Baby Loss (Public Health Guidelines)

Gavin Robinson Excerpts

Tuesday 21st March 2017 Commons Chamber

[Tim Loughton (East Worthing and Shoreham) (Con)]

I had not intended to speak in this debate—I just wanted to be part of it and perhaps to question the Minister—but you have tempted me, Mr Deputy Speaker, to add my three penn’orth. I, too, will not take up the remainder of the three hours and 50 minutes in making a few comments. I again congratulate my hon. Friend the Member for Colchester (Will Quince) on securing the debate.

The Government have made good progress on the smoking front, and that needs to be recognised, but 10.6% of people still smoke through pregnancy. That figure needs to be brought well down into single figures. My hon. Friend made a good point about the use of advertising messages with regard to alcohol. Of course, unlike alcohol, this issue affects only half the population. The graphic images on cigarette packets of diseased lungs, and those grisly television adverts with pus coming out of lungs and so on, really send home the message about the harm that any smoking can do. Making that clear to women who still take the risk of smoking during pregnancy would help to get the figure down further.

We still have a major problem in this country with high levels of baby loss through stillbirth as well as through the rather less quantifiable form of miscarriage, the true extent of which we do not really know. As I said earlier, it must be a priority for Government to work out why we have regional and cultural differences, and to extend and learn from best practice rather better than we do at the moment. Some of the pilots and experiments that have happened in Scotland are something for the rest of the country to look at and learn from.

Given the title of this debate, we could, strictly speaking, extend it well beyond just smoking, and I am going to take advantage of that. On drinking, there has been a very confused message for some time. I am an officer of the all-party foetal alcohol syndrome group. We produced a report that urged complete abstinence as the only safe way, and that must be the default position. For women who do choose to continue to drink in some form during pregnancy, there need to be very clear health messages, and perhaps lower-alcohol alternatives. If someone has to drink, there are ways of potentially doing less damage to their baby. The Government can be part of that through the differential pricing tax mechanism. We are rather bad at that in this area.

I remember going to Denmark some years ago and visiting a children’s home just outside Copenhagen that specialised in treating children who were the victims of foetal alcohol syndrome—particularly children of mothers from Greenland, where there is a particular problem with heavy drinking. Those children were born with all sorts of disabilities, some of which manifested themselves as the symptoms that we know of in ongoing conditions such as autism.

There may be an understating of the effects of foetal alcohol syndrome because it can appear somewhere on the autistic spectrum as well. We need to do more research into that. There is no more stark example than we see in Denmark of a direct correlation between excessive drinking and giving birth to a child who will bear the effects of that for his or her whole life, with the learning disabilities and other things that go with it. We have lessons to learn from that. We still need stronger messages to go out to women during pregnancy about the potential, and potentially lifelong, harm that can be done by inappropriate drinking.

[Gavin Robinson (Belfast East) (DUP)]

Although a strong message is important, the delivery of that message is crucial. There is a good argument for saying that the shock-and-awe messaging used in advertisements about driver safety or alcohol, and on cigarette packets, does not have the impact that we believe it should. Many mothers might take cavalier decisions about themselves, as many of us do. I certainly do when it comes to food and its health benefits; I do not follow the guidance. Does the hon. Gentleman agree, however, that a mother would never want to damage the future prospects of her child? The sensitivity of the message, however strong it is, is the most important element.

[Tim Loughton]

The hon. Gentleman makes a fair point. We, as grown-ups, can make a conscious decision to be gluttonous or to over-imbibe. That does damage to our bodies and our bodies alone, although there may be a cost to the taxpayer through the national health service. If anyone should be more sensitive and sensible about the damage that could be done to another individual, it is a pregnant woman. A pregnant woman, or a woman considering pregnancy, should be more amenable to good health messages.

It is a question of horses for courses, and I take the point that the hon. Gentleman makes about shock-and-awe tactics. The AIDS adverts in the ’80s could be described as shock and awe, and they were exceedingly effective at the time. We still remember those tombstones. One can go too far, however; members of the public are smart, and they recognise over-emphasis for effect. It hits them in the face, and they say, “I do not need to take any notice of that.” We need smart messaging, which is credible and honed appropriately for its target audience.

