainability and future commissioning of palliative and end of life care services.

Health and Care Bill: Sex-Selective Abortion

Abortion on the grounds of sex alone is illegal and I am glad that the Government guidance for doctors on how to comply with the Act makes this clear. With regard to the Non-Invasive Prenatal Test, this test is never meant to be used to determine the sex of a child, and I share your concerns that this test could be misused to inform sex selective abortion. That is why I am glad that the Government will continue to review the evidence regarding the test.

Health and Care Bill: Private Providers (Integrated Care Boards)

I welcome the intention, through the Health and Care Bill, to develop more integrated care between the NHS, local government, social care providers and other partners to deliver better integration of health and care services on the ground. The reforms proposed in the Health and Care Bill will continue to improve the quality and sustainability of NHS services and outcomes for patients.

Service provision by the independent and voluntary sectors has been, and continues to be, an important and valuable feature of our healthcare system, which I fully support. ICBs are NHS bodies guided by the NHS Constitution and with the values of the NHS at heart. Safeguards are already in place to ensure that the interests of the public and the NHS are always put first. The ICB chair would have the power to veto members of the board and there are robust requirements on ICBs to manage conflicts of interests.

That said, I do appreciate that there are concerns about private sector involvement in ICBs. It is important that people are assured that the work of ICBs will be driven by health outcomes, not by profits.

I welcome therefore that the Government has amended the Health and Care Bill, putting beyond doubt that Integrated Care Boards will not be controlled in any way by the private sector. No one that could potentially undermine the NHS due to their involvement in the private healthcare sector should sit on an ICB. The Government’s amendment [Optional: which I was pleased to support in the Commons] makes clear that no one may be appointed to an ICB who would undermine the independence of the NHS, either as a result of their interests in the private healthcare sector, or otherwise.

It is irresponsible scaremongering to suggest that Integrated Care Boards and Partnerships are being used to support privatisation, or cuts to NHS funding. The NHS will always be free at the point of use, and I believe these reforms will continue to improve the quality of NHS services and outcomes for patients. Ensuring every part of England is covered by an Integrated Care Board and Partnership is a key way of promoting local collaboration.

Primary care commissioners have long had the choice to commission services from a range of primary care providers. I believe it is crucial that local health commissioners have flexibility to commission partnerships, individuals and private and third sector organisations to deliver GP services to meet the specific healthcare needs of their local populations. Alternative Provider Medical Service Contracts (APMS) offer greater flexibility than national standard contracts, allowing commissioners to better meet local need and fill any gaps not covered by core general practice. Private and third sector providers play a vital role in the delivery of local services and must adhere to the same quality and safety standards as any other form of GP contractor.

The Health and Care Bill would extend the oversight that the Secretary of State for Health and Social Care has over the health service in a number of areas. This includes providing direction to NHS England and Improvement and the ability to intervene in health service reconfigurations.

On procurement, the Bill proposes the repeal of a number of clauses in the Health and Social Care Act 2012, including Section 75 which placed requirements on local health bodies to competitively tender for some health care services “where it adds no or limited value”.

The Kings Fund, an independent charity, has said about the reforms: “This Bill will remove cumbersome competition rules and make it simpler for health and care organisations to work together to deliver more joined-up care to the increasing numbers of people who rely on multiple different services.”

November 2021

Dr Liam Fox’s Down Syndrome Bill

Selaine’s response:

I know that with appropriate help and support, most people with Down's syndrome can lead healthy, active and more independent lives, achieving more than ever before. I do recognise, however, that people with Down's syndrome face significant challenges across all stages of life and it is right that the Government considers how to help make sure their specific needs are recognised and considered. That is why I fully support Dr Liam Fox’s Down Syndrome Private Members’ Bill, and I am delighted the Government does too.

The Covid-19 pandemic has further highlighted the need to improve access to services for people with Down's syndrome. The Down Syndrome Bill will require the Secretary of State to publish guidance to public bodies to ensure they are clear on how they should meet the needs of people with Down's syndrome. It will set out best practice across health, education social care and housing, giving practical advice on how the appropriate steps can be taken to meet the needs of those with Down's syndrome when planning, designing and delivering services.

It is especially welcome that the Government will consult widely on the proposed guidance, ensuring the voices of those with Down syndrome, their families and carers are heard, and that the guidance is fit for purpose. This, I believe, is essential.

I would like to take this opportunity to pay tribute to the work of my colleague Dr Liam Fox in bringing forward this important Bill. Whilst I am unfortunately unable to attend the second reading of the Bill,

I look forward to seeing its passage through Parliament and can assure you that the Bill has my full support.

November 2021

Cancer in the Spending Review

Selaine’s response:

I am glad that cancer survival rates have increased year-on-year over the past decade. Investment in research has been vitally important in achieving this and I recognise the important that we continue to invest properly in cancer research so that we can continue to drive up survival rates.

That is why I am pleased that over £882 million in government funding has been spent on cancer research across the UK since 2010. However, I also know that the Covid-19 pandemic has had an impact on cancer research, in particular through reduced access to funding for new projects. Therefore, I welcome the announcement in the Spending Review 2021 that the Government will commit £5 billion over the Spending Review period for health-related research and development, this is an increase of £1.2 billion on previous commitments.

I welcome the announcement that cancer diagnosis is at the heart of the NHS Long Term Plan. Over the ten years to 2023/24, cancer screening and diagnosis will be overhauled with the aim of detecting 75% of cancers in the early stages compared to around 50 per cent today. This will result in 55,000 more people a year living for at least five years following a cancer diagnosis. The Spending Review 2021 provided £2.3 billion to establish 100 new Community Diagnostics Centres to help deliver this.

It is encouraging that the 2021 Spending Review reaffirmed the Government’s commitments to recruiting 50,000 more nurses, providing hundreds of millions of pounds of additional funding over the next four years. I look forward to learning more about the Government’s plans and how this will help to increase the number of cancer nurses in particular. I also warmly welcome the commitment of £2.3 billion in the 2021 Spending Review to transform diagnostic services. This will support the opening of at least 100 community diagnostic centres across England benefitting millions of patients who will be able to access earlier diagnostic tests closer to home.

November 2021

Joint Replacement Surgery

Selaine’s response:

Thanks to the sacrifices of people across the UK, we have been able to protect the NHS from being overwhelmed by Covid-19. The extraordinary efforts of all NHS staff has ensured that the NHS withstood the challenge of the pandemic, treating and caring for millions of people.

Of course, the need to focus on the response to the pandemic meant resources were diverted to tackling the pandemic resulting now in a significant backlog in elective care. In England, 5.7 million people are currently waiting for treatment.

That is why I am glad that the Government is investing an additional £12 billion per year over the next three years in health and social care. I welcome the Government’s commitment to tackling the elective backlog through the biggest catch up programme in the NHS’s history. £2 billion will be spent this year, double the previous commitment, with an additional £8 billion to be spent in the following three years.

This welcome funding could deliver the equivalent of around 9 million more checks, scans and procedures and will mean NHS England can aim to deliver around 30 per cent more elective activity by 2024-25 than before the pandemic. This investment in elective surgery and diagnostic facilities will be vital in allowing those who suffer with arthritis to access the care they need.

November 2021

Funding for Mental Health

Selaine’s response:

While it is hugely welcome that we are on the road to parity of esteem, there is still more to do. That said, I am extremely encouraged by the news that, as part of the five-year funding offer agreed in 2019, mental health services will receive budget growth of £2.3 billion the fastest uplift in funding. This will enable further service expansion and faster access to community and crisis mental health services for both adults and particularly children and young people. I also welcome the Government's commitment of around £2 billion to address waiting times for mental health services, giving more people the mental health support they need, investing in the NHS workforce and helping to ease existing pressures in the NHS caused by Covid-19.

In the 2021 Spending Review, I was encouraged to see a new investment of £150 million in NHS mental health facilities linked to A&E and to enhance patient safety in mental health units. Additionally, around £300 million will be spent to complete the programme of replacing mental health dormitories with single ensuite rooms. The Spending Review also included welcome commitments to supporting ground-breaking innovative research to establish the UK as a life sciences superpower. This includes £95 million for the Office for Life Sciences, which I understand will support the launch of the Prime Minister’s healthcare mission on mental health. I look forward to learning more about this in due course.

I hope these new services help end the stigma surrounding mental health, offering crucial support to people suffering from crisis and those who have suffered in silence for too long.

November 2021

Multiple Sclerosis and Fampridine

Selaine’s response:

With more than 100,000 people across the UK diagnosed with multiple sclerosis, please let me assure you that helping those suffering from this condition to lead as normal lives as possible remains a key commitment of the NHS.

As I understand, diagnosis in the early stages of multiple sclerosis can be difficult, with some of the symptoms often similar to other conditions. I am therefore pleased that the National Institute for Health and Care Excellence (NICE) has produced guidelines to assist clinicians in diagnosing the condition. This guidance also provides clinicians with best practice for treating the many possible symptoms of multiple sclerosis, including mobility problems and fatigue.

I fully appreciate that those suffering from multiple sclerosis may also have specific long-term social care needs. That is why I am glad the Government has prioritised finding a long term social care solution with cross-party support. Better integration between health and social care provision, creating genuinely people-centred coordinated care, is also required, and I look forward to this being explored in forthcoming discussions.

I am encouraged that since 2015, £150.6 million has been spent on Multiple Sclerosis research through the National Institute for Health Research and UK Research and Innovation. This funding demonstrates the commitment both of the Government and of the scientific research community to support people living with MS.

I have been following with interest the experiences of people who have been prescribed Fampridine. In particular, I have read of the experiences of some individuals who took Fampridine during clinical trials, only to see it withdrawn when the trial ended. Improving mobility and, with it, quality of life is something I would expect those drawing up guidelines about the treatment of MS to prioritise. The National Institute for Health and Care Excellence’s (NICE) is updating its guideline on multiple sclerosis, including to take account of new evidence on the effectiveness of Fampridine for treating mobility in people with multiple sclerosis, and this guidance is expected to be published in July 2022. While this is ultimately a matter for NICE, I think it is important that NICE is aware of the strength of feeling about Fampridine and have ensured this is the case.

October 2021

Dementia and Alzheimer's in the Spending Review

Selaine’s response:

I believe that increasing public awareness and understanding of dementia among the wider public is vital to ensure that people are supported to live well with the condition.

Research is crucial to understanding and tackling dementia. Under the Challenge on Dementia 2020 strategy, the Government's commitment to spend over £300 million on dementia research between 2015 and 2020 was met a year early, with £341 million being spent by March 2019. The Government is also supporting the £79 million Accelerating Detection of Disease challenge, a project bringing together the NHS, industry and leading charities to support research into the early diagnosis of disease, including dementia.

I know that the Government remains committed to research, to combat dementia, and will shortly lay out plans for supporting people with dementia in England up to 2025. I look forward to seeing these plans and funding commitments at the next Spending Review. I will work with my colleagues in the Department of Health and Social Care to ensure that the manifesto commitment to double research funding to over £160 million each year by 2030 is delivered as swiftly as possible.

I have spoken with colleagues at HM Treasury about suggestions from some North Devon constituents for the Spending Review taking place this year. While I am not in a position to pre-empt the conclusions of the review, I am assured by my colleagues that they are aware of the points raised. The conclusions will be announced to Parliament alongside the Autumn Budget on 27 October.

Endometriosis and Polycystic Ovary Syndrome

Selaine’s response:

Endometriosis and polycystic ovary syndrome (PCOS) are common long-term conditions that can have a significant impact on a woman’s life, and I am aware of and sympathise with the hardships faced by women who experience severe symptoms. I believe it is important to raise awareness of the impact on women worldwide.

To provide support, all obstetricians and gynaecologists have been trained in the diagnosis and treatment of these conditions; it is a core part of their training. The NHS has published clinical guidelines on the management of endometriosis, and PCOS, to assist doctors. While there is currently no cure, there are several options for treatment and ways that individuals can alter their lifestyle to improve symptoms. NHS England has also developed units for severe endometriosis, with the expectation that all units provide women with severe endometriosis with care which meets the needs of each individual woman. I believe it is essential that care of this kind is specialised to a woman’s unique needs, and I know that Ministers want to empower people to shape and manage their own health and care and make meaningful choices.

The Government launched a consultation to help inform the priorities, content and actions of England’s first Women’s Health Strategy, with questions on gynaecological conditions such as endometriosis. I am told that analysis of the evidence gathered is underway with a view to publishing the strategy later this year. This is a most welcome development and I look forward to learning more about these plans.

