Dr Simon Opher
MP for Stroud · Labour · United Kingdom
“We must not say that things are getting worse, because I believe they are slowly getting better. As so many have said, we need to fix social care. We could have a system whereby the community is responsible for a patient as soon as they are ready for discharge.”
“I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for securing this debate and for her years of work in the A&E at St George’s. Emergency care is in crisis in the NHS, and corridor care is just an overspill because we cannot cope. That is because we are doing a few things wrong that we could remedy. I work as a GP.”
“That is absolutely true. We need to look at all the ways of reducing demand on GPs and, therefore, on A&E departments—that is what my speech is totally involved in—and pharmacies have a really good role to play. There is another thing here, which was noticed in the doctors’ strike.”
“We also need GPs to be assessing emergencies up until 10 o’clock at night to relieve the pressure on A&Es. There are a couple of other things. I have said about getting more experienced doctors involved earlier in the process, but we also need to invest in scanners—so many people in A&E are waiting for tests before they go home.”
“Dementia fluctuates, so just because someone has seen a slight increase in confusion, that does not mean that they need a whole batch of tests. We need to treat dementia more holistically. Polypharmacy—that is old people on loads of drugs—causes about 10% of admissions, so let us reduce that. We need good end-of-life care.”
“In Stroud alone, in four years, the number of over 90-year-olds went up 29% in just that short period of time. We have an enormous cohort of very elderly and frail people. Secondly, as we have heard, we have a lack of beds due to delayed discharge—I will not say any more on that.”
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“There are some very strong Maudsley guidelines based around micro-tapering, so that people can come off slowly and safely. Some kind of support service might have helped her constituent and stopped them taking their own life. In conclusion, we have a pandemic of over-prescription and we need to start looking at that. As chair of the beyond pills all-party parliamentary group, with the hon. Member for East Wiltshire we are trying to reduce prescriptions and make it safe for people to come off antidepressants.”
“In fact, yesterday I went with the Lord Mayor of Westminster and Lu Jackson to St John’s Wood library for a Comedy-on-Prescription event. Making people laugh can avoid the need for medication. We need to look at those things much more seriously and get people off tablets. The right hon. Member for Tatton (Esther McVey) said that one of her constituents took their own life when they were trying to get off antidepressant medication. The MHRA needs to put warnings on the packet, but it has failed to do so. We also need a support mechanism for people coming off tablets. Of the 8 million people on antidepressants, about 2 million are trying to get off them, so it is a major problem. GPs, actually, are not that well informed about this.”
“Some 8.7 million people are on antidepressants. My hon. Friend the Member for Blackley and Middleton South (Graham Stringer) spoke about Paroxetine causing increased risks of suicide. We need to wean ourselves off medications. National Institute for Health and Care Excellence guidelines say that for mild to moderate depression we should not start tablets, yet they are started. That is because people have become a bit over-medicalised, we have 10-minute appointments and no psychological therapies. We must also make use of social prescriptions, available to the NHS, where we can prescribe to patients something that is not medical. We need to de-medicalise what is going on. That can include lots of different things, such as exercise and being very creative.”
“If I may, I want to say a few things about vaccinations. Vaccinations save far, far more lives than they cause damage. Every medicine that has ever been invented has side effects and I do not deny vaccine side effects. However, the vaccine saved hundreds of thousands of lives. I ran the covid vaccination service in our area in Dursley. At the height of the pandemic, if we injected 180 people over 80, we saved a life—that is incredible. Compared to that, the side effect rate was incredibly small. It does exist and we need to look at it, but let us not get on the backs of vaccines. Vaccines have saved more lives than anything else. I really want to talk about antidepressants, on which the hon. Member for East Wiltshire (Danny Kruger) has already said a few words. We have a problem with over-prescribing in this country.”
“Thank you, Madam Deputy Speaker. I have quite a lot to say here, but I shall squeeze it into four minutes. First of all, having a regulator funded by a drug company is genuinely a case of marking one’s own homework, and we need to change that straightaway. I think we need a reform there. From clinical experience, I would also say that the yellow card system does work, but that we never get any feedback from it. That is one of the problems. The other problem is that clinically one is often not sure whether or not something is an adverse effect. We need a very easy system that can just be fired off. The right hon. Member for Tatton (Esther McVey) mentioned low white blood cells, for example, and whether that was a reaction. Then, when a number of different doctors get it, we can accumulate that information.”
