Oral Answers to Questions
Andrew Lewer Excerpts(8 months, 3 weeks ago)
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Andrew Lewer (Northampton South) (Con)
The Minister for Social Care (Helen Whately)
A year ago we set out a plan to improve urgent and emergency care, and the plan is working. Performance this winter has been better, with ambulance waits down by nearly a third, and we are learning the lessons from this year to make further improvements in the year ahead.
Helen Whately
I commend my hon. Friend for her hard work on supporting the new hospital, for the leadership she is providing and for her work on encouraging residents to have their say in the consultation. I cannot prejudge the outcome of the consultation but I agree with her that the new hospital will be great for patients, with its modern facilities. She is right to say that an urgent treatment centre can provide excellent emergency care for the majority of people who attend A&E.
Andrew Lewer
Northampton has been the beneficiary of many welcome new or improved facilities in recent years, including a children’s A&E, a main A&E and the announcement of a community diagnostic centre. However, the missing piece of the jigsaw is an urgent treatment centre, for which I have been campaigning for many years now. Will the Minister inform me on the progress on that centre?
Helen Whately
I congratulate my hon. Friend on his successful campaigning for healthcare in Northampton, which is, as he says, benefiting from upgrades to the children’s A&E and the main emergency department and will soon have one of our 160 new clinical diagnostic centres. He will know that his local NHS integrated care board will decide whether to fund a new urgent treatment centre, and I have every confidence in his ability to persuade it of doing so.
NHS Dentistry: Recovery and Reform
Andrew Lewer Excerpts(9 months, 2 weeks ago)
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Victoria Atkins
The hon. Gentleman was obviously asleep at the beginning of my statement, because I set out what I hope is a fact agreed across the House about the pandemic—the real problem. People who had a relationship with a dentist before the pandemic do not face quite the same pressures as people who may have moved home or whose dentist may have moved practice. That is the cohort of people who we are trying to help. It really would help if Labour Members focused their arguments a little more on the facts, rather than on the scripts that their Whips have given out.
Andrew Lewer (Northampton South) (Con)
I very much welcome this statement and the meetings I have had with my neighbour, the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). The Secretary of State said that Northamptonshire will be included in a dental van roll-out, which is welcome, but the rest of the statement had a very rural focus. She will recall that my Prime Minister’s question focused on shortage in Duston. Is it at least a possibility that vans will go to suburban areas as well as rural ones?
Victoria Atkins
The criteria that will apply to the areas covered by vans are clearly set on dental need and other factors such as distance from an NHS dental practice. We have been able to identify areas of particular need, where we want to get that help as quickly as we can through the dental van initiative and the other ways detailed in the plan.
Oral Answers to Questions
Andrew Lewer Excerpts(10 months ago)
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Helen Whately
The hon. Gentleman obviously was not listening to my answer; in fact, he was reading aloud. Our urgent and emergency care plan is working. It is reducing rates in A&E, and ambulances are getting to people faster. Meanwhile, I am sorry to say that in the Labour-run NHS in Wales, more than half of patients are waiting more than four hours in A&E.
Andrew Lewer (Northampton South) (Con)
Victoria Atkins
We understand how worrying the possibility of medication shortages can be. There is a supply issue with riluzole 50 mg tablets, caused by a supplier experiencing manufacturing issues. We have a well-established procedure in place to deal with such issues, and are working with the industry, the NHS and others to resolve it as quickly as possible. We have contacted alternative suppliers and have secured sufficient volumes of stock.
COP10: WHO Framework Convention on Tobacco Control
Andrew Lewer Excerpts(10 months, 1 week ago)
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Andrew Lewer (Northampton South) (Con)
I beg to move,
That this House has considered COP10 to the WHO Framework Convention on Tobacco Control.
It is a pleasure to serve under your chairmanship, Mr Vickers. I thank the co-sponsors of today’s debate, the hon. Members for Ealing, Southall (Mr Sharma), and for Linlithgow and East Falkirk (Martyn Day). I also thank all colleagues who have requested to speak, and the Backbench Business Committee for giving this application the urgent consideration that was asked for. The fact that Members wished to contribute to this debate, and to many others on similar topics of late, demonstrates how important this issue is across our United Kingdom.
I am pleased to see my right hon. Friend the Minister in her place, and of course I welcome her back to Government. I say that with no small amount of friendly bias, as she and I are constituency neighbours in Northamptonshire and have known each other for a very long time. We look forward to hearing from her later. I also welcome the shadow Minister, the hon. Member for Bristol South (Karin Smyth); I am keen for her to share her perspective on today’s proceedings. I state for the record that I have served as a vice-chair of the all-party parliamentary group for vaping.
I beg your indulgence, Mr Vickers, as I set the scene for why we are here today and outline the importance of what we are discussing. My co-sponsors and I were clear that this debate is not yet another opportunity to opine generally about smoking and vaping, or to merely rehash some of the well-known talking points that arise when we talk about these issues. Hopefully, it will not be a debate in which each side of the political divide claims to be cloaked in unique righteousness. I was pleased to have tripartite support for the debate application, and even more pleased that colleagues from a wide array of political parties, and from all four parts of the UK, have expressed a desire to speak in this and related debates.
It has been a stressful few days in Parliament. In some senses, the timing of this debate is very important, as it comes ahead of the 10th conference of the parties, but in other senses it is less fortunate, coming as it does straight after what we have been through over the past two or three days. Nevertheless, the debate is an opportunity for this mother of Parliaments to show our democracy at its best. We in the legislature can come together on a non-party basis to question the Executive and hold the Government to account. We should be conscious that many people from around the world will be watching these proceedings, given that the debate relates to international agreements and has a global perspective.