I welcome the work of Endometriosis UK and Verity, the UK PCOS Charity, to raise awareness of these conditions, as well as providing sufferers with further information and access to clinical trials and the latest research. Medical Research is funded through the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI). In the last five financial years, I am encouraged to learn that the NIHR and UKRI have awarded £8.52 million for research into endometriosis and £6.60 million for research into PCOS. This includes a wide range of projects, from basic science through to applied health research into diagnosis, treatment and service delivery. It is important that women with these conditions play a vital role in this research, and I am glad to learn that this is already the case.

While I am unable to attend the upcoming Westminster Hall Debate myself, I will ensure that ministers are aware of the points raised in the campaign emails sent to me.

October 2021

Parkinson’s Related Dementia

Selaine’s response:

The UK Dementia Research Institute (UK DRI), launched in 2017, is the single biggest investment the UK has ever made in dementia thanks to £290 million from founding funders the Medical Research Council (MRC), Alzheimer’s Society and Alzheimer’s Research UK. The UK DRI is leading the UK’s dementia research efforts and tackling the huge challenge of the condition. The Institute will transform treatment and care for people with dementia and is leading the way in early diagnosis and uncovering how to prevent dementia.

The Institute carries out research relevant to all dementias, Parkinson’s related dementia. I look forward to reading more about the experiences of those living with Parkinson's dementia in the Parkinson's UK Report, and while I am unable to attend the event, I will consider the points raised carefully.

October 2021

Epilepsy and Medical Cannabis

Selaine’s response:

There is strong scientific evidence that cannabis can harm people’s mental and physical health, and damage communities. However, recent cases have shown the need to look more closely at the use of cannabis-based medicine in treating patients with very specific conditions in exceptional circumstances, which is why the Government decided it was appropriate to review the scheduling of cannabis.

The decision to reschedule these products means that senior clinicians will be able to prescribe the medicines to patients with an exceptional clinical need. Following short term advice issued in September 2018 the ACMD reviewed the rescheduling in November 2020, and I welcome that they recommended that no changes be made, enabling senior clinicians to continue to prescribe these medicines where appropriate.

Moreover, NHS England has published a review which is aimed at assessing the barriers to prescribing cannabis-based medicinal products where it is safe and clinically appropriate to do so. My ministerial colleagues have also been clear that given the nature of the medicine, it should only be prescribed by specialist doctors and on a case-by-case basis. I believe these controls are necessary to develop clinical expertise and an evidence base for this treatment’s effectiveness.

The National Institute for Health and Care Excellence (NICE) has also developed updated clinical guidance on prescribing cannabis-based products for medicinal use, including for the management of chronic pain. It is crucial that this country keeps in step with the latest scientific evidence, so that patients and their families have access to the most appropriate course of medical treatment. Following difficulties in obtaining prescriptions, I am pleased that NICE has recently published a clarification of this guidance. While this does not represent a change in the law, NICE hopes that it will make prescribing medicinal cannabis clearer and simpler for specialists and therefore easier for patients.

The decision whether to prescribe an individual with medicinal cannabis is therefore 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.

Unfortunately, I will be unable to attend the End Our Pain Campaign’s parliamentary ‘drop in’ event on Tuesday 2 November due to a busy diary, but please be assured I will continue to closely monitor the roll-out of medicinal cannabis.

April 2021

Dementia Research

Selaine’s response:

Having attended an Alzheimer's Research UK event in Westminster and recently visited the Alzheimer's Society stand at the Conservative Party Conference, I am aware of the issues the charities are currently calling for. I hope that increasing public awareness and understanding of dementia among the wider public will ensure that people are supported to live well with the condition.

I know that the Government remains committed to research to combat dementia and will shortly lay out plans for supporting people with dementia in England up to 2025 and I look forward to seeing these plans and funding commitments at the next Spending Review. I will work with my colleagues in the Department of Health and Social Care to ensure that the manifesto commitment to double research funding to over £160 million each year by 2030 is delivered as swiftly as is possible.

I am proud to support a Government that is committed to taking the difficult decisions and tackling these problems head on, creating a sustainable adult care system that is fit for the future. An extra £36 billion will be invested in the health and care system over the next three years, including £5.4 billion in adult social care, to ensure it has the resources it needs to recover from the pandemic. Further, the Government announced a landmark £33.9 billion for the NHS by 2023/24 to secure the long term future of our NHS.

October 2021

Diabetes

Selaine’s response:

While Type 1 diabetes cannot be prevented and is not linked to lifestyle, Type 2 diabetes is largely preventable through lifestyle changes. That is why I am delighted that prevention is at the heart of the NHS Long Term Plan. One of the key commitments in the LTP is to double, to 200,000 people per year by 2024, the scale of the NHS Diabetes Prevention Programme which supports those identified as high risk of type 2 diabetes to reduce their risk.

To date NHS England has invested approximately £120 million of transformation funding into local services to target variation and improve performance in the treatment and care of people living with diabetes since 2017/18. This is focused on improving attendance at structured education to increase understanding, improving achievement of NICE targets and reducing variation across the country, reducing amputations through improved provision of multidisciplinary footcare teams, improving timelines of referrals from primary care for patients with diabetic food disease, and reducing lengths of stay for diabetic inpatients through specialist nursing services.

I absolutely agree that technology could, and should, provide vital support to people managing diabetes and I know that new treatments and technologies are being created all the time. I welcome the DHSC Research and Development Budget for 2021 of £1.3 billion, which underlines the commitment to ensure that the best possible treatments and technologies are available through the NHS at the earliest opportunity.

I hope this reassures you about the commitment to tackling diabetes as well as supporting those living with it to lead healthier lives.

October 2021

Coronavirus: Vaccine and Children

Selaine’s response:

As the Chief Medical Officer has said, the Covid-19 Delta variant is highly infectious and very common, so the great majority of the unvaccinated will catch Covid -19. The likelihood of children becoming severely ill if they catch Covid -19 is thankfully very low, but there is still some risk. I am glad, therefore, that time has been taken to assess this decision carefully and thoroughly.

Earlier this year, the Medicines and Healthcare products Regulatory Agency (MHRA) approved the Covid -19 vaccines supplied by Pfizer and Moderna for 12 to 17 year-olds. It confirmed that both vaccines are safe and effective for this age group. The MHRA is one of the best medical regulators in the world and I can reassure you that authorisation would not be approved unless the expected standards of safety, quality and effectiveness have been met.

While the Joint Committee on Vaccination and Immunisation (JCVI) assessed that the health benefits from vaccination are marginally greater than the potential known harms, the margin of benefit was considered too small to support universal vaccination on this basis alone. That is why additional advice was sought and the UK’s Chief Medical Officers considered the matter from a broader perspective.

In their view, the likely advantages of reducing educational disruption, and the consequent reduction in public health harm, including mental health, from that disruption, on balance provide sufficient benefit in addition to those identified by the JCVI. The CMOs therefore recommend extending the offer of universal vaccination, with a first dose of Pfizer, to all 12 to 15 year olds and the Government has accepted this advice.

I understand that vaccination will be delivered in schools, supported by GPs and community pharmacies. Parental, guardian or carer consent will be sought prior to vaccination, in line with existing programmes. It is important that children can understand the risks and benefits of vaccination for themselves, so it is welcome that information will be provided in a way that is accessible to children and young people as well as their parents.

At every point in the vaccination programme, decisions have been guided by the best clinical advice and I know that this decision is no different. I hope all those aged 12 to 15 will accept this offer of vaccination.

September 2021

Health and Disability Green Paper

Selaine’s response:

I am delighted to see the publication of the Health and Disability Green Paper and the opening of the consultation into shaping future support for disabled people. I would encourage anyone with an interest in this important subject to contribute their views before 11th October via:

https://getinvolved.dwp.gov.uk/05-policy-group/health-and-disability-green-paper/

The Green Paper considers how to improve the DWP’s current services so they are better and easier to use, explore how extra support can help people navigate the system as well as what can be done to better support disabled people into employment. I welcome the wide range of measures discussed in the Green Paper as part of this three-pronged focus, for example, exploring how to improve the information on GOV.UK in order to help people access the relevant benefits online.

I know that DWP has run workshops across the country where local disability organisations and disabled people have shared their experiences and priorities for future change. Additionally, I welcome the publication of the National Strategy for Disabled People, which focuses on issues that disabled people say affect them the most across all aspects of daily life.

The Health and Disability Green Paper is an important step towards improving the way Government supports disabled people and people with health conditions. It focuses on issues that disabled people and people with health conditions have said they would like to see improved and reflects the extensive engagement undertaken before publication.

My colleagues at the DWP recognise that it is essential that any changes made to the health and disability benefits system are shaped by disabled people and their representatives. This is why the Department hosted a series of engagement events across the country, to hear about disabled people’s experiences of DWP services and priorities for future changes. This engagement is continuing through the consultation to ensure that disabled people and people with health conditions help inform potential improvements that we can make.

The consultation closes on 11 October. If you would like to respond you can do so here:

https://getinvolved.dwp.gov.uk/05-policy-group/health-and-disability-green-paper/

Consultation responses will inform a White Paper, which is due to be published next year.

September 2021

Private Providers (Integrated Care Boards)

Selaine’s response:

I welcome the intention, through the Health and Care Bill, to develop more integrated care between the NHS, local government, social care providers and other partners to deliver better integration of health and care services on the ground. The reforms proposed in the Bill will continue to improve the quality and sustainability of NHS services and outcomes for patients.

Service provision by the independent and voluntary sectors has been, and continues to be, an important and valuable feature of our healthcare system, which I fully support. Safeguards are already in place to ensure that the interests of the public and the NHS are always put first. The Integrated Care Board (ICB) chair would have the power to veto members of the board and there are robust requirements on ICBs to manage conflicts of interests.

I know that the Bill does not allow private sector providers to influence, or to make, decisions on spending, but it is welcome that the Government has committed to putting that beyond doubt. They will bring forward an amendment at the next stage of the Bill’s passage through Parliament to protect the independence of ICBs by preventing individuals with significant interests in private healthcare from sitting on them. I know that ministerial colleagues will be working to ensure that any amendment is appropriately worded and does not have any unintended consequences. I look forward to seeing their proposed amendment in due course and can assure you that I will scrutinise its contents closely.

September 2021

Dementia

Selaine’s response:

I believe that increasing public awareness and understanding of dementia among the wider public is vital to ensure that people are supported to live well with the condition, and I am encouraged that there are over three million Dementia Friends, including myself, a national support network run by the Alzheimer’s Society which helps dementia sufferers to lead lives that are active, creative and meaningful.

Research is crucial to understanding and tackling dementia. In 2017, the Government launched the UK Dementia Research Institute, in partnership with the Alzheimer's Society and Alzheimer's Research UK, with £290 million funding, the single biggest investment ever made in the UK in this field. Under the Challenge on Dementia 2020 strategy, the Government's commitment to spend over £300 million on dementia research between 2015 and 2020 was met a year early, with £341 million being spent by March 2019 through the Department of Business, Energy and Industrial Strategy, and the Department of Health and Social Care. The Government is also supporting the £79 million Accelerating Detection of Disease challenge, a project bringing together the NHS, industry and leading charities to support research into the early diagnosis of disease, including dementia.

By the end of 2020, all relevant staff were scheduled to have received appropriate dementia training, including training relevant staff to be able to signpost interested individuals towards research via the Join Dementia Research Service. I understand that good progress has been made towards this goal, and more options are currently being explored to increase take-up of more advanced training among those who need it.

Last year the Prime Minister announced the Government’s intention to provide the NHS with an additional £33.9 billion by 2023/24; this is the largest, longest funding settlement in the history of the NHS. This landmark settlement investment will secure the long term future of our NHS and demonstrates the Government’s commitment to fund our NHS and public services properly. As part of this, there is a commitment to improving detection, with more targeted screening and Rapid Diagnostic Centres, so that in ten years’ time these measures will help 55,000 more people to survive cancer each year, and prevent 100,000 heart attacks, strokes and dementia cases.

I am pleased that Alzheimer Research UK is holding an event on 15 September, and I will be attending.

August 2021

Self-Isolation

Selaine’s response:

We are seeing an increasing number of people being asked to self-isolate as the case number across the country rise. Self-isolation has played a critical role in helping to control the Covid-19 outbreak by denying the virus the human contact that it needs to spread. I know we are all grateful to the many people all across the UK, who have selflessly done their duty and self-isolated, making sacrifices to keep the virus at bay.

It is the responsible thing to do to self-isolate when told to do so and I am disappointed when I hear that some businesses are asking employees to ignore the advice from the NHS.

As part of step 4 of the Government’s Covid-19 roadmap, double vaccinated people will no longer be legally required to self-isolate if they are identified as a close contact of a positive Covid-19 case. The new rules are due to come into effect from 16 August. To ensure young people can make the most of their education as restrictions continue to ease, under 18s will also be exempt from self-isolation if they are a close contact.

I am keen for this to be introduced as soon as possible as this will also help reduce the number of self-isolations that may not be necessary after a negative test.

