Oral Answers to Questions

Debate between Baroness Laing of Elderslie and Steve Brine

Tuesday 5th December 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

No, no—you do not get another supplementary question. I was about to call Layla Moran for Question 16, which is grouped with this one, but unfortunately she is not present so I shall go straight to the Chairman of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

The Government previously committed to publishing a dental recovery plan, which the former dental Minister, my hon. Friend the Member for Harborough (Neil O’Brien), said that the Government would publish shortly. He also told my Committee:

“We do want everyone who needs one to be able to access an NHS dentist”.

We were surprised, but he said it. We were told that the plan would be published during the summer or before the summer recess. When will the plan be published, if that is still the intention? Presumably it will come alongside the response to our “Dental Services” report, which was due on 14 September.

Countess of Chester Hospital Inquiry

Debate between Baroness Laing of Elderslie and Steve Brine

Monday 4th September 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

I place on record my sympathy to the families, who have conducted themselves with the utmost dignity throughout this process and who remain in my thoughts and prayers as well. I welcome the judge-led statutory inquiry that my right hon. Friend has announced. It is the right thing to do, as are the phases of the inquiry, which prevent stuff from taking too long to move fast. As that work moves forward, and the debate rightly continues to touch on how we regulate managers working in the NHS, and remove them, I ask that Ministers remain alert to any “us and them” thinking between managers and clinicians. Surely any successful hospital trust is one team working together, so that defensive medicine is all but impossible.

Lung Cancer Screening

Debate between Baroness Laing of Elderslie and Steve Brine

Monday 26th June 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Chairman of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

I remember dear James Brokenshire saying the words that the Secretary of State repeated today in the House. James made this happen—this is a fantastic prevention announcement. Although this nationally expanded programme cannot prevent lung cancer, will the Secretary of State confirm that we will stick by the principle of making every contact count? When people come forward for a lung risk assessment, we can offer emotional support where a problem has been detected, provide smoking cessation services to those who are still smoking, or just put our arms around people where there are comorbidities. When people come into contact with the health service, will we make every contact count for them?

Patient Choice

Debate between Baroness Laing of Elderslie and Steve Brine

Thursday 25th May 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Chair of the Select Committee.

[Steve Brine (Winchester) (Con)]

This form of patient choice has of course been available for at least 15 years; it just has not been made available to patients. Can the Secretary of State confirm that the referral management centres sitting at integrated care board level will be compelled, not asked, either to change that or to get out of the way altogether? Given that the vast majority of people on the waiting lists are already there with a specific trust, how exactly will they be given the option either to stick where they are, or to twist and exercise that choice to receive treatment sooner?

New Hospitals

Debate between Baroness Laing of Elderslie and Steve Brine

Thursday 25th May 2023 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

I am grateful for the statement; the Select Committee will want to have a good look at it, and we will start when the Secretary of State comes to see us next month. At the last election, I promised my constituents significant investment in Winchester Hospital. That is already happening, and now with early work in cohort 4 we have the promise of the elective hub to scale the orthopaedic list. Can the Secretary of State be clear with my constituents that, as the new Hampshire hospital comes together as part of the wider cohort 4, it will be for clinicians to make the clinical case on what safe and sustainable services look like in the long term for those people?

Breast Screening

Debate between Baroness Laing of Elderslie and Steve Brine

1st reading
Wednesday 30th March 2022 Commons Chamber

[Steve Brine (Winchester) (Con)]

I beg to move,

That leave be given to bring in a Bill to make provision for the purposes of increasing uptake of NHS Breast Screening Programme appointments, including in groups currently less likely to take up such appointments; to extend eligibility to that programme to persons at an increased risk of breast cancer because of their family history; and for connected purposes.

Last weekend saw Mothering Sunday, and for many of our constituents that meant a time to catch up with Mum and maybe have lunch, go for a walk or buy some flowers. My little ones did that for my wife. For some, however, Sunday was not a day for lunch, or a walk, or a catch-up; there were flowers, but they were dropped off at the churchyard or the crematorium, as they are every year, and that group included me, as it has for the past 19 years. I was in my late 20s, away on my stag do in Wales, when I got a phone call very early in the morning to say I needed to get home. My mother was in hospital at that point, with only one possible outcome. She passed away a few days later, five weeks before Susie and I got married. She was just 52 years old.

People say that events and our life before we enter this place shape how we approach some of our time here, and they are right. Colleagues here and constituents in Winchester and Chandler’s Ford know that breast cancer is an issue I am passionate about, and now they know why. For my first five years as an MP, I co-chaired the all-party group on breast cancer; then, in 2017, it was the privilege of my life to serve as the Cancer Minister. We said then, as we do now, that for cancer early diagnosis can be game-changing—cancer’s “magic key”, as it is often put.

