The National Health Service

Lisa Cameron Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute privilege to speak in this debate on the Queen’s Speech and the NHS. I basically committed most of my adult life to working in the NHS. I heard the poignant speeches from the hon. Members for Dudley South (Mike Wood) and for North Tyneside (Mary Glindon) regarding their very personal experiences. That goes to show that the NHS is part of us all—it is part of our families—and therefore we owe it a debt of gratitude. We owe it everything we have in terms of supporting it going forward.

I am pleased that, as the debate has progressed, it has seemed much more cross-party and consensual. When I worked in the NHS, I would have said that having it pelted about like a political football was no good. It might seem like something we can all banter about in this place, but for staff working in the NHS and watching it, it is very serious, and they want it and the issues to be taken seriously. I am therefore pleased that, as the debate has continued, we seem to be coming together on many issues and to be able to take them forward consensually.

I pay particular tribute to the staff who work in the NHS and in social care because that role is largely undervalued in today’s society. However, it is absolutely crucial. To be honest, the NHS just does not function without the integration with social care that we are trying to achieve. Fifteen minutes of care is not enough. This needs to be appropriately funded. I know that from personal experience, as a carer for my own grandmother. We had to bring her to live with us because we felt that the social care system left her feeling quite lonely; she had only certain episodes of care each day. She needed mental stimulation as well as practical physical care. So I hope the Government will consider those issues and make sure that we look at social care in a holistic way and that we look at people’s mental health and loneliness alongside their physical health needs, because 15 minutes of care, as it has been tagged, is certainly not enough.

I am delighted that mental health is a key focus. Had I been elected 20 years ago, when I started my career in the NHS—beyond that now, if I am honest—that would have been a closed door. We have come quite a long way in terms of mental health. There is a long way still to go but I am pleased that it has been prioritised. I ask that there is investment for child and adolescent mental health services. As awareness of the need grows, young people are coming forward, but they need to be seen and treated very quickly.

In particular, I want to ask the Minister about training in autism diagnosis for staff in CAMHS. It is not about providing new staff to CAMHS; it is about providing training for existing staff, so that there is no postcode lottery anywhere in the NHS. For a family with a young child reaching those developmental milestones or losing one or two developmental milestones, waiting for a diagnosis and adequate support is far too long a time to wait.

I pay tribute to the Thalidomide Campaign, which had its 60th anniversary event at Speaker’s House just last week. My constituent, Jerry Cleary, has battled for years for justice. I ask the Minister to consider meeting me, members of the campaign and Members who have constituents who are affected because they told me last week that they feel like the forgotten campaign—the forgotten tragedy—and that really cannot happen in today’s society.

Like other Members, I would like to mention medicinal cannabis. I have a tragic case in my constituency. Lisa Quarrell has a young son, Cole Thomson, who has now been prescribed medicinal cannabis, but they have to pay for this prescription at great cost. It will not be prescribed in the UK, so they are having to travel back and forward. Can she be included in the medical trials going forward? She came down to meet the Secretary of State and he promised that she would be included, yet she has not been. She needs to know what the outcome is and we really urge him to see this through.

I thank everyone who has taken part in the debate in a consensual way. I hope that we continue to build on that because, as I have said, the NHS is there for us all in our time of need. We must be there for the NHS.

Social Care Funding

Lisa Cameron Excerpts

Tuesday 1st October 2019 Westminster Hall

[Sir Vince Cable]

That is a helpful and humane suggestion, and if we approach this whole question in terms of its practicality, rather than with abstract ideology, we might make some headway. What my hon. Friend suggests seems an eminently sensible way to start that process.

The last and most difficult issue is the one in which successive Governments have got hopelessly bogged down: the so-called catastrophe risk for the small number of people who are caught with prolonged expenses as a result of residential care. When I was in government the Dilnot report attempted to address that issue, but I think we have moved beyond that now. This is a classic problem of insurance, and it is now recognised in a way that it was not before—I think the current Prime Minister said this publicly—that the private insurance market cannot, and will not, deal with this problem. If there is to be insurance it must be social insurance, and large numbers of people will have to make a contribution to prevent the burden falling on a small number of unfortunates who contract long-term conditions, with all the costs involved.

That could be done in a variety of ways. One idea is a supplement to national insurance. Another idea from 10 years ago, which I had no problem with, is that if we are to solve the problem of people losing their inheritance, everyone who pays inheritance tax should pay a small supplement. That struck me as a good social insurance principle. Whether or not that formula was right, we have now got to a point of accepting that this is a social insurance problem, and there are different mechanisms for dealing with it. If we are reasonably grown up politically, we should find a way of closing that gap.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

The right hon. Gentleman is making a fantastic speech on what we will all agree—Brexit aside—is the issue of the day. I visited Parkinson’s UK in East Kilbride, and Parkinson’s sufferers are particularly affected by social care catastrophe burdens because theirs is a degenerative condition that can start in their 50s, or even earlier, and go on for the rest of their lifespan. Does the right hon. Gentleman think the Government should look at conditions that particularly affect people and start by focusing on those as a priority, as the hon. Member for Totnes (Dr Wollaston), the Chair of the Health and Social Care Committee, said?

