Oral Hormone Pregnancy Tests

Baroness Primarolo Excerpts

Thursday 23rd October 2014 Commons Chamber

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. I suggest to remaining speakers that in order to ensure that everyone gets into this important debate in the time we have left, each speaker should take no more, which means less, than 10 minutes. That will share the time fairly and enable us to hear what the Minister has to say at the end.

--- Later in debate ---

[Yasmin Qureshi]

I thank the Minister for that reassurance. I am sure that those from the victims’ association who are watching the debate will be reassured too.

I thank the Minister again for what the Department has offered to do. We hope it will be done speedily and that there will be a resolution. As we know, many of the victims are now approaching their 40s and 50s. Their medical conditions are worsening and some have died. It is important that they understand what has been happening. They have never, ever asked for this—they have never even suggested it—but perhaps after the investigation we could think about some kind of financial settlement or compensation. As I have said, this is something that I am saying. I think that that would be only fair after all their suffering.

Finally, I have spoken in the Chamber from time to time, but today is the first time that, when I came into the Chamber, I got a little butterfly in my stomach. It reminded me of when I was a barrister before I became a Member of Parliament. I would have that feeling when going into court for a special case of particular significance. When I came in I almost felt that I was going to present a legal case to ask for—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. Does the hon. Lady intend to talk her own proposal out? If not, perhaps she should allow me to put the question now.

Question put and agreed to.

Resolved,

That this House notes that children were born with serious deformities due to hormone pregnancy test drugs taken by expectant mothers between 1953 and 1975; also notes with concern that as the surviving victims enter their forties and fifties many of them face a host of new problems as their bodies continue to suffer; further notes that no official warnings were issued about these drugs until eight years after the first reports indicated possible dangers; further notes that some doctors continued to prescribe the drugs for pregnant women after official warnings from the Committee on Safety of Medicines; calls on the Secretary of State for Health to fully disclose all documents relating to the use of Hormone Pregnancy Tests held by the Department from the period between 1953 and 1978; and also calls on the Secretary of State to set up an independent panel to examine these documents.

NHS Services (Access)

Baroness Primarolo Excerpts

Wednesday 15th October 2014 Commons Chamber

[Andy Burnham]

I want to make some progress.

The letter identifies six areas of major concern, and I shall focus on three of them today. The first is GP services. The letter states:

“A shortage of GPs means that patients are struggling to get an appointment to see their doctor.”

Paul Turner-Mitchell got in touch with me today to say that getting a GP appointment is now like trying to get sought-after concert tickets with the phone stuck on redial. I am sure that a lot of people watching this debate today will know exactly what he means. It is becoming the norm for people to ring the surgery early in the morning only to be told that there is nothing available for days. This year, 13 million people have either waited a week or more for a GP appointment or could not get one at all. That figure has gone up by 2.5 million since 2011.

Why is this happening? It is happening because the GP budget has been repeatedly cut under this Government, because Labour’s 48-hour appointment guarantee has been axed and because the Government—in the words of their own GP taskforce—have presided over a “GP workforce crisis”. The number of GPs per 100,000 population increased from 54 in 1995 to 62 in 2009. However, the figure has now gone back down to 59.5.

At Prime Minister’s questions today, the Prime Minister tried to claim that there were 1,000 more GPs in the NHS than under the last Government. This is simply not true. I wonder what we can do about it, Madam Deputy Speaker. We have a Prime Minister who regularly abuses statistics at that Dispatch Box, and even when he has been found out, as he has on many occasions—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. I am going to request that the right hon. Gentleman rephrases the point he just made about the use of the statistics, as he made an accusation against the Prime Minister and I do not think it is acceptable for him to say that. Will he rephrase it, please?

[Andy Burnham]

I will rephrase it, Madam Deputy Speaker, but we have had rulings from the Office for National Statistics in respect of these things. I shall say that the Prime Minister has misused statistics at that Dispatch Box and there is plentiful evidence that that is the case. Statistics have been misused, and I wish to give this example from today. Figures from the 2009-10 census—this was the final year of the previous Government —show that there were 32,426 GPs then. The most recent figures report 32,201 GPs, which is 226 fewer. So let us get some facts on the record.

The second area highlighted by the letter is accident and emergency, the classic barometer of the whole health and care system. The letter states:

“Major accident and emergency departments in England have failed to meet their waiting times targets for an entire year.”

An entire year! What have Ministers been doing? In fact, it is longer than a year, as the target has been missed for 63 weeks running. We must remember that we are talking about this Government’s own, lowered A and E target. Before the Secretary of State says that that is not the figure for the whole NHS because it excludes minor injury units and walk-in centres, I can tell the House that the NHS as a whole has missed the A and E waiting time target for five out of the past six weeks. Almost 95,000 people waited longer than four hours in A and E in September 2014, which compares with 70,000 in September 2013. So there has been a dramatic deterioration. A and E performance over the past six weeks has been worse than it was last winter. Loud alarm bells should be ringing in the Department about this coming winter, but instead of having a plan it seems that Ministers have given up on ever meeting their own target again. The annual winter A and E crisis is now a permanent spring, summer and autumn crisis, too.