Breast cancer is incredibly treatable if it is detected early: 98% of women who have the disease detected at stage 1 survive for at least five years after their diagnosis, and many go on to lead full lives. It is true that we have made huge progress on tackling cancer—indeed, survival rates have been increasing year on year for the past decade or more and have doubled in the last 40 years in the UK, thanks in large part to more cases being caught early. Our NHS breast screening programme is estimated to prevent 1,300 breast cancer deaths every year across the UK—but we need to go further. That is even more true today than it was pre-pandemic, given that, according to figures on NHS England’s latest cancer waiting times, there are nearly 9,000 women in England living with undiagnosed breast cancer due to the impact of covid. The pandemic has, to put it mildly, not helped our efforts to detect breast cancer earlier through screening.

I want to put on the record my thanks to the staff at Hampshire Hospitals and in breast screening centres across the UK. They have worked and continue to work tirelessly to pool and expand capacity so that catch-up appointments can be offered to women who were not screened while the programme was paused. Despite all the hard work, between April 2020 and March 2021, about 936,000 fewer women in England were screened for breast cancer compared with the previous year. Routine breast screening appointments were suspended in March 2020—a mistake we must never repeat—and restarted in the summer of that year, but we are far from fully recovered. The latest breast screening performance data for England shows that the percentage of women taking up their screening invitation within six months has reached an historic low of 62%—well below the national minimum standard of 70%. My fear is that this will be another terrible legacy of the pandemic, even after all the delayed screening invitations have been sent.

The long-term impact of the disruption will depend on how quickly screening services can fully recover, not just in offering catch-up appointments but in making sure as many women as possible accept that invite. Reducing the shortfall in the number of women screened is key to identifying the majority of “missing” breast cancer patients and ensuring that all breast cancers are diagnosed as early as possible. Although addressing the invite backlog and the drastic drop in attendance is the most immediate priority, we cannot deny that breast screening uptake was already in steady decline before the pandemic. Covid has simply accelerated the trend, with potentially tragic consequences.

I welcome the Government’s new 10-year cancer strategy and praise them for continuing to take action on early diagnosis of cancer. I urge them to view the new strategy as an opportunity to double down on that mission, and I know they do. My Bill will help the Government to sustain focus and ambition on maximising uptake in the NHS breast screening programme, both in this recovery phase and into the future. Going further, the Bill will also help to ensure that this is delivered in an equitable way, which will be instrumental in addressing the long-standing disparities seen in early cancer diagnosis.

Research shows that in the UK, women from ethnic minority backgrounds and those living in areas of high deprivation are less likely to attend routine breast screening. Those groups are also at greater risk of being diagnosed with later stage breast cancer and have worse survival rates. It is essential that efforts to recover the screening programme do not inadvertently undermine the Government’s commitments on early diagnosis, especially their ambition to shrink the inequalities gap. That is why some of the measures taken to try to improve the screening programme’s efficiency during recovery, most notably the switch to an open invitation model, have raised so many concerns.

Research indicates that when people are asked to call and arrange their own screening appointment, uptake is lower than when they are provided with a timed appointment. Without sufficient funding, staff and community engagement, permanently switching to an open invite model risks further deterioration in uptake and fewer breast cancers being detected early. It is vital that the impact of open invitations on uptake of breast screening is fully assessed before any long-term decisions are made. The Bill will help to ensure that data relating to equalities is collected and used to assess fully the impact different invitation models and interventions have on uptake and its variation across different groups. I am grateful for the work the Department of Health and Social Care is doing to prepare a White Paper on health disparities, and I look forward to working across the House to tackle those inequalities. The Bill I propose is just one way to get that work started.

It is vital that, as we recover the NHS breast screening programme, we do not miss the opportunity to look into the future and prepare for some of the much-needed changes that are likely to occur. I commend the Government for exploring, with their 10-year cancer plan, a call to evidence on the increased testing of family members of cancer patients to determine whether they are at increased risk of cancer, which could have implications for the screening programme. Right now, women at very high risk of breast cancer because of their family history receive more frequent screening through the national screening programme. Women at high or moderate risk should receive this through locally commissioned screening services, but research suggests that the locally commissioned services are not fully implemented in many regions, as they are not mandatory and are subject to financial constraints. This is a missed opportunity to diagnose breast cancer in at-risk women at the earliest stage.

Professor Sir Mike Richards’ 2019 review of screening services, which I and my right hon. Friend the Member for South West Surrey (Jeremy Hunt) commissioned in office, recommended the establishment of a new single screening advisory body to make recommendations on both population and targeted screening, commissioned through similarly nationally agreed standards and service specifications. The Government recently announced that the UK National Screening Committee will be relaunched this spring with an expanded remit covering targeted screening, but nothing further has been announced yet about giving recommendations on targeted screening equal weight and funding, as Sir Mike suggested. The Bill would ensure that steps are taken to ensure that commissioners fully implement existing National Institute for Health and Care Excellence recommendations on screening for women at moderate or high risk of breast cancer as a result of their family history.

