Childhood Obesity

Baroness Chapman of Darlington Excerpts

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend for his question. Absolutely, we always need to ensure that we are trying to learn from best examples, either in this country or from around the world. The OECD talks about four major strands: information and education; increasing healthy choices; modifying costs, such as a sugar tax; and restrictions on the placement of food and promotions. Noble Lords can see that we are taking much action in all those areas. Most of all, I am pleased to see that, influenced by a trailblazing initiative started in Amsterdam, we are now funding five local authorities to follow that across Birmingham, Bradford, Nottingham and Lewisham to see what we can learn from those initiatives.

[Baroness Chapman of Darlington (Lab)]

My Lords, what parents, health professionals, educators and retailers want is some consistency and clarity from the Government. Can the Minister confirm whether the Government intend to maintain the previous Prime Minister’s plans to ditch the vast majority of their 2020 obesity strategy, against the advice of the current Chancellor, who just two months ago signed a letter from former Health Ministers on the need for an anti-obesity strategy? We need to know where we are.

[Lord Markham (Con)]

I hope the noble Baroness will forgive me if I am not quite sure which former Prime Minister and Chancellor she is referring to. I could not resist that, but I take her point and will respond in writing.

Health Incentives Scheme

Baroness Chapman of Darlington Excerpts

Thursday 28th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for that important question. When I am being briefed, I test my officials and make sure that I am able to answer as many questions as possible. I am told the “eatwell plate” costs about 3p less per adult per day than the current diet in the UK, but I will write to the noble Baroness with more detail. If the noble Baroness is not happy, she can challenge that.

[Baroness Chapman of Darlington (Lab)]

My Lords, I really think the Minister can afford to be less prickly about all this. No one is disparaging the idea of a pilot; there have been many hundreds of pilots in this space, to my knowledge, and probably many more that I do not know about. The easy thing is piloting it; the hard thing is rolling this stuff out and having an impact. It is just that we are rather underwhelmed with the scale of this pilot, given the scale of the challenge we face. But in the interest of being positive about all this stuff, a Parkrun practice pilot has been taking place in GP surgeries up and down the country—only about 20% of them are actually taking part. Early assessment looks incredibly positive. It does not actually cost anything to implement. I encourage the Minister to try to accelerate the rollout of this initiative and, if he does not already, to take part in his own local Parkrun.

[Lord Kamall (Con)]

I thank the noble Baroness. I would like to know on what basis she thinks I should take part—I hope I am not looking unhealthy. I also apologise to noble Lords if I have come across as prickly; maybe I just got too excited about this scheme. As someone who been quite critical in the past of schemes that do not work and who has looked at evidence behind such schemes, I am excited that this is a real pilot, as opposed to a one-size-fits-all national system. We can see what works and then roll it out. I also thank the noble Baroness for making me aware of the scheme in GP surgeries. Maybe the noble Baroness could do me a favour and send me some details, so I can look into it in more detail and see how we could roll it out.

Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021

Baroness Chapman of Darlington Excerpts

Monday 22nd March 2021 Lords Chamber

[Baroness Chapman of Darlington (Lab) (Maiden Speech)]

My Lords, I am grateful for the opportunity to make my maiden speech while the House is considering such important matters, and also for the very warm welcome I have received since being introduced.

I am sure that, like many others here, I never expected to be sitting on these red Benches. I grew up in Darlington with my parents and brother, and I have many of the same friends now that I had then—and it is fair to say that Darlington made me who I am. It is the birthplace of the railways and the home of the Northern Echo and pioneering bridge builders. It is an exceptional place and I was proud to represent it in the other place for almost 10 years. It is where my two sons, Ted and Dan, are getting towards the end of their school education, and where they will always be proud to say that they are from. The maternity unit where they were born still has consultant-led births, and Darlington Memorial Hospital still has its accident and emergency service, because of the campaigns that I led. Hundreds of Department for Education jobs remain in Darlington because of the argument I won with the Government. Darlington and the north-east is a great place to live, to grow up and to grow old.

However, like people in too many other towns, the people of Darlington chose to turn away from my party in 2019. The party of the NHS, the minimum wage and the Good Friday agreement was no longer speaking for the priorities of the women and men working in our towns. It was our greatest defeat since 1935. When this happens, a party cannot say, “What is wrong with the electorate?”; we must ask ourselves where we went wrong. I was glad to chair Keir Starmer’s leadership campaign. He is a good leader, with integrity, compassion and experience, and he will make a great Prime Minister. He has built a good team of people, who have no airs and graces and who roll their sleeves up and get stuck in. The Labour Party’s director of communications, Ben Nunn, was at ease knocking on doors in my home town in the freezing cold in 2019. He knows, as all of us in my party know, that we need to listen and to change if we are to win. The challenges of the gig economy, demographic change, the climate crisis and now pandemic disease must be faced by political leaders and the public together.

The Labour Party does not belong to interest groups or factions. It belongs to people like my parents, who worked their whole lives looking after others; like my fellow Labour fighter and husband Nick, who grew up in the Welsh valleys in a family of steelworkers and miners and who is, like me, Labour to his core; but also to people such as my brother Robert and my sister-in-law Alison, who runs her own business in the most difficult circumstances and who is not much interested in politics. It is their party too, and it will win again only when the British people see us as a party that is theirs, and one that will build a better future with them. We must give the Labour Party back to the people of Britain.