“I thank the right hon. Member for giving way. Could I make an appeal to all of us? I do not think that either side of this debate has covered itself in glory. I agree that this is a very dangerous precedent about the ombudsman, but let us not make this party political, please. Let us make this about the WASPI women. Is there not a way, at least, of compensating the very worst off among the WASPI women? I would appeal for that.”
“That is not in this Bill, because it is a matter for the Department of Health and Social Care, but it will transform that area.”
“Actually, the Bill will ensure that every child growing up in this country will have the best possible start in life, and will break down the barriers to opportunity. Like the right hon. Member for Stone, Great Wyrley and Penkridge (Sir Gavin Williamson), I went to a comprehensive, and I believe that comprehensive, state-run education should be excellent—that is why I support the Bill. Every teacher I spoke to before the election was cheesed off with what was happening in education. They were so depressed about what they were doing—that is one of the reasons I got involved in this. Every teacher I have spoken to who has read the Bill supports it. Surely we should be listening to them. Colleagues have mentioned mental health. The Government will bring a mental health worker into every school.”
“I conclude by commending the Government for committing to ensure that every child has the opportunity to thrive. The Bill is a bold step towards addressing inequalities and improving the lives of the next generation. By introducing free breakfast clubs, this Government are not only tackling hunger but investing in health and education. As such, I urge my hon. Friends not to get waylaid by the political things that are going on around this Bill. It is an excellent Bill, and we need to support it.”
“We need to be careful of the food industry lobby, which is incredibly powerful and has been providing free food for breakfast clubs. All I would say is that there is no such thing as a free breakfast. Companies are trying to promote their own products, and we must be very wary of them. There is quite a lot of evidence that free school meals reduce obesity, and I would support their universal roll-out, not just in Wales and London. In London, there has been a reduction in obesity levels as well as improvements in learning, so let us work towards that when conditions allow. In the interim, we should go for auto-enrolment for free school meals, which would improve funding for schools and enable about 400,000 children to receive those meals.”
“There is strong evidence that obesity is a massive problem harming the wellbeing of our children. Some 10% of children entering reception are obese, and in year 6, 22% are obese. Free breakfast clubs will reduce those numbers. In Stroud, we have been working really closely with local primary schools to get nutritious local food into the school diet, not relying on national companies to do so. We have a commitment to try to procure 50% of that food from the local agricultural community; I am very proud of that, and keen to encourage it. Another point about breakfast clubs is that it is really important that children eat together—that is what we used to do at our primary school. It fosters a feeling of wellbeing, and the Long Table in Stroud is an organisation that encourages that.”
“That is our manifesto commitment. One reason I am here is that, under the last Tory Government, a child in my constituency had to wait six months for treatment following a suicide attempt at school, and that is simply not acceptable. On the review of the curriculum, every teacher I have spoken to has said that we need to improve the arts and music, which would in itself improve wellbeing. Rather less controversially, I will concentrate on clause 22 and the provision of free breakfast clubs. I have been a GP for the past 30 years, and I understand that health and education are inextricably linked—we cannot learn when we are hungry. Free breakfast clubs will ensure that every child, irrespective of their background, has the foundation they need to start the day.”
“The Government are now putting £79 million into music hubs and spending £5.8 million through the music opportunity pilot for people with special educational needs. I shall finish by showcasing a number of local organisations. Strike a Light, which brings drama and music to young people, is really inspirational. The Music Works in Gloucester is also truly inspirational, particularly for children from deprived backgrounds. We have the Prema arts centre in my village of Uley. Gordon Scott, the director, has been teaching the piano to countless children over the past 20 to 30 years. Let us campaign to get music teaching in every primary school.”
“Recently I was asked to join the Stroud Red Band, which was one of the most fun things I did as part of my campaign to become an MP, so I thank those involved. There are serious problems. As we have heard, there are a lot of issues due to the 30% fall in uptake of music GCSE at school. Playing music has a massive impact on children’s mental health. If we are trying to prevent mental health problems, teaching children music is one of the most effective things we can do, and it can also be used to treat mental health difficulties. Our Tory friends might be interested to know that it actually helps with academic maths as well, which is really important. As many hon. Members have said, there are massive inequalities in provision.”