Young people and double vaccinated individuals, identified as close contacts, will continue to be advised to take a PCR test, to detect the virus and variants of concern. Anyone who tests positive following the PCR test will still be legally required to self-isolate, irrespective of their vaccination status.

The pandemic is far from over, and it is right that we all continue to act with caution. However, we can take hope from the fact that science has shown us the way forward in the form of the vaccine, just as it has done so many times throughout our fight against this virus. I urge everyone to take up the offer of a vaccination as soon as they are able.

The next few weeks will be difficult for many employees and employers, but I urge patience and understanding. I am seeing many businesses and many of the services provided by our councils choosing to continue with some or all the procedures that we have all become accustomed to over the last few months. I welcome and appreciate this, while the legal restrictions may have been removed, we still have a responsibility to act in a safe and reasonable manner, for both ourselves and others. Many businesses are understandably reflecting the caution that the majority of their customers want to see.

Government instruction and in some cases extreme intervention into our daily lives has been necessary in the global emergency, but the recent legal restrictions we have faced must be the exception, not the rule. We all know how the virus transmits and I believe at this time can take responsibility for our actions as we learn to live with this coronavirus moving forward.

July 2021

Maternity Care: Continuity of Carer and Baby Loss

Selaine’s Response:

I believe that every woman and their baby should receive personalised, high quality care. One of the key commitments in the NHS Long Term Plan (LTP) published in January 2019 is to make the NHS one of the safest places in the world to give birth. The Government has set out a range of new measures to deliver its ambition to halve the rates of stillbirths, neonatal deaths and brain injuries that occur during or soon after labour, and maternal deaths by 2025. To help meet this target, I welcome the Government’s announcement that it will recruit 3,000 more midwives.

I firmly agree that the continuity of carer model is extremely important, and is associated with reduced pre-term births, hospital admissions, reduced need for intervention during labour, and an improved experience of care. Local maternity units are rolling out a standard continuity of carer model and the NHS Planning Guidance 2019/20 stated that that they should prioritise women who could be at higher risk. Please be assured that work is ongoing to roll out this model, though that has been slightly more difficult during the 12 months of the Covid-19 pandemic.

While it is welcome that the target to reduce neonatal stillbirth and neonatal mortality rates by 20% by 2020 was met, with almost a 25% reduction reported, more work is being done in this area to further reduce these rates. Losing a baby is devastating, and it is vital we do everything possible to ensure that parents who have previously lost a baby are properly and consistently supported through any future pregnancies. I was unfortunately unable to attend the Westminster Hall debate on “Progress towards the National Ambition to reduce baby loss', I understand that this is close to the hearts of constituents and will ensure I follow this matter closely.

July 2021

Health and Care Bill

Selaine’s response:

The unprecedented threat of the Covid-19 pandemic has reminded us how vital our health and care system is to all of us. I want to assure constituents 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 joined up, 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 we have seen as a result of 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.

In particular, the comments from the Chief Executive of NHS England, who has 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.

July 2021

Adult Social Care

Selaine’s response:

I believe we must all receive dignified care in old age, and with an ageing population, this is one of the biggest challenges our country faces, and I stand by the Government’s commitment to ensure that the most vulnerable in society are given the support that they need.

While it is important to note that as of June 2021, 84% of all social care settings were rated good or outstanding by the Care Quality Commission, more needs to be done to tackle this serious challenge, crucially by securing a long term funding solution.

I am delighted that the Prime Minister has spoken of his determination to tackle this, stating in his first speech as Prime Minister that “we will fix the crisis in social care once and for all with a clear plan we have prepared, to give every older person the dignity and security they deserve”.

At the Spending Review in November 2020, local authorities were enabled to access over £1 billion of spending for social care, through £300 million of social care grant, and the ability to levy a 3% adult social care precept. This is in addition to the £1 billion social care grant announced during 2019, and the £3 billion provided to local authorities to address Covid-19 pressures, including in adult social care. I know that this Government is committed to sustainable improvement of the adult social care system.

Money alone will not fix the problem, and reform is needed to encourage high standards across the whole country. It is vital for us to consider ways of better joining up health and care services, and I am encouraged by the use of the Better Care Fund to assist local government and the NHS with the implementation of integrated health and care services.

In the Conservative Manifesto, on which I was proud to stand, we set out our aim to build the same level of consensus on social care that we have already built on the NHS, across political parties, so that an answer can be brought forward that solves the problem, commands the widest possible support, and stands the test of time. I firmly support the renewed commitment in the Queen's Speech to bring forward proposals to reform social care during this Parliament, and eagerly anticipate taking part in a conversation about establishing a care system fit for the 21st century.

July 2021

NHS England Reform

Selaine’s response:

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 constituents 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 joined up, 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. 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.

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 Nigel Edwards, the Chief Executive of the health policy think tank the Nuffield Trust, that these proposed reforms would allow GPs, hospitals, community services and social care to “work better and more effectively together” in the longer term are reassuring.

NHS managers have played a vital role throughout this pandemic, and I am pleased that Chris Hopson of NHS providers, which represents NHS managers, agrees with these reforms that will end the “unnecessarily rigid NHS approach to procurement”. It is also welcome that this White Paper enacts the recommendations of the 2019 Kark Review for stronger measures to ensure that NHS senior managers have the right skills, behaviours and competencies. I understand that there are no plans at this stage to statutorily regulate senior NHS managers and leaders, and I will continue to monitor this closely.

More broadly, I am pleased at the Government’s clear commitment to supporting the NHS and our wider healthcare system. The Government will provide the NHS with £33.9 billion in funding by 2023/24, which is the largest, longest funding settlement in the history of the NHS, and is confirmed in law by the NHS Funding Act. In addition, the NHS Long Term Plan commits £4.5 billion in primary and community care to help strengthen local healthcare networks.

July 2021

Coronavirus: Vaccine Boosters (Asthma)

Selaine’s response:

The Joint Committee on Vaccination and Immunisation (JCVI) concluded that only those with more severe forms of asthma are at clinically high risk from Covid-19. This group are defined as adults with asthma who require continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission and will have been eligible for vaccination as part of priority group six. An individual with a more severe case of asthma may have been included in the clinically extremely vulnerable group, in which case they will have been eligible as part of priority group four.

To assist GPs in identifying patients eligible for a vaccine in each priority cohort, NHS Digital aligned specifications for the identification of patients via their medical records with GP system suppliers. Asthma sufferers were identified through this system and invited to make an appointment when the vaccination programme reached their priority cohort.

While the programme of first and second doses continues, the Government has confirmed that a booster shot programme will happen in the autumn and steps are being taken to prepare for this. Of course, some logistical matters remain to be resolved, but it is anticipated that the booster programme will be rolled out in a similar way to the current programme albeit with some differences for example to account for the annual flu vaccination programme.

June 2021

Mental Health Support for Young People with Cancer

Selaine’s response:

Improving outcomes for patients diagnosed with cancer remains a key NHS priority. Last December, the Minister for Prevention, Public Health and Primary Care said that "the Government will stop at nothing to make childhood cancer a thing of the past for generations to come", a commitment which I firmly support.

I absolutely believe that we must do all we can to provide appropriate support to those suffering with cancer and their families. NHS Cancer Services for Teenagers and Young Adults must meet a wide range of criteria which not only includes establishing clear care pathways and providing the best medical care, but also assigning a key worker and providing support at every stage. This includes ongoing physical and emotional support during and after treatment is finished.

I know that my colleagues across Parliament, as well as charities and health teams are working to make sure that everything possible is done to ensure children and young people with cancer, as well as their families, have access to appropriate psychological support.

June 2021

Arthritis, Joint Replacement Surgery and the impact of the Pandemic

Selaine’s response:

I would like to first commend Versus Arthritis for their work to support people suffering with arthritis and to raise awareness of the condition.

I am grateful to everyone who has worked so hard to stay at home throughout the pandemic. Their efforts have undoubtedly saved lives and enabled our NHS to provide urgent treatment like cancer and emergency care. However, I understand that 4.7 million people in England are now waiting for care, with around 380,000 of those having been waiting more than a year, in addition to people who have not contacted their GP when, in ordinary times, they would have reached out for help. I believe that we must act urgently to tackle this problem.

As a result, I welcome that the Government is already working with the NHS to accelerate service recovery. In March 2021, an additional £7 billion of funding was announced for healthcare services, including £1 billion to target backlogs in elective services. As part of the commitment to the recovery of non-urgent services and to address elective backlogs, £325 million has been provided for new investment in diagnostics equipment to improve clinical outcomes.

I know that staff throughout the NHS are working extremely hard to tackle the backlog, indeed in January and February 2021 NHS staff completed almost 2 million operations and other elective care while also providing treatment to 140,000 Covid-19 patients in England. However, I agree that there is more work to be done in this area over the coming months.

June 2021

Children and Young People's Mental Health

Selaine’s response:

It is incredibly important to protect and support the health of children and young people in our society. In recent years we have made huge progress in understanding mental health issues, and I support efforts to transform children and young people’s mental health for the better. Approximately 10% of 5 to 16 year olds have a clinically diagnosable mental health problem, and since 2015, an additional £1.4 billion has been invested to transform children and young people’s mental health services.

The Children and Young People’s Mental Health Green Paper sets out ambitious proposals to improve mental health services for children and young people, together with over £300 million of funding. This will incentivise and support schools and colleges to train designated leaders for their pupils’ mental health, and introduce new mental health teams, both of which will ease pressure on NHS mental health services.

The NHS Long Term Plan makes a commitment to offering children and young people the best start in life. As part of this, there is an additional commitment to deliver on the promises made in the ‘Five Year Forward View for Mental Health’ so that 70,000 more children and young people will access treatment each year by April 2021. Moreover, by 2023/2024 at least an additional 345,000 children and young people aged 0-25 will be able to access support via NHS funded mental health services and school or college-based Mental Health Support Teams. In particular, I welcome the Secretary of State's announcement that £79 million from the additional £500 million for mental health announced at the 2021 Spending Review will be allocated to accelerate the commitment to expand these services.

Early intervention is absolutely vital in the fight against eating disorders and everyone with an eating disorder must have access to timely treatment. That is why I am glad that an ambitious new access standard has been introduced, aiming for 95% of children (up to 19 years old) with eating disorders to receive treatment within a week for urgent cases and four weeks for routine cases by the end of 2020. While in view of the coronavirus pandemic I know that this has been a particularly challenging year, and I share my constituent's disappointment that this target was not met, I know that NHS staff have been working extremely hard to refer people as quickly as possible. I am certain that services will continue to improve, particularly as NHS services return to normal following the disruption of the past year.

June 2021

Abortion ('DIY Abortions')

Selaine’s response:

Abortion care is an essential part of care for women, and safeguarding measures are still in place as part of care during the pandemic. The Royal College of Obstetricians and Gynaecologists has offered guidance on this issue which can be found here:

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-abortion/information-for-women/

Guidelines have been issued which enable women to take both Mifepristone and Misoprostol at home for the duration of the outbreak, so that they do not have to visit a medical practice and risk exposure to the virus, and to enable doctors to prescribe medicines from home via telephone or video consultations without consulting a second practitioner, so that abortion care can be provided even in the case of staff shortages. I have been assured this alteration will last only as long as the temporary provisions enacted by the Coronavirus Act 2020 to protect women seeking care endure. The medicines must still be instigated prior to nine weeks and six days into the pregnancy. I am aware of data that indicates an increase in the number of abortions carried out in April 2020 by comparison with April 2019; I am also aware that the same dataset shows lower abortion rates during May and June 2020 compared with the same months in 2019.

The pandemic has had an impact on many aspects of daily life, the full picture of which may not be clear for some time to come. I will, of course, continue to monitor this sensitive issue.

A consultation was held to explore whether these temporary changes should be enacted long term, the results of which are currently being analysed. You can find more information on that here:

https://www.gov.uk/government/consultations/home-use-of-both-pills-for-early-medical-abortion

I understand that making a decision regarding abortion care can be an extremely difficult one, and I believe that we must do all we can to support women to make an informed decision, taking into consideration all of their options, with medical professionals offering impartial advice. I will continue to do all I can to ensure plenty of information is available to women making enquiries relating to abortion care including all options available to them.

June 2021

Animal Research

Selaine’s response:

Animal research still plays a role in providing vital safety information for potential new medicines. It is worth remembering that, as a result of findings from animal studies, a large number of potential new drugs never get as far as being tested in humans. Some aspects of the toxicological assessment of new medicines cannot be adequately assessed in humans, and animal data will be the only kind available.

Without animal testing it is highly likely that a large number of potentially dangerous new medicines would be tested in healthy volunteers and patients in clinical trials, and I know ministers believe that this would be quite unacceptable. However, animals are only used when there are no suitable alternatives, and by encouraging new cutting-edge approaches to science we will ensure that standards of animal welfare are improved. I am absolutely opposed to animal tests where alternative approaches could be used.

