Hepatitis C (Haemophiliacs)

Gregory Campbell Excerpts

Tuesday 29th October 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Member for Wythenshawe and Sale East (Paul Goggins) on bringing this important matter to the House’s consideration. I will speak specifically on behalf of my constituents, as I think will everyone who speaks today, from a heartfelt understanding of the problems that those constituents have faced for a number of years. My hon. Friend the Member for Upper Bann (David Simpson) illustrated the time scale. If ever there were a powerful case for the Minister to answer, this is one. Many of the speeches made today will be impassioned. I welcome the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison) to her position, and I look forward to working together on many issues in future.

The background to the case is clear. I have spoken to constituents of mine who are victims. Some of my constituents live daily with these illnesses through no fault of their own but rather as a result of the Government’s inaction at a time when action was important. My constituents have sent me a briefing, and I have relied on them for information as well as for the personal details that they have given me, although I do not intend to mention any names out of respect for confidentiality and personal issues.

The Archer inquiry investigated the fact that between the 1970s and late 1980s, 4,670 people with haemophilia were infected with hepatitis C through treatment by the NHS that they loved and respected, which ultimately, unfortunately, let them down. Of those, 1,243 people with haemophilia were also exposed to HIV, as the right hon. Gentleman said. Almost half of those infected with hepatitis C and almost three quarters of those co-infected with HIV have since died and many have tragically left families behind. When looking at the impact on the individuals, we can never forget about the effect on their families; many individuals have experienced poverty and discrimination as a result of their infections. People, either through mistrust or lack of knowledge, sometimes unfairly discriminate against those with infections. The provisions recommended by the Archer inquiry would offer appropriate support and compensation to those affected and would ensure that steps were taken to improve blood safety.

The previous Government argued that the reason why financial support was not made available at comparable levels to those in the Republic of Ireland, for example, was that the disaster affected the two countries differently. I am unsure how that was worked out. Perhaps the disaster was measured in numbers, but the disaster is the same to each individual and each family. No-fault Government payment schemes were established to provide support to those affected. The Archer inquiry, which was non-statutory and funded from private donations, reported in February 2009 on the Government’s response. Among its recommendations was a call for reform of support for those affected in line with the scheme used in the Republic of Ireland. If we had had in Northern Ireland and the rest of the United Kingdom a scheme similar to that of the Republic of Ireland, our constituents would have been much more satisfied. What does the Minister think about the Republic of Ireland’s scheme? Is it possible that we can try to match it?

Despite the Government’s announcing on 10 January 2011 an increase in payments to some of those infected with hepatitis C, what has been put in place is not adequate to support people through their illnesses. The Government’s scheme now has two stages, as outlined by the right hon. Member for Wythenshawe and Sale East. A first stage payment of £20,000 is available to eligible people. Following that, successful recipients of the first stage payment whose hepatitis C infection has led to advanced liver disease can receive a second stage payment of £50,000. Those who have received the second stage payment are also entitled to additional annual payments of £14,000, paid monthly or quarterly. The money may look good and it sounds like a lot of support, but, as always, there is more than meets the eye to the press release. As the saying goes, the devil is in the detail, and that is clearly the case here. The Hepatitis C Trust supplied an interesting briefing and is calling for a rethink of the strategy and policy. The trust, with which I certainly agree, asks that the first and second stage categories be removed. As a constituent of mine said, the payment can never compensate for what has happened, but it can offer support and help people to adjust to and live a life affected by it.

People infected with hepatitis C can experience severe symptoms, including extreme fatigue, depression, aching limbs, headaches and abdominal pains, which may mean that they are unable to work for long periods of time. The right hon. Member for Wythenshawe and Sale East referred to Atos in his speech—I think it was also mentioned in an intervention. The situation of people who are unable to work for long periods of time needs to be understood. Symptoms can lead to difficulties in holding down a job and receiving an income. Sufferers rely on help from family and sometimes from other carers, and the fact that the annual sum starts only when a person’s hepatitis C has caused cirrhosis does not take any of that into account. Understanding the problem is the crux of the issue. The briefing I received from the Hepatitis C Trust put it succinctly:

“Some patients without cirrhosis are far more symptomatic than some who have reached that stage. Indeed, some patients die whilst still in stage 1. Therefore there should be no distinction between stage 1 and stage 2 payments for people who have been infected with hepatitis C through contaminated blood. They should be entitled to the full and on-going support immediately.”

The second point raised in the briefing is that there has been no Government apology to date. The right hon. Member for Wythenshawe and Sale East referred to the Pat Finucane case and the apology that the Prime Minister made, so I urge the Minister to consider an apology for those infected, who have suffered many years of illness as a result. Having listened to some of the apologies, which should never have been uttered, that have rolled off Government Ministers’ tongues to pacify and placate people for political gain, I find it difficult to believe that there has been no Government apology. I have sometimes heard Members of this House and the Prime Minister apologising on my behalf when no apology was needed and yet here, when there clearly was a fault and when innocent people lost their lives following treatment by the NHS, mouths seem to be suddenly closed. I cannot understand that mindset. A mistake was made that has cost lives and has cost other people the price of living with horrific diseases, and if that does not deserve a heartfelt apology then I am at a loss to think what does.

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

Does my hon. Friend agree that what sufferers and their families need are empathy, an apology, to which he has alluded, and a commitment to ongoing support for the remainder of their days? If they saw that coming from the heart of Government, we would have accomplished a significant amount of what the right hon. Member for Wythenshawe and Sale East (Paul Goggins) and his predecessor have sought to achieve.

