Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Monday 13th May 2024 Commons Chamber

[Jo Churchill]

I join my hon. Friend in that, because any way we can help lift skills across the piece, such as through boot camps and workplace academy programmes, to help people into high-skill, well-paid jobs, particularly in areas where perhaps that has not been the norm, is to be welcomed and congratulated.

[Jim Shannon (Strangford) (DUP)]

rose—

Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Monday 18th March 2024 Commons Chamber

[Jo Churchill]

I thank my hon. Friend—it is seemingly quite a large number on my birthday cards today.

My hon. Friend has been a fantastic champion of his local jobcentre, and has campaigned vigorously to ensure that Darlington is at the forefront of innovation. I will be meeting his team in April. I have been to seven jobcentres since the last DWP questions, and I will make sure that his work coaches are at the top of my list.

[Jim Shannon (Strangford) (DUP)]

The Minister, in her response to the hon. Member for Darlington (Peter Gibson), has emphasised what she will do for his local jobcentre. Whatever she will do for Darlington, she will also do for the rest of the United Kingdom, including my constituency of Strangford. Across this great United Kingdom of Great Britain and Northern Ireland, how can we work better with further education colleges to get our young people ready for the jobs that become available?

[Jo Churchill]

I talk regularly to colleagues in the Department for Education, ensuring that those skilled boot camp SWAPs make people job-ready, because they have not only the experience but a guaranteed interview. That is the way we are driving those numbers up.

Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Thursday 28th April 2022 Commons Chamber

[Jo Churchill]

I am working with my hon. Friend the Member for Taunton Deane (Rebecca Pow) on this, because the challenge in sewers is acute with the build-up of wet wipes. As I say, we have recently conducted a consultation. That consultation has now finished. We are now reviewing the results, and we will be bringing forward more information shortly.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her response, and in that theme of positive strategy going forward, what discussions has she had with the Department of Health and Social Care about the packaging of medical supplies being more readily recyclable? The pandemic has clearly illustrated and highlighted the reliance on single-use plastic, and we must do everything we can to reduce that.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

T5. Farmers across the United Kingdom of Great Britain and Northern Ireland are very innovative and want to diversify. Can I ask the Minister a straightforward question? What is being done to encourage farmers to do just that to help the economy?

[Jo Churchill]

Up to 2028-29, we will be investing £270 million across a programme of innovation to boost research and development, and innovation. I spoke to Northern Irish farmers only this week. They are with us in driving that forward.

Badger Culling

Debate between Jo Churchill and Jim Shannon

Monday 21st March 2022 Westminster Hall

[Jo Churchill]

That is the date that I have been directed to. As my hon. Friend knows full well, as do I as somebody who worked in the Department of Health and Social Care during the pandemic, these things have a habit of not always coming through. As my right hon. Friend the Member for Scarborough and Whitby said, something might be deemed unpalatable or it may not have the degree of sensitivity we need, but it is right that we try to ensure that the vaccine for both cattle and badgers is where we are getting to, so we can drive down and deliver on what the Godfray review said—that we should replace culling with vaccinations and disease surveillance.

We are developing several schemes and initiatives to make it simpler for those who are suitably trained to start vaccinating badgers. There is no single measure that will eradicate bovine TB in England by 2038. That is why we have to continue to have a wide range of interventions. We need to strengthen cattle testing and movement controls, which the hon. Member for Cambridge mentioned. We have to improve biosecurity on the farm and when trading, and we need to develop that cattle vaccine, in addition to building our support of badger vaccine. Cattle controls and measures continue to be the foundation stones on which our TB eradication strategy is based.

[Jim Shannon]

I thank the Minister for her positive response and for clearly charting a way forward, which hopefully will address the issue. Has the Minister had the opportunity to speak to the devolved Administrations, in particular Edwin Poots, on this subject matter?

[Jo Churchill]

I was, in fact, due to go tomorrow, but I am now unable to. I dare say those conversations will happen in short order. I know that my Northern Ireland equivalent is looking at this issue at the moment, and it is hoped that we can learn from one another. We can certainly get those conversations where we can all be enabled to make the right decisions as swiftly as possible.

The hon. Member for Weaver Vale pointed out that culling causes badgers to move, and perturbation, as my hon. Friend the Member for North Herefordshire said. Taking that into account is important. That is why we need a gradual, monitored, evidence-based approach, so we do not risk perturbation and the disease getting a hold. We need the areas that can cull to do so while we build the vaccination capability and a vaccinated population.

The strategy is rooted in routine and targeted testing of herds, movement restrictions on infected herds, rapid detection and removal of cattle testing positive. My hon. Friend the Member for West Dorset (Chris Loder) said that it is particularly stressful when a calf is involved. We do have an isolation policy so that a positive cow is pulled out in order that the calf can be born.

Measures such as the statutory testing of cattle, movement between farms and surveillance at the slaughterhouse also apply. Over the last 12 months, we have compulsorily slaughtered more than 27,000 individual head of cattle in England to control the disease. Many of us represent rural constituencies, and we have heard today from virtually every Member about the misery that both sides of this bring to people. The cost to Government of dealing with the disease is about £100 million a year; it is a huge burden for the taxpayer.

One of our top priorities, as I have said, is to develop the vaccine for cattle so that it does not interfere with the TB testing regime. We hope to get that introduced within the next five years. It is expected to be a game changer in providing a strong additional tool to help to eradicate the disease. It is important that we look at the trials that are ongoing at the moment and we get the evidence base. There is not a single answer to the scourge of bovine TB, but by deploying a whole range of policy interventions, we can turn the tide on this insidious disease and, we hope, achieve the long-term objective, which I think everybody shares, of ensuring that we make England officially TB free by 2038—sooner if we can make it, but definitely not much later.

Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Thursday 27th January 2022 Commons Chamber

[Jo Churchill]

I do not think I can say any more than that it was described as similar to the narcotics industry. We need to treat fly-tipping with that much seriousness: we need to crack down and make sure that the people who are earning illegally and blighting others’ lives are hounded out of this industry.

[Jim Shannon (Strangford) (DUP)]

May I first thank the Minister for her enthusiasm in the matter? She clearly means what she says and I thank her for that. The most recent statistics from back home show that in the past two years the Department of Agriculture, Environment and Rural Affairs cleaned up 306 illegal waste sites, costing half a million pounds or the equivalent of 15 nurses’ pay. What discussions has the Minister had with her counterpart in the Northern Ireland Executive to discuss how we can combat these issues together and take the pressure off local councils?

[Jo Churchill]

I thank the hon. Gentleman for his question. I meet Ministers from the devolved Administrations regularly. I have not had specific conversations on the matter, but I would be happy to because fly-tipping knows no boundaries. We need to sort it out together.

Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Thursday 9th December 2021 Commons Chamber

[Jo Churchill]

I join my hon. Friend in congratulating Harrow Council on being one of the first councils in the country to join the Trees for Streets project, which is funded by the green recovery challenge fund. It aims to support the planting of 250,000 street trees over the next 10 years, transforming our urban environment. The national planning policy framework supports that; it promotes street planting and makes clear the expectation that trees should be incorporated into new developments, making our environment better for us all.

[Jim Shannon (Strangford) (DUP)]

The Woodland Trust Northern Ireland has encouraged all local councils to adopt a tree strategy in order to adopt ambitious tree planting targets. Will the Minister introduce a similar scheme here on the UK mainland to encourage the idea of localised tree planting in communities?

[Jo Churchill]

I refer the hon. Gentleman to the answer I gave a few moments ago, but I would be happy to talk to him further about what is happening in Northern Ireland to see whether there are lessons to be learned.

