Access to Migraine Treatment

Dehenna Davison Excerpts

Wednesday 20th March 2024 Westminster Hall

[Dehenna Davison (Bishop Auckland) (Con)]

I beg to move,

That this House has considered access to migraine treatment.

It is, as ever, a pleasure to serve under your chairmanship, Mr Mundell. Let me start by stating the blooming obvious: migraine is not just a headache. It is a complex neurological spectrum condition, of which a headache is just one possible symptom. This is a very strong early message to anyone suggesting that migraine attacks can be cured with a couple of paracetamol: it is time to learn and to be better. Listen to this debate and to the testimonies of those living with this debilitating condition, and help us together overcome the stigma surrounding migraine, which for centuries has acted as a barrier to accessing quality treatment for those suffering.

Before I get into the full swing of things, I want to express my gratitude to the House authorities for organising a survey to which more than 500 migraine patients responded. I am grateful to each and every one of them, and to others who reached out to me separately to share their experiences. Some of those testimonies have been eye-opening and some have been quite harrowing. I will endeavour to include as many as I can in this speech. As ever, my thanks go to the National Migraine Centre and the Migraine Trust not only for their support for this debate but for their round-the-clock work to support people living with migraine.

We cannot have a Westminster Hall debate without a bit of a history lesson at the beginning, so I did a bit of a dig through the history of migraine and found that the earliest known references to it date back thousands of years to ancient Egyptian times. The father of medicine, Hippocrates, was the first to document clinical observations about migraine in about 400 BC. Classifications of headache were first outlined in the first century AD by Aretaeus of Cappadocia, whose category of heterocrania displayed many similar symptoms to migraine. Galen wrote of severe pain affecting almost half the head in the second century, and the Iranian physician al-Rāzī devoted an entire chapter of his book to the symptoms and treatment of migraine in the 9th century. Then in the 17th century, Thomas Willis published his theory that megrim owed to the dilation of blood vessels within the head.

Throughout the years, key figures are reported to have experienced migraine. They include leaders such as Julius Caesar and Napoleon Bonaparte, Ulysses S. Grant and Robert E. Lee, Woodrow Wilson and John F. Kennedy; great thinkers such as Sigmund Freud, Friedrich Nietzsche and Charles Darwin; artists such as Van Gogh; writers such as Virginia Woolf; and actors such as Elizabeth Taylor, Hugh Jackman and Gwyneth Paltrow. There is even strong speculation that the trippy nature of “Alice in Wonderland” was inspired by Lewis Carroll’s own migraine attacks with aura. In his diaries from 1885, Carroll talks of the

“odd optical affection of seeing moving fortifications followed by a headache.”

His works led to the term “Alice in Wonderland syndrome” being coined to describe

“Certain hallucinations peculiar to migraine”.

In Carroll’s diaries of 1856, he records a trip to see William Bowman, one of the top ophthalmologists of his time, to discuss the visual disturbances in his right eye, which Bowman was unable to formally diagnose. Perhaps that was because it was not until the 1870s that visual manifestations of migraine began to gain more widespread recognition among medical professionals.

Migraine is than twice as likely to affect women, but in that period it was believed that we weak women merely had hysteria and fragility of the mind, unlike the ambitious men who got migraine only because of how hard they were working. Women being taken seriously in healthcare is a bit of a pet peeve of mine. Although I greatly welcomed the women’s health strategy, I was a little disappointed not to see migraine more formally mentioned. Perhaps the Minister will discuss that with me separately.

The 1870s were 150 years ago, and we might naively assume that in that time the magnificence of medical innovation has created cures and solutions that mean that people no longer suffer the terrible symptoms of migraine. Back in 1954, the then Minister of Health told those affected by migraine:

“Cheer up; there is a good deal of work going on, mostly under the Medical Research Council”.

That led to a response in 1960 by John Rankin, then the hon. Member for Glasgow, Govan, who said.

“For six years, and long before that time, the good work, so we are informed, has been proceeding, yet nothing appears to be happening.”—[Official Report, 4 March 1960; Vol. 618, c. 1671.]

More than 60 years later, despite migraine affecting roughly 10,000 people in every constituency in the UK, a Hansard search informs me that there has been no full debate on migraine in Parliament since the 1960s.

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate my hon. Friend on her powerful and extremely well informed speech. One of those 10,000 in the Kettering constituency is Lisa, who has written to me to say,

“I spend most of my weeks, either with a migraine or with the after effects, which include complete exhaustion that can last two or three days. I have medication that does not always work. I get facial paralysis and will often have slurred speech, light sensitivity, nausea, dizziness, along with immense pain and pressure in my head. It is an awful existence.”

I want to pass on to my hon. Friend that Lisa adds,

“I am so glad to know that it is being debated in Parliament today.”

[Dehenna Davison]

I am grateful to my hon. Friend for passing on Lisa’s remarks. She is one of millions in the country living with this condition and experiencing the debilitating effects. I hope that, following today’s debate, we will see improved access to treatment. I ask my hon. Friend please to pass that on to Lisa.

As I said, there are 10,000 people in every constituency but no debates in Parliament since the 1960s. I make special mention of Lord Londesborough for raising a question on migraine in the other place in October last year, rightly arguing that this invisible disability deserves much greater priority and resourcing across the NHS.

It is 60 years since the last parliamentary debate. Those suffering the crippling effects of migraine alone might feel that, even now after all that time, little progress has been made, but I am here to be optimistic. New treatments, such as CGRP blockers, are proving highly effective for many migraine patients, helping to reduce the severity, longevity and frequency of migraine attacks. For many taking CGRP blockers, they are often called a lifeline. One patient responded to our survey, saying that CGRP injections have “virtually eradicated my migraines”.