That is why when we in the all-party group on foetal alcohol syndrome produced our report, we had a big debate about whether we should recommend complete abstinence or whether that was just not realistic for some people, who were still going to drink. I take the view that the default position must be that drinking harms a woman’s baby, but if someone absolutely has to drink, for whatever reason, there are less harmful—but always harmful—ways of doing so. We need to nuance that message appropriately for different audiences. Of course, different cultures have different attitudes to drinking, foods and so on.

I move on to a subject that is completely different, but still within the scope of this Adjournment debate: perinatal mental health. I declare an interest as the chair of the all-party group for the 1,001 critical days, and as the chairman of Parent Infant Partnership UK, a charity that is all about promoting good attachment among parents and their children in the period between conception and age two. One of the biggest, most powerful and most effective public health messages that we can give is that effecting a strong attachment with one’s child, right from the earliest days, will have lifelong benefits for that child. That includes the time that the child is in the womb. A mother who is happy, settled and in a good place is much more likely to pass on those positive messages to a child than a mother who is stressed and suffering from perinatal mental illness or various other pressures.

At least one in six women in this country will suffer some form of perinatal illness. We know from the science, which is producing considerable data, that a child who is not securely attached—preferably to both parents but certainly to the mother, to start with—is much less likely to thrive at school and to be settled and sociable, and more likely to fall into drink and drug problems and to have difficulties with housing and employment. The first 1,001 days are absolutely critical, and we should be doing more. It is a false economy not to do so, and not to invest money early on.

The Government have quite rightly flagged up the importance of mental health. The Prime Minister absolutely gets the importance of mental health, and particularly of perinatal mental health. The additional money allocated is good, but it is still not enough. The problem, as we all know, is that that money is not making it through to the sharp end, so opportunities are still being missed to identify women who have some form of mental health problem—typically depression around the time of pregnancy—signpost them to the appropriate services and deliver quality and appropriate services in a timely fashion. That is why the charity I chair, PIP UK, has seven PIPs around the country, operating out of children’s centres, to which women can be referred, often with their partners, to get the support and confidence they need to effect the strong bond and attachment with their child.

The Maternal Mental Health Alliance has costed the problem of not forming such bonds at £8.1 billion each and every year. I repeat that, each year, the cost of getting it wrong is over £8 billion. The cost of getting it right is substantially less, yet too many clinical commissioning groups around the country still do not even have a plan for delivering perinatal mental health for women where and when they actually need it. On top of that, in our report “Building Great Britons”, the all-party group calculated that the cost of child neglect is over £15 billion a year in this country. By not getting it right for really young children and for babies, we are therefore wasting £23 billion financially, but far more importantly we are not giving those children the very best start in life socially, which we could do with a bit more, smarter and better targeted up-front investment.

I reiterate to the Minister and his colleague, the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood)—she very kindly saw a delegation from the all-party group on the 1,001 critical days recently, and I know she takes this subject very seriously and has convened a roundtable—that we absolutely must come up with such public health messages and talk in this place about the importance of getting it right early on, but what matters at the end of the day is actually delivering the service to those women where it is needed, at the appropriate time and place.

Finally, may I take the liberty of mentioning to the Minister, as I think I did in a previous Adjournment debate, the question of the registration of stillbirths? It is a subject on which I have campaigned for some years in this place, and on which I have had a private Member’s Bill. This falls within the remit of baby loss, which is in the title of this Adjournment debate; I know you are scrupulous, Mr Speaker, about our not straying beyond the remit of a debate.

Following some very helpful responses from predecessor Ministers and officials at the Department of Health and having convened various roundtables—with the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists and other key players, as well as various stillborn charities—I thought we had got to a place where the law could be changed to emulate what has been done in New South Wales in Australia. However, we still have a iniquitous and highly distressing situation: somebody who has gone through the trauma of carrying a child as far as 23 weeks and six days will find, if the child is, tragically, born prematurely and stillborn, that the child is not recognised in the eyes of the state, although a child born just after the 24-week threshold will be recognised as a stillborn child. I have previously raised the example of a woman who had twins either side of that threshold: sadly, they both died, but one was never recognised, while the other was recognised as a stillborn child, with a certificate being issued by the hospital.