I fully support all steps to establish new methods and to support the life sciences and research industry. Since 2017, the Government has invested around £1 billion through two Life Sciences Sector Deals, helping to generate significant levels of industry investment in the UK. I am committed to making the UK the leading global hub for life sciences. The Life Sciences Investment Programme (LSIP) aims to unlock the potential of the UK’s best health and life science innovations, allowing companies to grow in the UK. This investment programme consists of up to £600 million of joint Government and industry investment.

It is important to remember that existing scientific research methods ensure that by the time medicines reach clinical trial, risks are significantly reduced.

June 2021

Inpatient Units

Selaine's response:

I absolutely believe that patient safety and care for those with autism and learning disabilities should be to the highest standard and I am deeply concerned at the abuse that patients in Winterbourne and other hospitals faced.

Children, young people and adults with a learning disability, autism, or both, with the most complex needs, have the same rights to live fulfilling lives. Since 2015, the number of people in inpatient care has reduced by almost a fifth, which is welcome progress.

The NHS Long Term Plan sets out key changes to inpatient units for those with learning disabilities and autism. This includes a commitment to reducing the number of admissions and decreasing the amount of time spent in these units.

However, I do appreciate the need to do all we can to support the prevention of inpatient admission and so it is welcome that the Long Term Plan includes increased investment in intensive, crisis and forensic community support. This will enable more people to receive personalised care in the community, closer to home, and reduce preventable admissions to inpatient services. Local providers will also be able to take control of budgets to reduce avoidable admissions, enable shorter lengths of stay and end out of area placements.

I firmly support the four principles set out in the Government’s proposed changes to the Mental Health Act as an important measure for protecting patients, service users, and their loved ones. I understand that the Government is currently reviewing feedback from the consultation on reforming the Mental Health Act, which included consideration of the introduction of new duties on commissioners to ensure the adequate supply of community services for people with a learning disability and autistic people.

I will of course continue to monitor this issue carefully and contact ministerial colleagues to ensure that these changes work for patients, families and carers.

June 2021

Health and Disability Green Paper

Selaine’s response:

I appreciate that there is frustration at the delay to the Health and Disability Green Paper, but it is my understanding that, given the necessary focus on the departmental response to Covid-19, the Department for Work and Pensions (DWP) are working to a longer timescale than previously anticipated. The Minister for Disabled People is continuing to engage with disabled people and their representatives and is committed to publishing the formal consultation document in the coming months.

The Green Paper will consider how to improve the DWP’s current services so they are better and easier to use, explore how extra support can help people navigate the system as well as what can be done to better support disabled people into employment.

The DWP has run workshops across the country where local disability organisations and disabled people have shared their experiences and priorities for future change. Additionally, the Government plans to publish a National Strategy for Disabled People, which will focus on issues that disabled people say affect them the most across all aspects of daily life.

June 2021

HIV Action Plan

Selaine’s response:

Please allow me to assure you that every effort is being made to fight discrimination surrounding HIV and AIDS, and to ensure that those affected can access the necessary treatments available to them. I know that treatment for HIV has continued throughout the Covid-19 crisis.

While I welcome the news that new HIV diagnoses across the UK fell by 15% between 2017 and 2018, more remains to be done. That is why I support the Government’s commitment to stopping new HIV infections by 2030, through a National HIV and Sexual Health Promotion programme. Additionally, following the success of the NHS England funded three-year impact trial of pre-exposure prophylaxis (PrEP), for HIV prevention, I was delighted to learn that PrEP is becoming routinely available across England since March 2020, as part of the government's aim to end HIV transmission by 2030.

The funding from the Department of Health and Social Care will ensure anyone who is at a high risk of contracting HIV will receive PrEP from their local sexual health clinic to reduce their risk of getting the virus. NHS England will cover the costs of the drug and local authorities will be supported with £16 million funding to deliver services.

I welcome the Government’s continued work with charities such as the Terence Higgins Trust and the World AIDS Day initiative, in order to raise awareness of HIV and reach groups with the highest rates of the infection.

June 2021

Crohn's and Colitis

Selaine's response:

I know Crohn's, Colitis and other Inflammatory Bowel Diseases (IBDs) can have a deep and lasting impact on quality of life, and it is essential that those living with this condition are aware of the specialist services available from the NHS.

IBD affects over 300,000 people in the UK, but there is relatively low public awareness, which poses difficulties for sufferers. I am pleased to see that NHS Choices, and charitable organisations such as Crohn’s and Colitis UK, work tirelessly to improve public awareness, and provide useful information on the symptoms, diagnosis and treatment.

The National Institute for Health and Care Excellence has published guidance for the management of IBD, which states that sufferers should receive treatment from a local Multidisciplinary Team, comprising of a range of experts, from dieticians to specialist clinical nurses. I am also glad that the guidance states that patients considering or undergoing surgery, should receive information about their treatment from a specialist.

The Department of Health funds research through the National Institute for Health Research (NIHR). NIHR welcomes funding applications for research into any aspect of human health, including Crohn’s disease, IBS, and Ulcerative Colitis.

I appreciate that long-term conditions like IBD can affect a person’s ability to work. Patients may be entitled to reclaim hospital travel costs through the Healthcare Travel Costs Scheme, available on the NHS Choices website www.nhs.uk and those too ill to work may receive benefits. Information about financial assistance for sufferers of disabling long-term conditions can be found here: www.gov.uk/financial-help-disabled.

I have been most interested to learn more about the impacts of IBD through IBD UK's report The Hidden Cost and a Vision for Change. I was pleased to learn that 72% of respondents rated the quality of their care as excellent, very good or good. I would certainly be happy to work to raise awareness of the symptoms among the public and among healthcare professionals to assist with more swift diagnosis, and to learn more about the other recommendations in the report.

While I understand that progress on the inflammatory bowel disease RightCare scenario has been delayed due to Covid-19 pressures, a working draft has been reviewed and commented on by NHS England and NHS Improvement’s working group and by Crohn’s and Colitis UK.

NHS England and NHS Improvement are in the process of updating the original working draft based on these comments. It is anticipated that a revised version will be ready to be share with IBD UK and their partner organisations for consultation in May, and I look forward to having the opportunity to review this document at the earliest opportunity.

May 2021

Catch up with Cancer Campaign

Selaine’s response:

I was delighted when it was announced that NHS services could begin restarting from April, starting with the most urgent, like cancer care and mental health support. The NHS is open for business, even during this time of additional restrictions, and anyone who needs care and treatment should continue to access it as and when they need it, especially when delays could impose both an immediate and a long term risk to health.

Cancer is a priority for the Government and survival rates are at a record high. Since 2010 rates of survival from cancer have increased year-on-year. Around 7,000 people are alive today who would not have been had mortality rates stayed the same as then. I agree that we need to keep working on this, which is why I welcome the Government's stated aim to see three quarters of all cancers detected at an early stage by 2028 (currently just over half are detected at an early stage). The plan will overhaul screening programmes, provide new investment in state-of-the-art technology to transform the process of diagnosis, and boost research and innovation. This is part of the NHS Long Term Plan (LTP), published in January 2019, and forms part of how the Government will achieve its ambition to see 55,000 more people surviving cancer for five years in England each year from 2028.

I will continue to support the Government and the NHS to deliver on this, in spite of the ongoing coronavirus pandemic. In particular, I welcome that the Government has already announced £3 billion funding to support the NHS recovery from Covid-19, to help to ease existing pressures and enable hospitals to carry out extra checks, scans, and other operations or procedures. This will help to ensure that cancer patients are able to access the care that they need as safely and quickly as possible. This was reiterated as part of the Spring Budget 2021, and I firmly support the Government's ongoing commitment to the NHS and the vital service it provides, during normal times as well as the pandemic.

One of the measures outlined in the LTP is safer and more precise treatment, including advanced radiotherapy techniques and immunotherapies to continue to support improvements in survival rates. This will be supported by a £130 million upgrade of radiotherapy machines across England, as well as commissioning the NHS new state-of-the-art Proton Beam facilities in London and Manchester. In addition, the LTP commits to reforms to the specialised commissioning payments for radiotherapy hypofractionation to support further equipment upgrades. Faster, smarter and effective radiotherapy, supported by greater networking of specialised expertise, will mean more patients are offered curative treatment, with fewer side effects and shorter treatment times. Starting with ovarian cancer, the NHS will ensure greater access to specialist expertise and knowledge in the treatment of cancers where there are fewer or more risky treatment options.

I fully intend to attend the virtual Cancer Summit on Wednesday 26th May, to ensure I am aware of the latest updates and information.

May 2021

British Sign Language

Selaine’s response:

Deafness or being hard of hearing should not be a barrier to participating in society and I understand the desire to see British Sign Language (BSL) recognised as an official language of the UK. If I were successful in the Private Members Bill ballot, I would instigate a survey of the constituency to ascertain which bill would be the best one to progress to fully represent what is important for the constituents of North Devon. I am not averse to this bill, but I would want to see what else there is that needs addressing before committing to any particular bill.

It is clear to me that the Government and the public sector should lead by example in ensuring that important communication is accessible to all. I am, therefore, glad that public health information has been available in many alternative formats including BSL during the Covid-19 outbreak. Covid-19 press briefings with BSL have been available on the Downing Street social media channel and the BBC News channel has provided live BSL interpretation for the briefings.

BSL, more broadly, may also be offered in schools as part of the school curriculum. I understand that the Department for Education is working to develop draft content for a potential GCSE in BSL and that a consultation on the content is due to published this year.

May 2021

Dementia

Selaine’s response:

Under the Challenge on Dementia 2020 strategy, the Government's commitment to spend over £300m on dementia research between 2015 and 2020 was met a year early, with £341m being spent by March 2019 through the Department of Business, Energy and Industrial Strategy, and the Department of Health and Social Care. The Government is also supporting the £79m Accelerating Detection of Disease challenge, a project bringing together the NHS, industry and leading charities to support research into the early diagnosis of disease, including dementia.

By the end of 2020, all relevant staff were scheduled to have received appropriate dementia training, including training relevant staff to be able to signpost interested individuals towards research via the Join Dementia Research Service. I understand that good progress has been made against this goal, and more options are currently being explored to increase take-up of more advanced training among those who need it.

The Prime Minister recently announced the Government’s intention to provide the NHS with an additional £33.9 billion by 2023/24; this is the largest, longest funding settlement in the history of the NHS. This landmark settlement investment to help secure the long-term future of our NHS is extremely welcome, and I hope you agree it demonstrates the Government’s commitment to properly funding our NHS and public services. As part of this, there is a commitment to improving detection, with more targeted screening and Rapid Diagnostic Centres, so that in 10 years time these measures will help achieve 55,000 more people surviving cancer each year, and 100,000 heart attacks, strokes and dementia cases being prevented.

The Government is integrating and improving health and social care to protect people at every stage of their lives. In the manifesto on which I was proud to stand it was made clear that we must build the same level of consensus on social care that we have already built on the NHS, across political parties, so that an answer can be brought forward that solves the problem, commands the widest possible support, and stands the test of time. I stand by this commitment, and urge my colleagues and constituents of all political beliefs to take part in a conversation about establishing a care system fit for the 21st century.

I know that the Government remains strongly committed to research to combat dementia, and will shortly lay out plans for supporting people with dementia in England up to 2025. Sadly, I understand that the mobilisation of the health research system against Covid-19 will have an impact on the speed with which the Dementia Moonshot plans can be implemented. However, I will work with my colleagues in the Department of Health and Social Care to ensure that the manifesto commitment to double research funding to over £160m each year by 2030 is delivered as swiftly as is possible.

I believe increasing public awareness and understanding of dementia among the wider public is vital to ensure that people are supported to live well with the condition and I am encouraged that there are over 3 million Dementia Friends.

April 2021

Disabled Children's Partnership Campaign

Selaine’s response:

I can only imagine the additional challenges for disabled children and their families during the pandemic, and I welcome the work of the Disabled Children's Partnership in highlighting this issue through the Left in Lockdown campaign. I am determined that disabled children and their families in North Devon should receive the support they need to lead fulfilling lives and be part of the community. I wholly support the excellent work this campaign is doing to highlight the reality of the challenges disabled children, young people and their families face in living a life many of us take for granted.

As part of the Covid-19 mental health and wellbeing recovery action plan, the Government announced £79 million of funding to improve access to mental health services for children and young people, including disabled children. This includes additional funding for Mental Health Support Teams in schools and colleges. Funding is also provided for respite care.

Further, supporting children and young people with special educational needs and disabilities (SEND) and their families is a priority for this government, and their educational, physical and mental wellbeing remains central to our cross-government response to the Covid-19 outbreak. That is why education settings have remained open for children and young people with an education, health and care plan throughout periods of national lockdown.

