Oral Answers to Questions

Debate between Jim Shannon and Jackie Doyle-Price

Tuesday 23rd July 2019 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman, as usual, raises a very important issue indeed. Of course, people with special educational needs will be at risk of mental ill health more than any other cohort of children. I am having regular meetings with the Under-Secretary of State for Education, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who has responsibility for children and families, about this very vulnerable group. Having targeted mental health provision across mainstream schooling generally and put in such investment, we now really need to home in on the groups at highest risk.

[Jim Shannon (Strangford) (DUP)]

Will the Minister outline what discussions have taken place with the devolved Administrations to ensure that best practice and best results are implemented UK-wide, especially considering that Northern Ireland has the highest level of mental health issues pro rata in the whole of the United Kingdom of Great Britain and Northern Ireland?

[Jackie Doyle-Price]

As usual, the hon. Gentleman raises an extremely important point. Of course, health is a devolved matter, but that is not to say that all four nations cannot learn more from best practice in each place. I am pleased to say that we are now increasing our contact with representatives of the devolved Governments, and we will very much be sharing such best practice.

Medical Aesthetics Industry: Regulation

Debate between Jim Shannon and Jackie Doyle-Price

Tuesday 14th May 2019 Westminster Hall

[Jackie Doyle-Price]

The hon. Lady is right, and I am grateful for the spirit in which she makes her comments. Anyone who establishes themselves in business as a beautician wants to deliver a good service, has pride in what they do and would not want to be accused of doing anything unsafe.

My first focus of activity is those organisations that train people in these procedures, because I can see a situation in which a beautician will have paid thousands of pounds to go on a course and will then think that they are qualified, but they might not be. That is where we need to bring the focus of regulation in the first instance, so that when somebody proudly displays their certificates, consumers can have some guarantee that they are legitimate. I welcome the opportunity to air these issues with the all-party parliamentary group as we move this system of regulation forward.

Sadly, we only have 30 minutes for this debate, so I doubt whether I will be able to get through as much as I would wish, but I will do my best. I am grateful for the interest of all Members here. We will continue this discussion. It is worth saying that Botox treatments and dermal fillers are increasing and, along with laser hair removal, now represent nine out of 10 non-surgical treatments performed in the UK. This is a major area of risk.

Hon. Members have referenced the campaign that we launched today. Clearly, consumers will be the best defenders of their own interest, but we must make sure that they have access to appropriate information with which to do so; we need to do much more to inform people about the risk. Just as in my hon. Friend the Member for South Leicestershire’s example of his constituent, I am quite sure that many people who have had fillers—who have gone to have their lips done, like they do—would have no idea that there is a risk of their artery being injected with poison. We need to make sure that consumers are much more aware of that, which is why we are doing so much more in the next six weeks to try to raise public awareness.

We will focus on targeting our messages to women aged 18 to 34, on whom the majority of the treatments are undertaken. I am pleased that we are working with Bauer Media, which publishes Grazia, Closer and Heat, which I hope will be appropriate vehicles to reach that audience. We will make sure that the NHS information is kept up to date and remains a meaningful resource for consumers.

[Jim Shannon]

Would the Minister consider making it so that under-18s could not have this treatment?

Mental Health Support: Young People

Debate between Jim Shannon and Jackie Doyle-Price

Tuesday 9th April 2019 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend makes a good point. Transition is clearly an area that we need to address, and she is right to highlight the importance of this in universities.

The hon. Member for High Peak made a number of points in her speech. She referred to people with ADHD and ASD, and I could not agree with her more that there is a real issue with the failure to diagnose people with those conditions early enough. We know that those people are more likely to suffer from mental ill health, so early diagnosis is absolutely crucial if we are to equip those young people with the tools to look after themselves. I am pleased that that has been a target in the forward plan that we will roll out. The hon. Lady also rightly highlighted the issues surrounding county lines and knife crime, and there is no doubt that the increased incidence of trauma in communities will bring with it more demand for mental health services. That is something that we are very much tackling as part of the Prime Minister’s summit, which took place just last week.

I have been very pleased to work with the hon. Member for Ogmore (Chris Elmore) on this, and I welcome his all-party parliamentary group’s report on the impact of social media. The impact of social media brings with it a whole new set of pressures on children’s and young people’s mental health. It brings greater intensity to relationships, for example. We think our children are safe in their bedrooms, but they are not necessarily, and we need to be vigilant about how we hold social media and internet providers accountable for the content that they host on their sites.