Regulatory Reform

Baroness Primarolo Excerpts

Tuesday 9th September 2014 Commons Chamber

[Norman Lamb]

rose—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. May I say to the Minister that I know he is trying to be helpful, but he will soon be seeking to answer this debate? We have only one more speaker to go, so to help the flow of the debate perhaps Members could finish their speeches and then he can respond.

[Richard Fuller]

I am grateful for the direction, Madam Deputy Speaker. My third question relates to the legalities and costs, which were mentioned by the Minister and were in the justification for making this change from committees in common to joint committees. I am still a little at a loss as to what those legalities and costs are. What costs are currently incurred or are anticipated to be incurred, and why would the costs be substantially less with joint committees? I am not looking for a generic answer such as, “There are some legal costs here and legal costs there.” I am looking for something specific, because if we are to make a change, we have to demonstrate that a substantial administrative burden has been taken away.

My fourth question relates to the impact of the change on existing committees in common. I think it would be correct to say that the Healthier Together review in Manchester is proceeding as a committee in common, not as a joint committee. Would that be the case if this change is made, or would it be possible, either automatically or by choice, for existing committees in common to be transferred to joint committees with the same decision rights that joint committees would have? I am not too clear as to the position for committees that are already extant.

My fifth question relates to the Minister’s statement that committees in common somehow place a “burden”. I would be grateful for his clarification that he does not believe that the essence of localism, which was a substantial intention behind the reform introduced my right hon. Friend the Member for South Cambridgeshire, is the burden to which reference is being made. Sometimes one fears that there is tension between localism and common advance. If we allow the people who are on joint committees and their decision making to get further and further away from the people, the burden of having to go back to get local approval is lost. I hope that the Minister can clarify that that is not what is meant in the order’s reference material.

Finally, there has been a lot of commentary about the fact that it is up to committees to change their minds later on and to decide whether it is a joint committee or not. But the Minister can be clear that not all the consequences of what a committee will find can be known at the outset. Can he clarify whether it is possible for CCGs that are already signed up to joint decision making on joint committees by majority voting to change their rules, or are they bound by those rules once they have signed up to them? I am very grateful for the opportunity to debate these issues on the Floor of the House, and I look forward to hearing the Minister’s response.

Wanstead Hospital

Baroness Primarolo Excerpts

Thursday 4th September 2014 Commons Chamber

[John Cryer (Leyton and Wanstead) (Lab)]

I wish to thank Mr Speaker for granting this debate on the closure of Wanstead hospital in Redbridge in north-east London in my constituency.

Wanstead hospital has not existed as a full general hospital since it closed in 1986. It is where my hon. Friend the Member for Ilford South (Mike Gapes) was born 62 years ago—it is his birthday today, so I wanted to mention it. Hon. Members will have noticed all the bunting hung outside to celebrate that event, and he is happy for me to point it out. What remains of Wanstead hospital are two intermediate care wards called Heronwood and Galleon. The care is usually provided to elderly people who have perhaps been ill or in hospital and are not well enough to go home, and they need intermediate care before they can return to their homes.

This issue affects not only the London borough of Redbridge but three London boroughs: Redbridge, Barking and Dagenham, and Havering. It stretches from the boundary of Redbridge in the west to the boundary between Havering and Essex in the east—a huge swathe of north-east London. The plan is to take the three boroughs, cut all the intermediate care beds—there are currently 104—and reduce them to 40 beds located at King George hospital in Ilford. Apart from anything else, that is six miles from Wanstead so it is a long way for people in my constituency, many of whom are elderly, to travel. The facility in Dagenham at Grays Court is being closed, and the biggest facility is Wanstead hospital, which has 48 intermediate care beds over the two wards. We have already lost 35 beds in St George’s hospital—not to be confused with King George hospital—which is in Hornchurch in Havering and is an old RAF hospital. Those beds were lost last year and the plan is now to concentrate all the intermediate care beds in one place in Ilford at King George hospital.

The ongoing consultation has been produced and launched by an obscure and unaccountable group led by chief officer Conor Burke and the chairman, Dr Mehta. This group is not a clinical commissioning group; it has an overall strategic planning role above the CCG. Conor Burke and Dr Mehta are accountable to a small board that is made up of representatives of the three CCGs from those boroughs—hardly a shining example of democratic accountability.

It is basically a deeply flawed consultation. I was told by Conor Burke and Dr Mehta on 13 June that they might possibly be engaging in a consultation that would lead eventually to the closure of what remains of Wanstead hospital and those two wards. They did not volunteer that information; they said that there might possibly be a consultation only because I asked what the future held for Wanstead hospital. They said not that it was closing at that point, but that there might be a consultation. I asked three times for an assurance—which I received—that I would be informed as soon as the decision to consult on the future of Wanstead and the other facilities was made. I was not told about that decision. I found out about it only on 18 July when I received a letter with a consultation document stating that the consultation was already under way. If they treat elected representatives like that, God knows how they treat members of the public. It calls their track record into question.