To the best of my knowledge, this debate is one of a kind. It is the only substantive discussion on next month’s meeting of the framework convention on tobacco control, COP10, taking place in any parliamentary democracy. It is my hope that we can shine a light on the World Health Organisation’s sometimes less than ideal proceedings.
I thank my hon. Friend the Member for Harrow East (Bob Blackman) for having secured the debate in this place on the WHO framework convention on tobacco control in March 2020. We all share a dislike, to put it mildly, of smoking. I pay tribute to the work that he and his colleagues do on the all-party parliamentary group on smoking and health to drive smoking cessation. Who in Parliament does not hate smoking? I do, and where we have differences, they are only on how best to drive it out. Since that debate nearly four years ago, we had one subsequent conference of the parties to the WHO: FCTC COP9, which took place in Geneva in November ’21. Today, of course, we are discussing COP10, which will be held in Panama in just over a fortnight.
We all know the term “COP”; it has become something of a household name, thanks to the United Nations climate change conference, which concluded its COP28 meeting in the United Arab Emirates last year, and which is heralded as a beacon of openness, transparency and engagement. The UK hosted COP26 in Glasgow in November 2021, which was expertly presided over by my right hon. Friend the Member for Reading West (Sir Alok Sharma). Ministers from Governments from all over the world attend these meetings. Indeed, our own Minister for Energy Security and Net Zero, my right hon. Friend the Member for Beverley and Holderness (Graham Stuart), was so enthusiastic about COP28 that he went to it twice. The conference sessions are open to the media, to civil society and to other interested stakeholders to participate in.
What a contrast that is with the FCTC and COP10. Despite smoking being one of the leading causes of death in the UK, killing about 80,000 people every year and causing one in four cancer deaths, there is likely to be no ministerial representation from the Government in Panama. It is unfortunate that such an important area of health policy is left to officials. Unlike the climate change COP, the FCTC COP meets and takes decisions behind closed doors, away from the scrutiny of Parliament and the press. The decisions taken in Panama next month will have wide-ranging influence over the UK Government’s approach to smoking cessation and the regulation of tobacco harm reduction products, which many smokers use to quit combustible tobacco.
For nearly a year, I have been asking the Department of Health and Social Care who will be in the UK’s delegation to COP10 in Panama. I have been asking what positions that delegation will take, and whether we will continue to stand up for Britain’s world-leading and evidence-based approach to tobacco control and smoking cessation. I know that a great many Members from across the House have made similar representations to the DHSC. Despite repeated oral and written parliamentary questions on the subject, Ministers have not yet set out the UK Government’s approach to COP10 in any detail. Clearly, none of us wants our Government to be as opaque as the World Health Organisation is on this and many other issues.
My first request of the Minister is that she asks my right hon. Friend the Minister for Energy Security and Net Zero to give serious consideration to attending COP10 in Panama next month. Members may ask why that is so important. The UK is one of the largest financial contributors to the FCTC, with millions of pounds of taxpayers’ money being shipped off to the WHO in recent years to support this agenda. That is whole streets-worth of residents of my constituency’s total contribution to the Exchequer. Every penny of tax that street after street of them pay goes to funding the WHO. We have an obligation to our constituents to ensure that the money is well spent, so we need to know who will be standing up in Panama on their behalf, and what policy positions will be supported or opposed.
What we do know is that the WHO takes a highly sceptical view of tobacco harm reduction products, including vapes, heated tobacco and oral nicotine pouches, arguing that they pose a risk to health. As I have mentioned, that is in direct contrast to the UK’s world-leading approach to tobacco control. It really is world leading, and we should be proud of what we have accomplished in recent years in driving down smoking rates and saving lives. Public Health England, which is now the Office for Health Improvement and Disparities, has been clear that vaping is at least 95% less harmful than smoking, and that heated tobacco products are considerably less harmful than conventional combusted tobacco cigarettes. That is independent, peer-reviewed evidence from a glittering array of public health experts, clinicians and scientists, not funded by players in the tobacco industry. Not only has it formed the bedrock of the UK Government’s approach to smoking cessation in recent years, but our model has been heralded by public health experts in countries and universities across the world as a beacon to follow. I therefore pay tribute to the Minister’s predecessor, my hon. Friend the Member for Harborough (Neil O'Brien), for the groundbreaking “swap to stop” scheme, which he announced early last year. For many of my constituents, vaping is a vital alternative that helps them to curb their smoking habits and quit, and the “swap to stop” scheme, which offers free vape starter kits to smokers, is a welcome tool in the arsenal.
When the Minister unveils her legislation later this year, we will have the opportunity to debate some of the fundamentals, including ensuring that children do not access nicotine products, and giving trading standards the enforcement powers that they need to tackle rogue traders who sell to minors or sell illegal products. However, we must not throw the baby out with the bathwater by introducing draconian measures that discourage adult smokers, whether deliberately or not, from making the switch to vaping. That is a fundamental point. Over-regulation and blanket bans are not the safe option; they could cost lives.
I agree with the Minister’s remarks in the debate last week that we must clamp down on packaging with cartoon characters, and vapes shaped like toys, but I discourage the misconception that flavoured vapes are not designed for 60-year-old smokers. There is very clear research on this: in a 2003 opinion poll by OnePoll, 83% of smokers stated that flavours helped them to quit smoking, and there is a definitive and widely available study on this matter by the University of Pennsylvania. Constituents tell me that it is precisely the availability of a wide range of non-tobacco flavours that enables them to make the switch away from harmful cigarettes. I oppose the suggestion from the hon. Member for Walthamstow (Stella Creasy) that adults are not interested in fruit-flavoured vapes. Why should adult smokers be discouraged from switching away from smoking, which will cost them their life, by a vaping market that is reduced to tobacco-only flavours that constantly remind them of smoking, and trigger their desire to smoke a cigarette?
