Rachael Maskell
MP for York Central · Labour (Co-op) · United Kingdom
“I welcome today’s statement and I welcome the Secretary of State to her place. York hospital was heralded as a cheap build, but we are paying a heavy price today. We know that heat in that hospital will have an impact on clinical outcomes as well as on staffing.”
“The conflict is moving beyond traditional warfare; we are now seeing extensive drone use, mercenaries being brought from Colombia, and the exchange of money too. We also know that Russia has its own interests in weapons and gold. We must look at the minimal interest in Sudan and the developments in Port Sudan at this time.”
“When we think about the fact that 33.7 million of the Sudanese population are in need of humanitarian assistance, 13 million have been displaced, 19.5 million are at levels of food insecurity and need urgent attention, and there are 8 million children who are not in the safety of school every day, getting their education, which will fuel…”
“Will the Minister tell us what progress has been made in that area, how that money has been spent and its impact to date? As we see increasing brutalisation in war, we have to focus even more on how we use international law to hold actors to account, and on the pace of that process, because it takes forever and a day to bring people to ac…”
“In the assault on El Fasher in particular, we saw the systematic raping of women, the burning of people and places, and the escalation in the next chapter of the civil war that has raged since April 2023.”
“It is a pleasure to see you in the Chair, Dr Allin-Khan. I congratulate my hon. Friend the Member for Gillingham and Rainham (Naushabah Khan) on securing such an important debate.”
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“Its outstanding public health team are engaging in driving down smoking levels, with a new centre of excellence to co-ordinate population-level interventions, and investing in programmes of activity targeted at those who most need them. With stop smoking support and lung health check screening, work is under way to screen and divert. Like many colleagues across the House, I am asking the Government to publish the tobacco control plan; to publish a strategy to tackle the rise in vaping, particularly among our young people; to give local authorities the means and tools to safeguard a generation; and to introduce an annual public health windfall tax on these companies in the Budget next week. It is all about profit for them, and that profit should be used for public health.”
“Mr Khan recommends spending £125 million each year to enable the UK to hit its target, which will be missed without the investment that we absolutely need to see; increasing the age at which people can buy tobacco products; and ensuring that every public health intervention is made. I take the point made by my hon. Friend the Member for Blaydon (Liz Twist) about the illicit trade in tobacco, which we also need to crack down on. There are 15 strong recommendations in Mr Khan’s review, and I want to see the Government taking action, responding to that report and publishing their plan. Unlike the Minister, Humber and North Yorkshire ICB is not sitting back.”
“The UK Government aim to reduce the level of smoking to just 5% by 2030, but there is no tobacco control plan. In York, the local authority’s public health grant has been cut by 40% over the term of this Government, yet we do not know what is to come in 22 days’ time, when the public health grant runs out. On top of that, we have not seen the health disparities White Paper. We understand that it has been scrapped, so what on earth is going on? Tobacco companies make an annual profit of £900 million, yet only £2.2 million is spent on prevention. We need funding, we need professionals, we need education and we urgently need to move people to a space where their lungs and bodies can start to recover. Despite Javed Khan’s independent review of tobacco control, published nearly a year ago, the Minister has been silent.”
“Every minute, another victim is admitted to hospital, with 506,100 hospital admissions attributed to smoking. Last year, the cost to the public finances was £2.6 billion. These wretched companies are fleecing their victims of their hard-earned living, with an average smoker spending £2,500 a year. Some 70% of smokers want to quit, so we need to ensure they have the means to achieve that. Let us remember that these multimillion-pound companies prey on the poorest, with 31% of households with somebody who smokes falling below the poverty line—if ever there was exploitation, this is it. Many new communities of people coming into the UK from challenging places across the world also have a high prevalence of smoking, presenting a new challenge for public health teams, and it is important to get on top of that too.”
“Thirty years ago, I did my dissertation on this very issue for my degree, and my conclusions were simple: money buys silence. Labour must never touch dirty money, and nor will it. That money kills, whether directly or indirectly. Instead, we must invest in health. According to Action on Smoking and Health, 9.2% of the community in my city of York smoke. While that is lower than the national average of 13%, it costs our city £46.9 million. In my ICB area of Humber and North Yorkshire, 2,500 people, sadly, die each year. The healthcare costs are £8.2 million, adding to economic costs of £19.9 million due to lost earnings and £10.9 million due to smoking-related unemployment. What a lot of money. Let us reflect: 6.6 million people smoke across the UK. There are 150 new cancer cases a day, and 54,300 a year.”
