Leaving the EU: Health and Social Care

Lisa Cameron Excerpts

Tuesday 19th March 2019 Westminster Hall

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

It is an absolute pleasure and a privilege to serve under your chairmanship, Mr Bone. I thank my hon. Friend the Member for Argyll and Bute (Brendan O’Hara) for his thorough and passionate account of why a clear focus on the health and social care system is so important. That will be true beyond Brexit, but Brexit is our immediate concern, which is why we must give it serious attention.

The NHS does fantastic work. I had the privilege of working for four years in Argyll and Bute, covering the hospital there as a forensic psychologist. Rural hospitals in Argyll and Bute are excellent and innovative in their practice. Even 10 to 15 years ago, when I was working there, we were grappling with the internet and how to engage in therapy on timescales that would best suit patients. The use of technology in those rural areas was innovative, and I commend the NHS staff I worked with, many of whom still work there, for their work to provide fantastic patient care.

Two weeks ago there was an extraordinary meeting when seven all-party parliamentary groups came together to look at health and social care. I am fortunate enough to have been the chair of the all-party parliamentary group on disability since the 2015 general election. The chairs of the all-party groups were there and we brought in carers and service users to speak about their concerns. There is growing concern in Parliament about the NHS, and about the implications of a no-deal Brexit, particularly on medicines regulation and our ability to staff hospitals and provide excellent care, as we always have. It was an important and informative meeting and I suggest to the Government that a further meeting might come out of it, with the all-party group chairs, to hear the views of the service users and carers who attended, and to take forward some of their recommendations. They are on the frontline and know what happens day to day in our services. I am sure that they will be extremely informative and constructive if they have an opportunity to meet the Minister.

When I was a member of the Health and Social Care Committee, we conducted an inquiry into Brexit, medicines, medical devices and substances of human origin. A particular concern was raised about our ability to lead on research trials, and about patients’ ability to participate in trials, particularly on diseases that are perhaps less common but where there is a need to pull in subjects or participants from a huge area such as the EU. Currently, patients here can participate in such trials, and we can also lead on some of them. That has brought some of the best scientists and researchers to the United Kingdom. I would be interested to hear from the Minister how we will ensure that continues. Also, how will our constituents continue to have access to such important trials, rather than having to wait until some way down the line to get new and innovative medications?

During that inquiry, the Select Committee urged the Government particularly to look at regulatory alignment and the implications of no deal. We raised concerns about the lack of references to Brexit in the Department’s single departmental plan. It would be useful to have an update from the Minister on that work, which I am sure is ongoing. There was also some concern about protecting the UK’s position globally in relation to pharmaceuticals. On the matter of full membership of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, reassurance was sought that that matter would be taken up at the earliest opportunity. It would be extremely helpful if the Minister gave an update on that.

The Select Committee recommended negotiating a close relationship with the EU, including associate membership of the European Medicines Agency, and supported the Government’s intention in that respect. Our report stated:

“Failure to achieve an ongoing collaboration would signal the triumph of political ideology over patient care.”

I say firmly to everyone involved, from all parties in Parliament, that patient care must be placed firmly before political ideology. The NHS is one of our most prized institutions—for everyone across the United Kingdom—and must remain so. Our overriding message was that almost all the evidence received suggested that

“the UK should continue to align with the EU regulatory regimes”

for medicines and devices. An update from the Minister would be helpful.

The hon. Member for Coventry South (Mr Cunningham), who is not currently in his place, made an interesting intervention about predatory procurement. I understand that we do not want to be alarmist in Parliament, but patients bring such concerns to us, so reassurance from the Minister would be helpful. The hon. Member for Henley (John Howell) spoke eloquently about his constituency and talked about diabetes and cystic fibrosis. Many constituents go to their Member of Parliament seeking reassurance about the implications of Brexit for their medicinal needs. The hon. Gentleman also spoke about mental health, which we cannot speak about enough in Parliament, because for many years it was never broached. I am the Scottish National party’s spokesperson on mental health, so I thank him for raising it, because I consider it important for it to be mentioned in as many debates as possible. It has an impact in every part of our lives, and if we are to provide holistic care it must have parity with physical health in all we do.

My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) spoke about medicinal isotopes. There is a huge pharmaceutical industry presence in my constituency, and I have been in touch with those businesses in the past month. There continue to be grave concerns about alignment and regulation for the industry. I think it is the continuing uncertainty that puts such a burden on businesses.

