Hepatitis C

Jim Cunningham Excerpts

Tuesday 12th June 2018 Westminster Hall

[Sir David Amess (Southend West) (Con)]

I beg to move,

That this House has considered elimination of hepatitis C.

I should tell the House at the outset that I am not really the instigator of this opportunity to debate hepatitis. The colleague who had succeeded in securing the motion is not able to be here, but I am delighted to share my thoughts with the House.

I was a member of the Health Committee from 1998 to 2007, and during that time we certainly spent a lot of time considering hepatitis. I am also the co-chairman of the all-party parliamentary group on liver health. I have been the chairman now for some 13 years—simply because I do not think anyone else wants to take on the mantle, to be frank. When we set up our all-party parliamentary group, we looked for a celebrity to head it all, as one does, and we chose George Best. The House might feel that George Best was an unlikely person to head up the charity, but at that time he was a reformed character, and he did a lot of good in those early years. Unfortunately, as we all know, a great toll was taken on his health and, sadly, he died.

We then looked for another celebrity, and—what a joy—Anita Roddick of The Body Shop, who was a wonderful and remarkable lady, became our patron. She died in 2007. The House may know that she contracted hepatitis C from a blood transfusion in 1971 and was unaware that she was living with the disease until 2004. A routine blood test revealed the diagnosis. She was a tireless campaigner, and we owe her a great debt of gratitude, but since 2007 we have struggled to find a patron to head up the organisation as president. If colleagues have any ideas, I know our APPG would be glad to hear from them.

The APPG recently conducted an inquiry into the elimination of hepatitis, and in March it launched a report entitled “Eliminating Hepatitis C in England”. It is my intention to refer to the report’s recommendations throughout my speech. We have an excellent Minister here, and I hope that both he and the shadow spokesperson have had sight of the report. If not, we will ensure that they get it in full; perhaps they could come back with their suggestions on how we might take the recommendations forward.

In our report, we suggest raising awareness, prevention, testing and diagnosis, care and treatment, funding and monitoring progress, so we have covered every single aspect. I take this opportunity to pay tribute to Charles Gore, the former head of the World Hepatitis Alliance, and to the secretariat of the APPG, the Hepatitis C Trust, for all their assistance. They have been wonderful in all the work they do for us, ensuring that our group is effective.

On 14 December, I visited Her Majesty’s Prison Wandsworth—not because I had been sent to prison but, ironically, to accompany the Minister who has resigned from the Government today, my hon. Friend the Member for Bracknell (Dr Lee), although I do not think his resignation was the result of our visit. It was a very good visit indeed, and of course it is in the constituency of the hon. Member for Tooting (Dr Allin-Khan).

The visit allowed us to tour the secondary screening and healthcare facilities in the prison and to participate in a roundtable on the subject of the hep C virus and the importance of testing and of attending appointments. It was a wonderful visit; I pay tribute to the governor, and I know the Government are focused on the excellent work that is being done there. We talked to inmates and the governor, and the Ministry of Justice, NHS England, the Department of Health and Social Care and Public Health England were represented.

Perhaps the Minister and I should have compared notes, but I will say a little bit about what hepatitis C is. As I am sure that most hon. Members are aware, it is a blood-borne disease that affects the liver. It can subsequently lead to liver cirrhosis and cancer, and it has been linked to cardiovascular disease, musculoskeletal pain, kidney issues and mental health problems. I see we have two practitioners present in the Chamber; they might want to contradict me if they think I have got the cause of hepatitis C wrong.

The virus is said to chronically infect some 71 million people globally. Sadly, 214,000 of them reside in the United Kingdom. That is why I welcome the United Kingdom’s decision to join 193 other states in signing the World Health Organisation’s global health sector strategy on viral hepatitis in 2016. It has the principal aim of eliminating hepatitis C as a major public health threat by 2030—and I believe that if we are serious about that, we can do it. At least one Member of the House of Lords, who regularly attends our APPGs, has the illness himself. He speaks with great passion in the other House about the challenges he faces.

