Learning Disabilities Mortality Review

Lisa Cameron Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

I pay tribute to my right hon. Friend, whose incredible work over many years campaigning on behalf of autistic people up and down the country has made a magnificent difference. She is right to raise this issue. It is of course unacceptable that people with autism have poorer health outcomes, and we are determined to address this. I meet regularly with representative groups and we take on board all their comments about how they would like to see the situation improved.

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

The report makes tragic reading. Some of our most vulnerable citizens are four times more likely to die prematurely than the general population, and there have been many avoidable deaths because of systemic failures. The situation cannot continue.

Let me ask the Minister three questions. First, will she look at the Scottish patient safety programme, a national programme that has been running since 2008 and is achieving good outcomes? Secondly, given that the Health and Social Care Committee has heard that learning disability nurses are very scarce, will she redouble the efforts to ensure that training for and recruitment to those roles are prioritised? Picking up symptoms early may be crucial to the prevention of morbidity. Thirdly, staff turnaround in social care is a real issue. Social care staff who know a client well, and can notice early changes such as signs of illness and report them timeously to ensure prevention, are crucial, and consistency in care is therefore critical. How will that be addressed?

[Caroline Dinenage]

The hon. Lady is right to raise those points. The Government are absolutely committed to reducing the number of people with learning disabilities whose deaths might have been preventable had there been different health and care interventions. That is why we set up the learning from deaths programme, and have commissioned an investigation of the issue. We are determined not only to learn from every single one of these tragic and avoidable deaths, but to share that learning with those in trusts up and down the country so that they can take a clear look at what is going on under their noses, and ensure that the terrible incidents that we have seen in the past do not happen again.

The hon. Lady was wise to raise the issue of training. It is important to have specialist practitioners, but it is also important to ensure that all healthcare staff, throughout the country, have the training that they need in order to recognise and support the needs of people with learning disabilities. That is something that we have done very successfully with dementia: we record the number of staff in the country who have received tier 1 and tier 2 training, and we are looking into how we can extend that to address the issues of people with learning disabilities.

Oral Answers to Questions

Lisa Cameron Excerpts

Tuesday 8th May 2018 Commons Chamber

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

2. What role his Department has in supporting people with mental health problems to access help in relation to housing, debt and employment. [R]

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

The Department is working with the NHS and across the Government to increase the support available for people with mental illness and on related issues. This includes investing £39 million to double the number of employment advisers in IAPT—increasing access to psychological therapy—as well as reviewing the practice of GPs charging for evidence of patients in debt crisis and the introduction of a duty under the Homelessness Reduction Act 2017 for the NHS to refer people at risk of homelessness to the local authority.

[Dr Cameron]

A quarter of people experiencing mental health problems are also in problem debt, and eight out of 10 mental health practitioners surveyed have said that they have less time to deliver clinical care because they are being asked to assist with the task of writing up debt management plans. Does the Minister agree that to ensure the best chance of recovery, commissioning groups require to integrate advice alongside mental health care, particularly for those in problem debt?

[Jackie Doyle-Price]

The hon. Lady makes a sensible point. Of course it is true that people’s personal circumstances are a symptom and a cause of mental ill health. We are doing more to enable those delivering mental health services to signpost people with problem debt to appropriate services. Clearly, that becomes easier where those services are co-located with citizens advice bureaux. In addition, the Breathing Space programme aims to provide a break for people with debt. I recognise, however, that this is a serious problem and that debt problems will cause mental illness.

Breast Cancer Screening

Lisa Cameron Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

We are absolutely guaranteeing that all women affected who are still alive will be invited to have a screening if they want it. Only those under 72 will automatically be sent a date and time for their screening. Those over 72 will be invited to talk to the helpline so that they can form a judgment as to whether a screening is appropriate, but anyone who wants one will get one.

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

I should like to thank the Secretary of State for his comprehensive response. Can he advise me how many women who have moved to Scotland might be affected? If not, will he work double time to ensure that those who have been affected and who have moved to Scotland will get their letters timeously within the correct period?

[Mr Hunt]

I believe that the IT work, which is a collaboration between the Scottish NHS and the English NHS, will be completed in the week of 15 May. That is why we are confident that we will be able to get the letters out to people registered with Scottish GPs who have moved from England by the end of May, which is the same timescale as for getting the letters out to people living in England. We will then know that number, and I will of course let the hon. Lady know.

Autism

Lisa Cameron Excerpts

Thursday 29th March 2018 Commons Chamber

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

It is a pleasure to follow the hon. Member for Henley (John Howell), who made excellent points in his very detailed speech. I thank the Backbench Business Committee for once again prioritising autism in this Chamber. It is extremely important for autism to be raised, not just this week but throughout the year.

There are many faces here that I recognise from previous debates on this subject. There are champions across the House and across parties for autism and autism awareness. I thank hon. Members for their contributions and I look forward to hearing some more. In particular, I thank the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan). She is an excellent chair of the all-party group on autism. She has led the way on this issue for many years, from the Autism Act 2009 to the present day. I enjoy working with her very much and hope to continue to do so. Research indicates that there are approximately 100,000 children with autism and 700,000 on the autistic spectrum, including children and adults. That is a large part of our population and it is apt that we discuss their needs and issues, and how to ensure that they achieve their full potential.