[Jim Shannon]

I thank my hon. Friend for that contribution, which refers to something that we would all want to see. I am reminded of what my mother told me as a child: “Compassion is your pain in my heart.” She was referring to an understanding of the problems facing other people, which, in a way, is why we are here. We are here not just because we want to be MPs, but because we are privileged to be elected by our constituents. We see their problems and we must illustrate and expand those problems in this great House, of which we are privileged to be a part.

Psychological Therapies

Gregory Campbell Excerpts

Wednesday 16th October 2013 Westminster Hall

[James Morris]

The hon. Gentleman makes a good point; there are major issues with children and young people’s mental health, and I will come on to that later in my speech.

I want to talk today about improving access to psychological therapies. That is a big area on which I have been focused on in my role as chairman of the all-party parliamentary group on mental health. The improving access to psychological therapies programme was established under the previous Government in 2006, following work by Lord Layard, who looked at the economic benefits of a widespread programme of access to psychological therapies across the country. IAPT was initially launched with small pilot areas and then was formally launched in 2008. I do not think anyone here would deny that the IAPT service has made progress. We have seen 1 million people entering treatment and 680,000 people completing treatment, and we have seen recovery rates of about 45%, with 65% significantly improved. The IAPT programme has led to 45,000 coming off sick pay and benefits, and we have seen 4,000 new practitioners trained in the national health service.

The programme was started by the previous Government, and in February 2011, the current Government published their “No health without mental health” strategy, which committed them to investing more than £400 million over four years into the IAPT programme. At the same time as the publication of that strategy, the Department of Health also published its “Talking therapies: A four-year plan of action”, which had the objective that by March 2015, 15% of the adult population would have access to evidence-based psychological therapies that are capable of delivering rates of recovery of 50% or more. Therefore, some progress has been made, but I want to raise serious questions today about how we should take the IAPT programme forward, about the scale of our ambition, and about the extent to which real choice is embedded in the system. I believe that those questions need to be addressed urgently.

The Department of Health, in its assessment of IAPT—its very comprehensive report was published in November 2012—was clear about challenges that the IAPT programme faced in the future. In particular, its report talked about the challenge of waiting times, stating that one of the challenges is

“building adequate service provision (including number of services, and size and efficiency of workforce) to ensure access for all who need treatment within 28 days of first contact.”

The report discusses the challenge of:

“Unmet need—addressing issues concerning equitable access to services where access is lower than expected among some population groups.”

It also refers to the challenge of “Patient choice”, which goes to the heart of the questions that I am raising today, and

“increasing information on treatment options and ensuring that treatment plans are agreed by both patient and therapist.”

Another challenge is the:

“Funding distribution process—ensuring that appropriate investments continue to be made in local IAPT services, to continue to expand capacity and assure quality in line with the overall financial expectations set out in the Spending Review.”

The Department of Health is clear, therefore, about the challenges faced by the further roll-out of the IAPT programme. In order to meet the challenges that come out of the Department’s assessment, we need radical thinking. We need to build on the strength of the existing IAPT programme, but we also need to address some of its fundamental weaknesses, which I believe are holding the programme back.

A central issue that we need to have an honest debate about is the fact that the IAPT programme is still dominated by the use of one therapy—cognitive behavioural therapy, or CBT. The National Institute for Health and Care Excellence guidelines that were drawn up in 2005 made the recommendation that CBT should be the default treatment option for the NHS, because it had the most random-controlled-trial supporting evidence for its effectiveness. In 2010, the guidelines were modified slightly to allow five other therapies into the NICE recommended mix. The reality, however, is that IAPT is still dominated by CBT. Again, I am not arguing that, in many circumstances, for patients with particular forms of anxiety and depression, CBT is not an appropriate form of treatment. However, it is a short-term, highly manualised approach to mental health treatment.

There is an interesting quote from NICE’s recommendations on psychological therapies:

“In using guidelines, it is important to remember that the absence of empirical evidence for the effectiveness of a particular intervention is not the same as evidence for ineffectiveness.”

That is a wonderful little quote from NICE.

One of the consequences of our approach to research into the efficacy of particular forms of mental health treatment, and of NICE’s approach to the formulation of its guidelines, is that long-term therapies such as psychotherapy and psychoanalysis, to name just two, which require long-term commitment from the patient and from the analyst, have effectively been locked out of IAPT. In Britain, we have a mature and highly professionalised cohort of therapists in psychotherapy and psychoanalysis. They have, over the past five years, found themselves unable to provide the sort of capacity that we need in IAPT. One of the consequences of that, and of the dominance of CBT, with a focus on training up therapists to concentrate on CBT, is that we have a monolithic model.

Within IAPT, we have access, but no effective choice for the patient—choice that is focused on the individual needs of the patients and on an assessment of the patient’s particular requirements. We have a professional cohort of highly trained therapists in long-term therapies who are unable to assist the NHS in extending capacity for the provision of psychological therapies and who are unable to become part of the conversation to address the programme challenges identified by the Department of Health’s assessment of the three-year IAPT programme in 2012.

We need to recognise those weaknesses in the existing IAPT programme, because there are still 50% of people who have been through the programme who have not responded well to CBT. Some 85% of people who are currently suffering from severe mental anguish cannot gain access to any appropriate psychological therapy on the NHS. We urgently need a review of the existing NICE guidelines, and I know that Professor David Haslam, the chair of NICE, has recognised the issue and has agreed to initiate a review.

