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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“Thank you, Ms Ghani, for calling me to speak. It is always a pleasure to see you in the Chair. I thank the Petitions Committee for selecting this topic for debate, particularly given the number of signatures, because we know that everyone who has petitioned will either have personal experience or know of others with personal experience of what it is to be self-employed and to adopt, and the challenges that brings. Before I home in on the petition itself, I want to pay tribute to the families who provide safe, loving, forever families for children.”
“The Government have committed to improving adoption, so this is yet another opportunity for them to do so, and I hope the consultation will therefore be inclusive. He said, “it is crucial to the success of an adoption placement that an adopter takes time off work to care for and bond with their child.” That must apply to the self-employed as much as to the employed. There is no difference in the eyes of that child, or in that child’s needs.”
“Why is it that adoptive parents continually have to chase everything, and dedicate their time to feeding into the bureaucracy and trying to get it to work for them, as opposed to the Government addressing the issue? Statutory pay will aid the recruitment of potential adopters and will assist in the success and stability of others. We know that 3,000 children are in need of a family. A full consultation was committed to by the Under-Secretary of State for Business, Energy and Industrial Strategy, the hon. Member for Sutton and Cheam (Paul Scully), who has responsibility for parental pay and leave, during his evidence to the Petitions Committee in 2020, but we must include adoption pay, too.”
“Adoptive parents should not have to go cap in hand to their local authority either. Special guardians, kinship carers and adoptive parents need recognition that they, even more than birth parents, need to be 100% focused on family building. There is time for the Government to carry out a consultation on the Taylor review prior to their promised employment Bill. I ask the Minister to commit to that consultation today. The 2013 statutory guidance on adoption states in paragraph 9.38 that “The local authority should consider making a payment of financial support equivalent to the Maternity Allowance to adoptive parents who are ineligible to receive” statutory adoption pay.”
“I ask that adoptive parents do not suffer any detriment either. If we, as a society, value parenting and recognise its importance, there is no excuse for exclusion. I hope the Minister will forgive me, but I am impatient. Self-employed parents need support now. We know how hard self-employed people work to make their businesses a success. We heard from the hon. Member for Carshalton and Wallington (Elliot Colburn) about the challenges of the pandemic and how hard people worked to make their businesses thrive. They cannot juggle work around bonding with their child. Ensuring that the right attachments are made is a full-time task. That is why we need to ensure that the self-employed get the financial underpinning to not have to worry about paying their bills, not least at a time when the cost of living is such a challenge to all families.”
“We are particularly concerned about black and minoritised children in the care system, as well as older children and young people who have been in care the longest. As an APPG, we have more work to do, but so do the Government. Self-employed parents need help, too. The crucial period of bonding as a family forms is vital in forming attachments and a new rhythm in a child’s life. The self-employed need the same opportunities as other parents to dedicate time to this. Denying statutory adoption pay is nonsensical. I trust that the Minister agrees. We await the legislative response to the Taylor review. I ask that the Minister ensures that the voice of adoptive parents is not lost in that process. The right hon. Member for Basingstoke (Mrs Miller) made a powerful plea for other parental rights to emerge in such a Bill.”
“We welcome the commitment of £144 million for the adoption support fund and £19.5 million for the implementation of the adoption strategy over the next three years. It is a sound investment, on which we will see a return. We need a workforce plan to support children in the care system and their families. There is a deficit in timely support for families, and the scars of trauma emerge in various expressions. Three quarters of children experience abuse or neglect prior to adoption. They need support to be in place at the right time. In our APPG’s “Strengthening Families” report published last year, we identified the importance of aiding parents in the matching process. It has been more challenging through the pandemic, but we cannot let a recovery period delay the process of family building.”
