(7 years, 9 months ago)
Commons ChamberMy right hon. Friend has made a generous offer. I will address the point that he has made in two ways. The Under-Secretary of State, my hon. Friend the Member for Winchester, is responsible for cancer screening programmes. Our current advice is that national uniform screening would not be productive, but we know about that route. I come back to my right hon. Friend’s experience because he had the wherewithal and courage to face up to a health issue that he had identified and take things forward. I think that the best way of getting improved outcomes is to empower patients to look after and manage their own care, and to have mature conversations with medical professionals so that full investigations can be made. Such conversations would lead to earlier screening. I would be delighted to work with my right hon. Friend to achieve that. We educate the public by sharing real life examples, and that is how we give them the tools to look after themselves. I look forward to working with him on that.
In the time I have left, I re-emphasise that we are making good progress and remain on track to deliver each of the 96 recommendations in the cancer strategy. That will help us to transform cancer services in England, to the benefit of all cancer patients including those with lung cancer. I cannot thank my right hon. Friend enough for securing this debate. I wish him continued success with his own health and send my best wishes to his family, who have gone with him through a very painful and traumatic journey. I thank him again for all the work that he is doing to raise awareness of the disease.
Before I put the question, I want to echo what Mr Speaker said. Welcome back, and know that this House is at its best when we need to support each other. I have been through that, and I cannot speak highly enough of the way that people get together. Welcome back, and may your health continue to be of the best.
Question put and agreed to.
(7 years, 9 months ago)
Commons ChamberWarrington Borough Council faces funding pressures of more than £3.3 million to meet its adult social care needs in 2018-19. Does my hon. Friend agree that it is up to the Government to support councils in their efforts to provide quality social care to their communities, not to pass the buck—
Order. I need to correct that. When I say “order”, it means you should stop. I am not trying to cause any problems. We must have short interventions. If not, I will have to put a time limit on speeches. Intervene, by all means, but interventions must be short.
My hon. Friend the Member for Warrington South (Faisal Rashid) is spot on. It was telling that the right hon. Member for Ashford (Damian Green) made the point that local councils have reached the point where they do not want to deliver social care any more. We know perfectly well what the reason is. If they had the funding, I am sure they would be delighted to deliver social care, but we know what impact the cuts have had.
Ministers have focused on squeezing more out of local taxpayers, which provides only a drop in the ocean compared with the extra funding that is needed to close the gap.
To follow up on the issue of training, it is important that people who are going into people’s homes to care for them or who care for people in a home setting have all the training they require to perform the duties that are expected of them. Too often, they are not given the training they need and are expected to do far more than they are qualified to do.
I believe there is a voluntary time limit of seven minutes. We are in danger of spoiling that. If we do, I will have to bring in a time limit of about 5 minutes. I do not want to do that, so I need Members to help me ensure that everybody gets an equal amount of time.
My hon. Friend the Member for Great Grimsby (Melanie Onn) is absolutely right and I welcome all the interventions, but I should probably now crack on with my speech. She is spot on in saying that there is a critical need for training in the workforce and that not enough has been invested in them.
My hon. Friend the Member for Hartlepool (Mike Hill) mentioned Unison, which has done fantastic work in the sector. Its biennial survey with Community Care magazine last year revealed a worrying picture of care workers having a lack of time to spend with residents. Nearly half the respondents to the survey said that the volume of cases they were responsible for left them feeling “over the limit” and more than half blamed staff shortages for their heavy workload.
As well as providing direct care, practitioners often have a responsibility to support the army of family carers who themselves are working to look after relatives at home. The shadow care system, as it is known, is running alongside the care system, keeping the whole thing going through the love and good will of unpaid family support and kinship carers, as has been discussed. For example, the Junction Foundation in my constituency, which I am proud to support as my charity of the year, does a lot of work with young carers who bear the pressures of looking after relatives while their peers are enjoying growing up. In Redcar and Cleveland, we have a fantastic organisation called Carers Together, which provides support and tailored services to people in care roles. It is aware of around 7,000 carers in the borough, but the 2011 census suggests that the number could be much higher.
I want to say a bit more about the workforce. As my hon. Friend the Member for Worsley and Eccles South said, they are underpaid, undervalued and overworked. The National Audit Office report from February was damning in its assessment that the Department of Health and Social Care
“is not doing enough to support a sustainable social care workforce.”