The return to school for all pupils was prioritised due to the significant and proven impact caused by being out of school, including on wellbeing. The support schools provide to their pupils as they return to face-to-face education should include time devoted to supporting wellbeing, which will play a fundamental part in supporting children and young people’s mental health and wellbeing recovery. The expectations for schools in this regard are set out clearly in the main Department for Education guidance to schools, which also signposts further support, available here:

https://www.gov.uk/government/publications/actions-for-schools-during-the-coronavirus-outbreak

I am encouraged by the commitment to improve opportunities and life chances for all children and young people, and I know that health and care services play an integral part in achieving this.

April 2021

NHS and Centene

Selaine’s response:

I understand that a number of constituents have concerns about Centene's involvement in GP surgeries. I would like to reassure those constituents that patient care will not be affected, and all services will remain free at the point of delivery. As with all GP services, those for which Centene is responsible will continue to be regulated and inspected by the Care Quality Commission. The Clinical Commissioning Groups where this has happened have followed the appropriate and robust processes prior to transfer of responsibility to Centene. The NHS has always involved a mixture of public and private provision, and it is absolutely not for sale to private providers.

March 2021

COVID-19 Recovery Plan for Children with SEND

Selaine’s response:

I know that the pandemic has presented many difficulties and challenges for children and young people with special educational needs and disability (SEND), so I am pleased that supporting them is a priority for the Government. I welcome that the specific needs of children and young people with SEND are considered as a priority for education recovery work, and that Sir Kevan Collins has been appointed as Education Recovery Commissioner to deliver this programme.

To help support families of children with SEND, £40.8 million has been provided for the Family Fund during 2020-21, including £13.5 million to respond to the impact of the outbreak of coronavirus. This funding has helped to support over 80,000 low-income families raising children with disabilities or serious illnesses. Separately, over £42 million has been allocated to extend contracts and grants which enable schools, colleges, families, and local authorities to support thousands of children with SEND.

High Needs Funding has been boosted by £780 million throughout 2020-21, and that a further £730 million will be provided for 2021-22. A consultation was recently held on a number of small technical changes to the High Needs National Funding Formula (NFF) for the 2022-23 financial year, and I welcome that the consultation represents the first stage of a longer-term review of the High Needs NFF which will consider how the distribution of funding can be improved to achieve the highest quality support for the most vulnerable children and young people.

Helping all pupils to catch up on learning lost as a result of the pandemic is of paramount importance, and it is welcome that a £1.7 billion recovery package has been created. This includes £83 million to expand the National Tutoring Programme (NTP) and I am pleased that, of the 33 NTP providers, 26 have specific expertise in supporting children with special educational needs. Providers of the 16-19 Tuition Fund, which received a £102 million extension, have also been asked to have regard for the needs of pupils with SEND when making prioritisations for small group tuition.

March 2021

Telemedical Abortion

Selaine’s response:

I completely understand what an incredibly emotive issue this is, and I appreciate the strength of feelings on all sides. Abortion care is an essential part of care for women, and I would like to make the reassurance that safeguarding measures are still in place.

The Royal College of Obstetricians and Gynaecologists has offered guidance on this issue which can be found here: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-abortion/information-for-women/

I have been assured this alteration will last only as long as the temporary provisions enacted by the Coronavirus Act 2020, to protect women seeking care endure, and the medicines must still be instigated prior to nine weeks and six days into the pregnancy. I understand that a consultation has been announced to explore whether these temporary changes should be enacted long term. You can find more information on that here: https://www.gov.uk/government/consultations/home-use-of-both-pills-for-early-medical-abortion

Making a decision regarding abortion care can be an extremely difficult time, and I believe that we must do all we can to support women to make an informed decision, taking into consideration all their options, with medical professionals offering impartial advice. I will continue to do all I can to ensure plenty of information is available to women making enquiries relating to abortion care including all options available to them.

March 2021

Motor Neurone Disease (MND)

Selaine’s response:

With early diagnosis key to treating the symptoms of MND, I am glad that the National Institute for Health and Care Excellence (NICE) has published new guidelines for clinicians on the assessment and management of MND. These set out the signs and symptoms of the disease, and recommend that patients suspected of having MND should be referred without delay. The Royal College of GPs and the MND Association have also worked together to produce a Red Flag Tool which sets out key signs of MND to help GPs to identify suspected cases and ensure prompt referral.

I recognise the valuable contribution made by carers of people with MND, many of whom spend a significant proportion of their life providing support to family members, friends and neighbours. I agree that carers must receive the right support to help them carry out their caring roles, and a new cross-Government National Carers Strategy is being introduced to look at what more can be done to support existing and future carers.

I was extremely interested to read about the research undertaken by the University of Edinburgh which identified an issue with MND patients' nerve cells, suggesting that this damage could be repaired by improving the energy levels in mitochondria. While I understand that this research is still in early stages, it is a most welcome step forward, and I will certainly follow this closely.

March 2021

Conversion Therapy - Update

Selaine’s response:

I understand the concerns of some people of faith, however I do not agree with those who believe that this law would ‘criminalise Church’. I believe that the Church and religious institutions should be able to preach what they believe in, such as the words of the Bible, however it is my view that this should only be done to those who wish to listen. It is not the intention nor will it be the outcome of the proposed new law to infringe on religious freedom, but instead to protect those in the LGBT community who have already faced much persecution and inhumane treatment.

The Government is aware of the concerns that some constituents have raised regarding religion and faith, and my Ministerial colleagues have said that they will continue to engage with religious organisations and groups to understand how best to support LGBT people of faith. While it is not the Government's place to dictate what is legitimate spiritual guidance, it is the Government’s place to protect all their citizens, some of whom find any act from someone of faith to attempt to change their sexual orientation deeply harmful and traumatic.

March 2021

Conversion Therapy

Selaine's response:

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, because being lesbian, gay or bisexual is not an illness to be treated or cured.

I am encouraged that 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, 2% 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.

I welcome the firm commitment to preventing these activities from continuing. Led by colleagues in the Government Equalities Office, research is underway to look at the experiences of those subjected to conversion therapy. I have received assurances that Ministers are thoroughly considering all legislative and non-legislative options in order to end conversion therapy practice for good, and will outline their plans in due course.

I am positive about the steps that have been made so far in the UK to achieve LGBT equality, and I am confident that this good work will continue.

March 2021

Medical Freedom Bill

Selaine's response:

While I understand that a range of options are being considered to encourage people to receive the vaccine, the Government does not plan to make the Covid-19 vaccination mandatory.

It is right that we rule out no options at this stage. Conclusions and the outcome of the review will be set out in advance of Step 4 of the Roadmap. As the Prime Minister has said, it may be that there is a role for certification in the future, but for now the emphasis is rightly on our vaccination and testing programmes.

I am satisfied that steps will be taken to appropriately consider the impact of any certification approach and, if necessary, apply relevant safeguards. As such I do not feel a Medical Freedom Bill such as the one proposed by Save Our Rights UK is required.

March 2021

Cancer Treatment and Coronavirus

Selaine's response:

When people start treatment for cancer, their medical team works with them to balance the risks and benefits of treatment before agreeing a plan. As a result of the pandemic, it may be that doctors consider the risks of certain treatments, particularly those that weaken the immune system, to be much greater than normal. They will take into consideration how urgent your treatment is: in some cases, delaying treatment might not make a big difference to the outcome. Patients with cancer visit hospitals regularly, but for those who are particularly vulnerable, this may have been more risky than usual at the height of the pandemic as it may result in exposure to the virus. As a member of the Radiotherapy APPG I did raise concerns about access to cancer treatment during the pandemic directly with the Minister responsible.

The Secretary of State for Health and Social Care announced the restoration of NHS services on 27th April, starting with the most urgent, like cancer care and mental health support. The NHS is open for business, and anyone who needs care and treatment should continue to access it as and when they need it, especially when delays could impose both an immediate and a long term risk to health. I know that continuation of cancer services is absolutely vital in many cases, which is why I welcome that restarting cancer care in a safe manner has been a priority for the NHS and for the Government. I welcome also that, due to covid-19, the 21 cancer alliances in England have established hubs to ensure dedicated cancer care away from hospitals dealing with the virus.

I welcome that the Government has already announced £3 billion funding to support the NHS recovery from Covid-19, to help to ease existing pressures and enable hospitals to carry out extra checks, scans, and other operations or procedures. This will help to ensure that cancer patients are able to access the care that they need as safely and quickly as possible.

Any changes to treatment protocol to ensure patients are treated safely should be carried out in full consultation with patients, to ensure that they fully understand the reasoning behind any changes made in line with guidance from clinical experts. If you have concerns about your own situation, I would strongly encourage you to speak to your medical team to discuss your options.

March 2021

Covid-19 Vaccinations and ME/CFS

Selaine’s response:

The Joint Committee on Vaccination and Immunisation's (JCVI) advised prioritisation list for the initial phase of the Covid-19 vaccination programme was specifically aimed at the prevention of Covid-19 mortality and the protection of health and social care staff and systems. I understand that currently ME/CFS are not listed as specific conditions in the priority list, however those with chronic neurological disease are included in priority group 6.

The JCVI has recently clarified that the examples of clinical risk groups, listed in the Green Book: Immunisations against infectious disease, are not exhaustive, and the advice states that within these groups, clinical judgment should be applied to consider the risk of Covid-19 exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from Covid-19 itself. More information and support, including advice on contacting your GP, can be found on the ME Association website here:

https://meassociation.org.uk/2021/02/latest-covid-19-me-cfs-and-the-jcvi-priority-vaccination-list/

February 2021

Support for Unpaid Carers

Selaine's response:

I recognise the valuable contribution made by carers of all kinds; residential, domiciliary, paid and unpaid; many of whom spend a significant proportion of their life providing support to family members, friends and neighbours. I wholeheartedly believe that carers must receive the right support to help them carry out their caring roles. A tenth of adults in the UK provide unpaid care for a friend or family member, and these people should be supported in the invaluable work that they do.

The Government is committed to supporting the 5.4 million unpaid carers over the coming months. Funding has recently been extended to Carers UK’s support phone line until March 2021 to cover the winter period, and the Department for Health and Social Care has provided free flu vaccines for unpaid carers. In addition, the Department for Education has launched the ‘See, Hear, Respond’ service in partnership with Barnardo’s to support young carers through this challenging time. I am assured that cross-departmental work is ongoing to scope further support options for young carers.

Existing support will remain available including the Carer’s Allowance, as well as through NHS volunteers who can provide support by going shopping or collecting prescriptions. Ministers have committed to regularly updating and bolstering the online guidance for unpaid carers, and I will continue to monitor progress in this area, speaking up for unpaid carers in Parliament.

February 2021

UNICEF: Future at Risk

Selaine's response:

The UNICEF report is correct to note that the pandemic is exerting severe pressure on essential and life-saving health services in many, particularly poorer, countries around the world. This threatens to increase levels of maternal and child mortality, and thus global progress towards achieving Sustainable Development Goal (SDG) 3. Unless decisive action is taken now past progress towards this goal, as with many others, such as education (SDG 4), risks being erased altogether.

I am proud that UNICEF notes that the UK has been at the forefront of global health agendas for decades, with an exceptional aid track record. I am confident that current and future development efforts will honour this reputation. In 2020, for example, the UK pledged a total of £166million dedicated to tackling food insecurity and to provide aid to more than 7 million vulnerable people in some of the world’s most dangerous places.

I appreciate the call for the UK to publish a plan for ending preventable deaths of mothers, new-borns and children. Nevertheless, Ministers have been clear that the UK's approach to this particular issue will be informed by the outcomes of the Integrated Review. Working from first principles in this way is the right approach in my view, thus, it is best to wait until the Review has concluded before the UK commits itself to a detailed course of action on this issue.

I wholeheartedly agree with the recommendation that the UK should aim to lead global efforts to build resilient health systems. The Prime Minister has already set out a five-point plan to strengthen health systems against global health crises, and committed to putting girls' education and empowerment, including reproductive health, on the global agenda as part of our Presidency of the G7 this year.

February 2021

Foster Carer Vaccine

Selaine's response:

The Joint Committee on Vaccination and Immunisation (JCVI) has set out a strategy that prioritises protecting those most at risk of death and serious disease. In line with the recommendations of the JCVI, the vaccine is initially being rolled out to the priority groups including care home residents and staff, people over 80 years old and health and care workers, then to the rest of the population in order of age and risk, including those who are clinically extremely vulnerable and all individuals aged 16-64 years old with underlying health conditions.

Once those most at risk have been protected, Phase 2 of the programme will commence. This may include targeted vaccination of those at high risk of exposure and/or those delivering key public services, such as teachers and foster carers. As with the first phase of the programme, these decisions will be guided by expert advice from the JCVI. My Minsterial colleagues are aware of the case being made for prioritising foster carers.