I want to touch on access to diagnosis, which other hon. Members have raised, for both adults and children. Unfortunately, this continues to be a postcode lottery across the United Kingdom. It has been raised repeatedly in evidence to the Health Committee and I am aware from my own constituency surgeries that there are still barriers to families, children and adults attaining a diagnosis within an appropriate time span. It has been mentioned that as MPs we are leaders. It is therefore important that, locally, we seek to help constituents to overcome those challenges. I recently wrote to the chief executive of our local NHS trust to find out about waiting times for adults and children. I was pleased with the response, which presented quite an optimistic picture. However, that is not commensurate with people’s experience on the frontline so we then have to go back and look at the difference between what services should deliver and are expected to deliver, and what they say they are delivering and can deliver. What additional support can we give to the services? What are the challenges preventing children and families on the frontline from accessing the services in the way that they should and as we expect? Those challenges are still in the system and it is important to overcome them.

[Dr Sarah Wollaston (Totnes) (Con)]

I thank the hon. Lady and my colleague on the Health and Social Care Committee, who always brings such expertise and experience to these debates and to the Committee. Does she agree that it is not just the variation around autism, but the scale of that variation that is so striking? Children cannot access any of the other services that might be available without the initial diagnosis.

--- Later in debate ---

[Dr Cameron]

That is an apt intervention, and I agree entirely. It is not just the postcode lottery, but the widespread variation right across the United Kingdom. Through the all-party group, we hear that people from different parts of the UK feel that they have to battle the system repeatedly at every stage. This is very important. In Health questions, I have asked the Secretary of State whether the Department might consider putting individuals who can diagnose autism into every child and adolescent mental health services team. I know that the Department is looking at data and waiting times. That is so important to getting some degree of stability in the services provided and to ensure that everyone has adequate access moving forward. Knowing where we are to start with can only be a good thing when we look at the progress being made.

As has been mentioned, autism spectrum disorder affects people across their lifespan, so it has to be at the core of policy across many Departments, including those responsible for education and community. This is also about our surgeries. I have taken on the excellent points made by the hon. Member for Bristol West (Thangam Debbonaire) and I will start my own such surgery in the near future. We have discussed it since our last debate on this subject and it is an excellent idea. I recommend that, as MPs, we all move forward in the same manner, walking the walk, not just talking the talk.

The management of our local shopping centres have been positive about having autism-friendly opening hours so that families can come at particular times. The setting will be made appropriate and people will feel included and relaxed when they go about their daily life. There is so much more to be done. On employment, the autism employment gap is so much higher than the disability employment gap. We must take that forward.

[Dame Cheryl Gillan]

Has the hon. Lady heard about the autism exchange programme, which Ambitious about Autism developed in partnership with the civil service? It has found that employers are pleasantly surprised at the benefits they get from employing people with autism.

[Dr Cameron]

That sounds like an absolutely wonderful initiative, and I hope that it is rolled out to many more organisations. We should all be working with local business communities to champion the potential of people with autism in the workplace. They have great skills to offer and should certainly be given the opportunity to be part of our workforce.

Before I finish, I want to touch on mental health and criminal justice. The last such debate that I took part in in the Chamber was about people who have not only autism, but mental health issues. That is extremely important; it is another reason why they should not be excluded from services—they need quick access as a priority. The Royal College of Psychiatrists estimates that those on the autistic spectrum are seven and a half times more likely to commit suicide. That is an absolutely startling statistic. If we put up barriers before people get to services and support, that figure can only rise. I ask the Minister to address access to services and the understanding of comorbidity within primary care.

On criminal justice, I recently met the Minister of State, Ministry of Justice, to discuss this issue, because I feel that those on the autistic spectrum are often lost in the criminal justice system and are very vulnerable within it. They are subject to bullying and have difficulty adapting and coping in that situation. We must do all that we can, so I was pleased to meet him and discuss some issues and practices from Scotland, and to share best practice right across the United Kingdom on special witness measures, support for those going through a court process and pre-arrest. In my constituency, we have a wonderful police training college at Jackton. I spoke to Police Scotland, which assures me that all its officers have undertaken mental health training and autism awareness training. That is excellent and just what is needed. We must continue to build on that.

I am pleased to speak in this debate, but the more I speak about autism, the more I realise how much more work we have to do. I am pleased to be moving forward on a cross-party basis. I will always be a champion for autism in my constituency and I like to work with like-minded Members across the House, of whom there are many and of whom I am very proud.