We also need to look again at how we formulate evidence on the efficacy of mental health treatment. For certain long-term therapies, it might not be appropriate for research to be totally focused on randomised control trials, which are also costly to undertake. We therefore need to look at new types of evidence base. We also need to think about developing a new commissioning model for psychological services to create real choice. I will come on to talk about how that might work.

We also need to consider other groups who may benefit from greater choice and access to psychological therapies. The hon. Member for Upper Bann (David Simpson) talked about children and young people. He is right to be concerned about them; it is a major issue that we face in Britain today. Some 850,000 children between the ages of five and 16 are known to have mental health problems. There is a children and young people’s IAPT, which provides a broad range of interventions —parenting therapy, interpersonal psychotherapy and family therapy.

I think we all know and agree that early intervention for children and young people is crucial to prevent problems from becoming more serious. Lots of evidence shows that early intervention at the onset of psychosis in children and young people and suitable psychological therapy treatment can prevent that from blowing up into something much more serious later on. Perhaps we can learn some lessons from the children and young people’s IAPT for adult services, while recognising that the children and young people’s IAPT needs to be developed further.

Also, we must not exclude or not think about the needs of people aged over 65. As we all know, we have an ageing population, meaning that mental health in older people is an increasing problem. The Department’s “Talking Therapies” action plan committed the Department to address the underrepresentation of older people using IAPT. A quarter of people over the age of 65 have symptoms of depression that require intervention, but only one in six will consult their general practitioner. Therefore, IAPT needs to be tailored to meet the needs of older people. Those needs are not just one, single need; the needs of a 65-year-old may be different from those of a 90-year-old.

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

I congratulate the hon. Gentleman on securing the debate. Earlier, he alluded, as my hon. Friend the Member for Upper Bann (David Simpson), did, to the problems in the younger age group, and now he is talking about the older age group. Given the significant increase of referrals in the past couple of years, does he agree that one of the overarching principles is that we will need significant additional resources to deal with the problem right across the age groups, from the young to the old?

Herbal Medicine (Regulation)

Gregory Campbell Excerpts

Tuesday 9th July 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Bosworth (David Tredinnick) on bringing this matter to the Chamber for consideration. Many of us have herbal shops in our constituencies. We are aware of their good work, and that has been backed up in interventions today.

I have been contacted about the issue by a small local health food shop in the main town of my constituency, Newtownards, and by numerous patrons of that little shop who benefit from it. That is the point I want to make. The issue is clear: if EU interference continues, it will put businesses out of operation and people out of jobs, and it will result in more people searching the internet for remedies that may not be safe. That will not bring about any benefits. The EU lingers like a shadow over almost everything. Regulation is needed, but it is also necessary for common sense to prevail, and the balance may be difficult to achieve.

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

My hon. Friend has touched on the crucial point of the debate. Balance is needed to try to avoid people accessing unauthorised, unprofessional and perhaps harmful products, but to enable them to access products made by professional herbalists that they believe and evidence shows improves their condition. We must ensure that we get the balance right between the pursuit and prosecution of those who engage in bad practice and the promotion of those who engage in good practice.

[Jim Shannon]

My hon. Friend has gone to the crux of the debate in those few words. It is about getting a balance between allowing people to continue to use their herbal medicines and ensuring that they do not indulge in anything outside that.

I beg your indulgence, Mr Bone, because I would like to take this opportunity to highlight the save our supplements campaign, which has been well publicised. We should all be aware of the goals of that campaign and the ramifications for today’s topic of regulation. The issue that is causing concern in health shops is maximum permitted levels. It has been suggested to me that interference by Brussels—the shadow of Europe is almost like the grim reaper who hangs over everything that we do in the House—will set low doses for dietary supplements, so removing choice from consumers and adversely impacting on high streets.

--- Later in debate ---

[Kate Hoey (Vauxhall) (Lab)]

It is a pleasure to follow the hon. Member for Strangford (Jim Shannon). I congratulate the hon. Member for Bosworth (David Tredinnick) on securing the debate, which is very timely, given that the House is about to rise for the summer recess, and we are seemingly still no nearer to getting what was promised some time ago—indeed, by the previous Government as well. It has been a long saga, as the hon. Gentleman outlined. I shall speak only briefly, because I want to give the Minister a long time to explain why we are in this position.

I start by reiterating my view that when people voted to join the common market back in 1975, they never would have dreamt that the EU would interfere in this kind of thing. However, it is absolutely crucial that if we are going to prevent the very well-established and effective herbal medicine products from disappearing, literally, from our shops and stop the consequent blow that that would mean for the retail sector, we need to get this regulation as quickly as possible.

I dislike regulation and want to see less of it. I believe that most people have common sense; they know what is good for them and want to do what they think is right. They do not need bureaucrats from the Department of Health telling them all the time what they should and should not be taking. We hear that all the time in so-called public health adverts, when most of what is said is either common sense or complete nonsense. I am a great believer in using not only herbal medicine, but natural products from our countryside. There are so many common-sense things that most of us grew up with—not necessarily only people brought up in the countryside but them in particular. If someone got stung by a nettle, they went immediately and looked for a docken leaf. We did all sorts of things naturally, and now, very few people seem to feel that that is what we should look to. I am afraid that vested interests are the reason for a lot of that. The pharmaceutical industry does not want to see it happening and would love to get rid of all health food shops.

[Mr Gregory Campbell]

Does the hon. Lady agree that as well as the vested interests that she alludes to, at times, in the medical establishment, there is almost a form of elitism that denigrates herbal medicine, suggesting that it only has a placebo effect and is not practically of benefit to people, even though many testify that it is?