For a woman who has given birth to a stillborn child, such a situation is one of the most sensitive and vulnerable of times. My hon. Friend the Member for Colchester knows this so well, and other hon. Members have given their own very emotional accounts of going through such traumas. The fact is that the state has still, so far, failed to take the straightforward and fairly cost-free step of coming up with a simple registration scheme for those for whom such a scheme would help to provide some form of closure.

For a stillborn child born at under 24 weeks—what I am talking about is different from miscarriage, although I am in no way trying to underplay the trauma caused by having a miscarriage—to be recognised as a human being, rather than as a child who, sadly, was born before an artificial threshold, seems to me to be a sensible but humane thing to do to help the too many women who still give birth to stillborn babies. We need to bring that figure down, and we are doing so. In the meantime, we can at least give some succour and comfort to parents who have to go through this situation by saying that we appreciate and recognise what has happened, and sympathise and empathise with what they have gone through.

May I ask the Minister again whether there is any way that we can get this campaign going again? The issue has featured in one of our national soaps: an actress who went through it in real life re-enacted it in “Coronation Street”. There has also been a lot about it in the press. I ask the Minister to ask his Department to look at this issue again to see whether something can be done, because I think there could be a solution.

Mr Speaker, I have more than abused my privilege in this three hour and 50 minute debate, but these are issues on which there is a good deal of sympathy and empathy in the House. Yet again, we are greatly indebted to my hon. Friend the Member for Colchester for bringing them back to the House, where we have the power to make a difference to our future constituents’ lives.

Psychosis: Early Intervention

Gavin Robinson Excerpts

Wednesday 7th September 2016 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is a pleasure to serve under your chairmanship, Sir Roger. I thank the right hon. Member for North Norfolk (Norman Lamb) for securing this extremely important debate. I declare an interest, having worked as a clinical psychologist for 20 years in the NHS, and as a continuing member of the British Psychological Society, our professional body.

I shall start by giving a little context. I am heartened by some of the progress that has been made and by initiatives on mental health taken by Governments in the UK and Scotland over the years. When I started out, it was quite commonplace for patients to wait up to or more than a year for treatment. There appeared not to be any urgency about dealing with the waiting list and waiting times. That has improved very much, and we have waiting list standards. The HEAT targets—health improvement, efficiency and governance, access and treatment targets—focus service providers, policy makers and resources. So things are improving, but we clearly still have much work to do. I concur that we need to work in a conjoined way across the UK and share best practice models in doing so.

The service when I started in practice clearly was not good enough. Patients had been waiting far too long by the time they came into treatment. Often they had been admitted to hospital in an acute situation—perhaps they were suicidal—or had had multiple episodes of psychosis, and we were not providing the best possible standard of care. Psychosis is a distressing illness, which tends to be long-term, although people can recover at an early stage if we pick up their symptoms and provide the appropriate care timeously.

In psychosis, people experience symptoms of paranoia and, often, delusional belief systems that take them outwith reality. They may experience visual and auditory hallucinations. It is distressing for the person and also very much affects their family and those around them, and we must take it very seriously. Although it affects quite a small proportion of the population, it has huge ramifications for family relationships.

[Gavin Robinson (Belfast East) (DUP)]

The hon. Lady is building on an impressive speech by the right hon. Member for North Norfolk (Norman Lamb). Does she accept that while it is right to pay attention to how quickly people get treatment after diagnosis, the biggest barrier to early intervention and treatment is securing diagnosis? I have personal experience, as my wife struggled for two years to get a diagnosis. Once she got it treatment was put in place, but it was far too long to wait. Until we crack that nut and, rather than dismissing people’s symptoms and struggles, deal with them practically, sympathetically and professionally, early intervention is only a myth to be discussed. We need the diagnosis first.

Brain Tumours

Gavin Robinson Excerpts

Monday 18th April 2016 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Warrington North (Helen Jones) on her detailed and concise presentation. I am here because my constituents have contacted me. I suspect that is why we are all here: we have poignant personal stories to share.