The last year has been extraordinary for all of us, but I am looking forward to being an active working Peer, and I am sure that I have much to learn about how this Chamber and its committees work. I am keen to understand what can be achieved through the winning of votes at this end of the Parliamentary Estate. I can promise that I will give it my all, and I look forward to working with all of you in the years to come.

Health Infrastructure Plan

Baroness Chapman of Darlington Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend for his question. He is right to highlight the importance of design, particularly in A&E and emergency departments, for the ability of staff to manage increasing demand and increasingly complex cases. As he highlights, Kettering General Hospital NHS Foundation Trust is included in HIP 2 for the seed funding to develop that business case and its proposal. I am happy to work with him and I hope that he will work with the trust to develop the business case in accordance with the criteria for bidding against future funds.

[Jenny Chapman (Darlington) (Lab)]

A couple of years ago, my constituents and I led a spirited and successful campaign to maintain A&E and maternity services at Darlington Memorial Hospital, but our attention now turns to the state of mental health services in Darlington. I know these problems are not unique to my constituency, but they are dire. There are young people and children in Darlington who have been waiting for 18 months for an autism diagnosis. The situation needs urgent attention. Will the Minister please meet me to discuss how we can improve the situation?

[Edward Argar]

As the hon. Lady will know, improving mental health services for those with mental health needs is at the heart of this Government’s agenda. The Government have already announced investments of over £400 million in improving the mental health estate since July 2017, but she highlights a specific point and has a specific request—that I meet her. Given the number of meetings and visit requests I have had today, there may be a slight wait, but I would be very happy to meet her.

Acquired Brain Injury

Baroness Chapman of Darlington Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Jenny Chapman (Darlington) (Lab)]

I thank my hon. Friend the Member for Rhondda (Chris Bryant) for securing this debate. I knew nothing at all about acquired brain injury until I met someone in my constituency called Nicola Hughes, who told me that she also had known nothing about acquired brain injury until her husband acquired his. I do not know the circumstances; I have never asked her, and she has never talked to me about exactly how it happened. What she has made very clear to me is the impact it has had on her, their daughter and their family, and how inadequate she believes the support is for families of people with an acquired brain injury.

Nicola says that the hardest part of the whole journey for her and her family was when her husband came home. Their isolation, and the lack of support that was there for her, for him and for their daughter is something that we cannot allow to continue; it must be addressed urgently. Initially she was expecting him to get better and was waiting for recovery. I know that happens for some people, and it is a wonderful thing and should be happening more, but for some people, that is not the likely outcome. She has had to learn to love and be with a new person, effectively. It is a journey that I do not think any of us can appreciate unless we have found ourselves in that situation.

In Parliament, we talk a lot about inspiring people, and Nicola is incredibly inspiring. She has written children’s books to explain to her daughter what is the matter with her daddy, to normalise the situation and to get her used to what is happening. One of the things Nicola has told me about that concerns me a lot is the lack of consistency in support for families when people leave hospital. She said there is a clear discharge programme in Oxford, where all staff are briefed and letters go to the family’s GP so that the carer’s GP knows that their patient has now acquired this new caring responsibility and may need additional intervention and support. She said that the support is virtually non-existent in some other areas, and I fear that my area of Durham Tees Valley is not up there with the best in that regard.

I have been to Headway and taken the time to understand the pathway on which many of my constituents find themselves. I do not think we have it right. Luckily, thanks to Nicola and her leadership, we have a wonderful Headway branch in Darlington, but if that was not there, there would be virtually nothing for people in such circumstances. Services should be provided according to the need of the person affected and their family, not according to where they live. I know we say that about lots of conditions, but I have never seen it as stark as I have seen it with brain injury. I would be grateful if the Minister could take it upon herself to look at the services available in Durham Tees Valley in particular and to get back to me with her assessment of how far we are from meeting what should be national standards—a minimum expectation for patients and their families.

--- Later in debate ---

[Seema Kennedy]

I have found it is always good to be sceptical in this place.

The NHS long-term plan was announced in January this year. There are some key actions designed to improve the care, treatment and support of people with long-term conditions, such as ABI. Community services, which play a crucial role in helping people with long-term conditions such as brain injury, remain as independent and well supported as possible and are to receive significant investment. The long-term plan set out £4.5 billion of new investment in primary and community care, including for expanded community multidisciplinary teams, providing rapid targeted support to those identified as having the greatest risks, including those with long-term health conditions.

There is also the comprehensive model of personalised care, which includes self-care, care planning, personal health budgets and social prescribing, and which we hope will reach 2.5 million people by 2023-24.

[Jenny Chapman]

I am worried about the long-term plan. Yes, brain injury is included, but so is just about everything else. My concern is that brain injury is getting lost and is not getting the priority it needs; although I appreciate the Minister taking the trouble to raise points and ask questions, that will not be sufficiently effective. We need something with more teeth. We need to be very clear what a patient can expect, what their rights are and what their family can do about it if those things are not provided. Trusts and whatever the structures are in the different parts of the country must be compelled to provide a certain level of service.

--- Later in debate ---

[Chris Bryant]

This has been a good debate and I am grateful to all those who have taken part. I am grateful to the Minister for what is, I think, her bearing down on NHS England, although she is sounding too nice about the way she is going to approach it.

[Jenny Chapman]

Nice is good.

[Chris Bryant]

Nice is good, obviously, but a little bit of bearing down is important. I am grateful to the UK Acquired Brain Injury Forum, Headway, Sue Ryder, the National Star College near Cheltenham and so many other organisations, including the Child Brain Injury Trust and the Disabilities Trust, who have done so much work in the field to inform us about a subject that was completely unknown to many of us, in the same way that it is unknown to so many members of the public.