“I thank the hon. Member for Chichester (Jess Brown-Fuller) for bringing forward this essential debate. I am a GP in Stroud and I have been championing arts in healthcare for over 30 years because creativity makes you better, and there is now a lot of evidence that that is the case. The Gloucestershire integrated care board—the health authority—under Ellen Rule, is investing £600,000 in creative and social prescriptions, which is incredibly exciting. I am helping to run a campaign to try to make music instrument tuition available in every primary school in the country. I co-chair the APPG for opera, which shares that aim, and the APPG for creative health. I also learned the flute at school.”
“Does my hon. Friend celebrate the work of Standing Together, which is a group of Israelis and Palestinian people working side by side for peace? Would he support it in its call for the suspension of arms transfers to Israel and for the immediate recognition of the state of Palestine?”
“I thank the hon. Gentleman for giving way, and I thank you for your chairmanship, Ms Vaz. I am from Stroud and for the past six years, even before I became a politician, I have been trying to get a greenway established in the village of Dursley that would run for about six miles to the train station. I found that there was not even funding for a feasibility study, so at the moment, we cannot get it off the ground. So I want to ask the Minister whether there will be a fund to make feasibility studies of new routes.”
“Over the past 14 years, the amount of creative education, particularly at primary level, has been reducing and reducing, so I welcome what the Minister said. There is evidence that doing creative things and learning creative subjects improves our wellbeing, mental health and academic learning. Would the Minister support my campaign to bring musical instrument teaching to every primary school in the country, not just the more well-off ones?”
“It is an utter joy, and a joy that is shared by my two-year-old granddaughter, who absolutely loves buses. So let us develop rural public transport, and take it back to what it was in the past.”
“Its cancellation has caused havoc for schoolchildren, as well as those who cannot get to work, cannot get to doctors’ surgeries and cannot get to hospitals. People have written to me saying they have had to turn down job offers. That is how important rural bus services are. A key issue in this instance was the lack of co-ordination between local authorities. It seems petty, but this is a major problem. The funding for that cross-border bus service was lost because local leaders failed to reach an agreement. That is an example of the extent to which fragmentation can affect rural public transport. Let me end by describing one of the pleasures of my week. I leave this place, take the train to Stroud and then get on to my favourite bus, the 65. I sit on the top, and I ride over Selsley common to my home.”
“The impact of nearly four decades of deregulation on our public transport system has left many communities stripped of any public transport or at the very least, of any accessibility or affordable bus services. I am therefore delighted that this Government plan to restore power to local communities, enabling local leaders to set fares, determine routes and establish timetables, taking control away from unaccountable private operators. However, I urge the Minister to confirm that rural areas without an elected mayor will have equal opportunities to benefit from the shift towards community-controlled bus services. Wotton-under-Edge had a lifeline of a bus service, the 84/85 going south to Bristol. The problem was that it crossed a boundary line between a combined authority area and Gloucestershire.”
“Under successive Conservative Governments rural bus services have been run down, and it is interesting today to observe the attention being paid to the subject of public transport on the Opposition Benches. There has been a staggering 27% reduction in bus services since 2011, and in rural areas there is a £420 million shortfall. However—to answer the hon. Lady’s question—I am encouraged by the fact that we are investing £1 billion in improving bus services, including £8 million designated for Gloucestershire. As a little aside, may I mention Stroudwater station, which was closed in the 1960s? I agree with the hon. Lady about small railway stations of that kind. They cost a great deal to develop, but when money allows and when we have got ourselves out of our current financial hole, it will be fantastic if we can invest in small stations.”
“I thank the hon. Member for Glastonbury and Somerton (Sarah Dyke) for initiating the debate, and I also commend my hon. Friend the Member for Dunstable and Leighton Buzzard (Alex Mayer) for her excellent maiden speech. Public transport, including buses, is a bit of a passion of mine. I am from Stroud, and there are many small villages in my constituency—including Dursley and Wotton-under-Edge, to name just two—so I know that public transport is about more than infrastructure. It represents a range of opportunities. It is about equality and community, and that is particularly true of rural areas, because it tends to run as a lifeline for many local residents.”