There is also a danger that over-regulation will exacerbate the black market. In fact, as colleagues pointed out in the Westminster Hall debate on illegal vapes on Tuesday, the black market has flourished in recent years. Between 2020 and 2023, more than 2.5 million illicit vapes were seized by trading standards across 125 local authorities, and the enforcement agency warns that that is just the tip of the iceberg. Do we want to grow that iceberg, or reduce it as much as possible?
There is a tendency for us politicians to pass legislation or produce guidance from Whitehall so that we can say that we are taking robust action on an issue, without having regard to how it might be implemented. The UK already has stringent restrictions in place via the Tobacco Advertising and Promotion Act 2002, so much of the issue is really about enforcing the many existing laws, rather than a need for new ones. Speaking as a long-standing local government man—and I am still vice president of the Local Government Association—underpinning this issue is the new burdens doctrine, which this Government have signed up to and adhered to for many years. That doctrine states that all new burdens on local authorities must be fully assessed and funded. It is a cornerstone of Whitehall Departments’ preparatory work before they pass responsibilities on to local authorities, and I urge the Minister and her officials to keep that broader point in mind for discussions at the conference.
The real risk is that at COP10, the WHO will, as is expected, call for regulatory equivalence for tobacco harm reduction products, so that they are treated in exactly the same way as combustible tobacco products. That is not only counter to the UK Government’s position; if successful, it will significantly harm public health goals, not just in this country but across the world. Some countries have already banned vapes but not cigarettes, and that will cost huge numbers of their citizens’ lives.
Additionally, why bother to “swap to stop” at all if cigarettes and vapes are taxed in the same way and there is no price differential or flavour incentive to quit? That said, I am conscious that the Minister is still compiling her response to the recent consultation on smoking and vaping ahead of new legislation, which we await with interest.
There is one occasionally repeated fallacy that must be nailed and not repeated, given its harmful potential. It is not nicotine that causes lung cancer, and nor does nicotine itself kill its long-term users; rather, it is the constituent chemicals inherent in the combustion of tobacco within cigarettes that causes harm. Nicotine vapes, oral nicotine pouches, and indeed heated tobacco products—which are sometimes known as “heat not burn”, given that there is no combustion involved—are all essential in giving adult smokers a range of solutions for their smoking cessation journey. For the avoidance of doubt, I quote Cancer Research UK, which says that nicotine
“is not responsible for the harmful effects of smoking, and nicotine does not cause cancer.”
Tackling misinformation is at the heart of this debate, as we consider some of the measures that the WHO is proposing to enact at next month’s COP10 meeting, and the harmful effects they will have on public policy here at home.
As ever, the devil is in the detail, so I ask colleagues to forgive me if I take a few minutes to speak to some of the specific policies under consideration in Panama, and why the UK delegation must stand firm against them. The words of the Chief Medical Officer for England are ringing in my ears:
“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.
We need to consider how our public health bodies can effectively communicate that to adults who currently smoke.
One of the most worrisome proposals being put forward by the WHO is item 6.2 on the agenda, which covers tobacco advertising, promotion and sponsorship. It is widely understood that the WHO will push for an expansion of article 13 of the FCTC to include reduced-risk products—vapes, “heat not burn”, and oral nicotine pouches —within the restrictions on advertising, as if they were the same as combustible tobacco, when, as I hope I have already illustrated, they are not.
Like everyone else in this room—I cannot stress the importance of this enough—we have to ensure that children are not targeted by nicotine products, but successful uptake by adult smokers of these reduced-risk products as part of the UK Government’s strategy of tobacco harm reduction relies on the ability of responsible manufacturers and retailers to provide important and accurate information about the products’ health benefits when set against traditional combustible cigarettes. There are still 6.4 million smokers in the UK, and they are our constituents, our neighbours, our families, and—I am very sorry to say—for many of us, our friends.
Misinformation on this issue is not only dangerous; it is lethal. The best must not be the enemy of the good. The extent of misinformation is such that, according to Action on Smoking and Health, four in 10 smokers believe that vaping is as harmful or more harmful than smoking. That figure increased by a third last year. A recent YouGov poll also found that over 50% of people thought that vaping was more harmful or as harmful as smoking. Whenever there is an online newspaper article about this subject, to which I have obviously been paying particular attention in the last week or so, I am amazed by the extreme, contradictory and occasionally potentially dangerous views expressed.
The proposals under discussion at COP10 would limit the ability to tackle misinformation on relative harms, while simultaneously restricting the promotion of reduced-risk products to adult smokers. As I alluded to earlier, the UK delegation must challenge any attempt to bring about regulatory equivalence between combustible tobacco and reduced-risk products—in particular “heat not burn” products, which the Office for Health Improvement and Disparities has made clear are substantially less harmful than smoking.
There is a risk through item 6.3 on COP10’s agenda that the WHO will seek to do just that: to push Governments around the world to regulate vapes and other reduced-risk products in the same way as combustible cigarettes, leading to the concern that that could extend to proposals on taxation and price points. If the WHO is successful, any financial incentive to switch away from cigarettes will be removed. That point has been made by many colleagues on many occasions, and I know from our work together on the APPG for vaping that the hon. Member for North Tyneside (Mary Glindon)—my colleague and co-author of an article on the issue—has spoken passionately about it and her own personal experiences. Such measures would send the wrong message, and would only perpetuate the dangerous myth, believed by 40% of smokers, that vaping is as harmful as smoking, and would therefore obviously discourage them from switching in the first place.
Will the Minister undertake to confirm that the UK delegation will block any measures to restrict the ability to effectively communicate with adult smokers on the health benefits of switching away from combustible cigarettes? Will the UK delegation oppose any move towards regulatory equivalence, including on taxation and price points?