Cervical Screening

Debate between Jo Churchill and Jim Shannon

Monday 19th July 2021 Westminster Hall

[Jo Churchill]

Indeed I will. I would be happy to write to the hon. Lady, because I have looked at that issue. If there is a chance that someone may have abnormal cells, they should get them checked out. The hon. Member for Coventry North West (Taiwo Owatemi) spoke about making sure that we reach those communities who would not necessarily come forward, for a number of reasons.

The hon. Member for Wythenshawe and Sale East (Mike Kane) spoke, as several did, about using technology better, and about the challenges of screening and the health inequality that there is in certain communities for access to screening. I have met NHS England several times about that, to think how we can use that technology and different avenues—I will speak in a minute about the self-sampling sample.

We have to think differently about how we encourage women, because not every woman will come forward in the same way. We have different pressures on our lives at different times. Perhaps we are not as good at the younger end, because people think, as the hon. Member for Pontypridd said so eloquently, “I didn’t think it would happen to me.” Perhaps they have a young family or are busy at work. All those things mean that we have to make it as easy as we possibly can to access screening wherever you are and in whatever form suits you, because there are also cultural barriers for some not only to cervical screening but to breast screening, where they are hesitant to come forward.

[Jim Shannon]

I referred to my wife, who had some difficulty making the appointment. What she did was talk to my mum. I feel women talking to women is much easier. We should not always push to the back of the queue, for instance, a family member having a substantial discussion. Sometimes it starts with a discussion, before they go to the hospital. It very important to have family members around to support and give advice.

Alcohol Products: Labelling

Debate between Jo Churchill and Jim Shannon

Tuesday 27th April 2021 Commons Chamber

[Dan Carden]

Will the Minister give way?

[Jim Shannon]

Will the Minister give way?

[Jo Churchill]

My goodness—stereo!

[Jo Churchill]

Now is a great time to focus on making sure that we enable people to make the healthier choice as the default choice, and that we work to ensure that people have the right information for them. All I am willing to say at this stage is that nothing is off the table. There are a lot of strategies. Rather than making any blanket statement, the important job now is to refocus and to deliver on some of the commitments that we would like to see, and to make sure that the consultation is rolled out so that we can have that dialogue and make sure that we are doing the right thing for individuals but also across the industry.

[Jim Shannon]

I thank the Minister for outlining very clearly a strategy to address the issues that the hon. Gentleman is referring to. Minister, I know that it is not technically your responsibility, but I think perhaps—

[Jim Shannon]

Apologies, Madam Deputy Speaker. One massive issue has been the promotion of drink at cheap prices so that people can get drunk cheaper. Would the Minister be sympathetic to discussing this issue with the industry—the Portman Group has been referred to—to try to address it?

[Jo Churchill]

I think the hon. Gentleman refers to minimum unit pricing. As I say, we are refocusing on making sure that we are having a broad range of discussions. As he pointed out at the beginning of his intervention, this is not something that sits within my responsibility. However, I have heard, and I am sure others have heard, his plea for that work, which does go on in other parts of the United Kingdom.

Alcohol labelling is one part of wide-ranging cross-Government work to address alcohol-related health harms and their impact on life chances. The Government are committed to supporting the most vulnerable at risk from alcohol misuse. We have an existing agenda on tackling alcohol-related harms, including an ambitious programme to establish specialist alcohol care teams in the worst-affected 25% of hospitals, because I do recognise some of the challenges within the workforce that the hon. Member for Liverpool, Walton mentioned. We continue to support the children of alcohol-dependent parents—a situation that wreaks such havoc.

As part of the prevention Green Paper, we are committed to increasing the general drinking population’s direction of travel towards lower-strength alternatives when they have moderate drinking habits. We are working with the industry and other stakeholders to create more consumer choice and availability in the low-alcohol and no-alcohol sector. They are often very palatable alternatives, particularly for those who are driving or who may have a reason to want a clear head the following morning. The more choice that we can give people in that area, the better.

The Government have committed to publishing a new, UK-wide cross-Government addiction strategy that considers the full range of issues, including drugs, alcohol and problem gambling. While each of those comes with its own set of issues—as the hon. Gentleman said, the second part of Dame Carol Black’s review is due shortly—there is also much common ground and many benefits to tackling addiction in a complete, comprehensive and joined-up way. The scope of the addiction strategy is still being developed, so I consider this debate and his calls most timely as we consider what more can be done to protect people from those alcohol-related harms.

I emphasise the Government’s commitment to ensuring that alcohol labels provide the information that people need to make informed choices about the products that they are purchasing. I stress, probably for my husband and children mostly, that we are not saying, “You can’t enjoy a drink.” What we are saying very clearly is that we would like to encourage the nation’s drinking to be responsible, and to help people not to be one of those statistics that wreck lives.

We believe that people have the right to accurate information to help them to make decisions about the products that they purchase, and we are committed to ensuring that the labelling on alcohol provides that. Progress has been made in relation to the UK CMO’s low-risk drinking guidelines and other information on alcohol products, but we are not complacent. We will continue to actively monitor the position and keep it under review, and ensure that we level up so that people, no matter what drink they choose, can get accurate information from the product.

We await the consultation to ensure that we take everyone with us, because it is important that we do things in a measured but directed way in order to bring the benefits to the most people. I thank the hon. Member for Liverpool, Walton for introducing this Adjournment debate and for everything that we have discussed. Let us hope that we can get there.

Question put and agreed to.

Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Tuesday 13th April 2021 Commons Chamber

[Jo Churchill]

I agree wholeheartedly that we should encourage all children to make sure that they can take part in sports and enjoy the outdoors. Regular physical exercise is important for the health and wellbeing of young people, and the local community has an important role to play in developing facilities. That is why the Government launched a £150 million community ownership fund, to ensure that communities across the UK can benefit from the local facilities and amenities that are most important to them. That includes community-owned sports clubs and sporting and leisure facilities that are at risk of being lost without community intervention, and I urge my hon. Friend to work with his community to ensure that he has those facilities locally.

[Jim Shannon (Strangford) (DUP)]

What plans the Government have to ensure an adequate number of nurses in the cancer workforce to deliver the targets for cancer set out in the NHS long-term plan.

Covid-19: Community Pharmacies

Debate between Jo Churchill and Jim Shannon

Thursday 11th March 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Sir Graham. I am incredibly grateful to my hon. Friend the Member for Thurrock (Jackie Doyle-Price), not only for securing the debate today, but for her work as chair of the all-party parliamentary group on pharmacy, and across the health space more generally.

All those who have participated today have shown how important pharmacy is to every one of us. The voices of my hon. Friends the Members for Barrow and Furness (Simon Fell), for Harrogate and Knaresborough (Andrew Jones), for Bolton West (Chris Green), for Carshalton and Wallington (Elliot Colburn), for Henley (John Howell), for Winchester (Steve Brine), for Isle of Wight (Bob Seely) and for Southend West (Sir David Amess) joined those of the hon. Members for Strangford (Jim Shannon), for Birmingham, Selly Oak (Steve McCabe), for Coventry North West (Taiwo Owatemi), for Halifax (Holly Lynch) and for Bootle (Peter Dowd). Everyone recognised how important community pharmacy is in their community, and I want to join in the thanks given to that community today and say how much I value what it does on the frontline. As my hon. Friend the Member for Harrogate and Knaresborough said, pharmacy workers are key, skilled frontline workers and deliver over and above, every day, to our communities. I repeat the thanks of the Prime Minister and the Secretary of State for Health and Social Care, and add my gratitude.

