Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 29th October 2019 Commons Chamber

[Caroline Dinenage]

The hon. Gentleman is absolutely right to raise this matter, and I know that he is meeting the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), shortly to discuss the details of that individual case. More broadly, the long-term planned commitment to spend that additional £4.5 billion- worth of investment in primary and community health services will definitely help those services to be delivered much closer to people’s homes.

[Huw Merriman (Bexhill and Battle) (Con)]

Hospice in the Weald is building the UK’s first cottage hospice, and I viewed it on Friday. It allows family members to care for and stay with their loved ones until the end of their life, and it is absolutely fantastic. The cottage hospice is looking for a Minister to come and open it. I know that there is an election coming, but will a Minister from the winning Front Bench come and do that honour for us in East Sussex?

[Caroline Dinenage]

I am grateful to my hon. Friend for mentioning that brilliant initiative. I think we will probably be falling over ourselves to volunteer to do the honours, but I would be very happy to put myself forward for that.

Health Infrastructure Plan

Huw Merriman Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

As the hon. Lady will know, improving mental health services for those with mental health needs is at the heart of this Government’s agenda. The Government have already announced investments of over £400 million in improving the mental health estate since July 2017, but she highlights a specific point and has a specific request—that I meet her. Given the number of meetings and visit requests I have had today, there may be a slight wait, but I would be very happy to meet her.

[Huw Merriman (Bexhill and Battle) (Con)]

On Friday, I had the pleasure of visiting the Conquest Hospital in Hastings with my amazing neighbour, my right hon. Friend the Member for Hastings and Rye (Amber Rudd). The hospital was delighted with the £14 million that has just been allocated to its sister hospital in Eastbourne to help to develop wards there, and the trust would be absolutely delighted if it were able to deliver a new hospital. May I ask my right hon. Friend—he will soon be right hon. if he is not already—what more the Conservative MP team in East Sussex, one of whom, my hon. Friend the Member for Lewes (Maria Caulfield), is sitting right in front of me, can do to get a new hospital delivered to our constituents on the East Sussex coast?

[Edward Argar]

I pay tribute to my hon. Friend and to my right hon. Friend the Member for Hastings and Rye (Amber Rudd) for their campaigning work on behalf of their local hospital trust, East Sussex Healthcare NHS Trust, and their two local hospitals, the Conquest and Eastbourne. The investment that we envisage flowing from this seed funding will lead to current district general hospital services being provided from a significantly enhanced environment at both Eastbourne and the Conquest—something that my hon. Friend the Member for Bexhill and Battle (Huw Merriman) has campaigned for very actively. I encourage him to continue doing so and to continue working very closely with his local trust to ensure that it continues to develop those services.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 7th May 2019 Commons Chamber

[Matt Hancock]

I do not recognise the number that the hon. Gentleman talks about, but we are changing the way in which the GP contract works to ensure that this new technology can be most effectively harnessed to deliver patient need in a way that also works for the NHS. I am slightly surprised that he has not yet got up to say thank you for our announcement on primary care services in his part of London, which we are going to be expanding while stopping the closure of A&E. A little bit of gratitude for that would also go down well.

[Huw Merriman (Bexhill and Battle) (Con)]

8. What steps he is taking to improve care for people with autism.

[The Minister for Care (Caroline Dinenage)]

We are absolutely resolute in our commitment to improving care and support for autistic people, and we will launch a refreshed autism strategy, which will include children, by the end of the year. We have also launched a national call for evidence, to hear what we are doing that works and where we need to do more, and we have already received more than 2,000 responses.

[Huw Merriman]

I welcome the NHS long-term plan and the steps that will go towards helping autistic people in the healthcare system. Does the Minister agree that we will make a real difference only if we improve the recording of autism in local health and care records? Will she therefore commit to requiring the NHS to record autism diagnoses in each area with the aim of improving autistic people’s health?

[Caroline Dinenage]

My hon. Friend is absolutely right to raise this issue. Reasonable adjustments are critical for improving the experiences of health and care for autistic people. That is why the long-term plan commits to a digital flag in patient records, which will ensure that staff know whether a patient has a learning disability or autism. At the same time, we are looking at how we record where a diagnosis of autism has been made.

Social Media and Health

Huw Merriman Excerpts

Tuesday 30th April 2019 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

My generation growing up might have feared bullying in the playground, but largely home was a refuge and place of safety. The problem for the current generation is that they can find themselves being bullied 24/7 because of social media. It is little wonder that when I contacted Twitter after seeing some rather libellous material it told me that in its view it was not abusive, even though it was against the law in this country. Does the Secretary of State agree that until social media companies understand that they have to operate under the norms and laws of this country, and not just abide by Californian norms, they will never reform?