“I thank my hon. Friend for raising that issue, on which she is probably more of an expert than I am. We have recognised the role of digital and the fact that many children in adoptive settings can be traced or can trace their birth parents without having support around them. We have to recognise the digital age in which children are growing up in order to keep them safe and to protect them. I am sure we will talk more about this subject. The Minister for Children and Families, the hon. Member for Colchester (Will Quince), is committed to building stable families and providing the care and support that young people and their parents need. He has a sizeable task. Over 80,000 children are in care. I trust that, with the imminent publication of the review by Josh MacAlister, he will simultaneously fix the gaps in the adoption journey.”
“It is not a high cost to the Government in the scale of things and, as well as the savings to the Government from ensuring that self-employed parents have the support around them, statutory adoption pay would be immeasurable for parents and for the child. Now is the time to act, and I trust that the Minister agrees.”
“The Government recognise how necessary statutory maternity entitlements are for parents to bond with their child, and they must recognise how much more important such support is for a child who has experienced multiple forms of trauma and who could have complex needs that need addressing. Life is often exhausting for an adoptive parent who is trying to form a new family and working to give their child the safest home possible. The services need to be there in a timely way to support and nurture that child, and to ensure they have the best start in life when perhaps their first start was not the right one. The “Good Work” review does not accept that there should be a differentiation in the support received. On statutory adoption pay for the self-employed, we are not talking about a lot of people.”
“The hon. Gentleman is absolutely right. Normally it is the parent who does the joining up, and that is clearly not right. The Government need to make sure that the adoption strategy looks at every aspect of an adoptive parent’s journey and ensures that the facilities, support and services are in place to give the child the best possible start in life. It is exhausting for parents, who find themselves having to negotiate—this is where the law stands at the moment—with a local authority to see if they fit any of the criteria, on which there is no guidance. We know that cash-strapped local authorities may not be minded to pay specific attention to what is a very small cohort of parents.”
“The Minister is right to say that the circumstances of an adoptive family are different from those of a birth family. However, the fact that there are different circumstances means that the Government should look at those circumstances specifically. My ask today is that the Government go away and consult on that, to have a better understanding of why these measures are so important.”
“I just seek another commitment from the Minister. Will he meet the Children’s Minister to discuss this issue further, not least in the light of the Government committing to respond to the Taylor review in legislation? I would have thought that that would be a great opportunity to take this issue further and to ensure that we have the support in place for self-employed adopter parents.”
“I am grateful to my right hon. Friend for the speech that he is making. When the Government made their decision about the triple lock, we were not facing the energy crisis that we are facing today. Bearing in mind that older people expend at least twice as much energy because they are at home for more hours, and that we are starting to hear of cases of people dying of hypothermia, should not the Government not only reinstate the triple lock but underpin energy bills?”
“I chair the all-party parliamentary group for ageing and older people, which has just had an inquiry into the matter. One thing we suggested was that, since a lot of older people visit their GP at some point, GPs should be active in asking their patients whether they are eligible for pension credit. That would help them to claim the benefits that they should be able to obtain.”
“In York, it is about not just competition but collaboration. We have 100 rail companies leading in rail operations and in high-end rail engineering. We find that collaborative approach not only benefits the industry but takes the future of our railways forward. What is the Minister doing to invest in rail clusters, similar to the clusters in which her colleagues in the Department for Business, Energy and Industrial Strategy are investing in other areas of the economy?”
“Can we have a statement on covid? In York, the case rate is now 625 cases per 100,000 and shooting up. In York Hospital, the bed occupancy rate for patients with covid is now greater than it has been at any previous point in the pandemic, including during the spike because of the delta variant. We were promised guidance on care home visits and for care home staff and NHS staff, but it has not been brought forward. We urgently need to know how the Government are to manage the rise in the number of covid cases, so may we have a statement?”
“Today DP World has inflicted the ultimate pain on workers by sacking them on the spot. They are safety-critical workers in a safety-critical industry; they cannot simply be replaced. Will the Minister ensure that no ship sails with agency staff crewing it in the future? Will he ensure that he works with Nautilus and the RMT so that our shipping industry is put in a safer space than it is in today?”