[Jim Shannon]

The Childline charity has reported a 30% increase in referrals in the past year. That is an indication of the pressure being put on our children. Has the Minister had an opportunity to speak to Childline?

[Jackie Doyle-Price]

I have not had that opportunity yet, but I am sure I will.

I could say an awful lot more, but I do not have much time remaining. It is clear from hon. Members’ contributions to the debate that we all recognise that this is perhaps one of the biggest challenges facing our young people right now. It is heartening to see that so many people are really seizing those challenges, whether by demanding better services or by asking for changes to Government policy to deal with some of the threats. That is all very welcome, and I have no doubt that all Members will continue to challenge me on this important issue.

Question put and agreed to.

Oral Answers to Questions

Debate between Jim Shannon and Jackie Doyle-Price

Tuesday 8th May 2018 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend is right that once children become obese they are going to become obese adults, with all the health problems that come with that. I do not want to steal the thunder of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), but rest assured that we will examine what more we can do to tackle obesity in children.

[Jim Shannon (Strangford) (DUP)]

I declare an interest as a type 2 diabetic. Bearing in mind that three out of five people with diabetes have mental health issues, will the Minister outline what support services GPs should be able to offer at the first diagnosis of diabetes? Early diagnosis is key.

[Jackie Doyle-Price]

I could not agree more. We need GPs to understand that they must consider a patient’s needs as a whole, not just the condition that is presented at the time, and that message has been sitting behind the guidance that we have been issuing to GPs on how they manage patients with long-term health conditions.

Oral Answers to Questions

Debate between Jim Shannon and Jackie Doyle-Price

Tuesday 19th December 2017 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend highlights one of the biggest challenges we face. There is no doubt that the rate of organ donation is much lower among black and minority ethnic populations, and yet they are more likely to suffer from diseases that require a donated organ, so we are keen to work on that. Only this week, I met organisations connected with the black and Asian community to discuss how we can communicate, getting the right messages through the right messengers, to encourage people to join the register.

[Jim Shannon (Strangford) (DUP)]

I fully support the organ donation opt-out, because it will increase the pool of organ donors. Will the Minister comment on whether the recent statistics from the Welsh Health Department show an increase in the provision of organs due to presumed consent? In other words, has it been a success so far?

[Jackie Doyle-Price]

I thank the hon. Gentleman for his support. The figures from Wales come at an early stage, but the system that we are looking to introduce has much in common with that in Spain. The issue is not so much about the register moving towards an opt-out system, but the wraparound care that goes with it, such as the specialist nurses who speak with relatives when they are going through the trauma of losing a loved one, and the public debate that raises awareness. Taken together, they are what will lead to more organs becoming available.

Abortion Act 1967: 50th Anniversary

Debate between Jim Shannon and Jackie Doyle-Price

Monday 6th November 2017 Commons Chamber

[Jackie Doyle-Price]

I understand that the hon. Lady feels strongly about this issue, and nobody can doubt her passion and commitment to women’s welfare. My understanding of the grant she referred to is that it went strictly towards the support of women who chose to go through with the birth. I am happy to look at that further. I am not entirely sure it was the largest donation, but I am happy to look into that. However, the hon. Lady is right when she says there should be genuine choice. We do not want anyone to feel that they cannot have an abortion, any more than we want them to feel that they have to have one. We really want women to be able to make informed choices and to feel empowered to have the child, if that is what they would like to do. The important thing is that we empower women. That is the whole purpose of what we are trying to do here—to empower women and allow them to make choices that are safe for them.

Since the Act was passed, there have been regular calls from all sides of the debate for changes to the legislation, and the hon. Member for Kingston upon Hull North has outlined her views clearly today. As she said, this Government and previous ones have always viewed legislative change as a matter for the House to take a view on, and there are no plans to change that.

The Act was last amended in 1991 by the Human Fertilisation and Embryology Act 1990. This reduced the time limit for most abortions from 28 weeks to 24 weeks. No time limit applies where there is a substantial risk that the child will suffer from a serious handicap or that the pregnancy would cause grave permanent injury to the physical or mental health of the mother or put her life at risk. So amendments are possible, and it is ultimately Parliament that decides the circumstances under which abortion can be legally undertaken. The Government will always ensure that regulation works to make that as safe as possible.

The hon. Lady outlined clearly her belief that abortion should be decriminalised, and the Government will no doubt take a view as and when she brings forward her Bill, as indeed will the rest of the House. It is true that any abortions conducted outside the grounds in the 1967 Act currently remain a criminal offence, and there is no intention for that issue to be dealt with by anything other than a free vote.