Leaving the EU: NHS

Lisa Cameron Excerpts

Thursday 22nd March 2018 Westminster Hall

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

It is a pleasure and privilege to serve under your chairmanship, Mr Stringer. I thank the Backbench Business Committee for enabling this important debate, and the right hon. Member for Exeter (Mr Bradshaw), my friend and colleague from the Health and Social Care Committee, for his detailed and valuable contribution. He outlined the grave concerns that most of the Committee have heard and feel themselves on some of the issues relating to Brexit and the NHS. It is important to our Committee that the Minister is listening, that the report is taken seriously and that our recommendations are taken forward.

This is a solemn day. I echo the sentiments of other Members who have spoken. It is a year since we lost PC Keith Palmer, who sacrificed his life in preserving our democracy here at Westminster. My thoughts are very much with his family and with everyone who has been affected by that horrific attack on Westminster and our democracy. It is important that we also remember Jo Cox and her extremely poignant words: we do have much more in common than sets us apart. I wish to take those sentiments forward. No matter what happens, if we work together and take things forward constructively, there is always a positive way ahead to defeat extremism and terrorism.

I come to the topic of the debate. My constituents are finding it difficult to have continued interest in the Brexit debate, given how lengthy it has already been, but when it comes to the NHS that is entirely different. The NHS is fundamental to our values. I have never met anyone who has tried to say that it is not such a valuable institution or the bedrock of our society, or who does not greatly admire and understand the dedication of the NHS staff who serve us all so well. We all—our friends, family and ourselves—rely on the NHS at the most vulnerable points in our lives. The NHS is therefore different for most of our constituents across the United Kingdom. It must be treated with priority and preserved, and all steps must be taken to ensure that any impact of Brexit on our NHS is fully mitigated. We rely on the NHS, and we will continue to do so. The first point I make to the Minister is to emphasise the importance of our NHS.

My second point is on the workforce, which has already been touched on by many Members. I have been sent a report by the British Medical Association. I refer the House to my background as a psychologist, having previously worked in the NHS. There are real concerns about the workforce and Brexit. The BMA highlights in its report its concerns that highly skilled doctors and professionals will choose to leave the UK because of the ongoing uncertainty in the negotiations. Like other hon. Members, I think it is important that the Department reassure those staff about how valuable they are and about how much their contribution is wanted and needed moving forward. It is imperative that we continue to retain their services for our populations.

Quite astoundingly, nearly half of EEA doctors—45% of them—surveyed by the BMA in November 2017 said that they were considering leaving the UK following the referendum vote. Those are critical numbers. I believe that in England 7.7% of the workforce, or 12,029, are EEA graduates. The figure I have been given in Scotland is 5.7%, or 1,339—it is 8.8%, or 550, in Northern Ireland, and 6.4%, or 624, in Wales. These are high numbers of people working right on the frontline to preserve our healthcare and we need to make sure that they can continue to do that.

Some might say that there has been a shortage or a short-termism in our own training of medical staff, and that issue also has to be addressed in the future. However, it takes a very long time to train doctors and nurses. We must therefore consider the much-needed and valued services that we have at this time and at least for the next decade in relation to our staffing model.

The next issue I will talk about is mutual recognition of professional qualifications. The BMA is calling for the maintenance of reciprocal arrangements, such as mutual recognition of professional qualifications, after Brexit, which would enable professionals who qualified in one member state to practise their profession in another. So what are the Minister and his Department doing in relation to that issue? It seems crucial for the next decade or so that we maintain the workforce that we have and that we ensure we can continue to attract highly skilled professionals to come to the UK to work.

Reciprocal healthcare and the European health insurance card, or EHIC, have already been mentioned. It seems very important, particularly for people who have the most chronic illnesses and who are moving from the UK to the EU, or who are on holiday, and for those coming here from the EU, that we have some form of arrangement in that regard for the future. I must say that I have had some difficulties with the EHIC in the past, with my own family, in being able to utilise it appropriately in some countries. However, it is not until something is lost entirely that its merit and value are realised. I do not think that it has been a perfect system by any means. However, it is certainly something that we want to retain and ensure is still available to us in future, particularly for some of the most vulnerable people, who still wish to be independent and to travel but who may find it extremely difficult to afford insurance, and therefore might otherwise put themselves at risk.

The Committee heard a lot of evidence about life sciences when producing this report. I have been astounded by the evidence we have been given about just how world-leading our life sciences are. I have to say that that is not something I was acutely aware of, even given all my years in the NHS, but we have world-leading life sciences. We have some of the top researchers and we have been involved in, and leading, some of the most crucial clinical trials. We must ensure that we hold that position in future. That is a real issue, because there is a concern that if those who are very much at the top of their game in research are unable to continue to lead on clinical trials from the UK, they might seek to leave. We cannot allow that to happen, because it would plunge our world-leading life sciences sector into the depths.

I would really appreciate it if the Minister spoke about how we will maintain our life sciences at their current level and how we will ensure that our fantastic university hospitals—I have one in my constituency: Hairmyres hospital—continue to support the great research work they do alongside their clinical work, and that they have all the amenities and the top professionals they need in the future.