The consultation document has not been made widely available, and I receive e-mail after e-mail saying that it is difficult to get hold of it or access it online. It is not in the libraries, GP surgeries or community centres—at least not the ones that I or anybody I know frequent. The document sets out a series of options, and then states, “This is the option we want.” It is clearly pushing respondents in a particular direction. That is not a clear, fair or neutral consultation. They are saying, “We’ll set out a few options for you, but this is the one we want, and if you respond, we want you to support this option.” That is clearly what the consultation document says, as anyone will see, if they can actually get hold of it. Only a couple of hours ago, I received an e-mail from a constituent I know quite well who told me about her difficulty—she is an articulate, intelligent person—getting hold of the consultation document and then responding online.

Another great difficulty, and a point that has met with another rebuff, was the request to extend the consultation deadline. The consultation started in July and will end on 1 October, but there has been call after call to extend it until 31 October, because most of the current consultation period falls in the holidays and most people do not know it is happening. I have met scores of people in Wanstead and elsewhere, even people who have used the facilities, who do not know the consultation is up and running. One of the richest ironies of the process is that the newly elected health scrutiny committee on Redbridge council—all people elected on 22 May—clearly requested an extension to 31 October, but so far the health tsars in north-east London have said it is not necessary.

The plan put forward by the senior health managers was to create two teams. The community treatment team, which provides care in people’s own homes—I have nothing against that, but I think we need the intermediate care beds as well—is not available after 10 pm, and the intensive rehabilitation team stops at 8 pm. It is promised that the CTT will respond to any call within two hours, but if someone needs help at 3 o’clock in the morning, when both teams are off duty, they will need to call the out-of-hours service or the emergency services, which I think is inadequate for a lot of people in need of intermediate care.

Both teams are up and running and seem to have done a good job. The reaction from the public who have received their care has been very positive—I cannot dispute that. However, we now see a proposal to introduce massive changes to intermediate care across a huge swathe of north-east London, including three of the biggest London boroughs—Havering is the second-biggest and Redbridge is one of the biggest—based on very little evidence. There have been intermediate care beds at King George for only a year, and the beds lost at St George’s in Hornchurch were cut only last year, in 2013, yet we now face a huge cut in bed numbers and their concentration in a facility that has been run for only a year, with two relatively new community-based teams, both based at King George hospital. The system is just not tried and tested. In my view and that of most of the people I represent—in my experience—we are not in a position to say the system will work, yet those beds will be lost, and once beds are lost, they are rarely got back.

The health tsars tell me that the beds are not being used. I dispute that. For one thing, last winter, which was very mild, 75 out of the 104 intermediate care beds were used. That is a relatively low number, but, as I say, it was a mild winter. If this or next winter is very cold and harsh and intermediate care beds are needed, we will only have 40 located at King George, rather than what we used to have, which was three far more accessible facilities across the three boroughs. I am being told stories off the record—nobody has gone on the record—by NHS staff and constituents that people are being turned away from Wanstead hospital and sent to King George in Ilford in order, I can only imagine, to massage the figures. I am also told by doctors and nurses who work for the health service that it is quite difficult to get into Wanstead hospital. Again, that will bring down the bed occupancy figures, adding grist to the mill of the senior health managers who are keen on getting bed occupancy down, so that they have a perfect justification for closing Grays Court and Wanstead hospitals and putting 40 beds in the King George hospital.

The Minister will be acutely aware, I imagine, of the difficulties experienced by local hospitals, by which I mean general hospitals. Queen’s hospital in Romford has faced enormous difficulties, as I am sure she will be aware. Capacity at Queen’s was forced down because the Care Quality Commission felt that the hospital was not capable of dealing with the relevant number of people—particularly in maternity, but in other areas, too. Whipps Cross hospital in my constituency has also had significant problems, receiving a series of very critical reports from the CQC.

King George hospital, where the intermediate beds are planned to be located, has been under threat of closure for years. It is only because of the stalwart efforts of my hon. Friend the Member for Ilford South and others in campaigning to keep the hospital open that it is still there. It could close at some point in the future. Against that background, with all those problems in the acute trusts across north-east London, it seems to me that taking out all the intermediate care beds with huge cuts and putting in 40 beds in Ilford at the King George is, at best, a foolhardy decision.

Let me make one more point about the consultation—the lack of accountability. The whole process, in my view, has been deeply flawed. Perhaps the greatest talking point among my constituents is the pig-headed refusal to extend the deadline to the consultation until the end of October, which seems a fairly modest sort of request. The demand for it was overwhelming and the scrutiny committee elected on 22 May called for the extension, yet the senior health managers in north-east London seem absolutely determined to refuse that relatively modest request.

Why are these senior managers so unwilling to respond to public opinion? It is because they do not have to respond to public opinion. The two people responsible for this exercise were not elected. I am not saying that there was a glorious era when everybody running the NHS was elected—such an era never existed—but these two people were certainly not elected and they are not particularly accountable. If they are at all, it is to a fairly obscure board, indirectly appointed. That has resulted in a process that provides a pretty disgraceful example of sweeping aside the wishes of local people, local councillors and locally elected representatives, and saying, “We know best. If only all these daft people would leave us alone and let us get on with it, we can make all the decisions and run the health service efficiently.”

