Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Victoria Atkins]

I thank my hon. Friend sincerely for her question. The good news is that community diagnostic centres have now delivered over 6 million additional tests and scans since July 2021 thanks to the hard work of NHS staff, but I will of course be delighted to meet her to discuss her plans for her local constituency.

[Derek Twigg (Halton) (Lab)]

T3. New British Heart Foundation analysis shows that the number of people dying before the age of 75 in England from heart and circulatory diseases has risen to its highest level in over a decade. The rate of premature deaths from cardiovascular disease has now increased in England for three years back to back. Why are the Government taking such a long time to get to grips with this crisis?

[Andrew Stephenson]

The NHS long-term plan commits to a number of key ambitions to improve care and outcomes for individuals suffering from cardiovascular disease, including enhanced diagnostic support in the community, better personalised planning, and increasing access to cardiac rehabilitation. Those ambitions will support the delivery of the aim to prevent 150,000 heart attacks, strokes and dementia cases by 2029.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 17th October 2023 Commons Chamber

[Steve Barclay]

My hon. Friend raises an important point, and I know she has secured a debate in the House this week to further explore these issues. She will be aware that there has been a 13% increase in the number of midwifery programme place starters since two years ago. That is alongside the £165 million added to the maternity budget since 2021 and the key increase in midwifery places in the long-term workforce plan.

[Derek Twigg (Halton) (Lab)]

It is obviously welcome to train and recruit as many staff as possible, but part of the problem is actually retaining the staff. We are increasingly seeing among the reasons given for leaving, particularly by nurses, their work-life balance. What is the Secretary of State doing to address that?

[Steve Barclay]

Just yesterday, I met leaders of the NHS Staff Council, who represent trade unions under Agenda for Change, as part of our ongoing discussions on the agreement we will reach with them, which includes working together on retention and how we address some of the challenges the workforce face.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 11th July 2023 Commons Chamber

[Helen Whately]

I congratulate my hon. Friend on his commitment to ensuring that we are focused on cancer outcomes and on his successful campaign for that to be included in the NHS mandate, which it has been, as I just mentioned. The best way to improve outcomes for cancers is by catching cancer early. That is one reason why we have a range of metrics, including process metrics, which measure early diagnosis and therefore help us to achieve our ambitions on outcomes. Other metrics such as patient experience are important as well.

[Derek Twigg (Halton) (Lab)]

I agree with the hon. Member for Basildon and Billericay (Mr Baron). One of the problems is the time it takes from the GP’s referral to the consultant at the hospital and the treatment then starting; there are still concerns about delays in that. What is the Minister doing to speed up the process from not just the GP’s referral to the consultant but from the consultant to treatment starting?

[Helen Whately]

The hon. Member is right that the duration is very important. One reason why we are focused so much on increasing early diagnosis is because we know that the sooner we diagnose people, the more likely they are to have a successful outcome from cancer treatment. We are seeing improvements in cancer survival. For instance, in 2010, two thirds of people would survive for one year after a cancer diagnosis; now the figure is three quarters. The NHS is working very hard on further improving cancer diagnosis, and we have reduced the number of people waiting more than 62 days since the pandemic by over a third.

Lung Cancer Screening

Derek Twigg Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

My hon. Friend, an experienced parliamentarian, opens two different issues there. As he well knows, one is a question of tax, which, rightly, I say as a former Treasury Minister, is a matter for the Treasury. As for the roll-out of the programme, the additional cost of the programme will be £1 billion over the seven years. That is the additional cost of that expansion, but how it is funded will be an issue for the Treasury.

[Derek Twigg (Halton) (Lab)]

Anybody who has lost a loved one through lung cancer will know what a horrible and cruel disease it is. Obviously, we welcome any move to improve screening and get more people screened. But I would be interested to know two things from the Secretary of State. First, in one of my local hospitals—recently, I asked a parliamentary question about this—only 77.8% of patients got an urgent referral within 62 days, so quite a lot of people did not. Secondly, how much of the £1 billion will be used to bring in the extra clinicians and staff who will be needed to do the screening?