[Sir Vince Cable]

The hon. Lady is quite right. We are talking about a variety of conditions. I listed some, and Parkinson’s is clearly one. With Parkinson’s, it is difficult to separate the health and the social element, which is one of the problems with a lot of these conditions and why the current distinction is so arbitrary and unsatisfactory.

Perhaps I could finish with a quotation from Her Majesty the Queen, although it does not relate to her need for social care. Two and a half years ago she made a speech in which she said:

“My Ministers will work to improve social care and will bring forward proposals for consultation.”—[Official Report, House of Lords, 21 June 2017; Vol. 783, c. 6.]

That was two and a half years ago, and the basic question is: where are they?

Artificial Intelligence in Healthcare

Lisa Cameron Excerpts

Thursday 5th September 2019 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute pleasure to serve under your chairmanship, Mr Paisley—I believe it is the first time I have done so in Westminster Hall, which is particularly pleasing to me. I thank everyone who has taken part in this excellent debate, and I particularly thank the hon. Member for Crawley (Henry Smith) for securing it. I think the one thing on which we can have cross-party agreement is that the more debates we have in which Brexit is not the focus, the better. I am sure we could all go through the Lobbies to agree on that.

This is such an important debate, and I think the public and many of ourselves as MPs are just beginning to catch up with how important it is, which is why I am particularly pleased that the hon. Member for Crawley secured it. He linked technology, the NHS and artificial intelligence in such a detailed speech, and he chairs an important all-party parliamentary group. We can see that technological advances are saving lives on the frontline, which is tremendously important to people right across the United Kingdom. That is why we cannot over-focus on this issue. More and more debates will be about it in so many different domains, particularly in health.

The hon. Gentleman brought up an important issue: education of the public, which will be absolutely key going forward. It is such a crucial issue for us all to consider, because it is not just about medical and healthcare professionals becoming educated, and perhaps their training changing over time to incorporate all these new techniques and procedures, and about how the world is becoming much more digitalised, with 5G and so on coming on stream; it is also about public understanding and ensuring that the public are involved in their healthcare going forward, and that they are absolutely able to engage with it.

Like the hon. Member for Strangford (Jim Shannon), I am a real technophobe. It took me over a year to try to pay for things by tapping a debit card on machines in stores. Now, I love it. I probably do not even carry any money now, but at first I was so anxious that I would be walking about and having money removed from my bank account that I avoided using it. That is one of the concerns about the technology. It is about bringing the public and those of us who, unlike my own kids, have not grown up with such technology as the norm.

We have to get people on board and ensure that, across the lifespan, people can really benefit from the digital revolution that is happening, and that people do not become more isolated and left out of society because they are left behind. That is important for their physical health—monitoring prevention and so on—and for their mental health, in terms of feeling really engaged and involved in society. We have to integrate all this with the professionals in our healthcare settings, with the public being a key focus.

As has been said, artificial intelligence will be so crucial at every step of the patient’s journey. It will include prevention—we have already heard about some of the developments. There is some amazing work being done at Queen’s University Belfast on early prevention, detection of ovarian cancer—my goodness, how life-saving will that be?—and early interventions, not just for physical health, but for mental health. I am very keen for us to look at how we can engage more with AI and digital technology, perhaps in relation to depression, anxiety and how patients can monitor their mood, and at how technological advances can promote what we want to do: achieve parity of esteem for mental health services and physical health services. There is also treatment and recovery. It will be about prevention, early intervention, treatment and recovery, and the technology will be crucial at every step of the way.

I was pleased to hear the hon. Member for Cambridge (Daniel Zeichner) talk about developing standards, because everything in healthcare is about developing standards, best practice and guidelines, and that is what fosters the public’s faith in the work that we do. Our NHS is so loved right across the United Kingdom. When private companies bring their expertise in research and technology into such a beloved institution as the NHS, it is extremely important that the public have a sense of those companies’ remit and the sensitive nature of the data, that protection and security issues are addressed, and that standards are of the utmost importance for maintaining that.

The hon. Member for North East Derbyshire (Lee Rowley), too, spoke of the importance of security and international collaboration and research. Again, we have to think about other countries and how they manage data. We take part in lots of clinical trials—I am going to mention the EU, then move on to talk about, more broadly, the situation internationally. We have to look at developing standards commensurate with those of other countries, and we must at least know the limitations of the collaboration that can be undertaken when it involves our NHS and is about our patients’ data. He also mentioned his personal family circumstances and how important the advances have been for his own family and their healthcare. It is always very poignant to have that personal experience to bring to debates, and to speak about the impact that has made.