“Tobacco is still the biggest killer, luring people into horrible diseases such as cancers—including lung cancer—stroke and heart disease, as well as dementia, which, as we have heard, is the focus of national No Smoking Day. Given that that costs the NHS £2.2 billion a year and social care £1.3 billion, I have to ask why the Government are content not to set out an ambitious plan that is ruthless with the tobacco giants yet compassionate with their victims, taking every step to draw people out of their addictions and recover their health. Why are Government paralysed when the evidence is screaming at them? This is the difference between the Tory party and the Labour party: Labour knows that health inequality is unjust. We want to take people to a safer, healthier place. That will be our priority.”
“We will never forget Margaret Thatcher taking $1 million from Philip Morris as a consultant. It is children that these despicable companies are targeting. I have been following the vaping debate, and child vaping is the latest fad. British American Tobacco and others are at it again, addicting children to their products, using different products at different times, with different flavours and colours and cheap devices. They are once again addicting a generation. Among young people, vaping is now seen as cool, as smoking once was, but the harms of these stimulants are unknown, and a lifetime of expense lies ahead, costing users physically, mentally and financially. These wolves in sheep’s clothing need calling out, and today’s debate is a good place to start.”
“I am angry because they are deliberately causing harm and taking advantage of marketeering, peer pressure and a pack of lies around a pack of cigarettes to make their victims feel good about succumbing to the powers of their addictive means. Once people are hooked, companies draw their prey into a lifetime of handing over precious savings to deposit in their bank accounts. Those companies are using their resources wisely. British American Tobacco has bankrolled the Institute of Economic Affairs, a Tory think-tank that wants to privatise the NHS. One of its trustees has reported funding a former Health Secretary with £32,000 between 2010 and 2018—the less said about him, the better. With 30 Tory MPs benefiting in all, what could their motivation be? What could BAT’s motivation be?”
“It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing today’s debate. I was really sorry to learn about the circumstances that have brought him here; they really do account for why he is such a passionate advocate for non-smoking. For decades, tobacco companies have used every manipulative means possible to recruit the next generation of smokers. For them, it is about big profits—£900 million at last count. With around 75,000 victims of their exploits dying every year, those companies have to market their products to new generations to replace those who die.”
“I thank my hon. Friend for making that really important intervention. We must help communities that are finding it hard to quit, including new communities. We really welcome the large number of asylum seekers who have come to York, but we know that there is a higher prevalence of smoking in that community. We must ensure that proper interventions are targeted at BAME communities too. The figures speak for themselves, and the Minister cannot afford to sit back any longer. Labour will not. We want to save lives, and we want to save the health of our NHS too.”
“York’s XR Stories has opened up new and unique opportunities in the digital creative space and will accelerate the UK’s global digital media offer, which, as the Secretary of State will know, will play a significant role in the future creative economy. So what steps is she taking to invest in the digital creative cluster? Will she meet me to talk about York’s opportunity to accelerate the UK’s place in a global space?”
“The state of our railways is deeply concerning, with rising passenger costs set against poor service delivery on the TransPennine Express. In York, our digital and advanced rail cluster is being held back by the delayed Government announcement about the Great British Railways headquarters. Can we have a statement to set out how the Government are going to fix our broken rail network and unlock GBR?”
“NHS dentists form a really important part of the primary care workforce. However, in places such as York, we have a complete desert, where my constituents just cannot receive NHS dentistry. What is the Secretary of State going to do for my constituents, so that their oral health needs are addressed?”
“York is England’s only human rights city and we have welcomed asylum seekers. It is a privilege to provide a safe haven for them, but this legislation is a real affront to those values. Can the Home Secretary publish the legal advice on how her legislation is compatible not only with international law but with the European convention on human rights?”
“York has already framed its future economy, whether through Buy Yorkshire, with 4,000 more jobs for our city and region, through digital and advanced rail, which is currently providing 5,500 jobs and has the ability to grow, or through the emerging digital creative sector, which is an exciting innovation across York. However, the Government have been slow in giving that support and getting the money out of the door. We are frustrated because we want to press ahead, so how will the Secretary of State deliver for our city?”