It was Rare Disease Day just a few weeks ago, and I took part in it. We sang outside Westminster tube station to raise awareness of rare diseases. Rare diseases are of course rare, so many people do not experience them. However, there are many types of rare disease, so it is quite usual that some of us will know at least someone who has experienced or is living with a rare disease. It is crucial that people with rare diseases participate in clinical trials, because we need them in order to make progress on prognosis and find the best treatments. We need to ensure that we maintain that collaboration with the EU, because otherwise patients on the ground will suffer.

Patients with rare diseases might already feel quite isolated; they will have few other people they can speak to who are experiencing the same difficulties or have the same diagnosis. However, they need to be included in clinical trials, which cannot be conducted in the UK alone. Will the Minister comment on how we will ensure that that collaboration continues, particularly on rare diseases?

On medications, the Committee heard evidence about time-sensitive supply chains and the potential risks to them. The need to ensure that sufficient stock is on the UK market could mean the stockpiling of those products, and manufacturers might not supply certain products to the UK until only a few weeks before they are needed, so the supply chain is crucial. This work is time limited. Distributors of medicines in the UK usually keep about 10 days’ worth of stock, but many manufacturers can stock medicines for up to four months in wholesale warehouses. How will that work, depending on the negotiated arrangement? We need to get medicines timeously to patients who need them—particularly, as has been mentioned, radioisotopes for those who suffer from cancer and other illnesses.

These issues are crucial. When I speak to constituents, Brexit seems like a hypothetical thing, way in the distance. However, as soon as we start to home in on what it will mean in their day-to-day lives for their health and wellbeing and that of their families, and for our NHS, Brexit comes to the front of their minds. That is why the Minister has the weight of the world on his shoulders, because he is required to take forward these vital issues for everybody who depends on the NHS and our services. I look forward to his reply. On medical radioisotopes, I led on the cancer strategy in the main Chamber just a month or so ago. It is vital that we get this right for our cancer strategy, to ensure that all the other work that it underpins can move forward in the way it is supposed to.

I will finish by briefly speaking about qualified persons, which is something I did not know much about before the inquiry. I am led to believe, from the evidence that we heard, that they are already a scarce resource. There has to be mutual recognition of the training of qualified persons between the EU and the UK, so that these qualified persons, who we need to ensure the safety of medications, remain in the country and can do that vital work. What progress has the Minister made on work relating to qualified persons?

I do not want to take up any more time, because other Members wish to speak, so I will end where I started. Brexit can seem like a concept that is not linked to our everyday lives. When it comes to the NHS, however, that is entirely different. It is crucial to all patients—it is crucial to all constituents, actually. It therefore falls to the UK Government to ensure that the very best outcome for clinical care is negotiated and achieved.

--- Later in debate ---

[Stephen Barclay]

We can see the variability of forecasts, but the OBR’s forecast, which is the one that really matters—there is consensus that the Government rely on it and that Government planning is undertaken on the basis of it—shows a clear trajectory of improvement that is not reflected in much of the doom and gloom that we have heard in recent weeks. The debate is better informed if we tie it into the benchmarking that the Government use when setting fiscal policy.

The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) commented on the fact that her constituents are bored by the length of the Brexit debate. I am sure that if anyone is watching the debate, that will resonate with them. That is why it is so important for us to look forward. We should look at the areas of real concern where the Department needs to focus, such as maintaining the regulation and considering the mutual recognition of qualifications, which is a real issue that we want to make progress on with the European Union, because it is of concern to people. To look constructively at how we address some of those issues is far better than having groundhog day on the same areas.

[Dr Cameron]

Given the evidence we heard, and given that I have emphasised how critical the NHS is to the public and that it is a key priority for Brexit, I am perplexed that the Secretary of State for Health and Social Care does not have a place at the Brexit table in Cabinet. Far be it for me to try to elevate him even further, but the NHS is crucial and pivotal and deserves to be at the core of Brexit.

[Stephen Barclay]

The hon. Lady is right to recognise the skills and talent that the Secretary of State brings to this debate as to many others. It is no coincidence that he is the second-longest serving Secretary of State for Health. It would be recognised across the House that it is a demanding job. It is to his great credit that he has been in post for such a period and that he has championed patient safety in the way that he has, which the shadow Minister has generously recognised on occasion.

The Secretary of State’s role in Government was further signalled and underscored by the Prime Minister in the recent reshuffle, when the responsibility for social care was added to the Department. As the debate has reflected, social care, and how we address it from an immigration perspective, and from a training and upskilling perspective, is one of the key legitimate areas of the Brexit debate. We are focused on that in our discussions with the Home Office and others.

The hon. Member for Motherwell and Wishaw (Marion Fellows) picked up on the need for a transition period. That point reflects the fact that the Government are listening and have responded constructively. I know from my previous role in the financial services sector in the City that there is a strong desire for a transitional period. That point was also raised by many in the healthcare sector. It is to the great credit of the Secretary of State for Exiting the European Union that those discussions have been conducted in such a constructive way. There has been a lot of doom-saying and negative commentary—“Nothing will be agreed; it won’t work.”—but he has assiduously stuck to his task. While there are some formal processes still to be completed, significant progress has been made on a transition deal, and there is reasonable consensus that it is constructive.