I say to my hon. Friend the Minister that I also welcome the target announced by NHS England in January of eliminating hepatitis C by 2025, five years ahead of the WHO. However, many problems surround the virus and its elimination, and confusion persists over how the virus is spread. Many people do not appreciate that it is spread by blood-to-blood contact. Instead, some still believe it can be spread by sneezing, coughing, spitting or other forms of physical contact. I am advised that that is not the case and it is only blood-to-blood.

Furthermore, it is estimated that between 40% and 50% of the approximate number of people chronically infected with the virus in England do not know they have it. At the start of the debate, I pointed out that Anita Roddick did not know she had it until she was tested in 2004. Between 64,000 and 80,000 people are living in England without the knowledge that they have the virus. Even more worrying is the Polaris Observatory’s prediction that the UK is set to miss the WHO target of eliminating hepatitis C by 2030.

[Mr Jim Cunningham (Coventry South) (Lab)]

I welcome the efforts the Government are making to tackle this problem. I do not want to digress too much, but there is still the outstanding problem of contaminated blood. The hon. Gentleman knows that as well as I do, because we have had many debates on this in the House of Commons. Even the previous Prime Minister said he was going to do something, but nothing has really happened yet, and there have also been allegations that some of the records—for want of a better term—have disappeared somewhere. We asked for an inquiry into that in the last Parliament.

NHS Outsourcing and Privatisation

Jim Cunningham Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

I shall take your guidance, Mr Deputy Speaker. It is always a pleasure to indulge the right hon. Lady, but I have to point out to her that Councillor Cutts of Nottinghamshire County Council is cutting care homes across Nottinghamshire. The record will show that.

[Mr Jim Cunningham (Coventry South) (Lab)]

rose—

[Jonathan Ashworth]

Given that Mr Deputy Speaker has just castigated me, let me make a little progress. Hopefully, I will be able to take more interventions towards the end of my remarks.

Underfunding and lack of capacity have driven more and more—

--- Later in debate ---

[Jonathan Ashworth]

I say to the right hon. Gentleman, of whom I am tremendously fond, as he knows, that I agree broadly with the point that he is making. If my memory serves me correctly, he sits for a Sussex constituency and, of course, in Sussex, we had the shambles of a patient transport contract that went to a firm, Coperforma, which did not even own any ambulances and which was leaving patients stranded on their doorstep waiting for transport to dialysis appointments and to chemotherapy appointments. It often could not then pick up the patients from the hospital and take them home. That contract had to come back in-house. It is these types of privatisation that we believe are doing great damage to the health service.

[Mr Jim Cunningham]

rose—

[Jonathan Ashworth]

My hon. Friend has been very patient, so I will give way to him.

[Mr Cunningham]

My hon. Friend has been generous in giving way. Does he agree that private companies are also increasing car parking charges, which is a tax on patients, and that, more importantly, because of the lack of social workers we have bed-blocking in the national health service, too?

[Several hon. Members rose—]

Education (Student Support)

Jim Cunningham Excerpts

Wednesday 9th May 2018 Commons Chamber

[Mr Jim Cunningham (Coventry South) (Lab)]

Once again it is women who are being hurt, particularly adult women who have brought up a family and want to take up a new career in nursing. They are being denied that opportunity or being forced into debt.

[Angela Rayner]

Forced debt for students and nurses of whatever gender is a really important issue, which I will come on to. My hon. Friend is absolutely right to highlight that we need to encourage both genders to see nursing as a legitimate career.

I mentioned that there are 700 fewer students training to be nurses. That is the first fall in close to a decade.

Cancer Targets

Jim Cunningham Excerpts

Tuesday 1st May 2018 Westminster Hall

[Mr Baron]

I thank the hon. Gentleman for his kind words. I am aware of those statistics, and I will come to the 62-day target specifically later in my address. He is right to say that many CCGs and cancer alliances are not close to achieving many of those targets. That is obviously a problem when treating cancer, but it highlights a bigger issue: we should be focusing on outcome indicators rather than process targets as a means of encouraging earlier diagnosis. I will address his point specifically in a moment.