The fact that pharmacy workers are a key part of our NHS family, as my hon. Friend the Member for Thurrock said, and have risen unfailingly to the many, varied and enormous challenges of the pandemic should not go unnoticed. There are 11,210 pharmacies sitting at the heart of our communities. They are easily accessible: 80% of them are within 20 minutes for someone walking there. They are highly rated, as many hon. Members have said, and highly trusted. Throughout the pandemic they have stayed open and served their communities. They have provided vital pharmaceutical services. Medicines are not something that people can choose to have or not have.

I am immensely proud to stand here as the Minister for pharmacy, and I thank everyone involved in community pharmacy for their hard work, whether they talk to patients every day or are involved in the vaccine roll-out or the broader team. From the times I have spoken to them, I know that they are tired. They have worked unbelievably hard for the past year. I do not think that, when this started, anyone anticipated that it would go on week after week. They have been working evenings and weekends, and I would like to thank them for it.

Hon. Members might recall that we agreed a five-year deal back in July 2019, before the pandemic. It commits almost £13 billion to community pharmacy—just under £2.6 billion a year—and was the joint vision of Government, NHS England and the pharmaceutical negotiating committee, the PSNC, for how community pharmacy will support the delivery of the NHS long-term plan, and patients.

As we have heard from many, particularly my hon. Friend the Member for Southend West, there is so much more that pharmacies are saying they want to do for our communities. Having spoken to many pharmacists and their teams, I know that using their full skillset is something they would welcome. It is what they want to do and what they want to see happen.

Over the period of the five-year deal, community pharmacy will be more integrated into the NHS and will deliver more clinical services, taking pressure off other areas in the NHS, as the first port of call for minor illnesses. That recognises, importantly, the skill base in the sector. To that end, more than 2,800 pharmacists each year go into training at the current time; there are more than 10,000 in training at the moment. We are making sure that, as the current cohort come out, they are equipped to be part of that future high-skilled workforce, enhancing their skills for consultation and so on.

[Jim Shannon]

One of the advantages that I am sure the Minister is coming to is that GP surgeries and A&Es will potentially have fewer people to see if the pharmacies take over that role.

[Jo Churchill]

I thank the hon. Gentleman for that point.

We are already making good progress on the journey. The community pharmacist consultation service went live in November 2019, enabling NHS 111 to refer patients into community pharmacies for minor illnesses or the urgent supply of prescribed meds. We have had more than 750,000 referrals so far.

In November 2020, we expanded that service to GP surgeries, so GPs can now formally refer patients to community pharmacies for consultation. In February, we introduced the discharge medicines service, enabling hospitals to refer discharged patients into a community pharmacist for support with their medicines. There will be more services introduced over the financial year.

Those services are to do what pharmacists and their teams do best, and that is to help patients. My hon. Friend the Member for Southend West spoke about hepatitis C. I assure him that, as of last year, we gave access to hepatitis C testing to those pharmacies that chose to take up that option.

I agree with my hon. Friend the Member for Winchester that there is great potential in hub and spoke dispensing. I also agree with the hon. Member for Nottingham North (Alex Norris) that there is already experience to learn from in the sector.

As set out in the community pharmacy contractual framework five-year deal, we want to make dispensing more efficient and, by doing that, free up pharmacist time to provide more clinical services—they are highly skilled, and we know they want to do that. The Medicine and Medical Devices Act 2021 paves the way for us now to progress legislative change to enable the better use of skills in pharmacies, something that several Members this afternoon have alluded to. There is a large amount of will to make sure that the whole team can use their skills appropriately and perhaps free up the pharmacist a little more for him or her to concentrate on other areas.

We have already started informal engagement with stakeholders—that started this week—which will be followed by a formal consultation. I am afraid I cannot give hon. Members an exact date, but I will commit that I want that to be as soon as possible—I want us to get on with this. I thank my hon. Friend the Member for Winchester, who knows the sector extremely well, for his comments about the opportunities that lie therein. I am sure that many hon. Members will want to work to develop that.

New services will develop and expand the role of community pharmacy across three key areas. Several hon. Members alluded to the fact that pharmacies would be expert in helping with prevention, urgent care and medicine safety and optimisation. Those are all areas in which growth is envisaged in the short, medium and longer terms.

That brings us to the pressure. I am well aware of the pressures community pharmacies are under. Not only has the last year brought quite unprecedented circumstances, but it has not allowed some things to go on that we thought would be embedded by this point. Throughout the last year, we have had conversations with community pharmacy and stakeholders, and have tried to respond as best we can by putting in place a package of measures and support for the sector.

Most community pharmacies have been able to access some general covid-19 business support, including various rates reliefs and some retail, leisure and hospitality grants, and we estimate that there has been access to about £82 million in grants. There has been extra funding for bank holiday openings, when—particularly looking back to last Easter, for example—the sector has responded phenomenally by remaining open and giving patients access across long holiday periods; for a medicines delivery service for shielded patients, which has been mentioned and has been hugely appreciated; and for a contribution to ensure that social distancing measures can be in place in every pharmacy.

We are still talking, however. We have provided personal protective equipment free of charge via the PPE portal, and have reimbursed community pharmacies for PPE purchased. We have also provided non-monetary support, such as the removal of some administrative tasks, flexibility around some of the opening hours, support through the pharmacy quality scheme for the sector’s response to covid-19, and the delay to the start of new services, all of which have been requested.

Between April and July 2020, an advance payment of £370 million was made to support community pharmacies with cash-flow pressures, which were extremely acute. Those were caused by several issues, including a sharp increase in prescription items in the March-April period, higher drug prices, delayed payments from the pharmacy quality scheme, and extra covid-related costs. Acting swiftly and providing those advance payments helped to alleviate immediate cash-flow concerns, but since then pharmacies have been paid for the increased items that they have dispensed, reimbursement prices were increased to reflect higher drug prices, and payments have been made under the pharmacy quality scheme.

We are still in discussions with the PSNC about the reimbursement of covid-19 costs incurred by community pharmacy, and I can reassure the House that the Government will take a pragmatic approach. I expect to deduct any agreed funding from the £370 million advance payments, and to discuss timescales around the advance separately with the PSNC, being very mindful of the pressures. We need to assure ourselves that community pharmacies are financially stable. Without that stability, they cannot deliver those services.

I am aware of the concerns that current funding is not enough, and I need to work with the sector to look at things in much more detail, because pharmaceutical services are complex, and there is a range of different providers. The hon. Member for Nottingham North mentioned that he has a Boots in his constituency, but that is a very different operation from many of the individual pharmacists, such as Tim, who has a pharmacy on the harbour in the constituency of the hon. Member for Isle of Wight.

Whether they are independent, small-chain or large-chain pharmacies, no two pharmacies are the same. The solution has to be one that we can tailor. A balanced and considered approach must be taken to maintain the variety and vibrancy that we all recognise as absolutely key in the pharmacy network. People and patients absolutely value the diversity that best suits them and their own needs. We need a sustainable funding model that works for all types.

I have heard the concerns about pharmacy closures, and I can assure Members we monitor the issue very closely indeed. Our data shows that, despite the number of pharmacies reducing since 2016, there are still more than there were 10 years ago. We have seen more closures in deprived areas, as many Members have said. However, importantly, there were more in deprived areas, so making sure that there are still more pharmacies in deprived areas is extremely important.

Proportionally, the closures reflect the spread of pharmacies across England, with closures tending to be where they are clustered. The most recent data shows that three quarters of the closures were part of large chains, and that aligns with consolidation announcements made before the pandemic. It is important that we protect access to pharmaceutical services. The pharmacy access scheme protects access in areas where there are fewer pharmacies and higher health needs so that no area is left without access to a local NHS pharmacy.