I am conscious that other colleagues wish to speak. Thank you, Mr Vickers, for indulging me in setting the scene more generally and outlining some of the concerns as the Government head into COP10.
Sir Christopher Chope (Christchurch) (Con)
My hon. Friend is making a brilliant speech, and I am grateful to him. Can he explain why we would be required to follow any recommendations that come out of COP10? As a sovereign country, surely we would be able to decide whether we wished to accept the recommendations.
Andrew Lewer
I will develop my hon. Friend’s point in my closing remark.
If the UK delegation attends COP10 and goes along with international agreements, even if they are not legally binding, there will be a mood music and atmosphere, as we have heard in recent days, that because we are a signatory and have agreed to go along with them, we therefore need to follow along. My hon. Friend the Member for Christchurch (Sir Christopher Chope), possibly more than anyone else, has been robust about the limitations of international bodies with respect to this Parliament and this country. However, as we discovered this week, their prevailing influence is great, and not standing up to proposals at such events therefore leads inexorably to their proposals being absorbed into British policy and lawmaking.
It would be hugely beneficial if the Minister attended COP10 in Panama and flew the flag for our world-leading public health strategies for smoking cessation. She is someone who passionately championed, when she stood astride that Wembley stage back in 2016, Britain’s great future as an independent, free-trading and outward-looking nation, having taken back control of our laws, borders and money. I do not believe for one moment that she wishes to see responsibility for our public health policy abrogated to another supernatural—sorry, supernational: a Freudian moment there—unelected body of bureaucrats. To assist in setting out the UK position, perhaps my hon. Friend the Member for Winchester (Steve Brine), in his capacity as Chair of the Health and Social Care Committee, might have the UK delegation appear before him and his colleagues to answer questions before COP10 gets away on 5 February, as well as afterwards.
Our constituents, many of whom have written to us about this in recent days, have the right to know what the UK delegation will or will not be doing on their behalf, let alone who is in it. I am sure that I speak for many Members when I say that we would welcome clarity on that point. I am grateful to the Minister for coming to respond to the debate. I am sure that she will use the opportunity to provide us with some of the answers we seek, and will undertake to keep the House and colleagues fully informed. I hope she will make a statement from the Dispatch Box at her earliest convenience after the conclusion of COP10 to update us on the outcomes from Panama.
I look forward to the contributions of colleagues from all parts of the House, and to the response from the shadow Minister, the SNP, and the Minister, who I know shares my passion for ensuring that our Parliament retains its status as the sovereign decision-making body.
Andrew Lewer
Small is beautiful. I found myself agreeing with virtually everything that everybody said; I do not think I have ever before been in a debate, here or in the main Chamber, where that has happened. It is confirmation that light is better than heat. Alas, the Minister is not attending COP10, but I am grateful to her for naming the chief delegate, and for outlining the policy stances in more detail than we have had before.
I have not said, and I do not think anyone else has, that nicotine is harmless. I do not want to minimise the impact of nicotine, but think of a man emerging from the desert, dying of thirst, who is given a glass of dirty water. The fact that he has a glass of water is more important than the fact that it is not perfectly crystal-clear water. That is the case with smoking cessation. I absolutely agree about children, but we should bear in mind the new burdens doctrine, and the huge plethora of laws that we already have. Properly funding trading standards, so that it can tackle the issue, is more critical than having new regulations. Also, there is no evidence for claims about a gateway; the recent University College London studies on 16 to 25-year-olds are especially compelling on that.
We need to dispel naiveté in both direction about flavours. We heard about packaging that looks like Coca- Cola bottles, and having the vapes next to the sweets. Let us just get rid of all that, and not have an argument about silly designs that are obviously for children. However, let us also not be naive about the huge number of people who use flavoured vapes, and about modern 20 and 30-somethings, who think a bubble-gum flavour is not obviously for a teenager; it is for them. Lots of people use flavoured vapes. I have a relative in her 30s who does. As a result, she is not smoking, and that is the more important thing. Plainer packaging that is not directed at children and not having silly names is fine, but flavours that take people away from the taste of tobacco have an important role to play.
I am not a banner by nature—I have voted against various measures banning stuff—but cigarettes are different. If, when smoking was invented, we had said, “The idea is that we roll up a weed and set fire to it to give ourselves lung cancer,” smoking would never have existed. When I was a Member of the European Parliament, I was on STOA, the Science and Technology Options Assessment Panel, which was supposed to be the science and technology committee on evidence-led policymaking. However, some of its members—I was one of them—were honest with themselves that we often come to an entrenched position and then go find the evidence that backs it up, rather than the other way round. We all do it; we do not all admit to it. It is useful that we are at an early stage of consultation, so that we do not have an entrenched idea that we must defend with convenient evidence. Instead, we are evidence-led, rather than having set in stone what we will do. The reassurances we have received on that point, and the outlines given on where we are going with COP10, are extremely welcome. With that positive and uplifting statement, it is my great pleasure to conclude the debate.
Question put and agreed to.
Resolved,
That this House has considered COP10 to the WHO Framework Convention on Tobacco Control.
Oral Answers to Questions
Andrew Lewer Excerpts(1 year, 4 months ago)
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Neil O’Brien
It is to protect public health that we have provided cost of living support worth £3,300 on average per household, and that is why we have been paying about half of people’s average electricity and other energy bills. However, we always look at further things we can do to drive improvements in public health.
Andrew Lewer (Northampton South) (Con)
The Minister for Social Care (Helen Whately)
In the last three years, the National Institute for Health and Care Research has invested more than £30 million in kidney disease research. NHS England is following a national approach to reduce healthcare inequalities, with a specific focus on some of the risk factors for kidney disease, such as chronic respiratory disease. As diabetes is the most common cause of kidney disease, it will be a focus of our major conditions strategy.
