Oral Answers

Lisa Cameron Excerpts

Tuesday 25th April 2023 Commons Chamber

[The Minister for Social Care (Helen Whately)]

My hon. Friend makes a really important point. I can say to her here and now that functional neurological disorder was previously regarded through a diagnosis of exclusion. It now has a rule-in diagnosis with available treatments, which is a major step forward in destigmatising the disorder. I am very happy to meet her to discuss this further.

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

T5. As chair of the all-party parliamentary health group, I have heard from UK patients who struggle to access GP appointments from chain GP practices. Many of those practices have very low ratios of GPs to patients, including, in one case, only two GPs registered for 30,000 patients. Will the Department meet the APPG to address these grave concerns?

[Neil O’Brien]

We have increased real-terms spending on general practice by over a fifth since 2016, and as a result there are now 10% more appointments happening every month. We are grateful to GPs for that. We have more doctors and clinicians, but we want to keep going, and I am happy to discuss this with anyone who has useful ideas to keep us powering forward.

NHS Staffing Levels

Lisa Cameron Excerpts

Tuesday 22nd November 2022 Westminster Hall

[Margaret Greenwood (Wirral West) (Lab)]

I beg to move,

That this House has considered NHS staffing levels.

It is a pleasure to serve under your chairmanship this afternoon, Mr Hollobone. I pay tribute to all the nurses, doctors and other medical professionals—indeed, everybody who works in the NHS—for the work they do to look after patients and keep us all safe.

I have been overwhelmed by the number of organisations that have shown interest in this debate and have shared details of how the NHS staffing crisis is impacting on the people they represent. They are too numerous to mention here, but they include the Royal College of Nursing, the Royal College of General Practitioners, Versus Arthritis, Cancer Research UK, Unite the union, Parkinson’s UK, the Royal College of Midwives and many others. It is clear that there is insufficient capacity in the NHS in England to meet the needs of patients.

The NHS staffing crisis is a direct result of the failure of Conservative Governments to plan and deliver the workforce that we need. The crisis is not just about the impact of the pandemic; it predates that. In June this year, there were more than 132,000 vacancies in the NHS in England, which is up from around 98,000 the previous year and from around 105,000 in March. When we look specifically at registered nursing staff, as of June there were over 46,000 vacancies. Alarmingly, that is almost 8,000 more than in March. For medical staff, there were over 10,500 vacancies in June, which is around 2,500 more than in March.

By way of comparison, in December 2019 there were around 38,000 nursing vacancies and more than 8,800 medical staff vacancies. What was already an extremely serious situation before the pandemic has become worse. Staffing shortages create stress for NHS workers, and delays and deteriorating quality and safety for patients. As well as vacancies, waiting times for treatment and emergency services have continued to soar. Last month, of the nearly 1.4 million people who visited major A&E departments, more than 550,000 waited more than four hours from arrival to admission, transfer or discharge. That is 45.2% of attendees, which is way short of the target of 95% to be seen in four hours. In December 2019, 31.4% waited for more than four hours. Again, an already serious situation before covid has got worse.

As of last month, a total of 7.1 million people in England were waiting to start routine hospital treatment. More than 400,000 people had been waiting more than 52 weeks, and more than 2,000 longer than two years. Behind those statistics are huge numbers of people waiting in pain and anxiety. Cancer Research UK points out that, in September of this year, only 60.5% of patients started treatment within 62 days of an urgent referral, against a target of 85%. That means that, in September alone, around 6,000 people waited for more than 62 days for their cancer treatment to start. Even before the pandemic, cancer patients were waiting too long for diagnosis and treatment. The 62-day target has not been met since 2015.

On the Conservatives’ watch, millions of patients are being deprived of the timely treatment that they desperately need. Because of the unacceptable delays, some are paying for expensive private healthcare, and many are distressed to do so, because they believe in a publicly owned, universal, comprehensive national health service. They have been failed by Conservative Governments.

The staffing crisis is having a devastating impact on retention. Last month, the Health Service Journal reported that a record number of NHS workers voluntarily resigned from their jobs during the first quarter of this financial year. Almost 35,000 resigned voluntarily, which is up from around 28,000 during the same period in 2021 and around 19,000 in 2020. The most common reason for leaving during quarter 1 of 2021-22 was work-life balance, which almost 7,000 NHS workers cited as their reason for leaving.

A few months ago, I met with members of the Royal College of Nursing. They told me about the incredible amount of pressure that they are under because of staff shortages. They also told me of nurses suffering financial hardship. Some are going to food banks, some are unable to afford to drive to work, and some are leaving the profession to work in chain stores for better pay. However, it is not just about pay. The nurses told me that they often simply do not have enough colleagues to work alongside them. That is extremely stressful for them, and dangerous and deeply unfair for patients.

I turn now to industrial action. NHS staff care deeply about their patients, but they can also see that the NHS is at breaking point. Earlier this month, the Royal College of Nursing voted to take strike action in its fight for fair pay and safe staffing. That is unprecedented and has not been done lightly. The RCN has been clear: its members have voted for fair pay for nursing, safe patient care and to protect patients.

Numerous other organisations, representing thousands of workers, are also balloting for industrial action, including Unite the Union, Unison, the Royal College of Midwives and the GMB union. The Conservative Government’s failure to address the NHS staffing crisis is putting those working in the service under immense pressure and, in some instances, putting patients at risk. It is notable that, in a poll of 6,000 adults, carried out on behalf of Unite, 73% of respondents supported NHS and careworkers receiving pay rises that keep up with the cost of living. The Government should take note.

We cannot discuss the NHS staffing crisis without highlighting the Conservatives’ privatisation agenda, because it does impact on people working in the service. The Health and Care Act 2022 split the NHS in England into 42 statutory integrated care systems, each comprising an integrated care board and integrated care partnership.

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

I thank the hon. Lady for making such a poignant and important speech, and for securing this debate, because we are all grappling with the issue. Does she agree that the staff in the NHS do their very best, but the future planning of the workforce is also an issue? We do not have enough staff for the future workforce plan. That is particularly the case in mental health and learning disabilities. I read that 215 young people took their lives in 2021, the highest figure since records began. Is that a concern to her, because I think it is for most of us in the House? I am sure that, in the excellent speech is making, she will want to highlight that.

World Menopause Day

Lisa Cameron Excerpts

Thursday 27th October 2022 Westminster Hall

[Carolyn Harris (Swansea East) (Lab)]

I beg to move,

That this House has considered World Menopause Day.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank the Backbench Business Committee for granting time for this important debate. I am delighted to co-sponsor it with the right hon. Member for Romsey and Southampton North (Caroline Nokes), who shares my passion and determination to improve access to support and treatment for those experiencing symptoms of the menopause.

