Post Office Horizon System

Jim Shannon Excerpts

Monday 29th June 2015 Commons Chamber

[Andrew Bridgen (North West Leicestershire) (Con)]

I pay tribute to the work carried out on this issue by James Arbuthnot, the former Member for North East Hampshire, and Mike Wood, the former Member for Batley and Spen, both of whom I worked with for more than two years in a working party in search of a fair settlement on this matter. Unfortunately, throughout the process we all lost faith and trust in the Post Office’s willingness to investigate the issue properly and thoroughly.

To give some background on how the Post Office has let down sub-postmasters and Members of this House throughout this process, let us consider how it has dealt with the matter from the outset. The Horizon accounting system used by sub-postmasters was introduced some 15 years ago. Almost immediately, a spate of discrepancies began to appear as sub-postmasters attempted to balance their accounts at the end of the day. From that time forward, there has been failing after failing on the part of the Post Office.

The Post Office has finally acknowledged that its help system for the Horizon software was completely inadequate, but even with that admission the Post Office continues in its failure to demonstrate any appetite to deal with issues arising from the Horizon system in a fair and transparent way.

[Jim Shannon (Strangford) (DUP)]

Is there not something disgraceful in the fact that criminal charges were pressed against these sub-postmasters and sub-postmistresses when the fault lay with the Post Office, yet nearly two years after the investigations those charges have not been lifted? The shadow hanging over their heads has not been lifted either. Does the hon. Gentleman not feel that it is time to bring that to an end?

[Andrew Bridgen]

The hon. Gentleman tells a tale which has been told too long to the working group. We need to bring matters to a head and I hope the debate tonight will give us an opportunity to do so.

The mediation scheme that was set up to handle disputes about the software system has not delivered what Members of this House had understood was agreed at its inception. It was flawed in a number of ways, the most significant being that it excluded those who had pleaded guilty.

Drugs: Ultra-rare Diseases

Jim Shannon Excerpts

Tuesday 16th June 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

First, I congratulate the hon. Member for Leeds North West (Greg Mulholland) on bringing this matter to Westminster Hall for consideration. Westminster Hall is well filled today because we all have constituents who are suffering and do not have access to the drugs needed to combat these rare diseases. I also congratulate the hon. Gentleman on his hard work on this issue, for which he is well renowned; we have all said that, but it is the truth, and we all want him to know that we know it.

I am glad this debate has occurred, because it is on a subject that affects many people in my constituency. We have heard some stories and we will hear more before this debate is over.

The diseases we are considering may be rare, but collectively they affect the lives of 3 million people across the United Kingdom. That emphasises that everything must be done to create a comprehensive initiative for providing care to those affected by these difficult and challenging diseases.

Rare diseases tend to be life-threatening or chronically debilitating. There are between 6,000 and 8,000 rare diseases. Each one affects less than 0.1% of the UK’s population, but Rare Disease UK calculates that 75% of these illnesses affect children.

We are here today on behalf of our constituents, but we are also focusing very much on young people across the United Kingdom of Great Britain and Northern Ireland who have these problems.

The ultra-rare diseases that have been mentioned include Morquio disease, Duchenne muscular dystrophy and tuberous sclerosis. I would also add Prader-Willi syndrome, which some of my constituents suffer from.

The chance of improving people’s quality of life depends very much on a narrow timescale. It requires quick diagnosis, treatment and drug provision, so that drugs can be accessed when they are proven to be most effective. In other words, as every Member who has spoken has said, time is of the essence—the people who are suffering need help now, not in six or 12 months. It is our duty to make that timeline as transparent and effective as possible within the finite resources we have, and I understand the problems the Minister has. There must be adequate assistance for practitioners, to allow for timely diagnosis and the timely provision of drugs and treatment.

[Mr Anderson]

The hon. Gentleman has been very consistent on this issue, and he is right: as those of us in the all-party group on muscular dystrophy have found, one of the main reasons for delays is that clinicians—particularly GPs—do not see these diseases very often, and when they do, they are sometimes lost as to where to go. Once a disease is diagnosed, the people suffering from it should have no worse access to treatment than people with much more common diseases—surely that is the issue that has to be addressed. Once a disease is identified, we have to get to grips with it, and people have to get the medication and the support they need, so that they can get on and live the best life they can.