It is important to recognise that covid-19 is also an opportunity, which many Members have alluded to. The pandemic has shown across healthcare the value of our highly skilled community pharmacy teams, and how they can contribute and receive more funding. Commissioning community pharmacies to operate the medicines delivery service has been vital to ensure that vulnerable constituents have received their medicine. Community pharmacies have delivered the biggest flu vaccination programme ever, vaccinating more people than ever before.

There are currently around 200 pharmacy-led covid-19 vaccination sites, with a target to double that number by the end of this month, and there have been 60 more this week alone—on many of the questions around vaccines, I will defer to the Minister for Covid Vaccine Deployment. I expect more to follow, and NHS England is looking to designate more pharmacy-led sites, including sites that can deal with up to 400 vaccinations a week in areas where there were not sites that could deal with large quantities of vaccine, which initially put some sites off.

We are considering the important role of community pharmacy and how that can play out in future as we learn to live with covid-19 and having vaccinations. In addition, community pharmacies are taking part in pilots of antigen testing at lateral flow test collection sites. If those are successful, community pharmacies will be able to provide a valuable service to their local area and will be paid to do it.

The community pharmacy continues to be part of local PCNs, and I know it stands ready to take its full part in primary care as we learn to live with the disease. Those examples show how community pharmacy is helping the broader healthcare family fight covid-19. The Government are keen to make better use of the clinical skills, while giving pharmacies opportunities to generate more income above the £2.5 billion per year that the five-year deal went to—and there are opportunities.

Finally, I once again thank my hon. Friend the Member for Thurrock for this important debate. The past year has tested all pharmacies, and the following months will continue to be challenging. I am personally committed to doing everything I can to support all community pharmacies in what I view as their essential role as part of the NHS family, which, again, many have spoken of. This is a responsibility on all of us. Pharmacies bring incredible value to local communities and their patients. We are beginning to see the light at the end of a troubling tunnel, and we would not have made it this far without the contribution from community pharmacy. I look forward to having the conversation to ensure that we get a sustainable funding model not only with colleagues but, mainly, with the sector.

Breast Cancer Screening

Debate between Jo Churchill and Jim Shannon

Wednesday 16th December 2020 Westminster Hall

[Jo Churchill]

I am so sorry, Sir Edward. As I was saying, the challenge is that there is variation in the system. That variation occurs for a plethora of reasons, not only those that are covered by an impact assessment on accessibility via open appointments. It is important to keep an eye on all the data.

I am proud that we have a national breast screening programme that offers every woman between the ages of 50 and 70 an appointment every three years. We will strain every sinew to ensure that nobody waits longer than 36 months. We will not step back from that, even with the challenge of driving the backlog down. The programme reaches millions of women and detects approximately 20,000 cancers each year. I recognise the challenge, but every single individual provider has been asked to produce a recovery plan, which should help us to understand the variation. I recognise that about half a million women are waiting, but there are also 500,000 women who have not replied. They will need to be re-approached and encouraged into the system. It is incumbent on everyone to give women the confidence to come forward.

We have also had to look at making sure that women are asked to come forward in accordance with priority by targeting the women who are most likely to have an occurrence of breast cancer. High-risk women will not have open appointments; they will be called immediately. We will then screen positive women in the pathway, followed by screening results that have not been processed, routine open episodes, those who have previously been invited but not screened, and the delays. It is important that we prioritise, so that we target the women we are most worried about.

I am aware that this year, the national breast screening programme could not maintain the service that it normally provides. In March, as the NHS responded to one of the biggest challenges that has faced our healthcare system in a generation, many local providers made the decision to pause appointments so that arrangements could be put in place to protect staff and patients from covid-19. We were unaware at that point what we were dealing with. Staff and facilities were redeployed to tackle the outbreak of the pandemic, but as soon as it was possible to do so, it was made an absolute priority that they were brought back in to do the job that we need them to do.

I am sure that there is not a single Member in this Chamber, or indeed the House, who does not pay tribute to the hard work of all NHS staff. Cancer staff and their teams have done a particularly incredible job of making sure that people across the cancer family have received treatment. Earlier today, I talked to a young man about the treatment he has had, and I talked to a young woman who experienced chimeric antigen receptor T-cell treatment earlier this year. The redeployment of staff left a shortfall in the breast screening programme, and screening appointments for many women have been delayed. I know that that wait, and the anxiety it drives, is incredibly difficult. For those who are looking for reassurance from their routine screen, or who are waiting to receive an all-clear or an early warning that something is wrong, this is undoubtedly a challenging time. However, I want to be absolutely clear that no woman has been left behind, and no woman ever will be. It is a priority to ensure that services are there. Improvements are being driven by the heroic efforts of staff, who have been working longer days and over weekends. They have gone above and beyond to schedule as many appointments as possible to help to drive down the backlog that was created earlier this year.

The first priority is to screen women aged 53 who have not yet had their first screening appointment; those who have passed their 71st birthday and have not yet received their final breast screen; those at very high risk of breast cancer, as I said; and those who have been identified for further treatment. I am pleased to say that the tremendous efforts of screening staff—the nurses, the radiographers and the whole team—are succeeding and the backlog is steadily reducing. The number of women waiting for screening, having received an invitation prior to the first wave, decreased by 98% between 1 June and 4 November.

Screening has been made a clear priority this winter and NHS commissioners have been instructed, where humanly possible, not to redeploy their staff or their facilities away from screening services. It is a priority, and that is absolutely the right approach. My message to everyone is that breast screening services are running, they are safe, they will continue to run through the winter and they are standing up to the increased capacity that is coming towards them.

When people receive an appointment to attend, I urge them to go. “Do not attends” are so frustrating. Those appointments could be taken by a woman who—although she would not want a diagnosis—might get into the stream quicker.

[Jim Shannon]

I suspect that on some occasions, ladies are not attending because of the fear of catching covid-19 at the hospital. I have spoken to some ladies back home and that was one of their concerns. How can we address that?

[Jo Churchill]

Essentially, by constantly reassuring them that the reason why we can do elective operations, have out-patient clinics open and carry on doing some of the business as usual is because heroic efforts have been made to make sure that there are safe places. I pay tribute to Dame Cally Palmer, who has made sure that rapid diagnostic centres have been stood up to ensure that patients can access care safely. We had 17 at the start of the pandemic, and we now have 45. The cancer alliances have worked extremely hard in all our regions. There is no one silver bullet, but it is important that we do what we can for patients.

If people have any concerns or notice any abnormal changes in their breasts, they should contact their GP. I pay tribute to my hon. Friend the Member for West Bromwich East, and I am pleased that her mum is now in good health. CoppaFeel! is a great charity and its website shows how to do a good check. Breast Cancer Awareness Month still went on—I did wear it pink—although it did not quite have the same profile as usual. It is every woman’s responsibility to make sure that they check their breasts monthly. If they see anything unusual that they are concerned about, such as puckering or discharge from the nipple, GPs are open and there to help women.

One thing that can help is to make sure that people go, but we are here to talk predominantly about screening services. Cancer diagnostics and treatments are back on track. The latest official data for October 2020 suggests that GP referrals are back to almost 85% of pre-pandemic levels, compared with August 2019. I appreciate that that leaves a lag, but we are heading in the right direction.