I looked around a few times just as I sat down, and I thought, “Why is the chair behind me empty, and where is the hon. Member for Strangford?” Then I turned round again a third time, and there he was. He never fails to take part in as many debates as possible in the House of Commons, and to ensure that his constituents are so well supported and their issues addressed at every step of the way. I am pleased that he recently learned to text, because it sounds like he is similar to me in being trepidatious about technology. Both our examples show why we have to educate the public and try to ensure that we all become up to speed with the technology. I mentioned the wonderful facilities at Queen’s University Belfast, where I was going to go and study before deciding to stay at Glasgow University; when I was training as a clinical psychologist, I had also applied to Queen’s. I could have gone to Queen’s if I had not gone to Glasgow, so I have always had a soft spot for it. I am delighted that its research is formative and will make such a difference.

From my experience of working in health, I know that computer programs managing data are very important, but the systems do not link up. For instance, health boards pay millions of pounds for systems that work for child services and for adult services, but the data cannot be transferred between the two. Children become adults, so how do we merge the data across their lifespan? Will the Minister look at that issue? For most people, transferring data seems commonsensical, but it is not happening in practice. Aligning it better would save a lot of money; we should not have to change systems that have already cost the taxpayer millions of pounds.

I was pleased to secure a debate on smart cities just before the recess, in which we talked about 5G. Driverless technology will enable ambulances to get to incidents much quicker when we have 5G technology and the next industrial revolution—this technological revolution—happens. I would be interested to hear from the Minister how 5G fits in with the issues we are debating and the advances that are being made. Where does she see the future lying?

I have spoken about this issue with some international delegations, particularly from Japan and China. We talked about the fact that technology and artificial intelligence have had an impact on social care. Robotics is being used in care homes—for example, robots can remind patients to take their medication. I would be interested to know a bit more about how we are linking to our international partners. We must collaborate safely in a way that enables patients in social care and the NHS to benefit from technological advances.

We have talked about how important this technology will be for surgical procedures. That was described very well. I agree wholeheartedly that there must be a partnership between robotic techniques and skilled clinicians. That is what the public wants, and that will always be the safeguard as we take these issues forward.

On the issue of prevention, smartphones and smart watches, technology has had a massive impact on reducing missed appointments in the NHS. Sending patients a text to remind them to come to appointments saves money and clinicians’ valuable appointment time.

Social media must be responsible when it comes to health. Through its technological advances, it is already playing a huge part, but young people in particular often get inappropriate information from websites that are not properly regulated. The large companies must take much more ownership of those issues. I have discussed these issues with Facebook and Twitter recently. There are sites that tell people how to develop an eating disorder or harm themselves. We must look at regulating them further. Will the Minister address their impact on mental health? Will she think about not just mental health treatments that we can develop through technology, but about how we ensure appropriate regulation is in place for sites that are not managed by our NHS or professionals and are causing harm to the public?

I am pleased to say that Scotland is to have its own £15.8 million AI health research centre based at the University of Glasgow. It will be a genuine collaboration between NHS research and other industries. We are keen to ensure that all partners are involved and that we can generate the very best practice in technology and healthcare.

Body Image and Mental Health

Lisa Cameron Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is a privilege to speak in this debate. Indeed, it is always a privilege to speak in debates about mental health, and, having worked as a psychologist prior to coming into Parliament, I always think my timing has been good, because 10 or 15 years ago we would not have been speaking about mental health, and the doors to any conversation about it would have been firmly closed.

I am always grateful that these issues are prioritised by Government. The Minister has been doing a fantastic job in this regard, working cross-party, and she has all our support. I thank her for the work that she has done and I too hope she continues in her position; if I could send in a recommendation or something, I would be very happy to do so.

[Andrew Griffiths (Burton) (Con)]

I am not sure a recommendation from the Opposition Benches will help.

[Dr Cameron]

Indeed.

Body image is a very important issue, and it is an interesting one as well, because it is coming more to the fore through social media and through society in current times, when there is this striving for perfection. As we heard, in the past that might have been about looking through glossy magazines, but now it is all about how glamourous we can look on Facebook or Twitter, how many friends we have, and how many people want to befriend us because of the way we look—because they think that equates with our being some kind of fantastic person, when of course it often does not. And sometimes the most glamorous of people can also be the most shallow, I have to say.

Society is encouraging stereotypes that place great stresses on our young people today, and that has an adverse impact on their mental health. Social media companies must look at this in much more detail in terms of regulation, as we have heard. I have been very pleased to contribute to the work done through the Department, which is looking at issues of social media abuse and the impact of social media on young people’s development and mental health and how they relate to the world. It is almost as if we have become an artificial world rather than engaging with each other in our day-to-day lives just as we are, with all our diverse shapes and sizes being the norm.

[Andrew Griffiths]

The hon. Lady is raising some very important points, and I think we all recognise that young people are under more stress and pressure than ever before, particularly through social media. Does she agree that schools have a key role to play in trying to provide support for young people? I am sure that, like me, she welcomes the new Trailblazer programme that the Government have offered, but does she agree that if we can ensure that young people feel able to ask for support and help in the classroom—in the school environment—we will have a better opportunity to tackle these issues at the very start and help those young people before the problem gets worse?