“It is time that the Government’s policy moved from a pause on shale gas production to a full stop. The people of this country have moved on, and so has the science. On Friday, the Under-Secretary, the hon. Member for Mid Norfolk (George Freeman), was in York looking at the BioYorkshire project, which will change and transform the future of our energy supply through the biofuels industry. Will the Minister not invest in that instead of old technology that simply will not deliver?”
“If homes are checked and safeguarding is agreed, let people come to our constituencies and the homes of our constituents, and to where there is spare capacity in other buildings. I keep raising the issue of the 7,230 empty homes leased by Annington Homes to the Ministry of Defence; let them be occupied. In York, let the empty care homes be converted and empty hospitals be transition points. All must play their part. No more excuses. I trust that from this point, all our actions will restore our nation’s reputation as a place of sanctuary for all.”
“I believe that today’s statement only asked questions, but we desperately need answers, and we need those answers now. The same should be true for the thousands of Afghan refugees who have been imprisoned in bridging hotels for the last seven months. They must not be forgotten, as they too have fled terror, and as they are locked away, their mental health is deteriorating and they are feeling abandoned by this Government. We need Homes for Afghans, too, and homes for all who flee. We must be generous as a country, as our constituents are demanding. This Government have too often been on the wrong side of history and the wrong side of humanity. Let not perfection be the enemy of good.”
“While safeguarding is important, bureaucratic hoops must be removed, because it is what people across my constituency want and it is what I want. We heard today about the Homes for Ukraine scheme, but it raises more questions than it answers. What happens after six months? What happens if a placement breaks down? Who will then safeguard the interests of that family? What about school places? What about access to our NHS? What about access to mental health services? They are already under immense pressure and yet specialist trauma services will be required. How are families matched? It seems that refugees somehow have to advertise that they are in need of a home and somehow families offering their homes have to find that match. Processes need to be in place and systems need to be adopted.”
“There is no need to process visas in centres across Europe. That can happen on arrival here and with no added so-called risk. A friend of a constituent sought to get a visa. They went and made inquiries and were told they should go to a place called Kyiv. For the Minister’s information, Kyiv is in the middle of a war zone. That shows the shambolic mess operating in the Home Office. At the same time, support should be given to people for all of their travel. They should get free travel through Europe and across the UK as they arrive and are placed with families. The Home Secretary seems to have confused and conflated security with sanctuary, and she has displayed her prejudice. Other nations have put our Government to shame. I was glad to see some movement over the weekend. To home a refugee and their family would be a privilege.”
“The hostile dogma of the Home Office says that women, children and old people fleeing war and terror must first collect a visa, as if going on holiday, or should opt to pick vegetables from our fields to enter the UK. What a disgrace. They face more risk themselves than they pose any risk to anyone else. While the U-turn was welcome on Thursday, the impact will be minimal, as family members will stick together until all have the required the documentation that the UK, unlike other countries, demands. As with all passengers, and as goes for any of us, border security checks will screen for immediate safety. Once people arrive in the UK, with their whole lives packed into a single bag, families should then receive any emergency protection visa or documentation and the warmest of welcomes at our ports, airports or Eurostar.”
“It is a pleasure to see you in the Chair this afternoon, Mr Dowd. I thank every single petitioner for using their power to act on this matter, and I thank people across our nation who have stood with refugees over these last few days, as millions of people have crossed borders and millions more have been internally displaced—no doubt soon to cross themselves into an unknown future. Until 17 days after this most brutal of conflicts commenced, the UK showed no recognition of this reality nor of its responsibility, legal or moral, to give proper sanctuary. The powerful testimony of families welcoming complete strangers from across Europe to form new families has shamed this Government. These families asked for no checks, and they asked no questions. They have just shown compassion.”
“I am grateful to the Minister for giving way. Could he say how long it will take for a family with no family connection in the UK coming through the Homes for Ukraine scheme to be placed with a family here? [ Interruption. ]”
“That is the moment to break out of the past which has let down people with long-term health conditions and move into a new era. I very much hope the Minister will be able to bring that forward.”