Urgent referrals were 156% higher in October than in April, which is when they were most affected. That shows that we are not only getting there, but beginning to go beyond. Nearly 88% of cancer patients saw a specialist within two weeks following their referral, and nearly 96% of patients received their treatment within 31 days of a decision to treat. In October, 83.5% of breast cancer patients received their first treatment within 62 days, and breast cancer treatment activity was at 101% of last year’s levels. However, these figures do not hide the fact that there is a backlog and we have to work as hard as we can to address that. The “Help Us Help You” campaign, launched in October, is a key part of this and reinforces that message of seeking help. We will closely monitor the effect of covid restrictions on referral rates to ensure that the number of people coming forward with symptoms remains high, because it is about confidence. Some pathways are more problematic than others, but the important thing is to make sure that we get as many people as possible through the pathway.

I turn to the theme of breast screening for younger women. As the hon. Member for Midlothian (Owen Thompson) has said, this has been found not to be evidenced-based. There is a risk in referring women for unnecessary tests, in over-treatment, and in operating on women who have diseases that mean that that is likely to cause harm. Women with a very high risk of breast cancer, such as those with a family history, may well be offered screening earlier and more frequently. Sometimes, in life, we just have to ask a question, and I recently asked a breast cancer specialist about this. My hon. Friends the Members for Chatham and Aylesford (Tracey Crouch) and for Norwich North (Chloe Smith), and the former Members for Dewsbury and for Eddisbury, all of whom are in the younger age group, are going through treatment—I think one of them is post treatment—and I was their age when I was diagnosed. Just because something looks right, it does not necessarily mean that it is, and we have to act on the evidence. That is where we are at the moment for young women.

We published the people plan in July, and I recognise, as Sir Mike Richards did, that the screening workforce is a challenge and it is important that we drive more individuals into the areas of radiography, mammography, pathology, nursing and cancer specialist nursing. The spending review provided another £260 million to continue to grow the workforce and support those commitments, which were so important in the NHS long-term plan.

Health Education England has also provided £5 million to support training and development programmes through the National Breast Imaging Academy, which aims to improve breast screening recruitment targets and early diagnosis. It has already made significant progress, launching the mammography level 4 apprenticeship; recruiting the first of the NBIA radiology fellows, who will benefit from specialist training in breast radiology; and developing e-learning for health programmes on the breast.

To improve screening uptake, we need to work with cancer alliances, primary care networks and the regional teams to promote the uptake of breast screening and to get to as many people as possible. As I said, the open appointments systems is something that we are looking at, and we hope that the result will be that we get more women through. The national cancer recovery plan was released this week. It is a joint effort from cancer charities, royal colleges, national teams and patient voices, and it was led by the national clinical director for cancer, Professor Peter Johnson. Its whole ethos is to outline the actions that need to be taken to restore demand to at least pre-pandemic levels by raising national public awareness through campaigns; ensuring that there are efficient routes into the NHS for people who are at risk of cancer; improving referral management practice in primary and secondary care; and setting out immediate steps to reduce the number of people who wait more than 62 days from urgent referral, so that patients are seen as quickly and safely as possible. Finally, it ensures sufficient capacity to meet demand through maximising the use of available capacity in both symptomatic and screening pathways, which both feed into the same funnel, optimising the use of the available independent sector capacity, enabling the restoration of other services, and protecting service recovery during winter.

This is an excellent plan, which will work towards the long-term plan ambitions for cancer services to continue during the pandemic. I am fully committed to seeing it through and working with Dame Cally Palmer and all the others to ensure that we can get to a better place. I recognise that, as the hon. Member for Westmorland and Lonsdale said, there have been some remarkable changes to treatments with radiography and other treatments in cancer. We must take those silver linings where we can.

I pay tribute to my hon. Friend the Member for High Peak for coming to me to say that High Peak was special due to its geography, and he did not want the women he serves in his constituency to be disadvantaged in any way by a loss of service. I understand that the decision to put breast screening services into static positions was taken to maximise capacity. I was quite amazed that, pre pandemic, 70% to 80% of screening happened in mobile units. They are particularly helpful in dispersed rural areas, but with some of the challenges of providing covid-secure spaces—some of those units did not even have running water—a decision was made to bring them back to a static site. The static units can stay open longer and at the weekend, making about 1,000 more appointments possible in a three-month period, so a lot more women can be seen.

Although I take on board the point about travel, I am asking women to bear with us—to work with us. These are temporary changes, but they are a vital measure in the recovery of breast cancer screening services, allowing more women to be seen, particularly those who may have missed an appointment this year. I know that longer travel times are difficult. I know that those beautiful hills that my hon. Friend’s constituency is blessed with do not have particularly good bus services either. This is not always an easy proposition, but it was decided that, for now at least, optimising the service to see as many people as possible should take priority over optimising a mobile service.

When my hon. Friend came and met me, I could not give him any assurance, and he has pressed me again today. I assure him that this is a short-term measure. The increase of appointment availability will assist us in in being able to resume mobile screening for High Peak, safety permitting, by July 2021. I have been reassured by the Chesterfield Royal Hospital NHS trust that it is monitoring attendance, that this compromise is temporary, while services recover, and that the usual screening locations will be reinstated in the longer term to ease access. I take this opportunity to stress that the screening services are safe to attend and a range of measures have been put in place to ensure that people go.

I thank my hon. Friend and all other hon. Members who have participated today. I pay tribute to all the incredible staff across the country who are working so hard on the backlog and to make sure that cancer services stand up and catch up over the winter period. Hon. Members have my absolute commitment that we are focused not only on the short-term recovery of screening services, but on their long-term improvement too. Prevention, public health and early diagnosis continue to be a huge priority for me. We will continue to bear down on screening services, making sure we have the right kit in the right place and that we are delivering the different parts of the cancer pathway for men and women to have the best treatment.

Healthcare Support Services: Conception to Age Two

Debate between Jo Churchill and Jim Shannon

Tuesday 15th December 2020 Westminster Hall

[Jo Churchill]

I agree wholeheartedly with my hon. Friend. We are in a different time as regards parenting. Many couples choose that the father will stay at home. Often they do an excellent job at raising their children, as that part of the family unit. It is about communicating, sharing responsibility, and the services that wrap around families. My hon. Friend the Member for East Worthing and Shoreham used a lovely phrase when he talked about supporting, not supplanting, parents: holding hands to make sure that there is help there when someone struggles with breastfeeding or to understand the right thing to help a child sleep, or when there might be conflict in the house and they reach out. I take the point made by my hon. Friend the Member for Truro and Falmouth about a trusted carer giving people signposting. I asked my sister, who recently became a grandparent, what the most challenging thing was, and she said it was definitely the isolation and separation, which did not even allow her to hold her new granddaughter for six weeks after her birth.

[Jim Shannon]

The Minister is responding in just the way we knew she would, and I thank her for that. I mentioned in my contribution the importance of church and community groups, which by their nature are on hand to help and assist. Does the Minister recognise the good work that they do? Church groups are important to those of faith—and those of no faith—and the community groups are also important for what they can do, such as mother and tots provision.

[Jo Churchill]

Indeed. I think that often the role of family hubs can be support and education. However, a good health visitor can change a life, when it comes to moving on. An excellent midwife changed my journey, when I was struggling to feed my children for the first 10 days. Everyone says that those things are easy, but there is nothing easy about it, but after managing to get support people, hopefully, really feel they can fly. That is why it is vital.

Coronavirus has meant that many parents feel isolated, as I have said. They have not had access to the support of those closest to them, or other supporting work—whether that is faith-based or otherwise. That has added to the emotional pressures that many new parents face. For many babies the pandemic will represent time missed in, for example, getting to know grandparents. For some families it has meant a lack of professional wraparound support. There has been pressure throughout the system, but we have been in the middle of a global pandemic. It is just a statement of fact, not an excuse.

