NHS Dentistry: South-west

Jim Shannon Excerpts

Tuesday 12th November 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for securing this debate. Does the hon. Member not agree that the story in the south-west is being replicated across all of the United Kingdom of Great Britain and Northern Ireland? He may not be aware of a survey of almost 300 dentists in Northern Ireland that found that almost nine in 10 intend to reduce or end their health service commitments in the coming year. That could be the end of NHS dentistry. Is he experiencing the same thing in the south-west? If he is, Government must really grasp this issue, and, as the hon. Member for South Devon (Caroline Voaden) said , get it done.

[Richard Foord]

I am glad that the hon. Member for Strangford made that point, because I did not know about the situation in Northern Ireland. It sounds like some regions of the UK are not getting the attention that they require when it comes to NHS dentistry.

I want to share the story of two of my constituents, Mike and Shirley. I have received correspondence from them and many other residents, such as Martin Loveridge, who has had a similar experience. Mike and Shirley are hard-working people. Mike is almost 75 and retired after more than 50 years in horticultural work. Shirley, aged nearly 70, is still taking on part-time cleaning work to make ends meet. In 2023, their dentist in Sidmouth finally went private, driven away by the broken dental contract that we have heard described. The impact of that shift has been devastating.

Shirley developed a dental abscess. Anyone who has had a dental abscess will know what excruciating pain it can involve. Years ago, Shirley suffered from a similar infection, which led to sepsis. This time, instead of receiving urgent care from the NHS, Shirley faced the following choice: either wait in pain or go private. Plainly, this incident is a stand-out case, given that it was crucial that she received NHS treatment for sepsis, but typically, it would cost them £1,200 in dental fees—a sum that is simply unaffordable for people in Mike and Shirley’s position. Mike has not seen a dentist since May 2022 because he simply cannot afford it. Mike and Shirley tried to get NHS dentistry—they went to NHS England, Healthwatch Devon and the complaints department of the Devon NHS—and they had people admitting to them the dire state of the system, but they were offered no real solution. They spent hours on “Find a dentist”, an NHS website just for that purpose, but they were referred to a clinic that was 80 miles away, an impossible journey for them.

Breast Cancer: Younger Women

Jim Shannon Excerpts

Tuesday 12th November 2024 Westminster Hall

[Wera Hobhouse]

The hon. Lady is absolutely right that we need to continue to raise awareness, but I am pointing out that even when young women are aware and go to a doctor, the doctor says, “Don’t worry about it.” However, I agree that we need to continue to make sure that women examine their breasts and are aware of the risks of breast cancer, even when they are young.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Lady yesterday. This is a massive issue for me and my constituents back home, and they bring it to my attention all the time. It was great to attend the Breast Cancer Now “Wear It Pink” event last month to raise awareness of the most common cancer in the UK. Studies have suggested that breast cancer among younger women has a more aggressive pathophysiology, correlating to poorer outcomes compared with those for breast tumours in older patients. Does the hon. Lady agree that consideration must be given to lowering the age requirement for breast screening to ensure quicker intervention for younger women?

[Wera Hobhouse]

I will come to that later in my speech, but I absolutely agree with the hon. Gentleman. We are here to make the case for earlier screening programmes for younger women, because it is becoming such an issue—the rates are increasing. It is because of Lucy’s struggle to get a diagnosis that she felt the need to speak up on behalf of the countless young people who would not question decisions made by medical professionals.

Woman and Equality: North of England

Jim Shannon Excerpts

Tuesday 5th November 2024 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move,

That this House has considered inequalities faced by women in the north of England.

It is a pleasure to serve under your chairmanship, Sirusb Christopher. This debate is about the “Woman of the North” report, published in September 2024 by Health Equity North. I thank Health Equity North for the report and for their support for today’s debate, as well as all those who contributed to that vital research.

Women in the north of England face unequal challenges and inequalities in their lives and their health, compared with the rest of the country. They are more likely to work more hours for less pay and be in worse health. They are also more likely to be an unpaid carer, live in poverty and have fewer qualifications. In fact, the inequality between women living in the north of England and those in the rest of the country has grown over the past decade. It has harmed women’s quality of life and work and harmed their communities and families.

Today, I am going to debate the key findings of the research and highlight the report’s recommendations. The report does not make for easy reading. Even though the Minister, like me, will be all too aware of the impact of austerity on our communities, many of the findings will, I am sure, come as a shock, as they did for me.

I will not be able to cover everything, but I hope the debate will begin a dialogue between the Department and the contributors to this important research.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this issue forward. First, there is an anomaly—there are two and a half times more self-employed men than women, with jobs and opportunities. Women have the skills and the talent, but one of the things that holds them back is childcare. It does not matter where someone is in this great United Kingdom of Great Britain and Northern Ireland: if they do not have childcare, they have nothing—they cannot get the opportunities. Last week on the TV it said that the cost of childcare for some families is as much as the mortgage. That is a massive issue.

[Mary Kelly Foy]

I could not agree more. That is why I am pleased that the Labour Government will be bringing in thousands of new nursery places and breakfast clubs, which will hopefully alleviate some of the problems of childcare. I know that childcare is an issue not just in the north of England but also in the north of Ireland.

I shall begin with employment. Employment rates for women in the north are lower than the national average of 72.2%. In my region, the north-east, the rate is just under 70%; in Yorkshire and the Humber, it is just over 70%; and in the Minister’s region, the north-west, it is just over 71%.

Disability and long-term sickness is a major issue in the north. All northern regions have levels of disability and long-term sickness higher than the national average, and considerably higher than the south-east. The report states that the resulting estimated economic cost is around £0.4 billion per annum. Compounding that is the fact that the median weekly wage for women in the north is below the national average for both full-time and part-time employment. For instance, the average weekly wage for a full-time working woman in the north-east is £569. That is much lower than the national average of £625 and considerably lower than the average weekly wage for women in London, £757. Overall, women in the north could be losing out on around £132 million a week.

In terms of education, the number of women without qualifications is higher in the north than it is in the south and the south-east. That leads to the next point about women and poverty—an issue that is worth its own debate. A higher percentage of families in the north are on universal credit than in regions in the south. In fact, the average number of families on universal credit across the north is 3% higher than in the south. The figure is even higher if London is excluded.

