Infant First Aid Training for Parents

John Howell Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Sarah Newton]

I very much welcome my hon. Friend’s intervention as a young mum. Rowena had her first aid training through the Red Cross, which can provide my hon. Friend with specialist training for babies and children. Administering first aid to a young child is quite different from administering it to an older person. I commend my hon. Friend, and I hope that, as a result of our work today, many more parents will do the same.

[John Howell (Henley) (Con)]

This is an excellent debate. The scale of the task we face is quite enormous. A survey published in The Daily Telegraph not so long ago showed that only 24% of parents thought they had the skills to be able to stop their child choking. That is a very small percentage. What can we do to encourage a vast number of parents to get the training?

[Sarah Newton]

My hon. Friend makes an extremely good point. I am blessed to say that I have three children, who are in their twenties; I remember how many times I was worried about them and went to my GP or to A&E unnecessarily. I wish I had done the training, because I would have felt much more confident as a parent—I certainly would have saved some valuable time in A&E and with doctors.

I was prompted to secure this debate to continue the work I have done to prevent avoidable deaths from sepsis. We have made huge progress, and the Government have done excellent work with the UK Sepsis Trust to make sure that parents are aware of the symptoms of sepsis, as are our healthcare professionals, from paramedics right the way through to people in hospitals, and professionals in nursery schools and primary schools. They are all having sepsis training. That is important, and now is the time to build on that and to empower parents to spot the signs of not only sepsis but all other serious illnesses.

--- Later in debate ---

[Julie Cooper (Burnley) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Truro and Falmouth (Sarah Newton) on securing this important debate. The subject has had a lot of attention in the news recently, but not much attention in this place. Having listened to the speeches and talked to colleagues across the House, I do not think there will be much disagreement here today. The fact that there are not many Members here says more about the subject than it does about any other business in this House, important as it is: any Member seeing the title of this debate might say, “It’s a no-brainer. What is there to talk about? Of course it is something we support.” It is important to put these things on the record.

Members have talked about their personal experiences as parents and grandparents—I am sure we all want to congratulate the hon. Member for Moray (Douglas Ross) on the new addition to his family. People have spoken movingly about their own children and grandchildren. As a parent and a grandparent—I am going to be a grandparent again next week—I am reminded of how important the subject is, and we ought to give proper consideration to it. This debate gives us that opportunity, so I am grateful to the hon. Lady for securing it.

[John Howell]

As the hon. Lady rightly says, a lot of people have spoken from personal experience, but we as MPs have a role far beyond that—we are champions in our own constituencies. Does she not think that we should take the lessons learned and go out and make these points very forcefully in our constituencies?

[Julie Cooper]

I am grateful to the hon. Gentleman for that important intervention. I shall certainly speak with a loud voice about the subject in my constituency, and I encourage all Members to do the same.

The other point made by the hon. Member for Moray was that access is not easy. In preparation for this debate I checked up on access to training courses for my constituents and found that, even though I represent an urban community, it involves a 60-mile drive or a long train journey on a slow, rickety train line. That presents a massive barrier to my constituents accessing such training. I totally take the point that the hon. Gentleman makes, and I agree with him entirely.

The safety of our children is and always should be paramount, and it is therefore important that, in the event of an obvious health emergency, parents have at least a basic knowledge of first aid so that they can take action before professional help arrives—actions that might save the child’s life. The hon. Member for Truro and Falmouth made a strong point about how it is important that parents are trained to recognise the symptoms of what can be serious diseases, such as sepsis and meningitis. It would be useful if parents were equipped to recognise the symptoms before they decide whether to call 999 or take their child to hospital, because knowing how to spot the symptoms really does save lives.

First aid, as the term suggests, is the first medical attention that a person receives after an accident or during a medical emergency. Despite what many people have been led to believe, first aid does not have to be delivered by medical professionals—we have established that. A person’s chances of surviving a medical emergency are increased dramatically if a member of the community can respond with first aid immediately. What happens in the crucial minutes after someone dials 999 or the NHS’s 111 and before professional help arrives can be the difference between life and death. The British Red Cross reported that close to a quarter of infant deaths could have been prevented had there been a qualified first aider on hand, and who better to be trained than the parent?

Services for People with Autism

John Howell Excerpts

Thursday 21st March 2019 Commons Chamber

[John Howell (Henley) (Con)]

I, too, wish to start by paying tribute to my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan), and I am glad that all our thoughts are with her.