We tried very hard to get the one-year survival rates into the DNA of the NHS. The Government listened, and we now have CCGs being held accountable for their one-year survival rates, which is good news. The logic is simple: earlier diagnosis makes for better survival rates, so by holding CCGs to account for their one-year figures and, in particular, the actual outcomes, we encourage the NHS to promote earlier diagnosis and therefore improve detection.

A key advantage of focusing on outcome measures is that it gives the local NHS the flexibility to design initiatives tailored to their own populations to improve outcomes. CCGs can therefore choose whether to widen screening programmes, promote better awareness of symptoms, establish better diagnostic capabilities in primary care, embrace better technology or perhaps improve GP referral routes—any or all of those, in combination—to try to promote earlier diagnosis, which in turn will improve the one-year cancer survival rate figures.

Rather than the centre imposing a one-size-fits-all policy, the local NHS has been given the freedom to respond to and focus on local priorities, whether that be lung cancer in the case of former mining communities or persuading reticent populations to attend screening appointments. As an all-party group we try to do our bit. Each summer, the group hosts a parliamentary reception to celebrate with the 20 or so CCGs that have most improved their one-year survival rates. Successive cancer Ministers have supported that in the past, including the incumbent.

There is strong evidence, however, that that outcome indicator is being sidelined by hard-pressed CCG managements, who are focused on those process targets that are connected to funding. If the process targets are missed, there is a cost; if the one-year figures are missed, there is not. In recent decades, the NHS has been beset by numerous process targets that, instead of measuring the success of treatment, measure the performance against process benchmarks, such as A&E waiting times.

[Mr Jim Cunningham (Coventry South) (Lab)]

I pay tribute to the hon. Gentleman, because I know he has a strong interest in this issue for a number of reasons—as we all have, because cancer in one form or another touches nearly every family in Britain. I agree with him that it is the outcomes that matter, not the input. I wonder whether the targets are in the wrong place; I may be wrong, and the hon. Gentleman knows more about it than I do, but I think he has made an important point. The problem seems to be how to get the NHS to implement that.

[Mr Baron]

I completely agree. The problem as I understand it is that, according to the House of Commons Library, there are something like nine process targets focused on cancer alone. Briefly, it is an inconvenient truth that, if we look back over the past 20 or 30 years, we will see that the NHS has been beset by process targets from both sides and for the best of reasons. The bottom line is that we have not caught up with international averages in any meaningful way over those 20 to 30 years, so we must start to question the efficacy of those process targets when what we are trying to do is to improve survival rates. If we get the NHS focused on one-year survival rates, it should look at the journey as a whole, not just a small part of it, in trying to promote initiatives to encourage earlier diagnosis, which at the end of the day is what we all have to do if we are to improve survival rates.

Lung Cancer

Jim Cunningham Excerpts

Thursday 26th April 2018 Commons Chamber

[James Brokenshire (Old Bexley and Sidcup) (Con)]

I am very grateful to you, Mr Speaker, for your kind wishes and kind comments and the support that you have given to me as I renew my acquaintance with the ways and processes of the Back Benches. I very much appreciate your kind words and support.

A week ago today, I had the privilege to speak in the brain tumour debate inspired by the incredible work of Baroness Tessa Jowell. It was one of those very special moments in this House, which was made even more poignant by Tessa being present to hear the debate and to hear the tributes to her courage, her spirit and her determination to bring about positive change for people to live well with cancer for longer. The abiding theme through all that debate was a message of hope—hope for the future, hope for others, and hope in the face of personal physical adversity. There was also the overriding power of human kindness, compassion and love, and I want to return to some of those themes later on.

At the end of August last year, I was out in Northern Ireland for a family weekend. It was a Saturday afternoon and we had had some fun exploring somewhere new with the kids and we were about to have some lunch. I had just sat down when I realised that I needed to clear something from my throat, thinking that it must be a bit of food or perhaps some phlegm. The next think I remember is looking down and realising that my tissue had a bright red blob of blood in it. I felt my heart pounding and a knot at the very pit of my stomach at the shock. That is the thing about cancer: half of us will get it, and it can strike just when we least expect it.