I do not say this as a party political point, but I do not think the national health service was set up for the convenience of well paid senior managers whose wages are paid by the taxpayers I represent. The NHS was set up by Nye Bevan after the second world war in order to provide care for everybody. In future, we should move to a position whereby the people who use the NHS and run it at the sharp end should be far more involved in decisions about how to provide care that will always be free at the point of need. There has to be a change. This exercise has brought home to me just how unaccountable so many senior NHS managers are. If they are unaccountable, they will not care what the people who use the facilities for which they are responsible think. Their lack of accountability has to change in the long term.

[Madam Deputy Speaker (Dame Dawn Primarolo)]

I call the Minister.

Hospital Car Parking Charges

Baroness Primarolo Excerpts

Monday 1st September 2014 Commons Chamber

[Mr Geoffrey Robinson (Coventry North West) (Lab)]

I congratulate the hon. Lady and the hon. Member for Harlow (Robert Halfon) on securing the debate. I think that my hon. Friend the Member for Coventry South (Mr Cunningham) was also involved in that.

The hon. Member for Hereford and South Herefordshire (Jesse Norman) touched on the heart of the problem. I was an ex-Paymaster General when the Coventry bid was pushed through as a PFI project. We have a magnificent new hospital, but people’s impression of it is not how good the facility is, but how high the car parking charges are, necessitated, unfortunately, by the PFI contract. Does the hon. Lady agree that the key point to put to the Treasury is that these PFI contracts are often too onerous to be sustained by the normal income that the NHS can expect a hospital to generate, and, in particular, the car parking fees built into that are too high?

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. I remind Members that about 37 Back Benchers want to speak in three debates that must finish at 10 o’clock, and we must also take the Front-Bench speakers and the proposers. We need interventions to be short, pithy and to the point, and Members must be disciplined if everybody who wishes to speak is to be able to do so. Time is of the essence.

[Jackie Doyle-Price]

The hon. Gentleman reiterates the point made by my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman). We have all learned a lot of lessons from poorly negotiated PFI contracts. It is worth noting that in Scotland and Wales, the movement to get rid of NHS car parking charges has not been limited by those contracts, and there are ways to see those contracts through.

--- Later in debate ---

[Stephen Lloyd]

I thank my hon. Friend for giving way and for facilitating this very important debate. One area she has not yet touched on is the impact on built-up areas such as the one surrounding Eastbourne district general hospital. The car parking charges at the DGH are really quite high, so instead of using the car park people are parking around and about, which is making it very difficult for residents. If it is done badly, it is bad for residents—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. Short means not many words. A large number of Members are waiting to speak. The hon. Member for Thurrock (Jackie Doyle-Price) has now been on her feet for 17 minutes. This is going to be a severely curtailed debate and Members will get only a minute or two unless we can start making some progress. Remember that interventions must be short if there are to be any more. I wonder whether the hon. Lady would consider, in respect to her colleagues who wish to speak, drawing her remarks to a close.

[Jackie Doyle-Price]

Thank you, Madam Deputy Speaker—I certainly will. My hon. Friend the Member for Eastbourne (Stephen Lloyd) makes a very good point. I would also add that money could still be made by reducing car parking charges but enforcing action against those who should not be using the car park.

In deference to you, Madam Deputy Speaker, I shall make my comments briefer and move to a close so that other Members can speak, but I just want to reiterate this final point. The NHS is supposed to be free at the point of use, but it is not when patients who have to drive are paying through the nose. Hospital car parking charges are a tax on the sick. We should send a strong message to the managers of all hospitals that we expect them to take steps to reduce this financial penalty on the most vulnerable in our society.

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. I will start with a time limit of five minutes. Because we need to get through two other debates, the five-minute limit will apply to all the debates and it may be necessary to reduce it further in fairness to Members who are still waiting to participate in the remaining debates. From now on, you have five minutes maximum on the clock for speeches in this debate.

--- Later in debate ---

[Yasmin Qureshi]

I did not know about the Nottingham tram, but I am pleased that people there will have a tram stop to deal with the problem. Something like that would be brilliant in my constituency. There is a bus that goes to my hospital, the Royal Bolton, but because of its location the service is not frequent, so getting there is quite difficult. Such public transport solutions can help people as well. My hon. Friend is absolutely right that many older people cannot drive, so they also have that challenge.

Perhaps we do not think enough about the number of appointments most older patients have, as do those who are generally ill and have to go in and out of hospital for appointments numerous times. The way forward may be to abolish car park charging full stop, so that a scheme can be applied nationally. The minute we have a discretionary system and leave each hospital trust to decide for itself, some—perhaps because where they are located means they have a large parking space—can charge a small amount, such as 50p, while other hospitals that lack space because of where they are must charge a bit more. Leaving things to discretion means having, as everyone says, a postcode lottery. A better solution might be to make special dispensation, across the whole country, for those going to hospital appointments or those who are in hospital for some days.