Several colleagues mentioned the impact of leaving Euratom. I simply remind the House that there is nothing in the Euratom treaty that prevents materials from being exported from an EU member state to countries outside the EU, nor do those materials fall into the category of so-called special fissile material, which is subject to nuclear safeguards. We very much recognise the short half-life of medical radioisotopes and the need for rapid delivery, but again there is much that can be constructively done.

The shadow Minister mentioned subsidiary companies. I do not want to incur your displeasure by straying too far from the subject of Brexit and into subsidiary companies, Mr Davies, but as the shadow Minister raised that point, I feel it is appropriate to address it. He asked what TUPE protections there will be. There are TUPE protections now and the Government have absolutely no intention to change that.

For those who sometimes suggest, as Opposition Members occasionally do, that subsidiary companies within the NHS is a form of privatisation, I merely remind the House that this legislation was passed in 2006 under a Labour Government. I was not in the House at the time, but I do not recall—this may be one for those connoisseurs of Hansard—that it was presented by Labour Ministers as a way of achieving privatisation in the NHS. Subsidiary companies are 100% owned by their parent company, which is the NHS family, so they stay very much within that.

Mental Health Act: CQC Report

Lisa Cameron Excerpts

Tuesday 27th February 2018 Commons Chamber

[Jackie Doyle-Price]

I thank my hon. Friend for that comment. He has highlighted both the reason why we tasked the CQC with conducting annual inspections and an instance in which, having been given a conclusion and a set of recommendations, we have delivered, and we will do the same in respect of this report.

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

The report makes clear the need for a major shift in focus that will place patients at the centre of their care. What is required is a human rights approach in which the least restrictive option is adhered to. Detention must be the last resort.

A key issue is that patients feel invisible in the present system. Will the Minister go to the frontline? Will she visit the hospitals, speak to the staff about resourcing, and speak to the patients and the carers who are in, and have been through, the system? Will she hold the focus groups that are so badly needed with patients and carers to ensure that the system is overhauled and their voices are heard?

[Jackie Doyle-Price]

The ethos that the hon. Lady has outlined is very much the one that is being proposed by Sir Simon Wessely, which is why he is organising round tables, but I assure her that I am visiting services at the frontline as well. At the core of the point that she has made is the issue of a rights-centred approach for mental health patients, and that too is at the centre of Sir Simon’s inquiry. Patients need to be empowered to ensure that they receive the right treatment. Central to that is the whole issue of consent, which is something that very much concerns me, and not just in the context of mental health. We may be able to take the lessons from Sir Simon Wessely’s review and apply them elsewhere in the NHS.

Cancer Strategy

Lisa Cameron Excerpts

Thursday 22nd February 2018 Commons Chamber

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

I beg to move,

That this House has considered the Cancer Strategy.

Thank you, Madam Deputy Speaker, for your guidance. I will try to behave much better timewise in this debate, which it is an honour and a privilege to introduce. I pay tribute to the Backbench Business Committee for enabling the debate, to the all-party parliamentary group on cancer for its timely and extremely important report and, in particular, to the hon. Member for Basildon and Billericay (Mr Baron), who could not be with us today but deserves our thanks for the extraordinary amount of work he has done on this issue.

We in the House are all on the same side against cancer and in our ambition to achieve world-class cancer outcomes. My speech will address—briefly, according to your instructions, Madam Deputy Speaker—the recommendations of the all-party group’s recent report, “Progress of the England Cancer Strategy”. The report received more than 80 contributions from charities and bodies and truly reflects the passion in the sector, but it is also a cry for help, progress and a positive way forward. My speech will address the report’s four main areas of concern: workforce strategy, data, transparency and funding. It is open to colleagues to raise all aspects of cancer care and treatment, but, on behalf of the all-party group and the hon. Gentleman, I will stick to the recommendations in the report.

The report considers progress as we reach the halfway point of the NHS cancer strategy 2015-20 and is the result of an inquiry that the all-party group held last summer and autumn. The inquiry was formally launched at a summer reception last July and the number of written submissions was far larger than anticipated, showing the dedication of those working in the field. Many submissions came from cancer alliances and others on the frontline of the services being provided and identified many pressures and challenges. The evidence from frontline services in particular seemed to amount to a call for help. In its report, the all-party group concluded that although progress had been made since the launch of the strategy, the NHS

“will struggle to achieve the objectives set out in the Cancer Strategy unless corrective action is immediately taken.”

To this end, the all-party group has listed recommendations, a copy of which will shortly be sent to all MPs. The lack of workforce planning emerged as a key concern. The cancer workforce is constantly recognised as the biggest barrier to implementing our strategy. We are all pleased that Health Education England published its report into the cancer workforce in December 2017, but it was originally promised for December 2016. According to written evidence from Breast Cancer Now, the workforce is the greatest challenge in delivering the cancer strategy. The all-party group also heard that transformation funding is being withheld from cancer alliances because of their performance against the 62-day waiting-time target—a new conditionality of funding that emerged only after the bidding process had closed.

