Liz Twist
MP for Blaydon and Consett · Labour · United Kingdom
“I thank my hon. Friend for this report on redress schemes, which certainly reflects the experiences of my constituents who have been involved in some of those campaigns.”
“As the Leader of the House said, today is World Suicide Prevention Day, and I thank him for his comments. In the UK, someone takes their own life every 90 minutes—the length of a football match.”
“These standards, which cover both community and urgent care, must be developed in consultation with the chief medical officer. Crucially, the new clause mandates the Secretary of State to report performance against those waiting times, alongside mental health expenditure, to Parliament every year.”
“I certainly agree with my hon. Friend’s concerns about the need for action on autism. She may be pleased to hear that the all-party groups on suicide and self-harm prevention and on autism will be doing joint work on the matter in the near future.”
“The right hon. Gentleman touches on another angle, namely the world of the internet, which provides such a challenge. The work of Ripple is important in preventing that harm, but there is so much more to do. I congratulate Ripple on its award.”
“I welcome the Bill, and was pleased to be a member of the Bill Committee. I also welcome the Government’s new clauses, about which the Minister has spoken today. New clause 159, to which I have added my name, seeks to address a long-standing legislative omission in our health service. I thank my hon.”
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“Who have you put in place as your director of patient experience within the organisation? How are you routinely collecting information from a whole spectrum of users from the whole of society? How are you doing that in a confidential way for the reasons we spoke about earlier, and then ensuring that people are acting on it? I do not think we are doing anything like enough of that, and we need to get much better and do far more of it.”
“Thirdly, we need wider transparency. There are way more than 183 different metrics and we need to have far more on patient experience. They need to be routinely collected in the same way that we do surgical audits or audits of GP work. Those all got in the public domain; that was a big element of the 10-year plan. Finally, as I said before, we need boards to take full responsibility and accountability for all aspects of quality, which includes patient experience. As I go round and meet individual hospital boards, I ask them about that. I spend quite a lot of time with chairs and new non-executive directors coming into NHS providers, and I continually emphasise, “This is a crucial area for you to focus on as a board.” What are you asking your exec colleagues?”
“Those are: safety, so ensuring that basic standards are in place; effectiveness, so making sure that patients receive the right care in the right place at the right time and it is delivered to a high standard; and, crucially, patient experience. In the quality strategy, we emphasise that all three of those are crucial. You need to have all three and all three need to be done really well. We then go on to talk about different mechanisms for improving those dimensions. Crucially, we have a set of 183 metrics, which we will review within the NHS England quality committee while it still exists, and then within the National Quality Board. We also expect every region to review those metrics, as well as others, and every ICB and provider to review the ones that are relevant to them. So the next bit is to have all those different metrics.”
“Q Dr Dash, you have explained why you believe that the changes to Healthwatch will strengthen patient responses. How do you think that could be strengthened to ensure that the levers really are being pulled for patients? That seemed to be the case. Dr Dash: There are a few different things. First, we have talked about appointing a director of patient experience. They will report directly to the chief exec of the NHS. That is crucial; it is about emphasising the importance. We are about to do the interviews for that person, so I hope they can be in post very quickly. Secondly, we are hopefully about to publish the quality strategy. Within that strategy, which has come out of the 10-year plan, we are very clear about the three dimensions of quality.”
“I know that that is the Government’s intention, but it is about more than legislation. Where is the work to make that happen?”
“Fundamentally, our worry has been—again, this goes beyond the legislation—how do you genuinely create a system where the culture is not as paternalistic as it has traditionally been, where you are empowering both staff and patients and citizens to have more say in their care, and where system leaders are not constantly looking up for permission, worried they may be held to account for quite a narrow set of metrics? Although managing money and constitutional standards is very important, if we are to deliver the 10-year plan aims and improved patient care, it is more than that. Our worry has been that the abolition of NHS England by the legislation will narrow things. We do not know, because it is broader than legislation, but how do we fundamentally shift the culture?”
“We have a slight concern that, even though the Carltona principle should mean that the Secretary of State will enact powers in a way that does not slow things down, because of the broad sweep of powers given back to the Secretary of State, and the quite extensive powers of direction, politicians come under extreme pressure to intervene in certain cases or when there has been a scandal or patient safety issue, and that could lead to things clogging up.”
“Q Ms Woolnough, you have talked about the abolition of NHS England, and, as I understand it, you are dealing with what the position is rather than taking a stand. Beyond the legislation, what are the key things that we should be looking at to get the transfer of functions to ICBs and DHSC right? Sarah Woolnough : We have talked quite a lot about the culture in the NHS and whether these changes enable the sort of shift that lots of people talk about wanting. Let us be really serious about devolving power and earned autonomy, and about the balance between politicians rightly being held accountable for high-level metrics but with enough operational freedom to allow local systems—services close to people and patients—to get on and do the best for them?”