“It may be an individual, a partner and their carer, or a family unit. They get that more community- based support. In the context of fostering, it is different families, so there is that concept of a community raising a child. Why do we not look at that for later in life for people with chronic conditions and for how we can provide support? Carers are often with their partners for weeks at a time with hardly any social interaction, and that can be quite telling if someone has an acute psychological condition as well. Much more can be done for carers, as well as patients, as we move forward. We need a strategy, a workforce plan and funding. In this new world of integrated care partnerships, we have an opportunity to deliver that. July is day one.”
“Of course, if someone is more isolated, they may experience more loneliness and that impacts on anxiety, depression, motivation and function. People’s skills and confidence then decline even further. We need to ensure the programme has the resources it needs. People are whole beings, and we need to recognise that in our health systems. For too long, we have talked about arms and legs or lungs and brains, but we do not talk about people, and it is people who need that support. If we can look at such a model, we need to think carefully about how we socialise our health system. I have been looking, in a completely different context, at fostering. There is a programme called the Mockingbird programme. I do not know if the Minister has heard of it, but groups and different people come and support the family.”
“Often, people get locked into a space where their life has changed so much that they become more isolated. They lose those social connections, and they also lose their ability to move forward. That might be because, for instance, they have lost their speech, or they might not have the same ability to communicate with people in all sorts of ways. We need to look at how we bring social prescribing into this agenda, as well as the voluntary sector and community support, which is necessary. I want the Minister to look at different pathways to bring that whole family of measures together. Often, we have isolated that into the various parts of someone’s body or mind, as opposed to looking at the person holistically.”
“I cannot remember if we are at 6.2 million people or more, but with those kinds of figures many people will need additional support—for example with their diet, or they may be less mobile—so as not to trigger other thresholds that further delay their surgery. It is important that people do not become sedentary and that they have the support they need. If people have a lung disease, it is important that they do not increase the damage to their lungs, lose function or become psychologically impaired, because it is then harder to regain function. We do not want to see people spiralling, which can happen very quickly. Once people get into that place—which is not a great place to be—it is much harder to get people back, so let us really focus on that area. Fourthly, I want to talk about people living with chronic conditions.”
“Some 44% of people with a neurological condition do not access the services they need. We have a big amount of catching up to do. The biggest thing is that if somebody loses their confidence there is a rapid decline. We must remember that many of these people are elderly and live on their own. They do not have the interventions and the injection of hope that they need. We are talking about life-changing events—people’s whole world is reoriented. We need to make sure that patients maintain social connection, where possible, and are able to access that support. Waiting lists for elective treatment have become so long.”
“Some 50% of people eligible for cardiac rehab cannot access it. From running cardiac rehab classes, I know how people gain confidence from rehab to do things they never thought they would be able to do. They no longer live in fear, but live a confident life. One in five people receive post-hip fracture rehab on discharge. I know of many cases where all the money is spent on repairing somebody’s hip or getting them a new hip, then getting them up, standing and walking in hospital, only for them to go home and just sit in a chair. Those patients then become fearful, which means social care has to come in, costing the NHS and the care system. It also means that somebody loses their independence, which is the biggest cost of all. This issue needs to be addressed.”
“Secondly, we have to look at patient management and how people enter services. It should be a given that patients will continue with their interventions once they leave formal healthcare settings. We need to make sure there is a continuum of regular assessment and monitoring. For some individuals, some of that assessment and monitoring can be done at home, but some of it will need external intervention. Thirdly, regular support may not always require an intensive burst of intervention—sometimes it will—but if it can enhance function, it does need to be examined. I looked at some statistics provided by the Chartered Society of Physiotherapy. Only 15% of people with lung disease deemed eligible for pulmonary rehab are able to access it, which is quite shocking and we really need to address that.”