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), is an excellent Minister and she knows how important this issue is. I believe every Member of this House can agree on the importance of early, equitable diagnosis of breast cancer and the central role the NHS breast screening programme has in achieving that. We needed to up our game pre-covid, and we certainly need to up our game post covid if we want to avoid being back here in 10 years’ time having exactly the same conversation. By working across the political divide, we can get back on track to ensure and improve early diagnosis of breast cancer. It will not save Mothering Sunday for me, but it might for thousands of other people in the future.

[Madam Deputy Speaker (Dame Eleanor Laing)]

The hon. Gentleman has made a moving speech, to which we all paid attention.

Question put and agreed to.

Ordered,

That Steve Brine, Craig Tracey, Munira Wilson, Julie Elliott, Tracey Crouch, Mrs Sharon Hodgson, Mrs Pauline Latham, Alex Norris, Caroline Nokes, Dame Caroline Dinenage, Miriam Cates and Bambos Charalambous present the Bill.

Steve Brine accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 6 May, and to be printed (Bill 297).

Health and Care Bill (Ways and Means)

Resolved,

That, for the purposes of any Act resulting from the Health and Care Bill, it is expedient to authorise the charging of fees in connection with the licensing of cosmetic procedures by virtue of the Act.—(Rebecca Harris.)

Health and Care Bill (Programme) (No.3)

Motion made, and Question put forthwith (Standing Order No. 83A(7)),

That the following provisions shall apply to the Health and Care Bill for the purpose of supplementing the Orders of 14 July 2021 (Health and Care Bill (Programme)) and 22 November 2021 (Health and Care Bill (Programme) (No. 2)):

Consideration of Lords Amendments

(1) Proceedings on consideration of Lords Amendments shall (so far as not previously concluded) be brought to a conclusion six hours after their commencement.

(2) The proceedings—

(a) shall be taken in the order shown in the first column of the following Table, and

(b) shall (so far as not previously concluded) be brought to a conclusion at the times specified in the second column of the Table.

TABLE

Education Route Map: Covid-19

Debate between Baroness Laing of Elderslie and Steve Brine

Thursday 25th February 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I hope that we can now proceed. These are rather difficult circumstances.

[Steve Brine]

Summer schools are part of the catch-up programme. The hon. Gentleman has got his point on the record.

In many ways, the announcement on Monday about the return of schools was naming a date. That was the easy part. The challenge now is how we do that in the cautious, irreversible way that I have spoken about. I have reached out and heard from many of my constituency headteachers in the past 48 hours, and I have to say that the negativity and “yes, but what about” drain from some national figures on this subject is strikingly different from talking to my constituency heads, and the practical Winchester good sense I have seen from them. Let me quote one, who said:

“There is certainly a lot of work to be done before the 8th of March, but there is a sense of positivity and relief of our pupils coming back to school”,

and that is typical of what I have heard. I have been interested to hear, as there is much talk during the debate about safety in schools, comments such as:

“I am very happy to report that we have had no covid cases in school since September”,

or,

“no confirmed adult or child covid cases since this all started almost a year ago (not tempting fate).”

That of course will not be the case everywhere. There are a terrible tales and terrible examples, but I cannot but be honest and report to the House that that is what I have had from some of my constituency heads. None of that is to say that we do not have problems—of course we do—and I will just touch on three and then let others speak.

Testing for covid is right up there for my secondaries. Whether we like it or not, the return will be staggered for many in the week of 8 March, prioritising years 10 and 11, but it is the sheer practicality of testing all students three times that is the challenge. As one school said to me, “I’m deploying as many staff as possible to testing while still allowing teaching to take place”. For big secondary schools where the majority arrive by bus, there is an obvious compounding factor that makes extended hours or weekend testing very difficult. We will get it done with that can-do attitude. Speaking to the Secretary of State this lunchtime, he reminded me that the guidance released yesterday said that schools can test in the week leading up to 8 March, which is next week. I hope that some big secondary schools—the one that gave me that example has 1,200 pupils—will take up the offer of doing that next week.

Secondly, in terms of testing in the academic sense, Minister, can we please be brave and face the issue of statutory testing at primary levels at this time? Having now missed two years of these tests, this may be the moment to draw breath and check that they are what we want to do, and that they are there for the right reasons.

Thirdly, on the catch-up programme, which I know we will hear more about from the Chair of the Select Committee, my right hon. Friend the Member for Harlow, if and when we can get him back online, I welcome the one-off recovery premium and the fact that it is for schools to use “as they feel best”, as per the Government’s statement, but we would be wrong to rest on that. It cannot remain a one-off.

On the national tutoring programme, £300 million is a lot of money. I know that the Department for Education has said that it has been shown to boost catch-up learning by as much as three to five months at a time, but I want to be reassured—this may be one for my right hon. Friend’s Select Committee in due course—that external tutors, who do not know the pupils, their profile as learners or the individual strategies used by an individual school to ensure consistency in the approach to that learning, continue to be the best way to spend that large amount of money.