To correct one element, perhaps we have given the impression that all is gloom. I have met so many people who have had brain injuries and whose personality change has been marked, but sometimes they have developed a phenomenally savage wit that they did not have before. There are people who have said, “Yes, it has changed me, but I have become a new person and that person can play a full part in society and has discovered other ways of appreciating life.” So let us not turn all of this into gloom. I just want us to be able to do better—to make sure that there are enough rehabilitation beds for every single person to get the improved care from which they could benefit.

I have met the deputy Prime Minister several times and I think it is really important that the Government now decide, as a matter of priority, to set up some taskforce—probably of junior Ministers, probably with this Minister at the helm—to drive forward this issue in all the different Departments that it affects. We could get the health bit right and lose out on so many other bits and, in the end, we would have failed the people we are talking about.

Who knows what will happen to the Government? Anybody who says they know what is going to happen to the Government later on this year is lying, but I wonder whether there might not be a moment now to say, “We are going to make this a priority. It is going to be a three-year taskforce and we are going to make sure that every single Department pulls its weight to make sure that we truly deliver.” As I said earlier, it is almost cruel to save lives and not give people the quality of life that they deserve.

Question put and agreed to.

Resolved,

That this House has considered acquired brain injury.

Cervical Cancer Smear Tests

Baroness Chapman of Darlington Excerpts

Monday 28th January 2019 Westminster Hall

[Jenny Chapman (Darlington) (Lab)]

It is a pleasure to speak in this debate, particularly under your chairmanship, Sir Roger. It is great to be in a Parliament in which women are prepared to stand up and share some of the most private, intimate things about their lives—probably things they have not told their mothers—in a forum such as this.

[Hannah Bardell]

I just want to say that, when I went to the sexual health clinic in Edinburgh, my mother came with me. She was the only person I trusted—and, yes, until today there were only a handful of people in my life who knew that story.

[Jenny Chapman]

She sounds fantastic—how lucky you are.

We are now in an age in which women can stand up in Parliament, as I do not think they could even as recently as 2010, when I was first elected, and talk about the cost of Tampax, smear tests, their sexual history—

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

And mesh.

[Jenny Chapman]

And mesh, as my hon. Friend never stops reminding me. That is a good thing—a wonderful thing—and I am really proud to be part of it.

When I saw that this debate was taking place, I asked for the data for Darlington, because I wanted to see where we stood. I was anticipating the same thing I normally get when I compare health data for the north-east with the rest of the country, but I was pleasantly surprised: take-up is better in the north-east than in most places in the UK, which is a very interesting fact. Part of it, I think, is about the stability of communities and the ability to access services that are themselves stable. They do not tend to move around too much and GPs tend to serve for longer. Although there can be many problems with access to services, it appears that, in this regard at least, women in my constituency are availing themselves of the opportunity to get tested at a higher rate than women in other parts of the country. That is very welcome.

Looking at the data on Darlington, I notice that the participation rate among 25 to 49-year-olds is fairly steady at about 74% or 75%. The take-up among older women—those aged between 50 and 64—has gone down by 2% in the last year, which seems to be the case in other parts of the country as well. I welcome the discussion about testing young women under the age of 25, but we should be mindful that we might be sending the message to older women that they do not need to worry. Take-up is perhaps dropping off more quickly among older women than among those in other age groups due to embarrassment, indignity and all of that. At the risk of oversharing, the only smear test I have ever had—where I really did not care happened not long after I gave birth to my second child. That was not an issue at that point. However, I am mindful of the fact that older women are not taking part in the way we would wish. Some of that is obviously about the indignity, but also there is a lot of misinformation and misconception about cervical cancer.

I have heard it said that once a person is no longer as sexually active as they might have been earlier in their life, or does not change partners quite so often, they are somehow at less of a risk or no longer need to be so concerned about cervical cancer, and their need for a test is therefore reduced. I have heard people say that, if they are in a same-sex relationship, they do not need to have a cervical screening test. There seems to be an association between sexual activity and a risk of cervical cancer. I do not know where that has come from or why it persists—my hon. Friend the Member for Warrington North (Helen Jones) referred to it when she talked about vaccination. That kind of misconception seems to apply to older women as well. If the campaign mentioned by the hon. Member for Henley (John Howell) takes place, it is very important that they take the opportunity to get those messages right, too.

My hon. Friend the Member for Rotherham (Sarah Champion) made a very helpful point about women who have been victims of sexual abuse. They have a very special and entirely understandable concern that is not taken into account by the blunt approach that service providers can take. More thought needs to be given to that. Disabled people might have additional needs when accessing this test, and I am absolutely certain that not every setting will be able to cater for those needs in a way that enables a disabled woman to have the test with the dignity and sensitivity that we would all expect.

The declining participation in smear tests is a trend that should ring an alarm bell for Ministers, and I am sure it does. This is a red-flag dataset. It is great that we have the data—it is fantastic to debate something with clear information, and when we can see good-quality data over time and get a good idea of what is happening in different parts of the country. We must use that to nip this problem in the bud before it gets even worse. From people I have spoken to, access to this service is one of the principal reasons, along with all the other things that we have talked about, why women are not participating in increasing numbers and why we are seeing those numbers decline.