My hon. Friend the Member for North Ayrshire and Arran also said that one in five GPs are EU nationals and talked about our heavy reliance on workers from the EU, who do a fantastic job in the NHS. A number of witnesses to the Health and Social Care Committee told us just the same. We of course do not want to lose their valuable skills and expertise. They have built bonds with patients—or, if they work in the social care sector, with the people they care for—over a long period of time, and that cannot be overestimated. We must never undervalue their contribution. They need their place to be secure. Many of those workers do not earn over the £30,000 threshold, so we need a specialist case to ensure that the expertise stays in the country to support those vulnerable constituents of ours who need it.

Something that was repeatedly raised with the Select Committee—the hon. Member for Strangford (Jim Shannon) also mentioned this—is the fact that we have come to rely on high levels of staffing from the EU and elsewhere. It has been mooted that if we cannot attract staff from the EU, we could attract them from India or perhaps Africa. Those places in particular need their trained staff, and something must be done about training for young people in this country who want to go into health and social care settings.

[Alison Thewliss (Glasgow Central) (SNP)]

My hon. Friend makes a good point, but she will be aware that many people who have qualifications are currently not allowed to work by the Home Office. Two of my constituents worked in a care home and it would have loved to have them back, but the Home Office says no. Does she share my frustration that the Government say one thing on the one hand, and then something else on the other?

[Dr Cameron]

My hon. Friend makes an excellent point. Things have to be joined up exactly so that we can provide the continuity of care that patients need so much. There are thousands of excellent, high-achieving students who particularly want to study medicine, as well as psychology, occupational therapy and other occupations that are badly needed to support our NHS and our community health services. We must invest in these young people as we go forward. That point was made strongly by the hon. Member for Strangford, who is always an extremely good advocate for his constituency.

I look forward to the Minister’s response on social care, on medicines regulation and on the other issues we have spoken about. My hon. Friend the Member for Glasgow East (David Linden) also expressed concern about social care and those working in care homes. We must make that a more attractive occupation for people coming from school. I did it for a few years before going into clinical psychology; it is a rewarding occupation where carers build a real bond with those they care for. I ask the Minister to meet the APPGs, and I say to him very sincerely that we want to collaborate in a constructive way.

Health and Social Care Committee

Lisa Cameron Excerpts

Thursday 28th February 2019 Westminster Hall

[Dr Williams]

I thank the hon. Member for so eloquently making the case on an issue that we did not look at specifically in the report; we did not look at multiple-child families. However, we made some comments in a more general way.

I will make two points in response. The first is that providing services to families is not enough. The whole environment in which they live, including the poverty that many families find themselves living in, is probably as important as the provision of services. The second point, which we make in the report, is that we should consider the impact on the early years in all policies as a principle—as a “health in all policies” principle—and we should particularly consider the impact of all policies on the developing brain of children. We state that very clearly as a recommendation in our report.

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

I congratulate the hon. Member for Stockton South (Dr Williams) on chairing an absolutely transformative report, and I also congratulate all the other members of the Health and Social Care Committee for their excellent work in putting the report together. All too often, trauma has been excluded from the work that we have done; we as a society have not recognised the importance of trauma in a young child’s life. I think trauma is at the root of many societal issues, as the hon. Gentleman says.

My question is on the work that the hon. Gentleman said had been done to involve fathers. What are the recommendations to involve fathers further, and to make sure that the system does not exclude them? Also, a number of grandparents, particularly paternal grandparents, who come to my surgeries feel excluded, but very much want to be involved in the first years, because those are the transformative years.

[Dr Williams]

I thank the hon. Member for the contribution that she has made to the Health and Social Care Committee, and to our thoughts in developing these ideas. We learned during our inquiry that fathers often feel excluded—systematically excluded. Much of the literature and many of the interventions are targeted at mothers. Culturally, services tend to push fathers a little bit further away, rather than bringing them in.

We recommend that the healthy child programme becomes a healthy family programme, and of course we know that every family is different. Families have different members; in some families, grandparents play a huge role, and in others, a lesser role. Our main recommendation is about a cultural emphasis, or a cultural change, in the healthy child programme, to make it a more holistic family experience.