On mental health and anxiety, I think that educational catch-up in my area will be okay in the short to medium term, but the anxiety and the mental health challenge that I am hearing about, and which I referred to at the start, is structural. There is a structural weakness that is undermining it all. I have heard from so many constituents and parents who have said that, of course, they are pleased that schools are going back from 8 March, but their children are nervous about going back. They have got used to not being out in society—can I believe that I am even saying these words in the House of Commons? They are incredibly anxious about doing this, and that structural challenge will be with them long after the catch-up programmes have done, hopefully, their best. I have to say, masks for the anxious are really not helping, so I very much welcome the Government’s intention to review that after the Easter holidays.

Finally, on Monday, I mentioned organised outdoor sport—not school sport, which I know is allowed from 8 March. The fact that organised outdoor sport is not allowed at the same time does not help with getting over the anxiety and getting the endorphins that we know and I know, as a former Public Health Minister—I have spoken about this many times in this place—run from that sport. That not coming back at the same time does not help.

I hope, in opening the debate, that I have framed some of the key issues and that we can now proceed without incident.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the hon. Gentleman for his impromptu opening of the debate. We will now have a three-minute limit on Back-Bench speeches, and I am afraid that not everyone who is on the call list will be called this afternoon.

--- Later in debate ---

[Steve Brine]

I will wrap up the debate. Every speaker thanked and praised their teachers and support staff for the work that they have done, and rightly so. Everyone touched on that challenge in one way, shape or form, whether they spoke about eating disorders or about general anxiety and mental health. I thought the hon. Member for Twickenham (Munira Wilson) put it well when she said that pupils cannot catch up educationally if they are struggling emotionally. I think we would all agree with that. A number of colleagues touched on the whole issue of the chance, perhaps, for a radical rethink of our educational offering and exams, for instance, and maybe that is right.

Let me finish by thanking the Backbench Business Committee for agreeing to today’s debate, all those Members who put their name to it, and, of course, the Chair of the Education Committee, my right hon. Friend the Member for Harlow (Robert Halfon), for opening the debate alongside us today. I thank him for his comments, especially when he said that there is no room for negativity in achieving what we need to achieve in education full stop, but especially around the catch-up that is needed. We need a plan for education and we need a plan for positivity, and if we can all do that, we might get somewhere.

Question put and agreed to.

Resolved,

That this House has considered the proposal for a national education route map for schools and colleges in response to the covid-19 outbreak.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am now going to suspend the House for three minutes in order that arrangements can be made for the next item of business.

UK Musicians: EU Visa Arrangements

Debate between Baroness Laing of Elderslie and Steve Brine

Tuesday 19th January 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Steve Brine.

[Steve Brine (Winchester) (Con)]

Is it not the case that the longer the situation persists, the worse it gets—

[Madam Deputy Speaker]

Order. This is my fault, but I missed out Mary Kelly Foy. I beg the House’s pardon and that of the hon. Gentleman. Mary Kelly Foy.

Public Health: Coronavirus Regulations

Debate between Baroness Laing of Elderslie and Steve Brine

Tuesday 13th October 2020 Commons Chamber

[Steve Brine (Winchester) (Con)]

To follow on from what my right hon. Friend said about our strategy being to suppress the virus until a vaccine makes us safe—until science saves us—the Prime Minister yesterday was, very wisely, cautious in his answer to our hon. Friend the Member for Wycombe (Mr Baker) on the vaccine. What if it does not come, and what if it comes and the efficacy of it is not good enough, and there are challenges with roll-out and all sorts of other challenges that he and I know about—the anti-vaxxers notwithstanding? Can he give those of us who are nervous about—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. This is not a question but a very quick intervention. I have 89 people who want to speak. If there are to be interventions, they must be short.

Leaving the EU: Tobacco Products and Public Health

Debate between Baroness Laing of Elderslie and Steve Brine

Monday 7th January 2019 Commons Chamber

[Steve Brine]

In conclusion, Madam Deputy Speaker, taking my lead from your look—Members will have a chance to contribute—this instrument constitutes a necessary measure to ensure that our tobacco control regulations continue to work effectively after exit day. I should, however, emphasise that, due to the instrument being made under the withdrawal Act, the scope of the amendments in the instrument is limited to achieving that objective. Therefore, at an appropriate point in the future, the Department will review where the UK’s exit from the EU offers us opportunities to reappraise current regulation to ensure that we continue to protect the nation’s health. That is timely on this day of all days, when we have published our long-term plan.

I urge Members to support the instrument, to ensure the continuation of effective tobacco control and harm reduction. I commend the regulations to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I apologise to the Minister for my moment of inattention a minute ago. It was not inattention to what he was saying; it was that I had happened to look at the statutory instrument before us, which for the first time in parliamentary history is illustrated. The illustrations are shocking. Having listened carefully to what the Minister said, I was making a mental note to ensure that every teenager I know sees these illustrations. It is not for me to make any value judgment on whether one should smoke, vape or otherwise. The Minister has done that very well.