Data from the Skills for Care charity suggests that there is currently a turnover rate of 32% for the role of care worker in adult residential care in England, but that rises to a shocking 44.3% for care workers in adult domiciliary care. It is completely understandable that people working in this tough environment decide to leave the care profession when the pressure becomes too great. If people are to see social care as a viable career, they need to feel valued, and too often that is not the case.
With demand for social care increasing as our population ages, the workload will only get larger for the staff who remain. As the National Audit Office report also suggests, the Government are simply not providing the leadership that is needed. Local councils and care partnerships that are commissioning care are not being given the confidence of a national strategy designed to support the workforce and recruit new carers. A national strategy, for example, could see health and social care brought more closely together. The silo mentality between the NHS and social care has meant that the two services have passed patients to and fro, duplicating resources and missing the opportunities to work together to deliver better outcomes.
It is welcome that the Government have endorsed more partnership working, and these relationships are already getting results. In Redcar and Cleveland, our current partnership, which is led by the health and wellbeing board, has been given a rating of excellent by the National Audit Office. Our better care fund shared budget with the local clinical commissioning group is already leading to some positive outcomes, with a reduction in the number of non-elective admissions to hospital. This joined-up working is also leading to the establishment of an intermediate care centre in Eston in my constituency, which will help elderly patients to avoid long hospital stays and receive recovery support closer to home. It is a great initiative, with the local council and the NHS working more closely together. These initiatives show the huge possibilities from integrating health and social care, but on their own, they barely scratch the surface in dealing with the crisis facing services.
Social care is in desperate need of an urgent cash boost to address the funding gap, to ensure that social care services are properly staffed, and to ensure that the workforce get the pay and development support that they deserve for the work they do. The social care levy and grants in the autumn 2017 Budget have staved off collapse, but the disastrous bankruptcy of Northamptonshire County Council shows what happens when the pressure from cuts becomes too great to manage.
In the longer term, the system needs reform and these decisions cannot be kicked into the long grass any more. It is time for a care system fit for the 21st century, which puts social care on an equal footing with the NHS, and does not leave elderly people and their families worrying about needing to sell their home to pay the care bill.
(7 years, 9 months ago)
Commons ChamberWe now come to the Backbench debate on surgical mesh, in which Emma Hardy is to move the motion. As is the custom, she has around 15 minutes. I am sure there could be a little leeway, but Members should be aware we have an important debate to follow.
Several hon. Members rose—
Order. The time limit for speeches is eight minutes.
(7 years, 10 months ago)
Commons Chamber
Several hon. Members rose—
Order. I call Barry Sheerman on a seven-minute limit.
My hon. Friend gives me a good opportunity to say to all those people who email me and contact me on social media that I cannot deal with all the questions and issues that come into my inbox, but I encourage those people to contact their MPs directly, because it is their own MPs who can help them—
Order. This is a very important debate. I put a seven-minute limit on speeches to try to give everybody a chance to speak. Given the interventions, I will have to drop the limit for Members lower down the list. I do not think it is fair. Interventions have to be short, and Members should think about whether they need to intervene—especially when they are summing up at the end.
Thank you, Mr Deputy Speaker.
I want to discuss waiting times for diagnosis, which are getting better. In the case of my son James, we could not get any kind of diagnosis within the NHS and had to go private. There is not yet the capacity within local areas to ensure that when there is something different with a child early on, there is somewhere to go. I contend the use of language by the hon. Member for Huddersfield—it is not that there is something not right, but that there is something different, and that use of language is important. I say that as someone who has shouted at a lot of people when my son has had a meltdown and said, “If you don’t understand what’s going on, could you kindly go away and keep your opinions to yourself?” That is not normally how I phrase it when I am in a supermarket.
I want to throw something into the mix. As we move forward with so much more work going on across Departments, we might look at having a regional centre of excellence on diagnostics for children on the spectrum, so that we can ensure that wherever we are—whether in the north-east, the south-west, the north-west or Scotland—we know as MPs that we can direct people to a centre of excellence that will be able to help to identify children’s particular needs and so that we never get into the question whether this is about mental health.
Autism is a permanent, different way of being, whether for profoundly autistic children, for whom a great deal of support is required, or those at the high-functioning end of the spectrum—the Asperger’s part—who can be incredibly successful. Some of our greatest inventors and businesspeople are in that space, but if people cannot make it through the basic education system because their needs are not met early on and they fall out of it, that will not happen. Early diagnosis is so important, and I ask the Minister to think about that.