All 12 local authorities in the north-east have rates of absolute child poverty above the English average. By contrast, all 30 local authorities in the south-west have rates of absolute child poverty below the English average.

The north is also the region of unpaid care, with 12% of women in the north-east providing it—just under 2% higher than the national average. Health Equity North estimates that women in the north are providing around £10 billion a year in unpaid care. Harrowingly, it also estimates that, in the last decade, the life expectancy of girls born in the north of England has begun to stall and in some cases decrease. In addition, girls born in the north will not live as long in good health compared with the national average. For older women, menopause is often cited as a potential driver of change in women’s health, which makes it all the more concerning that there are regional differences in levels of hormone replacement therapy, with lower levels of HRT being prescribed in the north of England.

The picture is even more bleak when we consider pregnancy and reproductive health. We have seen the biggest increase in abortion rates between 2012 and 2021, and there has been a demonstrable relationship between austerity, the implementation of the Tory two-child limit and the increased rate of abortions. I should also add that the two-child limit itself affects over a million children in the country, and it impacts over 60,000 babies, children and young people in the north-east alone. Right now, over 25% of pregnant women in the north of England are living in the most deprived 10% of areas, with 40% of pregnant women living in the top 20% most destitute areas. Tragically, stillbirths are the highest in the most deprived communities, and highest among black African and Caribbean women living in the areas of greatest deprivation. Also, women living in poverty are at increased risk of death and depression. Subsequently, babies are at a higher risk of stillbirth, neonatal death, pre-term delivery and low birth weight.

The report also refers to smoking and pregnancy; I am glad to see that the Tobacco and Vapes Bill will receive its First Reading today. It would be good to hear from the Minister whether the Government will continue to fund the financial incentives scheme for pregnant smokers.

Women in the north of England have the highest rates of domestic violence abuse in the country, which is something that many children are exposed to. That also deserves its own debate. When we consider mental health, the report highlights that, in a cohort of over a million women aged between 16 and 65, from 2005 to 2018, the prevalence of mental illness was higher in three northern regions compared with the south of England. With severe mental illnesses, such as bipolar disorder and schizophrenia, the north-west and the north have higher prevalence rates. Lastly, the report covers the reality of marginalised women in the north, which includes a range of areas, from criminal justice to education and health, as well as issues related to homelessness and substance abuse. I do not have time to go into each point, but I encourage the Minister to read that section if he has not already, and I will either write to him about those issues or table parliamentary questions.

The report’s recommendations are spread across multiple departmental areas, so the Minister may want to follow up in writing if he prefers. One key recommendation of the “Woman of the North” report is that central Government should deliver a national health inequalities strategy—one that convenes Government Departments from across Whitehall to put health at the heart of all policies to address the wider determinants of health. Many of the policies announced in the Budget, as well as the Employment Rights Bill, will be welcome, such as uprating universal credit in line with inflation and tackling zero-hours contracts. Of course, we wait in anticipation for the child poverty taskforce strategy next year, and I sincerely hope that we will see an end to the Tory two-child limit. In addition, the report recommends that the Treasury should consider targeted support for pregnant women, as well as improving childcare. When it comes to local and regional government, which I know the Minister has experience in, the report suggests targeted support delivered to 11 to 18-year-olds through careers hubs in the areas of greatest deprivation and a higher level of the adult education budget for the north. Greater support is also required for women navigating the social security system and for social security uptake, and for women to transition back to their families and integrate into their communities after involvement in the criminal justice system.

Finally, with health and social care, NHS England could provide additional support and investment for women’s health hubs, and health services should be supported to collect routine data on ethnicity and other key demographic data. That would help deliver better information for service development and improve our understanding of different health needs. It would also explore the ways in which the services’ work can be adapted to address health inequalities across different population groups, with examples including providing cultural sensitivity training, adopting a trauma-informed approach to care and promoting person-centred approaches.

I have been an MP since 2019 and have spoken about health inequalities ever since I was elected. Today’s debate is not pleasant, but I am genuinely hopeful that we can turn a page under a Labour Government. We have already seen positive measures, such as those in the Employment Rights Bill and the Budget. I look forward to the Minister’s reply and hope to work with him alongside Health Equity North to deliver happiness and dignity for women in the north, which is long overdue.

NHS Dentistry: Rural Areas

Jim Shannon Excerpts

Tuesday 5th November 2024 Commons Chamber

[Sarah Gibson]

I do agree with the hon. Member. The real issue for rural areas is, again, access to public transport. Dental provision might be relatively close in theory, but public transport does not allow people to get to the dentist. The issue of rurality is important and needs to be addressed.

Analysis conducted by the Rural Services Network shows that someone living in a rural area is less likely to be able to access an NHS dentist than those living in an urban area, with 10% fewer dental practices taking on new adult NHS patients in rural areas. The analysis also shows that in rural areas, there are 16% fewer dental practices with an NHS contract per 100,000 people. That again points to the fact that rural areas are definitely in a worse situation than urban ones.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this issue forward; the number of people in the Chamber indicates the interest in it right across the United Kingdom of Great Britain and Northern Ireland. Does she agree that dentistry is on the brink and that the additional national insurance contributions are going to push even more dentists into refusing NHS contracts and taking private patients only? Should not the Government immediately instigate an increase in prices in rural areas, to save the few dentists left who are braving rural isolation and the increased costs of operation?

[Sarah Gibson]

I agree with the hon. Member. The disparity is clear. As he mentioned, rural areas are being hardest hit by our broken NHS dental contract system.

Unfortunately, there does not seem to be much hope on the horizon. Denplan tells me that 90% of dentists plan to reduce their NHS commitment in the next two years and that the UK has the lowest dentist-to-population ratio in the whole of Europe. Although all dentists are dedicated to improving the nation’s health, access to NHS dental services remains a persistent challenge under the current system, particularly in rural areas.

Income Tax (Charge)

Jim Shannon Excerpts

Tuesday 5th November 2024 Commons Chamber

[Wes Streeting]

I am grateful for that intervention for two reasons. First, it gives me an opportunity to say to GPs, hospices and other parts of the health and care system that will be affected by employers’ national insurance contribution changes that I am well aware of the pressures, we have not made allocations for the year ahead, and I will take those representations seriously.