Turning to the impact of the Act in practice, it is important that we remember that, in the years before the Act, abortion was, indeed, the leading cause of maternal mortality in England and Wales. For example, the first confidential inquiry into maternal deaths in 1952, reported 153 deaths from abortion alone. The most recent confidential inquiry report found there were 81 reported deaths in 2012-14 for all direct causes of maternal mortality, such as obstetric complications, interventions and omissions. So since the Act came into force, women in Great Britain have had access to legal and safe abortion services.

[Jim Shannon]

Does that figure include those who committed suicide as a result of having an abortion and the effect it had on them?

[Jackie Doyle-Price]

The figures include those who have died as a result of maternal complications. I am not aware of any figures that detail suicide. However, we need to look at the whole issue of counselling for women who are facing any kind of unwanted pregnancy.

In 2016, 98% of abortions were funded by the NHS, whereas in 2006 just 87% were NHS-funded. That shows that the NHS is providing more and more of this service. Ninety-two per cent. of abortions were carried out at under 13 weeks’ gestation, and 81% were carried out at under 10 weeks, illustrating the fact that the procedure is becoming safer. Sixty-two per cent. were medical abortions, more than double the proportion in 2006—again, a good sign of progress. This data clearly shows that improving access and choice within the existing framework can be achieved. I am sure that all hon. Members will welcome the fact that the vast majority of abortions are taking place at earlier gestation times, which is safer for women and offers increased choice of medical abortion.

On home use, abortions in England can be performed only in an NHS facility or in a place approved by the Secretary of State for Health. At present, a patient’s home is not an approved place for abortion. I am aware that the Scottish Government have recently granted approval for the second stage of early medical abortion treatment to be undertaken in a patient’s home in certain circumstances. As I have said repeatedly, our overriding principle is that all women who require abortion services in England should have access to high-quality and safe care. We will continue to engage with women and with stakeholders on ways to make our safe and regulated services even more effective.

A key part of an abortion service is providing information and services to enable women to make informed decisions and to support good sexual health. This includes information about, and provision of, contraception and testing for sexually transmitted infections. Abortion providers should be able to supply all reversible methods of contraception—including long-acting reversible methods, which are the most effective—and offer testing for sexually transmitted infections as appropriate. Before the woman is discharged, future contraception should have been discussed and, as far as possible, the chosen method should be initiated immediately. All women should be offered testing for chlamydia and offered a risk assessment for other sexually transmitted infections such as HIV and syphilis. Provision of effective contraception is essential if we are to make progress towards our ambition to reduce unintended pregnancies in women of all ages. For women aged 24 and under, we have seen significant reductions in the abortion rate, most notably in under-18s, where the rate has reduced from 18.2 per 1,000 in 2006 to just 8.9 per 1,000 in 2016. Rates in women aged over 24 have remained stable or increased slightly. We know that we have more work to do to ensure that we see improvements across all age groups.

Over the past 50 years, there have been significant improvements in women’s health, in the regulation of abortion, and in the safety of abortion. It is appropriate that we look back, take stock, and congratulate ourselves on that, and that we continue to ensure that the way in which we allow for legal abortion makes it, at all times, safe and well regulated.

Question put and agreed to.

Contaminated Blood

Debate between Jim Shannon and Jackie Doyle-Price

Thursday 20th July 2017 Commons Chamber

[Jackie Doyle-Price]

I can give the hon. Gentleman that commitment. I have already discussed this with the Welsh Minister. It is a UK-wide inquiry and health is a devolved matter, so obviously we will need to work closely to ensure that we all respond to what the inquiry finds.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her statement and commend the hon. Member for Kingston upon Hull North (Diana Johnson) for her tenacity on this issue. Although only last December the Northern Ireland Health Minister allocated funding for contaminated blood victims to put us on a par with compensation paid on the UK mainland, it is essential that any UK investigation includes the Northern Ireland victims—I am speaking on their behalf—so that it is not done on an England-and-Wales-only basis. Can she confirm that that will be the case?

[Jackie Doyle-Price]

I can reassure the hon. Gentleman that we are very sensitive to the facts as they apply to Northern Ireland, and we will by all means ensure that the requisite dialogue takes place so that we can deal with it sensitively.