(7 years, 11 months ago)
Commons ChamberI congratulate my hon. Friend the Member for Charnwood (Edward Argar) on initiating an extremely important and timely debate. I commend the sincerity and passion with which he has made his case. He has given me quite a long “to do” list, and I suspect that I shall have to come back to him, given the lateness of the hour.
You and I have attended many Adjournment debates together, Mr Deputy Speaker, and it is nice to see so many fellow Members here.
In fairness, the hon. Member for Strangford (Jim Shannon) is always here.
Indeed, and it is always a pleasure to see the hon. Gentleman in his place.
It illustrates the very real interest colleagues have in this important issue. I am grateful for the opportunity to discuss the work of the Department and NHS England in delivering on our commitment to better support people with eating disorders. As my hon. Friend the Member for Charnwood said, eating disorders are both complex and devastating, and are serious life-threatening conditions with some of the highest mortality rates of any mental health disorder for many of the reasons he outlined: people often become so ill that they and their families do not realise how ingrained the problem is. These conditions can also have severe psychological, physical and social consequences, and they often start, and are prevalent in, young people, which is why early intervention is so crucial.
I will set out what we are doing to support children and young people, but that is not to diminish what my hon. Friend said about adults’ needs, which I will come to later. Having said that early intervention is vital, everyone with an eating disorder must have access to timely treatment. That is why we have set up the first waiting times to improve access to eating disorder services for children and young people, so that by 2020 some 95% of children with an eating disorder will receive treatment within one week for urgent cases and within four weeks for routine cases. I am pleased to be able to report to the House that we are making good progress towards that goal. The latest figures published in the mental health “Five Year Forward View” dashboard indicate that the NHS is on track to meet that standard, with almost 77% of all patients starting urgent treatment within one week and 83% of patients starting routine treatment within four weeks. That information is for the third quarter of 2017-18. We are making progress, but we still have to meet that goal. The number of people seeking treatment is rising, so we will need to make sure there is a commensurate increase in the ability for patients to get the care they need, as well as continue with our reduction in waiting times.
It is a testament to the work done by Members and Beat, and to the fact that there is greater general awareness, that more people are seeking treatment. Raising awareness and improving the understanding of eating disorders is important. My hon. Friend referred to community treatment, and it is our view that in-patient treatment should be seen as a last resort, which is why the Government announced in 2014 that we would invest £150 million to expand eating disorder community-based care. We are making good on that promise, and as a result 70 dedicated new or extended community services are now either open or in development. That will mean that at least 3,350 children and young people a year will receive swift, effective eating disorder treatment in the community.
The services are designed to give young people with eating disorders and who self-harm early access to services in their communities with properly trained teams. That reflects the fact that there was a lack of consistency, which needs to be tackled on a concerted basis so that we have fewer out-of-hours placements, recognising that the road to recovery is often quicker when people have access to their immediate family networks.
The services available include access to talking therapies, so that children and young people have a choice of evidence-based therapies, and a treatment plan agreed with their therapist and recorded outcomes, thereby avoiding the need for hospital stays. By improving care in the community, we can improve outcomes and recovery, and reduce rates of relapse or the numbers of young people transferring to adult services, which is another area of risk. We and NHS England want to make sure we have consistency in provision, and are investing in new in-patient care where there is seen to be a lack.
I am pleased that my hon. Friend highlighted the great work of Beat, and it is worth noting that the Secretary of State spoke at the launch of the Beat report and paid tribute to the young people who speak out. The bravery of those young people probably does more to raise awareness of eating disorders than anything any of us can do, despite our best intentions. Beat found that one in three adults in the UK could not name any signs or symptoms of eating disorders, which again shows we have a long way to go in raising awareness.
The Government understand the importance of increasing understanding and raising awareness. I will highlight some of the things we are doing in this area. First, we have published NICE guidelines on managing and treating eating disorders for everyone over the age of eight, including adults, children and young people. That guidance is available for healthcare professionals and commissioners who provide public services to people with eating disorders.
Secondly, we have set out ambitious plans in the children and young people’s mental health Green Paper, partly to address the point made by the hon. Member for Enfield, Southgate (Bambos Charalambous). We are trying to create new mental health teams in schools, perhaps the earliest of early interventions, recognising that the earlier we can intervene, the more likely we are to avoid longer-term damage and crisis and to achieve better outcomes with people who are struggling. Some 8,000 new NHS staff will work closely with those teams in schools to deliver that enhanced support.