Vaping: Under-18s
Andrew Lewer Excerpts(1 year, 6 months ago)
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Dr Hudson
I agree. That is exactly right: there is a paucity of data. I will ask the Government and the Department of Health and Social Care to create the datasets so that we can make evidence-based decisions.
Concerningly, ASH Scotland suggests that children with mental health issues including mood disorders and eating disorders, who are among the most vulnerable people in society, are potentially more likely to use vapes. That is a real concern. I am passionate about mental health, especially among our young people, and I urge the Government to continue to protect the most vulnerable. That has been the hallmark of this compassionate Conservative Government.
Anecdotally, we hear much about the impact of these products. We hear reports of children’s sleep patterns being disrupted. They set their alarms for 2 o’clock or 3 o’clock in the morning so that they can vape in the middle of the night to avoid withdrawal symptoms the next day. At school, there have been reports of students leaving lessons and even walking out of examinations because they simply cannot last without the use of a vape. If vaping is having a detrimental impact on our young children’s life chances, this is a matter not merely of health but of social and educational development. One teacher in my constituency noted that the issue is so widespread that vapes are being illicitly traded in the school playground.
I want to touch on the marketing of vapes to under-18s, as colleagues have done. A particular issue with the vaping market is the flagrant targeting of under-18s as potential consumers through trendy advertising on social media. Products are promoted with bright colours and inviting fruit flavours—sweet flavours such as mango, bubblegum and cherry ice.
Andrew Lewer (Northampton South) (Con)
The Office for Health Improvement and Disparities annual review of vaping reveals that 39% of ex-smokers use fruit-flavoured vapes, against 17% who use tobacco. There absolutely are issues with marketing, advertising and presentation to young people, but does my hon. Friend agree that an overly simplistic blanket ban of flavours might have the serious unintended consequence of preventing some potential vapers from vaping, meaning that they would carry on smoking and thus massively increasing their chances of an early death?
Oral Answers
Andrew Lewer Excerpts(1 year, 7 months ago)
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Maria Caulfield
Absolutely; choice is important. Only last month we published the single delivery plan for maternity and neonatal services, which I am sure Members across the House will already have read. It puts women at the heart of decision making and learns from the Ockenden and East Kent inquiries, to ensure that women have better choice when giving birth.
Andrew Lewer (Northampton South) (Con)
The Secretary of State for Health and Social Care (Steve Barclay)
The urgent and emergency care recovery plan sets out how we will invest more than £1 billion in increasing capacity, including 800 new ambulances, an additional 5,000 core beds and a further 3,000 virtual wards, to provide more than 10,000 out-of-hospital care settings.
Andrew Lewer
A key component of delivering better urgent care services will be expanding the network of urgent treatment centres across the country. Can my right hon. Friend assure me that a UTC in the major population centre of Northampton will be a high priority for the Department?
Steve Barclay
My hon. Friend is right to highlight the importance of UTCs. Nationally, they are above the national standard: 95.5% of patients are seen within four hours. He is a highly effective campaigner on health issues—he helped to secure the £2.8 million of investment for a new paediatric emergency department in his local area—and I know that he will be making a similar case to his local commissioners.
Motor Neurone Disease Research: Government Funding
Andrew Lewer Excerpts(1 year, 11 months ago)
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Helen Whately
The hon. Member makes two really important points. As he says, several prominent sportsmen who have been effective campaigners have sadly been affected by the disease, and there is a potential relationship with head injuries. He also made a point about the challenge of diagnosis, which I will take away.
The hon. Member for Kingston upon Hull East rightly talked about the tenacity of campaigners such as Rob Burrow and how effective their visible campaigning has been at raising awareness of MND. The disease affects a significant number of people, with around 5,000 suffering from it right now. Sadly, we know that people do not live very long with MND, so a really significant number of people across the country are being affected over time. It is incredibly cruel for the individuals who suffer.
I heard the request of the hon. Member for Kingston upon Hull East for a meeting, and I will come to some of the plans to address his calls in a moment. As I said, MND has a huge impact on those who have been diagnosed, and it is devastating for them and their families. We have made real progress in research, but we are yet to learn why motor neurones die off. There is still no cure for the disease and only one drug is licensed in the UK to treat MND, which is why the Government committed back in November 2021 to make at least £50 million available for MND research over the next five years.
Before I go into more about research, I want to say something about how we are supporting people living with MND, which is a degenerative condition—often rapidly so—that requires complex and anticipatory care. For that reason, the majority of services for people with MND are specialised and commissioned nationally in the 25 neurological treatment centres across England. In the absence of a cure, we want to make sure that people with MND have access to the best health and care support available to meet their complex needs. It is really important for people suffering from MND and their carers to have specialised and targeted support, including devices to help people with MND to be able to continue to communicate effectively for as long as possible, as well as other types of care.
Since November 2021, we have invested £790 million in the National Institute for Health and Care Research biomedical research centres, which bring together experts to translate scientific breakthroughs into treatments for patients. At the Sheffield centre, researchers have already pioneered evidence-based interventions to manage the symptoms of MND. In September, the Sheffield researchers published promising clinical trial results for the drug tofersen. Professor Dame Pamela Shaw, the director of the NIHR Sheffield BRC, said:
“I have conducted more than 25 MND clinical trials and the tofersen trial is the first trial in which patients have reported an improvement in their motor function.”
I want to emphasise that because, until now, it has been very hard to be optimistic about developing a cure for MND or even effective treatment. The trial is, in fact, grounds for optimism against this cruel disease.