Secondly, it gives me a chance to ask the hon. Member and the Opposition: do they support the investment or not? Are they choosing to invest in the NHS or not? They are now confronted with the hard reality of opposition. Just as when we were in opposition we had to set out how much every single one of our policies would cost and how those would be funded, they have to do that now. If they oppose the investment, they have to tell us where they would make the cuts in the NHS. If they oppose the investment, they have to tell us where they would make the cuts in school budgets. Those are the choices that we have made, and we stand by those choices. The Opposition will have to set out their choices, too.

I was told that because the Conservatives had run up huge deficits in NHS finances, I would not be able to deliver the 40,000 extra appointments a week that we had promised. In fact, I was told that we would have to cut 20,000 appointments a week instead. The Chancellor and I were not prepared to see waiting lists rise further. She put the funding in, and an extra 40,000 patients will be treated by the NHS each week. That is the difference that a Labour Budget makes.

[Jim Shannon (Strangford) (DUP)]

It would be churlish of anybody in the House not to welcome the £22 billion that has been allocated to the NHS. Everyone across this great United Kingdom of Great Britain and Northern Ireland will benefit from that.

A number of my GP surgeries have contacted me about their national insurance contributions, which they see as a catalyst to perhaps not being able to deliver what they want to do for their patients. I understand that the Labour party and Government are looking at that in a consensual way. Can the Secretary of State please give me the latest position so that I can go back to my GPs and tell them, “This has been looked at and there will be something coming”?

[Wes Streeting]

I am grateful for that intervention. It is of course for the devolved Administrations to decide how to use the Barnett consequentials that the generous uplift in funding provided by the Chancellor will provide. We make no bones about it: we had to make some difficult choices in the Budget to plug the £22 billion black hole that we inherited, to deliver on our promises and to ensure that we are fixing the foundations of our economy and our public services. We have asked businesses and some of the wealthiest to make a contribution. I say to people right across the House that they cannot welcome the investment at the same time as opposing the means to raise it. If they do, they have to explain how they would find the money.

--- Later in debate ---

[Darren Jones]

My hon. Friend is absolutely right. These were promises made by the last Government that they knew they did not have the money to pay for. This was spending from the general reserve—the money put aside for genuine emergencies each year—that they blew three times over within the first three months of the financial year. Anyone who runs a business, anyone who runs family finances and anyone who is in charge of the country’s finances should know that that is shameful, and the Conservatives should apologise to the country for it. Nowhere is that more true than in our public services, which have suffered as a consequence of the Conservatives’ mismanagement. For example, Lord Darzi’s independent report into the state of our NHS found that the past 14 years had left the NHS in a critical condition.

[Jim Shannon]

We very much welcome what the Government are doing in relation to the contaminated blood and Post Office Horizon scandals, but let ask the Minister a very gentle question—a question that needs to be answered—in relation to the WASPI women? When the right hon. Gentleman was in opposition, we all supported the WASPI women, and now he is in government. I understand that the Government are looking at this issue. What will happen to the WASPI women? Can we expect to have that addressed during this term?

[Darren Jones]

As the hon. Gentleman knows, the ombudsman reported to this House before the election, making a number of recommendations, but did not conclude the basis on which a compensation scheme might apply. Further work is therefore required, which the Secretary of State for Work and Pensions is looking at, but I would point him to the fact that this is a Government who honour their promises. If we look at the infected blood scandal or the Post Office Horizon scandal—an issue that I worked on for many years—we were told by the Conservatives that they were doing the right thing by compensating the victims, but they did not put £1 aside to pay for it.

From education to our justice system, we have inherited public services that are on life support, but I do not need to tell working people that. Sadly, they know it all too well, because the last Government lost control of both our public finances and our public services. This Budget and this Government will get both back under control. I will now outline how we should do that, by focusing on one simple word: reform. Reform is urgent, because we cannot simply spend our way to better public services.

This is a Government for working people, and we are determined that they will get the best possible public services for the best possible price, but public service reform is not just about policy or IT systems or procurement, as important as they are; it is about people. It is about the people at the end of each of our decisions: the patient in the hands of the NHS with worry and hope in their heart; the pupil in a school, college or university with aspirations that should be met; and the pensioner who wants to feel safe walking to the shops on their high street. Behind each of those people is a doctor, a nurse, a teacher, a police officer or a civil servant.

These are public servants who have chosen to work in public service to serve the public, as this Government do. They are public servants and people who today feel frustrated by not being able to access public services and not being able to deliver them. These are public services that, when performing well, deliver a well-functioning state and help keep workers educated, well and able to help grow our economy and protect our country. It is for these people that my right hon. Friend the Chancellor confirmed we will deliver a new approach to public services that is responsible, that looks to the future and that balances investment to secure public services for the long term with reforms to drive up the quality of those services today, and with reform as a condition for investment. From the Attlee Government founding the NHS to the Blair Government reforming poorly performing state schools, reform is in Labour’s DNA.

I now turn to some of the points made by right hon. and hon. Members today, and I begin by congratulating my hon. Friends the Members for Broxtowe (Juliet Campbell), for Sunderland Central (Lewis Atkinson) and for Stourbridge (Cat Eccles), and the hon. Member for Yeovil (Adam Dance), on delivering their maiden speeches.

There were many speeches today, so colleagues will have to accept my apologies for not being able to address all 80 contributions individually. However, I join my Labour colleagues in celebrating this Budget, because building an NHS that is fit for the future is one of this Government’s five missions. That is why we have invested over £22 billion, the highest real-terms rate of growth since 2010 outside of the covid response.

I have also heard the voices of hon. Members from Northern Ireland and Scotland, including the hon. Member for Inverness, Skye and West Ross-shire (Mr MacDonald), who encouraged me so dearly to listen to his speech but has not returned to the House for my summing up. Under this Labour Government, the largest real-terms funding increase since devolution began has been delivered for Scotland, Wales and Northern Ireland. This Labour Government are delivering from Westminster for the people of Scotland, Wales and Northern Ireland, and we will work in partnership with the devolved Governments to deliver the change for which people voted, and which we have now given the devolved Governments the money to deliver.