In my constituency, I am very fortunate in having numerous institutions, be they charitable or, as it were, full-time, and individuals who do a lot to take things forward, examine them and do the research on autism. I wish to make two mentions to start with. First, it was through this issue that I was introduced to Dame Stephanie Shirley, whose work in this area is phenomenal. She has spent a huge amount of her own money taking forward research in this area, and she is a beacon when it comes to providing a focus on dealing with autism and showing us what to do. Secondly, I would like to mention a charity called Music for Autism, which was set up with the Orchestra of St John’s. It uses music to influence the lives of those with autism. Those who have seen it in operation will know that it is a fantastic experience to see how members of the orchestra lap up the opportunity to work with those with autism and help enrich their lives. That is a great achievement.

I wish to concentrate on three areas. First, I want to follow the hon. Member for Cardiff West (Kevin Brennan) in commenting on the treatment of those with autism in the justice system. That needs to be concentrated on in three areas in particular: the police; the courts; and among prison staff, if it eventually comes to that. Only two things need to be done to take this issue forward in a big way. First, we need to identify those with autism at a very early stage, because as the hon. Gentleman said, that helps to make sure that we do not end up in a whole lot of disputes at a later stage. I am aware that the courts have put a lot of effort into making sure that they are autism-friendly for people appearing before them. I am also aware of a number of prisons that support people with autism; I think there is a pilot scheme, and I hope it will be rolled out across the prison system and that we can learn the lessons from it.

The second issue I wish to mention is education. Several Members have already mentioned education, but I wish to cover a particular aspect: the involvement of people with autism in designing training for teachers. Several Members have hinted at that point, but I do not think anyone has tackled it as boldly as I am going to. The involvement of people with autism in the training of teachers is absolutely essential. They can provide help with training and influence how it is devised in many ways, all of which will lead to more choice and to our paying special attention to the needs of those with autism.

Finally, I wish to comment on autism and jobs. Last year, I was appointed a special envoy for an autistic charity called SPACE—I am never good with acronyms, but I think it stands for Supporting People with Autism into Continued Employment. I became the envoy for that charity to promote the idea of Members taking on staff with autism in their offices. As a way of demonstrating that, I enthusiastically took on a young man from Hornchurch who has autism. When it came to saying goodbye to him at the end of his period with me, I really regretted that he was going. He had been an outstanding worker and made an outstanding contribution to my office. It had been a great experience, not only for him but especially for me and my staff. If we can encourage more of that, we will have a much better way forward for those with autism.

Leaving the EU: Health and Social Care

John Howell Excerpts

Tuesday 19th March 2019 Westminster Hall

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bone, and to follow the hon. Member for Argyll and Bute (Brendan O'Hara). Above all, this debate allows a reasonable discussion of the issue, which I hope we can have, but I was struck by the similarity between it and last night’s debate in the main Chamber. Like the hon. Gentleman, I am aware of constituents who have expressed their great problems in getting drugs for two conditions, in particular: insulin for diabetes and the drugs required for cystic fibrosis. Cystic fibrosis is a particularly horrible disease that requires a continuous supply of drugs, so I can understand the concerns.

Throughout all the discussions on this matter, I have been conscious of the lack of objectivity from anyone, including the medical profession. The hon. Gentleman seems to think that those in the profession can stand aside and take an independent line, but I do not believe that is true or that what they say is necessarily helpful. Allow me to pick up where the Minister left off: the guidance published by the Government for pharmacists and members of the public is not to stockpile medicines. As part of the Brexit contingency measures, the Department of Health and Social Care has asked drug manufacturers to ensure they have a six-week buffer stock, on top of the three months already in place, but the public do not need to stockpile medicines.

[Mr Gregory Campbell]

During a recent episode of “Question Time”, the new presenter Fiona Bruce asked the audience how many of them were stockpiling. Almost nobody put their hand up, much to the embarrassment of the BBC.

[John Howell]

The hon. Gentleman has much more leisure time than me, as he can still watch the BBC. I cannot remember when I last watched it, but I am pleased to join him in condemning its attitude. He makes a strong point. During the Brexit campaign, the health sector was dominated by the promise on the side of the famous bus, but equally, the remain campaign has lied through its teeth in saying many things. I have no real confidence that, if we were to have a second referendum, we would at any stage be able to have a debate free of exaggeration.