[Mr Jim Cunningham (Coventry South) (Lab)]

I appreciate the hon. Lady acknowledging the cancer organisations, such as Macmillan, which often rely on subscriptions. Does she agree—I am sure she does—that the public should be encouraged to give more subscriptions where possible?

[Dr Cameron]

Absolutely. The hon. Gentleman makes an excellent point. These agencies are working on the frontline with people and families at their most vulnerable and deserve all our encouragement, praise and, of course, funding.

In addition to setting out how cancer alliances are to be funded and supported for the duration of the strategy and into the future, the all-party group strongly recommends that the 62-day waiting-time target be immediately decoupled from any release of funding to the alliances. The previously mentioned issues prevent progress in improving cancer care and treatment, which is not our collective vision. The all-party group also heard that improving transparency in priorities and accountability would help to support the delivery of the strategy. At the moment, a lack of clarity and lines of communication are delaying its implementation. Publishing a detailed progress update on each of the strategy’s 96 recommendations would be a positive step forward.

It is generally accepted that the 62-day waiting-time target has been treated as a higher priority among clinical commissioning groups and cancer alliance leaders than survival or stage at diagnosis, as shown by the linkage between funding and performance against the measure. Decoupling funding from process and target performance in favour of a greater focus on outcomes would strongly be in the interests of patients, not least because, if outcomes are good and survival rates increasing, processes will also be functioning efficiently and correctly.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

The 62-day target has not been met since 2014, so the issue has been around for a while. Does the hon. Lady agree that more funding is needed if the target is to be met as soon as possible?

[Dr Cameron]

I absolutely agree with the hon. Gentleman. It is essential that the target be met and that resources be put in to ensure that it is.

The all-party group also found that access to detailed and timely data is critical for the strategy’s success, particularly in relation to data for rare and less common cancers. Strong concerns were also raised about how future data protection regulations might affect surveys, such as the cancer patient experience survey. The value of the cancer patient experience survey should be emphasised, along with outcomes from patients. We must hear from those who are experiencing services; they know how to improve things. In addition, the ageing UK population cannot be left out of the conversation. The cancer patient experience survey suggests that older people are less likely to have access to a clinical nurse specialist. Additionally, older patients are less likely to know the full extent of their illness. Age discrimination must come to an end, especially in cancer care.

The all-party group recommends that the NHS and Public Health England’s data team work to produce more timely cancer data and make them publicly available. It advocates that the Government ensure that the cancer patient experience survey and other such surveys can continue in a way that allows patient experience to be considered on a par with clinical effectiveness, rather than leaving patients without sufficient information regarding their cancer and care.

Furthermore, for specific cancers such as breast cancer, there are key priorities for delivery in the cancer strategy. It must ensure that data are collected for people living with incurable secondary cancer; that everyone with secondary breast cancer has a specialist nurse with the right skills and expertise; and that everyone has access to the right support after finishing treatment for primary cancer, so that they are able to live well after breast cancer. We should not ignore the fact that the strategy has had positive effects. In the last year, 16 cancer alliances and three vanguards have been established, and £200 million has been made available to them for earlier diagnosis and post-diagnosis support. In addition, 23 NHS trusts have now received new and upgraded radiotherapy machines. However, as the report makes clear, much more work still needs to be done.

In the few minutes that I have left, I want to speak a bit more about less survivable cancers. The Less Survivable Cancers Taskforce was in touch with me prior to today’s debate. It is made up of Pancreatic Cancer UK, the British Liver Trust, the Brain Tumour Charity and Action Against Heartburn, covering oesophageal cancer, and Core, covering all digestive diseases. The staggering 55% gap in morbidity is absolutely unacceptable. Much, much more must be done. Recently, I lost a very dear uncle to pancreatic cancer. As a family going through that experience, we know that we need much more research and much more specialist understanding. We need investment in those areas—it is absolutely crucial. I want to ensure that other families have a better chance of an improved survival rate, and I pay tribute to my own uncle for his courage in coping with that condition right to the end.

Hospice care is also absolutely essential. We must ensure that families and patients have dignity at the end of life. That is imperative. I have watched far too many family members die in hospital beds, surrounded by other patients with the curtain screens drawn, to know that that is not dignified and that where possible, we must improve services and access to hospice care.

I pay tribute to the Teenage Cancer Trust—we often think of cancer as an illness that affects older people, but young people are also diagnosed with cancer—which does fantastic work. Vanessa Todd in my constituency is an absolute advocate for the Teenage Cancer Trust. Although GPs may not expect a young person to come with such symptoms, which are perhaps not easily identifiable, it is something that we can increase awareness of to make sure that diagnosis is very quick and timely for young people to improve their prognosis.