I am very pleased by the great progress we are making with the vaccination programme. The quicker we get people vaccinated, the quicker we will be able to get back to our normal lives.

February 2021

Alzheimer’s

Selaine's response:

I can only imagine how challenging it must be for families caring for loved ones during this difficult time, particularly those who have needed to take on extra responsibilities. I know that the Government is working closely with system partners, stakeholders, local authorities and the care sector to monitor the impact of Covid-19 on people with dementia and to identify what additional actions may be required to ensure safety, and access to the right support and care.

Research through the National Institute for Health Research was commissioned on how to manage or mitigate the impact of Covid-19 on people with dementia and their carers living in the community. The research has considered the best ways to support people to stay well during the outbreak, including help to manage the psychological and social impacts of social distancing, self-isolation, and lockdown. You can find more information, including summary leaflets, here: http://www.idealproject.org.uk/covid/

I agree that we should do everything we can to offer support to people with long term health conditions, as well as those who support them, throughout this difficult time, and I will certainly continue to monitor this issue closely.

February 2021

Guide Dogs Accessible Vaccinations

Selaine's response:

I can assure you that I take the issue of vaccine take-up incredibly seriously and I welcome the Government's commitment to move the UK's vaccine programme forward with pace. I firmly believe that accessibility is a key priority, and so I welcome that the Department of Health and Social Care has been working to ensure information is provided about the vaccine in audio, Braille, large print, easy read and British Sign Language.

The framework for rolling out the vaccine outlines that providers are responsible for ensuring that their vaccination centres are accessible to all members of their community and they should take steps to improve access and reduce potential inequalities for people eligible to receive vaccinations. Patients booking vaccination appointments can choose a site that meets their accessibility needs and transport requirements and will be informed of the distance of the site from the postcode they have entered.

I am already working with vaccination hubs in North Devon to ensure that everybody can access the vaccine as soon as they are invited to do so.

February 2021

Vaccine – Learning Disability

Selaine's response:

The Joint Committee on Vaccination and Immunisation (JCVI) has carefully considered the prioritisation of those with learning disabilities. Current evidence strongly indicates however that the single greatest risk of mortality from Covid-19 is increasing age and that the risk of a serious health complications increases exponentially with age. When compared to persons without underlying health conditions, the absolute increased risk in those with underlying health conditions is considered generally to be lower than the increased risk in persons over the age of 65. The exception to this being the clinically extremely vulnerable. The JCVI's advice is therefore to offer vaccination to those aged 65 years and over, followed by those in clinical risk groups aged 16 years and over. This includes those with severe and profound learning disabilities.

While the JCVI has given the recommendations on the first phase of prioritisation, The JCVI is still due to come forward with further recommendations of future prioritisation. The JCVI is in the process of considering the next phase of the vaccination programme and they have said that the points raised with them regarding the wider numbers of persons with a learning disability will be taken into account in the relevant discussions and considerations ahead. I will be following the developments closely.

February 2021

FFP3 masks

Selaine's response:

Continuing to ensure our frontline staff are properly protected is of paramount importance to me, and to my colleagues on all sides of the House of Commons.

Over 3 billion items of PPE have been delivered since the start of the outbreak to 58,000 health and care settings. Almost 28 billion items of PPE have been ordered overall from UK based manufacturers and international partners to provide a continuous supply in the coming months and the Government is confident in the stocks and sources of supply of PPE to meet the needs of health and social care over the coming months.

FFP3 face masks are designed for use when carrying out potentially infectious aerosol generating procedures. Risk assessments in the workplace establish when different PPE is appropriate: FFP2 respirators may be more appropriate and deliver the required level of safety for the care a member of staff is delivering and FFP3 masks are not always necessary. The Government has worked with the NHS and with a range of suppliers to ensure that health and care facilities have plenty of PPE of the correct standard.

February 2021

Living with Disabilities during the Pandemic

Selaine's response:

It is troubling that so many people with disabilities feel forgotten during this crisis. As well as addressing this, we must ensure rights are not diminished and look for opportunities to change things for the better for good. Having read Scope's report in detail, I am aware it has been brought to the attention of my colleagues in the Department for Work and Pensions and the Government Equalities Office.

Regarding welfare, the Government acted quickly to suspend all face-to-face assessments for health and disability related benefits while also extending award periods, giving people peace of mind that their benefit payments would continue. By doing this, Ministers are protecting the health of individuals claiming these benefits, many of whom are likely to be at greater risk of severe Coronavirus symptoms due to their pre-existing health conditions.

It is my view that measures in the Coronavirus Act are temporary and proportionate to the threat we face. It is important that they will only be used when strictly necessary and will only be in place for as long as required to respond to the public health emergency. Local authorities are still expected to do as much as they can to comply with their duties to meet needs during this period, and the legislation does not remove the duty of care towards an individual's risk of serious neglect or harm.

February 2021

Vaccine Rollout in North Devon

Selaine's response:

Thousands more doses of the Oxford Astra-Zeneca vaccine have been received from the national supply chain and given to priority groups in Devon this week.

GP practices are prioritising use of the Oxford vaccine for use in older persons’ care homes as it is easier to transport and store.

The NHS has been asked to ensure everyone in care homes has been vaccinated by 24 January and it is our ambition in Devon to achieve this.

The focus now is on ensuring that we deliver to more people in priority cohorts and sooner, especially groups 1 and 2 with all those to group 4 offered a vaccine by the middle of February.

The Joint Committee on Vaccination and Immunisation (JCVI) has advised prioritising delivery of the first vaccine dose as this is highly likely to have a greater public health impact in the short term and reduce the number of preventable deaths from COVID-19.

The COVID-19 Actuaries Response Group has conducted a review into the logic of the UK’s vaccine priority ordering. This document shows the number needed to vaccinate in care homes is 20 vaccinations to prevent one death, compared with other groups in priority 1-4 of between 160 and 600 vaccinations to prevent one death.

I do agree that teachers, police officers and other frontline staff play a critical role and I acknowledge all their hard work throughout this challenging time. The Joint Committee on Vaccination and Immunisation (JCVI) has considered evidence on the risk of exposure and mortality by occupation.

The JCVI noted that occupational prioritisation could form a part of a second phase of the programme, which will target healthy individuals between 16 and 50 years old. As yet, the priority list for the second phase has not been established, however I know that ministers are aware of the importance of vaccinating teachers and teaching staff, the police force and other key worker groups. I look forward to learning more about future priorities.

I understand that people would like to see exact numbers of on how many people have been vaccinated in North Devon. We can extrapolate from what we have seen to say that at least 4000 people have received the vaccine just via the North Devon Leisure Centre Hub.

GPs, pharmacies and mobile vaccination units are being brought into use to enable the programme to reach all parts of North Devon. It is not always appropriate the ask the most vulnerable of our elderly into the Hospital or the North Devon Leisure Centre. The number of people and the number of ways that people are being vaccinated continues to increase each week.

There are 6500 people over the age of 80, so I do believe that we are well on the way, and in line with national projections to start on the over 70s in earnest this week.

I know that the wait is frustrating, we all want to see and hear that our family, friends, loved ones and neighbours have had the vaccine. Every day we get closer to a significant milestone and all the NHS and your local GPs are asking is that we are patient with them and that we wait for their call.

January 18th 2021

NHS frontline workers’ pay

Selaine's response:

I of course share your admiration for the frontline workers who are making immense sacrifices to help those affected by the coronavirus outbreak. Ongoing restrictions continue to present new challenges and our key workers are supporting people across the country.

I fully support the Government's announcement of a pay rise of 2.8 per cent, backdated to April 2020, in line with the recommendations of the independent pay review body for dentists and doctors. This pay rise is an important acknowledgment of the commitment and hard work of staff throughout this difficult time. Staff on the Agenda for Change (AfC) deal are already scheduled to receive pay rises, with the starting salary for a newly qualified nurse increased by more than 12 per cent by the end of the AfC time period, with all nurses receiving pay increases of at least 6.5 per cent; the Government has also introduced a nurses' bursary which provides at least £5,000 of additional support to nursing students. I understand that the NHS Pay Review Body, covering AfC staff, will return to making recommendations for next year's pay awards.

When people voted to leave the EU, they did so in the knowledge that the free movement system imposed by the EU would end. The Home Secretary has been clear that she had a particular responsibility to take back control and end free movement once and for all. I welcome the Government’s commitment to build a fairer single, global immigration system which considers people based on their skills, rather than nationality. The Coronavirus pandemic has proven beyond all doubt the need for an immigration system that will not just allow but actively welcome a range of health professionals to the United Kingdom. I welcome the fact that the Government has ensured that this will be the case. The new Health and Care Visa, creates a new fast-track visa route for eligible health and care professionals.

I am particularly pleased that the Government has taken action to ensure the immigration system does not unduly infringe the ability of the NHS to respond to the Coronavirus outbreak. It is good news that thousands of health professionals and their family dependants will have their visas extended for a year, free of all fees and charges. This comes after a previous announcement offering free visa extensions for health professionals whose visas were due to expire between 31 March 2020 and 1 October 2020. This further action taken by the Government will now extend that offer from 1 October 2020 until 31 March 2021.

The fight against coronavirus is a national effort, and my colleagues and I are committed to giving NHS staff the additional support they need throughout it. The dedication and sense of duty shown by key workers during the outbreak has been exemplary. I am grateful for their work in ensuring that society can continue to function.

January 2021

Coronavirus and IVF

Selaine's response:

I know that this has been an incredibly challenging time for those seeking IVF treatment and I am acutely aware of the time-sensitive nature of IVF.

I understand that the pandemic has been distressing for those undergoing or seeking IVF treatment. I was therefore encouraged that fertility services were among the first to reopen on the 11th May. I was also pleased to see that the Human Fertilisation and Embryology Authority (HFEA) extended the storage limit by two years so that those undergoing fertility treatment during the pandemic could have more time to continue treatment.

Clinical Commissioning Groups should commission fertility services in line with National Institute for Health and Care Excellence (NICE) guidelines which recommend three cycles of IVF. The Secretary of State for Health and Social Care has described the lack of equity as ‘absurd’ and has vowed to end postcode inequalities. Ministers have written to Clinical Commissioning Groups twice in the last eighteen months regarding these unfair variations.

The Secretary of State has said that all fertility patients should be dealt with fairly and not face any additional disadvantage as a result of services being stopped for six weeks. Nevertheless, fertility services remain the prerogative of Clinical Commissioning Groups and I trust that they will make the right decisions. I wold be happy to raise this with our local CCG should any constituents have issues themselves.

November 2020

Publicly-run Test and Trace

Selaine's response:

As part of an unprecedented response to this pandemic, my colleagues in the Department of Health and Social Care have drawn on the expertise and resources of a number of public and private sector partners to support our NHS and social care sector. The Government has been guided by the science throughout, consulting with a range of experts in each field, and has made significant progress in testing capacity and analysis.

Testing and NHS Test and Trace services are being provided through the NHS, and while it is true that providers like Serco and Sitel are working with the public sector to deliver these services, these providers will be held to the highest standards to ensure that the best service possible is delivered. Ministers are confident that 500,000 tests will be able to be processed daily by the end of October and are increasing the number of testing sites by 20 percent, which should enable people to find a test site closer to their homes, as well as increasing testing capacity.

It is a testament to the ingenuity of British businesses that they have been able to adapt existing resources in a time of great need for the country, and I am extremely grateful to all organisations that have offered their services at this time. For an undertaking of this scale, it is inevitable that there needs to be private and public sector cooperation. The public sector alone simply does not have the capacity, and I would highlight that we are carrying out more tests than practically anywhere else in Europe.

October 2020

Flu Jab

flu

Medicinal Cannabis

Selaine's response:

“There is strong scientific evidence that cannabis can harm people’s mental and physical health, and damage communities. However, recent cases have shown the need to look more closely at the use of cannabis-based medicine in treating patients with very specific conditions in exceptional circumstances. This is why the Government decided it was appropriate to review the scheduling of cannabis.

The decision to reschedule these products means that senior clinicians will be able to prescribe the medicines to patients with an exceptional clinical need. Following short term advice issued in September 2018, the current rescheduling and its appropriateness will be reviewed by November 2020.

Moreover, NHS England has published a review which is aimed at assessing the barriers to prescribing cannabis-based medicinal products where it is safe and clinically appropriate to do so. Steps have been taken to help ensure people with prescriptions for cannabis-based products for medicinal use do not have their treatment delayed or interrupted, by altering import restrictions. This is a welcome step towards improving the supply of cannabis-based medicinal products.