Anyone in or around Parliament last week might have noticed a buzz of activity. The reason, obviously, was that last Tuesday was World Menopause Day. It was an honour to welcome a group of women who have been instrumental in campaigning for change, from grassroots campaigners to clinicians and celebrities who are using their platform to amplify the message. The day ended with a rally in Old Palace Yard, almost 12 months on from our last Westminster menopause rally. Last year, I stood among jubilant women in Parliament Square. We were celebrating the fact that the Government had listened and committed to dramatically reducing the cost of NHS prescriptions for hormone replacement therapy in England, which would bring them somewhere near the free prescriptions in Wales, Scotland and Northern Ireland. They also committed to setting up a taskforce to look at other barriers women face.

This year, many of the same women were back again. They were as determined as they were last year. They were loud—possibly a little louder than last year. But they were a little less jubilant, a little more sceptical and far less confident in the Government’s commitment to the promises that they made in October 2021. However, they have not given up.

At the rally, Menopause Mandate launched a wonderful book, “It’s Beyond a Joke”, a collection of real lived experience stories from women. Some are graphic, some are funny, but some will break your heart. Every one is an honest account of a woman’s personal menopause journey, and every one is different, because no two women experience the same menopause. There are stories of misdiagnosis, insufficient workplace support and HRT shortages. There are stories from women who are struggling to afford the cost of the menopause, and from women who are hitting brick wall after brick wall when they try to access support. Thankfully, there are stories from women who faced some dreadful experiences but came out the other side—stronger, happier and ready to be their wonderful selves all over again.

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

I thank the hon. Lady for bringing this vital debate to Parliament. Her speech is a wonderful contribution on what so many people have gone through. Does she agree that menopause is not just a physical condition or response in the body, but something with a mental health and wellbeing impact? People need access to specialist services and clinicians, so that their psychosocial needs can be met in a holistic way.

Procurement of Evusheld

Lisa Cameron Excerpts

Wednesday 12th October 2022 Westminster Hall

[Daisy Cooper]

I am grateful for that question. In fact, Evusheld is now so effective that not only has it been rolled out in 33 countries, but a number of countries, including Japan, Italy, Spain and Israel, have actually put in repeat orders for Evusheld, and the Centers for Disease Control and Prevention in the US has even launched a public drive to increase uptake. In private discussions, both the Minister and his predecessor have indicated to me in meetings that there was some evidence that countries had bought the drug but were not using it.

Let us be clear: the failure of any Government to identify clinically vulnerable patients and distribute the medication to them has nothing to do with the effectiveness of that particular drug. Before we throw stones in glass houses, we should remember that of immunocompromised patients in England who caught covid and were referred for treatment, only 17% actually got it. That failure to distribute is more to do with the fracturing of our health systems; it is not about the effectiveness of this drug.

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

I thank the hon. Lady for bringing forward this vital debate on behalf of the many constituents who have contacted me and in my capacity as chair of the all-party parliamentary health group. Does she agree that when people feel they are being left to rot, it is not only their physical health that is impacted; their mental wellbeing is crippled in the stage of recovery where they need the most support possible?

[Daisy Cooper]

The hon. Member is absolutely right. Many people are clinically vulnerable because they have a health condition, and their physical health is getting worse, as it would when someone is stuck at home for two and a half years, but the mental health impact is also incredibly profound. We know that many of our constituents have experienced suicidal thoughts.

I turn now to the advice of the RAPID C-19 oversight group, which has been mentioned. The Government refused to share this advice for some time, and many of us were asking for it. I was pleased to see that this advice was finally published last Thursday on 6 October. I was pretty shocked for two reasons. First, the report actually says that the group looked at real-world data and the impact on people and that data was very strong. Then it looked at the data in a non-clinical setting and decided not to roll it out. That seems absurd to me.

There is a second problem with the evidence that was published last week. It lists the evidence that the group reviewed, and it leaves out one very critical scientific study by the Francis Crick Institute—a study that I believe the Government commissioned themselves. That study was commissioned to look at the effectiveness of a different drug: sotrovimab. That report concluded that sotrovimab was effective, and the Government are using that report to justify why they continue to use sotrovimab. However, the report also concluded that Evusheld was even more effective. So why not buy Evusheld too? Perhaps the Minister can enlighten us.

On the same day the Government published this RAPID group report, The Lancet—the world’s highest-impact general medical journal—carried an article by 19 experts calling on the World Health Organisation to update its guidance on Evusheld, based on the study the Government commissioned. In the article, those experts say that Evusheld should be used for not only preventative, prophylactic use, but treatment. The UK Government are really trailing behind. Can the Minister tell us why the RAPID study ignores this vital piece of research, which they must have known about?

Many of the people we are talking about have already had five or six vaccine jabs, even though they will mount very little, if any, response. The Government say it is important that these people get those vaccines, because they say some response is better than none. Why does that same test not apply to Evusheld? Why is it being singled out and held to an impossible standard?

Let us look at what the Government are proposing, instead of following the science. Ministers have referred Evusheld to NICE for further clinical and cost-effective assessment; apparently, we might hear back in April 2023. That is another delay—another six months of isolation—even though every other covid treatment and vaccine was urgently procured before being appraised. I ask again, why is the Government’s treatment of Evusheld so inconsistent?

Infant Mental Health Awareness Week

Lisa Cameron Excerpts

Thursday 16th June 2022 Westminster Hall

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

Thank you, Mrs Murray; it is a pleasure to serve under the chairmanship of such an esteemed lady and parliamentarian, who is friendly to all.

I thank the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), and congratulate her on securing such a vital debate. Having worked all my life as a psychologist prior to coming to the House, I think it is fantastic that there are champions for this issue in this place, because setting the right foundation right across the United Kingdom and giving people opportunities to thrive from their earliest days is a fundamental premise for creating a healthy society. The right hon. Lady should never underestimate the value of the work she is doing in this House, not just today but for generations to come. I wish her all the best with her early years review, and will gratefully give any support that I can offer.

We also heard from the hon. Member for Twickenham (Munira Wilson), who spoke about the social care system for children and the particular plight of children in care, which goes back to the disorganised attachment styles that were mentioned. In fact, this debate has taken me right to my psychology days—I trained a long time ago—and Bowlby’s theory of attachment, which is the foundation for much of what we are speaking about today. It is so important that if a parent is not there, there is a trusted and secure caregiver. It does not have to be the mother. As the hon. Member for Strangford (Jim Shannon) said, it is often the mother, but it can be the father or another trusted adult. The important thing is that there is a secure attachment.

The hon. Member for Twickenham was spot on when she spoke about why having disruption in early childhood—particularly for children who go into care settings—can have an adverse impact. We must make sure that trusted, secure and stable relationships are built and provided throughout every child’s life. That is vital, and we must support it.

The hon. Member also spoke eloquently about CAMHS support for infants and why it is so crucial. Helen Clark, a former MP who leads on the child mental health charter, is doing vital work on that through the charter with Play Therapy UK. There are many therapies that should be open and available to families with infants, including family therapy, behaviour therapy, which I used to do when I was practising many moons ago with very young children, and play therapy.