A constituent contacted me to say that he had been to a local hospital and was astonished to see that as a result of Brexit—although it has not happened yet—the ward was closing and had lost a large number of staff. I decided I would not let that go, but would find out the facts. I spoke to the matron who ran the ward in question. She said to me, “That is absolute rubbish. We have a full ward; this is a normal cycle of people’s leave and it has nothing at all to do with Brexit.” If we make Brexit arguments we need to ensure we have a rational and objective discussion, which so far we have not been able to have.

[Brendan O'Hara]

To have a rational and objective discussion, we have to rely on experts and take evidence from the people in the field. The contributors are objective: Macmillan Cancer Support, the British Medical Association, Cancer Research UK and CLIC Sargent have come to us to say there is a major problem. I presume the hon. Gentleman would not say that they are partisan players.

--- Later in debate ---

[John Howell]

I am not sure that I agree with the hon. Gentleman. As politicians, we have the principal duty to explore the situation. There will be times when we need expert opinions, but I am complaining about the debate and discussion in this country where people on both sides use the issue as a football and produce exaggerated claims.

I have a great deal of sympathy regarding mental health, an issue on which I have done an enormous amount of campaigning. Outside the EU, there is another organisation with responsibility for mental health, the Council of Europe, on which I serve as a member of the Parliamentary Assembly. The Council of Europe has an expert committee on mental health, which is nothing to do with the EU. That means that if we leave the EU, there is a body of evidence and recommendations already in place to take forward mental health issues. That expert committee has produced a reference tool to determine the essential basket of potential rights that an individual should have, to consider whether the human rights of a patient suffering from mental disorders can be maintained with a great deal of dignity. That is an important element that we seem to ignore; we pretend it does not exist, yet many of us spend a huge amount of time at the Council of Europe trying to push forward those sorts of rights, not to take the place of the EU—it works the other way around—but to provide a safety net for people who are suffering from mental disorders.

I want to end on the issue of care. In Henley, the Government have spent about £12 million rebuilding a new hospital that is a model of how to integrate care and medical provision. The hospital was built without any beds; the beds are in the care home at the side of it. That has changed the way that doctors look at the provision of care. They do not immediately think that they should simply send patients to a bed when they can be treated better at home. I have taken various Ministers along to look at that hospital. I do not think it will be affected by Brexit in the slightest. The model set up there is one we can all take as a better way for the system to work in future. I extend an invitation to the Minister to come and see that hospital and how it operates. I hope he will enjoy the experience and see the lack of impact that Brexit will have on the provision of service.

Health and Care Professions Council: Registration Fees

John Howell Excerpts

Thursday 14th March 2019 Westminster Hall

[Mr Cunningham]

In considering that, we have to remember that a lot of those workers’ salaries—for want of a better term—have in some instances been frozen since 2010, while in some instances they may have increased by 1% or 2%. With inflation at about 2% over that period, that is roughly an 18% cut in wages. Add the increased fee, and those workers are carrying a heavy burden that they should not have to carry. Adequate funding should be provided, rather than finding it by using hidden taxation methods. We all know that nurses and so forth in some of our hospitals have to pay car park charges. Given all those hidden costs, these workers are quite frankly bearing the brunt of the recession.

[John Howell (Henley) (Con)]

A lot of these organisations have always said that they want to keep their independence and do not want to be funded by other sources; they are pretty keen on making sure that that continues. Is the real issue not the amount of regulation that they have to deal with? That must be one reason why the funding level has increased.

[Mr Cunningham]

Organisations always argue that they want to be self-sufficient, but that should not come at the expense of the people whom they actually regulate. I am not an expert on the regulations that some of these bodies govern, but we should be very careful when thinking about changing regulations or reducing their amount. We would need to test that.

Altogether, the HCPC has not given a strong reason for this huge increase, leaving affected workers frustrated and angry. In addition, the Government’s response to the fee change has been very disappointing: in answer to written questions, they have just repeated the HCPC’s weak defence of the fee rise. Ministers have argued that the registration fees remain the lowest of any health regulator, but that does not change the fact that the rise is disproportionate and unfair. The Government should be concerned over the threats to staff levels in the affected professions, but Ministers say they have made no assessment of the impact on staffing of this rise. That is a complete dereliction of duty, with staff openly talking of leaving due to the rise.