[Matt Hancock]

My hon. Friend puts it exactly right. That is what the duty of care is all about. The argument—we hear it less and less, to be honest—that these are international companies and so will abide by somebody else’s laws, thanks very much, is wrong and out of date, as the online harms White Paper makes clear. We must establish a proper enforcement mechanism to ensure that it is the rules that this House sets—occasionally amended by the other place—that define the law of the land and that we do not have a wild west. This action to protect people’s health is just one part of the response needed to make the internet safe, especially for children.

Services for People with Autism

Huw Merriman Excerpts

Thursday 21st March 2019 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

I beg to move,

That this House has considered services for people with autism.

Every year, my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan), in her role as chair of the all-party parliamentary group on autism, moves a motion along the lines:

“That this House notes that World Autism Awareness Week runs from 1 April to 7 April; observes that autistic people continue to face a number of barriers to full participation in society; notes that it is 10 years since the Autism Act became law; and calls on the Government to improve support for children and adults on the autism spectrum, and ensure that the Autism Act is fully implemented across the country.”

My right hon. Friend cannot be with us today. She has asked me to explain that a close family member is critically ill and that she cannot leave their side. Though you, Mr Deputy Speaker, I send the love of this House to our right hon. Friend. She is a formidable champion of this cause, and someone to whom many of us have turned in our own hour of need. The best tribute that I can pay to her is to deliver the speech that she prepared and would have made today. These are her words:

“I welcome the Minister to the Front Bench and look forward to hearing what she has to say. My thanks to the Backbench Business Committee for granting this debate as we look forward to World Autism Awareness Week, a full seven days when people across the UK take part in activities to raise awareness of autism. I also thank the National Autistic Society for its ongoing support for the all-party parliamentary group on autism.

Hon. Members will be aware of my long-standing commitment to improving the lives of people on the autism spectrum, most notably through my role in spearheading the introduction of the Autism Act 2009—which has now been on the statute book for 10 years.

I was proud to introduce that Bill that became the only Act—which is the only Act dedicated to improving support and services for one disability. It was a landmark in the battle to improve the lives of autistic adults and their families. As a result of the Act, there has been a fundamental shift in how policy is developed and delivered for adults on the autism spectrum. For the first time, legal duties were placed on councils and the NHS to provide support to autistic adults in their local areas. In addition, the Act placed a responsibility on the Government to produce the national autism strategy, to set out its vision—and, importantly, to keep that strategy under review.”

[Andrew Selous (South West Bedfordshire) (Con)]

Like my hon. Friend I pay huge tribute to our right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) and all that she has done on the issue for so long. I am listening carefully to my hon. Friend’s excellent speech, and I wonder what he would say to a constituent who wrote to me about her son. She writes:

“My son is 21 years old and since leaving education has had nothing to do. He is not disabled enough to qualify for benefits but he is not able to compete for a job. He is caught in the middle.”

What more does my hon. Friend think we can do to help people like that young man with their future?

[Huw Merriman]

I thank my hon. Friend for his words and for championing his constituents. As he rightly says, some autistic people tend to fall through the gaps. Of course, all local authorities have a responsibility to take note when it comes to autism. We see individuals who are on the autism spectrum but are not receiving help because they might be outside a defined period. The extension of plans up to the age of 25 will go some way towards addressing that, but we still see people falling through the gaps. I will touch on some of the other areas that might address his concerns, or I will at least make calls to those on the Front Bench.

My right hon. Friend the Member for Chesham and Amersham continues:

“This year, it falls on the Government once again to review its strategy and identify what more needs to be done.

Each of us has about 1,000 people on the autism spectrum in our constituencies and it affects one in 100 people. We each will have many autistic people and their family members contacting us to ask for our help on areas from education to adult support, diagnosis to employment...”

[Derek Twigg (Halton) (Lab)]

The excellent speech mentioned the Government’s strategy. A perennial problem—it crops up all the time in my constituency—is the speed of diagnosis. The fact is that so many children with autism simply do not get an education. Surely the strategy must try to address that in a much better way than it has in the past.

[Huw Merriman]

The hon. Gentleman is absolutely right. Time and again we see that young people have to fail before they can be given the support they need. There are many examples of young people clearly failing when they go to a pre-school, but then they still have to move on to a mainstream school, where they will fail, before they can be given support. It should be blindingly obvious, and councils should look at those plans before children have to start primary school. Often councils say that they are not required to do that, but perhaps they do not know what their obligations really are.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The hon. Gentleman is indeed making an excellent speech. He also referred to parents. What is his view of the extent to which the needs of parents and family members should also be part of the strategy, not least because sometimes they do not understand the experience of their children and how best they can help? Family members also needs respite provision, for example, because of the demands of caring for children with autism. We should also recognise the amazing work that many specialist schools are doing to ensure that children with autism, who also have amazing talents, can express and develop their abilities.