[Steve Barclay]

I am sorry, but I missed the second part of the question. On the speed of treatment, that is why significant work is going into the faster diagnosis standard, which was hit for the first time in February. Part of the additional capacity going in—the extra 108 diagnostic centres—is to boost that capacity and speed up that treatment. There has been a surge in demand; a significant uptick in the nature of demand. That is the backlog we have been working through as a consequence of the pandemic, but the additional capacity is to address that exact point.

Oral Answers

Derek Twigg Excerpts

Tuesday 25th April 2023 Commons Chamber

[Steve Barclay]

As a result of the fantastic work of Sir Jim Mackey and Professor Tim Briggs through the Getting It Right First Time programme, we have been making significant progress in respect of elective procedures. When it comes to urgent and emergency care, there are lessons coming out of the various strikes which we are keen to adopt, but this situation is also clearly having an impact on patients and the number of cancellations. As my hon. Friend well knows, we publish the figures.

We have been working constructively with the NHS Staff Council. Unison voted by a majority of 74% to support the deal, there will be further votes this week from other key trade unions, and there will be a decision from the staff council on 2 May. Obviously, that will be extremely important when it comes to addressing the concern highlighted by my hon. Friend.

[Derek Twigg (Halton) (Lab)]

According to figures that I obtained recently from the House of Commons Library, in January 2023 54.4% of patients who were treated after an urgent referral received their first treatment within 62 days of that referral. The target is 85%. The figure for performance in January 2020, before covid, was 73.6%. Why has there been such a deterioration?

[Steve Barclay]

To be honest, I think the position is mixed. In certain areas we have seen significant improvements in performance: the faster diagnosis standard, for example, was hit for the first time this month. Purdah prevents me from going into the details of the 78-week wait, but I expect to be able to update the House very soon on the progress that has been made. As the hon. Gentleman says, there are still challenges as a consequence of the pandemic, but we are seeing much more progress than the NHS in Wales, and it is also worth reminding the House that, through Barnett consequentials, the Welsh NHS receives more funding that the NHS in England.

Covid Pandemic: Testing of Care Home Residents

Derek Twigg Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

My hon. Friend is absolutely right about how we ramped up incredibly fast from a capacity of just 3,000 tests a day in March 2020, to more than 38,000 in mid-April, and more than 100,000 by May. We were then able to test many millions per week during the course of the pandemic. That was the most extraordinary increase in the capacity to produce, carry out and analyse tests, and he is absolutely right to draw attention to it.

[Derek Twigg (Halton) (Lab)]

The Minister said that what my hon. Friend the Member for Leicester West (Liz Kendall) said was shocking. What is shocking is the number of people who died but who might have been saved in the first place. Is the Minister really saying that, at the beginning of the pandemic, there was no rush to get people out of hospital and back into the community without being tested?

[Helen Whately]

The questions about the discharge policy have been interrogated on a number of occasions, including by Select Committees. The hon. Gentleman will well know that in general, and in the work that we are doing now on discharge, it is rarely good for somebody who is medically fit for discharge to continue to be in hospital beyond that time. So of course it is right that when people are medically fit, they should be discharged home. The guidance of how that was done was set out on a number of occasions during the pandemic, and that guidance was updated both as we learned more about the virus and as greater testing capacity became available.

Urgent and Emergency Care Recovery Plan

Derek Twigg Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

My right hon. Friend makes an important point. Again, within that is patient choice and how we empower more patient choice—providing services that are free at the point of use—to use what capacity there is within the system, including in the independent sector. I absolutely agree that we should be maximising capacity. At Downing Street with the Prime Minister, we had a very useful roundtable with the independent sector about how we can make more use of its capacity. That is certainly an area that we are exploring.

[Derek Twigg (Halton) (Lab)]

I saw for myself only a few weeks ago the real crisis in our hospitals when I accompanied a close relative to Whiston Hospital, where I saw every single space in the corridors taken up by a bed, a trolley or a chair. Quite frankly, what the staff—doctors, nurses and support staff—were doing was amazing, and they deserve all our praise for the hard work that they are putting in. The Secretary of State’s lauding of the fact that two-year waits have virtually been eliminated is bizarre: when Labour left office, waits were somewhat less, with an 18-week target and many people being seen within weeks, not months. The Secretary of State said that the Government are on track to recruit 15,000 new nurses, but how many have left the NHS in the last two years?