Brain tumours kill more children and young adults than any other form of cancer. Every day, 10 children and young people in the United Kingdom learn that they have cancer. More than 16,000 people are newly diagnosed with this form of cancer each year in the United Kingdom, yet just 1% of the national spending on cancer research is allocated to this horrendous disease. I am glad to see the Minister in his place; I always look forward to his responses. I am sure that he will respond in a positive fashion and give us the hope for which everyone in this Chamber wishes, along with our constituents.

The allocation of funding is even more alarming when we consider the survival rates for brain tumour patients. Breast and prostate cancer patients, to give two examples, have an 80% five-year survival rate, compared with that of brain tumour patients, which is less than 20%. Clearly, more needs to be done on investment in brain tumour research. Can the Minister indicate what partnerships he is encouraging between universities, Departments and big business to ensure that we can move forward?

[Gavin Robinson (Belfast East) (DUP)]

Our colleague the hon. Member for North Down (Lady Hermon) could not be with us today, but she lost her sister, who was completely asymptomatic, at the age of 37. That reinforces the point that discovery often occurs too late, which is why research and awareness are crucial.

[Jim Shannon]

As always, I thank my hon. Friend for his intervention.

Secondary or metastatic brain tumours are particularly important to consider. Up to 40% of cancers in other parts of the body will eventually spread to the brain. Let us focus on the key issues, such as the blood-brain barrier.

The National Cancer Intelligence Network found that 61% of brain tumour patients were diagnosed in accident and emergency, including 53% of children up to 14 years old, 25% of those aged 15 to 24 and 20% of older adults. Although there are many charities, I will put in a quick plug for CLIC Sargent and its work. Its paper, “The Best Chance from the Start”, found that the rarity of cancer in children and younger people, added to the fact that symptoms can be non-specific, can make it challenging for GPs to recognise the symptoms.

Many constituents have written to me, but I will conclude by quoting two. One is my constituent Mary Patterson, a survivor. She was diagnosed, she had surgery and she is alive today, although her life is restricted. Another story involves a lady in my constituency called Heather, who writes about her late husband George:

“My own interest in this petition and upcoming debate came about because my husband, George Ramsey, died 1 July 2011 from a brain tumour, only nine weeks after diagnosis. He was just 50 years old, and had just retired from the fire service after 32 years of service. Unfortunately my husband received poor management from the neurosurgery department, and his treatment was delayed after the team ran out of time to discuss his case on two separate occasions.”

An ombudsman investigated and reported to the Assembly. I conclude with this comment of hers:

“In his last five years in the fire service, he was the community liaison and youth engagement officer for the Belfast area. The chairman of the Belfast City Council stated that George’s work had ‘made Belfast a safer place’.”

That is a touching and personal testimony. The sad thing is that it is happening to families up and down the country at this moment. Although we have the opportunity to get back on track, it is sad that it took a petition to bring us here.

Dementia and Alzheimer’s Disease

Gavin Robinson Excerpts

Tuesday 12th April 2016 Westminster Hall

[Jim Shannon]

We do need an awareness campaign—perhaps it starts with this debate today, working its way through to our constituencies and the people we represent.

Too often, carers are left to suffer in silence. The existing services on offer are not publicised enough and are not up to standard. The main social security benefit available to carers is the carer’s allowance. Those providing more than 35 hours of care a week are entitled to only £62.10. Further to that, carers may incur sanctions on how much they can earn on top of the allowance. Dementia carers save the NHS more than £11 billion every year, but they get only £62.10 per week for giving up their lives for someone less fortunate. I know the Minister’s Department is not responsible for that but, with respect, it is not a good reflection on Government given the hours spent by carers. Times are tough for the public finances, but it must be highly insulting to carers for them to see some of the things happening in the news when they are getting only £62.10 a week.

[Gavin Robinson (Belfast East) (DUP)]

Familiarity has been mentioned, and that is an important role for carers to play. My own grandmother deteriorated every time she was in hospital, because of the lack of familiarity. Does my hon. Friend support John’s Campaign, which encourages the provision of more time and greater support for carers in the hospital setting, as well as greater flexibility about the hours they can be there with their loved ones?