[Jim Shannon]

I agree wholeheartedly. I am sure the Minister has heard us all say that time is of the essence and that we should strike right away. That is what we are about.

The health and social care professionals involved in the diagnosis, treatment and care of these patients face difficult tasks. As I was saying, there must be adequate assistance for them, to allow for timely diagnosis and the timely provision of drugs and treatment. There also needs to be sufficient funding UK-wide.

In Adjournment debates and other debates about these issues, I have always referred to Queen’s University in Belfast and to the importance of research and development. Queen’s University is one of the universities that do research, and it works in conjunction with the Health Department. Perhaps the Minister could therefore give us some idea what the Government are doing on research and development to ensure that new drugs are found.

[David Simpson (Upper Bann) (DUP)]

My hon. Friend mentions research. As he will know, I am involved in a campaign in Northern Ireland and across the United Kingdom on complex regional pain syndrome. The condition affects children, but it mostly affects adults from the age of 50 onwards, and people can lose limbs to it. One in every 3,000 people is affected, and many lives have been destroyed. We need more research to find a drug to cure this condition, and research funding needs to be put in place so that that research can be done.

[Jim Shannon]

I thank my hon. Friend for his intervention. That is a message that I, too, believe in, and I am sure the Minister will respond positively.

Leaving aside all the statistics we have heard today, we need to imagine the emotional strain these things put on people and their families, and we have had examples of that. Only 35% of patients are aware of a licensed treatment for their condition. There is something wrong when that is the case. How come only 35% of people know there is something there for them? How are the Government addressing that? I am not attacking the Minister—that is not how I work—but how do we move things forward in a positive fashion? Of that 35%, 89% are able to access the treatment, but 11% are not. Therefore, 65% of people are not aware of the drugs, and of the 35% who are, a proportion are not able to get them.

Like others, I want now to touch on Duchenne muscular dystrophy. If Translarna is given at the correct time, we can prolong the sufferer’s mobility. My constituents deserve to have access to that drug as soon as possible, and that is what I would like to see happen. The effects of long waiting times and uncertainty are widespread, and although ultra-rare diseases affect the few, their effects for those who suffer from them are an inescapable reality and should be treated with the utmost seriousness.

Families deserve a solution to the continual failure to establish a lawful, robust and transparent commissioning service that enables the rare disease community to access new drugs in an equitable and timely manner and to avoid situations such as those we have spoken about, where crucial windows of opportunity pass by. This is a crisis—it cannot be described as anything else. People are in trouble, and they need our help now.

Let me quickly pay tribute to the lady who looks after the Northern Ireland Rare Disease Partnership, Christine Collins. Last year, we met the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), to discuss these matters. We were clearly moving forward, and the Minister was very responsive. The background information for the debate says that, in November 2013, the UK Department of Health and the devolved Governments published the UK strategy for rare diseases. In June 2014, the Northern Ireland Assembly endorsed it and gave a commitment to publish an implementation plan, and last year’s meeting provided an opportunity to underline the need for that to happen. Perhaps the Minister can give us some idea today of what discussions he has had with his fellow Minister to move things forward so that we can deliver on that commitment.

The debate has dealt with access to drugs. It has also given us an opportunity to bring out the gaps in the patient experience. Let us remember the patients, the families, the children and all those who suffer. They require a co-ordinated response from not only the health service and the social services, but research bodies and the relevant charities. I hope that the common experiences we have described signal the urgent need for access to these vital treatments. I remind all those in a position to have a tangible impact on drug access that while we are debating these issues, somebody else is falling into the trap and will, unfortunately, be unable to access the necessary drugs. I urge the Minister to respond positively, and I thank the hon. Member for Leeds North West again for giving us all a chance to speak about this issue.

[Several hon. Members]

rose—

--- Later in debate ---

[Dr Whitford]

Obviously, devolution gave us the power to do things differently, but I do not think that we should re-invent the wheel. Often, we will accept work done by NICE or re-evaluate it quickly, to see whether things should be applied differently, but we do not just go back to the beginning. However, I am sure that ideas can be shared in both directions.

It seems that certain drugs were left as orphans when the system changed. We know that patients with the brain tumour form of tuberous sclerosis, which the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) mentioned, can access the drug through the cancer drugs fund, but if they have a kidney tumour and are treated by urologists they are not part of that system and simply will not be aware of it. Such random unfairness exists.