As my hon. Friend the Member for Charnwood said, we talk a lot about children but what about the adults? To further improve adult eating disorder care, we have developed a pathway, together with detailed implementation guidance for providers. That is in development by the National Collaborating Centre for Mental Health, in partnership with NICE. It is being fully informed by the available evidence and the views of experts, and will increase healthcare professionals’ awareness of the early signs and symptoms of eating disorders so that they too can refer their patients without delay.
Central to all this is the data collection that is being done by NHS England. My hon. Friend wanted to make sure that the moneys we are making available are actually being spent on the services on the ground, and that all clinical commissioning groups are delivering against their obligations. We are collecting that data. NHSE is undertaking a very close CCG-by-CCG analysis of exactly the pattern of care in each area so that we can make sure that everyone has access to prompt treatment and that we have consistency in access to provision.
Later this week, as it is Eating Disorders Awareness Week, I will be visiting the Bristol eating disorders health integration team—weather permitting, that is. This is a team of psychologists, academics, commissioners, care and support providers, and people with lived experience of eating disorders who are all working together to improve care and quality of life for people with eating disorders in Bristol. The team focuses on both prevention and treatment. If we can find examples of good practice and share them, we will go a long way towards achieving consistency of provision. I very much look forward to meeting those clinicians and experts-by-experience to see what we in Government can do to support them.
Again, I thank my hon. Friend for bringing this debate to the House. I am sure that this is not the last time that he will speak to me about this issue, because it is not the first time he has spoken to me about it either. I thank everyone for participating in the debate. I know that everyone here has a significant interest in mental health and those suffering with eating disorders. We all know that this can be the most fatal of all mental illnesses, and that every death is a tragedy. That is why we are very much committed to doing everything we can to combat this terrible illness.
Question put and agreed to.
(8 years ago)
Commons Chamber
Several hon. Members rose—
Order. I am bringing in an eight-minute limit. I call Melanie Onn to continue the debate.
(8 years, 2 months ago)
Commons Chamber
Several hon. Members rose—
Order. We have a lot of people to get in and we have very limited time. Can I suggest six-minute speeches?
Several hon. Members rose—
I am going to have to drop the time limit to five minutes. If Members keep intervening it will go even lower.
Several hon. Members rose—
Order. The Front Benchers have up to eight minutes each.
(8 years, 2 months ago)
Commons ChamberThe hon. Lady will not be surprised to hear that I did not agree with much of what she said, but I will address some of her points.
Fundamentally, we are setting out, as has long been established, how to get a longer-term, sustainable system for funding our social care. It is absolutely clear from our debates during the past year that, as far as the public are concerned, there is a real lack of understanding about how, at present, the cost of care has to be met by the person who requires it. That is what leads to catastrophic care costs, and the dementia tax that she keeps mentioning, and that is exactly what we are going to tackle by having a cap on the overall cost. In doing so, it is very important to take the public with us and to have a fully informed public debate. It does not matter how far we think we have had such a debate in this place when legislating in the past, because it is quite clear that the public do not understand this. [Interruption.] We are only going to get public consent for a long-term solution if we have a public debate that is handled with maturity, and so far we have not seen very much of that.
The hon. Lady raised the issue of carers, and she suggested that carers’ voices are not being heard in this debate. [Interruption.] I say to her that they very much are being heard. [Interruption.] She can sit there and chunter, or she can listen to the answer to the question. It is entirely up to her, but it is rather a waste of my time in coming to this place if I am just going to be talked over. [Interruption.]
Order. I say to the Government Whip that I think I can control the Chamber. I thank him for his help, but I have already told him once that he does not need to worry. [Interruption.] Order. The Whip is well aware that he is testing my patience. I do not need any help.
Carers’ voices very much are being heard, and there is no way we can actually tackle the broad picture of how we fund and manage social care need without properly considering the needs of carers. I am very grateful to the 6,500 people who responded to the call for evidence. We have listened to them, and we will consider what they have said in bringing forward the Green Paper. In the meantime, it is very important to pull together exactly what support there is at present and then respond to that, and we will publish our action plan in January.