I thank everybody and, again, I thank the all-party group. It has been a privilege to open the debate for the hon. Member for Basildon and Billericay, who leads the group on these issues so well.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Before I call the next speaker, I say to hon. Members that I am going to try to continue my experiment of seeing whether people will self-regulate and behave in a decent, honourable fashion. That means taking eight to nine minutes, and not 13, 14 or 15 minutes. I trust the well experienced Mr David Tredinnick to do so first.

--- Later in debate ---

[Dr Cameron]

Today’s debate has been so profound and amazing, with so many personal contributions. I have been absolutely astounded by the breadth and depth of knowledge across the House and the absolute dedication to the cancer strategy right across these Benches. I am assured that we will work together, taking things forward very positively and making a difference.

It is important that we have discussed the fact that cancer cuts across the lifespan and recognise the serious issues for young people and their experience of cancer. We also looked at not just the physical aspects, but the mental health aspects and the support that is required. We talked about the fact that treatment has to be holistic and evidence-based.

I wish to commend the valuable contributions from charities and our NHS staff. To be honest, their support is invaluable because they are on the frontline. I also wish to mention the very personal contribution of the hon. Member for Lincoln (Karen Lee). She made such an amazing speech today. I am sure that, given her experience, she will go on to support and assist so many people, and I am delighted that she is a cancer ambassador. I am sure that many people will benefit from that in the future. Once again, I thank her and everybody here today, and I look forward to working with them on this issue.

Question put and agreed to.

Resolved,

That this House has considered the cancer strategy.

Hospital Car Parking Charges

Lisa Cameron Excerpts

Thursday 1st February 2018 Commons Chamber

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

It is an honour to speak in this debate, and indeed in any debate in which the NHS is at the heart of what is being discussed. I particularly thank the right hon. Member for Harlow (Robert Halfon) for bringing the debate to the House. As has been discussed, the matter is extremely important to patients, charities, emergency workers, volunteers, carers and NHS staff, so it is a credit to him that he secured this debate. He set out his case most eloquently and comprehensively.

The SNP Scottish Government scrapped hospital car parking charges approximately 10 years ago in all car parks that are owned by the NHS. I urge the UK Government to follow both this principle and policy.

As an NHS employee for more than 20 years, I must declare an interest. I was part of the campaign, all those many years ago, as a Unite rep, to scrap NHS parking charges. I was so pleased when we succeeded, because that has made a great difference to many people, and has saved some of the most vulnerable who are already facing so many financial difficulties from spending money on parking.

[Robert Halfon]

The hon. Lady has been very generous in giving way, and I thank her for her kind remarks. Given that, for the most part, hospital parking charges have been scrapped in Scotland, she must have heard about how the problem of people perhaps misusing the car parks to go shopping or whatever was dealt with.

[Dr Cameron]

Indeed. Where there is a will there is a way. It can happen; it can be done. Basically, it is a matter of prioritisation and making things happen. That issue can be raised with the Minister today.

Hospital car parking charges hit the most vulnerable people in our society: disabled people; those who are chronically and even terminally ill; families caring for terminally ill children; and those who require repeat appointments and lengthy hospital stays. Before the change in Scotland, I heard about families and couples who had had their cars impounded because their partner was giving birth in the maternity unit and things did not go quite to time, as happens so often in these cases, and they were unable to feed their meter. At a time of utmost importance for the family, that is one of the last things that we would want to have on our mind.

NHS staff, particularly those on community-based shifts, are also penalised. They often have no choice but to use their cars to travel from the hospital to make community visits, so they cannot travel by public transport to their hospital base. There is something fundamentally wrong with charging our valued NHS staff to get to their work of saving lives when their pay has already been affected for so many years by caps.

The SNP is clear that the founding principle of the NHS is services that are free for everyone—services that are not out for profit. We have heard today from hon. Members that it is sometimes cheaper to park in town centres than to park at hospitals. That just cannot be right. By 2015, getting rid of hospital car parking charges had saved patients and staff in Scotland more than £25 million. Parking charges are basically a tax on NHS treatment, and that cannot be allowed to go on. As chair of the all-party group for disability, I am particularly concerned that people with disabilities, who we know are more likely to experience poverty, are being doubly financially penalised if they require medical treatment, as in England they have to pay for hospital parking—should they have retained their Motability vehicles of course.

The right hon. Member for Harlow is right that there are pragmatic ways to address the issue. The things that are said to prevent change from coming about can be overcome. He discussed tokens and other pragmatic ideas that can be put in place and that can work. We have made this work—we made it a success—so it can happen. With the will, there is the way.

I will take a brief moment to extend the issue from hospital parking charges by addressing parking for NHS staff in health centres. I believe that all health centres in my constituency have free parking, aside from the new Hunter Community Health Centre multi-storey car park. I have been in a somewhat intransigent negotiation with NHS Lanarkshire for more than a year, as only a limited amount of permit parking has been made available for staff. This has unfortunately meant that some staff—often those in lower pay bands, such as admin staff—face extortionate weekly charges for getting to work. That is unprincipled and unfair. Why should we penalise only staff who work in a particular health centre?