“The implementation plan will not work if the workforce is not in place. As we know, to be able to achieve an EHCP, the workforce needs to be in place and it takes many years to train. Those professionals are not there currently, so how will the Minister ensure that the workforce is in place not just in the health pathway but in the school? The experience I am seeing in a particular multi-academy trust in York is that it is laying off the staff who would take responsibility for those children, as opposed to providing the therapeutic environment that children so need.”
“With the Office for National Statistics highlighting a 16.8% increase in food prices in the year to January, the Government have built their food poverty infrastructure on dependency on voluntary donations and retail waste donations. However, due to demand, food banks in York are running out and are eking out their food supplies. For my part, I am holding a city-wide donation day so that those who can give do so and those who are in need receive. We call it York Together, as we support one another. What are the Government doing to ensure that no one goes without?”
“T5. Child hunger has a significant impact on a child’s ability to concentrate, as well as on their behaviour and attainment. Labour has set out that it will provide breakfasts for children in school, and where Labour is in power it is providing lunches as well. What discussions is the Secretary of State having with the Education Secretary to ensure that children do not go hungry?”
“Investment in public health matters. In my constituency, we have a 10-year differential in life expectancy. However, the White Paper on health disparities has been scrapped, we do not have the tobacco control plan, there is no follow-on alcohol strategy and the public health workforce has been decimated. Given that the public health grant runs out in 36 days, can we have an urgent statement on what on earth this Government are doing about public health?”
“I congratulate my hon. Friend on securing the debate. Does she acknowledge that this has already happened in dentistry, with families taking out dental plans because they cannot access an NHS dentist?”
“I am listening carefully to the point that the hon. Gentleman is making. The knowledge and skills framework was introduced in 2004 as part of the “Agenda for Change” package, but the Government have not invested in the opportunity that the framework provides to do the very thing that he suggests—to enable people to climb the skills escalator and move through their profession into higher roles. Does he agree that we need to make that investment so that we are using the skills that are already in the NHS?”
“Michael Marmot has set out exactly what needs to be done, and he has looked not only at healthcare but at the broader issues of poverty and what really drives the inequality across our society, as has been said. We need to put the investments in the right place, which is what this Government are failing at. It is what the next Government will do when Labour comes to power. If only the Health Secretary, and indeed the Minister, could look at the evidence, understand the system, and put their feet in the shoes of people who work in the NHS, we would make such a difference. If nothing else, let us in York pilot some of these ideas. We are really keen to do so, because we know it will make a difference.”
“It is not about managing the system; it is about feeling the injustice and the inequality, and putting in the solutions that are needed. In closing, I want to touch on health inequalities. The health disparities White Paper has been scrapped, the 10-year cancer plan has been scrapped, the 10-year mental health strategy has been scrapped, and the Khan tobacco control plan has been scrapped. There is no plan for management around alcohol, and we have not seen a strategy on gambling. Public health has become the poor relative of the NHS, when prevention should be driving the NHS. Of course, the NHS public health workforce have been decimated under this Government, so how are we meant to shift the dial for the future?”
“There is so much more that Nimbuscare could do if only it had the money—taking all that expenditure out of the NHS and ensuring provision in the community and primary care, as opposed to secondary care. It works, it is more effective and it is better for patients—and of course there are other specialties, such as elderly care or women’s health, and respiratory clinics and others who need support. We can then start to see prevention and interventions being made, such as health checks, to ensure that people get the support they need. We can introduce social prescribing, to ensure that people have healthier and happier lives. There is so much that can be done, if only the Government had the kind of vision that Nye Bevan had when he set up the NHS.”
“The Government have got it wrong again because they do not understand the system. They just listen to who is shouting loudest and throw out money, as opposed to hearing what can make a real difference. I want to talk briefly about primary care, because Nimbuscare in York have achieved so much. It set up a paediatric assessment unit to take the pressure off admissions to the emergency department. The system is run by GPs and has saved 1,300 children from going into acute A&E. In fact, only 3% of referrals from the unit had to go on to A&E, and only one child was admitted. This is simply about understanding patient flows, who has the expertise, who can make the diagnosis, and who can provide the solutions and treatments, and about putting money in the smart place: in the NHS.”