Eating Disorders Awareness Week

Lisa Cameron Excerpts

Wednesday 27th February 2019 Westminster Hall

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

It is an absolute pleasure to serve under your chairmanship in this debate on Eating Disorders Awareness Week, Mr Bailey. We have certainly raised awareness today, cross-party, and have paid credit to the week. We will continue to work together on this.

I thank the hon. Member for Angus (Kirstene Hair) for introducing this important debate. She feels strongly about this issue and wants to contribute. She mentioned that she had contacted the Minister for Mental Health in Scotland and would like an appointment with her to discuss services. I am sure we can work together to take things forward, and to ensure that collaboration throughout the United Kingdom continues.

We want to improve our services. Today, we heard that there are gaps in eating disorder services in just about every area. We have also heard how things have moved on. When Karen Carpenter had an eating disorder and sadly died, there was not much awareness at all. Now, there is greater awareness, but that has raised demand. It is incumbent on us to ensure that we are able to meet that demand, so that when young people, or people of any age, come forward, they get help in a timeous fashion.

The hon. Member for Angus spoke about stigma, an extremely important issue. She also spoke about how the stigma affects ethnic minorities, particularly males, and prevents them from coming forward. We must do much more to ensure equality in service provision, and send the message that eating disorders do not discriminate. We must support everybody who comes forward.

I want to thank the voluntary agencies who work in this field so tirelessly: the Beat campaigners, many of whom are here today; our NHS staff up and down the United Kingdom, who do their utmost every day, often going beyond the call of duty in the work that they do; and the Scottish Eating Disorders Interest Group, who also do a great deal of work in the field.

The hon. Member for York Central (Rachael Maskell) talked about the lack of psychological support, which I hope the Minister can comment on. We have heard eating disorders described as being about weight, which is wrong on so many levels. It is psychological as well as physical. Relying simply on physical manifestations of eating disorders means that many people do not get the treatment they should at the time that they should. Often people who have, for instance, bulimia might not have a reduction in weight, and it will therefore not be obvious to a practitioner unless they have specialist, or at least additional, training in primary care and specialist services.

We have spoken a lot today about anorexia and have mentioned bulimia, but there has been no mention of obesity, interestingly, around which there is a real stigma across the population. We need to do more to make sure that those who suffer from obesity have psychological support, too, because their journey to recovery is extremely important. Again, that is linked with mental health.

Crucially, the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) spoke about technology and images online. We have done a lot of work in the all-party group on textiles and fashion, which I chair, to look at the impact of social media and the industry on body image, and the negative and stereotypical images that very few of us will ever live up to, and should not aspire to. Often the images are not healthy, either. Much more has to be done. I agree with him on what he said about regulation of the companies, the information that is put out, and being proactive.

We also heard from the hon. Member for Westmorland and Lonsdale (Tim Farron), who spoke about lack of support and comorbidity, mental health issues being very much conjoined with eating disorders. When I worked as a psychologist in mental health services, often referrals would come in for individuals who had depression or anxiety, but underlying that was a long-standing eating disorder. That is why it is important that training in primary care reaches out across community mental health teams, and is not just given to specialist eating disorder services, because often the initial referral will not give an indication of the underlying difficulty.

The hon. Member for Ayr, Carrick and Cumnock (Bill Grant) spoke about bulimia and the new guidelines for Scotland, which he welcomed. We know there is an issue with providing services for people in rural areas in a timeous way. I am pleased that the Scottish Government have dedicated £54 million to look at that. There will be new guidelines in line with SIGN, the Scottish intercollegiate guidelines network, and we look forward to collaborating on taking those issues further.

My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) spoke about peer support, which is extremely important. Young people are often much more able to reach out to other young people, so I ask the Minister: what best practice is happening around that, and what can we roll out across the United Kingdom? One of my local schools, Duncanrig Secondary, is doing mental health peer support work very successfully. It is that type of project that young people grasp hold of to make a difference for each other. I pay tribute to the Trust Jack Foundation in my constituency, which reaches out to young people with mental health problems and has filled a gap in our local services in Stonehouse. Its service is being used assiduously by our local young people.

The hon. Member for Islwyn (Chris Evans) spoke about his eating disorder, body dysmorphia, and personal struggle. That is such an important message to give in Parliament. In coming forward and seeking support, he is a role model for others, so I thank him for that. He also spoke about why it is so important to have person-centred and holistic care, and I entirely agree with that.