[Steve Barclay]

First, the hon. Gentleman is right to recognise the work that the staff have been doing. He mentioned a family member; when I made a statement earlier in January, I recognised that there has been huge pressure on the system. We saw the flu numbers and the spike in cases. On the two-year waits, the point is simply that there has been pressure on services—the pandemic impacts—across the United Kingdom, but the two-year wait is far worse in Wales, whereas we have cleared it in England. On recruitment and retention, we are bringing forward the workforce plan. The fact is that we are recruiting more nurses, but it is about meeting demand pressure as well.

Sudden Unexplained Death in Childhood

Derek Twigg Excerpts

Tuesday 17th January 2023 Westminster Hall

[Kwasi Kwarteng]

I am delighted that my hon. Friend has made that contribution. I must press on to the end of my remarks and look forward to what other hon. Members have to say on this sensitive, moving and tragic subject. The silver lining is that we will be able to make more progress in the years ahead.

It is vital to get on the record an undertaking from the Minister and his Department to encourage consistent medical education and training—there is currently very little—to help prioritise research into this category of death. Our urgent, immediate request is an undertaking to increase public information about this tragic phenomenon. How will the Minister help to prioritise scientific research to better understand this phenomenon, and to work out ways we can prevent and reduce the tragic deaths such as those experienced among many of our friends and wider communities?

I have written to the chief executive of the NHS to ask for more and better public information. The website should be updated. I urge the Minister to engage with NHS officials and managers through a commonly agreed platform, on which we can progress.

The initial response to this debate has been incredibly heartwarming and impressive. In the last few days, dozens and dozens of people have written in. They have outlined their experiences and told us about their own tragedies and their families, which have been torn apart and devastated by this phenomenon. It would be invidious of me to talk about those responses individually, but common themes run through all the submissions in this overwhelming response—in all the evidence we have accumulated in the last few days.

The thing that comes out most tragically and vividly to me is the sense of utter bewilderment about the cause of death. Many of us in our lives have dealt with personal tragedy and the passing of loved ones. In most of those instances, we have understood the nature of the illness, and there has been a degree of timing and ability to adjust to an appalling series of events. But let us imagine the death of a child who has all of his or her life in front of them and it is suddenly ended. If we can imagine that for one of our own children, we get a sense of how tragic and difficult that occurrence is. I commend the many people here who have gone through that heart-wrenching experience, who have had the courage to reach out to come and speak to MPs, and who work incredibly hard to make sure this goes further up the agenda.

The other principal thing that I have noticed is that there is not only bewilderment and the initial horror and confusion around the event, but a marked degree of ignorance about this phenomenon among the wider public. People do not know about this. We used to read and hear about what was called cot death, which was technically applied to children under the age of one, but, for the age group between one and four and for older children, there was not even a word or a phrase to describe what happens. If this debate can start a wider conversation about SUDC, I will feel that we have done a bit of our job. This is not the end; this is just the beginning of a wider debate on a deeply tragic occurrence.

Finally, because we do not have much time, I want to thank Nikki Speed, the chief executive officer of SUDC UK, who is here, and Julia and Christian Rogers for bringing this important subject to my attention and enabling us to have a wider debate. As I have said, I think it is the first time that this has been discussed, certainly in my experience as an MP of 12 years, in these precincts. I hope we can continue to work together to find adequate solutions and improve outcomes for people in this country.

We have had successes on the phenomenon of cot death—we made huge strides with that—and it is vital now that we turn our attention and expertise to SUDC. I thank Members from across the House who have listened with real respect not to me, but to the gravity of the debate. I am very interested to hear what my hon. Friend the Minister will say in response to our speeches.

[Derek Twigg (in the Chair)]

May I remind Members that they should bob if they wish to be called in this debate? There are five standing, so I must limit speeches to five minutes or so to get everybody in. I am sure you will all work together to try to achieve that before the wind-ups. I call Tim Farron.

--- Later in debate ---

[Mr Mohindra]

Unsurprisingly, my hon. Friend makes an excellent point, and I will cover it in a short while.

