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?

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?

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?

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.