I will never forget the feeling of looking out of the window during covid when the council was opening up the playpark across the road from my house and seeing the children, including my own, running to it. There is something very therapeutic and nurturing about peer support and being able to play in a positive environment. I experienced that exact sentiment when I visited refugee centres in Lebanon. One of the most fundamental changes for those young children was the building of a playpark in the refugee centre. They were able to smile and laugh and play. Therapeutic involvement is vital, as is having natural environments that enhance wellbeing. I thank the hon. Member for Twickenham for her contribution.

The hon. Member for Strangford is an absolute stalwart of this issue and so many others in the House. He spoke about the impact of covid-19 on children’s development. There will have to be a lot of research done into that, because we may not see the full impact for years to come. Longitudinal studies will be needed to address that. We must all come together to ensure that funding, support and programmes are put in place so that children have every opportunity to catch up with the socialisation and education they have missed during this critical period.

The hon. Member for Richmond Park (Sarah Olney) made an important contribution about gaps in service and maternal mental health. She also gave a shout-out for dads’ mental health, which is rarely mentioned but is so crucial. When I first came to the House, my husband took on many more of the activities I had usually done. The first week I came back from Parliament, I opened the fridge door and there were a whole host of Tupperware dishes in the fridge. I said, “What’s this? Where did it come from?” The neighbours had very kindly handed him food for himself and our children, because they assumed that they would be reliant on me and not him. I do not think he needed the food, because he stepped up to the mark, but it still shows that we cannot value fathers enough. They are all-round heroes when it comes to early childhood development.

The hon. Member also mentioned health visiting and face-to-face contact, which is extremely important. As chair of the all-party parliamentary health group, I know that face-to-face contact is vital for people. Particularly when they are speaking about mental health and wellbeing, they find it very difficult to do that over Zoom. They often do not bring it up at all in that format or over the phone. It is important that they have a personal relationship that is built up over time. The same can be said for GPs: it is vital that people can get back to seeing their GPs face to face, and we will be carrying out an inquiry into those issues.

I want to quickly mention adverse childhood experiences. I worked in and out of young offenders institutions and prisons for adults for a number of years, which involved visiting people because of their mental health issues and doing mental health assessments. Very few of the people I assessed after they had ended up in the criminal justice system did not speak of some trauma in childhood. The more we can do at the earliest stage, the better, in order to give people a path that will lead them to a fulfilling life. Early difficulties do not always lead to criminal justice problems, but there is a significant correlation, if not causation. We know the risk factors, and we must do all that we can. The British Psychological Society has highlighted that preschool children of parents with poor mental health are three times more likely than the general population to have mental health difficulties, so there is an intergenerational aspect, and we have to help with wellbeing more generally and across the lifespan for families.

Having come from being a psychologist to working as an MP, I see that we are not picking up young people who have autistic spectrum disorder or learning difficulties early enough. Those assessments can be done before they start school. The people who come to see me at my constituency surgery often tell me, “I have been saying for years and years that I need an assessment,” yet the waiting lists preclude that happening at the right time. Two years is a long time in the context of childhood development and the developmental milestones that children may not reach at the correct time because they do not have additional support to help them catch up, so we need to get early diagnosis through children and families hubs, or through community health services. As chair of the all-party parliamentary health group, I can say that this is an issue right across the UK, because I hear about it from people right across the UK. Parents are asking for help, and they need to have it.

Parenting programmes are vital. Our school system has become so dynamic that some of the things that we did when I was at school have been lost. Yesterday I spoke to a nutritionist, who told me that he is having to do a lot of work with parents on nutrition for infants. He said that some parents never undertook any kind of cooking at school—it was called home economics when I was there—and are blitzing McDonald’s to feed young infants. These are things that are fundamental for parenting support, and we need to make sure that we put them in place. We need access to paediatric care, including psychology and types of therapy such as play therapy, and we need parity between mental health and physical health. Looking at the wellbeing recovery from the covid pandemic will be key, and parenting programmes for parents who feel that they need a bit of extra support will be vital.

It would be lax of me not to quickly mention some of the work that the Scottish Government are doing. We have the baby box, which has been delivered to more than 200,000 families since 2017. It ensures that we in Scotland welcome every child, and that children have a basic provision for the first few months of their lives. We are saying very positively, “You’re welcome. We want to do our best for you throughout your life.” The Scottish Government also recognise the significant impact of the covid-19 pandemic and are doing work to address the issues that I have raised. We have the Best Start five-year plan for neonatal care, and perinatal and infant mental health programme boards have been set up. A number of increased payments and grants have been made too.

I concur with what I have heard in the debate, and I want to work wholeheartedly with everybody who is working in this vital area. It has been nice to be taken back such a long time—many decades—to my education as a psychology graduate and to Bowlby’s important theory of attachment. We should ensure that the work of Infant Mental Health Week is taken forward every week of the year, and especially that we hold infant mental health as a key issue in our work in Parliament.

Government Action on Suicide Prevention

Lisa Cameron Excerpts

Wednesday 8th June 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Bone. I start by thanking the hon. Member for Bristol East (Kerry McCarthy) and commending her work—she is an absolute champion for this matter. She spoke extremely powerfully on the need for data collection, which I think is the crux of taking good service delivery forward. She spoke very emotively about her own personal experience, and her words resonated with many people here when she advocated for services for those families who are left behind. I thank her for being a champion of this important issue. It is often neglected, and is something that for many years has been difficult for people to speak about. The more that it can be spoken about and raised in this place, the better for everybody right across the United Kingdom.

The hon. Member for Bradford West (Naz Shah) spoke about how difficult it is to access mental health services, particularly for children and young people. I think there are gaps—chasms, actually—in waiting times across the United Kingdom that need to be addressed. As chair of the all-party parliamentary health group, I hear about that constantly. No matter where someone lives, it is very difficult for them to access services. It takes far too long and people are falling through those gaps. The hon. Member for Blaydon (Liz Twist) spoke about the importance of levelling up regional and gender disparities. I am interested in the point she made about adult males being particularly at risk.

There has been good work going on across Scotland— I am sure these exist across the United Kingdom— through the Men’s Sheds developments. I have two in my own constituency that I have visited—one in Lesmahagow and Blackwood and one in the Stonehouse area. They are doing fantastic work to reduce loneliness and isolation, and to create environments where people can begin to speak about issues and receive important social support from like-minded people. We still have a society where there is more stigma for men who speak up about those issues, so such developments are crucial. The hon. Member for Blaydon is also an advocate for this issue in her role as chair of the all-party parliamentary group on suicide and self-harm prevention. She has made key recommendations for the Government to take forward.

The hon. Member for Liverpool, Walton (Dan Carden) spoke about the LGBT community and about alcohol-related harm. What is key—and I know this from my professional life prior to Parliament, working in psychology —is that often having an addiction diagnosis on someone’s medical records can make it more difficult for them to access mental health services. That just should not be the case because, exactly as he says, having alcohol or drug-related problems is, in itself, a risk factor for suicide. Therefore, it should be something that heightens people’s access to services, rather than diminishing it. I would therefore like to thank him once again for the work that he does on these matters.