[Huw Merriman]

The hon. Lady is absolutely right. A couple of years ago I was very proud to co-author the “Autism and education” report, which she also worked on. It showed many worrying statistics. For example, one in two teachers just did not have the confidence to teach autistic children. Unsurprisingly, 50% of autistic children had a miserable time at school and were not looked at.

The hon. Lady is right to give credit to the parents, who are on an incredible journey and are struggling themselves. Battling for the support that they need at the same time as providing care is emotionally draining. We all work with those parents, and we have so much respect for them.

[Martin Whitfield (East Lothian) (Lab)]

I congratulate the hon. Gentleman on securing the debate. I also congratulate the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) on all the work that she has done on this issue.

The hon. Gentleman is making some important points, but does he share my annoyance about the fact that, unfortunately, autism seems to be one of those invisible disabilities? Many parents talk about the way in which others judge their children, saying that they are just being naughty. That failure of understanding goes to the heart of the problem faced by autistic children and adults, whose contribution to our communities is enormous, individual and highly important. We should be able to open our eyes to all the strengths that they bring to us, and make a space in which they can be understood through the services that the hon. Gentleman is talking about.

[Huw Merriman]

The hon. Gentleman has put it beautifully. As he probably knows, a recent survey showed that 50% of autistic individuals and families were scared to go out, and did not go out, because they were worried about how they would be judged. That isolation is a huge challenge for us.

[Wera Hobhouse (Bath) (LD)]

rose—

[Dr David Drew (Stroud) (Lab/Co-op)]

rose—

[Huw Merriman]

I will take two more brief interventions, and then I will make some progress.

[Wera Hobhouse]

I am pleased that the debate is taking place in the main Chamber. We had a very moving debate some months ago in Westminster Hall, but this is such an important issue that it needed to be raised here. Unfortunately I shall have to leave soon. The debate was meant to start about an hour ago, according to my diary. I am so sorry not to be able to stay, but I am so pleased that the hon. Gentleman is raising the issue now.

[Wera Hobhouse]

In that case, Mr Deputy Speaker, I apologise.

My local authorities have some excellent care providers and support services, including Parent Carers Voice. Does the hon. Gentleman agree that services for children with autism should be financed through council budgets rather than the responsibility being pushed on to struggling families?

[Huw Merriman]

I think that we all face a real challenge. At a time when local authorities are themselves having to watch their budgets, it is the altruistic services—the support services—that tend to go. The challenge I face is that as authorities look just at their statutory obligations, they may end up spending more money to deliver those than they spent on some of the support services beforehand. I have every sympathy with the point that the hon. Lady has made.

[Dr Drew]

May I pay my own tribute to the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan)? The hon. Gentleman is doing a very good job of reading her speech.

What parents find most frustrating are instances in which a care plan has been agreed and is in place, and the local authority then tries to renegotiate downwards the sum that has been agreed. That causes problems for the parents and, obviously, for the person with autism, but is also causes problems for, in particular, specialist units. Does the hon. Gentleman agree that that is unfair, and the wrong way to go about dealing with this whole problem?

[Huw Merriman]

I certainly do. The challenge is to ensure that care plans are flexible enough to be built on, while also including an element of prescription so that there is a proper guide. What must not happen is plans being effectively reneged on when care and support are still needed. The hon. Gentleman made his point very forcefully. He also said that I was doing a good job reading the speech; I will carry on doing my best.

I was talking about the impact on services, as my right hon. Friend the Member for Chesham and Amersham puts it,

“from education to adult support, from diagnosis to employment, transition to transport. We know the many ways that an autistic person may turn to the state—and to us—for support, and how vital it is to make sure it is there to meet their needs.

The last national strategy ‘Think Autism’ in 2014 included wide-ranging actions. This was underpinned with revised statutory guidance, setting out clear duties on councils and the NHS to deliver on these actions—but we know that many local areas are not meeting all of their obligations. There are also questions about whether the Act goes far enough. As we reach the 10th anniversary of the Act, now is an appropriate time to ask these questions.

The All Party Parliamentary Group on Autism, which I am proud to chair, is spending this year doing just that. We are holding an inquiry into what has worked, what happens now and, most importantly, what needs to change. We are looking very broadly, to reflect the needs of autistic people,”

including in health and mental health; children, education and transition; employment; access to justice; adult support; and public understanding.