In June, the Government and charity partners invested in a £4.25 million collaborative partnership on MND, which includes LifeArc, the MND Association, the My Name’5 Doddie Foundation and MND Scotland. The Government are supporting groundbreaking research undertaken by the UK Dementia Research Institute. Seven of its 50 research programmes are dedicated specifically to MND, with world experts undertaking discovery science, translational and clinical research to drive medical progress.
There has already been work going on to invest in MND research, but I heard the impatience of the hon. Member for Kingston upon Hull East and have heard from other hon. Members. Indeed, my hon. Friend the Member for Northampton South (Andrew Lewer), who is here today, has also lobbied me and other Ministers on the desire for greater pace and so that money goes towards research quicker and then translates more quickly into treatments.
To that point, yesterday, we announced at the Department of Health and Social Care, together with the Secretary of State for BEIS, how we will deliver the full £50 million research commitment, which will build on our existing investments and successes to more rapidly fund MND research. In that regard, £30 million of Government funding will be invested immediately through specialist research centres and partnerships with leading researchers. That will include £12.5 million to the UK Dementia Research Institute to support groundbreaking research specifically into MND, a further £8 million investment into early-phase clinical research for MND via the NIHR biomedical research centres and £6 million for a translational accelerator that connects the DRI capabilities with those of the Francis Crick Institute, the Laboratory of Molecular Biology and the new MND collaborative partnership. We are investing a further £2 million in the MND collaborative partnership, which will specifically focus on data for MND research.
Andrew Lewer (Northampton South) (Con)
I am triggered by the reference to Francis Crick, who was also from Northampton, so there is quite a connection here, also given my great privilege to be the chairman of the all-party parliamentary group on motor neurone disease. I am grateful to the hon. Member for Kingston upon Hull East (Karl Turner) for having this debate, but particularly grateful to the Government for listening, making some really important announcements and pushing this forward. It has been received with great pleasure by the research community and MND sufferers. I hope the Minister will accept my thanks for that. I look forward to working further with her in taking this forward, now that we have the new announcements.
Helen Whately
It is good to hear from my hon. Friend. Credit goes to him for his campaigning, both personally and as chair of the APPG on motor neurone disease, together with that of other Members of Parliament, to push for investment to get out to the frontline on research. I look forward to working with him further so we can ensure this investment in research makes a difference for people suffering from MND and their carers, and for those in the future.
I have just mentioned the MND collaborative partnership, which is a mechanism by which the many initiatives that I just described will come together. The first meeting of this virtual institute took place at the end of November, and I am looking forward to hearing about further progress now that the funding is in place. The remainder of the committed £50 million of MND funding is available for researchers to access via the NIHR and the Medical Research Council. Government will support researchers in coming forward with ideas for new research via a joint highlight notice between NIHR and the Medical Research Council on MND. That will allow our funding to be responsive to progress in science and ensure breakthroughs reach patients in the quickest possible time. Further to that, the Secretary of State will shortly host leading researchers and patient groups at a roundtable to discuss MND research and help researchers make the best bids as quickly as possible. That addresses the call for a meeting from the hon. Member for Kingston upon Hull East.
Oral Answers to Questions
Andrew Lewer Excerpts(1 year, 11 months ago)
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Maria Caulfield
I thank the hon. Lady. I know she raised her constituent’s case in a Westminster Hall debate on 22 November and my understanding is that they now have an appointment for January, but there is absolutely a backlog from covid patients. We know that. That is why we are putting in over £8 billion in the next three years to deal with that backlog. That is in addition to the £2 billion we have already provided through the elective recovery fund. We have already virtually eliminated the two-year wait and we are now on track, by April, to eliminate waits of 18 months or more.
Andrew Lewer (Northampton South) (Con)
The Minister of State, Department of Health and Social Care (Helen Whately)
I thank all those who work in social care for what they do day in, day out for people whose lives depend on care. We are supporting care homes and agencies in their efforts to recruit staff, including with a substantial national recruitment campaign. In fact, colleagues may have seen some of the adverts while watching popular programmes such as “I’m a Celebrity”. We have also added social care workers to the shortage occupation list, so that social care can benefit from international recruitment to increase the workforce in the short term.
Andrew Lewer
A recent report from the Motor Neurone Disease Association, outlined at the all-party group on motor neurone disease, which I chair, found that most unpaid MND carers provide more than 75 hours of care a week, but many are unable to access respite services due to the lack of adequately skilled care workers equipped to care for the complexity of MND sufferers’ needs. Will the Minister commit to increasing specialised training for conditions such as MND in the social care workforce to protect carers’ health and wellbeing?
Helen Whately
My hon. Friend makes an important point. I, too, have heard from family carers about the difficulties that they have faced in getting skilled professional help, which, in turn, gives them support and respite. At the moment, we provide £11 million annually for a workforce development fund, which social care employers can access to help to pay for staff training. Looking ahead, we are working on social care workforce reforms, of which training and skills will form a substantial part. I commit to looking into his suggestion that specialist training for MND care should be part of that.
Motor Neurone Disease
Andrew Lewer Excerpts(2 years, 1 month ago)
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Andrew Lewer (Northampton South) (Con)
I beg to move,
That this House has considered the matter of investing in the future of Motor Neurone Disease.
After much delay due to circumstances out of our hands, I am grateful that we have the opportunity to debate this vital issue. I thank the Backbench Business Committee for its efforts in finding us time to speak about it today and the hon. Member for Newport East (Jessica Morden) for her support. Time is of the essence for those affected by motor neurone disease, but a time of calm seems not to be fated for the debate, having endured rail strikes at the first attempt and our national loss of Her Majesty at the second attempt. I had intended to comment that at least today was a day of calm, but that does not appear to apply.