It is an irresponsible move by the Government to hide behind the HCPC’s independence. They must take steps to prevent fee rises from being the norm for the HCPC, and for all regulators, and help to build bridges between healthcare professionals and the HCPC, as trust is breaking down. HCPC members are understandably angry, believing that it is exploiting a stranglehold over their jobs. The rise amounts to nothing less than a tax on practising, and it has had little scrutiny or debate. I would like the HCPC to reverse the decision to increase registration fees by 18%. The Government and the HCPC must change the way fees are decided on, to prevent such a huge change happening in the future. The HCPC must operate in a fairer and more transparent way, and the Government must play a role in ensuring that that happens. It is time that the Government and the HCPC stopped taking advantage of those who take care of us all.

In response to the rise in fees, Unison conducted a survey of affected members and found that 99% of respondents did not back it. Importantly, it found that 76% did not see the current £90 fee as good value for money. Members feel that the HCPC offers no real benefit except for allowing them to practise. They are also critical of the justification given by the HCPC for the fee rise.

First, it must be pointed out that the 18% rise completely outstrips inflation. If the HCPC was genuinely concerned to cover inflation, it could implement smaller, year-on-year rises. I doubt whether the staff could afford those, frankly, but it is one way to look at it. Secondly, it is unfair for members of other professions to cover the costs of transferring social workers to a new regulator. The HCPC faces upheaval because of the change, but it is wrong for other professionals to pay the price.

Thirdly, the case for needing more funding after the transfer of social worker regulation is dubious. Social workers make up a quarter of members, which is a substantial number of registration fees. We all know what a difficult job they do. Often they are put in a situation where they cannot win, and they bear the brunt of some of the ills of society, to say the least of it. However, they also account for more than half of all fitness to practise cases. That is the HCPC’s largest area of expenditure. Despite a loss of income, the HCPC will face a sharper fall in costs at the same time. That fundamentally undermines the case for an 18% rise, and proves that it is unnecessary.

Unison also highlighted several changes that the HCPC should implement to reduce spending. First, it must take steps to make its complaints process more efficient. The Professional Standards Authority for Health and Social Care found in 2018 that the HCPC’s investigation committee refers cases too readily to the fitness to practise panel and that more than 20% of complaints are found at final hearings to be “not well founded”. Overall, members are funding a system that handles complaints against 0.64% of registrants and sanctions just 0.09%. No wonder so many members are left feeling that they gain nothing from their registration.

The fee rise comes on top of many years of wage freezes and below-inflation wage rises. Although £106 might not sound much to the Government or to some higher-earners in the health sector, the rise will be a real hit to part-time workers and those on lower wages. Professionals are left doubting their trust in the HCPC after being ignored in the consultation. The HCPC is facing growing unrest and resentment among its members. Many are now moving to non-regulated posts, and part-time working will become a lot less attractive, inevitably causing a fall in the number of workers in the sector.

Eurotunnel: Payment

John Howell Excerpts

Monday 4th March 2019 Commons Chamber

[Mr Speaker]

It is worth pointing out that that Hancock was deliberately funny.

[John Howell (Henley) (Con)]

The Secretary of State has talked about medicines, but there are also prescribed foods—for example, the gluten-free food on which some people depend. What will the situation be for those foods?

[Matt Hancock]

Of course that matters enormously, too. Although medicines are the category 1 prioritised goods that will be using the extra procured capacity safeguarded by this settlement, there are other measures being undertaken by the Department for Environment, Food and Rural Affairs to protect the supply of foods.

Eating Disorders Awareness Week

John Howell Excerpts

Wednesday 27th February 2019 Westminster Hall

[Kirstene Hair (Angus) (Con)]

I beg to move,

That this House has considered Eating Disorders Awareness week.

It is a pleasure to serve under your chairmanship, Mr Bailey, for this very important debate. As we are in the middle of Eating Disorders Awareness Week, this is a timely day on which to remind ourselves of the good work that has been achieved in the past year, but also to look forward to where we want to be by this time next year.

I want to take this opportunity to thank Beat—the Eating Disorders Association—and the many other charities that have been in touch with me ahead of the debate for their sheer hard work and determination to keep this issue at the forefront of the Government agenda. I see many of you in the Public Gallery and want to say thank you for all that you do.