Although I have a legal background, I am not normally an advocate for a lot more law, because it is not always a good idea to have loads of legislation. In this case, however, it is worth thinking about having legislation or a directive with the even more novel approach of abolishing such charges altogether. At the end of the day, nobody goes to hospital for pleasure; they go out of necessity and because they are unwell. Therefore, a hospital that raises £500,000 or £1 million, with all the budget it has—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order.

Health

Baroness Primarolo Excerpts

Monday 9th June 2014 Commons Chamber

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I regret to inform the House that more Members wish to speak than time allows under the current time limit. Therefore, to ensure that everybody gets in, I must now reduce the time limit to seven minutes. Even that is really tight, so Members might like to be sparing with their interventions, so that they do not slow us down.

--- Later in debate ---

[James Duddridge (Rochford and Southend East) (Con)]

Sometimes we in Westminster get obsessed with the minutiae and detail of Bills and Committees, but our constituents do not have the same obsessions. As the Institute of Directors has argued, it is better to focus on a small number of Bills. A Volkswagen car salesman gets obsessed with the latest VW model, but the general public just appreciate better, cheaper cars. An engineer gets obsessed with a new widget, but the general public just want the machines to work. Our constituents do not get obsessed with Bills, how many of them there are, or whether they are nuanced towards the left or right. What they care about is that we get things right—and we are getting things right. One could argue that things are not happening quickly enough, but 1.5 million new private sector jobs is a darn good start. Is the reduction of the budget deficit by a third enough? No, it is not, but it is a darn good start.

This debate is a little bizarre, in that it is on health, even though health was not in the Queen’s Speech. The people on the doorsteps of Rochford and Southend East have not said to me, “Mr Duddridge, what we need is a new Bill on the health service.” In fact, I would wager that one or two constituents in every constituency would say that we have had far too many Bills on the national health service over the years, including recently. Having set out on this strategic direction in the NHS, it is right that we stick to it, bringing GPs closer to the broader care of individuals and bringing together social services and more traditional NHS care.

The NHS is a great British institution. When I was a teenager I attended religious education classes with a vicar, who asked: “If you didn’t know whether you were going to be born to a rich or a poor country or to a rich or a poor family, whether you were going to be fully able or disabled, or whether you were going to be healthy or suffer from ill health, where would you want to be born?” I say to this House that I would want to be born here in the United Kingdom, and one of the reasons for that is the national health service. When my son and grandparents were ill, they would not have received care anywhere near as good elsewhere. Yes, one or two places might have a slightly flasher health service—at double the cost—with shinier bells and whistles, but when a member of my family was ill I remember being told: “Internationally, the hospital in the States is very good, but the hospital your family member needs is the one they are going to, because it is the best in the world.” I think we are all grateful for that.

My hon. Friend the Member for Bracknell (Dr Lee) made an eloquent speech and he knows far more about the health service than I do, but he seemed to want politicians to coalesce and form a view that one Member’s hospital should close and another’s should be extended. That is part of a responsible debate in the House, but we truly need to trust health professionals. Southend has a particular problem with its stroke unit, which has historically been very good. The Basildon stroke unit started off from a lower base point, but stroke doctors across south Essex tell me that what south Essex needs is a single, hyper-acute stroke unit. We need to trust health professionals across the board.

I was going to make a speech about pensions on Wednesday, but I am making a speech about health today because I am going to meet the chief executive of Southend hospital on Wednesday. Despite health being one of the two ring-fenced areas, there are serious pressures. My hon. Friend talked about changes in pain threshold and people’s demands, but we cannot meet all those expectations. We need to have a balanced national debate about what we can do and the best way to do it.

Turning to other provisions, I welcome the private pensions Bill. If the Whip on duty is listening, I would very much like to serve on the Committee. I cannot imagine that many Members will volunteer and suspect I have already secured my place. More than 12 million people have underfunded pensions. It is a serious issue. The Chancellor has made some useful first moves on annuities, allowing greater choice for people coming out of pensions, but greater clarity is needed for those going into pensions.

Having previously worked in the investment and pensions industry, I know that all too often Government tinkered with the system and layered in cost for people who had only a small amount of money to invest. People often discuss the pensions of those on fat cat salaries, but most people’s pensions amount to managing only thousands or tens of thousands. A clearer, collective instrument that shares risk—greater risk can be taken when shared by a number of people—will be worthwhile.

I am not going to rewrite the Queen’s Speech like the hon. Member for Blyth Valley (Mr Campbell). I am not sure whether he was being real Labour, old Labour or a socialist, but I saw Members on the Opposition Front Bench give him welcome looks when he said that his speech was not Labour party policy. It would in many ways have helped Conservative Members if it had been Labour party policy.

One small change that I would have liked is a help to rent Bill. There are 15 million spare rooms in the United Kingdom. I am not talking about Opposition Members’ incorrect use of the term, but of spare rooms in houses that are owner-occupied and perhaps under mortgage. Not everyone wants to rent out a spare room to somebody, but the spare room relief of £4,250 has not been changed since 1997. Rather as we are doing with council and housing association property, we could release some of the spare rooms in owner-occupied houses by making it more financially advisable to rent out a room. There is nothing wrong in taking in a lodger—

[Madam Deputy Speaker (Dawn Primarolo)]

Order.