HIV and World AIDS Day

Debate between Baroness Laing of Elderslie and Steve Brine

Thursday 29th November 2018 Commons Chamber

[Steve Brine]

I thank my hon. Friend for his intervention.

As I was saying, much has changed since the late ’80s: health needs are different; we have better drugs and better diagnostic tools; and, as has been said, attitudes towards HIV and AIDS are totally different and totally transformed.

The hon. Member for Kensington mentioned Princess Diana—the original one, as opposed to the new one—and that incredible moment. I will repeat what I said the other night in Speaker’s House. I was in secondary school at that time, and I remember that powerful image being broadcast. I was only a teenager at the time, and little did I know that I would one day be the public health Minister talking about these issues. It was one of those images that is really seared into our national conscience. What a great loss that lady is to so many social causes, as well as of course to her family. It was an incredible image.

As the hon. Member for Brighton, Kemptown has said, today, it is not about dying of AIDS, but about living with HIV. I would go further, however, because it is about more than that, is it not? It is not really “living with”; it is just “living”. I am also very privileged to be the cancer Minister, and how many times cancer patients say to me—my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson), knows this, because people very often used to say this to us when we ran the all-party group on breast cancer together—that, “I am not my cancer. It is just something that I do and something that I have as well.” Happily, HIV is now just part of the hon. Gentleman: I am sure he would rather it was not, but it is not just something he lives with; it is something that he lives.

A big public health display in the foyer of the Department of Health and Social Care currently shows all the different public health campaigns over the years. The terrifying tombstone image is obviously something that we have, rightly, moved on from, but it is still an incredible part of our public health campaign history. Back then, the Government made the bold move to run a major public information campaign on HIV—“Don’t die of ignorance”—and we piloted needle exchange schemes, introduced HIV testing and raised the prospect with the public. If we consider the HIV epidemic in this country, we can be proud of the record of Governments of all parties over many years.

As figures released today show, the UK has met the UNAIDS 90-90-90 target—yes!—and it is one of the first countries in the world to do so. Members from across the House are proud of that, and the latest report from Public Health England showed that in 2017 an estimated 92% of people living with HIV in the UK were diagnosed, 98% of those were on treatment and 97% of those on treatment were unable to pass on their infection. That is a major achievement that we should be proud of. More importantly, those who work in our health service and have done so for years—like the partner of my hon. Friend the Member for Walsall North (Eddie Hughes)—should be even more proud.

Prevention is one of my passions, and one of the Secretary of State’s priorities. We do not yet have a cure for HIV, which is why prevention is so important. Our efforts to prevent HIV and AIDS have been highly successful, and much has been said about the international dimension, which I will touch on. The UK is a world leader in efforts to end the AIDS epidemic, including through our major investment in the global fund. Our largest investments are through multilateral organisations such as the Global Fund to Fight AIDS, UNAIDS and Unitaid, given their greater reach and scale. I met Lelio from Unitaid at the G20 in Argentina last month, and it is doing such good things with the investment that we announced in Amsterdam, to which the hon. Member for Cardiff South and Penarth (Stephen Doughty) referred. I work closely with my hon. Friends in the Department for International Development and the Foreign Office, and these three Departments are very tight and work closely together on this issue.

Excellent initiatives such as the MenStar Coalition aim to get more young men tested and on to life-saving HIV treatment to protect them and their partners. There is the Elton John AIDS Foundation and other partners, and MenStar is rolling out a self-testing campaign in east Africa. The UK is the second largest donor to Unitaid—a charity that does so much work against stigma—and provides an annual contribution of around €60 million as part of our 20-year funding commitment.

There has been much talk about the domestic situation, and NHS England launched the world’s largest pre-exposure prophylaxis—PrEP—trial last year. To be honest, I had never heard of that until I became a health Minister—why would I have?—but once officials had explained it to me, it did not take me long to think that it sounded like a real no-brainer. I know that many people are eagerly awaiting the results of the trial. I am one of them, and my officials know of my impatience, which is legendary in our Department. It is crucial to have the right information to address the major questions and effectively implement the PrEP trial on a larger scale.

The point about savings was well made and not lost on me. I am not in a position to make a policy promise at the Dispatch Box today, but on the point about places made by the hon. Members for Brighton, Kemptown and for Cardiff South and Penarth, I say only that I am listening closely and they should continue those discussions with me—I know they will. The Department met members of the all-party group on HIV and AIDS to discuss these issues, and they should continue those discussions with me. We are listening. Many of the public health challenges we face today require different approaches and fresh thinking if we are to make progress. Indeed, in the past few years many innovative ways to tackle HIV have emerged, including HIV testing options such as self-sampling and home testing services, which I know are very popular.