[Kevin Brennan (Cardiff West) (Lab)]

I welcome the APPG’s inquiry, and, in particular, the fact that it will look into the way in which adults with autism interact with the criminal justice system. I think that is an area in which the work of the Act could be extended. I pay tribute to the families who set up an organisation called Autism Injustice, and recommend its website, autisminjustice.org, to other Members and to people watching our debate who are interested in that interaction between autism and the criminal justice system.

[Huw Merriman]

The hon. Gentleman has referred to adults, but I remember going on a trip with the APPG to a young offenders institution that had tried to establish a wing that was autistic-friendly, and hoped to roll it out across the estate. He is right: a big cohort of the prison population are on the spectrum, and face particular challenges that need to be looked at.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

Will the hon. Gentleman give way?

--- Later in debate ---

[Huw Merriman]

I will give way one more time, but I really should make some progress.

[Bambos Charalambous]

The hon. Gentleman mentioned the issue of employment, which is vastly overlooked. Many employers do not know what adjustments they should make to become more autism-friendly, and people with autism are deprived of work as a result. Will the inquiry be looking at that issue?

[Huw Merriman]

A few years ago, Ambitious about Autism produced a big report looking looked at that specifically. I am fortunate to have in my constituency an organisation called Little Gate Farm, which takes people who have finished their education and makes them work-ready. However, it requires employers to give them a chance, and I am always writing to employers urging them to do so.

Let me give some examples. One young lad was obsessed with washing cars. We matched him up with a garage, and that is exactly what he does. Someone else was given a job in a bookkeeping firm. The big challenge there is ensuring that that young person takes time off, because they have become so used to the routine. The initiative has become so successful that people are throwing themselves into work. We must do all that we can, as Members of Parliament, to pair and support people.

My right hon. Friend the Member for Chesham and Amersham says that we in the APPG

“will hold the Government’s feet to the fire to see those recommendations reflected in the new strategy.

Our need to act is clear. Too many people”—

as we have just discussed—

“still have to wait too long for a diagnosis—more than three years in some parts of the country. Getting a diagnosis can be a crucial milestone, helping to unlock vital support. Delays in being diagnosed can result in people developing more significant needs, or mental health problems.

National guidance from the health watchdog NICE state clearly that children or adults suspected of being on the autism spectrum should start their diagnostic assessment within three months of being referred to their local autism team. But we know there is a postcode lottery in waiting times for appointments, with many parts of the country falling far short of the three-month target. Alongside the National Autistic Society, we have been pushing progress on this issue in this very chamber for several years. Valuable research”—

carried out by the right hon. Member for North Norfolk (Norman Lamb)—

“on behalf of the APPGA shone a further spotlight on these long waits and called for a mandatory minimum waiting time standard. I am pleased to have him on board again leading our inquiry on health and mental health, which heard evidence last week.

We also know that autistic people too often don’t get the physical and mental health care they need. They face high levels of health inequality, and evidence suggests that people may die early as a result, which has been highlighted by Autistica. It’s vital that all health and care staff receive autism training to ensure that our health service meets their needs and makes the changes and adjustments that it needs to—a key part of the Autism Act. I welcome the Government’s current proposals on mandatory training in autism and learning disability to all health and care staff following the dogged campaigning of Paula McGowan, a mother who tragically lost her son Oliver. It’s vital that this proposal is taken forward and that its impact is monitored. I hope the Minister will devote some time to make sure that this programme makes a difference.

I also welcome the inclusion of autism, alongside learning disability, as one of the four clinical priorities in the NHS 10-year plan to improve health services. This is a great step towards ensuring that the NHS supports autistic people as well as it supports everyone else. It sets out actions to reduce children’s diagnosis waiting times, reduce the number of autistic people inappropriately under section in mental health hospitals, and making sure that reasonable adjustments are put in place. But we need more details on how these, and other commitments in the Plan will be delivered (and how they will be funded). I would appreciate if the Minister could update the House on when we can expect to see this much-needed detail.

I am pleased to see the Government already thinking ambitiously about the future of the strategy. I warmly welcome the Government’s commitment to extending the autism strategy to include children and young people, as well as adults, for the first time.”

[Mr Philip Dunne (Ludlow) (Con)]

My hon. Friend is making an exceptionally powerful speech, and I applaud his role as chairman of the all-party group. It is particularly impressive that he has been able to pick up the role in this debate of my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) in her absence.

Returning to the question of education, my hon. Friend touched on the subject of young people a moment ago. Does he agree that the Government’s recent announcement of an additional 37 schools across the country to provide special needs support for people, including those on the autistic spectrum, is a welcome recognition of the challenges presented to our education system by the increasing prevalence, regrettably, of autism across our communities?