The GP patients’ survey last year found that 28% of patients found it “not easy” to make an appointment over the phone to see a nurse—up from just 19% in 2012. We have had many debates in this place on the difficulty in accessing GP services, which I know the Government will want to grapple with. It is affecting these women. A smear test is a very easy thing to want to put off. Someone might get round to making that phone call, but if it does not quite work the first time, it is tempting not to get round to it again for some weeks or probably months.

The work that Jo’s Cervical Cancer Trust has done is absolutely phenomenal—what a tremendous organisation. It is really impressive. Its data, stories and the way it puts those across in a manner that everybody can access and understand are fantastic. The trust found that one in eight women find it difficult or impossible to book an appointment for their smear test, which just cannot be right. It might be the case that women should be encouraged to access services not through a GP, but through a specialist clinic where they could access contraceptive services at the same time. That is now available in Darlington—it is also open in the evenings and is a very good service, which might be one of the reasons participation rates in my constituency are holding up relative to other areas of the country.

Obviously I take the point that the age of screening must relate to science, but I wonder whether this is a situation in which we might be able to prevent some of the misconceptions and anxieties about pain, which does not need to happen, or a lack of dignity, which there does not need to be if screening is done sensitively. Young women can have a good experience if they are encouraged to have a test at an early age. Perhaps we need to give some thought to positive early experiences of smear tests to increase participation rates among women over 25.

We need to consider an awful lot about access to the test and cervical cancer generally. This is an important part of it and I congratulate everybody who signed the petition and put it in front of us. We have an opportunity to do something that would make the lives of my constituents and everybody else’s so much better and safer. The Minister is listening and thinking hard, and I know he wants to do right by the people who signed the petition.

--- Later in debate ---

[Steve Brine]

Indeed. If the hon. Lady is not satisfied with what I say now, then please come back and we will make sure that she gets more information after the debate. Self-testing for HPV is an emerging area of medicine. It is not in the same place as the fecal immunochemical test for bowel cancer, but it is an emerging and exciting area of policy. I echo all the positive words that have been said about Jo’s Trust, Jo herself and Rob Music, who runs that charity.

Members will be aware that the NHS offers cervical screening to all eligible women aged 25 to 49 every three years and to those aged 50 to 64 every five years. The screening is designed to detect abnormalities of the cervix at an early stage so that women can be referred for effective treatment. It is important to remember that the purpose of population screening is to reduce mortality and morbidity from cancer and other conditions—that is why we do it—in people who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage. Hence prevention is better than cure.

The purpose of any screening service is to maximise the chances of healthier outcomes and, by association, minimise risk of harm to the whole population. With this in mind, the UK National Screening Committee considers the evidence on whether population level screening should be offered and makes recommendations to Ministers. It is not Ministers who make this stuff up, and nor should we. Using research evidence such as pilot programmes and economic evaluation, the NSC assesses the evidence for programmes against a set of internationally recognised criteria. It is important that these recommendations are made by experts based on the best available evidence, and not by politicians.

On this basis, in 2012 the UK NSC recommended that women should be invited for their first cervical screening at the age of 25. This recommendation was based on evidence that showed that the majority of women below this age would receive little benefit from being screened and treated, which can lead to unnecessary treatment, as we have heard from hon. Members. It is very rare that cervical cancer occurs in women under 25 —as the shadow Minister said, there are fewer than three cases per 100,000 women. That is no consolation to someone who, like Natasha, is one of those three who pays the ultimate cost. I am only setting out the facts as they are.

Younger women often undergo natural and harmless changes in the cervix—it is part of their physiology—and screening could identify those as cervical abnormalities. In most cases the abnormalities resolve themselves without any need for intervention. The recommendation picked up by the NSC in 2012 concurred with a major review by the Advisory Committee on Cervical Screening undertaken in 2009, so the advice goes quite a long way back. The hon. Member for Warrington North asked me whether the NSC would publish its evidence on the decision to screen from the age of 25. The NSC publishes minutes of all its meetings and the full rationale behind any recommendations. However, I will ask Public Health England and the UK NSC to publish any relevant evidence used by the NSC in reaching its conclusions and on which they based their recommendations that is not already in the public domain, which I hope she will be pleased to hear.

I will talk about HPV primary screening. Every life is precious and we cannot be complacent in continuing to do all we can to prevent cancer—those who know me know that I am not complacent. Therefore, we are modernising the cervical cancer screening programme by introducing the detection of human papillomavirus as the primary test in the NHS cervical screening programme. I can confirm that this will be implemented across England by 2020. Cancer Research UK estimates that, when fully implemented, HPV primary screening could prevent an additional 600 cases of cancer every year. As we have heard, almost all cervical cancers are caused by HPV, which is a very common sexually transmitted infection which is linked to the development of the disease.

In addition to changing the primary test in the cervical screening programme itself, I want to highlight that vaccination against HPV, introduced in 2008 under the previous Government, is now routinely recommended for all girls aged 12 to 13. In England and Wales the first dose is offered in school year 8. The programme aims to prevent cervical cancer related to HPV infection and the best way to do that is to vaccinate girls and young women. We are fortunate to have achieved good uptake of the HPV vaccination in adolescent girls since 2008.

The first cohort of teenage girls to receive the HPV vaccination in year 8—those born in September 1996—will turn 23 this year and become eligible for routine screening in two years’ time. It will be of intense interest to all of us to see what impact the vaccination will have on the number of abnormalities detected through routine cervical screening and we will be monitoring this very carefully. I will be watching it like a hawk, as Members would expect. We have already seen that the vaccine has led to a reduction in HPV infection in young women and we anticipate a fall in the numbers diagnosed with cervical cancer at the age of 23 to 24 this year.