Mortality statistics from Nomis indicate that about 128 children between one and 19 died of SUDC between 2013 and 2021. That is 128 families and their friends who have been devastated by sudden death. Unfortunately, in Hertfordshire, we had six deaths between 2017 and 2022; indeed, they were all in 2020.

I know that Nikki has put her own journey—her own story—on her website, and would I direct people to visit SUDC UK website. She went through great trauma back in 2013 when she lost her second child, Rosie. When my staff and I were researching for this debate in my office, all of us were emotionally moved by that, because we could all relate to the fact that this could potentially have happened to a loved one. Actually, not that long ago—back in December—I referenced the fact that I have another new niece, and I remember the joy I felt when I described her in the main Chamber. The other side of the coin would be the emotional shock of having to talk about the distress of losing someone at a young age.

With Rosie’s story, what made things worse was that it was the run-up to Christmas—there was a reference earlier to another family who unfortunately lost their child on Boxing day. For those families, what is meant to be a joyous time for families and friends will, unfortunately, forever be a real sore spot of emotional trauma, and the unknowns mean there has not really been much in the way of closure.

We have spoken about research. Hopefully the Minister, who is a very good Minister, will take away from the debate the fact that more research needs to be done. The Government have levers to help influence that, but I would urge academia to do more as well. It should not always require a Government steer to do the right thing.

We have spoken about the success of research into sudden infant death syndrome and about how, off the back of 13,000 research papers, there has been an 80% decline in deaths from SIDS. To date, according to my research, we have had only 55 research papers on SUDC, so there is a huge gap there, which can potentially—hopefully—be rectified.

In December 2022, the National Child Mortality Database reported data on SUDC for the first time ever. I hope we will continue to be report it, and in more detail, because what we have heard in other speeches today—my right hon. Friend the Member for Spelthorne articulated it amazingly well—is that the lack of knowledge is the main barrier to finding a long-term solution.

I will leave it at that, because I am sure there will be other excellent speeches forthcoming. However, I echo my right hon. Friend in saying that I believe that this is the start of the journey in educating more people in this place, and hopefully up and down the country, about SUDC.

[Derek Twigg (in the Chair)]

I call Robbie Moore, and I ask you to take account of the time as well.

[Robbie Moore (Keighley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Twigg, and I thank my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for securing this really important debate, which will hopefully shine a little light on the sad topic of sudden unexplained death in childhood.

It is only right that I begin my contribution by telling the story of a family from Silsden in my constituency whom I had the pleasure of meeting just last Friday. Cheryl, a senior nurse in our local A&E department, and Darren, a local police officer, are incredibly loving parents to two wonderful children. On Christmas day, they put their loving, happy and fun-going little boy, Jack, who was only 16 months old, to bed, only for him not to wake the next morning. That is incredibly sad news, and it was undoubtably devastating for the family. One cannot pull together the words to express the deep sense of loss, anguish, grief and heartbreak that Cheryl and Darren will be feeling. Of course, this also has an impact on their older son, Louis, who has lost a brother he will now not be able to grow up with and share that unique brotherly bond with. Since Jack passed away only on Christmas day just past, the family have had no answers as to what has happened, and investigations are still ongoing.

Sudden unexplained death in childhood is the fourth leading category of death for children aged one to four years old in England and Wales. Approximately 40 children are affected by SUDC in the UK each year—that is one to two seemingly healthy children passing away every fortnight, often going to sleep and never waking again. As we have heard, SUDC affects not just young children under one year old; more one to nine-year-olds die of sudden unexplained death than die as a result of road traffic accidents, drowning or fires.

Published epidemiological data suggests a common profile for children affected by SUDC. Most commonly, they are one to two years old, they are male and, most worryingly, they are dying unwitnessed, alone as they sleep. The child’s development is usually normal and their vaccinations are up to date.

Of course, as all of us have said, awareness is absolutely key, because if a parent, family member or friend does not know why the death has occurred, they will constantly ask, “Why?” Over 13,000 research papers have been published on sudden infant deaths. That has helped to pioneer safer sleep advice, which has led to an 80% decline in infant deaths. However, only 55 research papers have been written on SUDC.