“Instead of paying more for private, we should pay the NHS staff and get them back on to the wards, holding their heads up high again, confident that they are working for a service in which they are valued. One more thing on where the funding goes: if discharge funding goes to the acute sector, it can build more institutions, which is what the Government have decided to do. What it cannot do is push people out of the system, but if we gave that funding to social care, it could bring people out of the system. Therefore, joining up these new transitional units with hospitals has been a waste of funding. We should have invested in social care, so that those people can get home, get the care they need there, and get mobile and moving again, which would improve their quality of life.”
“That would also help improve patient flows across the NHS. I visited the amazing NHS staff in the emergency department in York just a few weeks ago. They want to do the job that they were trained to do, but they are having to manage a decline in staff as people go to agencies for better pay. They have to work alongside agency staff who are paid more than them, as are the CIPHER staff who come in and sit with patients—a move enforced by the NHS. That hardly boosts morale. And then we have Vocare—the least said about it, the better, as it sucks money out and fails to provide the necessary service. We cannot have patchwork privatisation. It does not work and it increases risks. We need to see the end of this fragmentation.”
“But I say to them, hold on, a Labour Government are on their way. This talk of using the private sector must stop. If we are serious about rebuilding capacity in the NHS, clearing backlogs and addressing the challenges—the Government, of course, are being very sluggish because they are not fixing the challenges as they come—we need to move staff back into the NHS as well as keep staff in it. The NHS has more than 133,000 vacancies right now. We need to get people back into the system and to pay them and respect them. If they are being paid more in the private sector, of course they are going to stay there, but we need to stop reinforcing the system of privatisation by moving work to that sector. We need to get those staff back into the NHS, working in a service of which they can be proud.”
“Nurses, physios, doctors, pharmacists and so many others should not be in the position of having to beg for a pay rise. They should be valued—and, of course, if we value something, we pay for it. Decent pay retains and attracts staff, which results in productivity soaring. When Labour came to power, the NHS had a pay rise after the Tories had decimated it. I worked in the NHS, so I know that people were on their knees, working double shifts and often working into the night when they should have gone home hours earlier. The same is true today, but if we invest in staff, productivity will rise and the outcomes will be so much better. People are burned out and breaking because they are unable to be the professionals that they trained to be. They cannot practice what is written into their DNA because the pressures are so great.”
“Many people are seeing their dentists every other year, and virtually none of my constituents has seen an NHS dentist. I know that to be true, because nobody is able to see an NHS dentist unless they are a long-term patient. People are often waiting five or six years to see a dentist. The oral health of my constituents has been failed because the Government have not put the right measures in place. We are losing the workforce and dentistry is being privatised before our eyes. Intervention is needed now, and it will make a difference. Of course, we are talking about not just dentists and health visitors but the NHS as a whole, and we know that the story is the same in maternity services, emergency departments, urology departments and all specialties.”
“10 priority—and did so over five years, scraping by in achieving it. However, the Government did not invest in those individuals, so come August 2022 there were just 7,013 health visitors, 1,000 fewer than in 2010. That means that we just do not have the health visitors—key public health professionals —to keep patients safe. Health visitors are working under considerable stress and strain, as well as not making the interventions that are desperately needed. This can and must be addressed. While we have promised to do so, the Government have been silent on health visitors. We have heard much about dentistry challenges in this debate. The data shows that 26 million appointments have been lost since 2018-19. In York, 126,130 appointments—62% of them—have been lost.”
“When the NHS cannot retain staff, it pays more to agencies. Last year, the NHS paid £3 billion for agency staff. If that money had gone into the pockets of NHS staff, the NHS would have retained them. Staff are now leaving at the highest rate ever: 42,411 staff left in the second quarter of last year. We understand that we cannot keep taking out of the NHS; when the staff are not there, we cannot train the next generation. Of course, we then pay more and more for agency staff. Turning to health visitors, I commend the Government for putting forward the health visitor implementation plan. In 2010, there were 8,092 health visitors, which was 4,200 short of the number required for safe working levels. The Government made it their objective to recruit those staff—it was a No.”
“As I said at the Health and Social Care Committee, the problem is that we still do not have a system that can integrate. Integrated care systems are collaborating at best, not integrating. They have separate funding, separate staffing and separate policies—we kid ourselves if we think that is integration. However, we need integration because we need to bring the whole system together. We also need to look at the workforce across the board. The Chancellor, when he was Chair of the Health and Social Care Committee, set out his determination to stop workforce depletion after 12 years of this Government. He recognised how it was impeding the NHS. But now there is no workforce plan to behold. As Labour did in 1997, we will recruit the workforce the NHS needs. We understand that staff need a pay rise.”