Boys have received a level of protection from the girls’ vaccination programme over the last 10 years and we have had debates in the House about that. I referred to the previous Chair, my right hon. Friend the Member for North Thanet (Sir Roger Gale), because he led a debate in the House about HPV vaccination for boys and there was a lot of debate about it. A lot of people said that the boys get herd immunity and therefore they do not need the vaccination programme. Again, I am led by the evidence and the advice that I am given, but my personal view was that I did not agree with the herd immunity argument. I was pleased that I agreed with the advice and from September 2019, all boys aged 12 and 13 will also be offered the HPV vaccination against HPV-related diseases, such as oral, throat, penile and anal cancer. I know the hon. Member for Rotherham wanted to hear about that. That will help reduce the incidence of HPV infection circulating in the population.

It is worth saying that, although HPV infection is the primary cause of cervical cancer, many other cancers, such as head and neck cancer, will be seen a long way down the line. Without wishing to be indelicate, I am told that the popularity of oral sex means that HPV vaccination will have a big impact on the incidence of oral cancers. As the dental Minister, I often hear from dentists that that is a growing problem, so I am pleased that we are able to make a positive policy response, which has been well received.

As the hon. Members for Warrington North and for Rotherham said, there are plenty of people who disagree with HPV vaccination. Whenever I speak on the subject— I can feel the tweets landing in my inbox as we speak—I open myself up to the responses of those who vehemently disagree. All I can say is that I think they are wrong and that that is what the evidence suggests. This is a free society and they are of course entitled to that opinion, but we base policy decisions on the evidence. That is where we are. What I have said about the HPV vaccination for girls, and now boys, is important, but I reiterate the message that it is still important for women who have been vaccinated to attend their cervical screening appointments when invited. It does not turn people into Wonder Woman.

The hon. Member for Washington and Sunderland West asked me what we are doing about education for young adults on HPV vaccination, and regional variations in uptake, a point that she has raised with me before. NHS England works in close liaison with Public Health England to deliver the HPV vaccination programme for girls, and in future for boys, and closely monitors uptake rates. It sends me regular reports. Local NHS England commissioners have access to those uptake rates in their area and, in due course, so will MPs. They work with providers, schools and healthcare professionals to improve coverage, sharing best practice where relevant. It became clear to me when looking at the information that there are variations, which is a concern. I made my concerns about regional variation in vaccination uptake clear to the NHS and have had meetings with NHS England and Public Health England on a number of occasions—twice in recent months—asking for additional action to increase uptake across England. I want them back in my office on a regular basis to report to me. That somehow seems to stimulate them.

I am pleased that the NHS long-term plan featured involving local co-ordinators to encourage uptake. That came out of those meetings along with various other commitments to improve vaccination rates, not just for HPV but across the vaccination piece. That includes requiring CCGs to ensure that all vaccination programmes are designed to support a narrowing of health inequalities. They know that I remain on their case. If the hon. Member for Washington and Sunderland West would like to continue the conversation on that with me, I should be pleased to hear it.

The review that the Secretary of State has asked Sir Mike Richards to carry out has been mentioned. Cervical cancer affects many women and their families, and screening can help to prevent many people from developing cancer each year. It is obviously important that women take up their screening appointments to help spot abnormalities. However, with uptake only at about 75%, we know that we need to make it easier to book appointments and more convenient for women to attend them—that point about access came up a number of times in the debate.

I met Mike recently and said that I have an app on my phone that tells me when my car is due for a service and lets me book a local appointment at a time that suits me. We do not embrace that kind of no-brainer technology enough in healthcare. We have to embrace modern technology to ensure that screening programmes are fit for the 21st century. The Secretary of State and I feel passionate about that, and it should offer greater ease of access. Doing that will, I am sure, improve uptake rates. That is one key reason why we are considering comprehensively how our current national screening programmes can be improved, particularly in the light of recent issues that could affect public confidence in screening and lower uptake.

Professor Sir Mike Richards will be leading a review of all three cancer screening programmes, which of course includes cervical screening. His review will report in the summer and will specifically assess the strengths and weaknesses of the individual programmes. It will also address, as I have just outlined, how the latest innovations can be utilised and integrated with research to encourage more people to be screened, and to make it easier for them to do so. That point was raised by many hon. Members, including the hon. Member for Warrington North. I met Sir Mike a couple of weeks ago to discuss the fact that his review clearly needs to set out how we can bring our screening programmes right up to date to make them fit for the people who use them. I await his recommendations with optimism. Mike ran screening programmes in the Department of Health and Social Care before the passing of the Health and Social Care Act 2012. He has great experience and credibility within the system, which is important. We have great optimism about his work.

We must do more to raise awareness not just of the importance of taking up screening, but of how to recognise the potential symptoms of cervical cancer. Breast cancer awareness campaigns have been phenomenally successful in that kind of work. In her petition, Natasha said that she wanted to make a difference to the next generation of young women by raising awareness of the symptoms. I have seen the videos online of her little girls—they are heartbreaking. Natasha certainly raised awareness of the symptoms of what is a terrible disease. I believe she has already made a difference, highlighting how vital it is for women with symptoms to contact their GP as soon as possible. Indeed, it is 10 years since Jade Goody, who also took on the fight to raise awareness, sadly died of the illness. We shall, with the permission of Jade’s family, use the anniversary to help raise awareness of the importance of screening, and of taking up appointments. In the aftermath of Jade’s sad death attendance rates rocketed. Obviously that has waned. We will, in Jade’s and Natasha’s honour, make the most of the 10-year anniversary to save other women.