The National Institute for Health and Care Excellence (NICE) has also developed updated clinical guidance on prescribing cannabis-based products for medicinal use, including for the management of chronic pain. It is crucial that this country keeps in step with the latest scientific evidence, so that patients and their families have access to the most appropriate course of medical treatment. My Ministerial colleagues have also been clear that given the nature of the medicine, it should only be prescribed be specialist doctors and on a case-by-case basis. I believe these controls are necessary to develop clinical expertise and an evidence base for this treatment’s effectiveness.”

October 2020

Coronavirus Act 2020 (Review of Temporary Provisions) (Motion)

Selaine's response:

“On the subject of scrutiny, Mr Speaker voiced his concerns today in the Chamber, and I am one of those that will be unable to speak in the debate today, being 56 on the call list. No amendments were selected by Mr Speaker because of the binary nature of this legislation and you can see his statement below. I would also like constituents to be aware that many of the restrictions that have been imposed have been implemented under the Public Health (Control of Disease) Act 1984, not the Coronavirus Act 2020.

The Government has listened to the concerns of backbenchers this week with regards to increased scrutiny of emergency measures and this has been detailed in the Chamber this afternoon by Health Secretary, Matt Hancock. All measures affecting the whole of England or the whole of the United Kingdom will be subject to a vote in the House of Commons wherever possible. The Secretary of State has also detailed that only those measures in the Act which are strictly necessary will be renewed, and I know a number of constituents were concerned about some of the powers given to the Government. Some of the powers relating to the Mental Health Act 1983 and sectioning will not be renewed, for example.

Therefore at this time, to ensure clarity through this unprecedented period I, along with Sir Graham Brady, will be supporting the Government to extend the emergency coronavirus legislation this afternoon."

September 2020

Click here for Mr Speaker's statement on the matter: https://parliamentlive.tv/event/index/30624341-5d7c-4599-ad0c-3dc106647…

Coronavirus and Mental Health in Schools

Selaine's response:

“I share your concern about the impact the coronavirus outbreak will have had on children and young people's mental health. In particular, being separated from their peers for such a long period of time poses a real risk to young people's mental health, as well as hampering their social development.

As such I am very pleased that schools and colleges have reopened. Recognising that some children and staff will need support as they make the return to education, it is very welcome that action is being taken to improve mental health support, with the Wellbeing for Education Return programme launching to improve the wellbeing of pupils and staff in schools and colleges. The £8 million programme will support staff working in schools and colleges to respond to the additional pressures some children and young people may be feeling as a direct result of the pandemic, as well as to any emotional response their staff may still be experiencing from bereavement, stress, trauma or anxiety over the past months. The programme has been created with input from heath partners, mental health experts, local authorities, and schools and colleges. The Department is also inviting educational psychologists to express an interest through their local authorities in providing temporary support for children and young people returning to educational settings in September 2020.

This action comes on top of the existing commitment to invest at least £2.3 billion of extra funding a year into mental health services by 2023-24 through the NHS Long Term Plan. This funding underpins the aim for an additional 345,000 children and young people to be able to access support through NHS-funded services or school and college based mental health support teams.

I welcome the action outlined above, and I agree with you that it is vital mental health support is properly funded. As such I will be pressing ministerial colleagues to ensure these services are considered in this year's Spending Review.”

September 2020

Arthritis and Covid-19

Selaine's response:

I know that arthritis can be an incredibly painful and debilitating condition, and we do need to ensure that people with arthritis are getting the treatment they need as the NHS begins to return to normal. I would like to set out some of the steps the Government is taking to make sure that happens.

The NHS is being provided with an additional £33.9 billion by 2023/24; this is the largest, longest funding settlement in the history of the NHS. This landmark investment to help secure the long term future of our NHS is extremely welcome, and I hope you agree it demonstrates the Government’s commitment to properly funding our NHS and public services: health is the Government's top priority.

Alongside this, the NHS was asked to undertake a clinical review of standards relating to waiting times. This must be clinically led to enable best, and safest, delivery of care for patients. I understand that NHS England has now prepared proposals, covering waiting times across the service, including elective procedures, mental health, cancer, and A&E. I understand that the recommendations following this review have been deferred as part of the NHS response to the Covid-19 pandemic, which is understandable. I will be sure to study these in due course.

I know that, while it has been important to postpone some NHS activities to protect individuals and enable resources to be used as efficiently as possible, my colleagues in the Department of Health and Social Care, as well as NHS Staff, are determined to restart elective procedures as soon as it is safe to do so. The exact pace of this restoration is determined by local circumstances, according to local need and demand, and according to the number of coronavirus cases being dealt with by the hospital. I have been in regular contact with the Northern Devon Healthcare Trust about this and other issues.

August 2020

Fix Dementia Care

Selaine's response:

I believe we must all receive dignified care in old age. With an ageing population, this is one of the biggest challenges our country faces. I support the Government’s commitment to making sure that the most vulnerable in society gain the support they need. Whilst it is important to note that more than 4 of every 5 people in care receive care from good and outstanding organisations, it is clear that more needs to be done to tackle this serious challenge – crucially by securing a long term funding solution. I am delighted that the Prime Minister has spoken of his determination to tackle this, stating in his first speech as Prime Minister that “we will fix the crisis in social care once and for all with a clear plan we have prepared, to give every older person the dignity and security they deserve”.

The Government is currently producing a Social Care Green Paper, which will consider a range of proposals to improve social care, as well as funding options to ensure our social care system is able to meet the needs of our ageing society and is placed on a sustainable footing for the long term. Since 2015 local authorities have had greater flexibility over the use of the council tax social care precept, so they can choose to raise extra money, as well as retain savings from the New Homes Bonus, totalling £240 million.

In the Spending Round in September, an extra £1.5 billion was made available to councils for adult social care services. This funding should be viewed as a significant down payment as we move towards a long term funding solution.

Money alone will not fix the problem and reform is needed to encourage high standards across the whole country. It is vital for us to consider ways of better joining up health and care services, and I am encouraged by the use of the Better Care Fund to assist local government and the NHS with the implementation of integrated health and care services.

July 2020

Shielding and Blood Cancer

Selaine's response:

It is crucial that those at most risk in our society are protected in order to safeguard their own health and prevent the NHS from being overwhelmed. I am also greatly saddened to hear of financial difficulties at this time. No one following Government instruction, should be penalised for their efforts.

I do not wish to see anyone put at any risk as the lockdown is eased. I have been reassured by colleagues in Government that they are following the best medical advice for getting people back to work. I strongly encourage employers who employ people with blood cancers to utilise the Coronavirus Job Retention Scheme (CJRS) for as long as possible until the safety of such employees can be guaranteed. As I am sure you are aware, the CJRS has been extended until October and it should be used where necessary. I would also like to take this opportunity to remind employers that they have a legal responsibility to ensure their employees and other people on the premises are protected.

July 2020

Carer’s Week

Selaine's response:

As a member of the Department for Work and Pensions Select Committee, I am particularly conscious of the invaluable contribution made by carers, and how our society could not function without their work. I recognise the vital contribution made by the multitude of different carers: residential, domiciliary, paid, unpaid. Many carers spend a significant proportion of their life providing support to family members, friends and neighbours. I agree completely that carers must receive the right support to help them carry out their caring roles. A tenth of adults in the UK provide unpaid care for a friend or family member, and these people should be supported in the invaluable work they do.

That is why a cross-Government National Carers Strategy was introduced to look at what more can be done to support existing and future carers. After a lengthy consultation with carers, the Government announced a two-year programme of support. This includes support for young carers, effective action to help carers balancing their caring and employment responsibilities, and ensuring that health and social care services are responsive to their needs.

The Government is continuing to support the implementation of improved rights for carers, enshrined in the Care Act 2014. I welcome the fact that benefits to support vulnerable and disabled people, including Carer’s Allowance, are exempt from the freeze on working-age benefits. I am also glad to note that the Department of Health and Social Care will continue to lead a programme of targeted work to support carers.

This year, Carers' Week has fallen during the coronavirus pandemic, a time which has highlighted the invaluable work carried out by carers, both paid and unpaid. I am pleased the Government has fulfilled its commitment to offer tests to all adult care homes for over-65s for their residents and staff. At the beginning of June, a new Social Care Sector Covid-19 Support Taskforce, chaired by David Pearson, was also announced. It will work to tackle and control the transmission of the virus in social care. I will continue to work with the Government throughout this difficult time in particular to ensure that carers are able to access the support that they need.

June 2020

NHS Testing (Opposition Day debate - 24/06/20)

Selaine's response:

I am aware that a number of people have raised the issue of the Opposition Day Motion yesterday, which proposed a weekly testing programme for NHS and social care staff. To be clear, I am not against regular testing of NHS staff. However, the Opposition Day Motion is not what the Chief Medical Officer has recommended, and the Government is following his advice.

Professor Chris Whitty has recommended a fortnightly testing programme which can be more frequent if the local or national epidemiological conditions demand, e.g. if there is a local outbreak or if national levels of transmission rise. NHS England and NHS Improvement have written to NHS Trusts across the country to ensure this is implemented. Testing is continuing to be prioritised for NHS staff who have symptoms to ensure that they can continue to work if they do not have Covid-19.

I was present for this debate and I spoke about the hard work of all those at North Devon District Hospital, in our social care sector, and at Public Health Devon. I listened carefully to all the contributions made during the debate and I was not entirely sure that the Shadow Secretary of State for Health was clear about the content of his motion. The motion asked for a weekly testing programme, whilst in his speech he only asked for weekly testing ‘if necessary’. Weekly testing ‘if necessary’ is completely consistent with the Government’s position.

It is also worth highlighting the fact that the Government’s amendment to the Opposition Day Motion passed without a vote, meaning the opposition did not oppose it.

June 2020

Abortion (Northern Ireland) (No. 2) Regulations 2020

Selaine's response:

I voted in favour of the above legislation on 17th June, and I want to explain why I made that decision to those constituents who contacted me.

This vote was about standardising the legislation on abortion across the whole of the United Kingdom. I agree that the Northern Ireland Assembly should be allowed to have its say, but the origin of the duty for the UK Government to legislate on this issue stems from the Assembly not having sat for several years. Legislation was therefore passed in July of last year which aimed to standardise abortion law but which stated that if the Assembly were restored by a set date, the law would not change. The Assembly failed to come to an agreement which led to its restoration, and so the Government are under a legal obligation to act.

In fulfilling its obligation, the Government has sought to mirror provisions under the Abortion Act 1967, and a consultation was held on the proposed framework. Whilst the Northern Ireland Assembly did vote against this change, it did so during a plenary session and so the vote had no bearing on the legislation. The Government’s legal duty to legislate therefore remains. However, the Assembly is free to amend the regulations so long as those amendments are compliant with the 1979 CEDAW Treaty.

June 2020

Abortion (Cleft Lip, Cleft Palate, and Clubfoot) Bill

Selaine's response:

The approach to abortion in Great Britain is set out in the Abortion Act 1967, which states that two doctors must certify that, in their opinion, a request for an abortion meets at least one and the same ground laid out in the Act. These grounds include “risk to the life of the pregnant woman”, and “substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped”.

There is guidance for doctors on how to comply with the Act has been issued, which stipulates that registered medical practitioners should be able to show how they have considered the particular facts and circumstances of a case when forming their opinion. Full details can be found online at www.gov.uk/government/publications/guidance-for-doctors-on-compliance-with-the-abortion-act. Not every pregnancy goes to plan and foetal abnormalities of varying degree of severity occur. Women need support and information to reach an informed decision about how to proceed. Health professionals must adopt a supportive and non-judgemental approach regardless of whether the decision is to terminate or continue the pregnancy.

Before making a decision about my position on this Bill, I am waiting to see the full text of the proposed legislation. I will then consider whether it is something I can support.

June 2020

Prison Safety and Coronavirus (plus Julian Assange)

Selaine's response:

I welcome the collaborative approach taken by Public Health England (PHE) and Her Majesty's Prison and Probation Service (HMPPS). This is essential to ensure the implementation of measures to keep prisoners and prison staff safe, protect the NHS and enable the continued operation of the prison estate.

Early data emerging indicates that explosive outbreaks of Coronavirus are not being seen across the prison estate and PHE modelling suggests that the measures introduced are demonstrating that jails are successfully limiting deaths and the transmission of the virus within the estate. I understand that this has been driven by a combination of increased social distancing, reduced transfers of prisoners between prisons and acting within individual prisons to reduce infection. This has reduced the Reproduction Number (or R) to 1 or below. However, until a vaccine or effective treatment has been found, the risk of large outbreaks remains. Ministers will of course continue to review and closely monitor the prison estate.

I understand many constituents have concerns regarding court cases as the outbreak continues. Courts provide a vital public service and justice must be delivered wherever possible. I welcome the fact that Her Majesty's Courts and Tribunals Service have increased the capacity for telephone and video hearings to allow for remote hearings where appropriate. The decision to hold a hearing by telephone or video is for the judge, panel or magistrate, taking into account the needs of the parties, including their ability to access and use the right technology.