[Dr Cameron]

Yes, those points are well made. We must do much more in the classroom to help young people grapple with social media issues and pressures, and to develop positive mental health and coping strategies so they can do that. We also have to help parents, like me and others here today, to understand social media; often children are far ahead of us and it can be very difficult for us to regulate what is happening online and make sure it is safe and secure.

I also commend the work of the all-party group on mentoring and the Diana Award. I recently went to a number of their events, one up in Scotland at Holyrood and one at Westminster just a few weeks ago. They are doing fantastic work to help young people who are being bullied in school and to provide peer mentors, because often, as we know, young people listen to other young people rather than parents or teachers. The work they are doing is going a long way in giving young people skills to understand how to challenge bullying, and to promote good mental health and to understand that it is very important that we support each other in society, rather than doing each other down. I commend them for their work.

I am chair of the all-party parliamentary group for textiles and fashion, which is undertaking an inquiry into inclusion in the industry. We have started our inquiry sessions, which have been extremely interesting. We have heard that although the industry is trying to become more diverse and to promote more diversity among its models and in the work that it prints, there are still many challenges and barriers for young disabled people and plus-size people in becoming models or getting into the industry at any level. We hope that the inquiry will highlight and raise awareness of the issues and ensure that the industry lives up to our expectations that it should be inclusive and diverse, just as the United Kingdom is.

The all-party parliamentary group on psychology recently conducted a research study that showed that although the number of abusive posts to politicians was almost equal across the genders, the content was quite different. Whereas male politicians were criticised for their position on a policy, female politicians were much more often criticised for the way they looked, held to account for not wearing the right things in Parliament—according to whoever thought they were the fashion guru—or trying to do them down based on their personality or personal appearance. That shows the stereotypes that must be overcome and the challenges in feeling confident in politics. We must support everyone to make sure we have a diverse Parliament moving forward.

When I highlighted this debate online today, my constituents asked me not to forget to mention how men are affected in terms of body image. That is such a good point. We often speak about the impact on women, and I have been doing that in much of my speech. They said, “Please don’t fail to mention how men are impacted because this is increasingly an issue in society, and the same stereotypes apply: having to be really buff, no matter what your day entails or if you are running about trying to juggle lots of different things. Always having time to go to the gym and to look fabulous and have all the best clothes etc.—these things also put pressure on young men.” I attended a very sad but poignant tribute at the weekend to my constituent Ryan Coleman, who sadly took his own life. We really must not underestimate the pressures on young men’s mental health nowadays in society. It is incumbent on Governments across the United Kingdom to ensure that young men as well as young women feel able to come forward, be referred and take up services; there is often much more stigma for young men in accessing services and acknowledging some of these issues.

We have spoken about cosmetic procedures. I do not have too much detail to speak about on that, but I am aware that there is not much regulation of such procedures and it is important that we get on top of that. As the Minister and the shadow Minister mentioned, when things go wrong, it is not just like having to go back to the hairdressers and getting a different colour put on. Cosmetic procedures can have a permanent impact on people, or affect them for a very long time, so regulation in this market is important. Other markets may be diminishing, but this market is growing exponentially so we definitely need to have regulation in place.

When I worked with people who have eating disorders, we knew from the research that body image was a core part of the issue that people struggled with. It is not just about weight; it is about cognition. It is about how people think about themselves. I worked with young people who were growing thinner by the day and had anorexia nervosa but felt that they were fat. When they looked at themselves in the mirror, they saw themselves as overweight and strove to lose more and more weight. When an eating disorder develops over time, we know that cognition becomes affected. That is why it is very important that people can be referred to local services. I know how difficult that can be.

When I was doing some work in mental health primary care, the problems in referring someone to tertiary care and eating disorder services were almost insurmountable. People had to go through the community mental health team. Weight comes into it again. They might not be quite at the threshold, but everyone in the family and the clinicians knows that the person is developing an eating disorder. We must have services that accept people, and a clear clinical pathway. Otherwise, by the time people arrive at the service that they need, their condition has deteriorated so much that they may need to be admitted to hospital.

We also need to ensure that we can treat people with eating disorders as close to home as possible. They often need cognitive behaviour therapy or family therapy, and families really need to be involved in that care. If the care is taking place 20 or 30 miles away from where the person lives, it is so difficult for families who are grappling with all the other demands on their time to be as involved as they really want to be.

Ahead of Mental Health Awareness Week this year, the Scottish Government announced a new advisory group on body image and young people’s mental health. It is important to have that group up and working; to be thinking about the issues that test young people today. We need to be ahead of the curve. The Scottish Government also recently announced a package of funds for social media advice for young people. We are very aware of the impact of social media. When we are looking through magazines, we can put them down and go off and do something else, but social media is constant. I see this with young people, including my own children: as soon as their phone rings—ding ding—they have to look. Social media is almost like an addiction. I am sure that the companies love that because people are becoming so reliant on it. We need to make sure that our young people have varied lifestyles; that they get out and about in the fresh air, as my mum used to say. I am repeating my mother now. I hope she is listening. I never thought that I would get to that stage, but there you are, I am. It is important for health.