On working-age adults, the hon. Lady is right to some extent in that there are some common issues in the adult social care system that affect both care for the elderly and care for working-age adults, and those common issues will be considered as part of the Green Paper process. At the same time, however, we are going through massive change in how we deal with people with disabilities. We have the very brave ambition of getting more and more people into work and we are on a journey of getting people with learning disabilities out of long-term residential care and into work in the community, and that brings a separate set of challenges. That work will go on in parallel, but the work on the Green Paper will look at the common issues as well as at the specific area of care for the elderly. I hope that gives her some reassurance. We cannot look at this in a silo—[Interruption.] She says this should all be looked at together, but care for the elderly and care for working-age adults face very distinct challenges, and I do not think we should diminish either constituency by grouping them all together.
On the funding gap, as the hon. Lady is well aware, we have made £9.25 billion available to local authorities to meet their needs over three years. The reality is that if we are to tackle social care in this country so that everyone gets the care they need as they come to the later part of their life, we need to build a longer-term, sustainable funding system. That is why we are taking forward this debate in the Green Paper, and I hope that everyone with an interest in this subject will get involved in that debate, because we can fix this problem in the long term only if we can take the public with us.
(8 years, 3 months ago)
Commons ChamberI would be more than happy to meet Luke and his parents. As well as researching the symptoms and the possible treatments for this disease, we need to understand the experience that families go through, because support for families has to be part and parcel of the treatment. I would be delighted to hear from Luke’s parents to learn from their experiences.
We often look at these things in a very clinical way—it is clinical practice—but we are talking about human beings and we are talking about lives. There is no substitute for bringing home exactly what we are talking about when young children are suffering with such a pernicious disease.
We will build on the studies I have outlined, and we will ensure that the funding provided for research results in better outcomes for those who are suffering, particularly where they are children, but we should remember there is hope. We heard Luke’s story, and we heard that he is at school. He has lived longer than his initial prognosis, so we wish him well. We have much hope.
Here on the Front Bench next to the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Hexham (Guy Opperman), and looking at the hon. Member for Sheffield Central (Paul Blomfield), I am struck by the fact that both have lived through brain tumours and come out the other side. They are an inspiration, and they show that, with the right treatment, people can live despite having a potentially killer disease.
It is my job as a Minister, and it is the job of the Department of Health, to ensure that we leave no stone unturned in making sure that we get the best possible treatment for anyone who suffers from these conditions.
(8 years, 3 months ago)
Commons ChamberIt is always a privilege to speak in these debates. I give special mention to the hon. Member for Bury North (James Frith), whose powerful and personal summary of his life has greatly added to the debate. Everyone who heard his contribution will appreciate it and thank him for it. The right hon. Member for North Norfolk (Norman Lamb) set the scene so capably, outlining the case for addressing valproate and foetal anticonvulsant syndrome. I pay tribute to him for the summary at the end of his speech, about which I will speak later, and his eight recommendations. If there are any recommendations to follow, those are they, as everyone in the House will agree. I thank all the other hon. and right hon. Members who have spoken, because their contributions were equally as important, and I also thank those who made interventions. The House shines better whenever we discuss issues on which we can have an input both personally and on behalf of our constituents, and this is one such issue.
There is no greater gift from God than a little baby. I have two wee granddaughters, and I adore them. We maybe do not spend as much time with them and our children as we should, but we try. They are both perfect in my opinion, even if they have some tantrums. As girls, perhaps they have different tantrums to boys—I only had boys, so I do not know. We live on coffee in my office—I suspect everyone else is the same—and I have watched my parliamentary aide as she refused her normal 10 cups of coffee and drank only caffeine-free beverages for nine months during her pregnancies. Indeed, her not drinking coffee was the first indication that she was expecting again. She had had two miscarriages but now had one baby and was expecting her second, so she was going to take every step that she could to ensure that the baby was perfect. She said that the reason for not drinking caffeine was that it can make the baby’s heart beat a little fast. Mothers everywhere will do almost anything to ensure that they protect that little life when they know of its existence. Unfortunately, as this debate has clearly shown, some mothers did not know what was happening, which is why I feel strongly that more research must be done for the mothers who have long-term health problems and do not know how the medication they need may affect their children. Every Member who has spoken has made that point.