[Jim Shannon]

My hon. Friend makes a salient point. He always hits on the issues that we should all be aware of.

I welcome the fact that the Government are developing a new carers strategy. I can only hope that this debate will raise awareness of the need for urgent and large-scale reform of the way in which the Government treat carers. I welcome the dementia-friendly communities strategy and the clusters of dementia groups. In my constituency we have a number of homes where patients with dementia and Alzheimer’s are looked after directly. I also have a dementia friends group who come together in the Church of Ireland church in Newtownards. They bring together all the people of Ards and North Down who want to participate. They give them art, they give them music and they give them a chance to interact, and it is marvellous what happens.

Briefly, I want to mention some of the things that happen in Northern Ireland. The Northern Ireland dementia strategy has a list of achievements to its credit in recent times, which I bring before the House to help the debate: £6.25 million in the Dementia Together Northern Ireland project; the appointment of dementia champions—perhaps the Minister will give us some thoughts about dementia champions in the whole of the United Kingdom, because things are happening, but I would like to hear about them.

Oral Answers to Questions

Gavin Robinson Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Ben Gummer]

My hon. Friend points to variations across the service. Premiums sometimes go up and down in different trusts. We are examining the whole scheme at the moment, and I am happy to speak to him further about what we are doing.

[Gavin Robinson (Belfast East) (DUP)]

Does the Secretary of State agree that this week’s public debate about breastfeeding has been destructive and condemnatory of women who suffer from post-natal depression and struggle to bond emotionally, never mind physically, with their children? Do we need to reframe the debate and reduce, rather than reinforce, the stigma for mothers who want to do the best by their children?

[Ben Gummer]

As my right hon. Friend the Minister for Community and Social Care, who is responsible for mental health, takes forward the increase in funding for perinatal mental health, he will want to work with me on breastfeeding rates and the relationship between breastfeeding and mental health that the hon. Gentleman correctly raises.

NHS Bursary

Gavin Robinson Excerpts

Monday 11th January 2016 Westminster Hall

[Paul Scully]

I will not give way. I am aware that I have been talking for quite a long time, and I am sure that a lot of hon. Members want to speak. With placements, student nurses have less time than other students to do another job because, although it is 50% placement time in theory, they are effectively working 37 or 38 hours a week, so it is difficult for them to have another job to raise money for their living costs, especially as their courses last for 42 weeks a year—many other courses last for only 30 weeks a year.

[Gavin Robinson (Belfast East) (DUP)]

Will the hon. Gentleman give way?

[Paul Scully]

I will give way to the hon. Gentleman because I have not yet given way to him previously.

[Gavin Robinson]

I am grateful to the hon. Gentleman, who is being generous with his time. He is making a key argument for introducing a salary for student nurses to remove the burdens and the levels of debt, rather than charging them tuition fees. Does he agree that the right argument is that bursaries were introduced to incentivise people and to encourage those who would otherwise be dissuaded from training for this noble vocation, thereby removing the burdens and the over-reliance on overseas students? Our Health Minister in Northern Ireland, Simon Hamilton MLA, has decided that he will not remove or scrap the bursary for just those reasons.

[Paul Scully]

I would rather that we re-examined the overall system and reconsidered how we work with student nurses to give them a fair salary. I would rather it be more straightforward, open and transparent, rather than calling it a bursary. Bursaries are effectively gifts, which can be taken away. If someone is working hard in a position that is not supernumerary, we need to examine that. At the end of my speech, when I talk about the petition, I will say that this is the start of an exercise. This is a welcome time to have the petition, because student nurses and the 154,000 people who signed it can help to shape the policy over the next academic year ready for whatever is in place for the 2017-18 academic year and beyond.

Cancer Drugs

Gavin Robinson Excerpts

Tuesday 20th October 2015 Westminster Hall

[Jim Shannon]

Absolutely. My father survived cancer three times because of the surgeon, the chemotherapy, the radiotherapy and all the other treatment that he received, and the drugs helped. So, by the way, does a good diet; there are lots of things that we need to do to tackle the disease. I draw the House’s attention to the recent developments in Northern Ireland. Hon. Members will know that health is a devolved matter. My party colleague, Simon Hamilton MLA, the Minister for Health, Social Service and Public Safety, has taken the initiative to release £1.5 million to fund specialist cancer drugs. That will allow for NICE-approved cancer drugs and treatment to go ahead this year.