“That is the only way we are going to create an NHS that will be able to cope with the number of frail, elderly people with multiple morbidities. Those people are a consequence of the success of the NHS over decades. People are living longer with cancer; the prevalence of cancer—the number of people alive with cancer—has doubled in 20 years. But that means that there are four million people who are not necessarily well. The only way to cope with that is to make a significant and radical change to the neighbourhood health plans and bring the public with us. That will happen only with proper patient and public engagement.”
“However, it can set an expectation for the ICB that, in developing its plans, it should be able to demonstrate that it has engaged with the local authorities, patient organisations and the public local to it. The legislation can set an expectation that the ICB is using population evidence to make the right commissioning choices and that, if reconfigurations, which may well be locally contentious, are to happen, engagement happens beforehand. As elected Members, the Committee will know that those conversations should start early and that local populations should not just be bounced into something. It will be incumbent on the new department to set those expectations with the ICBs about the new way of working.”
“Q Sir Ciarán, the 10-year health plan, which is behind a lot of this, demands that we are really ambitious in involving patients and communities in shaping the services that they need. How can we best support ICBs, local authorities and other organisations to drive that change? Sir Ciarán Devane: I go back to our having to convince people. Many people are convinced—that is probably the first thing to say. But we have to convince people of the benefit of doing this. Delivering the ambitious neighbourhood health plans that James describes will happen only if everybody is in the room and doing it. I do not necessarily think that the legislation can mandate that belief or the way to do that.”
“That has to be the expectation: if this reform, which is huge, is to deliver value, that is the value that it has to deliver.”
“Q Do you think that there are any good examples we can learn from? Sir Ciarán Devane: Yes, I do. I was in Epping recently, at St Margaret’s. I talked to the lady who runs the patient engagement: she is a volunteer and is a patient herself. They are a very good example, because they have said, “If we want to provide good services and avoid people turning up at the A&E in Harlow, we can do a neighbourhood diagnostic service.” The patient representatives got in very early. They ran some public meetings ahead of it and said, “We are thinking of doing this: what do you think? We’ll feed it back.” Everything good is happening somewhere. It is the variability that is causing the problem. We need to make sure that good practices are deployed across the sector.”
“A lot of guidance is already out there, particularly in children’s palliative care, where we have service specifications and NICE guidance and quality standards—there is even a legal duty to ensure that ICBs commission palliative care for children and adults. That accountability and support from the centre, and making sure that resource is there, is key.”
“Q You all represent patient organisations in different ways. I would like to put this in the context of the 10-year plan and the shift to involve patients and communities in shaping services. From your patient perspective, how can we best support ICBs, local authorities and other people to drive that change for patients? James Cooper: It is key that ICBs are given that support. In the conversations that Together for Short Lives and the services we represent have with ICBs, we certainly get the sense that they want support. They want to know how much they should be funding certain services, and they want to know how to plan.”
“Regarding the other provisions, I accept that great work has been done by many people in Healthwatch and its predecessor organisations, and by people working in the patient safety landscape, but again it is not working. I think that those bodies have been allowed to abdicate responsibility for the core role of patient experience and patient voice. That is not their homework; it is their actual job. It is not something that should be outside, and that is why I think this Bill is really important.”
“My experience in opposition and so far in government is that MPs are perplexed when they try to intervene on behalf of patients, or to get an answer locally as to why on earth chief executives of ICBs or trusts sometimes do not respond even to a Member of Parliament’s requests for meetings. I find that shocking, but it does happen. How on earth is a patient or somebody struggling through the system expected to get a response? Getting it right is not black and white, and it is not easy to get the balance right between the Secretary of State’s democratic oversight and autonomy at a local level, but the Bill starts the process of doing that, and it is fundamentally important.”
“There will be a lot of questions about it and a lot of concern about privacy, data, cyber and so on. We need to hold on to those benefits, which are huge in clinical terms and for patients. Another point we heard, which is also true, is that people think this already happens. People do not understand why, when they turn up at an A&E in Whitby, as we heard, or somewhere else, and then go back to central London, the systems cannot talk to each other. For me, that is about people’s trust and belief in what is a public service. It is a really important part of that. On abolishing NHS England, I do not think anyone has come to one of my constituency surgeries and said, “Please do this,” or talked about it in great detail, but people do understand.”