I am extremely pleased to have spoken in this debate. I am pleased that it has been given time in the main Chamber, where it should be, that we are prioritising mental health and that we are discussing the important issue of body image.

Children and Mental Health Services

Lisa Cameron Excerpts

Tuesday 16th July 2019 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I thank the hon. Member for Burton (Andrew Griffiths) for securing this extraordinary debate, in which there have been many contributions from both sides of the House and many interventions, which shows that the issue is a high priority in our constituencies. It is important that the subject was brought to this Chamber. His speech was detailed, extensive and passionate. I congratulate him on being an assiduous representative of his constituents.

We have heard about the main issues; I will not go through them all again but point some out. Workforce is obviously a problem, as are training, access to services, prevention, treatment, trauma and eating disorders. We have also heard about social media and how technology can be helpful in signposting people, but can also undermine mental health in young people, so appropriate safeguards must be put in place.

We have heard constituency cases from across the United Kingdom. The Office for National Statistics shows that the highest rate of suicide is in north-east England and Wales, but all Governments across the United Kingdom need to make tackling suicide a priority. I thank the Minister, who has been working hard on it and has made significant progress. The problem is, however, that we had such a long way to go that we are not yet where we want or need to be.

I thank the British Psychological Society and the Paediatric Psychology Network UK for sending me their updates and views. They pointed out the problem with access to child and adolescent mental health services and that the services continue to be run on medical models, so if a young person presents with suicidal thoughts or behaviours, unless they have a concomitant mental disorder such as depression or an eating disorder, they do not always gain access to the treatment part of CAMHS. That is wrong, because not every young person will be medically classified as having a disorder, but may need access to coping skills, treatments, counselling and perhaps family therapy. They may have social issues, rather than a condition that requires a medical diagnosis, but they still need access to crisis care to prevent suicide.

That has been brought home to me in the last couple of weeks, as we have suffered our own tragedy in East Kilbride. Ryan Coleman, a young man with his whole life ahead of him, took his own life. This weekend, I am going to a tribute event to mark his life and what he had accomplished in such a short space of time, and to support his family and friends. Families should not have to go through such tragedies, however, and Parliament must do more.

I thank the Trust Jack Foundation in Stonehouse, which has set up young people’s services to bridge the gap and make sure that something happens between a referral to CAMHS and being seen by CAMHS. It gives young people access to support from other young people who experience mental health issues and to support-based activities and therapies. Again, that came out of a personal tragedy—the loss of Jack—which his mother, a wonderful woman, has turned into a positive thing for other children across the area. I cannot thank her enough.

Transitions are important; we need to focus on the transition from child to adult mental health services, and services in colleges and universities. Will the Minister think about the children who have lost a parent serving in the armed forces, and update me on that? A couple of weeks ago, I went to an event with the armed forces parliamentary scheme where I found out that there is a lot of work going on in the US to support young people who lose a parent in service, but there is no much support, treatment and access to services in the UK. Obviously, children who lose a parent serving in the armed forces also lose their home and support network. They have to make dramatic adjustments, and for young people, that is a critical time.

Governments across the United Kingdom are trying their best to improve services, but we have a very long way to go. I want to help everybody in Westminster and the other Governments to achieve the progress we need.

Listeria: Contaminated Sandwiches

Lisa Cameron Excerpts

Monday 17th June 2019 Commons Chamber

[Matt Hancock]

I agree wholeheartedly with the wise words of my hon. Friend.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

What is happening in hospitals? Surely we should be role-modelling fresh and healthy produce? Giving people packaged produce, including sandwiches, to eat gives them the wrong message about health and rehabilitation. Surely we should be role-modelling correct behavioural choices at every opportunity when somebody goes into hospital? Will the Secretary of State speak to the Government’s behavioural insights team to consider taking that forward? In my experience, kitchens in hospitals do exist. If he looks deeply into the issue, he will find that staff and visitors often have restaurants in hospitals. However, fresh food from those restaurants is not always made available to patients. We need to tackle and stop that inequality, particularly when patients are fragile, frail and elderly.

[Matt Hancock]

I will happily look into the last point for the hon. Lady. She is absolutely right that a hospital should be a role model of fresh and healthy food, because after all, what is a hospital but a place to try to make us all healthy?

Medical Cannabis under Prescription

Lisa Cameron Excerpts

Monday 20th May 2019 Commons Chamber

[Jeff Smith]

The right hon. Gentleman is absolutely right. That points to the issue about where we get the product from. The problems, allegedly linked to increased episodes of psychosis, are from high-THC street cannabis, which is not what we mean when we talk about medical cannabis products. As I said, there are lots of different types of cannabis products. They are very often CBD-based, but when they contain THC—the psychoactive element—it is a much, much smaller amount than in street cannabis. It is like comparing apples and pears. He makes a really important point.