There is always great cross-party support in debates on eating disorders. I have been in this place for only 18 months, but it is the debates in which we are all travelling in the same direction that are so powerful, because we show our constituents that we can agree, and when we do, this place is much stronger and improves lives much more quickly.

As we know, eating disorders affect more than 1.25 million people throughout the United Kingdom, but that is a conservative figure, because many sufferers have not yet been diagnosed or identified. It is for that reason that this debate is opportune. We are all here today for those in the Gallery, for those who are fighting for this cause, for those who are currently fighting this debilitating disease, for those who have fought and come through it and for those who are currently living their daily lives as normal but may suffer at some point in the future. My colleagues and I will always fight your corner, and I am delighted to see many hon. Members here today to support the debate.

I wish to begin with the topic of stigma, which is the focus of the Eating Disorders Awareness Week campaign this year. As we know, eating disorders affect all age groups, genders and backgrounds. An eating disorder is not a diet gone wrong, a fad or a phase. It is not caused simply by a young female being exposed frequently to magazine images of skinny models or going on online platforms with similar material and deciding that they wish to look the same. It is an illness so deep rooted in the individual that it leads to devastating consequences for those who are suffering and for those around them.

[John Howell (Henley) (Con)]

My hon. Friend has talked about the effect on constituents. I have to say that, in this case, it was the effect on me, because a close member of my family suffered from an eating disorder. The help that was available was pretty close to negligible. Does my hon. Friend think that there is much more that we can do to increase the help available for people whose family members are in that sort of situation?

[Kirstene Hair]

My hon. Friend is absolutely right. The sufferer of course needs specialist support, but I will go on to speak about how I believe that we also desperately need to support families and, indeed, all those around them. This disease is so complex that it is often difficult to treat and, trapped in the disease, sufferers feel that there is simply no way out. Many believe that if the disease does not take them, they will take their own life, just to rid themselves of it. No matter how strong an individual is, an eating disorder is so all-consuming that once it has taken hold, some people believe that they will never live a normal life again, and many do not: the condition becomes chronic for about 20% of sufferers.

Normally, a series of events has encouraged the person’s mind to think differently about their body image. Perhaps they have decided that they are not good enough: one too many times, people or life events have created a narrative in their mind that they are inferior to those around them, or perhaps life is out of control in many aspects—nothing is going right. They compare themselves with others around them and see only the negatives in their own life and the positives in other lives, but they can take back control of one aspect of their life—control of what they eat. That may well start off as a diet, but not a diet that would be followed by a normal individual, which often fails. It soon becomes a focus and then a more extreme calorie-counting exercise that involves hiding food, burning off every calorie possible and social isolationism. Before they know it, the candle is burning at both ends. Before a sufferer has identified that they need help, the registered impact on their body is always perceived as being caused by some other reason. There is a voice inside a sufferer screaming that too much food is being consumed or not enough exercise is being done—praise when they miss a meal or hear the sound of a rumbling stomach. That voice inside a sufferer will not and cannot go away.

The loved ones around a sufferer see their daughter, son or friend fade into a shadow of their former self; they are helpless in every way. Parents struggle and are in emotional turmoil. They know that if their daughter falls and skins her knee, they can bathe it, put a plaster on it and make it better. If their son is upset because he is struggling at school, they can get him the support that he needs. We have solutions, and it is human nature to want to fix and help those we love. However, when it comes to eating disorders, everyone is helpless and feels hopeless. No one, unless they are trained, can provide support, other than the individual themselves. Many, if not all, sufferers who have managed to recover will say that it was the hardest journey that they have ever taken, but having spoken to some of Beat’s bravest ambassadors, we have seen at first hand the amazing, inspiring individuals they can become—but that is only if we help them.

As a result of the stigma attached to eating disorders, black, Asian and ethnic minority people, lesbian, gay, bisexual and transgender people and people from less affluent backgrounds are less likely to seek and get medical support. Research developed ahead of today’s debate showed that four in 10 people believe that eating disorders were more prevalent in white people than in other ethnicities, yet research shows that they are just as common or more common in the BAME community. Thirty per cent. thought eating disorders were more likely to affect the more affluent; in fact, they evolve at the same rate irrespective of education or income. Sixty per cent. of respondents believed that they affected only young people. That is having a significant impact on adults coming forward for support, and we see men and boys not being referred as soon as girls and females.