Although new effective treatments are being developed, they are not easy to access through the NHS. Across today’s debate, I will outline the key difficulties being faced by patients at each stage of the migraine journey, and will outline possible solutions to improving access to treatments and, ultimately, the lives of migraine patients. That is something that I think we can all agree is very much beyond politics.

Let us start with the basics and discuss what it is like to live with migraine. We had an example from Lisa, the constituent of my hon. Friend the Member for Kettering (Mr Hollobone). When experiencing a migraine attack, common symptoms can include a severe headache; nausea and/or vomiting; visual disturbance, such as blurry vision, spots of light or zig-zag lines; sensitivity to light and sound; an inability to concentrate and brain fog; difficulties forming words, which is not helpful in this place; and fatigue.

Interestingly, I had experienced migraine for years before I recognised some of the symptoms linked to it. I recall sitting at home reading “Managing Your Migraine” by Dr Katy Munro last autumn, with a coloured pen in hand, underlining all the symptoms that I experience when I get a migraine attack; and there were eight different symptoms. A severe attack can leave sufferers bed-bound in agony, with curtains closed, cowering in the darkness, unable to eat, unable to think clearly, and utterly miserable. Attacks can be completely debilitating, and I have experienced my fair share of them.

I am not the only hon. Member who lives with migraine. The hon. Member for Caerphilly (Wayne David) is unable to attend today but asked me to read his testimony in his absence. He said:

“I have suffered from migraine since I was a young man. It used to be extremely debilitating, but in recent years I have been able to minimise significantly the severity and frequency of attacks. There are so many different causes and triggers of migraine. For me, it is stress related. Manage my stress and I can usually manage my migraine.”

The hon. Member for Banff and Buchan (David Duguid) said:

“I first experienced migraine in my early teenage years, when I regularly had to be excused from school. I remember being particularly distressed at the disorientation and confusion, as well as the extreme headache and nausea, of course. Migraines have become no less debilitating as I have grown into adulthood but they have become less frequent, and I generally know what to expect when symptoms start, and what medication to take. Like my father before me, I now watch my 12-year-old son experiencing his first migraines and the confusion it brings. As much as I can empathise with my son, I am only too aware of how little I can do to relieve his distress.”

The frequency of migraine attacks can vary. Some people will experience a small number of attacks over a lifetime, some one or two a month, but for others migraine can become chronic, meaning that headache is present more than 15 days a month, with at least eight of those having other migraine symptoms. That is the condition that I live with, as do around a million other people in the UK. For me, that means that I have a headache all day, every single day. Although they vary in severity, they are none the less draining, particularly on the many days when they are coupled with other migraine symptoms.

Recently, I spoke to Mollie Campbell, a brilliant young woman who like me lives with chronic migraine. Her journey helps to outline some of the difficulties that patients face in accessing treatment. In her own words, she remembers her first attack vividly:

“on a normal day, I woke up in agonising pain in my eye, eyebrow, and head. When I say ‘pain’, I mean torturous and excruciating pain, the kind that makes you roll around on the floor sobbing in agony.”

Mollie sought help from her GP, but it took months, several misdiagnoses, a number of unsuitable drugs being prescribed and, eventually, her paying to access a scan privately before she was eventually diagnosed with chronic migraine. Unfortunately, Mollie’s story is not uncommon. It can take patients months, if not years, to get a diagnosis.

A commonly expressed sentiment is that GPs do not always take the condition of migraine seriously. One patient who responded to our survey explained that they waited

“five and a half years from first presenting to a doctor taking them seriously and investigating”.

Another said that

“it took 19 years to be diagnosed with migraines”,

and another:

“Doctors just don’t seem to know or understand enough about it and I have been fobbed off a lot.”

[Matthew Pennycook (Greenwich and Woolwich) (Lab)]

I was contacted by a constituent who wishes to remain anonymous and who suffers from debilitating hormonal migraines. She is frustrated by the lack of general awareness among medical professionals, GPs in particular, about the specific treatment and medication that those who suffer from that type of migraine need. Does the hon. Lady agree that to make progress in addressing the condition, we need to ensure greater knowledge among medical professionals about the specific treatments needed by those who suffer perimenopausal and menopausal migraines?

[Dehenna Davison]

I completely agree with the hon. Gentleman. He will be interested in a paragraph that I will be reading out shortly, which addresses his very point.

Another testimony said:

“I have suffered migraines for approximately four to seven years but never went to the doctors until recently through fear of being dismissed.”

Some believe that is because GPs across the board just do not know enough about migraines. One GP said to the Migraine Trust:

“In medical school, neurology is a small part. Unless you have specifically chosen to do neurology, you will not have any formal training.”

GP training on migraine and headache disorder is patchy at best, and often relies on local champions spearheading that, rather than a more formalised structured. Our clear ask to the Minister, therefore, is to ensure improved training on headache and migraine as part of the medical training for GPs, to ensure that early diagnosis is possible.

For those who get a diagnosis, seeing a neurologist or headache specialist is a crucial step in helping with ongoing management, not least because specialist treatments cannot be accessed through primary care—I will return to that point shortly. On waiting lists to see specialists, experiences vary, but the broader picture is not as positive as it could be. Two patients outlined how, after many years of waiting for a diagnosis, it took a further four years from that point until they saw a neurologist. One said:

“I waited five months to receive an appointment letter then another five months until the actual appointment date”,

and the other said that they:

“waited 15 months to see a neurologist who then referred me to a specialist. I have been waiting for seven months for that, with no appointment yet.”