I would like to highlight one story in my constituency that points out the need for such schools. It involves a mother of two autistic children, both of whom have to be schooled over 100 miles away from Ludlow, in the heart of my constituency, where she lives. She has campaigned with a local charity and not-for-profit group to open a new school—Overton school, just outside Ludlow, which is currently awaiting its Ofsted accreditation—partly so that other families who have to deal with the same circumstances will not have to travel 100 miles to visit their children.

[Huw Merriman]

My right hon. Friend is absolutely right, and I know how much he campaigns to deliver the solution he talks about because I am fortunate enough to share an office with him. He is a great champion of his constituents, and it is welcome news that more schools will be funded. The Minister will have heard his powerful pitch for his constituency. I can also reassure all Members that I am only temporarily sitting in for my right hon. Friend the Member for Chesham and Amersham; she will continue to be the chairman of the all-party group. I will now make progress, as I know others wish to speak.

My right hon. Friend the Member for Chesham and Amersham continues:

“For many families of autistic children, securing the right support for their child at school is a very difficult task—much harder than it should be. I am sure we have all been contacted by constituents who are struggling to get the school provision and support their autistic children need—this may be a place at a specialist school, or support to enable them to thrive and make progress in a mainstream school…

There’s one other very important issue that I want to draw to the attention of the House and the Minister. That is the continued inclusion of autism in the Mental Health Act as a mental disorder.

What this means is that autistic people and those with a learning disability—particularly those who have behaviour that is described as ‘challenging’—can be detained under the Act when they do not have a treatable mental illness. When this is twinned with a lack of appropriate support, particularly crisis support, to prevent someone being admitted to hospital, we see the numbers of autistic people in these hospitals increase.”

I would like the Government to address that challenge and issue.

I will conclude—I have failed to deliver my right hon. Friend’s entire speech, but she will be delighted that we have had a debate about this and raised awareness, so I finish on the following note. She says:

“Autistic people—children and adults—need the right support, at the right time, in their local communities. The wider community needs to have a much better understanding of what autism is and how it affects people. There are things that all of us can do to make our society a more inclusive place for everyone—in World Autism Awareness Week and beyond”,

that should be our goal.

[Several hon. Members rose—]

--- Later in debate ---

[Huw Merriman]

Thank you for chairing us this afternoon, Madam Deputy Speaker.

I have heard it said that Parliament is not delivering for the people. May I send a message and invite everybody here to join me in sending a message to people with autism or Asperger’s and their families? With the voices of my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan), the hon. Member for Bristol West (Thangam Debbonaire), my hon. Friend the Member for North Cornwall (Scott Mann), the hon. Member for Liverpool, West Derby (Stephen Twigg), my hon. Friend the Member for Dudley South (Mike Wood), the hon. Member for Dulwich and West Norwood (Helen Hayes), my hon. Friend the Member for Berwick-upon-Tweed (Anne-Marie Trevelyan), the hon. Member for Cardiff West (Kevin Brennan), my hon. Friend the Member for Henley (John Howell), the hon. Member for Strangford (Jim Shannon), my hon. Friends the Members for Torbay (Kevin Foster) and for Copeland (Trudy Harrison), the hon. Members for Glasgow East (David Linden) and for Dewsbury (Paula Sherriff), my hon. Friend the Minister for Care—I thank the Minister for all her commitments this afternoon—and the many others who intervened, the message is that we understand the challenges autistic people have to go through every day, and we will be by your side and will do our best to make sure that you have the services you deserve.

Question put and agreed to.

Resolved,

That this House has considered services for people with autism.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I am sure that the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) would have been very proud of all the contributions to the debate today, and I hope that the hon. Member for Bexhill and Battle (Huw Merriman) will send her our best wishes.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 19th February 2019 Commons Chamber

[Caroline Dinenage]

The hon. Lady is absolutely right to raise dementia. It is a massive issue in everybody’s constituency and there is hardly a family that is not affected by it in some way. We are on track to meet our pledge to invest £300 million in dementia between 2015 and 2020. We continue to fund research for dementia treatments and cures. The Care Act 2014 introduced a national threshold that defines the care needs local authorities must meet, eliminating the postcode lottery of eligibility across the UK.

[Huw Merriman (Bexhill and Battle) (Con)]

When the Minister of State looks at the proposals for the Green Paper on social care reform, will she consider the German system of compulsory social care insurance? The rate has increased by only 0.94% since its introduction in 1994, while delivering care for dementia and other impacts that were not assessed back in 1994.

[Caroline Dinenage]

My hon. Friend tempts me to do some big reveals about the contents of the Green Paper. I will say that it will look at a number of different funding options.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Steve Brine]

As I suspect the hon. Gentleman knows, I do not have that figure at my fingertips, but I will provide it to him. Health visitors are a critical part of the puzzle, and local authorities are well aware of that, as are Ministers.