The hon. Member for Strangford (Jim Shannon)—who is in his place in most of the debates that I happen to attend because he is such a strong advocate for his constituents—spoke about the devastating suicide rates in Northern Ireland, and something else that is very important, which was the impact of and bullying on social media. I think that that is something that really must be tackled. I know, from some work I have been doing with the Diana award in Parliament, that it has been supporting young people’s advocates across schools in the UK—anti-bullying ambassadors to give children and young people peer support—because often young people prefer to speak to peers than to parents. I know that myself, particularly from having adolescents at home who do not want to be seen with or speak to me at this stage in their life.

The hon. Member for Richmond Park (Sarah Olney) also raised an important constituency case—I am so pleased that the family is here today—that families are not listened to enough. Well, if we are not listening to families, who are we listening to? Families know people better than anybody else. I think that long gone is the time when we say, “Well, professionals know best.” It should be an assessment that involves everybody, wherever possible. Families who want to reach out to services are doing that because they have anxiety that something that is traumatic is going to happen in that case. They know that person better than anybody else, so they must be listened to.

When I worked in mental health, the training and risk assessment were very clear; it is not a static assessment; it is dynamic—it changes. That is the thing about it. The British Psychological Society issued guidance on risk assessment. A risk assessment is not a questionnaire; it is a clinical judgment with tools that help that. However, it also must highlight risk indicators. Importantly, it is not just that an assessment is completed; it is that there is a risk-management plan as well—people are aware of their risk indicators, they know when risk is heightened, they know who to seek help from, and that there is a risk-management plan that can protect them and prevent harm coming from risk. The point made by the hon. Member for Richmond Park is key, and I wish her all the support that I can give for her campaign for these matters to be taken forward and for key frontline staff to be given adequate training in risk assessment.

As chair of the all-party parliamentary health group, I hear constantly that the bar is set too high for access to services. Some of the things said are that because someone might have a personality disorder, they could not benefit from treatment. Well, we know that people with personality disorder diagnoses still suffer from mental distress, so of course they should be able to access treatment for that mental distress. That should not be a barrier to treatment. There are also psychological therapies that have been shown to be clinically valid for use in those cases, but people cannot access them.

People who have drug or alcohol problems may present at accident and emergency and be told, “Well, you’ll have to deal with your addiction and then come back and deal with your mental health problem.” However, that is not right either, because we know about the risk and the importance of services being integrated and created for dual diagnosis. Where people have more than one clinical condition, it is very important that both are treated together because, as has been said, mental health might be one of the triggers for alcohol and drug use, which, of course, exacerbates it.

[Dan Carden]

It is really important that we send a clear message that it is absolutely nonsense to send people away to recover from their addiction without the mental health support they need, as happens up and down the country. We should send a clear message that the guidance needs to be rewritten, and that support for mental health and addiction services must be delivered.

[Dr Cameron]

I thank the hon. Gentleman for making that important point. I wholeheartedly agree. If we are serious about preventing harm and suicide, and about helping people, their care must be looked at holistically. We cannot syphon off parts of people’s diagnosis and say, “Deal with this first, then that.” People’s lives are not like that. As we know, the formulation means that it is interwoven, so both conditions must be dealt with simultaneously.

Other things I have heard include, “It is attention-seeking,” “It is a behavioural issue,” “It is not a psychiatric illness,” “There’s no diagnosis,” but surely people who suffer acute psychological distress should have access to services without having to qualify in diagnostic terms as having a major mental illness. Many people need help at such time, and it should not need to be exacerbated to the point of mental illness if we can use prevention. Equally, many people who go on to harm themselves and even commit suicide never have a diagnosis of a mental illness such as depression or schizophrenia, but they still deserve help, so there must be services for them.

GP access is very important, as has been said. I know from my constituents and from chairing the all-party parliamentary health group that that is another issue that must be dealt with. People find it very difficult to see GPs face to face, and if they are in mental distress, speaking to receptionists on the telephone is really not adequate. They must be able to sit down and speak to a GP they know. It is hard enough to open up at that point, but without that access, I am afraid that so many people will fall through the net.

The Scottish Government have committed £120 million for a recovery fund following covid. They are committed to doubling the current £1.4 million of annual funding for suicide prevention, and they have a new strategy coming out.

I thank the services in my constituency, which have been on the frontline when people have been languishing on waiting lists, including the Trust Jack Foundation, set up because someone lost their life. The lady in charge of it is a wonderful individual who has taken her personal tragedy and turned it into support for other people across our constituency. Victorious People in East Kilbride is providing counselling for young people, and Talk Now in East Kilbride is providing services for trauma survivors. That is just to name a few of the fantastic services that have been developed.

I plead with the Minister to fill those gaps and make sure there are services for people suffering acute mental distress, crisis and suicidal ideation. They should not have to have a mental illness diagnosis to access treatment. That is why we are losing people, and families are being hurt in the process.

Special Educational Needs and Children’s Mental Health Services

Lisa Cameron Excerpts

Wednesday 9th February 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Fovargue, and to speak in this debate on behalf of the Scottish National party and also as chair of the all-party parliamentary group for disability, a role that I have been proud to champion in my six or seven years of being in Parliament.

We must thank the hon. Member for Newbury (Laura Farris) for realising how vital this debate is and for securing it. She spoke eloquently of her concerns, which were reinforced in just about every speech. Her questionnaire asking constituents about services is a fantastic initiative, getting to the frontline and the heart of what is happening.

When I visit local services in my area, they often give me statistics and tell me how things are improving, but it is not until I speak to people and ask about their experiences that I see whether it has translated into changes for the children who need the services. The hon. Lady emphasised that a timely CAMHS diagnosis is absolutely necessary for someone’s chances in life. That is the key message from today.

The hon. Member for Sheffield, Hallam (Olivia Blake) spoke from her heart about her personal experience. That is a very powerful thing to do in this House. She is a real champion for the screening of neurodivergent conditions. Because of her own struggles, she has been a role model for so many. It is important that she uses her voice, as she has done so powerfully today.

The hon. Member for Newcastle-under-Lyme (Aaron Bell) spoke of the battle faced by parents in his constituency and of the lack of staffing. It is not just about money; it is about training and staffing and making sure that there is an appropriate workforce plan. I hope that the Minister will address that point.

The hon. Member for Bristol East (Kerry McCarthy) eloquently said that the system as it stands is stacked against parents. From what we have heard, I think that is so true. There has to be mental health support in every school, and it has to be at a local level. We cannot expect families and children who are already extremely vulnerable to travel a huge distance for the care that they need.

The hon. Member for Bracknell (James Sunderland) said that 14 times more money is spent on adult services than on children’s services. I worked in psychology prior to coming to this House, and children’s services were always seen as a Cinderella service—entirely wrongly, in my opinion. Investing in our children is investing in our society for the future, and we really need to understand that.