Even when eventually under the care of a specialist, some outlined that the continuity of care was not there. One patient said:

“I was prescribed a treatment to try, and was discharged, and then I had to be re-referred to try and alternative when the first option didn’t work.”

Recent analysis from the Migraine Trust found that, on average, it takes 29 weeks to access a neurologist or headache specialist, which has doubled from 15 weeks in 2021. Even then, neurologists may specialise in other conditions such as stroke and Parkinson’s rather than headache and migraine. Part of the issue is a lack of neurologists and headache specialists around the country. The UK has around 1.1 full-time equivalent neurologists per 100,000 people, versus four per 100,000 in France and Germany. Regional variations mean a postcode lottery, with major disparities between waiting lists from trust to trust. Here, our key plea to the Minister is to ensure that more specialists are trained to plug the gaps in neurology and headache specialists and, ultimately, to speed up access to treatment.

Once a diagnosis is in place, the obvious next step is treatment. Often, GPs will prescribe acute medications such as triptans to help manage attacks when they occur. For those suffering more frequent migraine attacks, preventive medications can be prescribed, but many of those were not designed specifically for migraine, such as topiramate, an epilepsy drug, amitriptyline, an anti- depressant, or candesartan, for the treatment of high blood pressure. Some people do report an improvement in the severity and frequency of their migraine attacks, many do not, and can in fact experience negative side effects from such medications. Nevertheless, there are now treatments designed specifically for migraine, such as CGRP blockers, as already referenced, and there are many different kinds, such as wafers that dissolve on the tongue, injections or infusions.

However, National Institute for Health and Care Excellence guidelines are, for many, getting in the way of early treatment. Take, for example, the CGRP blocker erenumab—I always pronounce that wrong. A 2021 study in the Journal of Clinical Medicine by Maraia, Ricci and others found that, as a treatment for the prevention of migraine, erenumab successfully reduced the mean number of monthly migraine days and the acute medication used per month in 96% of cases—a real success story. However, NICE recommendations state that the drug

“is recommended as an option for preventing migraine in adults, only if…they have 4 or more migraine days a month”

and

“at least 3 preventive drug treatments have failed”.

Let us take a second to understand that. If someone is struggling with migraine, they must try three drugs that are not designed for migraine, usually for at least three months each, and if those are unsuccessful, they may be able to access a drug that is specifically designed to prevent migraine attacks. That makes little sense, and it can delay patients’ access to successful treatments for months, if not years. One survey respondent said:

“Getting treatment has been difficult. To access the latest treatments, you have to fail so many preventatives.”

The American Headache Society and migraine expert Professor Peter Goadsby suggest that CGRP blockers should be available as a first-line therapy, not as a last resort. We support that call, so I ask that the Minister requests that the NICE guidelines are updated to allow specialised treatments such as CGRP blockers to be accessible first, which would provide earlier, much-needed relief for migraine patients.

Similarly, despite NICE approval for many CGRP blockers, whether individual NHS trusts even allow access to them is a postcode lottery. One respondent said:

“Once help is found, though, it can be difficult to access as it depends on which area you live in.”

Another said that

“my NHS trust only allows the trial of one of the anti-CGRP drugs and if it doesn’t work you are not allowed to try another as it’s not funded.”

A Migraine Trust freedom of information request, which I found shocking, found that only 29% of trusts in England allow access to CGRP medications. Here we make yet another ask of the Minister: the postcode lottery in access to CGRP medications should be addressed and fixed, perhaps through fresh NICE guidance and a dedicated push from the Department of Health and Social Care for trusts to allow more access to these life-changing medications.

Another key change that could help those living with migraine to access positive treatment sooner would be allowing treatments such as CGRP medications to be prescribed by primary care practitioners. I have spoken of the success of some CGRP blockers, yet they can be prescribed only by specialists, such as neurologists, who can have extensive waiting lists, as we have discussed. Even if someone sees a specialist, they need to demonstrate that other treatments have been ineffective. If specialist drugs could be prescribed in primary care as a first resort, we could reduce dramatically the impact of chronic migraine on patients. Pilot work in Scotland has seen community pharmacy playing a greater role in prescribing drugs to prevent and manage migraine. A further ask for the Minister, if he will forgive me, is a review of CGRP blockers and other new treatment options, so that they can be prescribed in primary care.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Lady on securing the debate. On making the blockers more widely available, does she agree that, as well as the requests that she has put to the Minister, there should be discussion and consultation with the devolved institutions, so that people right across the United Kingdom can avail themselves of the same?

[Dehenna Davison]

I completely agree with the hon. Gentleman. As I said, migraine is a condition that does not discriminate. Roughly one in seven people in the world live with migraine, so it is as relevant in the devolved authorities as it is anywhere else. We want to ensure that migraine patients across the whole of the UK have access to the best possible treatment.

For those who cannot access CGRP blockers or alternative treatments through their local NHS trust, or who simply cannot bear the extensive waiting lists to see specialists, drugs bought privately can be incredibly expensive. For example, rimegepant is around £270 per month when taken as a preventive, Botox injections for migraine are around £700 every 12 weeks and Vyepti infusions are around £600 every 12 weeks, and that does not include the cost of seeing specialists and having the prescriptions written, which of course means an additional fee. For those on low incomes, those options are completely inaccessible without NHS treatment, yet some are unable to access them regardless because of the decisions of their local NHS trusts. One survey respondent said:

“I had to spend £8,000 on CGRP treatment privately before moving to a hospital who would fund me under the NHS.”