Of course, I could have left it; we blokes are pretty good at doing that. I felt fit and full of energy and I did not have any pain. It actually never happened again. I could have said, “It’s a one off; it’ll just sort itself out.” I did not, because deep down I knew that something really was not right. I trusted my instincts. I did not delay in going to see my GP. I trusted his advice in seeing a consultant when my initial X-ray was clear

“because we probably shouldn’t just leave it there.”

I trusted my consultant’s advice to have a bronchoscopy—a tube down my throat to have a poke around in my lungs—after my CT scan showed a small area of inflammation

“because we probably shouldn’t leave it there.”

At each stage, I could have left it there. I was too busy with work, too busy with Brexit and too busy with the Northern Ireland political talks, but I did not leave it there and that saved my life. I was lucky because my cancer was caught early. I was able to receive curative treatment—surgery to remove the upper part of my right lung—but, sadly, too often that does not happen. Too often people find out that they have cancer too late, and that is what we need to change.

Every year around 36,000 people will die from lung cancer. That is more than breast, prostate and pancreatic cancer combined. It is the UK’s biggest cancer killer and survival rates remain stubbornly poor. One of the main reasons for this is that it is detected at a point when curative treatment is no longer an option. Two thirds of lung cancers are diagnosed when the disease is at an advanced stage. Let me give hon. Members a sense of what this means. Some 83% of lung cancer patients diagnosed at stage 1, when the cancer has not spread, survive their cancer for at least a year. This drops to just 17% at stage 4, when the cancer has spread to another organ. But this is not a numbers game. It is real life—and death.

The Roy Castle Lung Cancer Foundation, which does such excellent work, gave me just one example of this stark reality. Steph lost her dad to lung cancer in December last year. He died 12 weeks after diagnosis. She said:

“I think the worst thing was my dad wasn’t given the opportunity to really fight it.”

We are talking about mothers, fathers, brothers, sisters, friends, loved ones and colleagues. Lives are cut short because we do not pick up on the signs and symptoms. We just do not get it picked up quickly enough.

Symptoms could include a persistent cough that just will not go away; feeling breathless but just not knowing why; hoarseness in the voice; unexplained tiredness or lack of energy; weight loss that cannot be understood; coughing up blood. Yet, according to opinion research commissioned by the British Lung Foundation and BritainThinks, one in five people in the UK are unable to name any symptoms of lung disease at all. Smoking is a clear risk factor, but many people who have never smoked develop lung cancer. I was one of them. Around 15% of lung cancers are in non-smokers. Given that 46,000 people are diagnosed each year, that is a big number in its own right.

I have been struck by the number of people who have asked me, “Did you smoke?” And that is how I have come to appreciate that stigma and misperceptions can be a barrier to getting people the help they need. Rightly, we have made huge steps forward in smoking cessation programmes. We have firmly cemented in people’s minds that lung cancer and other lung diseases are caused by smoking. But there are unintended consequences. Lung cancer can be caused by a number of factors, not just smoking, yet British Lung Foundation opinion research suggests that as many as a quarter of us assume that everyone with a lung condition is a smoker. This was brought home to me when I was contacted by someone with cystic fibrosis—a genetic condition—who told me that even he had been asked if he had smoked. There is even the suggestion that lung conditions are considered less sympathetically.

If someone links lung cancer so strongly to smoking and they have never smoked, they might simply ignore symptoms. Equally, if someone has obvious symptoms but is struggling with feelings of guilt or blame because they do smoke, they might not seek help. We need to challenge perceptions and ensure that stigma does not get in the way. We need to see that people with lung cancer receive the support and treatment they need, whether or not they have smoked.