“If we addressed those issues, we would make savings, pay the staff what they deserve and have a system that works for everyone. In 2004, Labour created “Agenda for Change”, which put NHS staff on decent terms and conditions and pay. All the Minister has to do is to put people doing exactly the same tasks in social care as they do in the NHS on that job-evaluated scheme. That would put the staff on those wages and terms, and give them the career opportunities that were created under the Labour Government through the knowledge and skills framework. It would save money and ensure that people get the pay they deserve. That is not a massive ask; it is common sense. That would also mean that we would start getting integration.”
“If that money were spent on recruiting, training and paying care staff the wages they deserve, we would see no delayed discharges. Patients would be at home and independent, and thousands of pounds from the Health and Social Care and DWP budgets would be saved. To make sense of the crisis, this is not just about the amount of money; it is about where the money is placed and how it flows. We could say the same about paying exorbitant amounts to the social care providers that are making billions in profit between them, as opposed to having a state-run social care service—what I would call a national care service—that is publicly accountable and controlled. The Government need to look at the waste in the system, and not just talk about the amount of money they are putting in.”
“To provide a timely social care package would have cost just £500 for the maximum package. The Government are paying £900 more per patient, per week. Imagine if that £900 went on social care staff pay—just hold that thought. No patient who goes into hospital independent, who then has a delayed discharge and ends up placed in residential accommodation because there is no care package available for them to go home, goes home from residential care—that is the case even though they were independent before they went in. Instead, they become deconditioned and dependent, with both the taxpayer and the patient paying a heavy price. The cost of that is £1,400 and rising throughout the patient’s life—not £500 and falling as the patient becomes more independent.”
“If they were employed on “Agenda for Change” pay scales, which are job-evaluated, we would not be carrying the 165,000 vacancies we see today. We would not have the delayed discharges and flows in hospital would return to some semblance of normality. Patients would get into emergency departments, freeing up ambulances to reach the sick in time. Stress levels of staff would fall and absenteeism would drop. But the wealthiest sitting in Cabinet do not understand that that is fiscal responsibility. Let me set out the challenge. In York, the local authority does not have social care capacity because staff are too low paid. Wages are very low and the cost of living is very high. The local authority is having to buy beds in residential homes, at around £1,400 per patient, per week. That is not out of the ordinary.”
“I was head of health at Unite and prior to that I worked for 20 years as a senior clinician in the NHS. I recognised the most caring of staff and the most visionary of leaders at Great Ormond Street. They are carrying out medical advances that we could only have dreamed about just a few years ago: cures for rare cancers that no child could previously have survived; state-of-the-art technology keeping the most delicate of hearts and lungs working; and research and science breaking new frontiers. However, like in my own patch in York, when they intersected with social care, the whole system ground to a halt. They cannot get the staff. Let us not be shocked: social care cannot get the staff because the Government have not provided the means by which to pay them. Many are doing highly skilled, professional roles, but are paid a pittance.”
“I thank my hon. Friend the Member for Jarrow (Kate Osborne) for securing this really good, much-needed and timely debate. It is a pleasure to follow my hon. Friend the Member for Wirral West (Margaret Greenwood), who set out the ideology that sits behind the Government party. Driven by the injustices of inequality, 75 years ago we saw the advent of the NHS under Nye Bevan. Health has moved forward ever since, until just recently when we have seen a drop in life expectancy. It is the injustices exposed today that have motivated many of us to speak in this debate. Just yesterday, as a member of the Health and Social Care Committee, I had the privilege of visiting Great Ormond Street Hospital. I have been steeped in health all my working life—for the record, I declare that I am a member of Unite and the GMB.”
“Seventy-two days out from the elections, the electorate do not know that they need to carry voter ID. It is one thing to say that people who are used to doing it will continue to carry voter ID, but people who do not know about it will not carry voter ID. Will the Minister set out everything he will be doing to communicate what each electorate will have to do between now and the election to get this ID?”