Cervical Cancer Screening

Baroness Primarolo Excerpts

Thursday 1st May 2014 Commons Chamber

[Steve Rotheram]

My hon. Friend makes a powerful point. In all honesty, I did not know an awful lot of this information before I was asked to head up the campaign in the Backbench Business Committee to get this matter debated in the House. I suspect that the same is true of many male colleagues on both sides of the House and many men in the wider public. We must destigmatise the use of words like “period” or “vaginal discharge” by men, because it is important that such things can be spoken about openly. As the father of two daughters, I certainly want them to be aware of the symptoms of this condition, so that they can bring them to my attention and I can help and guide them should they need a consultation with the GP. This is an important matter for us to debate in the Chamber. I am sure that other colleagues will go into the symptoms of this horrible disease.

The danger of highlighting the symptoms is that some women might misdiagnose themselves, causing them unnecessary worry. Conversely, if doing so means that one person with the symptoms is diagnosed with cervical cancer and has her life saved, it is well worth it.

According to the NHS figures, the vast majority of women’s test results come back normal. For about one in 20 women, the test will show some abnormalities in the cells of the cervix. Most of those changes will not lead to cervical cancer and the cells often return to normal on their own. Indeed, that is particularly true of young patients. In some cases, the abnormal cells need to be removed so that they cannot become cancerous.

About 3,000 cases of cervical cancer are diagnosed each year in the UK, which amounts to 2% of all cancers diagnosed in women. As I have stated, cases of cervical cancer in women under 25 years of age are extremely rare. They amount to about 1% of all cervical cancer sufferers in England. However, the relatively small number of occurrences should not be dismissed as statistically negligible. The mission of the NHS cervical screening programme is

“to reduce the number of women who develop cervical cancer and the number of women who die from it.”

The screening programme is credited with saving the lives of about 5,000 cancer patients a year across the board.

In 2004, the last Labour Government increased the age at which young females could have a test from 20 to 25, in accordance with international recommendations from the World Health Organisation. America has adopted the position that a test should happen at 20 years of age or within three years of first sexual activity, whichever comes earlier. To me, that seems an appropriately flexible policy to have. It is estimated that early detection and treatment prevents up to 75% of cervical cancers. The contention centres on the appropriate age at which screening should become routine and on the health consequences for somebody who chooses to have a test before the recommended age of 25.



So that I am not accused of presenting an imbalanced view of the medical thinking on this issue, I should say that there is an opinion among some professionals that smear tests on young women and teenage girls can lead to false positives, unnecessary treatment, anxiety for the patient, infertility or pre-term delivery later in life. There can also be discomfort, embarrassment or, less commonly, pain during the screening test. There is a very small chance of getting incorrect results, which could lead to abnormalities being missed or to unnecessary distress and treatment. There is also a chance of unnecessary treatment occurring if the abnormalities would have corrected themselves naturally. Some of the treatments that are used to remove abnormal cells may increase the risk of premature delivery in pregnancy.

Undoubtedly, there is still extensive debate in the medical profession about whether tests on young women would have the desired impact. In 2009, the British Medical Journal released a paper on the effectiveness of cervical screening with age, which concluded:

“Cervical screening in women aged 20-24 has little or no impact on rates of invasive cervical cancer up to age 30. Some uncertainly still exists regarding its impact on advanced stage tumours in women under age 30. By contrast, screening older women leads to a substantial reduction in incidence of and mortality from cervical cancer.”

For that reason, it is important to reiterate that the motion does not call for routine screening for under-25s.

I believe that it is the duty of any Health Minister to adhere to the medical advice that is presented to the Department. To my knowledge, no new evidence has emerged that is substantial enough to change the Government’s position on screening ages. I believe that, at this juncture, it would be prudent to follow the decision of the Advisory Committee on Cervical Screening in 2009 to reaffirm the policy that the age for routine screening should remain at 25. However, although it is right that politicians should not ride roughshod over medical experts, it is the job of Health Ministers to examine the orthodoxy of the day, to keep matters such as age restrictions under constant review if new evidence emerges and to scrutinise international patterns and comparisons.

I must mention that I am not a medical expert. My opinions are predicated on what I have read and learned about the subject. The debates on either side of the screening argument need to be qualified by further research. I believe that there are steps that the Minister can take right now to address those concerns and the concerns that have been highlighted by Sophie’s death. For me, the Minister should get to work on five things immediately.