The hon. Member for Bath (Wera Hobhouse) is an absolute champion in the field. She has collected thousands and thousands of signatures, and we support her work across this House in a truly cross-party effort to ensure we get the services that people require. I am sure the campaign that she runs to raise awareness will be successful in making a difference to people.

When I worked in psychology in the NHS, it was difficult at times to bridge the gap between primary, secondary and tertiary care, and difficult for people to be referred smoothly. I have raised that with Ministers in Scotland. When people present with an eating disorder, they do not always say, “I have an eating disorder. Can you help me?”, so it is key to have the training in place and a smooth care pathway—the two issues that I want the Minister to comment on. I know she is dedicated on this subject. I have met her numerous times, and I am keen to hear what she says today.

Children with Life-limiting Conditions

Lisa Cameron Excerpts

Tuesday 29th January 2019 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Dorries. I thank everyone who has taken part in this extremely important debate. It is an absolute pleasure to follow the hon. Member for North Tyneside (Mary Glindon), who raised the issue of Spinraza, and the hon. Member for West Ham (Lyn Brown), who spoke about her constituent Maryam and about why this issue must be taken forward by the UK Government. I hope the Minister will agree with her.

I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate and for speaking so passionately. Week in, week out in the House of Commons he champions the most vulnerable in our society. He gave a poignant speech to support children with life-threatening conditions. By securing this debate, he has let us all speak about the important issues raised by those conditions and the charities that do such excellent work, including Together for Short Lives, the Rainbow Trust, the Children’s Hospices Across Scotland at Robin House and CLIC Sargent, to name just a few. I also thank the Backbench Business Committee; I was extremely pleased to be part of the cross-party group that requested the debate. I have chaired the all-party parliamentary group for disability since 2015; we are working extremely hard on these issues, and I thank everyone involved in it.

I should like to mention my constituent Gary Butterworth of Westwood Golf Club, who, as well as playing lots of golf, has taken the time to raise more than £20,000 for Children’s Hospices Across Scotland. Every year I support the efforts of the club and Gary to fundraise; we will visit Robin House together later this year.

I also thank my constituent Lisa Quarrell, who has worked so hard over the past year not only to look after her six-year-old son Cole, who has experienced repeated epileptic seizures and whose health has deteriorated dramatically, but to try to access medicinal cannabis since the Home Secretary took up that issue. I hope the Minister will look at those issues very carefully, because the care pathways for families are not adequate. Lisa has battled day in, day out just to access the Home Secretary’s recommendations. Those families do not have the energy, in addition to caring for their children, to battle the system.

A number of issues have been raised in the debate. I want to stress the care and emotional and practical support that needs to be put in place for siblings. When a young child has a life-threatening or life-limiting condition, siblings often feel, not ignored, but not the focal point of the family’s daily life. There should be support for the whole family unit, and particularly for siblings. We heard about the need for family-friendly working policies and psychological support. I refer to my entry in the Register of Members’ Financial Interests, having worked as a psychologist.

Some remarkable speeches were made; I thank the hon. Member for Eddisbury (Antoinette Sandbach), who does such fantastic work in the all-party parliamentary group on baby loss, for raising the important issue of personal budget plans. Families should not have to think about finances at such a grave time in their lives. If I was wearing a hat, I would take it off to the hon. Member for Congleton (Fiona Bruce) for her excellent work in Parliament to strengthen families, provide support and raise issues that many find extremely difficult to broach. I hope the Minister looks very carefully at the hon. Lady’s recommendations.

My hon. Friend the Member for Glasgow East (David Linden) outlined the Scottish Government’s developments and funding for CHAS; I thank him for his work on those issues. The hon. Member for Swansea East (Carolyn Harris) spoke so poignantly that I was almost in tears while listening to her talk about the end of the world for individuals and their families. We must take that on board. I am sure the Minister heard those words clearly.

The hon. Member for Eastbourne (Stephen Lloyd) paid tribute to all his local hospices and spoke about the important issue of the number of consultants available. The Minister should look at that issue closely and meet the hon. Gentleman to discuss it. The hon. Member for Lewisham West and Penge (Ellie Reeves) spoke about the fantastic work of the specialist hospices in her constituency, and the need for funding to preserve and enhance that work. I thank the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for speaking about the importance of respite, which too often is forgotten about. Respite is not a dirty word; it is not about respite from your child but with your child, to enjoy them, to play with them and to do the natural things that families do.