Nobody should be priced out of quality healthcare, particularly when that healthcare can be truly life changing.

In all, I have outlined a number of tangible steps that could be taken and which would have a real and positive impact on those living with migraine, but let us return to Mollie’s story because, sadly, her experience is an example of how the current system does not always work for patients. In her words:

“Four and a half years later, there is not one second of any day in which I am not in pain. My pain is an average of 7/10 a day, and it soars up to 10/10 at least ten times a day...When it reaches these levels on a daily basis, every single day, you simply cannot live life normally anymore. I can no longer work, see my friends, or do any of the hobbies I used to enjoy. Every single thing that brings me pleasure is now impossible for me.”

For those living with severe chronic migraine, the huge detrimental impact on day-to-day life should not be understated. I have reached the point where I get anxious making plans, either for work or with family and friends, for fear that a severe attack may mean that I have to cancel at the last minute. With attacks seemingly getting more and more frequent, it feels increasingly like cancellation is an inevitability. This may sound really silly to some, but it is a really human example for me. I am a lifelong Swiftie and I managed to achieve the holy grail of getting Taylor Swift tickets for the Eras tour, but I am petrified that on the day a migraine attack might hit and take away my opportunity to see her live, because I would be devastated. Some might say that that is a silly example, but it is one of the things that are on my mind. If someone is living healthily, they do not have to have those sorts of considerations when making plans.

Many survey respondents reported similar concerns. One said:

“Migraine has impacted every job, social occasion and holiday over the last 15 years...It’s caused me countless days of agony. Migraine is a curse I wouldn’t wish on my worst enemy.”

Another said:

“I can’t make plans with people due to migraines making me cancel them last minute. I missed an expensive, once in a lifetime concert opportunity that I had been waiting 12 years for as I had a migraine that day. I had to leave a friend’s funeral early and not attend his wake due to a five-day migraine.”

One said:

“I have missed many family gatherings—New Years, Anniversaries etc. I have also missed events that I have purchased tickets to as I have been too unwell, losing out on both money and experiences.”

Another said:

“I gave up working 14 years ago, stopped socialising and even dread going on holiday, and travel was the thing I always most looked forward to.”

I received an email yesterday from June about her daughter. She is 35 and her migraine attacks are so severe that, in June’s words,

“she can no longer look after her children. At this moment in time,”

she

“cannot complete a simple jigsaw with her two-year-old daughter. This is my daughter who gained a first in her degree...She is upset about missing out on so much of her children’s lives, aged 5 and 2.”

I raise these examples to show that migraine has more than just a trivial impact on the individuals who are suffering; it has a real impact on them and on their loved ones and wider circle.

Many also spoke about the impacts of migraine on their working life. Mollie had just embarked on her dream internship when migraine hit, so she was unable to complete that internship and has struggled to work since. She is not alone. Many here will know that I gave up my ministerial role, as migraine meant that I could not keep up with the additional demands of government. Research by the Migraine Trust found that 29% of people with migraine had to move from full-time to part-time work and 25% had left a job altogether. One survey respondent said:

“I have been at risk of losing my job in the past due to having to take time off for migraines.”

Another said:

“I recently lost my job due to the number of migraine related absences I had.”

[Paul Girvan (South Antrim) (DUP)]

I thank the hon. Member for securing this debate. In the light of what she has just said, I will say that many people who suffer from migraine lose their job and have difficulty even accessing the likes of personal independence payment, because migraine is so debilitating whenever it happens but it is also unpredictable. Their life can become awkward when it comes to just doing things normally, but they have difficulty accessing PIP because of it.

[Dehenna Davison]

I agree with the hon. Member. In severe cases, migraine is absolutely a disability. It ruins lives. There is a separate discussion to have with the Department for Work and Pensions—I do not want to put all the pressure on the Department of Health and Social Care—about how it addresses chronic migraine and intractable migraine when making its assessments. I thank the hon. Member for raising that really important point, which came through from a number of our survey respondents as well.

Some workplaces make adjustments, such as allowing flexible working, but there are also reports of workplaces not making suitable adjustments. One respondent said:

“There is a complete lack of understanding that chronic migraine is a disability and employers are not willing to make allowances for this condition in the way they do with other disabilities.”

Shockingly, the Migraine Trust found that 56% of migraine patients said that their workplace had not made reasonable adjustments. That is why the organisation has launched its workplace pledge this week to encourage employers to make small, often low-cost adjustments that can make a huge difference for staff with migraine. We must remember that with one in seven people living with migraine, there is a good chance that even if someone does not, at least one of their colleagues probably does.

The impact of migraine on the workplace is not just confined to individuals dealing with the stress of potentially losing a job and income; there is a wider impact on the economy too. The Work Foundation has found that migraine causes between 28 million and 43 million lost work days per year in the UK, at a cost of around £4.4 billion. When we add the cost of that absenteeism to the cost of presenteeism—showing up and putting on a brave face but not being able to function normally —the Migraine Trust estimates that the total cost is closer to £9 billion.

We often talk about the need to improve productivity here in the UK, so surely helping those living with migraine access quicker and better treatment so they are able to work and fire on all cylinders would be a great step forward. That is especially so when coupled with the fact that, according to the Journal of Health Economics and Outcomes Research, the excess fiscal costs to the Government of one person living with migraine come to £19,823. That is the cost for one person, when there are 10 million in the UK battling the illness.