“We can all point to where it has gone wrong, but nobody has said that this is not the right thing to do. That is good, but there is still a lot of detail to go through. We need to keep highlighting the benefits. We heard from Peter Prinsley about whether patients have more control—we do think this is about empowering patients. That was what we said in the 10-year plan. The 10-year plan is about empowering patients in this very large system, for which they are now paying £200 billion of their taxes. We heard from the excellent clinical panel. I defer to clinicians about what they need, both if they are dealing with chronic long-term conditions—we heard that it can sometimes take two and a half hours for an assessment—or if they are working in a busy emergency department. The fact that this is needed will be controversial.”
“Q Minister, we have talked a lot today about ICBs, the local government Healthwatch and the single patient record, and we have heard some interesting comments. Can you summarise why you believe it is important that we look at this legislation now? Karin Smyth: I will come to the single patient record because I think it is a gamechanger. We have heard today from some fantastic experts about the work they are doing to identify how it might work and how we might bring patients and the public with us. Again— I do not think we should just bank this—we have not heard anybody object to it. We did have some evidence highlighting how things have gone wrong in the past. I worked at a primary care trust and clinical commissioning group at the time when care.data was brought forward.”
“For 14 years, the Conservatives presided over a house building crisis that locked a generation out of home ownership and left social housing in short supply. In Blaydon and Consett, my constituents have been calling for years for more social and affordable housing to be built. Will the Minister say how this Government are going the extra mile to ensure that we deliver on the calls of my constituents for more social homes?”
“People across the north-east, including in my constituency of Blaydon and Consett, have been benefiting from a £2.50 bus fare for a single journey, funded thanks to the Labour Government and Kim McGuinness, our Labour Mayor of the North East. With that fare, there have been over 100 million bus journeys and an increase in bus patronage. To build on that success, we need the national bus fare cap funding from this Government to continue. Will the Minister confirm that the Government intend to keep the £3 national cap on bus fares beyond March 2027?”
“Q6. The British Standards Institution is 125 years old this year. I am proud to have been working closely with it to produce and publish BS 30480: the world’s first free standard on suicide and the workplace. The standard has now been downloaded more than 12,500 times. As we all work towards reducing the number of people who die by suicide, will the Prime Minister support more workplace adoption of the standard and work with the BSI and me to achieve that?”
“The strategy said that it would “reduce the suicide rate over the next 5 years—with initial reductions observed within half this time or sooner”. However, we have now passed the halfway point, and sadly, those initial reductions have not been achieved. What is the Government’s plan to ensure that target is achieved by the end of the strategy?”
“We need to build in preventive measures and access to those mental health services. I would just like to comment on the point made by my hon. Friend the Member for Worthing West (Dr Cooper) about building public health issues into the overall health framework. We need to look at re-establishing that public mental health function within DHSC under the new arrangements, and indeed within ICBs. We need also to link this to our mental health strategy, which we are expecting in the very near future. I welcome the Bill greatly and look forward to seeing those issues addressed in Committee.”
“The second issue I wish to raise is Healthwatch. I understand that the Government’s real intention, through the Bill, is to strengthen the patient voice and the ability to raise issues, but there is real concern that an organisation inside the Department of Health and Social Care will not provide that independence. Will the Minister commit to looking again at how that independence can be built in and linked with the ability to pull the levers that Ministers have talked about, in order to make a real difference for patients? It is about getting that balance right. Finally, I want to talk about parity of esteem for mental health services. As we move from treatment to prevention services, we need to use this legislation to reinforce parity of esteem for mental health services, including in the ability to access them.”
“First of all, I very much welcome the Bill. It has been designed to deliver and work with our 10-year plan in that bigger picture. I will touch on three issues raised with me by my constituents in Blaydon and Consett. The first is the single patient record. Of course it makes absolute sense for everyone to be able to access up-to-date records when a patient is admitted. I think of the groups I have worked with who have rare conditions, for example, who find that when they are taken into a different hospital, the doctors there are unable to access the records of their specialist treatment. That is the first thing, although there is also a good deal of concern among my constituents and others about how that will be managed and brought about, and how the data will be handled and the contracts awarded.”
“T9. The latest Women’s Aid annual audit highlights that nearly 80% of domestic abuse survivors now face devastating tech-facilitated abuse and online stalking. How will the Ministry of Justice collaborate across Government to ensure that our courts and prosecutors are fully equipped to tackle digital violence?”
“I am proud to support the King’s Speech, which will continue to create the change that positively transforms ordinary people’s lives.”