We need to look at how we can learn from evidence in countries such as the Netherlands, Germany and Canada, as well as countries that have successfully introduced medical cannabis regimes, such as Australia and Denmark. What work are the Government doing to learn from the experience of those jurisdictions? There are currently at least 138 medical cannabis trials worldwide. We need to take into account that global evidence.

I would like to ask the Minister a number of questions. Why can clinicians make individual decisions on certain conditions but not others? For example, clinicians can make individual decisions on a case-by-case basis on Crohn’s disease, which my constituent’s grandson suffers from, but not on some other conditions.

We need a scoping exercise to look at how we can enable patients to get this medicine now. There are estimated to be something like 3 million cannabis users in the UK, with around 1 million of those using it for medical purposes. Those figures may be high but, whichever figures we look at, there are hundreds of thousands of people using cannabis to alleviate pain or help with a medical condition. At the moment, they get their product from the street—from the illegal trade. That is not good for them or for society. That is the key point. People are already using cannabis for medical reasons and getting it from illegal suppliers.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I thank the hon. Gentleman for giving way; he is making an excellent speech. On that point, I had a visit to my constituency surgery from one of our veterans, who had incurred an injury during his service. He was in chronic pain and felt that cannabis alleviated that, but he did not wish to buy it; he wished it to be prescribed and for Ministers to look at the research and studies, to ensure that veterans who need that assistance can have it.

[Jeff Smith]

That is not an unusual case. There are lots of people who want to use medical cannabis and do not want to buy it from the street or go to Holland to import cannabis products, and they are frustrated.

I will wind up, because I have been speaking for longer than I intended. On the funding issue, there are cases of clinicians being willing to prescribe but being blocked by trusts or CCGs. What is the Minister’s understanding of how many cases there are where funding is the issue, rather than prescription? Even where clinicians are willing to prescribe and there is new thinking, CCGs do not have budget lines for some of these products, so the reluctance is understandable. I am interested to know whether the Minister has any information on that.

It might cost more for the NHS to supply more medical cannabis prescriptions, but we have to compare that with the reduction in other costs. The estimate is that opioid costs would be 25% lower, and there would be fewer hospital admissions. Professor Mike Barnes said in his evidence to the Select Committee that we could probably introduce medical cannabis in this country on the NHS at no net cost, when we take into account the reduced costs elsewhere.

Our system is clearly too restrictive. It is not working. We need creative thinking and flexibility from the Government, and we need them to look at the different types of evidence from around the world. There are people in this country who, if they were living in Holland, Australia or Canada, would be able to get on with their lives, get their cannabis products legally and not have the worries of the campaigners in our Gallery today about them or their children and relatives having to go through chronic pain or the episodes of epilepsy that we have seen in young patients over the last year.

We all want to make some progress and are desperately frustrated that we are not able to get anywhere. I refer the Minister to the evidence given by Professor Mike Barnes. We need to look at other types of evidence to inform ourselves of a way to deliver the products that our patients need into their hands.

--- Later in debate ---

[John Howell (Henley) (Con)]

I congratulate my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) on securing this timely debate. Let me start by picking up on something that my hon. Friend the Member for Reigate (Crispin Blunt) mentioned: all we are talking about is medicinal cannabis. We are not talking about making cannabis available for general recreational use. I am sure that there are Members of the House who would have an opinion on that, and we could have a full debate on it, but we are talking only about use for medicinal purposes. The wording of the motion is very important. When I read it, I saw that it stressed the practicalities of getting cannabis medicines prescribed. It is not about the general issue—we had the debate on that and the Home Secretary reached his decision—but about the practicality of getting some sort of result.

I realise that this is not easy for the medical profession and that the Government have initiated a review of the barriers to clinically appropriate prescribing. That is a very important review to undertake. I am aware that the National Institute for Health Research is going to participate in the review, which is a positive step, and I will set out what I think are a couple of the barriers that prevent prescribing

What we are really waiting for is some NICE guidelines. I understand that they are coming, but they need to be brought along pretty quickly. We cannot wait for them forever, nor can the children who are suffering.

[Dr Cameron]

The hon. Gentleman is making an excellent point and an excellent speech, which relates to the practicalities for children in my constituency such as Cole Thomson. His mother, Lisa Quarrell, has been trying to get medicinal cannabis for him for some time. Not only does she have to battle his absolutely debilitating epileptic illness, which gives him multiple seizures every day, and to see the deterioration each day in his condition, but she has to battle the medical system, battle with financial costs and battle the Government as they take one step forward and two steps back, giving hope and then taking it away. It is too much and too traumatic for any family in that situation to cope with.

[John Howell]

I thank the hon. Lady for her excellent intervention, and I agree with much of what she said.