[Jim Shannon]

There is a forum and association, driven by the Health Minister, that discusses matters together with the three regions. A UK-wide strategy is already in place. The process is allowing that to happen already. However, it is delayed and has not happened yet; that is why we are concerned.

[Dr Whitford]

I think it is a matter of what ideas go on the table and what is being discussed in the meetings. Good ideas are going ahead. I commend the idea of including patients and clinicians in evaluations, because the numerical data from trials will often be small due to the nature of the diseases in question, and we will have to look wider. The problem for children is that if these drugs are to prevent deformity, they have to be got in early. People with Morquio already have the changes. We do not know yet how much change could be prevented, or how much saving there could be on a person’s disability in the long term if metastatic breast cancer treatments, which eventually become adjuvant treatments, are given earlier.

I commend the system I have talked about. I know it is difficult and challenging, but it is clearly fair, with an interim period for compassionate reasons, and people know where their voice should be heard.

Health Services in Staffordshire

Jim Shannon Excerpts

Wednesday 3rd June 2015 Commons Chamber

[Jeremy Lefroy]

I entirely agree with my hon. Friend and reiterate his remarks about the excellent work done in my constituency by staff at the County hospital to recover the situation, which a few years ago was extremely difficult, to one where the quality of care offered is of a very high standard.

To return to cancer and end-of-life services, the real concern has been over the method being used. To quote Macmillan:

“We think a procurement process is the best way to integrate the fragmented cancer and end of life services we have in Staffordshire. A procurement process is needed because at the moment there is no one organisation with overall control of cancer or end of life services.”

My argument has always been: in that case, what are CCGs for? They are there to commission, so why can they not commission? In the last Parliament, we gave them the ability to work together to procure services, so why cannot the four CCGs involved, together with Macmillan, simply make that happen? The answer I was given at the time was that the constraints on CCGs’ own administration costs—a reducing amount of funding per head—meant that it was impossible. Sometimes I am puzzled. We see this all over Government and have done for many years and across many Departments: we constrain spending on so-called bureaucracy and then, in order to get necessary things done, pay large sums of money to consultants to do precisely the kind of bureaucratic work that we forbid the experts from doing—in this case the CCGs—but, because it is called consultancy or programme work rather than overheads, it is allowed. There is a problem that needs to be solved—I do not deny that—and it affects the lives of my constituents and those of other Members, so it must be solved.

Macmillan says about the first two years of the contract:

“The main responsibility of the integrator will be to address the current inadequate data about pathway activity and the real cost of this activity. Much increased investment over the last decade has arguably been wasted by poor contract accountability and a lack of reliable data and analytics.”

That is important, but it is a research and advisory role. I have no problem with the CCGs calling in experts to offer them such research and advice, whether it is a private company, university or, indeed, another arm of the NHS. A fee will be paid for that work. Again, I have no problem with that, but I would like the Minister to say how much it is likely to be. As local MPs, we have a right to know, on behalf of our constituents, or at least have a rough idea.

According to Macmillan, after 18 months the integrator —I would say consultant—will be expected to

“present a more detailed strategy as to how they expect to achieve improved service outcomes. If the evidence is robust, arrangements will be made for all contracts to be transferred to the Service Integrator from the beginning of year 3. If not, the contract with the Integrator could be terminated and the Service integrator will be required to repay all (or a significant part) of their fee to date.”

That is where I do not see the logic. What makes an organisation that is good at research and advice the right body to run cancer services for our constituents? Why can it not simply be thanked for its advice and that advice, if it is good, be followed by the CCGs, working in co-operation with the providers? The risk is that the vital work that patients, the CCGs and Macmillan have done, with the very best of intentions, will be damaged by contractual arrangements that do not make sense and may put a private organisation with a somewhat different ethos in charge of commissioning NHS providers for services, rather than the other way round.

I have no problem at all with a private organisation producing a much better plan for cancer and end-of-life services, nor do I have a problem with social enterprises or private providers being involved in delivering certain elements of that plan, as they do now and have done under Labour, coalition and Conservative Governments. However, I do not see the logic in the organisation producing that plan becoming another bureaucratic tier between the CCGs, providers and patients. I therefore ask the Minister to take up the proposed contract with the CCGs.