The statistics might not be surprising, but we have to challenge them continually. They are preventing certain groups in society from appealing for help, and creating an inequality in support. As a result, people are more ill by the time they are referred, making the recovery process much more difficult and sometimes impossible. We have seen fantastic work by members of the royal family as well as other notable figures, who have raised awareness of mental health disorders and who seek to break down the barriers to people speaking out, but also recognise that it is okay to talk and okay for someone to say that they need help.

When sufferers reach out for help, they have often been suffering for years. They need urgent specialist help immediately. The average cycle of relapse and recovery lasts six years, and there must be constant efforts to reduce that. To undo months and years of torture, specialists need time and resources to allow a patient to open up, to analyse, to find out the root causes, to get under the skin of the issues and to develop the mind to fundamentally change—a long-term approach, but a life-changing one.

Families, too, need guidance and support on how to deal with this troubling time. Many do not know where to go for support. This was one comment from the social media campaign that I ran before the debate:

“When anorexia arrives in a family it is like throwing a grenade into a home and watching it explode...caring for my daughter has impacted on the mental health of all those in my family.”

That is why I agree with my hon. Friend the Member for Henley (John Howell) that family-based therapy would provide a much-needed support base throughout the recovery process.

Without the investment of time, those patients will be back in our GP surgeries and hospitals time and again. We must look beyond weight. This is an issue of the mind, so whether it is a case of referral or recovery, it cannot be determined by the number on the scales. As a result of the digital campaign that I ran, I heard from many people up and down the country, and I thank them for coming forward with their stories. One person, who wished to remain anonymous, said that

“my granddaughter never got so thin but she died nearly 7 years ago at the age of 19 and I feel that if there had been some positive help she would have been alive today.”

She had been disregarded simply because her weight was not low enough. Recent research shows that GPs do not have adequate training for supporting individuals who have an eating disorder, with three in 10 sufferers not being referred when required.

Non-surgical Cosmetic Procedures: Regulation

John Howell Excerpts

Tuesday 12th February 2019 Westminster Hall

[Alberto Costa (South Leicestershire) (Con)]

I beg to move,

That this House has considered regulation of non-surgical cosmetic procedures.

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I am grateful to lead this debate on an issue that I believe affects all our constituents.

We live in a time when there is a certain desire, especially among the young and impressionable, that one must always look one’s best, or in fact look different to how we may really be. There is nothing wrong with that; we live in a country that gives all citizens the ultimate freedoms over their choices and their own bodies. However, we in Parliament have a responsibility to the people, and our responsibility includes ensuring that those who wish to change their appearance and their body have all the information they need to make a fully informed and rational decision and, importantly, are able to trust those administering treatments and to have peace of mind that those treatments will be carried out correctly, with minimal risk to their health.

[John Howell (Henley) (Con)]

Does this matter not come down to a fundamental issue, namely that if something goes wrong, who do we sue? Is that not the nub of what my hon. Friend is trying to get at?

[Alberto Costa]

I thank my hon. Friend for that intervention. Yes, that is one of the core issues that I wish to raise today. The mark of a professional in our society is somebody who is regulated, who is trained, qualified and licensed, and who has ongoing regulation and development. However, in addition to that, in the private sector they must carry professional indemnity insurance, so that people do not sue men or women of straw and so that they have someone to sue when things go wrong.

My experience of non-surgical cosmetic procedures does not extend to Instagram celebrities or Kylie Jenner. Instead, I wish to inform you, Mr Hollobone, of the case of my constituent Rachael Knappier. First, I thank Rachael, her mother and her friend, who are all attending this debate here in Parliament. I also thank Rachael for her tremendous bravery and willingness to talk openly about the terrible injury that she sustained as a result of a botched non-surgical cosmetic procedure. I think Rachael has been a role model for hundreds, if not thousands, of people across the country who have read the articles in the British media about her trauma. They responded with sympathy, but most crucially an understanding of her experience, because—sadly—experiences such as Rachael’s are not confined to the few. Many hundreds of our constituents have suffered such botched procedures.

Children with Life-limiting Conditions

John Howell Excerpts

Tuesday 29th January 2019 Westminster Hall

[John Howell (Henley) (Con)]

My hon. Friend mentions the adjustments that need to be made in people’s homes. To what extent does she think local councils are living up to expectations in that respect?