I would like to mention the HIV prevention innovation fund, which I am very proud of. Innovative community-led interventions have had a significant role to play in limiting the HIV epidemic in England, so we set up the HIV prevention innovation fund in 2015 to support voluntary sector organisations. The fund has supported many projects since it started. I announced them at an event here in the House last year—the hon. Member for Cardiff South and Penarth, who chairs the all-party group, was present. In 2017, we awarded just under £600,000 to 12 projects. I am very pleased to say that we are running the fund again this year. The principle of the fund is something we are carrying over into other areas of policy, because it has been so successful. I want to see us do more of that.

This year we celebrated the 70th birthday of the NHS. I have already mentioned the incredible staff who work across the service. England has an outstanding record of achievements in HIV treatment and care. I want to take this opportunity to recognise and thank everyone for doing that. Care for people with HIV is now highly effective, and increasing numbers of people are living with HIV into older age with normal life expectancy. Antiretroviral therapy has transformed the outlook for people living with HIV, from what used to be a tragic death sentence to a very manageable long-term condition, as we heard so eloquently this afternoon.

Our policy is to make sure that HIV testing is as accessible as possible, in particular to those at increased risk. It is therefore very important that testing is available in a range of clinical and community settings—hence why the innovation fund and its programmes are important. Over the years, local authorities, which are now public health authorities up and down the land, have introduced innovations and improvements of their own, in particular on testing. We know it is working. Testing activity at sexual health services, which we know are under great pressure—we do not deny that for one moment—continues to increase and HIV diagnoses have fallen. HIV testing in sexual health services has increased 15%, from 1.07 million tests in 2013 to 1.24 million in 2017. Most significantly, we have seen a 28% drop in new HIV diagnoses between 2015 and 2017. That is encouraging and good, but we must not be complacent. I assure the House that we are not complacent and we want to continue to maintain this progress.

The hon. Gentleman mentioned the prevention strategy. That was a very top line document. I had a meeting this afternoon to discuss the prevention Green Paper, which will follow next year. I can assure him that the long-term plan, which will follow before that, will absolutely have sexual health and HIV in it. I am being very ambitious with officials on that. I know that he will rightly hold us to account and I thank him for giving me a chance to say that.

I want to touch on education and awareness. Education around HIV and how it is transmitted remains absolutely critical, as the hon. Member for Brighton, Kemptown said in his opening remarks. I am pleased to say that schools will be required to teach relationship and sex education from September 2020. The Government announced that relatively recently. I have been very involved in that in relation to the cancer brief, because I am very keen for schools to responsibly teach cancer awareness to young people. At secondary schools, there will be clear and accurate teaching about sexual matters, including factual knowledge around sex, sexual health—including HIV—and sexuality. The schools Minister was sitting next to me throughout his speech. He wanted me to pass on his congratulations to the hon. Gentleman on his speech.

Testing is the only way to be certain of HIV status. Last week was National HIV Testing Week and the Secretary of State took part. This flagship campaign promotes regular testing among the most at-risk population groups and aims to reduce the rates of late diagnosis or of those remaining undiagnosed. Sadly, stigma remains a significant factor in why people do not test for HIV. I understand that. This can mean that HIV goes untreated and can then be transmitted. It is vital that we continue to break down the stigma, normalise testing and support those most at risk of infection.

I want to mention the “Can’t Pass It On” campaign. Whoever is doing the marketing for the Terrence Higgins Trust is doing a very good job—I know it works with a very good agency. As I said at the reception the other night, I was on the tube the other day with my daughter, who spotted some advertising or branding for testing week. She asked me what it was, because it caught her eye, and I was able to explain it to her. She is only 11. If more parents did that for their children and relatives, it would help to break down that stigma. The trust’s website has a very good page on the “Can’t Pass It On” campaign that includes different people’s stories, and I have a funny feeling that before we leave the Chamber, “Lloyd’s story” will be on it, with a clip from today in Parliament. I will certainly be clipping it off the Parliament TV website and tweeting it out through the Department of Health’s social media account.

In conclusion, I congratulate the hon. Gentleman again on introducing this timely and vital debate, and I wish him and everybody well for Saturday who will be marking World AIDS Day, whether they be remembering and celebrating private, not yet able to do so publicly, and those who, like him, are able to do so publicly. They are all part of the story, and our best wishes and love go to them all. We look forward to brighter futures in this policy area, as we work towards what I am determined will be zero stigma and zero transmissions.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Would it not be wonderful if more people paid attention to the work done in the House in such debates—this excellent, positive, meaningful, emotive and successful debate this afternoon? If only.

Question put and agreed to.

Acquired Brain Injury

Debate between Baroness Laing of Elderslie and Steve Brine

Monday 18th June 2018 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Before the Minister responds, I should say that I appreciate that many want to make interventions because they do not want to stay until the end of the debate. We have only an hour and 10 minutes. A lot of people wish to make speeches and there will have to be a time limit. Interventions must be short.

[Steve Brine]

I do not know what you mean, Madam Deputy Speaker, but I will certainly be here until 11 pm.