[Mr Jim Cunningham (Coventry South) (Lab)]

It is good to see the right hon. Gentleman back, hale and hearty, as we say in Scotland. I wish him well for the future. He is quite right that not everybody who gets lung cancer is a smoker. Attention is often not drawn to health and safety at work, but people should be very careful. Workers who deal with deadly industrial processes are not always aware that this could have quite an effect on their health. Medical science is now gradually starting to make some breakthroughs, which gives us all a little bit of hope. I hope that he will touch on that.

[James Brokenshire]

The hon. Gentleman is prescient, because I was about to say that I believe there is real reason to be positive about what we can achieve.

Since my diagnosis, I have met leading experts in the field in the charitable sector and within our NHS. I have experienced incredible care by amazing NHS professionals on the frontline and spoken to experts in the field working on ground-breaking programmes. I have heard about new immunotherapies that are offering new hope even when surgery is not possible. I have even donated a small sample from my own tumour to an amazing Cancer Research UK programme to help understand cancer better by getting to the heart of its DNA to get to grips with its specific genetic make-up, help us find its weaknesses, and destroy it.

I commend the work of the NHS England clinical expert group for lung cancer, chaired by Professor David Baldwin, in seeing that speedier routes to diagnosis and other good practice can be applied across the country. The 10 new one-stop shop rapid diagnostic and assessment centres announced this month to speed up cancer diagnosis where there are vague or non-specific symptoms are another exciting new initiative. There is the work of the cancer taskforce in delivering the Government’s cancer strategy. There is the work of the taskforce for lung health to develop a five-year plan to improve lung health and prevent lung disease more generally. We should be hopeful, we should be positive, and we should be ambitious about what we can achieve and focus on how we can make the biggest impact.

From everything I have seen and experienced, early diagnosis and treatment lies at the heart of this. That is why I believe that a national screening programme for lung cancer is needed, as we have for breast cancer and bowel cancer. We are not starting from scratch. I commend NHS England for its announcement in November of a lung health check programme. It drew on the success of the Manchester scanner scheme, where mobile CT scanners detected four out of five cases of lung cancer in the early stages. In 12 months, the mobile scanning trucks picked up one cancer for every 33 patients scanned. Following this announcement, new lung screening pilots are about to get under way in various parts of the country.

But we risk each pilot doing its work in varying ways—not being joined up and with a fragmented approach to data collection preventing us from making comparisons and harnessing the lessons learned. There also remains some reticence to see this work progress to a national screening programme, with a desire to wait and see the results of the NELSON trial from Holland and Belgium. Yet we have already seen the huge benefits of CT scanning in the United States, and we have already dealt with issues such as false positives in other screening programmes.

There is a real human cost to delay. We should reflect on how many lives could be saved and how many lives are being lost while we wait. One example of this is Bill, whose lung cancer was picked up early through screening. He shared his story with the Roy Castle Lung Cancer Foundation, saying:

“If I hadn’t gone through that scan I could have been dead in a year’s time. The doctor when I went said it’s probably given you ten more years of your life.”

It is because of an overriding desire to see more people enjoy more years of life that I believe we should act now rather than wait. We should commit to a national screening programme and use the pilot programmes to support its implementation. If we want to see a step change in survival rates—to see people living through rather than dying from lung cancer—now is the time to be bold.

The last few months have been hard, knowing that in resigning from Government, my illness would be very public, and knowing that because of the need for a public announcement, many friends and family would be hearing about it on the TV or radio rather than hearing from me directly. When you go through something like this, it puts things in perspective and reminds you of what is really important—most especially, your family and those you love. In so many ways, it is even harder on them than it is on you. I want to thank my wife Cathy and my children Sophie, Jemma and Ben for the love and support they have given me and how they kept me going and kept me positive at some of my darkest moments.

I thank the incredible NHS professionals who have looked after me. They are very special people and without them I would not be giving this speech today. I have also got to know and appreciate even more the work of amazing organisations such as the Roy Castle Lung Cancer Foundation, Cancer Research UK, Macmillan Cancer Support and the British Lung Foundation. I have been humbled and overwhelmed by the kind messages of support, prayers and letters of encouragement from so many people, the contact I have had from people who have gone through or are going through a similar experience and the good advice I have received from key friends. It reminds you of the power of basic human kindness.