[Jenny Chapman]

It is encouraging to hear what the Minister says, and his comments about the legacy of Jade Goody and others. It is a tremendous thing that they have left to us, with the campaigns we have benefited from. However, is there not, up to a point, cause for concern in that the examples being used are younger women, which could reinforce the misinformation about the need for younger women to be more concerned about cervical cancer—and therefore for older women to be less concerned? Sometimes I wonder whether the prominence given to the examples in question may create an issue for another group of women.

[Steve Brine]

The hon. Lady makes a good point, and there is always a danger with public awareness campaigns, even down to the models, actors and actresses used in the advertising campaigns, with presentation and positioning. I take the point, and Public Health England, which works on such campaigns for me, will also take the point the hon. Lady raises. I assure her it will be sent a copy of the debate.

A number of hon. Members, including my hon. Friend the Member for Henley, who is no longer in his place, have raised the matter of GPs. Guidance for GPs has been developed and published, specifically aimed at improving the primary care of young women who present with gynaecological symptoms. That guidance, produced by a multidisciplinary group, including professionals, patients and the voluntary sector, and endorsed by the relevant royal colleges, offers clinical practice guidelines for the assessment of young women aged 20-24 who present with abnormal vaginal bleeding. GPs are continually made aware of the symptoms of cervical cancer and the need to refer women under the age of 25 for further investigation. From today’s debate, it sounds as if we have further to go, but we knew that, of course. As part of the delivery of essential medical services under the National Health Service (General Medical Services Contract) Regulations 2004, GP practices must offer consultations and, where appropriate, they must also offer physical examinations for the purposes of identifying the need, if any, for treatment or further investigation and, if needed, referring the patient onwards as soon as possible. The hon. Member for Rotherham made an excellent point about understanding the history of trauma that some women on their lists had had. Obviously it is a subject that she has a lot of experience of in her constituency; I thank her for making that excellent point, and I will ensure it is fed into the Mike Richards review.

I have mentioned the “Be Clear on Cancer” campaign a couple of times, and said that Public Health England will work to raise awareness of this disease through that campaign, which we have run in partnership with Cancer Research UK since 2011. It has covered many different areas and is scheduled to promote the uptake of cervical screening from next month.

While we are still on the awareness point, in the 2016 Budget the Government announced that Jo’s Cervical Cancer Trust, which does so much good work in this area, as has been said, would be a beneficiary of the tampon tax. It received £650,000 in funding to kick-start a campaign to get closer to eradicating cervical cancer. I take part in many of these debates and talk about cancer, as does the shadow Minister. One third of cancers are preventable and two thirds of cancers are just bad luck. With some cancers, we are nowhere near, but this is a cancer we can get rid of. This is a “bad” that we can eradicate. That is why we are so determined to get it over the line.

Jo’s Cervical Cancer Trust ran a campaign on eradication in 2017 and 2018; it was a wide-reaching awareness programme, with a specific focus on groups where there is a higher prevalence of non-attendance of cervical screening: interestingly, that is women from black, Asian and minority ethnic communities, women from disadvantaged backgrounds—a point already made—and women in the 25-to-29 and over-50 brackets. The funding enabled the trust to provide targeted education and information to those groups and to produce a body of evidence on the barriers to screening and how to overcome them.

The trust found that some young people do not attend appointments because they are embarrassed; that finding received a lot of press coverage and came out in Prime Minister’s questions last year. Others do not think the test is important, and yet more do not think they are at risk because they lead healthy lifestyles. One in four do not attend their screening appointment, and that needs to change, so this is important work.

From talking to Rob from Jo’s Cervical Cancer Trust, I know that one thing they found on the roadshows when they were testing this work in 2017 and 2018 was the importance of talking to women’s partners and the role partners can play in reminding, or nagging—whatever word we choose to use—women about taking up their screening appointments. Last week, the trust led their annual cervical cancer awareness week, with an event here in Parliament. The aim is to help as many people as possible to know how they can reduce the risk of the disease, and to promote that among their constituents.

The #SmearForSmear campaign reinforces the message that smear tests prevent 75% of cervical cancers, so while they may not be pleasant, as we have heard, they are important. I was pleased to support them myself, as most of the Health team did, at the event in Parliament last week, and I thank all hon. Members who took part; I know Jo’s Trust found it helpful. As Natasha’s Army says—this is such an important message—we need to support all young women to “lose the fear, take the smear”.

If I may try to draw my remarks to a close, this Government—as did the previous Government, and as will the next Government—recognise that cervical cancer is a devastating disease, and we are committed to providing well-managed screening programmes based on the most up-to-date, peer-reviewed evidence. Cancer is right at the heart of the NHS long-term plan, which was published on 7 January, and I am very proud of that fact. The plan sets out a comprehensive package of measures that will transform cancer diagnosis and treatment across the country over the next 10 years, a decade in which patients can expect to see vast improvements in the prevention, diagnosis and treatment of cancer. The aim is to see 55,000 more people surviving cancer for five years in England each year from 2028. That is quite an ambition, but we will get there.

Cervical screening saves an estimated 5,000 lives a year, and the Government are committed to continuing to do all we can to prevent cancer and ensure early diagnosis, which is often rightly called cancer’s “magic key”, so that more families do not have to go through these personal tragedies, as the Sales have done. We are up for the fight. I thank everyone for taking part.