First, the Government should address the online advice and guidance that is available to young women and girls who suspect that they have the symptoms of cervical cancer. At present, it is far from adequate. In the course of my research for this debate, I was amazed at the total non-existence of good online advice for young women who suspect that they are displaying the symptoms of cervical cancer. Despite young people having a higher propensity to use the internet to access information than most adults over the age of 30, there is an absence of advice on what steps should be taken by young people who are concerned that they are exhibiting the symptoms and on the support that is available. On the NHS “Your health, your choices” website, there is no mention of what young girls or teenagers should do. Instead, there is a vague information section on smear tests for over-25s. Users of the Public Health England website are forced to wade through pages and pages of material and to follow hyperlink after hyperlink before they finally find the information that they need in the frequently asked questions section. It appears that some of the information online—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I was very reluctant to interrupt the hon. Gentleman, but he has been going on for over 23 minutes. Other Members wish to speak and there are other debates today. The guidance is that Members should speak for 10 to 15 minutes, so I have given him a lot of latitude. I would be grateful if he thought about speeding through his points so that we can move on to another speaker.

[Steve Rotheram]

That is not as I was informed, Madam Deputy Speaker, so apologies if I have overrun my time limit. I was told absolutely the opposite. I will try to conclude, and I will contact the Minister in writing with any points that I miss out.

Whatever is said and decided today, this debate needs to be the beginning of the process, not the end. I said when I made my application to the Backbench Business Committee on 8 April that I was there as a spokesperson for the 320,000 signatories to the “Sophie’s choice” petition. Today, I have presented their case, which is a case for women’s right to choose, for clearer medical guidance for patients and professionals, for improvements to the sex and relationships education system—I will inform the Minister about that in writing—and for immediate action to tackle the blind spot that exists in the vaccination programme for 19 to 24-year-olds.

We must not forget that it was the people who put this debate on the Floor of the House today, and now it is time for the Government to listen to the British public and act. In their name, let us ensure that Sophie’s legacy is a life-saving one, so that her family and friends can take comfort from the fact that despite failings of the highest order in her case, Sophie did not die in vain.

--- Later in debate ---

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I think it will be helpful if I make sure that all Members who wish speak understand the time constraints. There is another debate this afternoon and some Members in the Chamber wish to speak in that debate too. This debate will end for Back Benchers at 2 o’clock. We will then move on to the Front Bench winding-up speeches so that this debate will end by 2.30 pm. I am therefore asking each Member to speak for about seven minutes, including interventions. There are a lot more speakers in the second debate and I need to be fair to them on time allocation too. I am not going to set the clock, but I hope that even when taking interventions each Member will consider the time and their colleagues who are waiting to speak. I hope that is clear in terms of the problems I have, as the Chair, to get us through the debates today.

Francis Report

Baroness Primarolo Excerpts

Wednesday 5th March 2014 Commons Chamber

[George Freeman]

On a point of order, Madam Deputy Speaker. I came to have a debate on the Francis report. The shadow Secretary of State is not mentioning the Francis report; he is launching a criticism of the Government’s record since the report, which has nothing to do with it.

[Madam Deputy Speaker (Dawn Primarolo)]

Frankly, that is my business and I do not require any help to decide what is in order. The shadow Secretary of State is remaining in order, as the Secretary of State remained in order. I think it is best that we continue with the Front-Bench opening speeches to make sure that we can get in all the Back Benchers who wish to speak in this important debate.

[Andy Burnham]

It is interesting that Government Members do not like it, but this is the reality in the NHS right now, 12 months after the Francis report. Patient care is being compromised in the mental health care system. If the hon. Member for Mid Norfolk (George Freeman) does not think that that is relevant, let me quote Professor Sue Bailey, the President of the Royal College of Psychiatrists. She said that mental health units are

“heading for a Mid Staffs scandal”.

If that is not relevant, what is?

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[Several hon. Members]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Before I call the next speaker, although this debate is due to run until 7 pm and obviously there will need to be time for the winding-up speeches, at the moment Members are speaking for 20 minutes or more. We will simply not have enough time to get everybody in if each Member speaks for that long. I am not proposing to set a time limit now, but I ask Members to give some consideration to their colleagues. Watch the clock—this is not a criticism of any previous speakers—and try to come in somewhere between 10 and 15 minutes, which is ample time. If that fails, I am afraid we will need a time limit, but I do not propose one at the moment.

NHS

Baroness Primarolo Excerpts

Wednesday 5th February 2014 Commons Chamber

[Paul Uppal (Wolverhampton South West) (Con)]

On a point of order, Madam Deputy Speaker. In response to yesterday’s sensitive statement on Sri Harmandir Sahib, the shadow Foreign Secretary, the right hon. Member for Paisley and Renfrewshire South (Mr Alexander), made a point about documents pertaining to Lady Thatcher not being released. In fact, they were released back in January. I would appreciate your guidance, Madam Deputy Speaker, as this is a very sensitive matter, and I would hate to see it politicised.

[Madam Deputy Speaker (Dawn Primarolo)]

I am grateful to the hon. Gentleman for notice of his point of order, but this is a matter for the right hon. Member for Paisley and Renfrewshire South (Mr Alexander), whom I understand he notified of his intention to raise it in the Chamber. It is not a point of order for the Chair, but he has got his concerns on the record, and I think he will have to leave it at that for today.