Organ Donation: Opt-out System

Debate between Jim Shannon and Jackie Doyle-Price

Thursday 13th July 2017 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

It is a pleasure to serve under your chairmanship, Ms Buck. I thank all Members who have participated in this debate. Organ donation has been such an established practice in the NHS for quite some years that we often forget about it. The way that everyone has brought the subject to life today, with references to their own stories and experiences, has reminded all of us how important it is. Perhaps it is time this subject had some renewed focus, if only to raise awareness and encourage people to opt in, whether or not we ultimately introduce an opt-out system.

I pay tribute to the hon. Member for Barnsley Central (Dan Jarvis). He could not have done a better service to his constituents Joe Dale and Max Johnson in the way he expressed his argument with considerable persuasion. Perhaps through him, I could send my good wishes to Joe Dale’s family. I hope they get some comfort from the fact that Joe lives on by giving life to others. As we know, one organ donor can save or transform up to nine lives. What better legacy can we have than for other people to live on? We, as Members of Parliament, could perhaps be more proactive in giving that message, as we breathe life into this much neglected subject.

I am told that we last considered organ donation on the Floor of the House in 2014. This opportunity to discuss it is very welcome, and we will have many more opportunities, given the confirmation from the hon. Member for Coventry North West (Mr Robinson) that he will use his private Member’s Bill to push this issue forward. I am sure it will get a good airing.

The hon. Member for Washington and Sunderland West (Mrs Hodgson) presented tests at the end of her speech for what we should bear in mind when deciding what to do in this space. I think we should do all those things, in any case, as we talk about kidney donation. The key has to be public awareness and ensuring that medical professionals do their bit to encourage people to participate in organ donation. We must also engage with community groups where there is a specific problem. That is my biggest priority.

I want to say a bit more about the context. Obviously, we want to encourage as many people as possible to make clear their intention to donate after death and to have that conversation with their families. That is often where the decision is made. Medical professionals need the requisite training to have these sensitive conversations.

As the hon. Member for Barnsley Central mentioned, not many people understand the system of organ donation. We can all sign up to be on the donor register, but not all of us will be in a position for our organs to be used. Quite often, organs can be used after an unexpected and traumatic death, and it is very difficult for any medical professional to have a conversation with the family about what should happen to the deceased’s organs. We need to have a lot more understanding and be a lot more willing to make it clear to our loved ones that we would want our organs to be donated if we were ever unfortunately in that position.

I must pay tribute to all those in the national health service who work in this area. Their determination and commitment makes donation and transplantation possible. Although we still need more transplants, we have seen a significant increase in donations in the UK. We saw 1,413 donors giving 3,712 transplants in the last year, which illustrates how many lives can be saved by one successful approach to donation.

It is incredible that, as NHS Blood and Transplant told us only this week, more than 50,000 people are now alive thanks to organ donation and transplantation. The first transplants took place in my lifetime, and they were seen as revolutionary. One reason we have not given this subject as much attention is that donations now tend to be seen as commonplace.

There is much to celebrate, but there is also much more to do, not least because 457 people died last year while on the active transplant waiting list. That ignores the 875 people who were removed from the list because they had become too ill to receive a transplant. Many of those will have died shortly afterwards. At any one time some 6,500 people are on the waiting list, and again, although waiting times are declining, we cannot be complacent. We need to make sure that those people have hope that, when they are on the list, they have a realistic chance of receiving a transplant.

Our biggest challenge is black, Asian and minority ethnic donors, for two reasons. First, black and Asian people are more at risk of illnesses that may require a transplant, such as high blood pressure and diabetes, and secondly, the consent rate for those communities is half that of the white population. The same is true for blood, so we need many more blood donors from the black community. There is a constant need for that because of the prevalence of sickle cell anaemia, but we know that only 1% of the nation’s blood donors are black. So we need to do much more not only in organ donation but in blood donation.

There is some encouraging news. Last year, more than 6.4% of all deceased donors were from black and Asian communities. That is a significant increase, so the direction of travel is positive, but we need to do much more. Average waiting times for kidney transplants have fallen for everyone, and that rise in donations from black and Asian communities has meant that the biggest fall in waiting times is for black and Asian patients—down from four years to two and a half over the past seven years. The direction of travel is good, but we need to do more, because people from black and Asian communities still wait at least six months longer than white patients. That problem needs to be tackled, because recipients are matched according to blood and tissue types, which differ across ethnic groups.