Giving up work for health reasons is not a choice that anyone makes lightly. For many, as well as the financial cost, there can be a significant cost to people’s mental health. Research by the Migraine Trust found that 78% of those living with migraine said it had a negative impact on their mental health and 65% reported experiencing anxiety as a result. People are missing work, cancelling arrangements with friends, missing out on social experiences that they have been looking forward to—and paid for—and feeling like they are a burden on their family. Others may not believe them, and they may wait months if not years to see a specialist; or they have the hope of trying another preventive that might work, only to have that shatter when it is another one that does not do so, and all the while they are living with excruciating pain. They are losing friends, losing relationships and feeling like they are losing their mind.

For some people such as Mollie, the darkness takes over entirely. She said that

“deep inside, I still had that same passion for life that all people in their twenties do. I want nothing more than to go outside and live my life, but this condition has me trapped in my own living room. My pain is now so severe, it has impacted on my mental health so intensely I contemplate suicide every single day of my life and have almost succeeded at times simply because I want the physical pain to end”.

We are here today to help people such as Mollie. We have a responsibility to help them and the millions of others suffering through migraine who need a lifeline. By improving access to treatments we can give them that lifeline. I hope the Minister will agree to meet me and the two brilliant charities represented here today to discuss further how we can do just that together.

[David Mundell (in the Chair)]

I ask hon. Members who wish to be called to bob.

--- Later in debate ---

[Dehenna Davison]

I am very grateful to the Minister for his remarks, and particularly for the fact that he has already actioned some of the points we raised by asking the MHRA to look into primary care prescribing. He also said that the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), is potentially exploring the further use of pharmacies, which is clearly a positive step.

My right hon. Friend the Member for South Staffordshire (Sir Gavin Williamson) made the brilliant comment that we clearly need to tackle migraine differently. I hope there can be a bit more oomph from the Department when it comes to recommendations from NICE. I appreciate that independence is crucial, but by raising awareness as we are doing today, and hopefully with some input from the Minister, we can perhaps still ask for another review without asking NICE specifically what to put into its guidance.

I am grateful to all right hon. and hon. Members who attended. They made some very interesting points and raised the cases of constituents living with this horrible condition. My right hon. Friend the Member for South Staffordshire talked about the wider impact of migraines, which many of us touched on. This is a health condition that does not just come on every so often; it has a wider impact on a person’s life and causes anxiety. It is about the in-between days when they are wondering when an attack might next strike. I am grateful to the Minister for recognising that and for talking about his own family’s experience of migraine, given that his sister suffers from the condition.

I am grateful to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) and the hon. Member for Midlothian (Owen Thompson) for sharing their experiences of migraine. Though their experiences were different in some ways, they were very similar in others, such as in the severity of attacks and the anxiety about how to tackle them. I was absolutely staggered by the amount that my right hon. Friend the Member for Romsey and Southampton North has spent on tackling her migraine. Botox can be an incredibly effective treatment, yet so many are unable to access it on the NHS, despite it being an approved treatment. That is another lifeline that we need to address. She raised the case of Monica, her constituent, who has had issues with her employer. I completely agree with my right hon. Friend and the hon. Member for Midlothian that migraine should formally be considered a disability, so that employers not only should, but have to put in place reasonable adjustments.

The hon. Member for East Londonderry—

[Paul Girvan]

South Antrim.

[Dehenna Davison]

South Antrim. I have my DUP colleagues confused—I can only apologise. It is because they both share a brilliant passion for Northern Ireland and for tackling the issue of migraine. I thank the hon. Member for South Antrim (Paul Girvan) for raising DWP assessments and the difficulty people have in accessing support when they are out of work as a result of chronic migraine. We have heard the statistics about how many people unfortunately have to give up work as a result of this disease, so hopefully we can take that up with DWP next time so that it can review its processes. Certainly, having chronic migraine listed as a formal disability would be a positive step in helping ensure that that is done.

The hon. Member also discussed the point around the devolved bodies. We heard some great testimonies from the SNP spokesperson, the hon. Member for Midlothian, about the positive steps being taken in Scotland and particularly the number of Scottish trusts that allow CGRP blockers to be prescribed. As he rightly said, that number is still not 100% and we need to go further to make sure that new, innovative treatment options that can work for so many people can be accessed by all those who are struggling.

I am grateful to the shadow Minister, the hon. Member for Bristol South (Karin Smyth), not only for responding here, but for getting in touch with me in advance of today’s debate so we could share a few notes about the impact chronic migraine can have. She is right to raise the impact on children—I did not particularly cover that in my speech, but my right hon. Friend the Member for Romsey and Southampton North touched upon it, given that she started experiencing migraine at such a young age. In some ways, it is even more terrifying for children because there is that lack of awareness of what is happening when a migraine attack strikes. Again, that is one example of how we need to get this right, in order to give people a better quality of life.

The hon. Member for Bristol South also talked about long-term workplace inactivity. Frankly, the best way we can tackle that is by getting people earlier diagnosis and earlier treatment that actually works. Part of that, as has been mentioned, comes down to knowledge and I am grateful to the Minister for talking about how medical training is outlined and done. It is great to hear that there are e-learning modules specifically on headache and migraine available for GPs and other medical practitioners to access—but I say we need to be bolder and I say we need to go further.

Off the back of this debate, therefore, I will be contacting some of those medical bodies to ensure they know just how debilitating and difficult migraine can be, in the hope that they can ensure not only that their educational modules are top notch and delivering the right information to the right people, but that people are taking those modules. They are not an optional extra; they are an absolute necessity.