Cancer Strategy for England

Jim Shannon Excerpts

Thursday 31st October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

There is hardly a day when I do not make a speech, Mr Betts.

I thank the hon. Member for Wokingham (Clive Jones) for securing the debate and for sharing his personal story. Demonstrating an issue is best done with a personal story, if possible, so I thank him for that—it was incredible. I am minded of his story, and I think of my dad as well. My dad is dead and gone now, but when he was living in this world he had cancer on three occasions. It was many years ago, and the expertise for cancer care and healing were not as good then, but he survived because of the surgeon’s skill and the nurses care, and because he was a Christian and he believed very clearly in God’s help and the prayers of God’s people.

I start by saying how pleased we are to see £22 billion set aside for the NHS. That is constructive and positive and we should welcome it. Within that £22 billion there will be money for radiotherapy, and hopefully for training and bringing staff forward—it is important to have that as well. The hon. Member for Wokingham referred to the Royal Berkshire hospital, and in Northern Ireland we have similar problems.

I am going to tell a story that has been heard often. I am sure that most of us in this House were struck by the candid and very emotional video released by the Princess of Wales to inform the nation that she was going through the valley of cancer. The video was in response to a concerted campaign of disinformation against the princess of my heart, and probably all our hearts. She was disgracefully confronted with that every day. She was forced into a declaration of her intensely private journey with cancer, highlighting the effect on her husband, children and family. That very public declaration and the updates that she has so wonderfully provided have started a wide conversation about the dreaded C-word. We are deeply indebted to the Princess of Wales for that.

We also had the announcement about the King’s health. I was surprised and I immediately prayed for him, as I do every day. But the announcement about the Princess of Wales, a young woman in her prime, goes back to what the right hon. Member for Herne Bay and Sandwich (Sir Roger Gale) said: many people do not see cancer as a disease of younger people. The Princess of Wales, who was apparently so healthy and vibrant, has caused many of our young people to remember that cancer is not a disease that is a respecter of person, age, religion or background. All are brought to their knees by this disease that is ravaging the nation.

In Northern Ireland the target is that at least 98% of patients diagnosed with cancer should begin their first definitive treatment within 31 days of a decision to treat. At least 95% of patients should begin their first definitive treatment for cancer within 62 days. The problem is that those timescales here on the UK mainland and for us back home in Northern Ireland are not always met—indeed, they are rarely met. That means that that first definitive treatment, which is so important, does not happen at the time it should, and the figures are not getting any better. With the £22 billion that has been set aside for the NHS, I am hopeful that, through the Barnett consequential for Northern Ireland, we will get additional money that we can use specifically for cancer treatment.

I want to make a point about research and development and make a plea for Queen’s University Belfast and the partnerships it has with companies. It brings students from all over the world to find treatments and cures for cancer. I know that happens in many other parts of the United Kingdom, which is good. Research and development is so important, so perhaps the Minister will give us some ideas about research and development when he sums up. I am pleased see him and welcome him to his place.

The question should not be about lowering the target, but about how we deliver and meet the target of curing cancer. Having spoken to cancer specialists, I know that the need for more staff in radiology and in labs to provide a quicker turnaround, as well as the need to ensure that there are trained specialist cancer nurses and staff in place, is a long-term issue that needs to be dealt with not with words but with action. We need to spend the budget in a much better way throughout the UK—perhaps the Minister will indicate how that will happen. I believe the answer lies in the recruitment of staff in all facets of the cancer machine—labs, radiology, pharmacy and care. Every area needs specialist training. We need to keep staff in place with better working conditions, rather than the wonderful staff that we have simply burning out due to the pressure.

[Noah Law]

The father of my constituent, Eli Martyr, has been diagnosed with bowel cancer. Despite a difficult time, his father is being looked after amazingly well by NHS staff. If the Government commit to a national cancer strategy, will they ensure that the second biggest cancer killer, bowel cancer, is given sufficient attention? Can we address the staff and kit shortages and ensure that we improve the bowel cancer screening programme to improve the chances of survival?

[Jim Shannon]

I am of an age—I am not sure many others are in this Chamber—where I get a test for bowel cancer every year. A kit is sent out to do the job. Thankfully, every time I have done a bowel cancer test it has come back negative. To be fair, the NHS has a good system for that. When someone reaches 60, they are sent a test. They do the test and the NHS comes back very quickly. If something is wrong, they will hear right away. Although we sometimes criticise the NHS—rightly so—we should always recognise the good things that the NHS does. The hon. Gentleman was right to bring that up; I thank him for that.

The questions regarding cancer care in England are the same as for Northern Ireland: “How can we get the best outcome with what we currently have?” and “How can we plan to do better in the future?” Neither are easy questions, but the fact that some 9,000 new cancer diagnoses are made every year in Northern Ireland—these are drastic figures—in a population of 1.85 million, equating to one in two people developing cancer in their lives, means this issue must be a priority for us all.

I know that in his response the Minister will give us some positives in relation to where we are—I expect that, knowing the nature of the Minister—but it would also be helpful if we could have some idea about how we can better address this issue together, across this whole United Kingdom of Great Britain and Northern Ireland.

NHS Winter Readiness

Jim Shannon Excerpts

Wednesday 30th October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I am just chewing a sweet, Sir Roger; my apologies. It is a pleasure to speak in this debate. I congratulate the hon. Member for North Shropshire (Helen Morgan) on setting the scene so well. Today, we had some good news in the Chamber: that £22 billion will be spent on the NHS. The good news for us is that, through the Barnett consequentials, some of that will come to Northern Ireland. We do not yet know how much, but we are sure that some of it will come.

As the DUP health spokesperson, I join colleagues in expressing concerns for my constituents and their access to good health care this winter. Everyone has spoken about that; we cannot ignore the issue. We hope what the Government have put forward today is a helpful financial solution that will go some way to addressing the issue. I am aware that health is a devolved matter, but funding is not devolved, nor is the obligation of Government to implement their promised NHS reform throughout the entire UK.

When I asked the Secretary of State for Health about that reform, he was very clear in his commitment that everyone in the United Kingdom of Great Britain and Northern Ireland would see the benefits. I hope today is a step in the right direction. The Department for Health has released the preparedness document for last year. I welcome some of the impetus, such as strengthening the urgent and emergency care system to provide alternatives to emergency departments, including urgent care centres, urgent streaming services, rapid access clinics and the local phone first services.