I have a couple of questions for the Minister. Can she confirm that total NHS funding for children’s palliative care will not fall as a result of the long-term plan, and that children’s hospices will not receive less funding? Will she clarify whether the increase in funding from £11 million to £25 million is intended to be open to providers of emotional and practical support, alongside the hospices? If not, what will be provided to ensure that we have that emotional and practical support? What steps will the Minister take to encourage clinical commissioning groups and local authorities to increase commissioning for the sibling support that I mentioned?

Oral Answers to Questions

Lisa Cameron Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Steve Brine]

I will look at what can be added to the Matt Hancock app—there is always room for more.

As luck would have it, today Public Health England has launched its latest “Keep Antibiotics Working” national public awareness campaign, which aims to educate the public about the risks of AMR and urges them always to take the advice of their healthcare professionals on antibiotics and, when necessary, to challenge them.

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

AMR poses a grave threat to health. Professor Dame Sally Davies, the chief medical officer, told our Health and Social Care Committee inquiry that if action is not taken to address this

“growing threat, modern medicine will be lost.”

Will the Secretary of State and Ministers heed that warning and ensure that AMR is prioritised?

[Steve Brine]

Absolutely. The UK is a global leader in tackling AMR and we are currently working on the refresh of our strategy. I was at the G20 earlier this month, where Dame Sally Davies, the chief medical officer for England, showed world leadership and led an exercise with world leaders to strengthen understanding by showing how developed countries would tackle an outbreak.

Childhood Obesity Strategy: Chapter 2

Lisa Cameron Excerpts

Monday 25th June 2018 Commons Chamber

[Steve Brine]

As my hon. Friend will remember from my speaking to the Health Committee, I have also been to Amsterdam, but unfortunately not for as long as the Committee members were. The whole-systems approach taken by Mayor van der Burg and Amsterdam is very impressive and has resulted in a 13% reduction in child obesity. Local authorities can learn from their attempts to market their cities, areas and regions, and I would suggest that having a good, healthy community and a good, healthy look when people walk out of the airport and do not see massive adverts for unhealthy fast food is an important part of that.

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

I welcome the Minister’s statement. Will he encourage supermarkets to offer free fruit to kids coming into the store? Nothing has changed my supermarket shop more than my local store doing so; when kids go in, they now ask for their free clementine rather than their chocolate.

[Steve Brine]

That is an easy one to agree with. Tesco has been doing that for years, and my children regularly avail themselves of the opportunity.

Gosport Independent Panel: Publication of Report

Lisa Cameron Excerpts

Wednesday 20th June 2018 Commons Chamber

[Mr Hunt]

I think we have made progress when it comes to whistleblowing because every trust now has a “freedom to speak up” guardian—an independent person inside the trust whom clinicians can contact if they have patient safety concerns. That is a big step forward, which was recommended by Robert Francis. Where I am less clear that we have solved the problem is in relation to having someone for families to go to if they think that everyone is closing ranks, and we now need to reflect on that.

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

I refer the House to my entry in the Register of Members’ Financial Interests and my history of working in the NHS.

A brave nurse came forward all those many years ago to highlight a concern, but the concern was not taken forward adequately at that time. Often in these circumstances, the NHS closes ranks, management remove the individual who raises the concern—the clinician in this instance—and allows the system to continue. Is there some way of monitoring the types of concerns raised by clinicians, ensuring that the staff who raise these concerns are not themselves penalised and that the system then takes accountability forward?

[Mr Hunt]

The hon. Lady is absolutely right to raise that matter. The nurse concerned, Anita Tubbritt, talks in the report about her concerns and the pressure that she was put under, and it was a brave thing to do. When the hon. Lady reads the report, she will see that nurse auxiliaries and others who were not professionally trained clinicians also came forward with concerns and were also worried about the impact that doing so would have on their own career. That is what we have got to stop because, in whatever part of the UK, getting a culture in which people can speak openly about patient safety issues is absolutely essential.