I have probably missed some bits—yes, I have: I am grateful to the hon. Member for Greenwich and Woolwich (Matthew Pennycook), who is no longer in his place, for raising a point about knowledge, particularly of hormonal migraine, which many people experience. It is right that we continue to research that and make sure that medical practitioners have the knowledge they need.

My hon. Friend the Member for Kettering (Mr Hollobone) also raised the experience of his constituent. Again, it was another human story that tells the tale of chronic migraine; another human story that tells the tale of just how difficult this blooming thing can be. I am grateful to all hon. Members here today for taking part in the debate, for getting involved and for showing that there are people here in Parliament who care. To people watching at home, I say, “We are here, we hear you and we are going to do all we can to make this better.” I will keep nagging the Minister until we really see improvements in migraine care.

Question put and agreed to.

Resolved,

That this House has considered access to migraine treatment.

North East Ambulance Service

Dehenna Davison Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

As I said in my opening remarks, I am happy to meet the affected MPs. It is important that we hear from everyone, whether that is the family and friends of those affected, staff who have concerns or MPs who hear from their constituents first hand, but may I just say that the staff in the North East Ambulance Service are working hard? In the past year, they responded in less than 15 minutes to more than 28,000 serious and life-threatening incidents. Mistakes can happen, and it is important to learn from them, but we should place on record our thanks for all the hard work they do on a daily basis.

[Dehenna Davison (Bishop Auckland) (Con)]

At a surgery earlier this month, Mr Mitchell, a retired paramedic, told me about how his wife suffered a cardiac arrest. He called an ambulance and was told that there would be a wait for that ambulance. After 20 agonising minutes, and knowing the importance of timely care, he drove his wife down to a local defibrillator and administered care himself. Ninety minutes after his call, five ambulances arrived on the scene. His wife, sadly, lost her life. That is just one case brought to my attention that outlines the absolutely shocking record of the North East Ambulance Service. Will my hon. Friend give me, Mr Mitchell and all our affected constituents her assurance that the Department will investigate NEAS’s failures fully and rapidly to ensure that no more lives are needlessly lost?

[Maria Caulfield]

I have heard of the sad incident affecting Mr Mitchell. Incidents such as that are exactly what we need to learn from. It is not acceptable for five ambulances to arrive on the scene after 90 minutes. We need a learning culture and system where staff can flag such concerns and learn from them, with systems put in place so that these incidents do not happen again, but my concern is that I am not confident that that is happening at the moment. I am happy to meet my hon. Friend and other local MPs to discuss what more needs to be done.

Oral Answers to Questions

Dehenna Davison Excerpts

Tuesday 19th April 2022 Commons Chamber

[Mr Speaker]

Order. Let us move on. What a waste of a question. Dehenna Davison.

[Dehenna Davison (Bishop Auckland) (Con)]

Thank you, Mr Speaker. I will try not to make this one a waste. I was grateful to the Minister for meeting me to discuss my ongoing campaign to restore the A&E to Bishop Auckland Hospital. Many of my constituents face a long drive to get to Darlington or Durham, and given that swift treatment can be a significant factor in outcomes for conditions such as strokes and heart attacks, does he agree that having A&E services spread geographically rather than just in strong population centres is an essential part of keeping our community safe?

[Edward Argar]

I did indeed have a positive and constructive meeting with my hon. Friend. It is right that we have access geographically spread to A&E services, but the decisions are rightly taken by clinical commissioners on the basis of clinical evidence. I know that she will continue fighting the corner for the reopening of her local A&E with tenacity and passion.

Menopause (Support and Services) Bill

Dehenna Davison Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Carolyn Harris]

I am going to leave that to the Minister to worry about. I am sure that the Scottish Government do not want me telling them what to do. I would be happy to have a go. If only I was on the Government Benches, then I would get it sorted.

I am not just asking the Secretary of State to do this. I want to work with him, his Ministers and colleagues from across the House to build a taskforce that will take on these issues and find the solutions, because I truly believe that, working together, we can change this—even in Scotland, if necessary.

We also desperately need to look at prescription charges for HRT in England and at what we can do to ensure that the cost is not a barrier to women accessing it. The menopause does not discriminate, so the cost to treat it should not either. There are women struggling to find almost £20 a month, and that just is not right when it is a time in life that women will reach. There is no avoiding the menopause for half the population. Most women will spend at least a third of their lives perimenopausal, post-menopausal or—the joy—menopausal. We must ensure that those women who need it are not denied HRT because of financial restraints.

[Dehenna Davison (Bishop Auckland) (Con)]

Like everyone else in the House, I thank the hon. Lady for her vociferous campaigning on this really important issue. Assuming that we get there and manage to abolish prescription charges for HRT in England, how does she perceive us running a good communication strategy so that women are still not put off because they do not know that prescription charges have been removed?

[Carolyn Harris]

I am sure that the Minister will enlighten us on that issue. That is the issue: whatever we do today, it has to be communicated to the wider population so that they understand our commitment to their health.

The biggest complaint I have received over the past few months is from women who need both oestrogen and progesterone. Women who have had a hysterectomy can take oestrogen on its own, but everyone else needs both. Despite the two hormones being combined into one product, women are charged individually for the hormones, meaning that each prescription costs them £18.70, and with 86% of women getting only three months’ supply each time, the costs begin to add up.

A Plan for the NHS and Social Care

Dehenna Davison Excerpts

Wednesday 19th May 2021 Commons Chamber

[Dehenna Davison (Bishop Auckland) (Con) [V]]

I would like to begin by congratulating my hon. Friend the Member for Aberconwy (Robin Millar) and the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on their excellent maiden speeches. I remember all too well how daunting that is, having made my own maiden speech in the Queen’s Speech NHS debate in January last year.