The hon. Member for Oxford West and Abingdon (Layla Moran) described what many of us experience: that people come to us and say that their MP is the last hope for their family. That is how we feel, because that is what people tell us: “You are my last hope; I have tried everything.” It is unacceptable that families have to battle the system to that extent. The Disabled Children’s Partnership contacted me prior to the debate and said that 60% of families with disabled children have sought mental health support for themselves, which shows just how desperate the situation is.

The hon. Lady mentioned another really important issue, which the British Psychological Society has also raised with me: the lack of educational psychologists in the UK. There is only one for every 5,000 young people. That is a really crucial issue that the Minister should take forward. To make a difference, we must have the correct professionals in place to undertake the required diagnoses.

The hon. Member for Cities of London and Westminster (Nickie Aiken) spoke really well about the trauma experienced by children in the pandemic. We must not underestimate that. Their childhood has been different from that of every other generation: the trauma that that cohort has experienced, the loss that many have experienced, the loss of their daily structure and the loss of contact with their loved ones, which was snatched away at a critical time. We need to improve services not just generally but very specifically for the most vulnerable children with special needs.

The hon. Lady also spoke about the impact of social media. I have heard so many negative things about online algorithms and the impact of constant social media use on children and young people’s mental health. That has such a negative impact that we should look at taxing social media companies specifically to raise money to increase mental health support. That must be addressed in the Online Safety Bill.

The hon. Member for Vauxhall (Florence Eshalomi) spoke about her excellent work helping those from diverse backgrounds in her constituency and the important issue of knife crime. She said that, when people are failed in childhood, they can go on to engage in antisocial behaviours; they are steered down that path because the system has failed them. We must ensure that we avoid that at a much earlier stage.

The hon. Member for Keighley (Robbie Moore) spoke about the importance of early diagnosis and the battle against bureaucracy, and the hon. Member for Strangford (Jim Shannon) about the impact of the pandemic and the lack of structure on children with special needs, which has been severe. In my own constituency, we are still struggling to get services back up and running at the level that they were before the pandemic. Parents are continually contacting me, worried that the pandemic may be used as a rationale to reduce services. That must never happen; we are here to champion those parents and to make sure that that does not happen. The hon. Member for Strangford also underlined all of the very bleak statistics that show the greater impact of the pandemic on children with special needs.

The hon. Member for Bury North (James Daly) spoke emotionally and powerfully about his son. The hon. Gentleman came here to listen, but decided to give us the benefit of his own experience. That is one of the bravest and most important things we can do when we come here to raise our voices for others. That personal experience resonates with everybody more than statistics or anything else that the rest of us have to say.

The hon. Member for Winchester (Steve Brine) said that he has been a Member of Parliament for almost 12 years and has been talking about these issues for 12 years. Clearly, these issues have to be taken forward. What I will say—this is slightly different from the speech that I prepared—is that having worked in the services, it is very clear to me that CAMHS cannot manage diagnosis and assessment for children with special needs, as well as the overwhelming number of children who are there for mental health issues. There has to be a streamlined diagnostic service that is available locally, at local authority level, where children can have that intervention, that assessment, because one year in a child’s life is a huge amount of time. The six years that we heard about is almost one third of their childhood. The developmental milestones that have gone by can never be caught up on, so early diagnosis is crucial. There has to be the development of a streamlined service with specialist practitioners who can do the diagnosis and also, from the diagnosis, provide intervention. Why wait six years for a diagnosis only to be told, “You’ve got your diagnosis, but nothing follows it”? That is totally unacceptable.

The all-party parliamentary group for disability would be keen to engage with the Minister, who I know wants to do her very best on these issues, and the Department to look at, where possible, streamlining services for diagnosis and treatment for those children with special needs who deeply require it—we have all said the same thing today—and to learn from best practice right across the UK. There are things that we are doing well in Scotland, and there are things that we can learn from as well. At the heart of this are children, and we must do our best for those children. I want to work collaboratively to try to ensure that we do, together, across this House.

Children’s Mental Health

Lisa Cameron Excerpts

Tuesday 8th February 2022 Commons Chamber

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

Children’s Mental Health Week 2022 comes at a time when the mental health of children and young people is discussed as never before. When I worked in mental health as a psychologist, the stigma was often so great across the generations that no one wanted to discuss mental health. That can never be allowed to happen again. No one should ever silence anyone on mental health, because speaking about it is key to wellbeing.

I welcome the debate today as mental health spokesperson for the Scottish National party but also as chair of the all-party parliamentary group on psychology. In the latter role, I have heard from young people from right across the United Kingdom. They tell me that the focus on mental health is required, as is ringfenced funding. For too long, children’s mental health has been a Cinderella service. It should not be because, the truth be known, children’s mental health is key to our society’s wellbeing for years to come.

It is clear that the pandemic has had a massive impact on the level of anxiety, depression, thoughts of self-harm and social isolation that many children experienced. They have had to process a life-changing event: the pandemic. Now they live with the impact of covid-19 on their childhood, and they will do that for the rest of their lives. We must recognise the trauma and loss for many, and that their childhood has been markedly different from that of other generations. Due to the restrictions, many children missed educational, social and developmental milestones. Many very young children missed vital infant socialisation experiences. As a result, social anxiety, depression and developmental delay is now a feature of many young people’s lives.

For children already struggling with mental health issues, treatment may have been interrupted, exacerbating their distress. For those needing help with an arising mental health issue for the first time, help was not as accessible as it should have been. For those children who have learning difficulties or disabilities, restrictions also meant that they often lost their additional crucial support. Those needs must be met. Children are the most vulnerable in our society and their needs must be prioritised and addressed at this crucial time. That is why it is vital that we recover from the pandemic with a children and young people-led recovery plan.

Children and young people must be involved in how their care is designed, choosing in what modality it is presented and having the option of varying levels of intensity to address mild to severe presentations. Mental health must be viewed as a continuum, with the treatment that best fits.

It is important to say that children’s learning is very different now from when I and many other MPs were at school. It is vital to ask children what works in terms of online technology and innovation. It saddens me that we must also be on top of the algorithms that are online. It is extremely concerning that when someone types in “self-harm” or “eating disorder”, many sites perpetuate harmful content rather than directing young children towards help and assistance. Our online harms Bill must address that. Just last week I discussed those concerns with developers of a new, positive online mental health platform for young children, called Hidden Strength, but I was shocked to hear that harmful content is being enabled and advanced by platforms.

It is exciting that in Scotland a new mental health innovation hub is being developed this year, with children’s mental health the key focus. The NHS Near Me platform is also being used by clinicians to connect with patients remotely, reaching 22,000 contacts a week. Building such services with children and young people themselves, with a “what works” agenda, is key. I was extremely honoured to meet local Members of the Scottish Youth Parliament recently to discuss their leadership on mental health. I was so impressed by what Mitchell Frame, Bethany Ivison, Jack Donaghy and Lennon Boyle had to say, and by their awareness of mental health as a priority for their generation.