“I see a concept in which the first phase looks at assessment and measurement, the second at self-management, the third at therapeutic interventions, and the fourth at the psychosocial support, which is also needed. First, interventions clearly need to be individualised. Everybody is unique in their presentation. We need to recognise that there is an opportunity to develop the service not only in domiciliary settings, but in rehab settings and, for some, in group settings. We have lost some of the collective healthcare that is important for not only the socialisation of health, but the encouragement from one patient to another. We have to capture that again. Often, a patient will be encouraged by seeing somebody else doing what they want to do and that will spur them on to go that little bit further.”
“Member said, it is right that people have the correct balance between physical and psychological health, and they have to be brought into one space. Sadly, if someone has a physical diagnosis, the psychological aspect is often left behind, because doctors are looking at the primary root of someone’s condition. We must look at people far more holistically than we do currently. I therefore want to set out a four-stage rehabilitation service to support the physical and psychological needs of people living with chronic ill health. Taking that approach forward will need funding and a workforce plan, which the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), has been incredibly powerful in calling for.”
“Under this Government there has been a particular focus on how new technology can help to provide support, measure things and move medicine forward. All those interventions are absolutely welcome, but they should not detract from the importance of the physical interventions that are necessary. We must ensure we maintain that baseline, so that if somebody does regress, we can give them an injection of rehabilitation to get them back up again to their normal functioning. It is really important to do that in a timely way. I very much look at this issue from a physical perspective because of my professional background, but I recognise that people with other clinical expertise and competencies will look at their particular field and the need that particular types of intervention. As the hon.”
“Without it, their progress and even their functions will decrease, and that will put even more pressure on both social care and the health system. The debate today is therefore really timely, allowing us to consider the new pathways that need to be created in order to support people with long-term conditions. They have been the poor relation for some time and we cannot let that situation continue. In the last decade or so, Labour in particular has been looking at pathways that could be developed, such as the expert patient, which enabled people to have control and management of their own disease. Enabling the patient to lead wherever possible is really important. New technology has come on board.”
“Therefore, the risks of a patient regressing and not reaching their baseline, and then regressing further from that, are even greater. The NHS is in some ways now coming under greater pressure than it did during the covid period. My concern is that the focus, politically and clinically, will be on the elective list and those numbers—we will drive up those numbers for sure and the Government will look at them—and will move on to dealing with acute care as it appears and to dealing with the elective backlog. GPs will of course make the same call, saying, “Look at our waiting lists, look at what is happening here.” Consequently, people with long-term conditions will be squeezed out of the system. That is why I am really grateful to the hon. Member for securing this debate. People absolutely need intervention.”
“However, as a physiotherapist myself who spent 20 years working in this area, I must say that I would find stroke rehabilitation very difficult on Zoom, and anything involving respiratory medicine as well, because it is all about diagnosing and treating people through the physiotherapist’s hands. Body-to-body contact is absolutely crucial in the development of interventions. Clearly, the lack of it has impeded people’s rehabilitation and had an impact on it. It is not just physiotherapy or occupational therapy that are affected; other services, from dietetics right through to psychological therapies, are also affected. For somebody who is already impaired, face-to-face contact is vital, particularly if they are neurologically impaired and have just had a new diagnosis.”
“Therefore, we need to consider these issues in that context. As I said, intervention at the acute phase of a disease can be intense, but it is about what happens next. We know that often there are not enough rehabilitation beds available to continue someone’s treatment. I have always argued that the convalescent stage is also really important for people to build their confidence, which is often what is needed after the acute stage. That is where the biggest challenge lies. As the hon. Member for Bromley and Chislehurst outlined, some services have been able to be delivered through new mechanisms, such as Zoom, that simply were not there before.”
“We have learnt a lot about respiratory conditions over the last two years with covid, and suddenly lungs have come into central view. Cystic fibrosis has been mentioned. Chronic obstructive pulmonary disease is a condition that really does need good management in the community. There are cardiovascular, psychological and other conditions. We must remember that comorbidity is an issue that impacts on and intersects with many conditions. Somebody who has a combination of COPD and Alzheimer’s will often not remember or be able to steer the management of their condition. As a result, they are perhaps more susceptible to getting an infection and then finding it difficult to clear their lungs or to follow whatever treatment is prescribed, so they are more at risk and early morbidity is a serious risk factor.”