I assure my hon. Friend the Member for East Worthing and Shoreham and others that the advice from the chief nurse, the Local Government Association and others is that redeployment should not occur unless it is unavoidable, because it is seen as so important that families with young children get assistance. As my hon. Friend said, there are challenges with respect to health visitor numbers. Both of us have debated that issue in this place, and I have also met Professor Viv Bennett. I am looking forward to the review because some of the open sessions at which I have joined my hon. Friend have highlighted the importance of the service.

For the first set of lockdown restrictions the health professionals in question were redeployed, although I assure Members that vital safeguarding functions were still carried on. I have spoken to health visitors on the ground who said that that was a key priority, to keep children safe. We recognise that that level of support is not what people would want or expect. However, I really want us to go forward from this point to deliver into 2021 and beyond.

As the vaccination roll-out is happening and we start, hopefully, to return to a more normal, albeit covid-tinged, way of life, there is still a long way to go.

Coronavirus has shown us, if we needed more proof, how valuable data sharing can be across the services, as my right hon. Friend the Member for South Northamptonshire said. The join-up between services for the early years has accelerated out of necessity, but has brought a bit of a silver lining to what has been a very difficult time. Some of the services and support can be provided digitally. I would be the first to say that I do not want 100% of services to be on a digital platform, but there are mothers of tongue-tied babies who have been able to access immediate support, with a professional on the other end of the video conference call who is able to explain what is going on at the point when the mother is getting quite stressed about the situation. There is therefore a place not for only better data and information sharing to improve services, but for different ways of working to ensure that we get the most out of them.

The early years are not only important for health and care. Many Government Departments have an interest or play an active role, which brings me on to family hubs. They sit very much under the Department of Health and Social Care, while being integral to ensuring that we deliver properly for families. On Sure Start centres and the use of family hubs, findings from the local government programme, the Early Intervention Foundation and the review of family centres, family hubs and other delivery models will inform the next steps, including any future consultation of the role of children’s centres. I know that my hon. Friend the Member for Congleton will not cease to fight for family hubs to be at the centre of all our communities.

Cancer in Teenagers and Young Adults

Debate between Jo Churchill and Jim Shannon

Tuesday 1st December 2020 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Strangford (Jim Shannon). I congratulate him on securing the debate and on the sensitive way in which he always approaches these subjects.

Someone once said to me, “You don’t choose it. It chooses you.” That is the challenge with cancer. People have very little control over when or if they have to make that journey. However, it is a matter of making sure that we have the services in place and can have early diagnosis, and that we never take our foot off the pedal in getting the right workforce and making the pathways simple. People are understandably discombobulated when they are told; it is a tsunami of emotions. I would gently say that in the case of someone’s child, the wave is even higher. I could not imagine the pain of being told that.

On that point, I thank the hon. Member for Strangford for talking about Alex. I thank my hon. Friend the Member for Wakefield (Imran Ahmad Khan) for his tribute to Daniel and to Ellis Price. I thank the hon. Member for North East Fife (Wendy Chamberlain) for giving us a little hope and showing us that Toby’s Magical Journey was a way those parents, through the most appalling circumstances, could turn their love of their child into something incredibly productive that is now helping parents who are going through the same thing.

As many hon. Members have said, the issue is a cross-party one. I was so pleased that the title of the debate was about raising awareness, because that is something that we can do in this place no matter what divides us about our other politics. We can raise awareness, and the issue of health is very much one that joins us, although the delivery of it is separate in the devolved nations that we belong to.

I thank those who have made contributions and want to add my good wishes to the hon. Member for East Dunbartonshire (Amy Callaghan). When I noticed that she had become the chair of the all-party parliamentary group on children, teenagers and young adults with cancer, I looked forward to perhaps being able to discuss things with her. As hon. Members have said, the ability to bring personal experience to this place—in the sphere of health, business or anything else—gives debates a power that is sometimes otherwise lacking. In these covid-tinged times, debates in this place have changed, but our ability to do things together—to raise awareness and make sure that people’s voices are heard—is still very much in our control.

We have discussed the fact that cancer is no respecter of anyone. I have two young friends who have been through the challenge of teenage cancer—and it is challenging. One was just a teenager and the other was just exiting that period of life, which, as everyone has said, is one with an awful lot going on, emotionally and in a person’s maturity. We have not talked about ensuring we get the transition right, but speaking to people from the Teenage Cancer Trust or young people who have had cancer, we know that ensuring we get them in the right place in the system is important, so that as they move into adulthood they are not on a ward with very young children and vice-versa.

We have talked about the challenges posed by covid-19. In phase one of the pandemic we stopped services, but as soon as we could push the recovery button, we did. I have focused, along with those leading the drive in the NHS—Cally Palmer and Peter Johnson—to ensure we do not do that again. It is important that people can access other treatments. As the hon. Member for Nottingham North (Alex Norris) said, if covid-19 overwhelms the system, all the other areas we so passionately debate will become secondary and access to those services will become more difficult. We should all be aware, however, of the ambition to be tough on this disease.

We will get into calmer waters. When we do, we need that long-term plan and personalised care interventions, including a holistic needs assessment, health and wellbeing information and support, and end-of-treatment summaries. We need to identify and address the more psychological, psycho-social and emotional needs from diagnosis onwards, and to inform GPs about what is happening to a patient and their ongoing needs. A patient’s journey in hospital is often quite short, so those other medical professionals need help and assistance to access the information they need in their training.

As several hon. Members pointed out, childhood cancer is thankfully rare. That offers professional challenges in ensuring the diagnosis is as early as we would like. We heard from my hon. Friend the Member for Wakefield about the short window between Ellis’s exhibiting symptoms and being in hospital. We often find that in young children; it feels as if the change happens in a week or so. That is a challenge for the profession, but one it is up for. It is incumbent on me to outline to everyone that, thankfully, these cases are rare, but that makes it challenging for doctors when they are looking at a set of symptoms.

In the light of phase one, we have set up the cancer recovery taskforce, which includes children and young people’s cancer charities, to ensure that their voice is heard. It is important that, as we are recovering, we ensure that individuals from across the cancer family have their voice heard, because no two journeys and no two individuals’ needs are the same. That is a challenge. We are focusing on early diagnosis, workforce, treatment pathways, data and support. We are addressing system recovery, urgent referrals and screening, and ensuring the right communication is in place.

I know personally—like all of us—of the devastation this disease causes and the pain it brings to individuals and their families, but the impact on a young person is particularly heartbreaking. We know that cancer is rare among teenagers and young adults, who account for less than 1% of all diagnoses. Approximately 2,200 cancers are currently diagnosed for patients between 15 and 24. However, today’s debate has provided an important opportunity to raise awareness and shine a light on young people’s specific needs, experiences and recovery from cancer.

One of the positives of covid is that many more cancer treatments have become more patient-friendly and less impactful on the individual; that relates to the point made by my hon. Friend the Member for Wakefield about the treatment not being worse than the disease. Therefore, as treatments progress and with genomic testing coming along, it is important to make sure that we target the disease and not the healthy part of the body, so that we get the most positive outcomes for individuals that we can.

[Jim Shannon]

In my speech, I referred to clinical trials and the need for young people to be part of them. That will improve the data and the end results. Perhaps the Minister is about to come to that point and I apologise if she is, but has she any thoughts on how we can do that?

[Jo Churchill]

I thank the hon. Gentleman; if he will give me a second, I will come to that. Like him, I believe that research is the way to unlocking some the problems.