One of the main barriers that I see is the simple question of who is allowed to prescribe. The General Medical Council holds a list—a specialist register—of specialist doctors who are allowed to prescribe. Why do we have a specialist list, and why can only those on that list prescribe? Is it because people are nervous about their careers or other things? Why do we limit the number of doctors who can prescribe in this way? I have read claims that something like 110 patients have been prescribed the medicine, but from what has been said in this debate, I understand that only one has received it.

Health

Lisa Cameron Excerpts

Tuesday 14th May 2019 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute pleasure to speak on behalf of the Scottish National party and to see you in your place, Madam Deputy Speaker.

As we know, public health campaigns can be extremely successful. They make health improvements in a widespread manner; individual interventions do not have the same effect. However, the work of public health campaigns and departments is not always visible. It tends to take place behind the scenes. Constituents do not often speak to their MPs about these issues. Very infrequently has anyone come to my door to ask about a cervical screening appointment, or about our campaigns and work on obesity. Public health is not the most visible area of our NHS, unlike the frontline issues of access to treatments, accident and emergency waiting lists and access to GP appointments. It does not have the profile that it ought to have, and it certainly does not feature the sensationalism on which the media often want to report. However, it is important to say that public health is fundamental to the health of the nation. Therefore, public health should not be underestimated and should certainly never be underfunded.

Since 2006-07, the annual health resource budget has increased in Scotland by £4.8 billion, and the Scottish Government have passed all consequentials on to health and care. Funding for NHS boards will increase again by £430 million—an increase of 4.2%—and the package of investments in health and social care in Scotland for integration programmes will be £700 million to the better. Health spending per head in Scotland is almost 9% higher than in England, according to Treasury analysis in 2018.

Investment in primary care is essential; our GPs are at the frontline and it is important that we increase funding for that. The Scottish Government have invested over £930 million in primary care, and £30 million will be invested to extend the free personal care individuals have in Scotland to the under-65s. Some £11.1 million will be provided to increase nursing and midwifery bursaries from £8,100 to £10,000 the following year. Again, midwives and nursing staff are on the frontline of our public health achievements.

Young families across Scotland receive the opportunity to have a baby box as soon as their baby is delivered, which is fundamentally to the good; it is about saying, “We know your baby is born; it is the most valuable thing in your life and we want every baby in Scotland to have the same start and to reduce the inequality we know impacts on people’s lives and families.”

We also need to increase our sportscotland funding, and there has been a pledge of 3%. We have discussed obesity today. I was a member of the Health and Social Care Committee when it was looking at the issue, and again this underlines the importance we must place on public health investment. Advertising and marketing campaigns overshadow the work we are able to do because of the huge investment the industry puts into encouraging people to eat and to feed their children the wrong types of food and to give ourselves treats many more times than we should. I have fallen foul of that, particularly since arriving in the House of Commons; our Tea Room has far too many little treats at the counter. These are all things we grapple with as families and individuals, and that is why it is so important that public health and public health campaigns are supported.

I am pleased to learn more about the Government’s nudge unit. The UK Government has put some investment into psychological approaches to public health and to health, and I was pleased to meet a member of the nudge unit a few months ago at the all-party group on psychology, which I chair, because we must try to help people shape their behaviours and make it as easy as possible to make the right decisions moving forward. Making the right decisions is difficult anyway, but things such as having the opportunity to have a piece of chocolate at the till when we are making purchases makes it that little bit more difficult for people to make the choices we know they need to make. Public health and taking responsibility for our health is all about shaping behaviour: making those choices ourselves through our motivation, but also the Government helping to shape the society we live in and make sure that the easy choices are the healthy choices.

It is important that we raise as much awareness as possible of mental health, particularly in this week, Mental Health Awareness Week. This has often been about communities plugging gaps, however. Progress has been made across the UK, but community mental health service waiting times are still far too long, particularly for young people and adolescents awaiting access to child and adolescent mental health services. That is why there has to be a partnership between public health, health services, voluntary agencies and others in the community.

An example is the Trust Jack Foundation in my constituency, which was formed following the tragic suicide of a young person in my constituency, Jack. His mother came through that terrible trauma and created the foundation, which enables young people in Stonehouse and elsewhere in Lanarkshire to have access to mental health services while they are on the waiting list for CAMHS, and it is really making a difference by giving them the support they need and the earliest possible intervention.

On disability, we must pay cognisance to the fact that those who are disabled are much more likely to be living in poverty than those who do not have disabilities. It is important to take account of that, because people who have disability have less access to the workplace, to transport, to adapted housing and even to shops, because in some cases, Changing Places toilets are not available in our shops. They also have less access to getting about, because Changing Places toilets and facilities and accessible transport are often not available. All those factors contribute to the impact of poverty on people with disability, and we need a joined-up approach across Departments if we are to make a difference.

I want to speak briefly about homelessness. I cannot help but notice that every time I arrive here in Westminster each day, there are people sleeping at the underground station just outside the entrance to Westminster. I have also noticed that, a number of times, there have been flowers left for those who have died there. It is incumbent on us all, as MPs and as a Government, to notice what is right in front of our eyes and to act to ensure that those homeless people have opportunities and that their health and wellbeing are cared for.