“Doctors are trained in assessing capacity, as has been said, but we are also trained in trying to find out the reasons someone wants to end their life. I think it is judging doctors harshly to say that they will not spot coercion. Interestingly, the only change in Australia was that they found that the judiciary review did not add much to the process. Otherwise, there does not seem to be a slippery slope, as long as the legislation is carefully done.”
“It puts me in a very vulnerable position. We need to resolve that. I think we are getting a bit confused between palliative care and assisted dying. A lot of people who receive excellent palliative care still request assisted dying. They are not mutually exclusive. I totally support what everyone is saying about developing palliative care, because that is really important, but that should not go instead of assisted dying. The things go together. Assisted dying is one of our tools in palliative care, as I see it going into the future. I have a couple of points about coercion, which people like me need to assess. If someone says that they feel like a burden, that is immediately not a good reason to approve assisted dying.”
“I am one of those medical practitioners, sometimes known as a doctor. I have been a GP for 30 years, and every year I look after four or five cases related to palliative and terminal care, so I have a lot of experience in this area. I would like to make some quick observations. First, a lot of patients who are dying of cancer ask whether we can curtail their life and finish it a bit early. That is a very common thing that they ask. I have had two patients go to Dignitas on their own, without family members, because the family members were fearful that they would be arrested on their return. We have been discussing giving a double dose of morphine. I think that almost all doctors in terminal care have probably done this—doubled the dose of morphine knowing that it might curtail the patient’s life. That is a big fudge.”
“I do think it is right for this Bill to require two doctors and a judiciary review, because this is new legislation and we must be sure that it is safe. These safeguards are incredibly important. I will finish simply by saying that having been a doctor all my life, I have tried to empower patients to make their own decisions over their healthcare, and this is a great opportunity to do that. I had one patient who had a terminal diagnosis and hanged himself. The family were devastated. It was a horrible way to die. I felt that we had failed as a medical profession. Let us not fail as a Government, a judiciary and the Houses of Parliament. Please support the Bill.”
“84 and 85 Yate & Wotton-under-Edge Circular bus service in South Gloucestershire. And the petitioners remain, etc.] [P003022]”
“This cross-boundary service enabled people in Wotton-under-Edge who do not have a vehicle to travel south to Yate and on to Bristol. The service also allowed people in south Gloucestershire to attend their doctors and schools, so it is really missed. I commend the efforts of Barbara Lawrence, a local resident of Wotton-under-Edge, who has been instrumental in trying to secure the return of this bus service. Following is the full text of the petition: [The petition of residents of Gloucestershire, Declares that the No. 84 and 85 Yate & Wotton-under-Edge Circular bus service should be re-instated. The petitioners therefore request that the House of Commons urges the Government to consider the needs of rural areas when allocating funding for bus services, and to take steps to encourage the re-instatement of the No.”
“In 2022, 175 countries agreed to come together to hammer out a global treaty to address plastic pollution, but after two years and with four out of five scheduled rounds of negotiations completed, we are still in the dark about what the treaty will really look like.”
“Plastic production, which is already far too high for our planet’s systems to cope with, is set to triple by 2050. The impact on climate change will be monumental. In its current state and with its current growth trajectory, plastic production will make achieving net zero impossible. Plastic production already has a global warming impact four times greater than that of the aviation industry, with 90% of emissions coming during the production process. By 2050, half of global oil demand will come from petrochemicals. Plastic production is out of control, and everyone agrees that there is a problem.”
“I beg to move, That this House has considered the Global Plastics Treaty. I thank you, Dr Huq, for chairing this debate, and the Minister for attending. Plastic pollution is putting all of Earth’s systems under stress. There is no corner of the world, from the top of Mount Everest to the bottom of the ocean, that is untouched by plastic pollution. Microplastics are accumulating in our bodies, in our vital organs, and in breast milk and placentas, and current levels of plastic production expose us to more than 16,000 harmful chemicals daily and to increasing volumes of microplastics. Plastic pollution is putting the Earth’s ecosystems and natural processes under serious strain, worsening climate change, biodiversity loss, ocean acidification and land use—and if you think the situation is bad now, it could be much worse in decades to come.”