On Fridays, I have taken to monitoring the free spaces in the car park. I can assure the House that it is half empty every single Friday, which is usually an extremely busy day for car parks elsewhere, so there are enough spaces for the staff. I once again urge NHS Lanarkshire’s chief executive, Calum Campbell, to reverse this decision and ensure that permits for staff, as requested, are restored and that this principled step is taken. I will be writing to him after the debate, which I am sure he will look forward to, as he always does. I will let him know that he has been mentioned in the House of Commons once again.

I thank hon. Members from all parties who have taken part in this debate: the hon. Members for Great Grimsby (Melanie Onn), for Telford (Lucy Allan), for Kingston upon Hull West and Hessle (Emma Hardy), for Colne Valley (Thelma Walker), for Slough (Mr Dhesi), for Batley and Spen (Tracy Brabin) and for Enfield, Southgate (Bambos Charalambous); the hon. Member for Cleethorpes (Martin Vickers), who raised an important point about people in rural areas being badly affected; the right hon. Member for Hemel Hempstead (Sir Mike Penning), who made an extremely pertinent point about volunteer drivers; and the hon. Member for Heywood and Middleton (Liz McInnes), who worked for the NHS as fellow Unite rep in my time, and who has done great work for the NHS.

Everyone who has spoken has urged the Government to act. We do not need any superficial rhetoric, but we do need action. I ask the Minister and the Government to act by putting NHS patients, staff, carers, relatives, volunteers, emergency workers and those who care about the NHS first. We are all requesting change. This request must be taken forward, and I trust that the Minister will do so.

Oral Answers to Questions

Lisa Cameron Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

I commend my hon. Friend for his work and thinking on this through the Public Accounts Committee, and he is absolutely right. I am more than happy to talk to him about this, but we actually have it as a priority to make sure that when NHS land is disposed of, NHS workers get the first opportunity to buy or rent the houses that are built.

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

There are still not enough staff trained in autism diagnosis across the NHS. Would the Secretary of State consider training a specialist in each community child and adolescent mental health service right across the country to ensure that there is no longer a postcode lottery?

[Mr Hunt]

I would always listen to the hon. Lady on those matters, because she has huge professional experience. I do not think we do well enough for families with autism, and we are looking at what we can do better, but I have a lot of sympathy for the case the hon. Lady is making.

Stroke Services

Lisa Cameron Excerpts

Tuesday 5th December 2017 Commons Chamber

[Sir David Amess]

My hon. Friend is spot on in her analysis. I know that the Minister will take the points that she has made to heart and consider how we can improve the present situation.

Consensus forecasts predict that 150 trained people are required to run a fully functioning 24/7 national service. Mr Guyler says that training in stroke intervention is not readily available, that not enough hospitals can afford 24/7 availability and that there are not enough expert neuroradiologists to interpret CT scans. He says that there are turf wars between neurologists, cardiologists, neurosurgeons, radiologists, vascular surgeons and neuro- radiologists on who can and will perform interventional stroke treatment in the future. I do not think it is for politicians to get involved in those turf wars. The medical staff need to sort out between themselves who will lead in these matters. Apparently, there are also turf wars between university and district general hospitals on who should perform the procedure.

Mr Guyler also highlighted the fact that we have the expertise to develop this treatment significantly. The UK has one of only five training simulators in Europe—we should be proud of that—which is based at Anglia Ruskin University.

What are the Government doing to encourage more areas to reconfigure acute stroke services? We do need a new national stroke plan. I was at the launch of the original plan at St James’s Palace many years ago, but it is now time for a new one.

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

The hon. Gentleman is making an excellent speech on stroke services, which are invaluable right across the United Kingdom. I refer the House to my entry in the Register of Members’ Financial Interests. Does the hon. Gentleman agree that it is important that people who suffer strokes also have access to psychological services? Many people experience depression when adjusting post stroke, and it is important that counselling is available to support them through that.

[Sir David Amess]

The hon. Lady, with her considerable expertise in this area, is right to bring that particular matter to the attention of the House. We certainly need more provision of the women and men who give that sort of support.

A significant part of a new national stroke plan should be the development of 24/7 access to mechanical thrombectomy for all United Kingdom citizens, no matter where they live. Southend has already shown itself to be both safe and effective. It exceeds the recommended audit standards, its improvement in patient outcome is similar to international trials and, despite a severely ill patient collective, its results exceed the British Association of Stroke Physicians’ quality benchmarks. I want all my constituents to have 24/7 access to the best possible stroke treatment, so I urge the Government to find a way of effectively introducing mechanical thrombectomy to all parts of the United Kingdom. What is the Government’s assessment of the national stroke strategy, and will the Minister update the House on progress with its replacement?

I am not criticising the Government’s provision in any sense but, as with all these things, we could and should do more. We could do better. It is frustrating that a wonderful technique is available but is not available to everyone. Perhaps we can find a few more resources now because that should result in a saving in the long run. Finally, does the Minister agree that this wonderful facility at Southend Hospital is a further good reason for Southend to be declared a city?