Awareness of teenage cancers in schools is important. Education from an early age on the causes and symptoms of cancer has been mentioned. I was pleased to see that this year’s curriculum for religious, sex and health education means that children are being taught about some of the signs and symptoms of cancer. In particular, that includes skin cancer, the link between smoking and lung cancer and ensuring that people keep a healthy weight. All these things help young people to become more aware of themselves, their bodies and their health outcomes. I hope that will encourage someone to pick up the phone and take steps towards discussing their health if they are worried about it.

As the mum of four daughters and, like my hon. Friend the Member for Wakefield, as the friend of parents who have been in this situation, raising awareness in a sensitive manner especially when the risks are low is something that we should all work on. Cancer is a frightening subject at any age and I pay tribute to the cancer charities that specifically deal with young people. As many Members have said, they do an amazing job not only to support people but to promote cancer awareness. For example, the charity HeadSmart helps to improve the understanding and awareness of the symptoms of brain cancer. The Teenage Cancer Trust, CLIC Sargent and Teenage and Young Adults with Cancer are also in this space, and the hon. Member for North East Fife pointed out that many local charities, such as Toby’s Magical Journey, do good work right across the country.

There is another debate in the conversation about moving to a cashless society and understanding how charities will probably have to reframe their work. In my constituency only last month, a small team of three raised more than £400,000 in an online auction. Things will have to move in a different direction when traditional collections cannot take place. We saw that with the Royal British Legion’s poppy collection, which was severely impacted. Like the hon. Member for Nottingham North, I am aware that if we are not careful, we will create a two-tier society because many people in all our constituencies still want to use cash. We could probably be smarter, but that is an issue for another day.

On the learning in school guidelines, we will keep an eye on how the research develops and feed that in. I will have further conversations with my colleagues at the Department for Education to understand how we look at the curriculum and what more we can do.

I turn to research. Only by understanding the data can we understand the treatment pathways and cohorts. I want to make a point about those carrying the BRCA gene, who tend to be much more at risk. A young friend with BRCA in their family recently had a double mastectomy. She wrote to me about the support that she had had from a charity and she mentioned raising awareness.

Understanding the data is really important. The National Institute for Health Research is leading a multi-stakeholder strategy with NHS England and NHS Improvement, cancer charities, teenage and young adult cancer patients and clinicians, focused on increasing the participation of teenage and young adult patients in research, as set out in the recommendations of the independent cancer taskforce in 2015 to improve outcomes. I regularly meet Cally Palmer. Our focus last week was on teenage cancers, because it is a challenging area where we know we have to do better. The collection of data is very important, as is the participation in clinical trials.

The NIHR clinical research network has funded specific teenage and young adult research and also nurse posts in its 15 local clinical networks, and has instituted measures to identify all teenage and young adult cancer patients participating in the NIHR portfolio research. It is also taking a lead role in an international initiative to remove artificial age barriers that prevent adolescents and young patients from accessing clinical trials.

There are some challenges around data protection and various other things that make the collection of age data a little problematic, but my offer to the hon. Member for Strangford is to take that away and further discuss with colleagues how we can do it. Although things often seem simple, they sometimes are not, and we have to consider the unintended consequences of collecting vast amounts of data. For example, who do we allow the data to be shared with? We can depersonalise it for research purposes, but very often people want it personalised because they think that perhaps the school should know or whatever. All these things are very sensitive and need handling in the correct way.

The long-term plans states that we will

“actively support children and young people to take part in clinical trials, so that participation among children remains high”

and rises to the 50% that the hon. Gentleman mentioned by 2025. However, it is a challenge. Clinical trials need to be more representative across the board. We often find that they are particularly skewed towards males, but that is for another debate. Pharmacology and treatments act differently across genders and age boundaries, so making sure we have the right participants is important.

More effective consent processes for using data and tissue samples will contribute to improving survival outcomes. We will seek the views of patients aged under 16 to ensure that the NHS continues to offer the very best services for young people, which is where the cancer patient survey is most important. That will be used alongside other data to inform service design and transformation.

It is a given that we all want to do more, but making sure that the ambition for the future of cancer diagnosis and care is foremost is something that I am particularly focused on.

I am pleased that we have delivered on our commitment of September 2019 and that all boys aged 12 and 13 are being offered the vaccination against human papillomavirus-related diseases such as oral, throat and anal cancer. That builds on the success of the girls’ programme, which has already reduced the prevalence of the main cancer-causing types of HPV, 16 and 18, by more than 80%. There is also prevention here, which is very important. Ultimately, that will reduce cervical cancers and other cancers as people go through their lives.

Our aim is to drive more personalised treatments for patients, but particularly children. From last year, we have targeted the use of whole genome sequencing, which will enable more comprehensive and precise diagnosis and access to personalised and less invasive treatment. Cancer treatment is often challenging, and the personal approach reduces medications and interventions that may be harmful to healthy parts of the body.

We also support increased access to clinical trials, making sure we have diverse participation across age, genders and ethnicities. Following from that commitment, we made available treatments targeting neurotrophic tyrosine receptor kinase gene fusion solid tumours earlier this year, following the National Institute for Health and Care Excellence appraisal. Further guidance that has been issued by NHS England and NHS Improvement prioritises the delivery of the long-term plan commitments that support the recovery of services.

The ambitions include improving survival rates and early diagnosis. In March, we had 17 live rapid diagnostic centres. However, since October we now have 45, and I hope the fact that, even during the pandemic, the cancer workforce have stood up a further—I will do my maths very quickly—28 rapid diagnostic centres shows that commitment. Continuing the accelerated roll-out of places where people can be swiftly diagnosed is vital to getting on top of this disease.

I know hon. Members have raised concerns about the impacts on services through the second wave. As I said at the start, we must protect NHS capacity for non-covid services such as cancer. We expect cancer services to be maintained, with the redeployment of staff or blanket decisions to postpone services made only as a last resort and only at the behest of the clinicians involved in the treatment of others in their local area.

I have been meeting regularly with the national cancer director, Cally Palmer, and this week NHS England issued its latest guidance on maintaining cancer recovery throughout the second wave. It is important to continue to advise children and young people and their parents, as several hon. Members have done, to contact their GPs if they are worried about any sign of cancer. It is far better to pick up the phone and ask and to have their worries allayed than to think that maybe they could have rung before.

Referrals in September were running at 102% against referrals last year, but we do have a backlog to make up, and we still have some challenges in some of the pathways, which I know the workforce are addressing as swiftly as they can. We saw 199,801 urgent referrals, which, as I say, was 102% of the normal rate year on year; in April it was at 40%. That gives hon. Members some idea of the differential that we have to drive forward. We intend to ensure that we get education right for professionals and that we maintain a patient-centred approach.

I would like to conclude by wishing all those young people the best for their treatment and a fervent hope that they get to ring the bell. At the end of treatment, in most wards, there is a bell that young people get to toll, which marks out that they have finished what is a pretty gruelling episode of their life. I would like to hear that bell ring out for every family. While I know in reality that that is not possible, with good attention to research, by ensuring that we collect the data appropriately, and with all of us focused on raising awareness, I hope we will hear those bells ring out much more regularly.

Oral Answers to Questions

Debate between Jo Churchill and Jim Shannon

Tuesday 1st September 2020 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

Diabetic eye screening has continued throughout the pandemic for those at the highest risk. NHS England and NHS Improvement are working closely with service providers to ensure that where services took the decision to reschedule screening appointments during the pandemic, those services are restored as soon as it is safely possible to do so in order to minimise any risk to individual patients and with appointments based on clinical need.