I have been very touched by the concern, kindness and support of colleagues from right across the House, some from people I might have expected, and some from people I did not. It has meant a great deal to me at a very difficult time. I hope that we can harness that spirit of good will and the skills, knowledge and experience of Members across the House, so that we can work together to shift the dial on cancer survival and above all deliver on the message of hope that I started with—hope for people receiving a lung cancer diagnosis just like me, hope for the future, hope for a continued life well led and hope for ourselves—and see that more of us are living well with cancer, and living well beyond it.

Social Care

Jim Cunningham Excerpts

Wednesday 25th April 2018 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I beg to move,

That this House notes that Government cuts to council budgets have resulted in a social care funding crisis; further notes that Government failure to deal with this crisis has pushed the funding problem on to councils and council tax payers and has further increased the funding gap for social care; is concerned that there is an unacceptable variation in the quality and availability of social care across the country with worrying levels of unmet need for social care; and calls on the Government to meet the funding gap for social care this year and for the rest of this Parliament.

It has been six months since the House called on the Government to commit the extra funding needed to ease the crisis affecting social care—six months of missed opportunities for the Government to bring more stability to our fragile social care system; six months in which the situation has deteriorated further. The care of older people and of younger people with disabilities seems sometimes to be an afterthought for this Government. The Secretary of State finally made a speech about social care in March, having had the words “social care” added to his title two months previously. Indeed, he told a conference of social workers:

“We need to do better on social care”.

This Government have had eight years to do better on social care.

The simple fact is that since 2010, things have got manifestly worse. I told the House in October that the care system, in the words of the Care Quality Commission, remains at a “tipping point”. Eight years of cuts to council budgets has meant that over £6 billion has been lost from social care budgets since 2010. The diminishing care fees that councils are able to pay in the light of those cuts have further destabilised the care sector, which is already described by the Association of Directors of Adult Social Services as “perilously fragile”.

ADASS reported last year that two thirds of councils had seen care providers close in their areas and that more than 50 councils had contracts with care providers handed back to them. A major chain of care homes, Four Seasons, recently ran into financial trouble, bringing with it the threat of care home closures and uncertainty for thousands of vulnerable elderly people. A few days ago, Allied Healthcare, one of the country’s biggest providers of home care, announced that it would be seeking a financial rescue plan from its creditors. Allied Healthcare has contracts with 150 councils and it cares for over 13,000 older and vulnerable people, so the Minister needs to tell the House how local authorities will be able to discharge their statutory duty to deliver care if Allied Healthcare collapses.

[Mr Jim Cunningham (Coventry South) (Lab)]

On local authorities, my hon. Friend will know as well as I do that because of the cuts to local authority budgets, there is, on the one hand, bed blocking in hospitals, because local authorities do not have enough social workers to prepare a care package, and on the other, when people can go into care, care is so expensive that they cannot afford it. Councils are under pressure to try to make up the shortfall, which they cannot do.

Austerity: Life Expectancy

Jim Cunningham Excerpts

Wednesday 18th April 2018 Westminster Hall

[Louise Haigh]

I could not agree more with my hon. Friend. She makes an important point, because it is exactly those post-industrial towns and regions that were invested in so heavily under the last Labour Government and have seen a fall in life expectancy over the last seven years.

Regional and class inequalities in health, as we know, are nothing new, but there is a more distinct change now taking place. In my city of Sheffield, the healthy life expectancy for women of 57.5 years has dropped by four years since 2009, while healthy life expectancy across the country has basically held steady. There are already too many areas in our country where healthy life expectancy is unacceptably low. The average baby girl born in Manchester between 2014 and 2016 will live to be 79, but only until age 54 will she be healthy. That is almost one third of her life spent grappling with health issues that will not affect the average woman born on Orkney until she is 71 years old.