[Kate Hoey]

The hon. Gentleman puts it very well. That is what happens, not only in the pharmaceutical industry, but with doctors, who have a very narrow view of what health is, in my opinion. That makes it all the more important that we ensure that alternative medicines are available. It is great that we have an heir to the throne who believes that some of this is really important. I wish that the Department would listen to His Royal Highness Prince Charles, because some of what he says on the matter is absolutely right.

The other issue that I want to raise is about the Health and Care Professions Council, which I think the Minister has overall responsibility for. It is based in my constituency and does a brilliant job. However, recently, it seems as though the Department’s general view on what it does and how it works has changed. We have been trying to get sports therapists registered for a very long time. Everyone agrees that that should happen. The HCPC, which is meant to be the body that gives advice, has gone and said, “This must be registered. We must do this.” Sport England wants it to happen, as does anybody involved in sport; yet somewhere in the Department, there is a block. I actually do not think that it is Ministers; I think that it is officials. Officials do not care who is in government; they do what they want to do; and they will continue to pull a line. It seems as though the Minister or the new Secretary of State could be dangerously close to heeding advice from officials to drop the whole thing. I worry very much about that.

111 Telephone Service

Gregory Campbell Excerpts

Wednesday 5th June 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I had not expected to be called quite so early. First, I should like to put on the record that health in Northern Ireland is a devolved matter—I understand that—but I am observing the 111 system from my position as a parliamentarian. I congratulate the hon. Member for Thirsk and Malton (Miss McIntosh) on securing this debate. She has encapsulated many people’s concerns. I appreciate the Minister’s efforts on health issues. I am sure that she will, in her response, deal with some people’s issues.

I support the idea behind this phone call triage, as it is called, and its being free to contact, bearing in mind that many GP surgeries have an 0844 number, which costs a great deal from mobiles—we have discussed that in Westminster Hall previously on many occasions, and will continue to do so—but there are clearly major issues with it. Although I accept that sometimes the girls in my office have to stay on the phone for an hour or more to fix some computer glitch with the printer or scanner, we are talking about lives in respect of this service. There have been too many difficulties to ignore.

We have background information on many areas, including those the hon. Lady touched on. Yorkshire and Humber provide examples of the figures and information, which state that there were three deaths and 19 potentially serious incidents coming through the system, clearly underlining the problems.

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

Does my hon. Friend agree that NHS 111 should immediately answer the phone to all those who contact it—that is obvious—offer direct, accurate communication and provide people with reassurance that they are getting an accurate diagnosis? Those things will be the judgmental touchstones upon which people will base the success, or otherwise, of 111.

[Jim Shannon]

I thank my hon. Friend for his intervention, which clearly outlines exactly what the 111 system should be trying to achieve. Sometimes, when hon. Members ask if I will take an intervention, they are looking over my shoulder to see what I am going to say next. My hon. Friend made exactly the point that I was going to make.

There have been lots of complaints about calls going unanswered and poor advice being given, which reiterates the point made by my hon. Friend. That follows concerns prior to the national roll-out, after pilot schemes showed disastrous results, with tales of patients waiting hours for advice and others being asked to call back later. That situation is quite unsatisfactory and must be addressed. NHS England stated:

“The safety of patients must be our paramount concern”.

So it should be, and if it is not, we want to ask why. It also said:

“NHS England will keep a careful eye on the situation to ensure NHS 111 provides not only a good service to the public, but one which is also safe.”

Examples mentioned by all hon. Members—we have them in front of us—provide information that contradicts that. In Greater Manchester, the 111 service was started and then abandoned. Dr Mary Gibbs, a GP providing out-of-hours cover when the system crashed there, said:

“Calls just weren’t coming through.”

Quite clearly, that is the issue. She stated:

“It was totally inadequate. Patients’ health was put at risk.”

The 111 service tends to be busiest when local surgeries are closed. Dr Laurence Buckman, chairman of the British Medical Association GPs committee, stated:

“We are still receiving reports that patients are facing unacceptably long waits to get through to an NHS 111 operator and suffering from further delays when waiting for calls back with medical advice should they manage to have their call answered… The quality of some of the information being given out appears, from anecdotal sources, to be questionable in some instances.”

The advice that people are being given does not always seem to have been up to scratch and is not of the quality that it should be. He added:

“If any area of the country is failing to meet high standards of care, then its NHS 111 service needs to be suspended.”

This is what the experts in the field are saying. NHS England needs to be more transparent about how the system is functioning across the country.

Home Care Workers

Gregory Campbell Excerpts

Wednesday 6th March 2013 Westminster Hall

[Alison McGovern (Wirral South) (Lab)]

I begin by congratulating my right hon. Friend the Member for Oxford East (Mr Smith) on securing the debate. There could not be a more important subject on which to have a Westminster Hall debate. I also thank the hon. Member for St Ives (Andrew George), who made a very important contribution. To add more thanks, the recent CQC and Unison reports have been incredibly helpful; for those of us who have been thinking about care for some time, the two reports have crystallised and explained, in a well researched way, the substantial challenge that we face.

If I may make a slightly parochial Merseyside remark, this is an extremely important issue for us, especially in Wirral, where we have an ageing population, which, I must say, we are very glad about. We are glad and proud that our grandparents and parents are living longer, but with that pride comes responsibility. That is why the challenge that we face is very important. I would like to thank my constituents, who have been very good in coming to several public meetings with me on the subject of care. I have asked them to help me think about that issue, because I know that many of them face this challenge. They have willingly given up their time to inform me about their concerns, and I am incredibly grateful.