Since then, our NHS has had the most turbulent of times. I pay tribute to the dedicated healthcare staff in my constituency, working day and night to keep us safe from coronavirus. I pay special tribute to Dr Poornima Nair, a dedicated and well respected GP at the Station View medical centre who died with coronavirus last year. In the House, I have talked about the light at the end of the covid tunnel. Thanks to the success of the UK’s vaccine roll-out, we are now beginning to see that light.

It was a UK grandmother who became the first person in the world to be given the Pfizer covid jab and, from then on, it has been onwards and upwards. The Government’s early focus on securing an extensive vaccine portfolio means that over 57 million doses have been given in the UK. The pandemic has really highlighted the importance of local healthcare and, as I mentioned in my maiden speech, it is one issue that unites every corner of my constituency. That has never been more true. From Bishop Auckland Hospital caring for covid patients to local GP surgeries and pharmacies vaccinating us to get us out of this pandemic, all parts of my constituency have pulled together.

Local healthcare provision matters, and that is why I will never stop banging the drum in this place for improved health services at Bishop Auckland Hospital. I am campaigning to restore the A&E that was lost under Labour, and I am grateful to both the Health Secretary and the Minister of State for Health for meeting me to discuss the campaign.  So far, the Government have invested £450 million to upgrade accident and emergency facilities in more than 120 trusts, so I know they understand how vital A&Es are to local healthcare provision, and I hope my ministerial friends will hear me clearly when I say I will continue to fight for the restoration of our A&E in Bishop Auckland.

The Queen’s Speech has healthcare at its heart, and I want to focus on one aspect that is close to my heart and to my politics: mental health. I have talked in the past about my own struggles around mental health. The importance of talking about it cannot be overstated. Every speech, every conversation, every time we talk about our own challenges that we have faced, we chip away at the stigma, but it is clear that talking about mental health alone is not enough. I am glad, therefore, that the Government are pushing ahead with their reform of the Mental Health Act 1983. Work is already under way on improving access to community-based mental health support, with £2.3 billion a year as part of the NHS long-term plan, but I am looking forward to seeing what further changes are proposed. The stigma around mental health needs to end, and every time we talk about it we help chip away at that stigma. Let us press ahead with improving the situation on the ground, improving mental health support and helping to ensure that no more lives are lost through poor mental health.

[Mr Deputy Speaker (Mr Nigel Evans)]

Thanks, Dehenna. Sadly, we had to cut the video—we had a still of you—and the audio was not brilliant. Perhaps you could have a chat with the technicians to try to establish what the problem was.

Women’s Health Strategy

Dehenna Davison Excerpts

Monday 8th March 2021 Commons Chamber

[Ms Dorries]

I thank the hon. Member for highlighting her constituent’s concerns. Abortion as such will not be part of the women’s health strategy, because it is being discussed under the sexual and reproductive strategy, which is also ongoing, and is a conscience issue in this House. It is not decided on party lines, it is down to individual Members’ votes, so it will not form part of the women’s health strategy, which will be about policy. However, the hon. Member is absolutely right; we will take evidence, we will look at that evidence and, if it comes in via the portal, we will pass it on to the sexual and reproductive strategy. However, there are no taboos and nothing that cannot be discussed. We want to hear about all women’s health issues, and I urge her to urge everybody she knows to click on the link and get involved.

[Dehenna Davison (Bishop Auckland) (Con) [V]]

I am grateful to the Minister for her statement and fully welcome the call for evidence. One area that I have been contacted about is IVF, for which we know there is currently something of a postcode lottery. I was contacted by my constituent Klara Halpin, who was seeking to have a child through IVF but was rejected NHS treatment in County Durham because her partner has children from a past relationship. However, if Klara had lived under a different clinical commissioning group, she would be eligible for that IVF treatment. Will my hon. Friend encourage women undergoing IVF to share their experiences, either to this review or the sexual and reproductive health review, to try to ensure more equalised provision of services right across the country?

[Ms Dorries]

Absolutely, and I thank my hon. Friend for her question and for highlighting that case. I urge her constituent to contact us and share her experiences with us. Fertility clinics across England have remained open throughout the last lockdown. Clinics obviously have to meet robust criteria to assure the Human Fertilisation and Embryology Authority that safe and effective treatment can be offered. I am not sure of the geography that my hon. Friend was talking about, but I am disappointed to hear the difference between two care commissioning group areas and would ask her to ask her constituent to contact us and let us know more details about her experience.

DHSC Answers to Written Questions

Dehenna Davison Excerpts

Thursday 19th November 2020 Commons Chamber

[Edward Argar]

The hon. Gentleman is indeed a prolific questioner, but his questions are always welcome and to the point. He highlights an important aspect that affects the response of the Department, which is that a significant number of questions, and the information required to answer them, is not held within the Department but by various health trusts, NHS England or other external bodies, which can occasionally introduce additional slight delays in the system. We are working closely with them to minimise that and get answers as quickly as we can to hon. Members.

[Dehenna Davison (Bishop Auckland) (Con)]

I thank my hon. Friend the Member for Christchurch (Sir Christopher Chope) for raising this matter and I recognise the importance of parliamentary questions for their role in parliamentary scrutiny, but it is only right that we recognise the substantial weight on the shoulders of the Department of Health and Social Care as it leads the charge against this pandemic. I personally have been blown away by the readiness and willingness of Ministers to engage through a whole range of communications, including Zoom, email and WhatsApp. I am grateful, in particular, for their engagement when it looked as though Bishop Auckland residents might have been teetering on the edge of tier 3 over the summer, which we thankfully avoided. Can my hon. Friend confirm that efforts are being made to clear the PQ backlog, but that other communication channels will remain open for MPs and their engagement?