I want to touch briefly on the subject of older adults. Public health campaigns will have to focus on and target older adults in the years to come. We are living longer by virtue of the good health we enjoy as a result of the interventions, treatments and technologies that are now available, but chronic illnesses will be with people for longer and affect many more people.

[Theresa Villiers (Chipping Barnet) (Con)]

Does the hon. Lady agree with a point made to me by a number of my older constituents at an event last week, which is that we need to ensure that sports facilities are providing the right encouragement and opportunities to keep older people active for longer, given that that is crucial for public health goals?

[Dr Cameron]

Yes, that is an absolutely fantastic point. I was going to mention the fact that our local sports and leisure facility has an agreement with the NHS that GPs can prescribe sports facilities to people so that they can have an exercise regime designed specifically for them. If they can benefit from such a regime, that can maximise their health. All these things actually save money in the long term, and that is why public health is so crucial. We really are investing for the good of the nation.

From my own experience of working in addiction services many years ago, I know that we have to take on board the fact that there are huge levels of comorbidity with mental health. Often, people in addiction services have a history of trauma. They are self-medicating with alcohol or drugs, and they are not coping with life due to their underlying mental health issues. However, those very same people are often refused access to mental health services treatment until they have dealt with their addiction. That is a circular argument, and those who are struggling with mental health and addiction problems never really get the support that they need or deserve. That is why integrated services in relation to addiction are so important.

[Diana Johnson]

I am interested to hear about what is happening with drug and alcohol services in Scotland, particularly the 9% budget increase that the hon. Lady mentioned. Has she had the same experience that I have had in Hull, where more and more people on the streets seem to be taking Spice, which turns them in an obvious way into someone who is taking drugs and which is causing real problems on the streets? Is that happening in Scotland as well? We have seen an 18% cut in drug and alcohol services since 2013.

[Dr Cameron]

This is always a difficult situation, because when people self-medicate, they tend to take the drugs that are available. They may take something that has an impact on their behaviour and personality, which may then have an impact on their life if they become involved in crime and so on. The types of drugs that are coming on to the market seem to lower people’s inhibitions, so they can get into terrible difficulties with the criminal justice system, but their difficulties—their underlying trauma and addiction—are not dealt with. That money is welcome, but we have a long way to go to ensure that we also deal with other issues.

Finally, it is important not to forget about our veterans when it comes to public health. These individuals who have served us may be invisible, silent or hidden in the background, but they need interventions and they need us to reach out. I wanted to mention the excellent Veterans First Point service in Lanarkshire for providing counselling without a waiting list to our local veterans to ensure that their needs are met.

I thank everybody who will take part in this extremely important and timely debate. The more that we can do in terms of public health, the better success we will have in years to come in dealing with inequality and the underlying issues that mean those in our society who did not get the best start do not get the chances that they deserve. We can achieve that only by working together on a cross-Government basis, with local councils and within communities, and I look forward to working with everybody in the Chamber who has an interest in moving this issue forward to ensure that progress is made.

[Several hon. Members rose—]

Oral Answers to Questions

Lisa Cameron Excerpts

Tuesday 7th May 2019 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

The all-party parliamentary group on psychology, which I chair, heard just last week that young people who have done extremely well with child and adolescent mental health services are being put on waiting lists when they move away from home to colleges and universities, and are having to start again from the beginning. They are falling through the gaps. Will the Minister ensure that that does not happen any more, that there is no longer a postcode lottery, and that people who have done extremely well in getting into university receive all the support they need?

[Jackie Doyle-Price]

I see that there is a meeting of minds. Not only do I agree with what the hon. Lady has said, but I have met the hon. Member for Dewsbury (Paula Sherriff) to discuss exactly that issue. There is clearly a systemic weakness in respect of those who move between home and university, and we will continue our dialogue to ensure that it is fixed.

Access to Medical Cannabis

Lisa Cameron Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

My hon. Friend represents Teagan Appleby, her family and her parents, and he speaks for the whole House in what he says. He has captured the essence of this debate. I am trying to resolve it to his satisfaction and to the family’s satisfaction as soon as possible. There are barriers to that resolution, and I am happy to work with him, with the APPG and with all others who have constituency cases to try to resolve this significant problem.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

The Secretary of State will be aware of the case of my constituent Cole Thomson, aged six, who has battled repeated epileptic seizures every night and has had terrible periods of deterioration. In order to gain the prescription, we have had to battle the system as well as the illness. Parents do not have the energy, when they are looking after a sick child, to battle the system, so can the Secretary of State ensure the streamlining of this process to make sure that specialist training is available? In the meantime, will he make available to parents a register of the specialists who can prescribe medicinal cannabis? The postcode lottery cannot go on.

[Matt Hancock]

Yes, I would be very happy to do both those things.