Some constituents have contacted me about this topic and how it relates to the safety of Julian Assange. It would not be appropriate for me to comment on an individual case, but the above measures are in place to ensure the safety of all in the UK’s prisons.

May 2020

Trade Bill NHS Campaign

Selaine's response:

The Trade Bill is an important piece of legislation which has a number of functions.

First, the UK has been working to reach continuity agreements with countries who we currently trade with through EU trade deals. The Trade Bill will enable these continuity agreements to be embedded into UK law so that the agreements can be fully implemented. In addition, in leaving the EU, the UK will be acceding to the World Trade Organisation’s Agreement on Government Procurement (GPA) in its own right. The Bill’s provisions will make sure the UK can implement procurement obligations under the Agreement, ensuring continued access to £1.3 trillion per year of global procurement opportunities for UK businesses. As an independent member of the GPA, the UK will be free to decide what procurement is covered under the agreement. Ministers have made clear that the UK’s GPA coverage does not and will not apply to the procurement of UK health services.

The Bill will also facilitate the creation of a new Trade Remedies Authority (TRA), to deliver a new UK trade remedies framework, which among other things will include protections for UK businesses from unfair trade practices or unforeseen import surges.

It is important to make clear that the Trade Bill is a continuity Bill, and its functions are largely distinct from the Government’s future trade agreements programme. Indeed, the Bill cannot be used to implement new free trade agreements with countries such as the US. The Bill simply enables the 40 free trade agreements that the EU had signed with third countries before the UK exited to be transitioned. Separate work on the future trade agreements programme is of course also pressing ahead, with negotiations already underway with the US, and soon to begin with Japan.

With specific regard to a UK-US free trade agreement (FTA), I believe that as our economy recovers from the challenges posed by COVID-19, we need to be negotiating enhanced trade ties rather than putting up barriers. I am reassured by my Ministerial colleagues’ commitment not to compromise the UK’s high animal welfare, environmental, food safety and food import standards in any future FTA, including one with the US. Ministers do not want to compromise the UK’s domestic welfare production standards either. I want to be clear that the NHS will also be protected in any future trade agreement, including one with the US. The price the NHS pays for drugs will not be on the table, and nor will the services the NHS provides.

It is important to make the distinction between the Trade Bill and the Government’s future trade agreements programme. The process of negotiating future trade deals is not primarily a matter for the Trade Bill. However, I want to reassure you that there will be opportunities for both the public and Parliament to consider, contribute to and scrutinise negotiations for future free trade agreements. Public consultations will run ahead of all negotiations, and a number have already taken place, including for negotiations with the US, Japan, Australia and New Zealand. Ministers have also committed to provide Parliamentarians, UK citizens and businesses with access to the information they need on trade negotiations.

May 2020

Children’s Services

Selaine's response:

I agree that our children’s services need proper financial support. I am pleased that in the 2019 Spending Review the then Chancellor made an additional £1 billion available to help local authorities meet rising demand for both children and adult social care. I also welcome that £84 million has been allocated over a period of five years to assist up to 20 local authorities to enhance their social care services, ensuring that they are able to engage more effectively with those who need support the most.

That said, I recognise that there needs to be a longer-term solution to ensure sustainable funding for children’s social services, and to ensure that funding is fairly distributed across the country. I welcome the conclusion of the review into the support available for children in need, which looked at what makes a difference to the educational outcomes of children in need and what works in practice to improve those outcomes. I am assured that the findings of the review will be acted on to inform and improve policy.

I hope this has provided a measure of reassurance. I will continue to closely monitor funding levels for children’s social services.

May 2020

Northern Ireland Abortion

Selaine's response:

I appreciate the strength of feeling about the issue of abortion and I welcome the balanced and sensitive approach the Government has taken. As the Northern Ireland Executive was not restored by 21 October 2019, it remained the UK Government’s legal obligation under section 9 of the Northern Ireland (Executive Formation etc) Act 2019 to bring forward the framework to provide lawful access to abortion services in Northern Ireland by 31 March 2020.

Following a consultation, the Government has now brought forward the new framework. I believe it delivers abortion reform for Northern Ireland consistent with the United Nations Committee on the Elimination of Discrimination Against Women Report recommendations.

The new framework does provide clarity and certainty for medical professionals and also ensures the health and safety of women and girls in Northern Ireland. I have attended a briefing from the Northern Ireland Minister who has explained why this legislation is worded differently to the legislation in the rest of the UK, which is now over 50 years old. The Minister has also met with the Northern Ireland Health Minister as the implementation and commissioning of abortion services will be a matter for the NI Health and Social Care Board to take forward. Further information about the reforms can be found on the Northern Ireland Office website.

May 2020

Welfare of Care Workers

Selaine's response:

I want to first express my gratitude to care workers for the incredible way in which they are doing a very difficult job. We all owe keyworkers a debt of gratitude and I agree that we must recognise their efforts appropriately.

Once we have beaten Coronavirus, we will all have to reassess the way we do things and ensure that the social care sector is put on a stable footing for the foreseeable future. The Government is committed to cross-party talks on the future of social care, and these talks will be wide-ranging and include issues such as pay.

In the meantime, I have been working to ensure that care homes have the Personal Protective Equipment (PPE) they need. The distribution of PPE is a challenge of huge proportions and any care home having difficulties can contact me and I will do my best to resolve them. The Government is doing everything it can and I am in constant contact with Ministers to ensure that PPE gets where it needs to be. Devon has sufficient supplies of PPE and I am working to make sure it stays that way. There is a new national PPE helpline available to those who need PPE here: 0191 283 6543 or email supplydisruptionservice@nhsbsa.nhs.uk . Anyone having difficulties can also use this facility set up by a local company, Applegate: https://www.applegate.co.uk/covid19

If you know of somewhere still struggling to get PPE, please do email me and I will escalate it and ensure that this is delivered as soon as possible. The Government is doing everything it can to get supplies to the right places but it is an enormous challenge.

April 2020

Young People’s Mental Health

Selaine's response:

It is incredibly important to protect and support the health of children and young people in our society; approximately 10 per cent of 5 to 16 year olds have a clinically diagnosable mental health problem.

Between 2015 and 2020, an additional £1.4 billion has been invested to transform children and young people’s mental health. This aims to help an additional 70,000 children and young people to access NHS specialist services a year by 2020/21. Schools and colleges will also be incentivised to train designated leaders for their pupils’ mental health, and introduce new mental health teams, both of which will ease pressure on NHS mental health services.

In addition, the NHS is on track to deliver new waiting time standards for eating disorder services by 2020/21. Four fifths of children and young people with an eating disorder now receive treatment within one week in urgent cases and four weeks in non-urgent cases. Extra investment will enable maintained delivery of the 95 per cent standard beyond 2020/21.

I know in North Devon, the waiting lists for mental health support are often too long, and I have been working with the Department of Health and our local NHS to try and improve the situation. I will put the event on 30th March in my diary and make every effort to attend.

March 2020

NHS Waiting Times

Selaine's response:

The NHS was asked to undertake a clinical review of standards relating to waiting times. I think it is important that any decision to alter the targets for waiting times in A&E must be NHS-led. Accordingly, the NHS has undertaken a clinical review of standards relating to waiting times, and has now prepared proposals covering waiting times across the whole of the health service. This includes waiting times for joint replacement waiting times, something many constituents have contacted me about.

The Government will now carefully consider the proposals before taking any next steps, and in the meantime will continue to hold the NHS to account on its existing standards.

In the meantime, the Government is investing to reduce existing waiting times which I know are too long in many different areas of the NHS. This investment includes an extra 50,000 nurses and 6,000 GPs, which should go a long way to improving the situation. As far as North Devon is concerned, we have always had recruitment issues due to our relative isolation, and I am working with our NHS Trust to find solutions.

March 2020

Protests Outside Abortion Clinics

Selaine's response:

This country has a proud history of allowing free speech but the right to peaceful protest does not extend to harassment or threatening behaviour. The law already provides protection against harassment and intimidation, and the police have a range of powers to manage protests. Like all members of the public, protesters are subject to the law and suspected criminal offences must be robustly investigated and dealt with by the police.

Following concerns about the tactics of protestors outside some abortion clinics, a review was instigated by Government in 2018. This review revealed that anti-abortion demonstrations take place outside a minority of facilities. In 2017 for example, 363 hospitals and clinics in England and Wales carried out abortions. Of those, 36 hospitals and clinics experienced anti-abortion demonstrations. With this in mind, the Government decided that introducing national buffer zones would not be an appropriate response given the experiences of the majority of hospitals and clinics.

That said, while I do not want to see peaceful protest curbed, it is completely unacceptable that anyone should feel harassed or intimidated simply for exercising their legal right to healthcare advice and treatment. The decision to have an abortion is already an incredibly personal one, without women being further pressured by aggressive protesters.

March 2020

NHS & Trade Deals

Selaine's response:

Under this Government, the NHS will always remain free at the point of use and in public ownership. I would not support anything which meant the privatisation of the NHS or additional costs on healthcare for those who need it.

Free trade is a driver of economic growth which can raise incomes, create jobs, and lift people out of poverty, which is why I am glad that outside of the EU the UK will be able to strike new trade agreements with countries across the globe. That said, more trade should not come at the expense of the high levels of quality and protection enjoyed in our country.

The UK will continue to ensure that the NHS is protected in all trade agreements it is party to. Outside of the EU, rigorous protections for our NHS will be maintained and included in any future trade agreement which the UK negotiates.

February 2020

Abortion in Northern Ireland

Selaine's response:

I am pleased that the Government recognises the sensitivity of this issue and the range of views expressed by people on all sides of the debate. It is a highly sensitive issue, regardless of where your view lies and one where it is important that the matter is considered with due care and sensitivity.

The Government is working towards the laying of regulations for a new legal framework for the provision of abortion services in Northern Ireland, as required by the 2019 Act. The new framework will be in force by 31 March 2020.

To help inform the shape of the legislation that is introduced, a consultation was held. This has now closed, and the Government is due to publish its response shortly. I very much welcome the Government’s commitment to ensure that the health and safety of women and girls, and clarity and certainty for the medical profession, are at the forefront of their considerations.

February 2020

Eye Care

Selaine’s response:

To ensure early diagnosis of eye disease, it is important that people are encouraged to get their eyes tested on a regular basis. Clinical advice states that most people should get their eyes tested every two years. Free NHS eye tests are available for those diagnosed with diabetes or glaucoma and those aged 60 or over. This helps to encourage people at particular risk of developing eye disease to have their condition checked regularly. The latest figures show around a 10% increase in the number of eye tests since 2010 so some progress is being made.

I also welcome the broad range of support available for those diagnosed with visual impairments. Many hospitals have Eye Clinic Liaison Officers, or similar early intervention support staff, who provide the practical support which patients need following their diagnosis, including advice on how to deal with their sight loss and maintain their independence.

I will liaise with the Health Secretary about this issue to make sure that North Devon is able to deliver the service that people with sight problems deserve and expect.

January 2020

Immigration Health Surcharge

Selaine’s response:

I believe that overseas visitors should be able to access our NHS as long as they make a fair contribution, just as the British taxpayer does. The NHS is a national - not an international - health service and I commend the Government’s determination to stamp out misuse of the system to ensure it remains free at the point of need in this country.

After a review of the evidence, the annual surcharge will now cost £400 per annum, with a discounted rate of £300pa for students (and their dependants) and Youth Mobility Scheme applicants. The proposed amount is still below full average cost recovery level, which is calculated as £470. The UK must protect its reputation as a great place to live, work and study, and increasing the IHS still offers access to far more comprehensive services at a lower cost than some of our main competitor countries.

The IHS applies to those living in the UK temporarily. Those with indefinite leave to remain and vulnerable groups, including asylum seekers and refugees, are exempt from the charge. It is only right that people who come to the UK for more than six months should contribute to the running of the NHS.

People for whom the IHS applies work in a broad range of jobs fulfilling important jobs in the public and private sectors, jobs that keep the country running. I believe that the IHS should be applied equally, to all non-EEA residents who are in the country temporarily. All residents will benefit from the £220 million funding for the NHS that this fund will provide. The answer is not therefore to exempt nurses from the charge, but to increase their pay; and this is happening.

This charge was brought in to ensure that temporary users of the NHS from outside the EEA are making a fair contribution to the functioning of our national asset, regardless of their employment status. Although some temporary migrants will be paying tax and National Insurance contributions, they will not have made the same financial contribution to the NHS which most UK nationals and permanent residents have made, or will make, over the course of their working lives. It is therefore fair to require them to make an up-front and proportionate contribution to the NHS.

January 2020