Importantly, throughout the pandemic the Scottish Government have developed their mental health recovery plan in conjunction with our local authorities, bringing support directly into our communities. Funding has enabled local authorities at grassroots level to provide a tailored local response for five to 24-year-olds. More than 200 new community mental health and wellbeing services for children and young people have been established and a youth advisory group set up to ensure that young people involved are at the core of self-harm prevention policies.

During the pandemic, the Minister with responsibility for mental health also wrote to all health boards to emphasise that mental health remains a clinical priority. Services must continue. The recovery plan has committed to providing 320 additional staff in Scotland in child and adolescent mental health services. CAMHS should be a step-up service where required, dependent on increased clinical need. It can never be a one-stop shop. A stepped-up model is needed. Online treatments must be available to all, with in-school counselling available across our schools and mental health support normalised across our local authorities and communities for families, as has been described. CAMHS need to be for clinically intensive presentations or they will remain overwhelmed.

It would also be helpful for best practice across the UK—perhaps the Minister will consider this—if diagnostic hubs were developed locally for young people who require assessment for specific issues such as autistic spectrum disorder, attention deficit hyperactivity disorder or learning disability, with input from multidisciplinary teams led by educational psychologists. Children should never have to be on lengthy waiting lists for CAMHS for assessment, because their diagnosis is key to getting other supports involved in their lives.

To conclude, I want briefly to mention the Diana Award and the all-party parliamentary group on mentoring, which I have been chairing. I commend all the MPs in this House from across parties who have contributed to our programme over the past two years. Over 200 MPs during this time have mentored a young person in their community. These are the life-changing opportunities appreciated by young people and their families, so Members should please get in touch with me if they want to prioritise mentoring a young person in conjunction with the Diana Award this year. This successful cross-party programme is promoting opportunity. It increases self-worth and wellbeing, and I thank everyone who has contributed. Together, we can make a difference across the House in policy and in our actions on children’s mental health. I thank all the teachers, volunteers and professionals working in the field. Mental health is key. Let us make a difference together in all our communities.

Down Syndrome Bill

Lisa Cameron Excerpts

Committee stage
Wednesday 26th January 2022 Public Bill Committees

[Dr Fox]

The Minister may say something about that when she makes her remarks, but it is entirely possible that, when guidance is given and there is a named person on the integrated care board, the Bill’s provisions and the measures required to apply it would reasonably be applied to other conditions of that nature.

Again, the fact that the guidance will be laid before Parliament gives us an opportunity in Parliament to deal with the very issues that many Members have reasonably raised. As all colleagues will know, we put Down syndrome as the only condition because of the difficulty of getting a private Member’s Bill through. Getting support requires it to be simple and concise. The fact that the guidance is laid before Parliament enables us to take the legislation forward in a proactive way without too much actually being said in the Bill. That is a good model for how we can take legislation of this nature through in future. I am grateful to my right hon. Friend the Member for Scarborough and Whitby and congratulate him in Committee for the first time on the honour recently—belatedly but very justifiably—bestowed on him.

I go back to the point: the fact that the guidance is laid before Parliament gives us all the chance, on behalf of our constituents, to look at some of these other conditions. If it applies for Down syndrome, why should it not apply in the same way and through the same mechanisms for other conditions? That is an important issue for the Committee to have addressed. With that, I conclude my remarks.

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

I only want to thank everybody across the parties who worked so hard on the Bill; it has been so heartening to see Parliament come together on something so important. As chair of the all-party parliamentary group on Down syndrome, I have had so many emails from people who are right behind the Bill and think that it will be ground breaking in giving them the recognition that they feel is so important in their lives and for their families.

This is an important piece of legislation, and I thank everybody who has contributed to it. The right hon. Member for North Somerset, who led it, has been exemplary in bringing people together and ensuring that the process is positive.

[Layla Moran (Oxford West and Abingdon) (LD)]

I add my thanks to everybody, but especially to the right hon. Member for North Somerset, for bringing this Bill. I agree that the emails we have had have been so heart-warming. My constituent Kelli, whose son Aaron has Down syndrome, said:

“I have three children, two older children without Down syndrome and Aaron. I have the same fundamental desire for each of them: that they are able to live happy and healthy lives, as far as possible, given the realities of life for us all.”

She says the Bill gives her enormous hope. I am sure the hon. Lady has had many similar emails.

[Dr Cameron]

Absolutely. That is the important reason we are all here—to make a difference to constituents’ lives. The hon. Member has shown that the Bill will have a positive impact on her constituent’s life; I am sure that across the Chamber we have all had many similar emails. The right hon. Member for North Somerset addressed some of the hopes for other conditions, which were also raised with me. I am pleased to support the Bill wholeheartedly and to have seen it progress so rapidly.

[Karin Smyth (Bristol South) (Lab)]

I congratulate my neighbour, the right hon. Member for North Somerset, on his work and on bringing together so many colleagues across the House. Everyone has worked enormously hard on this Bill. I thank the Minister for her co-operation. We should have more poachers turn game keepers—they are all terribly welcome.

As Members have said, the families of the 40,000 people with Down syndrome are all watching and listening to the debate carefully. As my hon. Friend the Member for Nottingham North (Alex Norris) previously said, we take every opportunity to remove all the barriers and to tackle stigma and the poverty of ambition that hold back progress in this area. The Bill is the perfect opportunity to do that, particularly around housing, mental health provision and education—all key areas that can really improve and empower those with Down syndrome across the country.

I welcome the Bill and the amendments. As the Minister said in the last debate, the Government recognise that the legal duties and frameworks are already in place. The duty under the Care Act 2014 is to assess people based on need and not diagnostic categories. It is vital that every person’s needs are met to ensure that they can fulfil their potential in their lives. This Bill is about people, not a condition; as it is implemented, we need to recognise that every individual will have their own specific needs. Social care is facing unprecedented strain, so new responsibilities must come with an assessment of investment.

I welcome the Department’s commitment that new guidance will be formed in consultation with partners, and a new burdens assessment will be undertaken ahead of that guidance. As you know, Ms Elliott, having chaired some of the sittings, I spent six weeks in Committee on the Health and Care Bill throughout the autumn. The provisions about having a named accountable person on the integrated care system and the guidance are very important and welcome developments. If the Government could learn from this Bill and take that approach more widely to the current legislation and other legislation, that would be not only good practice but very welcome for Members of Parliament and our constituents.

Our constituents expect us to see guidance and perhaps be part of scrutinising it, raising objections and problems and improving it—that is the role of a Member of Parliament—before that guidance is developed by organisations that are not accountable in the same way and imposed on our constituents. Bringing that circle back, so that Parliament has a greater role in the guidance, is really a very important step, and I hope that that starts to permeate not only the Department of Health and Social Care but other Departments and, indeed, current legislation.

I very much commend the right hon. Member for North Somerset for introducing amendments 1 and 2. They will be landmark—really important. I commend the Minister for working with the right hon. Gentleman to agree to them, and I thank everybody involved in the Bill. I agree with the right hon. Gentleman: this is an example of how Parliament and the proper role of Members of Parliament can be made real. That is only for the good of our constituents.