[Antoinette Sandbach]

I will come on to that point, but I know that in my area the situation is certainly not as good as it might be.

I hope that the Minister will commit to ensuring that children have a right to an integrated assessment, a plan and a personal budget to address their individual needs. Likewise, I hope that she will agree to review health and social care law, not only to strengthen the rights and entitlements for disabled children and their families, but to clarify them. That clarification would be hugely welcome, because uncertainty leads to some local authorities failing to meet their obligations. For instance, Together for Short Lives reports that 21% of local authorities are failing to meet their legal duty to commission short breaks for disabled children. That postcode lottery is deeply unsatisfactory and requires the Minister’s attention.

I was concerned to discover from December 2017 data that only one of the four Cheshire clinical commissioning groups was developing a strategy or care pathway for children with life-limiting conditions. The same data shows that although some of my area’s CCGs offer out-of-hours paediatric palliative care consultants, community children’s nurses and psychological support, others do not. Given that families have 24/7 responsibility, should not the NHS? My area is lucky to have specialist paediatric care close at hand, thanks to Alder Hey Children’s Hospital, but it is clear that even in Cheshire more must be done, which probably means that more funding must be put in place.

The all-party parliamentary group on baby loss wrote to the Chancellor at the end of last year to ask for a guarantee of the future of the NHS England children’s hospice grant beyond March 2019; for an increase in its value to £25 million per year; for parity of funding between children’s and adult hospice and palliative care charities in England; and for a funded, cross-departmental children’s palliative strategy for England. I was pleased to see that the issue received attention in the NHS long-term plan, but I am concerned by the mismatch between NHS England’s 27 December announcement about children’s hospice funding under the plan, and what was published in the plan itself on 7 January: the announcement said that the money was for hospice funding, but the plan said that it would be for palliative services, including hospices. Will the Minister clarify whether that £25 million will be for children’s hospices only, or for a wider group of children’s palliative care services?

Likewise, will the Minister guarantee that the £11 million children’s hospice grant will be protected and increased as a result of the long-term plan? It is vital that we resolve that, because in 2006-07 the children’s hospice grant contributed 14% towards the cost of providing clinical care in children’s hospices across England, but by 2015-16, when the grant had risen to £11 million, it contributed an average of just 8%.

I hope that the Minister will offer the reassurance that so many families deserve, not just about the finances but about integration and ending the postcode lottery. I am sure all hon. Members agree that these families need support, but now we must build on that agreement and implement a sustainable, compassionate plan to support them.

Cervical Cancer Smear Tests

John Howell Excerpts

Monday 28th January 2019 Westminster Hall

[Helen Jones]

The hon. Lady makes a good point. We need people to realise that women know their own bodies and know if something is wrong, so people must listen to what they say. There are too many examples of women having to pay for a private test before finding out they have cervical cancer. If it is not diagnosed early, there is a chance it will become terminal. If it is diagnosed early, the chances of survival are much greater, so we need to ensure that people are diagnosed early.

On the question of whether the age for screening should be reduced, I am not convinced at the moment. The scientific evidence does not support it, but I hope that the Government will keep it under review. If the evidence changes, we need to change what we do. Sir Mike Richards is undertaking a review of cancer screening and is due to report by Easter. I hope he looks at the issue. Ministers must ensure that they get the best advice and they have to proceed on that advice. We have to remember that, rare as it is, in 2016, 15% of women diagnosed with cervical cancer were under 30, and last year, 12 of those who died were under 30. We can and should do much more to prevent such deaths by ensuring that women are screened where necessary, even if they are under 25. If they have indications that require them to be screened, they should be. We must ensure that we promote the HPV vaccination programme, which is one of the best things that has been done in recent years. I say to parents who worry about it, “Don’t put your daughters at risk. Get them vaccinated.” We have to do much more to convince them that vaccination is the right thing. We have to do much more to make screening accessible and easily available to women, and it must be done in a supportive environment. Let us be honest: it is a bit like a sausage machine when we go to the GP, precisely because health workers are screening all the time. To them it is not at all unusual, but it is to the people who attend; that is the difference.

[John Howell (Henley) (Con)]

I hope that, like me, the hon. Lady will support the Public Health England awareness campaign that is about to start, which will try to tackle all the misunderstandings about screenings, and to overcome the feelings of fear and embarrassment that she described so well.