[Jim Shannon]

It is nice to see you in your place again, Mr Speaker. I thank the Minister for her response, which is, as always, comprehensive. In relation to diabetes, I wish to ask about both screening and weight loss. What funding has been set aside for those who are morbidly obese and need gastric procedures urgently to set them on the path to better health, in line with the Prime Minister’s statement and reaction to the massively increased risk of death from covid-19 for those who are obese? It is important that we address all the issues.

[Jo Churchill]

As well as our world-leading obesity strategy, we have today announced a targeted dietary approach to diabetes. From next week, thousands of people will be able to access a rigorous weight-loss programme to help tackle type 2 diabetes. The diet and lifestyle plans have been shown to put diabetes into remission for many people who have been recently diagnosed. This will provide 5,000 more patients with the first stage in an NHS drive to increase access to the NHS diabetes prevention programme and builds on the commitment to get another 200,000 people into the life-changing programme. We know that diabetes increases the risks of other health challenges and coronavirus, so it is vital that we take immediate action to help people.

GP Provision: Pilsley

Debate between Jo Churchill and Jim Shannon

Monday 10th February 2020 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I congratulate my hon. Friend the Member for Bolsover (Mark Fletcher) on securing this debate about GP provision in Pilsley. We know that general practice is the lifeblood of the NHS, and we understand the essential role that local practices play in their community, and this is particularly the case in rural areas such as Pilsley.

Before I address the specific issue of the proposed closure of the Pilsley branch surgery, I would like to mention the local work that is being done in Derbyshire that partly explains some of the things that my hon. Friend was talking about. First, Derby and Derbyshire CCG has been active in working with NHS England to expand the local workforce, and I am very pleased that three new GPs have been recruited in Derbyshire, one of them indeed by Staffa Healthcare. Secondly, the CCG has made progress in ensuring that GPs remain in the NHS and within general practice in particular, An example of that progress is the “GP Aspire” programme launched by the GP taskforce in Derbyshire. The programme started as a pilot back in 2018 and now provides support to all GPs across Derbyshire at any stage of their career. That includes, among other things, one-to-one careers guidance, signposting for wellbeing, mentoring, leadership and mental health advice. Since its launch, the programme has had some 116 individual contacts from Derbyshire GPs.

Retaining experienced GPs and encouraging more into the profession is the way we will be able to deliver more services across the nation and get more appointments into primary care, so people can get the right care from the right healthcare professional. On that, I add that I understand my hon. Friend’s point about pharmacies because the right appointment with the right healthcare professional for individuals will be hugely important as we begin to understand how to better work with the national health service across all the different healthcare professions.

I turn to the proposed closure of Pilsley branch surgery. As my hon. Friend outlined, the closure of a GP surgery is considered and decided by the local CCG, following the application from a GP provider. Such a decision understandably stirs up strong emotions within the local community, as he explained so well.

An application to close Pilsley branch surgery was submitted by Staffa Health in 2019. On the recommendation of the CCG, the public consultation was launched on 24 June. Staffa Health employed a wide range of feedback approaches during the 60-day period, including: meetings with staff; meetings with stakeholders and the patient participation group; issuing a letter, a “frequently asked questions” sheet and a questionnaire to all registered patients; text-message alerts to raise awareness of the consultation; and three face-to-face drop-in sessions. However, I understand what my hon. Friend said about the use of modern technology and how that may not always cover all patients who access local surgeries.

In addition to the consultation, the local petition calling for the closure to be halted, which got 592 individual signatures, was presented, and I join my hon. Friend in paying tribute to Sheila Baldwin and Wendy Hardwick, who organised it. I commit here and now to ensuring that my officials write to the CCG to ask it to set out how it has fully taken on board the views of the ladies and the broader petition and the action that it intends to take in response. Those local views can often help to deliver the most sensible solutions for everybody.

Following the conclusion of the consultation, Staffa Health decided to continue with its application to close the Pilsley branch to ensure the long-term sustainability of its whole practice across the three other local settings. A report was compiled and submitted to the CCG engagement committee for review on 8 January, and it commended the consultation for being “robust”. The report was also submitted to Derbyshire County Council’s improvement and scrutiny committee, and the final decision regarding the future of the Pilsley surgery will now be made by Derby and Derbyshire CCG’s primary care co-commissioning committee. The committee has been asked by Staffa Health to approve the closure, but to postpone it for a year from the date that approval is given. That postponement is to allow time to increase the number of consultation rooms at the neighbouring Tibshelf surgery and to address car parking issues. Those specific concerns have been raised through the consultation to date.

The committee met on 22 January and decided at the meeting to defer its decision to the next meeting on 26 February, which I understand will be after my hon. Friend has met the Secretary of State with Staffa Health. In the run-up to and following the PCCC’s decision, the CCG and Staffa Health are urged to continue to listen to the concerns that have been raised and to ensure that appropriate action is taken to reduce the impact on the community, which my hon. Friend laid out so eloquently.

As I stated, improving access to general practice is a leading priority for our Government and, consequently, I have asked that I be kept informed about developments regarding the future of Pilsley branch surgery. I understand that workforce shortages have been cited as a reason behind the application to close, as my hon. Friend said, and I appreciate how challenging the situation is for GP surgeries across the country. As the hon. Member for Strangford (Jim Shannon) outlined, it affects all of us, north to south, east to west, and particularly those trying to deliver across large rural areas and multiple sites, where delivery is extremely challenging. As such, I reassure my hon. Friend that tackling this issue lies at the heart of our determination to strengthen general practice and support those who work in it. We are committed to increasing the workforce, providing about 6,000 more doctors and 6,000 more primary care professionals such as physiotherapists, pharmacists and physician associates, on top of the 20,000 primary care professionals to whose funding NHS England is contributing.

[Jim Shannon]

Earlier, I referred to the possibility of a scheme allowing student doctors to commit themselves to five years in a general practice and thereby offset some of their student fees. Would the Department be prepared at least to consider that?

[Jo Churchill]

As the hon. Gentleman knows, we are always prepared to consider anything that will help to sustain the viability of the entire workforce. Offering appropriate career development, for instance, is important to ensuring that we retain doctors, nurses and other healthcare professionals. We do not just want to train them; we want to keep them as well.

Last year Health Education England recruited the largest ever number of GP trainees—some 3,540—but the system is under significant strain, and more trainees will be required to meet our target of 6,000 general practitioners. The five medical schools that are currently coming onstream will be to central to that objective. However, training new staff is only one piece of the jigsaw. As I have said, retention is just as important. The GP contract recognises that, and sets out an ambitious programme of initiatives which, by 2023-24, will support existing doctors. As well as introducing those workforce measures, we intend over the next 12 months to reduce the unnecessary burden of bureaucracy that often restricts GPs.

Our review has been agreed as part of this year’s contract, and will begin with a ministerial round table that will seek input from our partners across Government and general practice. Our aim is to free up valuable time for doctors and primary care professionals, while also ensuring that Government agencies, departments and patients have the necessary access to information. By recruiting and retaining more doctors in primary care, covering a wider range of specialisms, we will reduce the burden of bureaucracy placed on them and create additional capacity over the next five years. However, this is also about delivering care in the most appropriate setting as we strengthen general practice, and at the heart of each and every one of those settings is the patient. That can only work if we listen to the concerns and views of all involved in general practice, both staff and patients.

I commend my hon. Friend’s tenacity. He has lobbied both the Secretary of State and me to ensure that we know about the challenges at the Pilsley surgery, and that we listen and then continue a conversation that involves me but also, most importantly, the Secretary of State when he and my hon. Friend meet Staffa Health shortly. We will act on what we are hearing.

Question put and agreed to.