[Huw Merriman (Bexhill and Battle) (Con)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

The Department is working with the NHS to ensure that the £20 billion of extra taxpayers’ money is well spent: supporting social care, backing the workforce, using the best modern technology and strengthening prevention. On that note, I can tell the House that we now have a record number of GPs in training: 3,473—10% up on last year.

[Huw Merriman]

I thank the Secretary of State for so promptly accepting our invitation to visit us in East Sussex in January. He will be warmly welcomed. With that season in mind, what assessment has he made of the NHS’s resilience with winter approaching?

[Matt Hancock]

Of course winter always challenges the NHS, and this year will be no different. We have put in extra funding, including more capital funding, to ensure that we get the best possible flow through A&E and to ensure there is further funding for social care so that people who do not need to be in hospital can leave hospital.

Breast Cancer

Huw Merriman Excerpts

Thursday 18th October 2018 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I thank the hon. Member for Crewe and Nantwich (Laura Smith) for leading the debate with such care, passion and expertise. It is a great pleasure to note that the three Front-Bench spokespeople—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), the hon. Member for Washington and Sunderland West (Mrs Hodgson) and the hon. Member for Central Ayrshire (Dr Whitford) —have all served as chairs of the all-party parliamentary group on breast cancer. It is a rarity for all three Front-Bench spokespeople to have so much knowledge and, indeed, to care so much about the issue that they have spent their time campaigning on it in Parliament. I salute all three of them for their work on this matter and I very much look forward their contributions.

The statistics are well known and well rehearsed, but I want to put them on record. In the UK, 55,000 women and 350 men are diagnosed with breast cancer every year. Sadly, one in eight women will be diagnosed with breast cancer, 35,000 women are living with secondary breast cancer, and nearly 1,000 women die from breast cancer every month. Nearly 700,000 people in the UK are living either with or beyond breast cancer treatment. The positive that we can look at now is that 80% of women survive for five years or more. The title of the debate on the Order Paper, “Future of breast cancer”, is crucial, because it is all about the future. The progress made so far has been absolutely extraordinary, but we must not rest on that progress; we must look further forward and do even more, as science and medical developments allow us to.

I would probably have trotted out those statistics a couple of years ago when speaking on this matter, because it impacts on my constituents. However, personal experience of a loved one being struck down with breast cancer makes me more determined to be here to represent their cause and that of the thousands of women across the country who have to go through the same experience. I salute the courage and bravery of all who have been diagnosed with breast cancer and who have gone through the treatment. To watch those people undertake that brave journey is a humbling experience, because when I saw it with my own eyes, I thought, “Could I actually do this? Would I have the bravery and the strength to go through this myself?” It was the most extraordinary experience for me to see that.

I pay tribute to all the carers and those who provide support. They feel helpless, at times, and they wish that they could go through the wretched experience instead. They would do anything to change places, but they cannot. Those people do the most amazing job. On behalf of those who have been through the treatment, I salute all the brave families, friends and loved ones who went through it with them. The inner strength that their support must give to sufferers is absolutely tremendous.

Breast screening uptake is at its lowest level for 10 years, which is very concerning. Uptake is at 71%; the aim is to make that figure at least 80%, which would save 1,200 lives per year. If the Minister has time, I would like him to reassure us that the Government will take action in their attempt to reach that target. Screening is, of course, still age-based, and it was sad for me to note that the entry-level screening age would have been too high for the family member I referred to, who was only 42 when they were diagnosed.

It is incredibly exciting to meet groups such as Breast Cancer Now, which is carrying out a generation study, following 113,000 women from the UK over 40 years. I was absolutely blessed and fascinated to meet the people involved in that study at a recent all-party parliamentary group meeting. Of course, age is one profile, but we need to look at high-risk scenarios and investigate the genetic, lifestyle and environmental factors that can change the likelihood of a woman developing breast cancer. That study, which I think is exciting, identifies 160 common genetic changes associated with the development of breast cancer, as well as showing how various life events—such as the menopause—and lifestyle factors can have a great impact. The future is bright, because rather than just looking at age ranges, we are now really going into the detail with those studies to show how certain factors can lead to risk and then, where there is risk, providing screening. That is hugely important.

I paid tribute to those who go through breast cancer treatment and to their carers, who go through it with them, but I also want to touch on the phenomenal work that NHS staff do for everyone who goes through that journey. I thank them; they are the most extraordinary people, in terms of their sheer intelligence. It is incredibly reassuring to meet such bright, dedicated people. The other great thing about them is that they deal with everything in black and white—there is no messing around—and tell people exactly what is going on. It can sometimes be stark, but it reassures people that they are being led to the right conclusion.