The hon. Member for North Shropshire, who set the scene, referred to ophthalmology. It is important to include that because there are some questions along those lines. We had an event yesterday called “The eyes have it”. As the party’s health spokesperson, I try to go to as many health events as I can in the House of Commons. Those attending outlined a number of things they wish to see. Perhaps the Minister can give us some ideas on how we can improve ophthalmology across the United Kingdom.

I welcome the £3.4 million funding provided to general medical and out of hours services, to support GP practices to increase their capacity in light of the anticipated increase in demand over the winter. A figure of £4.3 million has been provided to support GP practices across Northern Ireland to provide proactive support and care to those in nursing and residential care homes. That is again an example of what can be done. I will mention some of the other positive things. I am hopeful that some of the extra money allocated to the NHS today by the Chancellor will filter its way towards Northern Ireland.

The hon. Member for North Shropshire referred to the ambulance service. The Northern Ireland Ambulance Service is increasing its range, capacity and clinical expertise at the ambulance emergency control to help ensure that cases are appropriately managed, without time delays. The enhanced hospital capacity, with 45 beds opened for last winter in my local Ulster hospital, will continue to be funded. Those are some of the good stories and news.

Another is the rolling out of the Pharmacy First pilot service for uncomplicated urinary tract infections in women aged 16 to 64 years. That will expand the current pilot of 62 community pharmacies to the entire pharmacy network of some 500 pharmacies right across Northern Ireland through an investment of £410,000. Again, money is being allocated in the right places to do the right job, which will hopefully make lives better. Over the winter period, it is estimated that this will deliver 12,000 consultations, freeing up capacity in GP practices.

The whole idea of the Pharmacy First pilot service was to ease pressure on GPs, and I know the Minister has always been committed to that. There are good things that can happen, and hopefully after today even more good things will be able to happen. Some £265,000 has been allocated for a new Pharmacy First sore throat test and treat service, which is being piloted this winter. When winter comes, there are colds, flus, sore throats and days off, and everyone rushes to the GP. This will reduce the impact on GPs. These good schemes can be of overall benefit to the NHS. The sore throat service will be piloted in 40 pharmacies, and it is estimated that 8,000 consultations will be delivered this winter, which is good news.

All these measures were welcomed, but none brought the result of an NHS that was prepared last winter. Indeed, that has increased my conviction that we are in a more difficult situation this winter and that the pressure on the NHS cannot be relieved by these small measures. If the Minister can, will she say how the moneys announced by the Chancellor today will be allocated and how that will improve the NHS’s response to this winter?

We need GP practices to be able to refer their patients for an MRI and know that they will be seen in reasonable time, rather than making the referral and then telling the patient to go and spend the day in A&E to get the MRI. Such small but significant things would make a difference and improve the service overall. GPs also tell me that they do not trust the red flag system and that A&E is turning into that red flag system for tests. How can we blame GPs for trying to ensure that they do not miss anything and for using the system in this way?

We need more capacity for MRIs, CAT scans and mammograms, and we need more trained radiographers. One of the things announced today was a significant investment in radiography, but when it comes to allocating the funds we must consider the need to ensure that we recruit and retain radiographers. The Minister may not have the answers to these questions, but does she know what has been done to train more radiographers and improve our NHS?

As a result of there being too few radiographers, 188,881 people in Northern Ireland—nearly 10% of the population—are waiting for a diagnostic test. The wait means that treatment such as radiotherapy is delayed and cases become more complex. That is the nature of having a health problem; people should get seen early and respond early. For some patients, even a two-week delay can mean the difference between life and death.

This long-term issue needs a long-term vision. That is why I am asking the Minister to take seriously schemes that would encourage our intelligent and capable young people to train here and stay here. I have been a great advocate of this and have raised this issue on numerous occasions over the years. We want these young people to train here and stay here with their skills. University bursaries or forgiveness of student debt in return for a period of employment in the NHS would be a positive way forward. Could the Minister look at that too?

Young people go into debt very early on and find it hanging over their shoulders for years to come. If we offer them a job in the NHS and they commit to staying, we can improve things. We have incredibly capable, intelligent British students, and we need to invest in their long-term careers in the NHS and allow them to work alongside junior doctors. We must prepare them for the marathon of NHS life rather than give them sprints that they cannot sustain. We should get the system moving in that direction. I believe that there is work to do not simply for this winter but for every day of the winters yet to come.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Sir Roger. I thank the hon. Member for North Shropshire (Helen Morgan) for securing the debate and hon. Members for taking part.

We have all just rushed from the main Chamber and I think I am the only person here who has come out enthused and excited after what we heard about the massive support offered—particularly for the NHS. It is the first Labour Budget delivered after the 14 years of the coalition and the Tory party’s time in power, and it lays the foundations for fixing our economy.

Just in case people did not clock all the figures, there will be £22.6 billion in day-to-day extra spending on the health budget, including a £3.1 billion increase in the capital budget, £1 billion of which helps address the backlogs of repairs that have been allowed to fester over the past 14 years. There is also an additional £1.5 billion for beds, new capacity for diagnostic tests, surgical hubs and diagnostic centres, to address the key point made by the hon. Member for Meriden and Solihull East (Saqib Bhatti). Let us take some of that funding and not just stop the decline but fix the foundations, setting the path for the next 10 years, as we have clearly articulated in the few weeks that we have been in government. When I speak to my constituents in Bristol South, they are most concerned about the NHS spending every penny of taxpayers’ money wisely, properly and where it needs to be focused. That is why we have concentrated on our three shifts and launched this national conversation—I hope everyone takes part.

We all know the problems, and that is what Lord Darzi helped us address. We also know that winter is a difficult time for our health and care system. Although we cannot predict the severity of the weather, we can predict much of the activity, we know what is likely to hit us most of the time, and we can certainly plan better. I remember working on the issue as a NHS manager back in the day, across primary, community, and secondary care, as well as with ambulance services and local authorities. A systems response is needed, and it is important that we are all involved in preparing and planning.