Acquired Brain Injury

Lisa Cameron Excerpts

Monday 18th June 2018 Commons Chamber

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

It is an absolute pleasure to speak in this debate on behalf of the Scottish National party. I worked in the NHS as a psychologist for many years, and I was involved in carrying out assessments of people who had acquired brain injuries. This is often a hidden disability. I would describe it as invisible much of the time and that contributes to much of the discrimination. It can have a major impact on people’s cognition, their personality—particularly if it is a frontal lobe injury—and their planning ability. It can have an impact on individuals’ speech. Some have to relearn vocabulary and the names of people they once knew. In severe cases, it can have a significant impact on someone’s memory. Consequent to all that is the impact on people’s mental health and their confidence.

I pay tribute to the agencies that work so hard with those individuals and their families, because a systematic and systemic family approach is what is needed to support individuals. The hon. Member for Strangford (Jim Shannon) is absolutely right in that regard, as he is in so many others. It is important to provide support to all members of the family. I also pay tribute to the hon. Member for Rhondda (Chris Bryant), who has played a crucial role in bringing this debate to the House. He is vociferous on this important issue, and he has again made sure that we have time to debate it.

My own husband suffered a head injury when he was serving in the armed forces many years ago, when his tank was overturned. He was a member of the Royal Electrical and Mechanical Engineers and is now a local veterans’ spokesperson. He was fortunate to have fast, intense rehabilitation. It is important that that is provided not only to those in the armed forces, but to the general population. I am interested in what the Minister has to say about medical spending on our veterans and their access to rehabilitation services in this regard, alongside our NHS trauma units.

There are also difficulties in relation to welfare benefit assessments, particularly for employment and support allowance and for personal independence payments. Those with an acquired brain injury often feel that their difficulties are not understood and not well assessed under the current procedures, so we need not only further training for assessors, but possibly to review the assessment process itself. Assessment sometimes does not pick up the fine changes that can have such a crucial impact on the daily living skills of people with an acquired brain injury. Support will be necessary because it can be difficult for those with such injuries to complete forms, gather adequate evidence and so on. The Minister for Disabled People is in her place this evening, so I will be grateful if she will meet with me, as chair of the all-party parliamentary group for disability, to discuss that further.

[Jamie Stone]

Does the hon. Lady agree that there is some evidence that the mobility aspect of PIP is not being recognised in this regard?

[Dr Cameron]

Yes, that is a fair point. Mobility is about not just how far someone can walk, but being able to plan a journey and many other aspects of day-to-day living skills that people can find so difficult. People may require support for such things, but that may not currently be picked up properly by an assessment.

Psychology is important in the assessment of such cases, because access to neuropsychology means that individuals can have memory and cognitive assessments at the time of injury and six and 12 months later to examine which functions have been recovered. That is important because different parts of the brain can take on functions that have been lost and because the individual’s pattern of recovery can be mapped, meaning that a rehabilitation plan can be specifically adapted to their needs. Access to neuropsychology is a key part of rehabilitation, so I will be interested to hear the comments of the Under-Secretary of State for Health and Social Care on neuropsychology services, particularly for those with an acquired brain injury.

Prisoners have been mentioned. Yes, there is a high level of acquired brain injury within that population and that has an impact in three ways: acquired brain injuries can increase impulsivity, they can lead to people making the wrong decisions and not thinking through the consequences, and they can lead to difficulty in undertaking the normal treatments available in prisons, such as cognitive behavioural therapy, meaning that such treatments may have to be adapted for prisoners to benefit from them. I am unsure whether that is occurring in our prison system, but it should happen right across the United Kingdom if cognisance is taken of such difficulties.

[Mr John Hayes]

This will be my last contribution because I know that others want to get in. The change in a person’s cognitive function, which is often perceived as a change in their ability to do things, is often also about them knowing how to do things, what to do, when to do it and why. That is different from losing a skill. It is about losing the ability to order things and to prioritise them, and that has a dramatic effect both on education and on their subsequent ability to work.

[Dr Cameron]

Individuals with a frontal lobe injury find planning extremely difficult and, in fact, may never again be able to plan in the way they once could. These are some of the issues that treatment would have to take on board, and perhaps further support will be required. The types of cognitive behavioural treatment that rely on people thinking things through in a sequence, which is particularly difficult for those with a brain injury, will not always be appropriate and may need to be adapted.