Of course, there are workload impacts. We know that the NHS faces challenges, and cancer departments absolutely share those challenges. A Macmillan Cancer Support survey from last year highlighted the increased workloads, complex patient needs and vacancies in key roles that are putting pressure on the cancer care workforce. Certainly, in my experience with the Maidstone and Tunbridge Wells NHS Trust, the staff were absolutely phenomenal. When things did not work, it was often because they did not have what is called back-office support. As a result, consultants have to run around doing admin work instead of focusing on their medical and clinical expertise, making them very expensive and overqualified admin resources. We often talk quite clinically about back-office savings, but perhaps we need to look very carefully before making such savings if they will have an impact on frontline services.

Some of the NHS communications systems can be incredibly clunky. Finding out via Royal Mail that one has an appointment after the appointment is due to take place—not just once, but twice—is maddening. These days, we embrace technology. We are told about dentist appointments via text messages to which we can respond to confirm, and the NHS should be doing the same thing. Before my journey with breast cancer, I was critical of people who missed appointments, but I had not reflected that people might miss appointments because they have not been told that they are taking place. It is maddening for consultants, because once people have received their notification, they are not even required to reply to confirm that they will attend their appointment. Of course, no one in the hospital thinks, “Someone has not got back to me; perhaps they have not received the letter.” We sat waiting in the hospital for hours, because the system did not know we were there despite the fact that we had booked in. That is maddening for patients, and maddening for consultants and staff.

Such issues may seem quite trivial, but they caused me to go back to the hospital to meet the heads of service to ensure that I could convey the concerns of frontline staff to senior management. I thought that that was the least I could do after the care and attention that the staff had given us.

I therefore ask my hon. Friend the Minister to think about the support staff, the systems that are in place and how we can better support the staff who help us to get better. I express my immense gratitude for those people and the support, expertise and help that they provide, not just during the treatment but on the journey beyond. That is the other thing that I have noticed: once a patient is given the all-clear, which is the best news, all of a sudden they face another journey, on which they will not necessarily be with clinicians. They will still have support staff from organisations such as Macmillan, who take great care of people.

I find myself speaking from experience, having been on an incredible journey that taught me a great deal about those who go through cancer and those who care for us through cancer. It has made me vow that I will always do everything I can in Parliament to try to make the situation better. I look forward to those on the Front Benches reassuring us that they will do the same.

--- Later in debate ---

[Steve Brine]

There is so much more that I want to get on to, so I will not go into that in any great deal, but I will give the hon. Lady a note on that. Lord O’Shaughnessy, who is part of the Department’s drugs team and who speaks on health in the other place, is working on the implementation of that legislation. The hon. Lady has asked me about this before, and it frustrates me incredibly that that Act is not being implemented more quickly, but that should not be taken as any indication of a lack of desire on our part to do so. However, I take the hon. Lady’s point.

It is still right for those prescribing decisions to be made by clinicians. However, I want breakthrough drugs to make it on to the market more quickly, instead of staying in the cancer drugs fund. There are good examples of that related to breast cancer, and we want to see it happen much more quickly.

My dear hon. Friend the Member for Bexhill and Battle (Huw Merriman) spoke personally and passionately —as always—about these matters, and I thank him for that. He raised lots of issues, including the screening programme. Everyone says that the breast cancer screening programme is a critical tool in ensuring that we catch breast cancers as early as possible, when there is a higher chance of successful treatment. However, we know that there is much more to do to improve uptake. In her party conference speech, the Prime Minister set out that we would transform our screening programmes, making them more accessible and easier to use and utilising the best research and technology. Further detail on that will be set out in the long-term plan later this year.

My hon. Friend also asked about technology in screening. I will come on to the screening scandal in a moment, but it is very much our aim that in the future patients will be able to make much greater use of technology to be informed of things, such as GP or screening appointments, rather than relying on Royal Mail. Our NHS app is being piloted and will be rolled out from December this year. That is just the start of the technology revolution that we want to see and that the Secretary of State has made one of his priorities. We expect the independent breast screening inquiry to make recommendations in that area.

Several Members asked about the inquiry into the breast screening problems that we had. We expect that to report shortly. I do not have an expected date, but several Members, including the hon. Member for Central Ayrshire and the shadow Minister, asked whether it is on schedule. I believe that it is, and I look forward to that report very much. With somebody as serious as the Macmillan chief executive leading that review, alongside others, I know that it will challenge us, as it is meant to; the former Secretary of State set it up to do so.