I also remember just how demoralising it was for staff in the early 2000s, coming into work every day to fight fires and sort out the awful trolley waits—not to mention how unacceptable that was for patients and families. The point about the impact on staff’s mental health and morale was well made by the hon. Member for Winchester (Dr Chambers). I also saw, and was proud to be part of, the changes we made under that Labour Government to end those trolley waits, and we will do that again. That is what Lord Darzi’s report shone a searing spotlight on, including the chronic lack of capital investment that has put many hospitals into a perpetual bed crisis, particularly during peak periods such as winter cold snaps.

While we have inherited a broken NHS, it is not beaten. As we have just heard from the Chancellor, this Government have taken the first steps towards fixing the annual crisis with new capital investment. However, one Budget cannot undo the last 14 years of failure, so while we fix the foundations we are also mitigating the immediate risks. At the very least, going into this winter we will be better prepared than we were last winter. That is because the managers in the NHS will be preparing for winter rather than planning for strikes, which is what they had to do the last three years—already a significant improvement.

The health service does face challenges on all fronts, and the figures are sobering. We have heard some of them today. In September, provisional statistics showed that almost one in 10 A&E patients waited over 12 hours to be admitted, transferred or discharged. The mean category 2 response time in September stood at about 36 minutes—around double the NHS constitutional standard. I recently attended a meeting where officials highlighted the number of attendances requiring admissions are already up by 1.8% in September compared to 2023, which is continuing to place increased pressure of patient flow. Those are the results of deep structural issues in the NHS that will not be fixed overnight. But work is already under way to rebuild resilience and manage pressures across the health and care system this winter.

I will come on to the specific work being done, but I assure hon. Members that the Government are taking the issue extremely seriously. I am already meeting senior leaders in NHS England and the UK Health Security Agency every two weeks to ensure that the risks can be identified quickly and that pressures are managed effectively. Once the peak winter period hits, the meetings will move weekly and include the Secretary of State.

Local NHS systems are best placed to determine how to respond to issues in their local area. That is why NHS England has worked with local systems to ensure robust winter plans are in place at a local level. As someone who knows exactly what is involved in that planning, I pay tribute to the staff for their skill, motivation and commitment to protecting every patient this winter.

[Jim Shannon]

There is no better choice the Government can make than committing that money to the NHS—we all welcome that. Anybody who does not would be insane. I always try to be constructive in my contributions. I asked about staffing and made the suggestion to retain students wherever they do their training. Sometimes they come to the end of it and go somewhere like Australia or New Zealand to get a job. Instead of that, if Government were to consider a bursary-type system to retain the staff, I think we would be able to address some of the pressure that we have.

[Karin Smyth]

I will come on to staffing to address some of those points. The hon. Gentleman makes an excellent point about staff recruitment and retention, which is a key part of our future look at the system.

On winter planning, the Government should not be micromanaging people in local systems as they do their job. Rather, we need to focus our efforts on where they are needed the most. Notwithstanding the excellent work of individual staff, let me repeat: the NHS is broken. None of us should underestimate how difficult this winter could be, but we are taking immediate steps to cushion the blow. First, we have set out our national winter planning priorities to NHS systems, local authorities and social care providers to support operational resilience over the coming months. Secondly, we are standing up the winter operating function seven days a week to respond to pressures in real time.

Thirdly, we are expanding the operational pressures escalation levels framework to give us a clearer picture of what is happening on the ground in all our systems. The framework uses comprehensive data to keep track of hospital pressures, and this year we are expanding its scope to mental health, community care and 111. Fourthly, we are continuing to support systems that are struggling the most through the urgent and emergency care tiering programme. Those are direct interventions to help systems get back on their feet and make the necessary improvements in performance.

Fifthly, we are providing targeted, clinically-led support to 19 of the most pressured hospital sites across the country, to help long waits in A&E and avoidable admissions over winter. Those measures are in addition to the aforementioned meetings that I hold with NHS England and UKHSA every fortnight. I am chairing every one of those meetings to ensure that we identify risks as soon as they arise, while supporting NHS England to mitigate them.

The party of the hon. Member for North Shropshire has called on the Government to set up a winter taskforce to prepare for an NHS winter crisis. Some might describe what we are doing as a taskforce; I actually think that is my job and the Secretary of State’s job, which, as I have outlined, is why we meet regularly with NHSE. I know that the hon. Member and others are sincere in their efforts to be constructive. I am happy to take away any specific suggestions about what we are not doing to help the NHS, because we all want the system to work well.

Children’s Hospices: Funding

Jim Shannon Excerpts

Wednesday 30th October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Liverpool West Derby (Ian Byrne) for setting the scene. It is nice see him in his place; he used to be in opposition, and now he is in government. He has been elevated, so well done.

I was saddened to hear about Zoe’s Place in the hon. Gentleman’s constituency having to become a stand-alone charity to encourage investment. There are many children who rely on these services, so it is never nice to hear the sort of news which he has presented today. Our hospices are pivotal within their local communities, so it is great to be here to discuss how to support them further.

It is also a pleasure to see the Minister and the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), and I look forward to their contributions. About a fortnight ago I attended a pop-up hospice charity shop here in Parliament. It was helpful to discuss the funding crisis facing our hospices with other Members and representatives. I also signed an open letter to the Minister of State for Care, and I look forward to hearing his responses in relation to these issues.

Over the years, I have supported the Northern Ireland Children’s Hospice, which holds three or four charitable events in my constituency of Strangford every year. People are very generous and incredibly kind. The money that John and Anne Calvert help to raise through those charity events is something we all appreciate.

To give some background on the situation in Northern Ireland, the Northern Ireland Children’s Hospice is instrumental in providing endless amounts of support for people and is incredibly helpful. Horizon House in Newtownabbey is a seven-bed in-patient centre that aids the local community, including through sibling and bereavement support. It goes beyond what would normally be expected, providing community care alongside hospice at-home and palliative care for 350 babies across Northern Ireland, which is really important.

In February this year, the hospice had to reduce its bed capacity to six due to a reduction in Government funding, with the intention of running six beds from Monday to Friday, and three beds on Saturday and Sunday—a drastic change from the seven beds, seven nights model. Incredibly active fundraisers added a huge £14 million to the four hospice care facilities back home.