“Today will be a difficult day for the community in Keyham, and my thoughts are with them, but I am not reassured by the Government’s response, particularly around mental health but also for victims of domestic violence and their former partners. I have a constituent who is in hiding right now because her former partner has had his firearms returned to him. What reassurance can the Minister give that this incident will be the last, and that my constituent will also be safe?”
“When land is available for urban development, external partners of local authorities often determine the future economic strategy for locations such as my constituency. How is the Department ensuring that there is a focus on a levelling-up agenda that benefits local communities, as opposed to a trickle-down agenda that benefits only the investors’ interests?”
“That is the kind of strategic approach that a Labour Government would bring in, because we understand how important it is to invest in the future and to grow out our economy. In my city, we are building the biosciences and focusing on rail, which are economies for the future, as well as creating clusters around culture and heritage. We see levelling up as an opportunity for the future, but it must be done in a strategic way, not piecemeal, as this Government have done.”
“We could use levelling-up money strategically to grow it further, creating high-quality jobs for my constituents, and jobs across the region. I point the Minister to the BioYorkshire project, which is creating 3,000 green collar jobs. That will be a green new deal for Yorkshire. There will be regional hubs in rural and coastal areas. It will make such a difference, not only for my city but for the whole region. It is levelling up that starts at the core and then builds out. That, academics say, is exactly how to build an economy for the future, how to spend taxpayers’ money wisely, and how to ensure that growth builds momentum; it is not a matter of having piecemeal projects.”
“It may achieve a photo on an election leaflet, but will not make the economic switch that is so desperately needed in many communities like mine. Gordon Brown’s recent paper on constitutional reform set out that we need to move not only resourcing but decision making into local communities, so that we can spring forward with an economy that will work for everyone. We have a rail cluster in York, with 5,500 highly skilled jobs. We have the York Institute for Safe Autonomy, and investment in leading companies is coming into our city. Why the Government are dithering over another project, the headquarters of Great British Railways, is beyond me. Those headquarters would show the country how we could grow an economic cluster.”
“He talks about economic growth and how it can be achieved—not through pet projects and a piecemeal approach, but by ensuring that we have a strategy to drive forward economies and to see the regeneration that places like York desperately need. Indeed, that is happening elsewhere in Europe—take Germany, where that regional focus is well understood. I draw the Minister’s attention to evidence given to the Levelling-Up and Regeneration Bill Committee by Professor Dame Ottoline Leyser of UKRI, who stressed the importance of growing the cluster economy, as did Andy Street and Tracy Brabin. These people are leading their regional economies, and recognise how to bring about advantages for it—how to bring together partnerships between universities, businesses, wider stakeholders, and communities. Focusing on pet projects does not achieve that.”
“I am not here to defend the bid from City of York Council—the Lib Dem-Green council could have put its focus on real levelling-up projects—although I would be interested to hear the Minister’s justification as to why it did not receive funding. We have other projects into which we could put that money to really level up York, but I am here to critique the process itself. It is evident to all that this is about justifying funnelling funds into pet projects in particular seats and granting a few other funding bids to justify that. I want to focus on how we can really level up. I follow the work of Professor Philip McCann, the chair of urban and regional economics at Alliance Manchester Business School, and it would be worth while for the Minister to read some of his work.”
“Taxpayers want NHS staff to be there when they need them, but as more and more staff leave the service, flipping over to work for agencies because they simply cannot afford to work for the service on their salaries, their money is being spent in the wrong way. On Friday, when I met NHS staff who came in on their day off, they said that the thing that is breaking them is the Government’s contempt for them. They simply want the Government to negotiate—so why will they not?”
“The Government’s job is to govern, but for months and months the Minister has been sitting on the sidelines watching this car crash happen, and it is the people of our country who are paying for that. Why does he not bring forward legislation right now to ensure that people on prepayment meters do not pay a different tariff from everyone else and that the other corrections can be put in place?”
“Therefore, carrying out proper research to understand the changes within the body would seem completely appropriate before the procedure continues, particularly for older women. In conclusion, we have talked about the need for women to be heard in the health service, but we need to gather that. I hear about the work that is being undertaken, but as we were saying in response to the “First Do No Harm” report, there should be proper logging of who has been through this procedure. We should seek out that voice, because we may see a different reflection of what has happened. In Jan’s words, the experience left her “deceived, patronised and betrayed”. That is simply not good enough for our NHS.”