“Every child deserves the chance to succeed, regardless of their background or their needs, and inclusive education that supports children with additional needs has long-term economic benefits. I will speak briefly about the regulation of waste operators. It is time for waste operators to be regulated—many are good and reliable, but others are not using permits, and we see the results in the form of fly-tipping locally, which many of our constituents complain about. I am glad that those rules are being strengthened. Finally, I will touch on energy. In the current global context, energy security is more important than ever. The local authority in Gateshead has created a local power scheme to benefit the area, and I hope that similar community-run power schemes will be part of the Government’s agenda.”
“They are fighting an outdated and ineffective system just to get those children the support they need, which is why I am glad that the education for all Bill will reform the system and invest over £200 million in training for teachers and support staff, helping them to better understand special educational needs and inclusion, on top of other money that has been provided for capital work on schools. However, naturally, some families fear that the changes will negatively affect them. I hope that the consultation that is ending today will help the Government to improve any forthcoming legislation, ensuring that it meets the needs of parents, teachers and young people and addresses their concerns.”
“I am pleased to see in the King’s Speech additional support for educating children with special needs. The Government will introduce the education for all Bill, which aims to transform the way in which special educational needs and disabilities are addressed. I have recently held events in my constituency to hear from some of the parents, teachers, carers and others whom that Bill will affect. I want to understand how we can help improve the lives of parents, teachers, and the young people themselves. Parents and teachers tell me about the monumental pressures they face in supporting their children and students every day. They worry that without sufficient support, opportunities for those young people will close.”
“However, I ask the Minister to confirm that health and safety—a key issue for workers—will be up there with growth as a priority, driving safety for our employees. The UK’s long-term economic security depends on raising living standards in every part of the country. Places such as the north-east have been left behind for decades, and our young people deserve greater opportunities. We are already taking steps to address that through our action on child poverty—we cannot build a resilient economy without ending the opportunity crisis and ensuring every child has the best possible start in life. True economic growth requires an inclusive system in which every child can go as far as their talent and effort will take them, so we must build on the recently passed Children’s Wellbeing and Schools Act 2026 by taking further positive steps.”
“I welcome the extensive measures that this Government are taking in this King’s Speech to create and enable economic growth across the country, including in my constituency in the north-east. As we know, growth is at the heart of this Government’s agenda, and a good deal of legislation has been proposed to ensure we make the conditions right for it. Bills such as the Government’s new regulating for growth Bill will drive our economic development forward. I am also pleased to see a regulation of late payments Bill—something that small businesses have long wanted—which is an important step forward. It was welcome to hear the positive news that the IMF has increased its growth expectations, and it is pleasing to see that the priority of growth will be written into legislation.”
“I recently had the chance to speak to air cadets at 1509 (Blaydon) Squadron, my local air training corps, where I received a good grilling on the job of an MP and on a wide range of issues affecting the cadets. They told me how they are learning practical and social skills, as well as being provided with training and outdoor pursuits by the RAF. Can we have a debate in Government time on how we can continue to build on the work of our cadet services to benefit our young people?”
“Consett is full of great community-focused organisations. Recently, I met those at Shadows of Light CIC, which offers dog-assisted therapy for care homes, young people, those at risk of suicide and veterans. I met them at the Foundation For Good, another charity in Consett, which focuses on wellbeing and support across the community. Can we have a debate in Government time on the vital role that social enterprises and charities play in strengthening and building our communities?”
“For every suicide death, at least 135 people, including colleagues, clients and communities alike, are directly or indirectly affected. Suicide is the leading cause of death for men under the age of 50. According to the Office for National Statistics, it was the leading cause of death for males and females aged 20 to 34 in the UK for all years observed, accounting for 27.1% of male deaths. Suicide touches nearly every workplace, yet most organisations lack the tools to address the emotional aftermath.”
“I beg to move, That this House has considered Government support for businesses implementing National Suicide Prevention Standard BS 30480. It is a pleasure to serve under your chairmanship, Mr Stringer. This debate is about a risk we often overlook in our workplaces, but which can have a great impact on families, work colleagues and a much wider group of people. We have rigorous standards for fire safety and electrical wiring, and for hard hats on construction sites. We accept those as the cost of doing business safely yet, until now, we have had no such road map for the most complex safety risk of all: the mental health and lives of our employees. Research shows that one in four adults has contemplated suicide, and one in 13 has attempted it.”
“Of course small and medium-sized enterprises are in a difficult position without large resources, but there are lots of things we can do. As the hon. Member suggests, I will ask the Minister what we can do to ensure that SMEs also have the ability to take part in this training.”
“This standard, informed by research, data and lived experience, aims to provide organisations with practical, evidence-based recommendations to help plan for, respond to and support people affected by suicide, or those with thoughts of suicide, in the workplace and beyond. The standard is designed to help workplaces support people who might be on the frontline of dealing with the stresses and strains of life.”