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

My hon. Friend is making a fundamental point about the community raising millions of pounds to support hospices, particularly palliative care, across society. Does he agree that that has to be seen, not as a replacement for Government funding, but an addition to it?

[Jim Shannon]

I thank my hon. Friend for that intervention. He is absolutely right. The £14 million raised in Northern Ireland for hospice care is extra money and—I say this very gently to the Minister and those in positions of power—that should not be taken by the Government as, “Well, we can take £14 million off what they’re doing in Northern Ireland because we’ve got £14 million from the volunteers.” That £14 million is vital to ensuring that the care goes forward.

With increasing reports of closures and decreases in some services, there is a clear need for the Department of Health, wholly supported by the Barnett consequentials, to find ways to financially aid our hospice services so that, years down the line, we do not see impending closures. The core priority, I believe, is to protect these vital services that provide so much to families across the United Kingdom of Great Britain and Northern Ireland.

Together for Short Lives revealed that the Northern Ireland’s Children’s Hospice has forecast a budget deficit of £1.46 million for 2023-24. That is due in part to a 6% cut in the hospice’s statutory income. Our hearts— and, most importantly, our thanks—are with the staff of hospice centres who work tirelessly to support those young children and families through that end of life palliative care.

I conclude with this, Mr Twigg—I am trying to keep to time—I strongly sympathise with the hon. Member for Liverpool West Derby and his constituents on what they are going through. I have every hope that the Government can do something to support the devolved nations, and indeed NHS England, in the funding crisis. This is the responsibility of the Department of Health back home, but that must be fully supported by Westminster, right here.

Diabetes Treatments

Jim Shannon Excerpts

Tuesday 29th October 2024 Westminster Hall

[Sarah Bool (South Northamptonshire) (Con)]

I beg to move,

That this House has considered diabetes treatments.

It is a pleasure to serve under your chairmanship, Mrs Harris. On 21 May 2021, my world changed forever when I was diagnosed with type 1 diabetes at the age of 33. While my diagnosis was a shock, given its late onset, the feelings of fear, disbelief and sadness are shared by all those diagnosed—young or old, with type 1 or type 2.

Diabetes is a complicated condition that has been done the great disservice of being stigmatised through misunderstanding. It is not necessarily that we have eaten too many sweets or not looked after ourselves. Type 1 is an autoimmune condition—we did nothing to cause it—and people can develop it later in life; Mr Speaker and I can attest to that. Type 2 is not just for the over-40s and the unfit; someone can be slim and active, like Sir Steve Redgrave, and still be diagnosed. That is why I have secured today’s debate. Breaking down the stigma and investing in early treatment of diabetes is so important to allow patients to live fulfilled lives, and to do so in the most long-term, cost-efficient manner for the Government.

Our understanding of how to treat diabetes has come on leaps and bounds since the discovery of insulin back in 1921, but there is still so much more that we can do. Some 5.6 million people in the UK are diagnosed with diabetes. That includes 4,329 people in my constituency of South Northamptonshire—more than 6% of the population. However, last year, just 54% of my constituents with diabetes received all eight of their essential checks, which are important for identifying and preventing complications.

The total cost of diabetes to the NHS is estimated at £10.7 billion, and 60% of that is spent on the costs of diabetes complications. Every week, complications from diabetes lead to 2,990 cases of heart failure, more than 184 amputations, 930 strokes and 660 heart attacks. Those should be preventable with the right education, the right support, and the right attitude from individuals and the Government.

There is so much that I could talk about on diabetes, but this is a short debate, so my initial ask of the Government, on type 1, is that we end the postcode lottery, with equitable treatment for those living with diabetes wherever they live in the UK.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing the debate. I declare an interest: I am a type 2 diabetic. In our discussion before the debate, I informed the hon. Lady that, when I was first diagnosed some 18 years ago, believe it or not, I was at least 17 stone and probably getting bigger by the minute. I went on a diet because that was what the doctor recommended; I am down to a nice trim 13¼ stone.

I am thankful for the NHS and the treatment offered, but there is a clear disparity between the treatment offered in different areas of the United Kingdom. Does the hon. Lady agree that diabetes does not have to be a death sentence, but does not have to adversely affect quality of life either? We must ensure that, no matter where someone is in this great United Kingdom of Great Britain and Northern Ireland, they should get a level of diabetic care that enables them to live life to the fullest. Does the hon. Lady agree?

[Sarah Bool]

Absolutely. I totally agree, and the hon. Gentleman makes a very powerful point. It does not have to be a death sentence; it can even lead someone to No. 10 Downing Street, if they are Baroness May, so it should not prevent anyone from achieving anything.

Going back to my asks for type 1, we must also commit to greater access to technology for diabetes, such as hybrid closed loop technology, and increase awareness of the condition and treatments in schools and among the public. We also want to see the expansion of early testing for type 1 diabetes to identify children who are living with the condition and to make sure that they and their families get the right support.

I apologise in advance to hon. and right hon. Members if I suddenly start to beep during this debate, or in the Chamber in the future. They can be assured that it is not because I am some form of 21st century R2D2; it is because I wear an insulin pump and sensors. When my blood sugar is running low, it will alert me so that I can consume a lifesaving sugary treat. This hybrid closed loop system has dramatically improved the quality of my life with type 1. It does not just benefit adults with diabetes like me; there are parents of young children with a HCL who feel they can finally sleep at night without fear of missing a nighttime low blood sugar for their little ones.

Type 1 is also a condition that creates a serious mental burden on those who live with it and their loved ones. As a condition where someone’s pancreas stops working and no longer produces insulin, it requires constant thought and calculations alongside normal activities. Each day, a person with type 1 is assessing how many carbohydrates there are in their food and how much insulin they should dose, taking into account whether they have exercised, will be exercising, or generally rushing around; how hot or cold it is; how tired they are; how stressed they are, with public speaking adding to the mix for me; for women in particular, what their hormones are doing; and, when they have low blood sugar, how quickly they can access a sugar supply.

My insulin pump and sensor have ensured that many of those burdens have been eased. I just wish that more of my fellow diabetics had the same opportunity. I know of one lady from the south-west of England whose local integrated care board did not prescribe HCLs, so she had to move to London, away from her support network, just to access that vital technology. That cannot be right. As part of building an NHS fit for the future, Ministers should ensure that wherever someone is in the UK, they can access vital treatments for diabetes, such as the HCL.