The state of general practice is gradually becoming critical in our area. Many GPs are retiring or approaching retirement. I welcome the Government’s plans to train more GPs, but we will also have to train more medical students or rely on recruiting from overseas.

[Jim Shannon (Strangford) (DUP)]

In Health questions this week, an issue close to my heart was raised about GP numbers and how many doctors are choosing to become GPs. We have similar issues in Northern Ireland. The difficulties in Staffordshire have been outlined, but they are mirrored across the whole of the United Kingdom, and particularly in Northern Ireland. Could any steps be taken to encourage more doctors to become GPs, thus dealing with the problem of the massive number of patients that each doctor has, because we are getting to the stage where doctors will not be able to cope?

[Jeremy Lefroy]

I am grateful to the hon. Gentleman, who hits the nail on the head. It is vital to increase the number of medical students and those training as GPs. I know that the Government want to do that and are committed to it, but I believe they need to expand the number of medical school places.

What plans do the Government have for expanding the number of medical school places and ensuring that those trained stay and work in the NHS, particularly in those areas that are running short of GPs? A seven-day personalised service is an ideal, but those GPs who take the care of their patients extremely seriously—and that is the vast majority of them—are already working extraordinarily hard. The European working time directive most certainly does not apply to GPs, even if it does to the rest of the NHS, and if it were to apply, our family doctor service would fall apart.

Finally, I wish to address the financing of the NHS in Staffordshire. All parts of it are under strain. The KPMG report showed, although some of its solutions have rightly not been accepted, that there is a serious problem. The answer is not to be found in short-term fixes, whether they be in Staffordshire or elsewhere. The NHS England 2020 plan—tough though it is—gives us the opportunity to think long term. Yesterday, I argued in this place for a cross-party commission, including the medical professions, on the future of health and social care and its provision and financing for the 20 or 30 years beyond 2020. I repeat that call today, and I urge the Minister and his colleagues to take up the challenge.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

We will absolutely remember them. That is why it is so important to embrace new technology. Sometimes people who have to travel long distances are able to use such things as Skype or to make a phone call to receive important advice. This is a big priority for us.

[Jim Shannon (Strangford) (DUP)]

With almost 82,000 people living with diabetes in Northern Ireland over the age of 17, does the Minister agree that this ticking time bomb needs more research into better treatments? One way of doing that would be to ensure that there is sufficient funding for Queen’s University in Belfast, in the hope of providing a superior treatment for the many who are affected and living with that disease.

[Jane Ellison]

The hon. Gentleman is right to draw attention to the important role of research. We will leave no stone unturned in looking at all aspects of the treatment or prevention of diabetes. The issue of research is something I recently discussed with the chief medical officer. I will draw to her attention the point he makes. As he knows, although health is a devolved matter we always make a point of sharing all research right across our United Kingdom.

Health and Social Care

Jim Shannon Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Let me first pay tribute to the former Member for Ross, Skye and Lochaber and thank him for his massive contribution over some 32 years and for his dedication and his humour, which were evident to all those whom he met in this House. He was a friend to everyone. I just wanted to put that tribute on record on behalf of my party.

It is a pleasure to follow the hon. Member for Congleton (Fiona Bruce), as there are many issues on which we agree. It has also been great to hear the contributions from some of the new Members on both sides of the House.

It is an honour to be back in this House as the Member of Parliament for Strangford. When I was first elected five years ago, I said that everyone in the House would remember Strangford, and I believe that they do. The Ministers, shadow Ministers and Members who visited my constituency always said that they were mesmerised by the beauty of Strangford and wished to come back. I now extend an invitation to Strangford to all new Members —and old ones as well—of this House.

I am, unashamedly, a Unionist. All four nations bring their qualities, traditions, history, culture and experiences to the United Kingdom of Great Britain and Northern Ireland, and together we are stronger. Having Scotland, Wales, Northern Ireland and England together in the Union is our strength.

As I listened to the Gracious Speech, I was delighted to hear the topics that were raised. I was pleased to hear about the EU referendum and that everybody in the United Kingdom of Great Britain and Northern Ireland will have the chance to cast their vote. I am pleased to hear about more free childcare, which I hope will be carried over to Northern Ireland, as well as the vital freeze on increases in income tax, VAT and national insurance for five years. I am delighted to hear that 3 million new apprenticeships will be created, that there will be measures to reduce regulation for small businesses and a bid to boost job creation, but I would have been glad to have seen an end to the iniquitous bedroom tax.