[Gavin Robinson (Belfast East) (DUP)]

I congratulate my hon. Friend on securing this debate. He mentions the figure that has been secured by our Health Minister in Northern Ireland. Has any thought been given to the amount of money or resources made available to reduce the time individual patients will have to wait before securing the drugs they need?

[Jim Shannon]

I am unable to answer that question effectively and honestly. I know that question will be brought to the attention of the Minister back home and the Minister here will have a response to it. Today’s debate highlights the issue and raises awareness. We have concerns about the long waiting list. As the hon. Member for South Down (Ms Ritchie) said, we need diagnoses early—the earlier the better. I find it frustrating when I hear from some of my constituents who might wait 12 weeks for a diagnosis and perhaps longer for treatment. We need to address that.

Health and Social Care

Gavin Robinson Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Jim Shannon]

I thank my hon. Friend and colleague for that intervention. He clearly outlines the case, and I want to make a comment about that as well. A young constituent of mine from Newtownards, Adam Owens, a 17-year-old boy, died some six weeks ago because of psychotropic substances, or legal highs, as we all know them. Our community is rightly angry at this loss of the life of a young man and we put on record our concerns for the family and everyone else.

We must address the issue of what is classified as legal, particularly when a young man has lost his life. I have spoken to the Police Service for Northern Ireland, to the Department of Health, Social Services and Public Safety and to the Department of Justice to ask for urgent legislative change. They all said that the change would have to come from this place, so I welcome the Government’s commitment in the Gracious Speech.

[Gavin Robinson (Belfast East) (DUP)]

My hon. Friend will be aware of the work on legal highs I have done at Belfast City Council. For the benefit of the Minister and the Department here, will he encourage those with the power in England and Wales to take advantage of the legal precedent we have set in Northern Ireland where we have secured not only destruction orders but prosecutions for the sale of legal highs?

[Jim Shannon]

I thank my hon. Friend and colleague for that comment, and the precedent has been set in Belfast in the past three weeks. I am pleased that we have set the precedent for the rest of the United Kingdom, as we often do in Northern Ireland. That legislative change has been made by local councils and I am pleased to see it.

The loss of that young man to legal highs should not be repeated. My hon. Friend the Member for Upper Bann (David Simpson) mentioned previous legislation. In a previous job, as a Member of the Legislative Assembly, I spoke about one substance that was an issue at that time, mephedrone. We changed the legislation in Stormont, but an ingredient was changed, the name was changed and all that good work was set aside. That is why we need this legislative change and why we need it urgently.

We had a rally in Newtownards organised by a teenager and his friends in response to the death of Adam Owens. It was attended by every age group, every social class and every religion, with people all there to express their concern and the need to see change on legal highs. We should bring this matter to the Chamber as soon as possible. As I said to the family, we cannot ease their heartache but we can work together to try to ensure that something worth while comes from the shock—that is, the end of legal highs. If we achieve that in this House, we achieve it not only for Strangford but for every constituency across the whole of the United Kingdom of Great Britain and Northern Ireland. That is why, although I welcome the Government’s promise to address the issue, I must ask for the timeline for the fulfilment of the promise. Perhaps the Minister can give us some information about what will happen.

As a Northern Ireland Member, I am well known for continually pressing for more funding UK-wide that is ring-fenced for the NHS and I am delighted to hear that the Government are responding to those calls and making more funding available for the NHS. Can the Minister give us some idea when the ring-fenced funding in the block grant will be made available to the devolved Assembly and whether there will be any restrictions on the use of the money?

There are many issues in the NHS that we must address. We need to address the long waiting lists that mean that people wait almost a year for simple hernia operations. Justice cannot be done to a pay rise for nurses within the current budget allocated to the Health Department, yet those men and women dedicate much of themselves to a job that most people in this room would find unbearable. It has been impossible for them to be recognised within the current budget. In addition, money should be set aside to make more cancer drugs available in all postcodes, instead of being subject to the postcode lottery that often operates.