So many Members want to speak on this important issue, so I will finish by mentioning the funding for a new Scottish trauma network. Since January 2017, four major trauma centres, in Glasgow, Edinburgh, Aberdeen and Dundee, have been working extremely hard to try to ensure a good care pathway for those in Scotland who suffer brain injury. It is incumbent on us all to communicate and to find evidence-based practice right across the United Kingdom.

NHS Long-Term Plan

Lisa Cameron Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

I totally take on board what my hon. Friend says. I am happy to engage with him and with NHS England. As he knows, we have taken the politics out of that particular process by giving it to NHS England, which I think is the right thing to do. I know NHS England would be happy to engage with him on that.

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

I welcome long-term planning in funding for the NHS, which is needed. However, as chair of the all-party group for disability, I know there are concerns that the learning disability workforce has fallen by a third, learning disability training is not yet compulsory and there are 1,200 avoidable deaths in the learning disability population annually. In Learning Disability Week, people are asking to be treated well. Will the Secretary of State prioritise this area and make sure our most vulnerable people with learning disabilities are no longer left behind?

[Mr Hunt]

I thank the hon. Lady for asking that important question. We have introduced a £10,000 golden hello for postgraduates who go into the learning disability field. She is right that we have had particular pressure on the learning disability workforce. In the aftermath of Mid Staffs, there has been a whole range of measures to improve hospital ward staffing ratios for nurses and that has had an impact on learning disability nurses. That is absolutely something we hope to address with this new funding.

Fortified Flour

Lisa Cameron Excerpts

Wednesday 16th May 2018 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Hanson, and to take part in this debate, which has been profound and poignant so far. I thank the hon. Member for Pontypridd (Owen Smith), who gave an extremely good, well-researched, evidence-based case for the fortification of flour with folic acid. There is scientific evidence, and when we know that we can do the right thing, there is no reason not to do so. His case was strong, clinically based and backed by the royal colleges and practitioners we should be listening to.

We heard that every week two children are born with spinal neural tube defects and that, as a result of potential defects, many terminations occur. As someone who has experienced a number of miscarriages in my life, there is nothing more horrendous than losing a baby: you question every single thing that you have done and everything that you could have done. If something like this could make a difference for those individuals who find themselves in that traumatic situation and do not seek terminations and for those who have unexplained miscarriages, we should be doing it.

There is absolutely no cost that can be put on losing a baby that you very much want to have. Often the tragedy of it is that it is unexplained. It is not until it has happened four times—another issue that we must address—that there is even any research into why it might have happened, or happened repeatedly. There are many individuals who may be or have been affected, who might not even know that a simple step such as this could have made the difference. That is certainly a step we must take.

As we have heard, the scientific basis is there. The countries that are leading now and protecting their populations by fortifying their flour with folic acid—I say again, such a simple step—have found no adverse consequences. Those countries have implemented the policy over a long period of time; they are looking at the health benefits and finding that any concerns about health costs were unfounded. The research is unequivocal in that regard and must be listened to.

As has been noted, the Scottish and Welsh Governments have both written to the UK Health Secretary, urging him to take action and introduce mandatory fortification of flour with folic acid on a UK-wide basis, because that is what is required. I am often in debates where there is little consensus across the four nations, but this seems to be one of those unique debates in which we are all saying, “This has to happen,” from across parties and across nations. There seems absolutely no logical reason for not taking this matter forward timeously, to protect families from the trauma of that unexplained miscarriage or of finding out that they have a baby who is very sick, and perhaps having to have a termination that they never wanted, or a difficult discussion regarding how to care for a young child who they want to see reach their full potential and want to give all the love in the world to, but who will have medical complications throughout their life.

I thank the right hon. Member for Belfast North (Nigel Dodds) for an extremely profound and personal account in memory of Andrew. We must pay heed to people’s personal accounts. That is what must guide policy. They are real people who are being affected; we are talking about families, and we must do the right thing. I also thank my hon. Friend the Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), who has done a lot of fundraising in this regard—even running a marathon, which is something I commend him for doing, and unfortunately not something I will ever be able to do myself. The hon. Member for Strangford (Jim Shannon), who is a health spokesperson for his party, made a good speech and asked important questions of the Minister, and the hon. Member for Newport East (Jessica Morden) advocated excellently for her constituents. For once, we are singing from the same hymn sheet. These are small nudges that we can make—small changes that make such a great difference. I urge the Minister to act.