“Early discharge has put more pressure on achieving a good baseline for somebody to move into the more chronic phase, the longer phase, of their rehabilitation. We know that once somebody goes home they do not have the physio nagging them every day and telling them to do certain things, so their function deteriorates unless there is good community intervention, which is what I want to focus my remarks on today. We are talking about a broad range of conditions—neurodegenerative and other neurological conditions. The hon. Member for Bromley and Chislehurst set out some of those, but we can think about motor neurone disease, where time is simply not on your side, or Parkinson’s, where intervention is really important to ensure people maintain function.”
“Through that time people’s baselines lowered as their function decreased, but it did not need to decrease. That is why it is so important to look at the issue today. I echo the remarks of the hon. Member for Bromley and Chislehurst on prevention. Of course, prevention is always better than cure, and having a strong public health strategy is crucial. In the acute and early intervention phases, many people missed out during the pandemic. We think about delays in diagnosis, the scale of treatment that people had because clinicians were placed elsewhere, and the value of input. We have talked about strokes today, and people having fewer rehabilitation sessions and less intervention from some of the leading clinicians, which meant they did not leave hospital at the same level that perhaps they did pre-pandemic. We need to pick that up now.”
“It is always a pleasure to serve with you in the Chair, Mrs Cummins. I thank the hon. Member for Bromley and Chislehurst (Sir Robert Neill) for opening the debate and for putting a lot of material as well as a lot of data before us to consider, which is incredibly useful. I am also indebted to the Backbench Business Committee for allowing today’s debate to go ahead. Even pre-pandemic, there were many challenges for people with long-term health conditions and their management. There was a really good focus on the acute phase, but as people moved into the more chronic phase of their illness, the amount of rehabilitation and support individuals received waned. It was dependent on geography, where someone lived, and on how many in-person interventions they had.”
“The Home Secretary has been on the wrong side of history and the wrong side of humanity. We are talking about women, children and older people. My constituent’s friend has just crossed the border into Poland, and when she went to get her visa she was told to go back to a city called Kyiv, in the middle of a war zone. There is still chaos at the borders—the Home Secretary shakes her head, but she was told that. There is chaos at the borders, so why can people not come visa free to the UK border to collect their documentation and then get the warm welcome that the Home Secretary talks about?”
“The pace at which we divest from Putin’s fossil fuels is important for stopping this war. As a result, as in wars past, if we scaled up our manufacturing to see retrofitting and our renewables industry, that could be not only the saviour of the Ukrainian people, but the saviour of our planet. Will the Secretary of State not only scale up, but lead an alliance of countries that need to make such urgent diversification to ensure that we apply this pain to Putin’s regime as quickly as possible?”
“When I tabled a written question asking whether there needed to be such a review, I received a complacent answer from the Minister for Defence People and Veterans, the hon. Member for Aldershot (Leo Docherty), saying that everything is all right and that we are meeting the current requirements. That answer came on 4 March, after this conflict had begun. There needs to be a review of our mindset to build up the security of our country, rather than just defending the Government’s position.”
“I have been carrying out a bit of an inquiry into Annington Homes, which owns a lot of the MOD estate. The MOD is currently leasing 7,230 vacant homes from Annington Homes. Given the refugee crisis and the fact that we have 11,000 to 12,000 people in bridging hotels, would it not be worth investing in those homes and bringing them up to standard, so that they could be used to rehouse people who have now been languishing in hotels for more than six months, not least because many of them served with our armed forces?”
“It cannot be business as usual. As many countries are needing to divest and diversify their energy supply away from Russia, what trade mechanisms can the Secretary of State put in place to ensure that the UK can be part of that effort to assist those countries achieving that objective?”