I have also been lucky in the Wirral because home care staff have met me and given me the benefit of their experience, along with council officers and councillors. I recognise that the problem is shared across all those groups. We are going to fix the problem together, and we are here today to ask the Minister whether he will join us in helping to do that.

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

On the point she just mentioned, does the hon. Lady agree that one of the pleasing aspects of this issue is the number of active senior citizens in all our constituencies who want, in a voluntary capacity, to involve themselves in the debate to try and lift the standards and ensure that we give the proper care to people in their own homes?

[Alison McGovern]

I could not agree more. Only last Friday, I was with Heswall Soroptimists, a very committed group of women who volunteer in our community, and who raised various issues about care. That is only one example of committed groups of citizens who are keen to be involved in finding a solution.

It is important that we make the moral case for change. Too often, people in need of care in their homes are hidden from our society, and people who need support, by their nature, can find significant barriers to their participation in democracy. Therefore, it is extremely important that politicians take the time to speak up for them. I have been meeting regularly with Wirral officers to try and work through some of those issues, and specifically, to discuss whether there is a way that we can improve the quality of care in our borough.

On that note, I flag to the Minister that such conversations are made much more difficult by the funding settlement that local government has received. The fact that local government has taken the biggest cuts from Whitehall has certainly impeded my ability, locally in the Wirral, to get change. I ask the Minister to note that point, and next time that he has conversations with Cabinet Ministers and the Treasury, to remind them of local government’s role in care and of the important challenge that we are trying to meet.

In discussions with Wirral council officers, we have also been trying to consider how to tackle the problem of information that has already been flagged. For people who are trying to procure care, it is difficult to know what quality standards they can expect and what the market looks like. I sympathise greatly with the points made by my right hon. Friend the Member for Oxford East about the role of markets in what is, I would argue, a bit of the economy that does not necessarily lend itself well to markets. I hope that hon. Members will forgive me if I sound like a bit of an economics geek when I say that, in any case, markets do not work well when participants have insufficient information. I believe that if we cannot solve that problem, the current system will never work.

I will move on to talk about two aspects of home care that have repeatedly been shown to be very important to my constituents. As I mentioned, we have had several public meetings in the Wirral to discuss these issues, and we have tried to bring together both those who work in care and those who receive care so that we can see the problems from either side of the coin. Those two aspects are 15-minute appointments and zero-hours contracts. Those two issues typify the insecurity at work and low investment in skills that home care workers face.

First, on 15-minute appointments, it might have been mentioned that the recent Unison report found that 46% of staff felt that they had to rush visits—that is nearly half the workers going into the homes of people who are very important and need help. The result is the feedback that I receive that due care and attention cannot be given to people. I am talking about basic matters of respect, such as addressing the person concerned as they would wish to be addressed.

Let me give an example from my own constituency. A care worker was in a couple’s home to make some food for them, but said that they were able to do that for only one member of the couple—the husband or wife—because that was all that they had been allocated time for. Most people expect to be able to sit down to a meal with their partner. That is a basic thing that we all expect to be able to do in our lives. Fifteen-minute appointments may or may not have been the cause of the problem in that case, but if 15-minute appointments mean that the normal standards that we would all expect to be upheld have to be disregarded, that is not a system that will work well.

I will read out a quote from one of the care workers to whom Unison spoke:

“When the person you go to needs more care or has incontinence you are only allocated 15 minutes for a meal and have to leave them. I haven’t left a client like that and would go over my time (although not paid for it), but it does mean you are running late for other calls.”

I cannot imagine what it must be like for someone to turn up at a person’s home and find, if they are incontinent, that the worst has happened. They are supposed to be there only to make them a sandwich or whatever and they must decide between being late for the next person, which will cause stress, or, frankly, rushing around doing things that they know they will not be paid for, which will cause them stress. At the same time, they are trying to make that individual feel better about what has happened. What skills and talents does someone need to make that situation go well? We should first admire the people who do this job, but also question what in the system is causing such a breakdown.

One aspect of this subject that I have highlighted as a result of listening to my constituents is that too much of the way in which our system works is task-orientated, not person-orientated. Dignity is extremely important. Increasingly, people have recognised that the way in which we treat others in society is ever more important. When we are asking people to do a list of tasks—no more and no less—rather than think about the individual and try to help them with whatever their needs are, we will not fix the problem. Individuals will feel bad about the care that they receive rather than feeling that it is a help to them. Another care worker quoted in the Unison report expressed that very clearly:

“I never seem to have enough time for the human contact and care that these people deserve.”

That is a lesson to us all.

Secondly, on zero-hours contracts, my right hon. Friend the Member for Knowsley (Mr Howarth), my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) and I have recently commenced a survey that is designed to listen to people across all industries who have experienced being asked to do or have taken on zero-hours contracts. Of course, for people who want a bit of work but do not need it to be regular—students or others—zero-hours contracts may not be such a problem. However, I think we all recognise in this Chamber the problems with that flexibility and insecurity in a world in which people are trying to provide routine, predictability and attention to detail for some quite vulnerable people. I think we would all question the appropriateness of zero-hours contracts.

There are two problems with zero-hours contracts that we need to consider. The first is inconsistent care. My constituents tell me that they would like to know who the person is who will be turning up and they would like visits to be predictable and regular, not least because of respect and dignity issues, such as knowing the little details. Often, people who need care face communication barriers. Understanding in detail how a person communicates is extremely important, so consistency of care could not be more important. How do zero-hours contracts support consistency of care?