I want to throw another point into the equation. People with ulcerative colitis, Crohn’s disease and other conditions who have infusions such as infliximab have to come off them if they want to get pregnant. Some people are made aware of such things, but does everyone know that? I suspect not, but they should. The hon. Member for Central Ayrshire (Dr Whitford) and others referred to the yellow card scheme, and people need to be made aware of when incidents happen. More needs to be done to ease families’ minds, and that is why I join with colleagues today to ask for more to be done not only in the case of this epilepsy medication, but with more long-term medications in general. We must look beyond this debate and encapsulate what other people are saying.
Sodium valproate is an anti-epileptic drug that is associated with greater risks in pregnancy than other AEDs. Other valproate medicines include valproic acid and valproate semisodium. The Medicines and Healthcare Products Regulatory Agency reports that, although the general risk of foetal abnormality is 2% to 3%, the risk for women taking sodium valproate is around 10%. Did those women know? This debate illustrates that they did not, but they should have known. We have to address the issue now.
The birth defects can include spina bifida and limb, facial and skull malformations. The use of sodium valproate in pregnancy can also affect a child’s development. Many Members, including the hon. Member for Bury North in his powerful speech, have told us exactly what valproate does. Children have delays in learning to walk and talk. The drug can lower intelligence, and affected children have poor speech and language skills compared with children of the same age.
There have unfortunately been many scandals over the years, and my constituents made me aware of the thalidomide scandal, to which I can relate. The hon. Member for Eastleigh (Mims Davies), like me, spoke in yesterday’s Westminster Hall debate on mesh implants: I have been contacted by many affected women, and they did not know what the risks were, either. They have lived with the repercussions for years. One Member mentioned a lady who had to go in three times in six years to have operations before she was cured.
The same is true of Primodos. A Member who is not here told me about his involvement with that issue. There many such scandals and, as other Members have said, we need to bring them all together under one headline.
I am not a doctor, and I have no medical skills, but I can read about symptoms. I have no medical training, but it appears that the risks are significant enough that people should be fully informed of them before they are prescribed such medication. The massive risks in taking these drugs during pregnancy will then be embedded in their minds.
Many of us were supplied with the Epilepsy Action briefing. The statistics are hard to read, but they are very clear. I also thank the Library for the in-depth information it has provided so we can prepare for this debate. The surveys to which hon. Members have referred go back to 1995-96, when a possible problem was first mooted, but no action was taken. The Library briefing says:
“This survey has been repeated in 2017, when it was found that 18% of women taking the epilepsy medicine sodium valproate didn’t know the risks this medicine can pose during pregnancy and 28% of women said that they had not been informed of the risks of this medicine in pregnancy.”
How can it be that lessons have not been learned?
Dr Rhys Thomas, an honorary consultant in epilepsy at the Royal Victoria Infirmary, Newcastle, says:
“This is a dramatic and important survey focusing on a crucial area for women with epilepsy. As a medical community, we clearly could be doing more, and should be doing more. Even if women are being told of the risks, this may be at the wrong time for them—or in the wrong way.”
Sometimes the risks are not explained in a way that people understand, which is wrong. We need to have the conversation, and it has to be repeated. People need to be aware of the risks, and I am not sure that that has happened in the way it should.
The Medicines and Healthcare Products Regulatory Agency figures suggest that up to four in 10 babies are at risk of developing disorders if valproate medicine is taken during pregnancy—that is massive. How can it be ignored? Approximately one in 10 babies is at risk of physical birth defects. Babies affected by sodium valproate can have severe problems that require lifelong care and support. Are we looking at prevention? Are we looking to the future? Are we looking at what the long-term care will be? I suspect not.
It is estimated that 20,000 babies have been affected and 400 babies a year are born to women taking sodium valproate. Epilepsy Action, the Epilepsy Society and Young Epilepsy have surveyed more than 2,000 women with epilepsy, and they found that some women are still not aware of the risks of taking epilepsy medicine in pregnancy. More than a quarter, 28%, of women who have taken an epilepsy drug have not been given information. That would indicate to me that a knowledgeable medical professional should have taken the time to go through the risks of being pregnant with people on the drug. After someone has become pregnant, it may well be too late, so those discussions with the GP are very important. It is not a matter of someone simply stopping a drug when their pregnancy test is positive, as that is not the safe way to do things.
In conclusion, I urge that the eight points are followed, but that we should put in place the compensation fund that everyone in this House wants to see, because that will at least help the families affected to deal with the financial positions they are in.
I call Cat Smith. If she could finish at half past, I would be grateful. In addition, if the wind-ups could be about nine and a half minutes long, that would allow us to bring in Norman Lamb.