--- Later in debate ---

[Gillian Keegan]

Down syndrome is a condition that has a very wide spectrum of abilities, as many conditions do—and as we all do, as people. Of course, the right support has to be provided for a whole range of different capabilities. We were talking about a particular case, and how important it is to get early access to speech therapy and to hearing aids so that people can develop language. It is very important to be able to maximise life chances.

Employment will differ for different people. The Government offer a range of programmes to support people with disabilities—learning or physical—to get into and stay in employment. All those programmes can also help people with Down syndrome. This includes the work and health programme and intensive personalised employment support programme, which offer personalised help and support for people with learning disabilities to get into work. The Bill creates the foundations to ensure that people with Down syndrome stay well, receive the right education, secure the appropriate living arrangements—the hon. Member for Bristol South mentioned the importance of the right support around housing—and receive support to transition into employment.

I feel proud that we can already see in our society that people with Down syndrome can secure meaningful employment. That is really important to their life, structure and self-esteem—as it is to all of us here today. We will continue to explore any steps required to make sure that people with Down syndrome can find work, where it is right for them and where that is part of their life’s journey. I expect to return to this issue in the development of the statutory guidance.

I would like to give a few examples, because all of us have met many people and seen the range of capabilities. Dilesh, who my team have spoken with, lives in Barnet with his family. He said he felt total inclusion at school, which was fundamental in providing him with the skills to secure a supported internship as a Project Search ambassador. Dilesh continued this role on a temporary basis and is working closely with his local jobcentre to find another job he enjoys. His mum believes the jobcentre has gone above and beyond to support him to reach his full potential.

We can also see big strides in representation that inspires people with Down syndrome to seek employment that truly matters to them. George Webster joined the BBC at 21 as the broadcaster’s first ever children’s presenter with Down syndrome. Ellie Goldstein, who has been a model since she was 15, has recently been in big campaigns for Gucci and Vogue while also studying performing arts.

On a world stage, George and Ellie are making big strides for representation and inspiring children, young people—not just with Down syndrome but with learning disabilities in general—and adults everywhere. Of course, we must also mention Tommy Jessop, who was very much part of a fantastic show that we have all enjoyed, and of this Bill as well. There are many role models now, and it is fantastic that they are being celebrated and seen much more in roles on our TV screens and in the media.

[Dr Cameron]

The Minister is making some extremely important points. Would she agree with me that it is very important that as many hon. Members as possible also engage in the disability confidence scheme in the workplace, to help employ and offer work-experience placements to people with disabilities in their constituency offices? Is it not also important that Members consider supporting the Speaker’s disability internship programme, which has been very successful in this House?

[Gillian Keegan]

As one of the Ministers who is a disability champion, I completely agree. It is only when one tries to take a view from the perspective of someone who has some kind of disability that it becomes possible to understand how difficult it is to do many daily things. Whether it is people with physical or learning disabilities, the more that we understand their perspective the more we can accommodate them. That, of course, makes a massive difference for somebody who has more to deal with on a daily basis than perhaps we do. It is important that we all take up the training that we are offered.

I thank my right hon. Friend for tabling amendment 3, which updates the long title of the Bill. I agree with those proposals. As outlined, this guidance only applies to England, as healthcare, education and housing are all devolved matters. I know there is also firm commitment from my counterparts to improve the outcomes for people with Down syndrome in Scotland, Wales and Northern Ireland, including through legislation. I look forward to working collaboratively with the devolved Administrations on this matter.

Regarding the schedule, it is important to have clarity within the Bill about who the relevant authorities are, and what functions the guidance will apply to. The list of authorities and their functions has been drawn from existing legislation, such as the Care Act 2014, the Children and Families Act 2014 and the Housing Act 2004. For that reason, the Government support the schedule.

This Bill is hugely significant. It will improve the lives of people with Down syndrome, improve their prospects and improve their families’ lives. I am proud to support it on behalf of the Government as it progresses through Parliament. I thank all the hon. Members for their support. To be in this privileged position, and to be able to use that privilege to make a massive difference to people, is probably what brought most of us here. I thank everybody for their support of the Bill.

[Dr Fox]

One question that was often asked before Second Reading, and continues to be asked, is: “Why Down syndrome?” Many have written to all members of the Committee, I imagine, saying, “Why pick a particular condition? Why not simply have it lumped in with learning difficulties?” The point is that those with Down syndrome and their families know that it is much more than “just” another learning difficulty.

There is the addition of complex health conditions—very complex, in many cases. The changes in demographics, which we discussed on Second Reading—for the first time, many of those with Down syndrome will outlive their parents—bring an element of the importance of care into the equation. Rather than singling out a single grouping, we have shown the increasingly complex needs that a range of different conditions will require, as medical science improves and we have greater life expectancy, which is something we should celebrate, as a society.

The point has been made, as it was on Second Reading, that this Bill is not about a condition, but about people—people who have a particular condition, their families, and the people who care for them. We are talking about individuals who, I believe, have for too long been more vulnerable than they need to be, and were overlooked by a series of pieces of legislation, which did not adequately take into account the combination of needs that they uniquely have.

We all come to this Bill from our personal experiences. As I said in the Chamber, my personal experience is through growing up next door to someone with Down syndrome, from working with people with Down syndrome and, as a doctor, coming into contact with a lot of them. I would like to say a couple of things about what this Bill is not. First, it is not a UK Bill; we purposely took that decision very early on. We could have made it a United Kingdom piece of legislation, and effectively confronted the Welsh, Scottish and Northern Ireland Governments, saying, “You must give us the legislative consent.” That would not have been in the interest of people with Down syndrome. It would have made it a constitutional Bill, with the arguments becoming about constitutional propriety and not about those who are actually involved.

I hope that, with the House of Commons taking this decision, we will see legislation from the devolved parts of the UK giving equal rights to those who live under those devolved systems. It should not matter where someone lives in the United Kingdom; they should have access to the same quality services, the same representation, and the same parliamentary remedies as anybody else. That is why the Bill was designed as it has been.

[Dr Cameron]

I thank the right hon. Gentleman for bringing those issues to the attention of the Committee. The Scottish Government are well aware of the Bill and its merits. They have had discussions and indicated that they will be taking similar types of legislation through their own processes, to see progress made.

[Dr Fox]

I am obviously aware of the discussions that we have had around that. I hope that the devolved Administrations will look at the timetable of the Bill’s passage through Parliament and when it is likely to get Royal Assent, to ensure that there is no time gap between the rights of those with Down syndrome in England and those in other parts of the UK. Those who the devolved Administrations represent should expect no less.

My final thought is that, as with any piece of legislation, this Bill will not be perfect. No Bill is perfect and no Bill requires no further work or changes, but getting the legislation on the statute book is, in itself, a statement of intent. It is a statement of recognition of the needs of those with Down syndrome. We know that private Members’ Bills will generally be limited in scope if they are to get through the House of Commons, but I believe the amendments to the Bill have, as I said earlier, taken it from being a good and well meaning Bill to a landmark Bill: we have signalled not just intent, but how we will give effect to that intent.