“The Secretary of State for Environment, Food and Rural Affairs has made zero waste one of the Department’s core missions, and has set up a circular economy taskforce.”
“That is why many of my constituents have written to me about plastic pollution, and more than half a million people have signed a petition calling for a strong global plastics treaty. Earlier this year, over 220,000 people decided to take part in the Big Plastic Count—a massive citizen science project where individuals count every piece of plastic waste that they dispose of for a week. The results showed that the UK throws away 1.7 billion pieces of plastic each week, with 58% of that being incinerated, producing toxic fumes and greenhouse gases. Incineration is the UK’s dirtiest form of power generation, and incinerators are three times more likely to be placed in poorer neighbourhoods, as was the case with the one built recently in the Stroud area. Fortunately, the new Government have taken bold steps to tackle plastic pollution.”
“Earlier this week, the BBC reported that a recycling site in Avonmouth, near Bristol—which is near my constituency of Stroud—is closing down due to low recycling rates and challenging market conditions. Last month, the industry body Plastics Recyclers Europe raised the alarm about a downward trend in plastics recycling as a result of the global glut of cheap virgin plastics. Flooding the world with cheap plastic allows no space for reuse and refill systems, and the recycling industry, to develop. Here in the UK, we deal with an excess of plastic waste by burning it and dumping it on poorer countries that do not have the infrastructure to deal with it. Both practices were allowed to increase under the previous Government, as the hon. Member for Glastonbury and Somerton (Sarah Dyke) said, and the public are rightly outraged.”
“I certainly do agree with you, and it is one reason that I am delivering this speech; thank you for that. It might seem obvious that plastic pollution cannot be addressed without significant cuts to the production of plastics, but that is the most controversial and politically challenging aspect of the treaty. Those involved want us to believe that we can recycle our way out of this crisis—something we know not to be true. Plastic can be recycled only a finite number of times, simply delaying the inevitable moment when it is burned or dumped in landfill, or even escapes into our environment. The fact is that oversupply of virgin plastics at ever lower prices is undermining the UK’s ambition to create a circular economy here in the UK.”
“I do apologise, Dr Huq. I shall try to do better. As I was saying, the Environment Secretary has made zero waste one of the Department’s core missions, and has set up a circular economy taskforce. This is a good move and will create jobs in repair, rental and recycling, as well as will significantly reducing CO2 emissions. The reuse of plastics, and not just recycling, is also incredibly important. It has perhaps dropped down the agenda a little, and we need to emphasise the point, so I thank the hon. Member for Glastonbury and Somerton for her intervention.”
“My ask of the Government today is this: are they willing to demonstrate international leadership and commit to doing everything possible to bring the treaty over the line?”
“The UK demonstrated our ambitions at the biodiversity COP in Cali, Colombia, and was one of the only countries to announce a genuinely ambitious nationally determined contribution at the COP29 in Baku. The plastics treaty is another vital opportunity for the UK to demonstrate once again that it is a progressive actor on the world stage, prepared to face down polluting industries and to put the brakes on the climate and nature emergency. That leadership role is needed now more than ever, particularly in sustainable energy and in recycling. Other countries are looking to the UK, reinvigorated by our new Government, to give the treaty process the injection of impetus and ambition that it needs to get over the line.”
“I thank the hon. Member for raising that point. I do believe that green initiatives and recycling have to begin at home; we have to do our own bit first and then spread the word. The Government signed the Bridge to Busan declaration, joining over 40 countries in reaffirming the need for plastic production cuts to be included in the final treaty. The treaty needs to go further; we need a treaty that delivers a strong global target to cut plastic production, that is ambitious about the level of cuts to global production, and that is specific about how much to cut production and by when, with a global target that is legally binding. The plastics treaty is the third time in quick succession that this Government’s international climate and nature leadership has been tested.”
“Q11. The previous Government failed countless women through chronic underfunding of maternity services. At Stroud maternity hospital, post-natal beds have remained closed for more than two years. Local, midwife-led units, such as Stroud, deliver fantastic quality of care for women, while having low intervention rates during birth. Can the Deputy Prime Minister outline what steps this Government will take to improve maternity services?”