Last year, 8 December marked the publication of the groundbreaking report “Sudden and Unexpected Deaths in Infancy and Childhood” by the National Child Mortality Database—I have read it, and it is well worth reading, for those Members who wish to do so. It concludes that, of the sudden and unexpected deaths in 2020 that have been investigated and reviewed, 16% are still classified as unexplained. It provides greater awareness and accuracy around understanding exactly which of the many children who are affected by seizures are at risk. It helps to address some of the knowns but, as many of us have outlined, there are still many unknowns. That comes back to the issue of why research is so important. I ask the Minister what we are doing to increase that research, as well as awareness, training among medical professionals, and the public information out there.

This is undoubtably a difficult topic to talk about, but we must never forget that at the heart of all this is the sad loss of a child. They leave behind a heartbroken family—parents, brothers, sisters and grandparents—and friends. In Jack’s case, he leaves behind a loving mother, father and three-year-old brother, Louis. I would like to thank them for their time in sharing their story and for educating me in the meeting I had with them last Friday.

[Derek Twigg (in the Chair)]

I will call the Minister no later than 5.16 pm.

--- Later in debate ---

[Neil O'Brien]

That is exactly what we want to do. We are committed to the health service learning from child deaths. In 2019, the Government published the “Child Death Review Statutory and Operational Guidance (England)”, advising NHS trusts on how they should support, communicate with and engage with families following the death of someone in their care. Listening to bereaved families and ensuring clear communication is integral to the process, and putting clear support in place is a top priority. That guidance sets out the full process that follows the death of a child in England. It builds on the statutory requirements set out in “Working Together To Safeguard Children” and clarifies how individual professionals and organisations across all sectors involved in the child death review should contribute to reviews.

It is important that when a child dies, bereaved parents should be supported to understand the child death review process and how they are able to contribute to it. The family should be assigned a key worker to act as a single point of contact for the bereaved family, who they can turn to for information and who can signpost them to sources of support. The hon. Member for Lancaster and Fleetwood mentioned one particular, excellent way to do that.

Each local authority area has a child death overview panel that is responsible for reviewing information on all child deaths, looking for possible patterns and potential improvements in services, with the aim of preventing future deaths. This process enables us to act quickly to address local failings within the system.

The first step towards understanding the problem is to get the data. In 2018, NHS England supported the establishment of the national child mortality database to reduce preventable child mortality in England. The NCMD records comprehensive data on the circumstances of children’s deaths and is the first of its kind anywhere in the world. The child death review process aims to ensure that information regarding every child death is systematically captured and submitted to the NCMD to enable learning to prevent future deaths.

In December, the NCMD published its report into sudden and unexpected deaths in infancy and childhood. The Government are grateful to the NCMD for its important research, which is a significant step forward. Of the 204 unexpected and sudden deaths of children reviewed by child death overview panels in 2022, 32 were classified as unexplained. The report highlighted that both explained and unexplained deaths in this age group were associated with a history of convulsions, but that association still needs further research, which I will come back to later.

The NCMD provides evidence for investigation, responding to deprivation, housing and other potential risk factors, which the hon. Member for Denton and Reddish (Andrew Gwynne) asked about. Housing Ministers are already strengthening the powers of the regulator of social housing to tackle unsafe homes, and introducing a decent home standard for the private rented sector for the first time ever, which will make sure that privately rented homes are safe and decent.

My right hon. Friend the Member for Spelthorne asked how we will improve medical education, and the report recommends consistent national training on the child death review statutory process and on sudden unexplained death in childhood. Sudden deaths of children over 12 months of age are not well understood, especially where those deaths remain unexplained. As I have outlined, child death overview panels will continue to develop their processes following the publication of the child death review statutory and operational guidance, and they will be supported by the NCMD and work with relevant professional bodies where appropriate.

We are modernising healthy child programme resources to improve available evidence for health and other professionals who work with children. This will include stronger evidence on safer sleep and sleep hygiene for older children, and NHS England is also making commitments to improve knowledge. The children and young people programme is reviewing the patient information made available, so that it is relevant and appropriate. This will involve a review of all NHS-commissioned information, including on febrile seizures. NHS England is also conducting a review of the leaflet that is handed out when a child dies, which will provide further information on sudden unexpected death in childhood.