Oral Answers to Questions

Baroness Chapman of Darlington Excerpts

Tuesday 8th May 2018 Commons Chamber

[Stephen Barclay]

If Members vote against the policy tomorrow, the reality is that they will be voting for a cap on the number of postgraduate nurses going into the system, and therefore they will be saying that more people should be rejected—more people should lose the opportunity to become nurses—because they want to have a cap that restricts the supply of teaching places.

[Jenny Chapman (Darlington) (Lab)]

7. What support GPs provide to mothers experiencing perinatal mental health problems.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

We are committed to improving mental health support for expectant and new mothers, and GPs are crucial to that. We recognise that specialist services are also required, and I am proud to announce today that NHS England will be spending £23 million on rolling out the second wave of community perinatal services to underserved parts of the country and is on course to achieve full geographic coverage by 2020-21.

[Jenny Chapman (Darlington) (Lab)]

Given that 95% of mums surveyed by the NCT said that they had experienced mental health problems, that only 22% said they were even asked about this by their GP and that only 24% of the country has any specialist provision, what more does the Minister think she ought to be doing?

[Jackie Doyle-Price]

The second wave roll-out will cover the entire geographical spread of the country. This is a transformational programme, so, by definition, it will take time to roll out, but I agree with the hon. Lady that GPs do have a role to play in this. The National Institute for Health and Care Excellence recommends postnatal checks for mothers, and NHS England expects commissioners to undertake that those guidelines are being met. As for any further support by GPs, she will be aware that there is a renegotiation of the GP contract and it will be covered there.

Emergency Services and New Estates

Baroness Chapman of Darlington Excerpts

Tuesday 27th March 2018 Westminster Hall

[Jenny Chapman (Darlington) (Lab)]

I beg to move,

That this House has considered the response of emergency services to calls from newly built estates.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful for the opportunity to bring this issue to hon. Members’ attention. In August 2017, my constituent Charlotte told me about a heartbreaking incident that claimed the life of her partner and changed her life dramatically. My constituent and I want the debate to be the beginning of a meaningful conversation, and to press for change in the way that emergency services and local authorities communicate when a house becomes occupied on a new housing estate.

On average, it should take the emergency services seven minutes to be on the scene of a critical incident, or a maximum of 15 minutes. In my constituent’s case, it took over half an hour. Neither the operator nor the paramedics were at fault. Instead, we found a significant problem with the GPS system on which our first responders rely.

We all have new developments springing up in our constituencies.

[Gloria De Piero (Ashfield) (Lab)]

I thank my hon. Friend for securing the important debate. I had a similar incident in my constituency in Kirkby on a new housing estate, where the ambulance took 30 minutes to arrive. Thankfully, that did not result in my constituent’s death, but we are talking about life and death situations. There must be a practical way of solving the problem.

[Jenny Chapman]

I agree, and I am grateful to see my hon. Friend and other hon. Members present. I regret not asking for more time, because conversations that I have had with hon. Members in the lead-up to the debate have indicated that there is substantially more interest in the problem than I had realised.

Like many young couples, Andy and Charlotte had recently moved into their new property. It was their first home together, in which they dreamt of starting a family. On the night of 11 February 2017, Charlotte found herself in a situation she had never thought she would encounter. Her partner Andy, a fanatical cyclist, had just completed a 50-mile bike ride—he had ridden more than 1,000 miles in the previous year. After settling down for the night, Andy became unwell, and it was later confirmed that he had suffered a cardiac arrest. Charlotte called 999, proceeded to carry out CPR on her husband and spoke to the operator.

Charlotte told the operator that the ambulance crew would need to access her estate via a particular road. Unfortunately, although a property may have a postcode, many homes on the 40,000 unadopted roads on new estates are not visible on the systems used in emergency or first responder vehicles.

As I later found out by sending freedom of information requests to all ambulance trusts, in many cases, emergency vehicle sat-navs are updated only every six to eight weeks on average. Even when updated regularly, the information used to update the sat-navs is only as up to date as that provided by Ordnance Survey. There is no standard process across ambulance trusts or other emergency services. One trust stated that it is

“aiming to update a minimum of every 6 months but sooner if practically possible”.

Thanks to Charlotte’s directions, the paramedics were in the correct area, but the ambulance ended up driving down a lane that led to a river bank with no bridge across to her estate. Charlotte could see the ambulance, but its way was blocked by a five-foot wall on one side and a six-foot fence on the other. The paramedics had no choice but to reverse back up the lane for three quarters of a mile, causing further significant delay.

Charlotte heroically gave CPR to her husband and directions to the operators. Thirty minutes after she dialled 999, paramedics finally arrived on the scene and took control. Their best efforts to resuscitate Andy tragically came too late to save his life.

I applied for the debate because in different circumstances, we would not be having this discussion. It is often the case that, through awful events, faults are identified and can be dealt with. Although nothing can bring Andy back, Charlotte would like his story to be used to stop similar incidents happening in future.

About 200,000 homes were built in 2017. Many hon. Members have such developments in their constituencies, so it is important that we get this right.

[Melanie Onn (Great Grimsby) (Lab)]

Has my hon. Friend given any consideration to earlier action? Perhaps local authorities could better engage with health services, ambulance services and Ordnance Survey at the planning stage.

[Jenny Chapman]

Yes. As I will go on to explain, the problem is that there is no standardised approach, but there ought to be.