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[Mr Reed]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Mr Reed, the Secretary of State has repeatedly made it clear that he is not prepared to give way to you, so perhaps we could move on with the debate. Perhaps you will find another way to make your point.

[Mr Hunt]

I think that that demonstrates, Madam Deputy Speaker, how much the Labour Opposition do not like hearing about the failings at Mid Staffs.

[Madam Deputy Speaker]

Order. I say to the Secretary of State that actually it does not indicate anything except that you do not wish to give way to the hon. Gentleman. So, return to your speech.

[Mr Hunt]

Thank you, Madam Deputy Speaker. We will all draw our own conclusions about why the Opposition are using these tactics, but I want to offer the Opposition today, a year after the Francis report, a chance to draw a line under this whole tragedy. I as Secretary of State am happy to move on from Mid Staffs in terms of the debates in this House if the Opposition pass three tests: to tell Labour in Wales to do a Keogh-style mortality review so that we deal with the poor safety in Welsh hospitals, just as we are doing in England; to apologise to the relatives and survivors of Mid Staffs not just for what happened, but for the policy mistakes that led to what happened; and to commit Labour to more compassionate, safer care in the NHS by promising never to accuse those who highlight problems of “running down the NHS”, and instead to support every whistleblower and concerned member of the public when they raise concerns. Do that, and the world will know that Labour has changed; but fail to do it, and the country will know for sure that the NHS is simply not safe in Labour’s hands.

[Several hon. Members]

rose—

[Madam Deputy Speaker]

Order. Many Members wish to speak. I am not going to set a time limit at the beginning, but I ask each Member to take no longer than eight minutes, including interventions. If Members take more time than that, it will be necessary to place a time limit on all contributions.

--- Later in debate ---

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I remind Members who wish to speak that I asked each Member to take eight minutes including interventions and without compensating for the time lost so that we could fit everybody in. We are in danger of being unable to fit everybody in because people are running over their time, so I remind Members to help each other out. If they are unable to, we might need a time limit, but I think we should be able to avoid that.

Accident and Emergency

Baroness Primarolo Excerpts

Wednesday 18th December 2013 Commons Chamber

[Mike Gapes]

On a point of order, Madam Deputy Speaker. This information was embargoed until two o’clock today, but following an investigation the Care Quality Commission has put King George hospital Ilford and Queen’s hospital Romford into special measures. I tried several times to intervene on the Secretary of State in order to raise the matter, but he refused to take an intervention from me. I therefore seek your advice: how can I draw attention to the matter and the fact that the previous Secretary of State said that King George’s A and E department would close within two years? That is clearly not happening. There is chaos in my local A and Es, yet the Secretary of State did not let me intervene.

[Madam Deputy Speaker (Dawn Primarolo)]

Mr Gapes, in terms of getting your argument on the record, you have just done so, although it was not a point of order, as I think you know. As you are fully aware, it is up to the Secretary of State, or any Member of this House, whether they give way to another Member or not. I am sure you will find ways to pursue this matter over the minutes, hours, days and months ahead.

I inform Members that there is a five-minute time limit on all Back-Bench contributions in order to ensure that as many Members as possible can participate in the debate.

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[Mr Peter Bone (Wellingborough) (Con)]

I apologise for being out of breath, Madam Deputy Speaker, but I just wanted to ask my hon. Friend whether the proposal he is talking about has all-party support in the north of the county?

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Mr Peter Bone has just arrived in the Chamber, but one is normally expected to be in the Chamber for more than just a few seconds so as to hear the debate before intervening. I am sure the hon. Gentleman apologises to the House.

[Mr Hollobone]

I am very grateful for the intervention from my hon. Friend the Member for Wellingborough because he has many duties to attend to in this House on behalf of his constituents and he has been at the forefront of the campaign to get extra investment into Kettering’s A and E, and also to develop the community hub patient facilities in Corby, Kettering and Wellingborough.

With the £3 million capital expenditure bid going to the Department, one of the options would be for a community hub at the Isebrook hospital, which would help to serve my hon. Friend’s constituents in Wellingborough and, by doing so, would take the pressure off the A and E at Kettering. If we are successful in this cross-party bid, the A and E at Kettering would be transformed into an A and E plus an urgent care centre on the site of Kettering general hospital. It would be a one-stop shop for local patients. The A and E at Kettering has the confidence of local people, but the local population growth means that capital investment is needed more than ever, and we look to the Government to provide that in early January.

[Mr Bone]

On a point of order, Madam Deputy Speaker. I apologise to the House for the discourtesy shown, but I was very surprised that my hon. Friend the Member for Kettering (Mr Hollobone) was called so early in the debate.

[Madam Deputy Speaker (Dawn Primarolo)]

I do not think that is a point of order, but the House has noted it and we will move on now so we do not waste any more time.

--- Later in debate ---

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I am reducing the time limit to four minutes. It is possible for each of the remaining speakers to have four minutes only if interventions are severely curtailed or if they do not happen at all—let me put it that way. The wind-ups have to start at 3.30 pm at the absolute latest. Those who have been waiting patiently and who have not intervened have had their time cut. Perhaps they will bear that in mind when they are called.