The second issue is stress. Insecurity at work causes stress, and in a world in which we are asking people, as I mentioned in my example, to turn up and help vulnerable people, we need them to feel confident and secure and to have enough skills to be able to tackle whatever problems are there. Recent research has shown the impact of stress and insecurity for those working in care on the manner of treatment received by the people for whom they are caring. That is an important message to us all as politicians. What responsibility can we take for creating more security at work for those who care for vulnerable people?

Comments have already been made about the pay levels in the sector. They are clearly low. Low pay plus zero-hours contracts mean that we will have people of relatively low skill. I mean “low skill” in the technical sense; I would argue that people who work in care are extremely skilled and extremely able practically, given what they have to deal with. However, investment in skills will clearly not happen where there is low pay and an insecure labour market.

Having described the problem, I will conclude by describing what I believe might be part of the solution. First, working in home care needs to be seen as an aspirational job. There is no reason why someone should not work in care and aspire to management, to moving up in their career. We need to find pathways through the career chain so that we can make this a genuinely aspirational job. A significant number of our young people are out of work. We need to demonstrate to them that home care work is valued in society and that if they pursue such a career, they will be invested in and respected as members of our society. We need to make that absolutely clear.

I again thank my right hon. Friend the Member for Oxford East for securing the debate. There could not be a more important subject than this. I hope that the Minister will respond positively and explain what we can do to bring some change to the sector.

NHS Commissioning Board

Gregory Campbell Excerpts

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

I take the point, but I again reiterate that the rules and guidelines for commissioners will remain exactly as they were under the last Government and under the right hon. Member for Leigh as Secretary of State.

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

The Minister referred to the amending of regulations. Will he tell us first when that is likely to happen, and secondly how it will ensure that the cloud of uncertainty hanging over the NHS is dispelled?

[Norman Lamb]

The amended regulations will be published within days. I entirely agree with the hon. Gentleman that it is important for clinical commissioning groups to have absolute clarity, so that they can prepare for the date in April when they take responsibility.

Suicide Prevention

Gregory Campbell Excerpts

Wednesday 6th February 2013 Commons Chamber

[Mrs Madeleine Moon (Bridgend) (Lab)]

I add my congratulations to those given to the hon. Member for South Antrim (Dr McCrea) on calling for this debate, along with his colleagues.

This is one of the few opportunities to address this important issue in the Chamber. There have been Adjournment debates and Westminster Hall debates, but a full Chamber debate is not a natural occurrence for this subject, so I very much welcome it. I begin with a quote from a recent inquiry undertaken by the all-party group on suicide and self-harm prevention. Someone working on suicide prevention in England said:

“So when you are having a discussion”—

as we are today—

“about what does suicide mean, and the numbers are very small compared to smoking or obesity, what is this about, well our deaths by suicide show…the ultimate loss of hope, the ultimate loss of meaning of purpose, yet they are an indicator. They may be small numbers, but they have a very big ripple impact and they are an indicator of what is happening further down that pyramid.”

This debate, as has been said, is timely, because of the publication of statistics by the Office for National Statistics which show that there has been an increase in suicides in the United Kingdom. In 2011, there were 6,045 suicides—an increase of 7.8% on the previous year. Across the United Kingdom, suicides have increased at different levels. In Wales last year, there was an 18.4% increase, and in Scotland, a 13.8% increase. However, Scotland has changed the data on which it bases its statistics, and it argues that if it had not changed statistical gathering information and the classification of deaths by alcohol, there would have been a small decrease.

In Northern Ireland, the figure is down slightly by 7.7%, from 313 to 289 deaths from suicide, but in 2009, it was as low as 260, so over that period there was an increase. In England, however, there is a 7.4% increase, but the figure varies across the country. In the south-east, it is 6%, but in the north-west, it is 9.3%, which will be of particular interest to you, Mr Deputy Speaker. The highest risk group—and there has been a lot of talk about young people, particularly young men—is men aged 30 to 44, with 23.5 deaths per 100,000. The 45 to 59 age group has the highest rate of suicides among women, and there is also an increase in deaths for men in that group.

When the ONS says there has been a significant increase, it means that we can be 95% confident that the increase has occurred because of an underlying reason, and not just by chance. Our job is to look at that underlying reason. What is driving these increases?

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

Does the hon. Lady agree that when Members and others deal with families who are trying to come to terms with a suicide, very often there is a lack of help when those families try to identify within the family circle a behavioural change and problem that led up to the suicide? Sometimes they are racked with guilt because they cannot identify the problems that ultimately led to the suicide. Perhaps that is where attention and resource can be deployed.

[Mrs Moon]

I apologise to the House. I have lost a contact lens, and I have to wear spectacles. I cannot read my papers when I am wearing them, and I cannot see all hon. Members in the Chamber when I take them off. If I am not wearing them, hon. Members must alert me if they wish to intervene.

The hon. Gentleman is absolutely right. Families tear themselves apart over the question of why. They try to analyse behaviour, particularly in the weeks leading up to the death, to seek an understanding of it. Only if there is a suicide autopsy can one begin to look at the reasons behind a death. That is a complicated procedure that cannot be carried out for every death, but it can give some understanding of the wider reasons behind such deaths. I totally agree that the distress for families as to why the suicide has happened is horrific.

That is why the research to which we have access is important. Haw, Hawton, Gunnell and Platt found that the economic recession had a clear impact on suicide. However, the increase in the suicide rate may be offset by adequate welfare benefits; their finding was very clear on that. Other measures likely to reduce the impact of recession included targeted intervention for the unemployed and membership of social organisations. They found that responsible media reporting was also important. Research at the university of Liverpool found that more than 1,000 people took their own lives during the 2008-10 economic recession in the United Kingdom.