“Thank you, Mr Vickers, for chairing this essential debate about dentistry in the south-west. My mailbox is full of people complaining about the lack of NHS dentistry, and we have heard all the horror stories. As a GP, I see people staggering into my surgery holding their face. I know no more about teeth than anyone else here, but we GPs have to try to treat them with painkillers and antibiotics, because there is nothing else available. We must change that. Let me quickly talk through the dental contract; I then have a couple of positive stories, which will perhaps stimulate the Minister in respect of what could lie ahead. As has been said, the current dental contract nationally has an £86 million underspend, which is absolute madness, but it is because the contract is incredibly restricted and restrictive.”
“We should remember that two thirds of general anaesthetics used for children are used for dental reasons, and a general anaesthetic is not without risk.”
“Dentistry is exceptional because dental treatment is preventive in its own right, so as soon as NHS dentistry is stripped away, there are immediately problems. We also have to make sure that young people’s diet is better. Dentist Cerri Mellish and I have developed a project in our area. Cerri sees young pre-school children who are under five. She has a quick look in their gobs and if there are signs of decay, they are whipped out and the children are given treatment. If there are any other signs of problems, she can give them fluoride enamel. These types of innovative solutions are really important. One thing that happened with the pandemic was that NHS dentists stopped registering new patients. The pandemic started in 2020, so almost all pre-school children are likely not to be registered with a dentist, which is a real disaster.”
“Yes, but that is even more shocking, is it not? There are also disincentives in the contract for dentists to take on new NHS patients. When we look into it, there are all sorts of other things. For example, a dentist cannot provide urgent NHS dentistry unless they have used up their quota of UDAs, which are issued to dentists at the start of the year. The whole system is crazy, which is why there has been such a massive saving. As we have heard, dentists are leaving the profession, and it is clear that we are not training enough. I accept what the hon. Member for South West Devon (Rebecca Smith) said about how dentists are trained and where they are likely to end up working, because that is incredibly important. As to solutions, we must have prevention.”
“We must get the prevention in place and start doing urgent dental care, and when we have enough money we can do more. It is all very well talking about fantastic NHS dentistry, but we need the funding for it and we need the taxes to pay for it. As a Government, we are responsible for that. In the long term, we need to look to universal NHS dentistry in this country.”
“That is absolutely true. Simple things such as dental brushing schemes, which we introduced in the Stroud area before the election, are essential. Those sorts of things are often laughed at, but they are probably the most important thing we do as a Government. One other quick win relates to urgent care. The Gloucestershire ICB, particularly in the Stroud area, was able to pay more for the units of dental activity and allowed all NHS dentists to do urgent care. In that way, some of the £86 million that the hon. Member for Honiton and Sidmouth (Richard Foord) talked about was spent. We were able to quadruple the number of urgent appointments. We can do that kind of work on a smaller scale, but I suggest that we need to do things step-wise.”
“It is the Budget that will finally compensate those who have been wronged by the infected blood scandal. It is a Budget that will rebuild Britain. Lifting people out of low pay and making our country more equal is probably the most effective way of preventing ill health and making our population healthier, so what I really welcome in this Budget is the huge amount of funding for the NHS—the biggest amount in 14 years. With that funding, though, need to come reform and an increase in productivity, and I want to outline a few little projects on which we need to concentrate to increase our productivity. On GP access, Dr Tom Sutherland of Dursley practice has—”
“I thank the hon. Member for Great Yarmouth (Rupert Lowe) for his speech, but he should know better, because one of his relatives used to be a doctor in my village in the Cotwolds. I, and the rest of the country, have waited for this Budget for 14 years. I have worked as a GP throughout that time, and I have watched with horror as our NHS has gone from being the best health service in the world—as it was in 2010—to being a service on its knees. For 14 years I have watched the gap between rich and poor grow wider and wider. For 14 years I have watched the fabric of our schools, and the NHS, fall apart. I therefore welcome this Budget. It is a Budget that lifts the curse of low pay and invests in the special educational needs of our children.”
“I understand that it will be mitigated through funding. I am not exactly sure how, but I have no doubt— [ Interruption. ] That is because I have not been informed, but I have no doubt that it will be coped with. I know that this Government will rebuild general practice, just as the Conservative party trashed it and broke the back of it. I am not taking any criticism from any of you about the NHS.”