Those are debates for other days, however. As the Democratic Unionist party spokesperson for health, I am pleased to hear that there will be legislation to introduce a blanket ban on the production and supply of so-called legal highs.

[David Simpson (Upper Bann) (DUP)]

Does my hon. Friend agree that although we welcome the legislation on legal highs we must ensure that we have proper enforcement? We have not had much success with the other illegal drugs, so we need proper enforcement.

[Jim Shannon]

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

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

[Gavin Robinson (Belfast East) (DUP)]

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

[Jim Shannon]

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

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

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

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

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

[Ms Margaret Ritchie (South Down) (SDLP)]

I thank the hon. Gentleman for giving way in this important debate on health and social care. Does he agree that a lot of these cancer drugs are trialled in specialised labs in the oncology department in Belfast, and that it is particularly sad that they are not available in Northern Ireland because of the lack of a cancer drugs fund?

[Jim Shannon]

I thank the hon. Lady for her intervention. Clearly, that is the issue for us in Northern Ireland. We want the cancer drugs to be made available throughout the United Kingdom.

Great progress has been made in cancer drugs. In fact, 60% of skin cancer cases can now be addressed with medication and chemotherapy. Those are fantastic steps forward. The other issues are all there—for example, GPs’ surgeries and diabetes. I declare an interest as a type 2 diabetic.

There are mental health issues that we need to address, not only for everyone in society but throughout the United Kingdom and for our soldiers too. I understand that there is not a bottomless pot of money, but we must do the best with what we have. It is also important to understand that your health is your wealth, that we must invest in the health of this nation, and that it is essential that such investment is UK wide.

In closing, I am thankful that the Government pledged to prioritise health, to ban legal highs and to take action on all the other issues that have been raised, but we need to have the pledges implemented urgently. They must not be left until next year or the year after. There is good news in the Gracious Speech, but I ask for details, and for implementation to take place as soon as possible, so that every benefit can come to everyone in the United Kingdom of Great Britain and Northern Ireland.

--- Later in debate ---

[Jane Ellison]

It is a very important part of cancer care, and something we have debated often in this House. I have seen for myself while on visits just how important the services that wrap around clinical care are.

Let me turn to an issue that we hope to give particular focus to in this Parliament: the need to tackle obesity. It is appropriate that I do so just after an intervention on cancer, because we are understanding more and more about the links between obesity and cancer in later life. They are frightening and shocking. We want to tackle issues such as childhood obesity fiercely in this Parliament. The biggest link between obesity and ill health, however, is that between obesity and type 2 diabetes. If not properly managed, type 2 diabetes can have devastating consequences, including loss of eyesight and limb amputations.

[Jim Shannon]

In my contribution I asked about legal highs. Perhaps the Minister could give some idea of what will happen with those.

[Jane Ellison]

The relevant Bill is being brought forward by another Department, but I noted that the hon. Gentleman welcomed it and am sure that we will return to that.

The start of a new Parliament provides an opportunity to take a serious and thoughtful look at how we tackle a big issue such as obesity. As I said during Health questions earlier today, there are no silver bullets; it will require effort on a global, national and local scale. We are working up our plans for that and will announce them in due course, but they will involve everyone. All parts of Government, local government, industry and individual families will need to move the dial on such a big issue in a way that has not been done in the developed world. There will be interest right across the House in tackling it, particularly the link with diabetes. I note that the right hon. Member for Leicester East (Keith Vaz), who has so often championed the issue in the House, is in his place.

The NHS is coping well with unprecedented pressures. That achievement has been possible only through the hard work of doctors, nurses and health professionals, together with our commitment to invest in the NHS, but a strong NHS needs a strong economy. It is only by having a long-term economic plan that we can increase the NHS budget by £8 billion in real terms over this Parliament. The public got that, even if the Labour party did not. However, there is much more to do. I hope that the era of scaremongering and running down the NHS is over—[Interruption.] Sadly, I am beginning to think it is not. I really hope that we can make a new start. One of the saddest conversations I had during the election—I am sure that this could be echoed by many colleagues on the Government side of the House, particularly new Members—was with an elderly constituent who had been informed very seriously by a Labour canvasser that the NHS was going to be sold to an American company. That was absolutely shocking.