My hon. Friend the Member for Bexhill and Battle mentioned the importance of early diagnosis. I am proud of Public Health England’s Be Clear on Cancer campaign, which I am responsible for. PHE ran its 14th Be Clear on Cancer campaign through February and March of this year, focusing on breast cancer in women aged over 70—a subject that is very close to the hearts of members of the APPG. Research shows that older women are more likely to delay presenting to their GP with breast cancer symptoms.

The campaign previously ran in 2014 and 2015, and an evaluation showed an increased awareness of the key messages that it promoted and, even more importantly, that more cancers were diagnosed during the campaign period. We are running the “Blood in Pee” campaign at the moment—I have all the glamourous things in my portfolio—and Be Clear on Cancer will go forward and from strength to strength.

[Huw Merriman]

I am incredibly impressed by what the Minister has said so far. Will he keep an open mind on the age limits for screening—particularly the entry age? I know that it has been reduced, but will he keep an open mind on reducing it further?

[Steve Brine]

I always keep an open mind. The truth is—the hon. Member for Central Ayrshire knows exactly what I will say—that although the screening review will no doubt make recommendations on that, there is a very heated and divided debate within the breast cancer community around screening, and not just about the age at which to begin it. We had the AgeX age extension trial, which broadened the range of ages at which we screen, but there is absolutely no consensus within the breast cancer community on the benefit of screening. That debate continues and rages strongly, and it is for policy makers to listen to all the different views, as the screening review will do.

Several Members, including the shadow Minister, rightly mentioned clinical nurse specialists and the cancer workforce. Last December, Health Education England published its first ever cancer workforce plan, which committed to the expansion of capacity and skills in fighting the big C.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 24th July 2018 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

Will the Secretary of State come down to East Sussex to view the Better Together partnership, which puts health and social care together?

[Matt Hancock]

How could I say no? The integration of health and social care is vital and long awaited, and there is so much to do.

NHS Outsourcing and Privatisation

Huw Merriman Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to contribute to the debate. I want to start by recognising the achievements of the Tony Blair Government in taking the ideology out of private-public, which was good, and fast-tracking a number of patients who had been waiting too long for knee or hip replacements by allowing those operations to take place using the private sector. My own family were able to benefit from that. That was a good example of looking at what was best for the patient. It was still free at the point of delivery and ultimately within the health system.

I find it deeply depressing to hear those on the Labour Front Bench this afternoon talking in a manner that completely unwinds that, putting the NHS as a political football first and what is best for patients second. The shadow Health Secretary was so excited about the concept that I thought he was going to spontaneously combust. It is a stain on the Labour party that it would go back in time in that manner.

Far from the exaggerations that we heard, the reality is that the proportion of private spend has gone up from 5% when Labour left office—not, as the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) said, 2.5%—to 8%. Since the NHS has been born, as GPs refuse to work within the NHS system, we have had private sector partnering. We have pharmacies. We have the pharmaceutical industry. The public and private have always worked together to make sure the patient gets the best outcome. I hope that somewhere along the line, the Labour party goes back to the formula that quite frankly got it into government and remembers that the public are not concerned about the politics. They just want to make sure that the NHS will be there for them in the fastest possible time, with the best care and free at the point of delivery—and that is what goes on at the moment.

We are seeing record levels of funding within the NHS, as we did under the Blair Government; I hope Members see that I am being fair and trying to make a cross-party point. I would like to see more funding in the NHS. While I do not like to see taxes go up—I would be the last person on the Government Benches to argue for that—I think the point has come when we need to look at our income tax rates and face facts. People are living longer, and they need better care. We need more money in our social care system as well.

As well as more money, we need reform. Reform only works when more money is put into the system. As well as seeing an extra 1p on income tax, I would like to see another penny effectively suspended. We can then go back to the public and ask whether they think it is acceptable that people abuse the A&E system and the people within it, and whether people should be charged if they turn up wrecked and take advantage. Is it acceptable that people mess around their GP surgeries, wasting time and money for GPs? If that does not work, perhaps we should put a second penny on income tax, because we need to take tough decisions to make this work.

Another point I want to make comes back to political footballs. Reference has been made to Sussex patient transport, and I chaired the group on that. It was a good example of a cross-party group that with other MPs—including my hon. Friend the Member for Lewes (Maria Caulfield), and the hon. Member for Hove (Peter Kyle) from the Opposition—worked with the CCG to try to find a solution. The reality was that the contract was not stripped out of the public sector. The South East Coast Ambulance Service NHS Foundation Trust refused to carry on the service: it said it was not interested, did not tender and gave it back. There was only one bidder in town—Coperforma. The system did not work well, which is why I was glad that another bidder, not present at the time, eventually came forward. Facts matter!