There are ways in which we can begin to look at some of the problems that are staring us in the face and that may be causing some of the increase that is becoming apparent. Suicides began to rise in the UK in 2008, following 20 years of decline. Figures rose almost 8% among men and 9% among women in 2008, compared with 2007. The figures reflect the increased effect of the recession. I want to reiterate that research has found that there are risks associated with failure to provide adequate welfare benefits. There are currently high levels of distress and hopelessness caused by the changes in benefit that are about to come into force.

Terminal Illness (Access to Medicines)

Gregory Campbell Excerpts

Wednesday 23rd January 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for The Cotswolds (Geoffrey Clifton-Brown) on bringing the matter to the House. I want to focus on the end-of-life issues that he dealt with in the second part of his speech. Obviously those concern us all, but I want to concentrate on them because of several interactions that I have had with constituents on the subject, and because there is a need for drugs. I am confident that the Minister will respond positively and I look forward to her comments.

I have spoken recently about ending the so-called GP death list—a term that I use very carefully; some people see end-of-life issues in that way and are concerned. I was shocked when I read an article that stated that thousands of patients have already been put on those so-called registers,

“which single them out to be allowed to die in comfort rather than be given life-saving treatment in hospital”.

That is one thing that has emerged from discussions that have taken place. The article states that nearly 3,000 doctors have promised to draw up a list of patients they believe are likely to pass away within a year. It is claimed:

“As part of an unpublicised campaign endorsed by ministers, GPs have been encouraged to make lists—officially known as End of Life Care Registers”—

which the hon. Gentleman mentioned towards the end of his speech—

“of people they believe are going to die soon and should be helped to do so in comfort.”

That is the terminology that is used. In my opinion if a patient refuses further treatment this is their decision, not the doctor’s. Treatments must be made available throughout the NHS to those who want and need them—those who need care.

How many times have we heard of patients with no hope suddenly going into remission? An example concerning a child with cancer recently came to my attention. The doctor advised no more treatment, but the sister of the little boy was not ready to say goodbye, and for her sake the family asked for one more course of chemo to prolong the time left and prepare the other child for the expected death. The little boy responded to the chemo that was given in the hope of allowing a few more weeks of life; but that time has turned into six months. Who knows what the future holds? The point I am making is that there are probably many examples from across the United Kingdom where a wee bit of extra effort can be made and where it may not be necessary to prepare for the inevitability of death, if there is also a possibility of life through drug treatment. Imagine if that family had not been allowed to ask for, or the doctor had had the power simply to refuse, the last bout of chemotherapy. That is not an everyday occurrence, but it does happen and it should give us reason to pause and think before making drastic moves.

In 2008 the Labour Government announced a range of proposals aimed at improving the care available to patients with life-threatening conditions. They stated that a key part of the new proposals was a change to the way the National Institute for Health and Clinical Excellence decides which medicines are approved for diseases that affect only small numbers of people. The hon. Gentleman focused in his speech on some diseases that do not kill a great many people in the United Kingdom, and on which, therefore, drugs companies do not spend money; but perhaps they should. I want to discuss that issue. What has changed in the past five years? Is there a greater availability of drugs? I am not sure that that is the case, and would appreciate confirmation from the Minister of how many more medicines have been approved on the list. Many UK universities do great work investigating drugs and conducting research with pharmaceutical companies, and Queen’s university Belfast is one of them, at the forefront of the good work being done on new drugs for ailments including cancer, diabetes, and dementia and Alzheimer’s. Students come from all over the world to do research and to learn there. I commend the university, which has been able to source individual funding, and the many other UK universities doing similar work.

The campaign Empower: Access to Medicine, set up by a man suffering from motor neurone disease, recently caught my eye. The campaign calls for a review of the law and ethics on drug development, as it takes many years and billions of pounds to take a new drug to market from A to Z. The last drug licensed for motor neurone disease, which damages the nervous system, leaving muscles wasted and weak, was riluzole, which has been in use for 20 years. Can there have been no scientific advances since then? I do not believe that. Les Halpin has commented that

“to see primarily it’s the regulations that are slowing the whole process down, it just means we could be waiting an awful long time until a new drug is produced.”

I have a dear friend, whom I have known for many years, who has motor neurone disease. I have seen a healthy man go from being a fun person in the peak of health to someone wasting away in a chair. The drugs have given him a longer life, and perhaps a better quality of life latterly, but they cannot stop the onslaught of the disease. The finality of what will happen to him is clear.

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

Does my hon. Friend agree that beyond the difficult and onerous issue of NICE approval of drugs that he and the hon. Member for The Cotswolds (Geoffrey Clifton-Brown) outlined, and which needs to be resolved, is the cost of drugs, post-approval? We need more work to be done on dragging down the cost, to make them more accessible.

Diabetes

Gregory Campbell Excerpts

Wednesday 9th January 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

First, I thank the hon. Member for Torbay (Mr Sanders) for bringing this issue to the House. Secondly, I declare an interest, as I am a type 2 diabetic and have been for four years. It has given me a knowledge of, and an interest in, the issue, although not a total knowledge—far from it. It has also made me more aware when constituents come to me with issues relating to diabetes and has given me an interest in those issues.

The disease has completely changed my life, as it would, because it is type 2. Diabetes is a major issue in every constituency. As someone who enjoyed the sweet trolley more than anyone else—to use Northern Ireland terminology, when there was a bun-worry going on, I was at the front of the queue—the sweet stuff was something that I indulged in regularly. Along with my stress levels, that has meant that I am a diabetic today.