The hon. Member for Strangford (Jim Shannon) makes a good point, which follows on neatly from the point made by the hon. Member for Brighton, Pavilion (Caroline Lucas). It also leads me neatly on to the point I was about to make. The all-party group on ABI is currently conducting a very broad inquiry into the condition—its causes, treatments and societal impact—and I am sure it will consider the wider family. When I say family, I do not just mean the nuclear family but society’s family and even the Church, which can embrace people suffering the life change the hon. Gentleman spoke about so well with regard to his brother. I want the all-party group to know that I will support its inquiry as best I can. They should know that that offer is there.

As a Health Minister, I will obviously focus on the health aspects of ABI, but I just want to highlight some of the other areas—this touches on one or two of the interventions—where its impact is felt and action is under way. On education, many children and young people with ABI are rightly in education and have special educational needs as a result of their injuries. The Government recently provided some £29 million to support local authorities with ongoing implementation of individual education, health and care plans to meet those needs. It is vital to us that health, social care and education services work jointly in developing these care plans. I know my colleagues in the Department for Education share that view.

On offending behaviour—ABI touches on a lot of different Government Departments—there is an increasing body of evidence suggesting that children and young people who survive traumatic brain injury are more likely to develop behavioural problems that can be linked to an increased vulnerability to offend. NHS England’s liaison and diversion service has collaborated with the charity Headway, which I mentioned at the start of my speech, to improve awareness of ABI in vulnerable offenders and the support available—the point raised by my hon. Friend the Member for Cheltenham (Alex Chalk). Further, the Ministry of Justice is piloting approaches to improve screening and support for prisoners with ABI to prevent a cycle of re-offending once they enter the secure estate. The Minister for Disabled People, Health and Work, my hon. Friend the Member for Truro and Falmouth (Sarah Newton), is very kindly on the Government Front Bench to listen to the debate and I am grateful to her. The Minister of State, Ministry of Justice, my hon. Friend the Member for Penrith and The Border (Rory Stewart), who has responsibility for prisons, had hoped to be here but was pulled away. I know he will be taking a close interest in what is said tonight, because this issue will come up again.

Sport is another area for which there is a growing body of evidence and concern about the levels of risk and response to injury. This is why the Government commissioned an independent review of the duty of care that sport has to its participants, which published its findings in April 2017, and we are now working to implement its recommendations, including around awareness and prevention of head injury while playing sport.

On trauma centres, it is vital that those with the most serious brain injuries receive the best care that our NHS —our birthday NHS—can offer. In 2012, 22 regional trauma networks were developed across England. Within those networks, major trauma centres provide specialised care for patients with multiple, complex and serious major trauma injuries, including brain injury. Two years after their introduction, an independent audit of the network, commissioned by NHS England, showed patients had a 30% improved chance of surviving severe injuries and that the networks had saved some 600 lives. There is a positive story there.

A vital part of the treatment pathway for people who have suffered ABI is neuro-rehabilitation that is timely and appropriate to their needs. There is good evidence that access to high quality rehabilitation both improves outcomes for patients and can save money.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Minister.

[Steve Brine]

I had finished, Madam Deputy Speaker. Incredibly, it was timed to perfection.

[Madam Deputy Speaker]

I beg the Minister’s pardon. I have never before heard such a feat of perfect rhetoric. Thank you for being so perfect. [Interruption.]. Yes, it was quite unusual.

NHS Winter Crisis

Debate between Baroness Laing of Elderslie and Steve Brine

Wednesday 10th January 2018 Commons Chamber

[Steve Brine]

The sustainability and transformation partnerships have been established across England—I am sure that the hon. Gentleman will have engaged with the one in his area—and they take local decisions about how services are organised in local areas. I implore him to engage with his STP; indeed, I know that he is already doing so. If he wishes to talk to me about this, he can of course do so.

Let me respond to some more of our contributors. The hon. Member for Bristol South always speaks sensibly. She spoke about the public representation and involvement in STPs. I agree that we could do more in that area, and as the Minister responsible for STPs, I want to see that we do so. Her point was well made. The hon. Member for Crewe and Nantwich (Laura Smith) spoke about her constituent, Elle, who lost her battle with cystic fibrosis. She speaks up for her constituents well, and very emotionally, and if she continues to do that, she will do extremely well in this House.

The hon. Member for Stockton South (Dr Williams) is a new Member, and I already have a lot of respect for him. In his typically sensible contribution, he made some sensible suggestions for improvement in the NHS. He went on to talk about how we could do better on prevention, and he was absolutely spot on. We all agree that prevention is part of our one NHS. He said that this was not all about money, and I agree. Money is a key part of this, however, and that is why we spend 9.9% of our GDP on healthcare, which is above the EU average.