I do not usually speak in the Chamber as filler material for procedural purposes. I speak only when I think that I have something to contribute, and that is very much the case today. Back in 2017 when I was selected to stand in my constituency of Northampton South after my time as an MEP, my first meeting was during a visit to the Motor Neurone Disease Association headquarters, which is in my constituency. I had heard of motor neurone disease, of course, but I had no idea that it would become so central to my time in this place and an issue that I would hold so close to my heart. As soon as I joined Parliament, I became a member of the all-party parliamentary group on motor neurone disease. I became a vice chair, and then chair, following Madeline Moon, a former colleague and a formidable campaigner on this topic.
I am sure that hon. Members know what comes with a diagnosis of motor neurone disease. It is a fast-acting and rapidly progressing neurological disease affecting nerves that control muscles. It leads to a rapid deterioration of the body, leaving many sufferers unable to speak. Ultimately, it results in death. Sadly, at present there is no cure. About a third of MND sufferers pass away within a year of diagnosis, and more than half within two years. It affects up to 5,000 people at any one time in the UK. However, I stress that that number would be much greater were it not for the fast-acting nature of the disease. It is therefore in a critical sense not a rare disease.
The debate is about not just stands and numbers but people, many of whom I have worked with and been inspired by. All hon. Members in the Chamber as well as those watching in the Gallery and at home will know about the campaigning of rugby league legend Rob Burrow and his family, as well as his teammate Kevin Sinfield, who have not only brought the Government’s attention to MND but raised its profile. Colleagues will know about the powerful BBC documentary that Rob produced.
Alongside Rob, Doddie Weir and Stephen Darby have shown the same tenacity and dedication to raising the profile of MND, as well as Lee Millard, David Setters and Chris Johnson, who have worked closely with the all-party parliamentary group. They have attended several of my meetings in Parliament and met Ministers as well. From my own constituency, Emma Moss, a mother and former deputy headteacher diagnosed with MND, has just received a Points of Light award for her campaigning. I am in no doubt that her family, especially her daughter, are immensely proud of all she has achieved in the face of adversity. I would like to also mention Ganesh and Rachel Thayanithy, whom I spoke with recently following from Rachel’s diagnosis. They have also shown that inspirational quality.
There are a lot of people I could mention who have done so much to highlight MND and support those with it, but I want to mention my right hon. Friend the Member for Bromsgrove (Sajid Javid) whose help was crucial as Secretary of State for Health, one of the busiest roles in Government. When I arranged for a group of MND sufferers and carers to come—this remains one of my most treasured memories—and proceed through the streets to No. 10 to demand action, my right hon. Friend came to see us. He did not just come and say hello; he stayed and spoke to virtually everyone. He had a lengthy discussion with the MND teams and with Professor Al-Chalabi in particular. Outside the bubble, and indeed even inside it, it is not always possible to know who really treats people well and with respect and gives them a fair hearing. I have certainly had some experiences of that myself here, but none of that applies to my right hon. Friend the Member for Bromsgrove, so let the record show that he really is one of the good guys.
In recent years, there has been ever-growing interest from the research community and the pharmaceutical industry in MND. A real surge in studies and trials have offered sufferers and their families some renewed hope for treatment and a cure. Some of those have included the treatment of spinal muscular atrophy, an inherited degenerative condition that targets motor neurones that predominantly occurs in infants and children. The ATLAS trial is actively recruiting SOD1 gene carriers and aims to establish a blood test which can give an early warning that physical disease will manifest within the coming six to 12 months. Participants can then take part in trials of the Tofersen treatment, which initial evidence suggests can substantially slow progression of severe disease, thereby boosting respiratory function, muscle strength and quality of life.
Essential to enabling that research is, of course, funding. After long dedicated campaigning, the United to End MND coalition achieved a huge victory in November 2021 with a commitment from the Government to invest £50 million over the next five years into targeted MND research, involving the creation of an MND research institute to accelerate the quest for treatments. What a rollercoaster that was from there not being any announcement in the Budget—down—to a special announcement a week later—up—that £50 million was forthcoming, made by my right hon. Friend the Member for Bromsgrove. The Government further confirmed in September 2022 that the funding would be ringfenced, which provided confidence, and further victories have followed. A group of charities and Government research organisations have awarded £4.25 million to MND experts at six UK universities to kick-start collaborative moves to find solutions to problems hindering MND research, such as better testing, data collection, wider trial participation and wider access to the only current life-extending treatment for MND, with the aim of making real progress and making it fully treatable within 10 years.
There is, however, so much more to do. The initial ambition of the bid was that the virtual research institute would free up researchers from having to engage with multiple application systems and assessment exercises marked in Whitehall. That detracts from the time researchers can spend on pure research and progressing treatments. I therefore suggest to Ministers that this would be a perfect opportunity to put into practice the new, new Government’s emphasis on cutting red tape. Researchers, desperate to get on, are presenting a way to make better use of public money for the benefit of the cause. Please be more imaginative about tackling process. Please do not let officials say that we have always done it that way. I am very pleased to go and see the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) to make progress on this issue. I believe that if anyone can cut through this, given his skills and experience, it is him.
Another key area on which progress is needed is access to genetic testing. That is particularly critical in the case of the Tofersen treatment, because it is a gene-based therapy targeting an inherited form of MND caused by mutations in the SOD1 gene. Currently, genetic testing for MND is typically restricted to patients with family members also affected by the disease and patients who do not have a family history but have symptoms starting early in life. According to the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, that state of affairs potentially overlooks hundreds of people, including many over-40s, who have a genetic form of the disease and for whom those new treatments, which are gene-based, could make a real difference. However, there are broader benefits in widening access to genetic testing, too, because it enables people to have an understanding and therefore earlier access to key advice and counselling, regardless of their age.