[Helen Jones]

The hon. Gentleman is right, and it is not before time to have such an awareness campaign. However, it is no good having one unless we ensure that screening is easily available and that people are treated well when they go. That is vital, because one bad experience can put a woman off ever going again, which is not what any of us want.

Natasha started the petition because she wanted to raise awareness of the symptoms of cervical cancer, and to ensure that other women did not suffer as she had suffered. That was a remarkable thing to do, and I hope that today’s debate, which I know her MP, the hon. Member for Newton Abbot (Anne Marie Morris), would have liked to have attended—unfortunately, she has to be in Committee elsewhere—will go some way towards doing that. I hope the debate will open up the dialogue on how best to get women screened, and when they should be screened, and I hope that the Minister will commit to keeping the age of screening under review, so that, if the scientific evidence supports screening earlier, that is acted on.

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Sir Roger, and to follow the hon. Member for Warrington North (Helen Jones) in this important debate. I thank the petitioners, as it is good to have the opportunity to discuss such an issue in open debate. I think that all Members will get the strong impression that there is agreement across the House for what is being proposed.

I will start with the Public Health England campaign, which I mentioned when intervening on the hon. Lady. I agree with her that it is about time we had such a campaign, and that it will have a hard job. On the one hand, it has to tackle issues concerning the women themselves—the enormous misunderstandings about the screening process, and the fear and embarrassment that surrounds it. There is not just fear about the illness; anything to do with cancer creates fear, so there is an enormous amount to overcome.

However, I suggest that the Public Health England campaign should also look at the other side. The Minister has heard us talk strongly today about the impact on GPs, and the way in which they have to handle the issue and make facilities available. It would be very good to have something in the campaign that targets GPs, making those points to ensure that testing happens in the right place, at the right time and in the most effective manner.

The hon. Lady also mentioned inoculation against HPV, which I support. I am pleased that we are now inoculating young boys against it as well, as that makes a very big difference. Those who have talked to medical professionals in this area will have heard stories about the number of people who develop cancer as a result of HPV. It is very good to have such inoculations, and to be able to support the campaign.

Like the hon. Lady, I am not yet convinced that the age for screening should be reduced. Around the world there has seemingly been a general trend to increase the starting age of such programmes. I think the American Cancer Society recommended that the age for cervical screening go up from 18 to 21, which is interesting. The reason she and I believe that the screening age should not be reduced is the false positives that are created. No one wants to be put in the situation of having a false positive test. It is not about the waste of money, but about the concern that a false positive creates for an individual. I am not yet convinced that the age should be brought down but, like the hon. Lady, I call on the Minister to look very carefully at it, to keep it always in his mind, and to keep reviewing it.

I think that Scotland has increased the age at which women go for their first smear test from 20 to 25. That, too, is an interesting reflection of the way things are going, and builds upon the difficulties in dealing with this matter. However, I thank the hon. Lady for presenting the case, and the petitioners for bringing it, and allowing us to discuss it in the way we are doing.

Oral Answers to Questions

John Howell Excerpts

Tuesday 15th January 2019 Commons Chamber

[Jackie Doyle-Price]

I have to advise the hon. Lady that we are on course to meet the targets in the five year forward view, but she is right to raise concerns about the workforce. Frankly, that keeps me awake at night. We are investing in a significant expansion of mental health services and that requires appropriate staff to deliver them. I can assure her, however, that we are in productive discussions with clinical leads in NHS England. We need to be much more imaginative about how we deliver services, and we are seeing substantial gains and improvements in performance through the increased use of peer support workers, who provide the therapeutic care from which many can benefit. However, the hon. Lady is right to hold me to account.

[John Howell (Henley) (Con)]

12. What steps he is taking to improve the diagnosis and treatment for patients with rare diseases and cancer.

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

Our much-mentioned new plan sets out the clear ambition to diagnose three quarters of all cancers at an early stage—up from half today.

[John Howell]

The blood cancer charity Bloodwise launched its “Hear our voice” report in Parliament last week. Will the Minister ensure that NHS England works with the charity to ensure that blood cancer is included in the 75% target?

[Steve Brine]

Yes, I will. I spoke at the launch of Bloodwise’s excellent report at its parliamentary reception last week. I have been clear since the new ambition was announced that the 75% target applies to all cancers, and we will not achieve it unless we focus on harder-to-diagnose cancers, such as blood cancer.