The hon. Member for Leicester West (Liz Kendall) said that this is not what happens every year, but the NHS is under great pressure at this time every year. A headline from The Guardian newspaper on 27 October 2001 stated “NHS faces another winter of crisis”. The NHS is often under pressure at this time of year, and the important thing is how we prepare for that. As I have said, we are better prepared than ever. It is a shame that the hon. Lady is not listening to my response. [Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I hesitate to interrupt the Minister, but I do not understand why there is so much noise on the Opposition Benches. I would not be surprised if Members were heckling the Minister, but they are simply making a noise, so the Minister cannot be heard. He is answering the questions that he has been asked this afternoon, and those who asked the questions ought to want to hear the answers.

[Steve Brine]

Thank you, Madam Deputy Speaker. The Members appear to be heckling themselves.

The hon. Member for Wirral West (Margaret Greenwood) said that the NHS was a political organisation. I totally disagree. The NHS is an organisation run by hard-working people who are public servants. They go to work every day to do a job for our constituents, and the NHS is not a political organisation. The Labour party is a political organisation, and it is politicising the NHS—

Southend Hospital

Debate between Baroness Laing of Elderslie and Steve Brine

Thursday 6th July 2017 Commons Chamber

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The hon. Lady’s question is slightly tangential to the subject of the debate, but I appreciate that she has made a connection. The Minister might be able to make the connection between the subject of the debate and her question, but I know that he will concentrate on the subject of the debate introduced by the hon. Member for Southend West (Sir David Amess).

[Steve Brine]

I will, Madam Deputy Speaker. I could feel you bristling at the length of the intervention. I can assure my hon. Friend that none of the options being considered includes the closure of any of the three A&Es, and all will continue to provide emergency care 24 hours a day, seven days a week.

I was mentioning the work of the Mid and South Essex STP, which was published in November 2016 as part of the work to ensure that there are sustainable services in mid and south Essex. There is now a major workstream looking at service configuration across the three hospital sites. Work led by clinicians in 2016 arrived at five possible future configurations for consolidated specialist services across the three hospitals. As well as providing the majority of routine hospital care for its local population, each hospital site would provide some centralised specialist services.

Let me briefly outline the current thinking as it has been set out to me. Southend hospital will continue, as I have said, to provide substantial emergency services 24 hours a day, seven days a week. In addition, it will be a centre of excellence, as my hon. Friend the Member for Southend West rightly said, for planned care, alongside its already well-established cancer centre and radiotherapy services. Basildon hospital will provide enhanced specialist emergency care—for example, specialising in the total management of major life-threatening illness. Broomfield Hospital in Chelmsford will provide a combination of specialist emergency and planned care, with the potential to provide a specialist centre for children. I have to emphasise that these ideas are being further developed by the clinical groups as we speak. No single preferred option for consultation has been arrived at.

Let me now turn to the proposals for emergency care. It is important to note, and I wish to reiterate, that in all potential options for hospital reconfiguration currently being discussed, Southend hospital would continue to provide emergency services 24/7. An options appraisal process was held earlier this year involving clinicians, stakeholders and local people. The higher-scoring options listed one hospital as the provider of specialist emergency care. Basildon was identified as the better location for that. Southend and Chelmsford would continue to provide emergency services, but they would be less specialised than Basildon. Southend would instead specialise in planned care, cancer and radiotherapy, building on the excellent work already being done at the hospital. There would be separate units specially designed to give fast access to assessment and care for older and frail people, children and people who may need emergency surgery. In some cases, that could include an overnight stay, if necessary. Those units would involve both health and social care so that patients could return home as quickly as possible with any continuing support and treatment that they may need.

The potential services in the A&E and assessment units at Southend would be able to respond to a range of emergency needs, some of which could be initiated by a 999 call and may involve an ambulance. The possibility of Basildon hospital being the provider of specialist and complex emergency care has benefits for local patients. It would have several teams of specialists ready to provide immediate access to state-of-the art scans and treatments around the clock, which is not always possible in the current three general hospital A&Es.

I also understand that the practice of taking patients by ambulance from Southend to a specialist centre is already established. For example, people who suffer an acute heart attack in Southend are currently taken by ambulance to the Essex cardiothoracic centre—that was easy for me to say—in Basildon. I have been advised that that arrangement has been in place for many years. Separating some of the major emergency work in that way releases capacity and resources for planned surgery and other treatments.

For the local NHS, new centres of excellence across the hospital group in both planned and emergency care have the potential to compete with the best in the country to attract high-calibre staff and bring the best of modern and world healthcare to mid and south Essex. I emphasise that in all options currently under discussion, about 95% of hospital visits would remain local at each hospital.

As I have stated previously, the programme is currently under discussion and I am advised that the aim is to launch a full public consultation at the end of the year at the earliest, centring on a single preferred option. The public consultation will explore in detail the benefits and implications of the proposals and will inform plans for implementation. Engagement with staff and local people will continue to influence and refine plans at every stage. That is a key principle, as I have said, in local reconfiguration of services, and it has to be right that the process is guided by those who know and understand the local area best.

In conclusion, as a constituency MP I completely appreciate the concerns of my hon. Friend the Member for Southend West, whom I again commend for his work.