The confirmation of an MND diagnosis is devastating for anyone to hear. A survey by the Neurological Alliance of 8,500 people living with such conditions found that 40% of those surveyed did not feel that they had adequate access to mental health services. That needs to change. Many said that they had waited a year from their first symptoms after seeing their GP to see a neurological specialist. That also needs to change— notwithstanding the backlogs from the pandemic, and so on—and not only for MND, but for the majority of neurological conditions. In the light of that, I hope that the Government will listen to growing calls from the MND community for the Government to invest in and establish a neuro taskforce to drive forward improvements in neurology services and ensure that the impacts of the pandemic are both understood and addressed for people seeking help for living with MND.
Many sufferers require around-the-clock care, which often falls to family members and loved ones. Although many will give the care that their loved one deserves, that is a difficult and demanding experience. The MNDA carried out a survey and found that 33% of those surveyed spent more than 100 hours caring for their loved one and 45% of those received no benefits at all. That heartbreaking situation should not happen, with even those who receive the carer’s allowance struggling to support somebody, having had to give up a full-time job to care for an MND sufferer—not to mention the problems with disabled adaptations. The MNDA is therefore calling on the Government to publish a recovery and respite plan for unpaid carers, which would focus on packages for carers, including mental health, financial and other measures.
As we move into the winter and spring, there are justified concerns from the MND community about the non-inclusion of MND carers in the winter and spring covid booster vaccination programme. I would be grateful if the Minister considered expanding access to MND carers.
MND is a disease that affects people from all communities. The nature of the disease requires specifically trained carers, as that not only ameliorates the condition but helps to prolong sufferers’ independence and autonomy, maintaining their wellbeing and dignity as the disease progresses. Given those specific needs, it is conspicuous that only 26% of people with MND received that sort of care.
Social care has been a matter of much discussion over the past few years and is one that I have spoken about many times in the House. As a former county council leader and a member of the Levelling Up, Housing and Communities Committee, I can say that the situation for sufferers of MND is a reflection of wider social care failings. The complexity of taking care of MND sufferers should not limit their access to services because agencies are reluctant or unable to commit time or money to that service. There is a need for specific support, particularly for respiration, but people with MND try to live their lives as richly as possible and the failings of social care must not hinder that.
Limited specialised care will otherwise continue to contribute to unnecessary danger. Inadequate understanding on how to use equipment, for instance, has left patients leaving hospital with incorrectly attached tracheostomy tubes, resulting in individuals having entirely preventable critical emergency readmissions. In the best-case scenario, the lack of access to skilled social care puts the burden on friends and families; otherwise, it leaves people going prematurely to hospital or to a hospice. The Department of Health and Social Care, which provides 20% of the £50 million that I referred to, clearly needs to recognise the relevance of social care to the conversation. We ask the Government to invest wisely to improve the quality of and access to social care. Those who live with MND need skilled and trained staff.
We are talking about significant sums being invested, but it imperative that the closer-to-home costs of MND are also addressed. Given how aware of finances we are in the current cost of living crisis, it does not take a very significant stretch of the imagination to understand that those with MND are all the more vulnerable to rising energy costs. Indeed, the household costs are double for people with MND, piling on top of already rising costs. The bills that MND sufferers face make very sombre viewing.
It is no surprise that four out of five people with MND consider the impact of the disease to be very negative. Their costs only increase over time as the disease progresses and they rely further on energy-consuming equipment. Inevitably, they spend more time at home fatigued by the disease, which has an energy impact. For those with MND, who have more to deal with than most of us can imagine, that financial uncertainty should be one less thing to have to think about.
I therefore hope that the Government will try to ensure that disability benefits are uprated in line with inflation and that those who live with MND and other disabling conditions receive continuing support with energy costs after the proposed end to the cap scheme in April. I also hope that the Government will increase the emergency support package that they announced in May to ensure that the most vulnerable are supported through the coming winter.
There are a huge array of issues to tackle with MND, simply because of the severity of the disease, but I hope that I have provided a run-through of the issues that need to be considered, especially by the Government. I look forward to colleagues’ speeches.
Several hon. Members rose—
Andrew Lewer
I thank all hon. Members who have spoken in this debate—I will not name them because I do not want to miss anyone—for their powerful speeches and for being here. It illustrates the importance of the work of the all-party parliamentary group, which provides an opportunity to work together and put political differences to one side for the benefit of our constituents. We know about dashing around for APPGs and emailing people to get them to turn up, but I never have to do that for the APPG on motor neurone disease; we always pack the room when we have a meeting.
The Minister has listened closely to the debate and the contributions of hon. Members, including the Front Benchers. His comments have been very encouraging, especially about getting to grips with red tape. He also made reference to the Francis Crick Institute—Francis Crick was, of course, a Northampton man.
“Moonshot” is the word used for MND research, but the genetic breakthroughs that I spoke about earlier mean that we now know where the moon is and we have a good idea how to get there. That £50 million can help us to achieve a cure for MND, but we need more haste in getting launched and onwards to the dream. What we have heard today has been really encouraging in that regard.
I thank all those at the MND Association for all their hard work and support over the years for me, and for the contribution that other key charities, such as MND Scotland and My Name’5 Doddie Foundation, make towards this work. That led to United to End MND, which has really punched through, as I described in my speech earlier.
This debate has focused on those who suffer from MND and their tremendous courage in facing something that none of us wants to face. We can hardly imagine the severity and experience of those who go through it and those who care for them and love them. I hope that we have demonstrated today that we take those suffering seriously and we take the inspiration that they provide us with seriously. It is a tribute to those who care for them that we are all so determined to help to find a way forward for people so that they do not have to suffer in that way in future.
Question put and agreed to.
Resolved,
That this House has considered the matter of investing in the future of Motor Neurone Disease.