At the moment, ambulance trust mapping databases are provided under the national public sector mapping agreement. Under the terms of that agreement, Ordnance Survey releases updates free of charge every six weeks, but it is reliant on local authorities or developers submitting a request. As I mentioned earlier, emergency vehicle GPS systems are updated only every six to eight weeks on average, when they receive a routine mechanical service—though even that is not the case for all trusts. There is potential for delay at several stages of the process.

There is no consistency between local authority areas, and I have found idiosyncratic practices. In one local authority, the ambulance trust said that its way of dealing with the problem was to send its officers along to planning meetings in person so that it could be promptly informed of new developments. Surely we can find a better way of doing it than that.

If different systems operate across emergency services, we miss the opportunity to find a much more collaborative approach. I ask the Minister whether, given the technological advances at our disposal, an auto-upgrade solution is possible. Most of us have self-upgrading smartphones. With lives at risk, surely we must be able to find some kind of new solution along those lines.

The practices of local authorities and developers could be standardised to ensure that they request that Ordnance Survey carries out work when at least one property on a development is occupied, even if the development is not completed and the roads are not adopted. If the postal service and Amazon can find a property such as Charlotte and Andy’s to deliver mail, could procedures and knowledge not be shared in a joint approach?

A good example can be found in the north-west. The North West Ambulance Service Trust response to my freedom of information request stated:

“On new large developments the map is often blank…so the team add descriptive route notes to aid crews. For example, take the first left on to Flower Crescent off New Bridge Street”,

which might be an existing road. That highlights that different and better ways of developing new mapping systems could save such incidents from occurring.

In speaking on Charlotte’s behalf, I want to make it absolutely clear that what happened was in no way the fault of the paramedics or the operator. It is a flaw in the complex system that our emergency services work with. I have called the debate to make the Minister aware of the problem in the hope that he will commit to act promptly to find the best way to resolve it.

To give some additional information, we sent an FOI request to every ambulance trust. I can provide the Minister with the responses we received, so he can see the disparity for himself. London Ambulance Service said that it had recorded 17 of these occurrences during the last three years, whereby crews had encountered difficulties in locating new build properties. The Welsh Ambulance Service recorded four occurrences, but most ambulance trusts just did not record incidents at all, so we do not know how frequently they are happening.

Given the risk to our constituents and the number of new developments, and the fact that this is a completely solvable problem—it does not require additional resource, and requires only someone’s attention to look at the process and organise it—the Minister could commit to action today.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

I thank the hon. Lady for securing a very important debate and for sharing the details of the extremely regrettable tragedy endured by her constituent. After 31 years in the fire service, I understand what she is saying, and my heart goes out to the family and to those who responded, for the challenges that they face in dealing with incidents that would have affected the fire service, the police service and other emergency services. I agree with her point that if Amazon and DHL find places, we should be doing it, and doing it better.

Should that be a planning obligation somewhere in the conditions of planning consent? Prior to a purchaser occupying a house, the developer could be obliged to ensure that the emergency services are aware, so that they can respond to calls using new technology? It is so important.

[Jenny Chapman]

That is a very sensible suggestion. I called for this debate not to provide the Minister with the answers—I just wanted him to know what the problem was and make him understand that it has a direct impact even though it is completely solvable. Nevertheless, the hon. Gentleman’s suggestion may well be a helpful contribution and could well provide us with a sensible way forward that would help significantly.

That is all I wanted to say. I just wanted to make the Minister aware of this problem, and I look forward to hearing his reply.

NHS Winter Crisis

Baroness Chapman of Darlington Excerpts

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

I very much note my hon. Friend’s bid for further training places, and he is absolutely right: there has been a 25% increase in the number of places. That is part of ensuring that we have more doctors, nurses and paramedics, which this Government have put in, to address the increasing demand that the NHS faces.

[Jenny Chapman (Darlington) (Lab)]

Given that, according to Age UK, one in three older people admitted to hospital is suffering from malnutrition, will the Minister now accept that cuts to adult social care are putting an avoidable and increasing strain on the NHS?

[Stephen Barclay]

What the hon. Lady’s question points to is how we better integrate care as between hospitals and the care sector. That is exactly the issue that the Minister of State, my hon. Friend the Member for Gosport (Caroline Dinenage), who has responsibility for care, is looking at in the Department, to ensure better outcomes from the money being put into the system.

Oral Answers to Questions

Baroness Chapman of Darlington Excerpts

Tuesday 14th November 2017 Commons Chamber

[Steve Brine]

The Mercer moustache is impressive indeed. I am a big supporter of Movember, because it has a positive mindset—it is very honest. As Movember says on its website, one in eight men in the UK have experienced a mental health problem and, tragically, three out of four suicides are men. So we welcome this campaign this month, focusing as it does on raising awareness of prostate cancer and of testicular cancer—“Check your Nuts”, to stay on message. Movember has also built partnerships with mental health services in the NHS and across the charity sector. I wish my hon. Friend well with his growth.

[Jenny Chapman (Darlington) (Lab)]

Will the Department urgently review waiting times targets for children to access mental health services? Even if CAMHS—child and adolescent mental health services—in my constituency achieves its targets, on current referral rates more than 100 children will need to wait more than nine weeks for their first appointment.

[Mr Hunt]

The hon. Lady is absolutely right; that is totally unacceptable. Anyone who is a parent would say that it is far too long. That is why we decided to have a Green Paper on children’s and adolescents’ mental health, which we are hoping to publish very soon.