As we set out in our manifesto, we are determined to target that audience, and we welcome the involvement of all hon. Members in that. We are looking at other partner agencies, and we are working with the National Black, Asian and Minority Ethnic Transplant Alliance. However, many other groups need to be engaged, not least to tackle misplaced cultural concerns about donation. It is not incompatible with Christian beliefs to bequeath one’s organs, and we need to make sure that that message gets out loud and clear by engaging with all community leaders in this space.

We have heard some persuasive arguments on opt-outs and why we should move towards an opt-out system, and I certainly understand the thinking behind that proposal. To add my personal experience of this, my constituent Patricia Carroll regularly lobbies me on the subject. Her daughter Natalie suffered from anorexia and diabetes, and died awaiting a kidney and pancreas transplant. Patricia tried to donate her own kidney to Natalie but was not a match. Following Natalie’s death, she decided to become a live donor. Last year—I think it was around Christmas—she gave a kidney to a 22-year-old young man called Joe who had been on dialysis for three or four years.

What Patricia has done for that family—it is the family, not just the individual—has transformed their lives. I again pay tribute to all live donors. That is an incredibly altruistic thing to do when recognising the impact it can have on the donor’s own health. It is amazing, particularly when there are donors who have absolutely no personal relationship with the beneficiary of their organ. Patricia will be watching with interest to see what I have to say about this.

There are obvious attractions to opt-outs as a tool; anything that will increase the pool of available organs will obviously be attractive. However, opt-outs on their own are not a panacea, and the references to what we can learn from Spain are significant. The issue is about what is wrapped around that. Specifically, it is not just about public understanding and public awareness of why we need donation and what it means, but about how the medical profession deals with it.

The crucial point that affects donation is the conversation in the room between medical professionals and bereaved families. We have seen examples of families refusing consent because they are not convinced that their relatives wanted to donate and it feels safer to say no. Equally, we have seen that being overruled. We find that the highest rates of donation are achieved when we have specially trained nurses who have that conversation with the family in a sensitive way. When such conversations take place, rates of donation go up significantly. Those conversations are critical. If we look at the experience of Spain, we see that that injection of medical advice achieved the step change in donation rates, over and above having an opt-out system.

None the less, we are interested to see the experience in Wales. We are certainly prepared to consider that, and obviously we need to consider it sooner than we might have intended, given the private Member’s Bill, but opt-out will never be a silver bullet to achieve more donation. We are committed to ensuring that we do whatever we can to increase donation. Our strategy, “Taking Organ Transplantation to 2020”, contained the ambitious targets that the hon. Member for Barnsley Central mentioned. Although we have not actually achieved the 70% that we are aiming for, the direction of travel is positive. The fact that more than 23.5 million people have opted in to donate their organs is quite an achievement, although I am not complacent. To give credit where credit is due, the NHS and everybody involved have achieved a great deal in achieving those figures.

The key thing is the availability of specialist nurses. We must ensure that organ donation is embedded as a normal consideration of end-of-life care, where that is available. We have looked at developing a new organ donor register that makes it easier for people to opt in. We are trying to make available as many opportunities as possible for people to do that, for example when people sign up for a new driving licence. In any interaction with Government, we need to give people that option, because where it is a positive choice, it is more likely to be effective.

[Jim Shannon]

We all agree about the need to raise awareness on the mainland and across the whole United Kingdom of Great Britain and Northern Ireland. When it comes to raising awareness—I presume the Minister will do so imminently—will she engage with the Northern Ireland Assembly, provided that it is still going, and with Scotland and Wales to ensure that we have a UK-wide programme of awareness to get people on the register?

[Jackie Doyle-Price]

The hon. Gentleman makes an excellent point. He might have seen that I am wearing a pin, which is a nice pink heart that says, “Yes”. That campaign is being run by NHSBT to highlight the need for people to offer to be a donor. If people are prepared to do it, they should wear this nice pin. We need to use any number of the tools at our disposal, and we need to be a lot more imaginative about the ones we use. I look forward to seeing him with his nice pink heart.

I should conclude my remarks to allow the hon. Member for Barnsley Central an opportunity to respond to the debate. I think that we are all united in the outcome we are trying to achieve, which is to encourage more people to be willing to donate their organs to achieve more transplants. With regard to the tools we employ to achieve that, we will look at opt-out and consider whether that would do anything, but in the meantime we are prioritising engagement with black and minority ethnic communities. We will continue to invest in specialised nursing to have those very sensitive conversations, because they need to happen. We will look at what more we can do to encourage more families to be willing to give consent at the time it needs to be given. I thank everyone for contributing to the debate.