“Suicide has a profound effect on every workplace it touches, whether through the loss of a colleague, supporting someone in crisis or managing the complex emotional and operational aftermath. Yet organisations are not necessarily equipped to address this issue openly and effectively. For employees without proper support, the trauma and grief of exposure to suicide significantly damages workplace attendance, retention, performance and productivity. Colleagues often experience profound feelings of guilt, inadequacy and confusion. Because people fear saying the wrong thing, they often do or say nothing, which leads to further distress and emotional toll.”
“Indeed, I will be pushing the Government to do all they can to support the implementation of the standard, and to recognise those psychological risks. As we know, male-dominated industries such as construction face severe historical challenges with work and mental health. Agriculture and farming workers face extreme social isolation and financial pressures, and have access to lethal means. Healthcare workers and emergency responders experience severe trauma alongside having ready access to pharmaceuticals. The economic impact of suicide is clear. In the UK, it is estimated at nearly £1.46 million per death. Nationally, this costs the UK economy nearly £10 billion per year, factoring in the cost of lost productivity, healthcare and emergency services.”
“I thank the hon. Member for that question. I had great pleasure in working with his constituents on the quilt exhibition in the Upper Waiting Hall; it was a tremendous experience, and they do tremendous work. Farming is indeed one of the industries most affected by these circumstances. I certainly commend the work being done on the agricultural side, by organisations such as Yellow Wellies, to ensure that those issues are addressed.”
“The standard itself calls for assigning a named senior leader to take responsibility for the organisation’s suicide prevention strategy and provide targeted training so that line managers are confident in spotting warning signs.”
“I thank colleagues from the BSI for being here in the Public Gallery today to raise awareness of their organisation’s hard work, particularly on the new standard BS 30480: “Suicide and the Workplace”. I know that the BSI has a positive impact on society through its work. As chair of the APPG on suicide and self-harm prevention, I am pleased to have supported work on that standard. I am also delighted that the House has endorsed the standard and is seeking to adopt it following internal consultation. The publication of the world’s first standard on suicide and the workplace represents a significant milestone in supporting mental health and wellbeing at work across the UK and beyond. The BSI, acting as convenor, brought together many leading individuals and organisations to develop it.”
“I thank my hon. Friend for that question. Certainly I agree that we must do all that we can. I hope that, in this debate today, we will be able to take steps forward to implement the standard. I want briefly to touch on the work that the British Standards Institution does. It plays a vital role in workplace standards of all kinds in this country. The BSI is 125 years old this year. I am sure the Minister will join me in congratulating the BSI on that achievement, and the enormous contribution it has made to businesses and the everyday life of people throughout the United Kingdom since 1901. British standards have helped with everything from saving lives with medical devices to air raid shelters during the war, crash helmets and now addressing suicide.”
“With help from the Government and colleagues in this place, we can all work together to achieve our ambition of seeing fewer people die by suicide.”
“First, will his Department help to promote this important standard with business, public sector bodies and throughout Government? Secondly, will he commit to jointly organising and attending a roundtable with me, the BSI, the Department for Business and Trade, key UK businesses, SMEs and the unions to discuss the roll-out of the standard across UK workplaces. Thirdly, will he say how the Government will ensure that small and medium-sized enterprises can access the trauma-informed training required to implement the standard effectively? We want to ensure that the standard not only raises awareness, but gives organisations the tools they need to reduce risk, intervene effectively and encourage conversations, breaking down the myths and the stigma that talking about suicide causes people to feel.”
“Furthermore, the Department of Health and Social Care could work with the Health and Safety Executive to ensure that workplace first aid and safety guidance emphasises the importance of managing risks to mental health using the standard. I am pleased the Government mentioned the standard in the men’s health strategy earlier this year, and that was significant. That is a good starting point for ensuring that employers start to implement the standard. The focus of today’s debate is how the Government can help with that task and help BS 30480 contribute to the national suicide prevention strategy. April is Stress Awareness Month in workplaces, and I hope the Minister will agree to some actions today, maybe on behalf of his colleagues in the Department for Business and Trade.”
“For example, Heathrow airport has publicly spoken about its adoption of the standard, and so has the Inclusion Education, in a recent BSI webinar in which I took part. Can we please encourage more to follow their lead? I believe we need the Government’s help to do this. As we have heard, the standard offers clear guidance for organisations of all sizes and sectors, including public bodies, charities, social enterprises, businesses and commercial enterprises. I hope the Government can actively promote it, especially within high-risk, male-dominated industries, by leveraging their new and existing partnerships, such as the upcoming three-year collaboration with the Premier League, aimed at improving men’s health, literacy and suicide prevention.”