The statistics have been mentioned, but they bear repeating, due to the seriousness of the UK’s problem, which is etched in everyone’s minds. The UK has the fifth highest rate in the world of children with type 1 diabetes. In Northern Ireland, we have 1,040 children with type 1 diabetes, some of whom are born with the condition. I want to give a Northern Ireland perspective, but I will bring in the UK strategy, because diabetes affects the whole UK, and that is why it is important. Some 24.5 children in every 100,000 aged 14 and under are diagnosed with the condition every year in the UK. We had a reception where we met some of those young people, and if we needed a focus, the focus was there that day for those of us who attended. I think that most of the people in the Chamber were there.

The UK’s rate is about twice as high as that in Spain, where it is 13 children in every 100,000, and in France, where it is 12.2 children in every 100,000. The league table covers only the 88 countries where the incidence of type 1 diabetes is recorded. There are 1,040 children under the age of 17 with type 1 diabetes in Northern Ireland, and almost one in four of them experienced diabetic ketoacidosis before a diagnosis was made.

Diabetic ketoacidosis can develop quickly. It occurs when a severe lack of insulin upsets the body’s normal chemical balance and causes it to produce poisonous chemicals known as ketones. If undetected, the ketones can result in serious illness, coma and even death. The diabetes itself is not the killer; it is the offshoots from it, the effects on the heart, circulation, blood pressure and sight, and the possibility of strokes and amputations.

The number of people living with type 1 and type 2 diabetes has increased by 33% in Northern Ireland. In my Strangford constituency, the number has gone up by 30%, with 800 people—I am one of them, by the way—becoming diabetic in the past seven years. That compares to 25% in England, 20% in Wales and 18% in Scotland. In our small part of the United Kingdom, the total number of adults—aged 17 and over and registered with GPs—with diabetes is 75,837, and a further 1,040 young people under the age of 17 have type 1. There has been a significant rise in that number also, with the prevalence in Northern Ireland now at more than 4%. An estimated 10,000 people in Northern Ireland have diabetes and do not know that they do. They have a ticking time bomb in their bodies; they wonder why they are not well, and the cause is diabetes.

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

My hon. Friend is talking about the different prevalence of diabetes throughout the UK. Does he agree that best practice regarding early detection and the promotion of an active lifestyle could be a target for all the devolved regions across the UK and here in England? The Minister would do well to respond in relation to Ministers in the devolved regions taking on such best practice to combat diabetes.

[Jim Shannon]

Yes, I agree. When people make interventions, I always wonder whether they have read my script—preventive medication is the very next issue on it.

In my doctors surgery in Kircubbin and, indeed, across Northern Ireland preventive measures are in place. There are diabetic surgeries, and the matter is taken seriously. The UK strategy that we have had for the whole of the United Kingdom of Great Britain and Northern Ireland and that will come to a conclusion this calendar year has made significant progress towards reducing the potential numbers, but diabetes has increased over the same period. There are some 100 diabetics in my doctors surgery in Kircubbin.

Induced Abortion

Gregory Campbell Excerpts

Wednesday 31st October 2012 Westminster Hall

[Jim Shannon]

I thank the hon. Lady for her intervention, but life is life as far as I am concerned; that is where I am coming from.

The survival of more than 70% of babies born between 22 and 25 weeks when high-quality care is available blows away the argument that a baby can be aborted until it is viable at 24 weeks. Recently, in America, a baby of 21 weeks responded to stimulus, crying and smiling, so there is evidence that shows clearly that it can happen. All the things that we associate with life are in evidence before the time of so-called viability.

I will give the example of a young girl from my constituency. A friend of mine had a grandchild who, they were warned, would not survive as she was so premature. The family prayed hard, and asked for all possible treatment to sustain the baby’s life. Today, Zoe-Lee is 13 years of age and is the light of her parents’ life. It is scary to think that if an abortion had been allowed at that time, that young girl would not be here today.

The question that has been posed to me by members of the medical fraternity is: how much longer can we justify doctors desperately—the hon. Member for Mid Bedfordshire referred to this as well—trying to save premature babies born at 23 weeks, while down the corridor in the same hospital, another doctor is aborting a 23-week baby, which is perfectly healthy, for social reasons?

A 24-week upper limit in the UK is outdated and out of line with other EU countries. In 2008, our 24-week upper limit was double the 12-week limit for most EU countries. Some 16 out of 27 other European countries had a gestational limit of 12 weeks or less, so if we want to be in line with other countries that have high standards, then let us do that.

Ask any woman who has miscarried a baby in early term—at, say, at 12 weeks—and she will tell you that she saw its perfectly formed fingers and toes, its spine and head, and that wee face. For me, it is almost unimaginable to take it from the womb at this stage, never mind any later, and to ask any general practitioner to do this is grossly unfair. I am no man’s judge, and I feel for those women who have felt that they had no other option than to take this step.

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

Does my hon. Friend agree—he seems to be coming to this point—that we need to try to develop a caring, compassionate approach to women who find themselves in the circumstances that he is outlining, but feel that there is no alternative to an abortion? We need to offer them another viable alternative.

[Jim Shannon]

I thank my hon. Friend for his intervention, because that is exactly the point I was coming to. For the reason I mentioned, I supported the calls by my colleague, the hon. Member for Mid Bedfordshire, to have better counselling in place for women considering abortion. Will the Minister update hon. Members on when new counselling will come into play, and on what has been done thus far?