The hon. Member for Lancaster and Fleetwood asked specifically about the NHS website. The team are reviewing the information with patient groups, so that it is appropriate.

A number of Members have quite rightly called for more research, and the report calls for further research into SUDC to better identify modifiable factors. My officials have contacted their counterparts at the University of Bristol to discuss potential research priorities, and I am happy to continue that dialogue with Members of this House and others, to scope further research priorities. Such research will help us better understand what can be prevented. The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including sudden unexplained death in childhood, and NHS England will be working with the NCMD to track trends in modifiable factors further. Their work will help to raise awareness across professions and identify key areas for research. My officials are also in contact with the chief nursing officer in England about any opportunities linked to the CNO’s research strategy. I look forward to hearing experts and parents’ suggestions on research, so that we all have better data on prevalence and a shared understanding of risks around gender, ethnicity and other characteristics.

Someone would have to have a heart of stone to not be moved by the contributions to today’s debate. By raising awareness and developing the understanding of modifiable factors, we can provide better information to parents and professionals, and help to reduce the risks, so that more families will not have to suffer in the same way.

[Derek Twigg (in the Chair)]

I call Kwasi Kwarteng to wind up. You have a bit more time than we originally envisaged.

Oral Answers to Questions

Derek Twigg Excerpts

Tuesday 6th December 2022 Commons Chamber

[Will Quince]

I thank my hon. Friend, who has been a long-standing advocate for a new general hospital for Warrington. The expression of interest from the trust has been received. We are currently in the process of reviewing expressions of interest for the eight new hospitals and aim to announce a final decision by the end of the year. I recently met him to hear about the plans, and the people of Warrington could not have a greater champion than him.

[Derek Twigg (Halton) (Lab)]

May I associate myself with the remarks of the hon. Member for Warrington South (Andy Carter) about the need for investment in Warrington and Halton Hospitals NHS Trust? It is important that both hospitals have that investment. Part of the capacity problem is the lack of social care capacity in the community, whether in a home or in patients’ own homes. Just recently, I had an email from the chief executive of Whiston Hospital, a large acute hospital, where 115 patients were in beds when they did not need to be—they should have been going out of the hospital—out of a total of 721 adult acute beds. Is that not an example of where the Government are failing to provide enough social care out in the community?

[Will Quince]

We are investing £500 million to create another 200,000 social care placements, but we have significantly increased the number of physical beds available in our hospitals. In July, before we made the commitment to increase bed capacity, we had 96,375 general and acute beds; in October, we had 97,350. We are also delivering that increased capacity outside of hospital through this winter by creating an extra 2,500 virtual ward beds.

Health and Social Care Leadership Review

Derek Twigg Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

I thank my right hon. Friend for his support of the report. Of course he speaks with incredible experience. He is right to raise the issue of the importance of targets, and sometimes targets can have unintended consequences. The report does talk a bit about the importance of that issue. I can assure him that as we make changes and work with our colleagues in the NHS to make reforms, we will certainly be taking that into account.

[Derek Twigg (Halton) (Lab)]

As the Secretary of State will have seen over his years as an MP and a Minister, there are managers and leaders who are excellent and outstanding and there are others who are not so good. Is not part of the problem, as the right hon. Member for Maidenhead (Mrs May) mentioned, the continual structural changes, which add to instability, the massive recruitment and retention problems and the record numbers of people using the hospitals? No matter what he does to improve leadership, it will not solve all those problems. Part of the problem is that we do not have enough people coming forward to take up leadership roles. At what point in the next five to 10 years does he expect to have solved the leadership crisis in the NHS?

[Sajid Javid]

The hon. Gentleman is right to talk about the importance of recruitment in the NHS—bringing in the right people in the first place and then retaining them—but I hope that he will also recognise that good leadership plays an important part in that. This morning, I went to Chelsea and Westminster Hospital, which is an outstanding and incredibly well run hospital, and heard from the leadership team about the important role that they play in attracting and retaining talent. I hope that he recognises that point as well.