[Edward Argar]

I am grateful to my hon. Friend, and I pay tribute to the officials in the Department, who are working hard to clear the backlog and do take this very seriously. As I say, we are trying to clear the older PQs first, and then get back up to the performance we had before. She is absolutely right to highlight the other methods of communication. I may not be the most technological Minister in this House, but we have been seeking to use every means we can to try to answer colleagues’ questions and to give them the information they need.

Public Health: Coronavirus Regulations

Dehenna Davison Excerpts

Tuesday 13th October 2020 Commons Chamber

[Dehenna Davison (Bishop Auckland) (Con)]

I know time is short, so I will keep it brief, Madam Deputy Speaker. The key point I want to get across is that, obviously, public health must be a priority but we must not forget the real human stories behind every one of the statistics. So we should look at not only the number of covid deaths but the economic impacts that lockdown measures are having right across our country. I have been banging the drum for our hospitality sector, pushing for additional support for it to protect those people who have spent their entire lives building up strong businesses that are integral to their local communities, right in the heart of those communities. I think of people such as Christian Burns and Cheryl Jeffrey. We must do all we can to try to protect them as best as we can as we move through this pandemic.

Public Health

Dehenna Davison Excerpts

Wednesday 7th October 2020 Commons Chamber

[Dehenna Davison (Bishop Auckland) (Con)]

I must admit that when I was elected back in December, I did not anticipate standing here among the green Benches to talk about it being an offence for two households to meet, but the impact of the pandemic is such that that is precisely what we are here to discuss. That is where we find ourselves.

In the early stages of the pandemic, when little was known about the virus, it was right that all steps were taken to stop the spread. Since then, we know that it has not spread evenly around the country, and we have seen a rapid rise of cases across the north-east. The Government are exactly right to take a localised approach, rather than subjecting those in local areas to overly restrictive national measures but, on that note, since north-east restrictions were announced, I have had emails from constituents in Middleton-in-Teesdale, Bowes and Hamsterley, confused and angry as to why they must be put through more serious restrictions, despite cases in their immediate local vicinity remaining low.

If localised measures are to become the norm, will it be possible to have data analysed on a more localised level, allowing areas with minimal cases, where local residents are working hard to follow the guidance, to enjoy more freedom? After all, we are the party of freedom. Also, if we are to have restrictions on businesses to reduce the spread of the virus, I believe that we must have greater protections for the sectors that are hit hardest by the inability to socialise.

One of my constituents is John Harper-Wilkes, who runs Lartington Hall, an incredible wedding venue just outside Barnard Castle. Couples who had booked to get married at Lartington Hall this year are choosing to postpone their weddings until next year, rather than getting married in front of socially distanced crowds of 15. John has done nothing to make customers postpone their bookings but, through no fault of his own, he has lost almost all his custom. He will now have to make all his staff redundant. The impact of such job losses be overstated, and the long-term mental health impact of unemployment or lost incomes can be devastating.

Another constituent, publican Christian Burns, has done everything that the Government have asked him to do to make his venues covid-secure and ensure that customers are safe to return to his pub. Last weekend, he told me, rather than his usual Saturday take of £5,000 to £6,000, he took only £128 all day, not even enough to cover his entire staffing bill. Given the 10 o’clock curfew and with households being unable to meet, I am really concerned that these restrictions may, without additional financial support, have the overall impact of closing pubs, and not just for lockdown but for good. We must make sure that our pubs, the social hubs of our communities, remain viable for the long term for the mental health of all those people who rely on them for social contact.

We have to balance reducing transmission of the virus with allowing business to carry on as usual. To stem the rising number of cases, I will support the statutory instrument today but may I please urge my right hon. Friends in the Government to look closely at how we can provide new tangible support for our hospitality and events sector? That is for people like Christian, John, Cheryl Jeffrey and Chris Robinson. We cannot let them down.

Covid-19 Update and Hospitality Curfew

Dehenna Davison Excerpts

Thursday 1st October 2020 Commons Chamber

[Matt Hancock]

As the hon. Member knows, although public health measures are devolved, it is only because we are one United Kingdom that we are able to have the strength of support that is in place right across Scotland. He and his party would do well to recognise that and to welcome the support that the UK has been able to provide in Scotland during these very difficult times.

[Dehenna Davison (Bishop Auckland) (Con)]

When my right hon. Friend visited Bishop Auckland during the election campaign, we spent our lunch break in a pub called the Merry Monk. Since then I have been in regular contact with the landlord, Christian Burns, who, alongside a lot of other pub landlords, has written to the Prime Minister expressing concerns about some of the lockdown measures that have been introduced. I recognise and welcome the unprecedented support that the Government have put in place—more than £190 billion is not small fry—but will my right hon. Friend please confirm to Christian and other landlords that Ministers will continue to work with the hospitality industry, particularly pubs? We need to save our pubs, because they are a lifeline for our local communities.

[Matt Hancock]

Absolutely. I really enjoyed my trip to the Merry Monk with my hon. Friend. We left before 10 pm, even though at that time we could have stayed longer. Of course we will keep working with the hospitality industry. I wish all the pubs in Bishop Auckland all the very best. We will support them as much as we can.