[Mr Jim Cunningham (Coventry South) (Lab)]

One of the factors, if not the sole factor, is that when we look at the past recession, most of the burden has been inflicted on women generally. We all know that. That is an anxiety factor, and there are good examples of it. One good example is the women of the Women Against State Pension Inequality Campaign. A lot of them were due to retire and had plans; those plans have gone now, because they will not get their entitlement. There are a number of factors that affect women more than men, particularly during a recession.

[Louise Haigh]

My hon. Friend is absolutely right. It has particularly hit older women, and I will come on to that disproportionate impact shortly.

Something is adversely affecting the health of our population, and as my hon. Friend has just said, none of it is happening in a vacuum. The observation is unavoidable that these patterns coincide with the era of austerity. It is simply inconceivable that the state of our public realm, welfare system, housing, fuel poverty, child poverty and our NHS have nothing at all to do with it. The number of NHS trusts with budget deficits has increased sharply since 2015, as have waiting periods for elective surgery and waits for urgent care. Hospitals are now warning of an “eternal winter”, as records show the number of patients receiving urgent care within four hours fell to a record low in March 2018. Almost half a million patients waited longer than 18 weeks for planned care.

This week, the Royal College of Physicians raised the alarm, writing to hon. Members to tell us that hospitals are “underfunded, underdoctored, overstretched”. That will not be news to anybody who has been anywhere close to the NHS in recent years. However, the shortage of doctors and consultants revealed by the RCP is systematic and shocking; 43% of advertised consultant posts last year in Yorkshire and the Humber were not appointed to. In acute medicine, only five out of 26 posts were successfully appointed to. The RCP concludes that these workforce shortages have direct implications for patient safety. Although our hospitals still provide expert care, relentlessly drawing on the good will of staff—who cannot possibly provide the best possible care when under such pressure—is unsustainable.

Issues within the NHS are being compounded by problems with the provision of adult social care. According to the King’s Fund, in 2016-17 there were 380,000 cases of a delayed transfer of care due to patients’ awaiting a hospital assessment. A similar number were waiting for a place in a nursing home. It is little surprise that the sorry state of our social care system should be linked to a fall in the life expectancy of older women living in the poorest parts of the UK, because that cohort has seen a disproportionate fall in their life expectancy. For the first time, health inequality is rising because the most deprived are suffering with poorer health.

I have often heard it said that the elderly have been protected from the worst ravages of austerity, but the elderly who live in deprived communities have been hit many times over. Relevant to this debate, they have been hit first by the cut in pension credit for lower-income groups and then through the funding pressures on adult social care. Of course, it is in the local authorities serving the most deprived areas that these effects have been felt the most.

Autism

Jim Cunningham Excerpts

Thursday 29th March 2018 Commons Chamber

[Dame Cheryl Gillan]

The hon. Gentleman makes a valid point, and I will come on to diagnosis a bit later in my speech.

May I put it on record that while many people associate autism with mental health, it is in fact a developmental condition—a lifelong developmental condition—and not necessarily a mental health condition? Autistic people are as likely to suffer from a mental health problem as anybody else—any neurotypical person. I really want to make sure that nobody in this House ever confuses that, and I hope that that puts the record straight.

I wish to touch on the Autism Act 2009. Almost 10 years ago, I was very privileged to draw No. 1 in the ballot for private Members’ Bills and then to take through the Bill that became that Act. We are coming up to the 10th anniversary of the Act, which is really important. A key element of the Act was to mandate the Government to produce an adult autism strategy, and the 10-year anniversary will coincide with a year in which that strategy is up for review. The all-party group is working towards holding to account every Government Department involved, and making sure that their feet are held to the fire, because this affects almost every area of public life and public policy. Ahead of the review, I want all areas of our Government to consider how they can better support people with autism and people on the autism spectrum.

It is also important to look at the good that that Act has done. Almost 10 years on, the National Autistic Society had a look at this, and it is worth reflecting on the fact that autism really is on the agenda now for an awful lot of people, and locally as well. Almost everyone is aware of autism. NAS polling showed that 99.5% of people were aware of autism, and almost every council—93% of them—has an autism lead.