There are other treatments that the Government should commit to fully exploring, such as early detection and new drugs. As with my diagnosis, more than 80% of type 1 diagnoses occur in people with no known family connection to type 1 diabetes. Many people are not aware of the four “T” symptoms that they should look out for: thirst, toilet, tiredness and thin. Early detection is vital in preventing complications such as diabetic ketoacidosis, which one in four children with type 1 are diagnosed with, and which can be lethal. Early detection can also identify people who would benefit from early intervention clinical trials and treatments.

The ELSA study is a programme funded by Breakthrough T1D that offers children between the ages of three and 13 a simple finger stick blood test to determine their risk of developing type 1 diabetes. The study is currently open to families across England, Scotland, Wales and Northern Ireland, with over 20,000 children having been screened so far. I ask that the Government work to have the programme expanded and implemented on the NHS nationwide, as it could drastically reduce the instances of future complications from type 1.

[Jim Shannon]

I thank the hon. Lady for giving way again. One of the things that we have noticed back home in Northern Ireland is that even if someone gets a type 1 diabetes diagnosis early on, it does not mean that their life is over—they can still go on. We have a high prevalence of young children in Northern Ireland who have type 1 diabetes, and for them it is rather scary but also a fact of life. I have seen some of those young boys and girls growing up and the diabetes has not affected their life at all. It is important to know that those being diagnosed early with diabetes can have a normal life and family.

[Sarah Bool]

I absolutely concur with the hon. Gentleman; people can live a fulfilling and fulfilled life, but they do need a little more help along the way. If we get that at the right time, it can literally transform a life so that they can live like everyone else.

One of the promising new treatments coming forward is teplizumab, which will delay the onset of type 1 in children by an average of three years. Approved by the Food and Drug Administration in the US in 2022, it is about to start a technological appraisal by the National Institute for Health and Care Excellence. In conjunction with the national early detection programme, teplizumab could drastically reduce the complications associated with type 1.

With the rise of social media, we have seen an ever-growing societal preoccupation with body image. Earlier this year Baroness May and Sir George Howarth released a parliamentary report into type 1 and disordered eating, also known as T1DE. T1DE is an eating disorder where someone might restrict their insulin to lose weight or experience an eating disorder such as bulimia or anorexia alongside type 1. Evidence suggests that up to 40% of women and girls and up to 15% of men and boys with diabetes experience some form of disordered eating, so we really must continue the work of Baroness May and Sir George in raising the profile of diabetes and its complications.

On type 1, I ask the Minister to ensure that the Government work with the NHS to increase awareness of the hybrid closed-loop technology, particularly among lower socioeconomic groups, and to fund its roll-out nationally; to provide comprehensive training for healthcare practitioners on HCL technology; and to establish a national diabetes registry to support technology adoption and track health outcomes.

Turning to type 2 diabetes, right hon. and hon. Members will have heard a lot about and might even have been tempted by Ozempic and Wegovy, known as the GLP-1 medications—seemingly magic solutions that have helped many in the public eye to shed unwanted pounds. However, that class of medication is an important treatment for those with type 2 diabetes as it is prescribed to lower blood glucose levels. My concern, and that of some of my constituents who have written to me, is that there is a real risk of a shortage of those medicines for type 2 diabetics while they are being prescribed for weight loss. It is therefore essential that the supply of those drugs is protected for diabetics. Will the Minister take action to ensure that everyone with or at risk of type 2 diabetes can access the medications that they can benefit from?

Alongside medications, we should ensure that newly diagnosed type 2 diabetics are given the right support. In some cases it is possible to put type 2 into remission, so it is essential that access to evidence-based services such as the NHS path to remission programme is increased for people in the first three years of their diagnosis. Likewise, people under the age of 40 with type 2 are at increased risk of developing diabetes complications, but are less likely to receive their essential care. The NHS type 2 diabetes in the young programme—T2Day—provides extra support for that group, including confirmation of diagnosis, additional checks, contraception and pre-conception planning, and assessment of cardiovascular risk. The Government must commit to sustainable long-term funding for the programme to ensure that the rise in type 2 diabetes in working age adults does not lead to a drastic increase in serious complications.

There are also inequalities across the diagnosis of diabetes. Those living in deprivation and people of black and south Asian ethnicity are more likely to develop type 2 diabetes but less likely to receive their diabetes care, and they go on to experience worse health outcomes. As the Government develop their plan for the NHS, they should use health inequality impact assessments for all diabetes-related policies to understand how reforms affect different groups.

As right hon. and hon. Members might have worked out by now, I could speak about diabetes all the way to the moment of interruption this evening, but I will draw my speech to a close. Acting as our own pancreas is hard and our illness requires 24-hour attention. Diabetes treatment is relentless, but so are we.

World Stroke Day

Jim Shannon Excerpts

Tuesday 29th October 2024 Commons Chamber

[Sarah Dyke (Glastonbury and Somerton) (LD)]

I am grateful to have this opportunity to address the House on World Stroke Day. Stroke is the UK’s fourth biggest killer and the single largest cause of complex disability in the UK. On our current trajectory, the number of stroke survivors will increase by 60% over the next decade, which will swallow up nearly half the current NHS budget. By that time, one in three people in Glastonbury and Somerton will be 65 or older, so we will disproportionately feel the impact of the increase in strokes over the next decade.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate. She mentioned the age of 65, which is really important; in Northern Ireland, there are some 2,800 new strokes every year. While the majority of strokes affect people who are over the age of 65, they can strike at any age. Some 25% of people who have strokes are under the age of 65, so does the hon. Lady agree that we must get away from the notion that stroke awareness is only for older people, and that we must be very aware of the FAST signs—face, arms, speech and time—that can make the difference between death and recovery? It can happen to young people as well.

[Sarah Dyke]

The hon. Member makes a really important point. Although we often assume that it is older people who suffer with strokes, so many young people suffer in the same way.

Unless there are major improvements, Somerset’s poor ambulance response times and poor life-after-stroke care will mean that a disproportionate number of the 42,000 people who will die from stroke in 2035 will be from my constituency.