All too often we pass legislation in Parliament that sets out great rights and therefore expectations, but we do not set out the mechanisms by which those expectations can be realised. That is the real importance of the amendments. They may look small today and may not be commanding the front pages tomorrow, because they were not accompanied by bottles of wine, but it is important that the Committee understands the importance of what we are about to vote for. We have shown, by setting the guidance in front of Parliament, that there is a link between those who require change and those who can institute the change. That is as it should be, and that is exactly what those we represent have a right to expect.

Amendment 1 agreed to.

Amendment made: 2, in clause 1, page 1, line 12, leave out “(4)” and insert “(4A)”.—(Dr Fox.)

This amendment is consequential on Amendment 1.

Clause 1, as amended, ordered to stand part of the Bill.

Clause 2 ordered to stand part of the Bill.

Schedule agreed to.

Amendment made: 3, title, line 1, leave out from “syndrome;” to second “and” in line 3.—(Dr Fox.)

This amendment brings the long title into line with the content of the Bill.

Asthma Outcomes

Lisa Cameron Excerpts

Tuesday 7th December 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr McCabe, in what is an extremely important and timely debate. I thank the hon. Member for Strangford (Jim Shannon) for securing it, and I know that the issue is very close to his heart. He exerts such energy, enthusiasm and dedication through his work with the all-party parliamentary group on respiratory health, and the issue also has a very personal resonance for him, as we heard, given that his son has been diagnosed with asthma. The hon. Gentleman has first-hand experience of asthma’s impact on a young person and a family, of the concerns that it brings to the whole family and of the need for improved, ongoing care for everybody affected.

The hon. Gentleman set the scene extremely well, and in a detailed manner. He raised with the Minister the issues that clearly need to be addressed, and ensured that we are all aware that we should be speaking more about asthma and its implications, given its impact on so many people across the United Kingdom. He gave some startling figures, including that three people a day die as a result of this treatable disease. We should be doing far more to ensure that those deaths do not happen and that the interventions required are delivered in a timely manner. Those who need additional support must get access to the trained nurse clinicians and the annual reviews that they so desperately need.

I also thank the hon. Member for Loughborough (Jane Hunt). I do not believe I have had the pleasure of speaking to her personally in this place yet, because of our absence during the covid pandemic. I look forward to speaking with her about her particular interest in health. I say that as a clinician, as the chair of the all-party parliamentary health group and as someone with an interest in taking these issues forward. She raised such important matters, including the move towards climate change-friendly, net-zero alternatives. She said that the move must be staged so as not to be too quick for the people who desperately need the medication to catch up, and that it must be done in a very pragmatic way so that it does not impact on those UK organisations that she spoke about, including in her own constituency. Those organisations are working so hard to ensure that science is at the forefront and that, while we achieve net zero, we put patient health at the forefront of all of the decisions that are made in this context. She spoke extremely well on that matter.

The hon. Member for Blaydon (Liz Twist) always speaks eloquently on health-related matters, and I very much welcomed her person-centred approach to the debate. She detailed the impact of asthma on people’s lives, and contributed that first-hand information to the debate. Asthma has a devastating impact on individuals, and people must have access to the biologic treatments that she described. Where there is innovation and excellence in our NHS, it must be available to everybody who needs treatment. That is why, importantly, she told the Minister that individuals must have access to community hubs for diagnosis, linked with early prevention and prescribing. There should be no postcode lottery; no matter where people live in the United Kingdom, they should have access to the treatment that they so desperately need.

While I think about hon. Members’ contributions, I will also briefly mention prescription charges, which the hon. Member for Loughborough also discussed and are extremely important. The Scottish Government abolished prescription charges in 2011, but in England the current charge is £9.35 per item. Since 2011, those suffering from asthma in Scotland have had access to free inhalers, meaning that no person is ever left without an inhaler because of cost. A recent survey conducted by Asthma UK found that three quarters of people living with asthma in England had struggled to pay for their prescriptions and that individuals had often turned to skipping doses of their inhaler to cut costs—again, the impact of poverty and deprivation causing detriment to those who have asthma.

[Jane Hunt]

I thank the hon. Lady for letting me intervene. I understand her point about Scotland, but there is available an annual prescription charge, which is far less. However, my point was really about the fact that asthma sufferers cannot help it, essentially. Is there something we could do there?

[Dr Cameron]

Absolutely, and the hon. Lady makes an excellent point. While the choice in Scotland has been to abolish prescription charges, I note that she did not suggest that to the Minister. However, she did suggest—perhaps because we know that asthma often starts in childhood and is not something that people have much control over—that an exemption could be applied. Following that recommendation from the hon. Lady, I would be interested to hear the Minister’s thoughts on the matter.

Cost itself should not mean that someone cannot access healthcare, and in a developed country such as the United Kingdom, there should be no prohibition owing to charges and costs, particularly for something for which people often need daily medication. We have heard from Asthma UK that that is happening—people are skipping doses and many are struggling to pay for their prescriptions in England.

In 2021, the Scottish Government published their respiratory care plan, which is a care plan covering 2021 to 2026. It includes a workstream specifically on asthma, and I am pleased that that is being taken forward at that level. We know that asthma attacks across the UK, including Scotland, have increased by a third over the last decade, and the number of people affected in the UK is among the highest in the world, with about 5.4 million receiving treatment for asthma. That is equivalent to one adult in every 12, and one child in every 11, so we know that asthma is widespread and that it needs to be a priority for Government action.

Asthma affects people of all ages, as we have heard, and often starts in childhood. I must declare that I have been diagnosed with asthma and have had asthma since childhood. I say to the Minister that there is absolutely nothing worse than the feeling of struggling for breath. I have found wearing a mask difficult at times, but I have continued to do so, and there are exemptions for people with severe health conditions. However, asthma comes upon people suddenly and can leave them with a feeling of such a lack of control, so it is important to have specialist advice from the nursing staff, which the hon. Member for Strangford spoke of.

I do not believe that I received such advice when I was younger; I think I was given an inhaler, told to go off home to practice and learn to use it myself. I wonder whether the issue that the hon. Gentleman raised—people overusing their inhaler medication—is down to there not being enough early intervention and education on how to use an inhaler properly.

I say to the Minister that although the recommendations have been raised on the Floor of this debating Chamber, we need meaningful data. We need to know about overuse, and the rationales and reasons for that overuse. Do people need more education and intervention from clinical nursing staff in the community hubs? Does the cost mean that people in poverty struggle to access treatment, and is that contributing to the death toll? That data is crucial.

As has also been widely mentioned, Asthma UK has indicated that NICE should develop comprehensive guidance on severe asthma. Can we also make sure that the newer treatment options—the biologic treatments—are widely available to everyone who needs them?

I thank everyone who has taken part in this debate, which has been an extremely positive one. I particularly thank the hon. Member for Strangford, because this issue is so important to so many people in the United Kingdom, and I look forward to hearing the Minister’s response.