[Mr Jim Cunningham (Coventry South) (Lab)]

The right hon. Lady does the House a great service by bringing forward this debate on autism. Can she tell me—perhaps she does not have the figures—about employers’ attitude to employing people with autism? Are there any statistics on that?

[Dame Cheryl Gillan]

The hon. Gentleman anticipates another bit of my speech. That is really important, because people with autism are disproportionately not being taken off the unemployment register. In fact only yesterday, with the all-party group for disability, I had a joint meeting with the Minister for Apprenticeships and Skills to look at the problems and consider how, working with employers’ organisations and the Government, we can try to improve the situation.

More councils now include autism in their joint strategic needs assessment, and almost every local area has a diagnostic pathway—those that do not will know who they are, but all but three are covered. That is really significant progress, but let us face it there is not a person in the House who does not know that we need to make more progress in this area, so I do not say that with any sense of complacency whatsoever.

I want to touch on a few areas, but I have only limited time. I have been very impressed by the number of Members on both sides of the House who have put in to speak, and it is really important that I hear from them.

I will start by talking briefly about education. My hon. Friends the Members for Bexhill and Battle (Huw Merriman) and for Lewes (Maria Caulfield) recently chaired an inquiry into autism and education under the umbrella of the APPG. They did some fantastic work, looking at how the education system in England currently works for children. The inquiry involved evidence sessions and surveys, and took additional evidence from more than 3,000 parents, professionals and people on the autism spectrum. It found that children are being held back from achieving their full potential because they are autistic. In our surveys, nearly 70% of parents told us that they had waited for more than six months for support at school, and 50% had waited for more than a year.

 Orkambi and Cystic Fibrosis

Jim Cunningham Excerpts

Monday 19th March 2018 Westminster Hall

[Paul Scully]

I totally agree. When I say that the Government are not the purchaser of the drug, it does not mean that they are without responsibility. The Government have a position, which I will flesh out in a short time, but it is important that they play the role of middleman to encourage negotiations between Vertex and NHS England to ensure that sufferers can get the cutting-edge treatment they deserve.

[Mr Jim Cunningham (Coventry South) (Lab)]

We are told the drug is not economical, but has anybody done the figures on that, given the seriousness of the disability? I wonder whether the hon. Gentleman or more probably the Minister have any figures. People cannot take things out of thin air and say, “It is not economical,” without letting us know the figures.

[Paul Scully]

I clearly do not have the figures that may have been done on the economics, but I know there is a test, which I will talk about later, in which the treatment falls between two stools. In effect, the system does not suit this kind of condition. It suits acute conditions far better—I will come to that shortly.

Organ Donation (Deemed Consent) Bill

Jim Cunningham Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Mr Robinson]

I am very pleased to have taken that intervention. I remember that one of the former Prime Ministers who supports us—Gordon Brown—wanted to introduce an opt-out system, but came up against a fairly immovable block in the then Chief Rabbi, Rabbi Sacks, who said then that at no cost could he commit the Jewish community to supporting it. That rather held matters up and the Government were then overtaken by other matters with that Bill, but yes, we will do that. I have been in touch, and we believe that the council itself has made an official statement supporting the Bill.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate my hon. Friend on his Bill, and I know that he has put a lot of hard work into securing it. As any Member who has dealt with a Bill in the House of Commons knows, a lot of effort goes on behind the scenes. He has given important assurances on an opt-out, particularly to communities such as the Jewish community, and it is important to convey that message across. I hope we will get further support on that basis.

[Mr Robinson]

I am grateful to my hon. Friend and my honourable colleague from our shared city—we are both immigrants to it, but we hold it very dear to our heart—and his support along those lines is most welcome. I notice that my right hon. Friend the Leader of the Opposition has come in. I repeat my warm tribute to his leadership on the issue and to the tremendous help that I have received from his office in backing up the Bill. I am deeply grateful. I also took the opportunity to express a sincere thank you to the Prime Minister, who has taken a personal interest and lent her support. I know that he will welcome that, too.