Abortion (Disability)

Lord Dodds of Duncairn Excerpts

Wednesday 9th April 2014 Commons Chamber

[Fiona Bruce]

The hon. Gentleman makes a relevant point.

Developments in the law, in medicine and in cultural attitudes have led me to introduce this debate. Because of the lack of clarification, the law is being applied in what one barrister has called a haphazard fashion. In 2007, the Select Committee on Science and Technology recommended that the Department of Health produce guidance that would be clinically useful to doctors and patients in this regard, and in response the Royal College of Obstetricians and Gynaecologists provided updated guidance in 2010, but there still seems to be a considerable difference in views and working practice about what comes within the law and what does not. That is concerning for parents, practitioners, law makers and disabled people, many of whom believe it is now time to review the framework within which this law operates.

It is hard to see the differing treatment of disabled fetuses and able-bodied fetuses as anything other than discrimination, about which disability groups are particularly concerned. Medical knowledge has changed radically since 1990, and even more since 1967, and there have been improvements in fetal medicine, including the ability to correct disabilities, even within the womb before birth.

[Mr Nigel Dodds (Belfast North) (DUP)]

I, too, congratulate the hon. Lady on bringing this important matter before the House. As the father of a disabled boy who had eight years of a wonderful life—he had spina bifida and hydrocephalus, he gave much love and everybody who knew him loved him greatly—I join her in her plea for an end to discrimination against children in the womb who are disabled. She makes an important point about developments in medical treatment, even within the womb, especially in the area of spina bifida.

[Fiona Bruce]

I thank the right hon. Gentleman for that intervention. He makes a pertinent point. Disabled children can enjoy life and can give great joy to their families. Even disabilities such as Down’s syndrome cover a very wide spectrum and we need to remember that. When mothers and fathers hear the news about a child’s diagnosis with fetal disability, it is important that they are given information about the spectrum and about their options.

We have seen changes in neonatal intensive care, palliative care, paediatric surgery, educational care and community support. Conditions that might previously have been grounds for abortion are now treatable, and attitudes towards people with disabilities have moved on greatly.

As has been mentioned, the Equality Act 2010 protects disabled people from being treated differently or discriminated against as a result of their disability. In light of all this medical, legal and cultural progress in our society, is it not now time to review the application of the legislation? If we do not consider a disabled person of inferior worth after birth, why do so before?

I want now to turn to a separate point. Many women feel steered, pushed or even rushed into having an abortion once it is determined that they might be carrying a disabled baby. Time and again I heard of that in a commission that I chaired in this House last year, which carried out a parliamentary inquiry into abortion on the grounds of disability. A copy has been placed in the Library. The commission’s committee comprised several Members of both Houses and all parties with different views on abortion but a common concern about the issue. We took oral and written evidence over several months from a total of 299 witnesses. Repeatedly, mothers told us that they had come, as one said,

“under huge pressure to have an abortion”,

because, as another said,

“this is the expectation of the health care professionals”.

Other mothers told us that they were not given support when making the decision, or they felt fearful that they would not be able to cope in future due to limited financial resources or community support in their locality. One said:

“My son (who is now eight years old) has Down’s syndrome. He was diagnosed in the womb at 35 weeks and I was actively encouraged to seek a termination by the doctor who gave me the diagnosis. I was given no support by my local hospital in my decision to keep my baby. I had to actively seek support elsewhere and I’m sure you will appreciate how difficult this was as I was heavily pregnant and in a vulnerable state.”

Parents may find that they are given only a leaflet on abortion, with plenty of advice on having an abortion, but no information specific to the condition that has been diagnosed, or information about what support they could expect if they kept the baby, or an alternative such as adoption. One said that

“choosing to keep the baby effectively meant I was on my own.”

Some mothers were made to feel irresponsible bringing a disabled child into the world on the basis that the child would be a drain on public resources. Many felt guilty about allowing their disabled child to be born. Recently we heard how distressed mothers were in Leeds general infirmary when they felt under pressure to abort babies with treatable heart defects. Was it ever Parliament’s intention that a treatable condition should come within the scope of ground E?

We also heard from a doctor, Mr Jayamohan, about particularly good practice such as counselling; expert support from trained clinicians; the provision of information about the child’s potential disability and treatment; the offer to speak to another family with a child with a similar condition; palliative care; and the opportunity to meet specialists as soon as possible after diagnosis, and so on, to enable parents to make their decision. One parent said:

“Guidelines and standards need to be set in place, which all hospitals need to meet, to ensure all families are given support on education of disabilities when faced with such a situation. To give a family a diagnosis of a disability and then to immediately follow that up with the advice that they can have a termination without any other information is simply not acceptable in a civilised society”.

Does the Minister agree that there is a need for better, more consistent, balanced information, trained counsellors, increased awareness of palliative care for newborns, and comprehensive information and support from the medical profession, whatever parents’ decision about the pregnancy? Would she consider developing best practice guidelines to encompass that?

We even heard of misdiagnoses. Parents told the commission about diagnoses that had proved to be incorrect. One said that

“we were advised my daughter be aborted up to birth due to the results of an antenatal test. The most serious result indicated Dandy Walker Malformation of the brain. In fact when scanned after birth there was no such malformation. Our daughter is now 6 years old and a happy normal child.”

Mr Jayamohan told the commission that of 32 post-mortems of late-stage terminations he had examined, two indicated that the diagnosis had been profoundly wrong. It is worth remembering that these are wanted babies, and parents who choose an abortion suffer grief from their loss. As one has said, it is a

“bereavement like any other person”.

Last year, more than half of ground E abortions were diagnosed by ultrasound alone, which I understand can carry a 10% to 15% rate of false positive diagnosis, meaning that of the 1,367 ground E abortions diagnosed by ultrasound in 2012, as many as 200 may have been falsely diagnosed. What steps are in place to help the Department assess the accuracy of prenatal diagnostics? Should not all be done that can be done to reduce the option of an abortion where it is not necessary or wanted? To that end, does the Minister agree that improvements need to be made in data collection, as there seem to be weaknesses, gaps and limitations in the collection of information on abortions that take place due to disability. One professor has described it as “very inaccurate”. We should be collating more information on the reasons for abortion beyond 24 weeks and analysing such data appropriately. We should consider a report to a coroner for all late-term abortions and carefully consider the need for post-mortems. There should be a national register for all congenital abnormalities, not just for Down’s syndrome. All this would help to improve future diagnosis and, I hope, lead to lower numbers of abortions.

Let me touch on the increasing concern about fetal pain. A new scientific consensus is emerging that babies in the womb can feel pain, even from 20 weeks—certainly, as seems incontrovertible, from about 26 weeks. Yet we permit disabled babies to be aborted at up to 40 weeks. One mother, when asked whether her child would feel pain, was told, “He’s going to feel it.” Is it because we believe that disabled babies do not feel pain, or because we do not care that they do, that we allow abortion at up to 40 weeks for them? During the passage of the Bill that became the Human Fertilisation and Embryology Act 2008, the age of viability was agreed at 24 weeks; it can of course be even younger. Why does this threshold not apply to the disabled?

The logical corollary is that society is saying that disabled babies who can survive outside the womb should not be allowed to do so. I cannot escape the conclusion that this is discriminatory. It simply cannot be right that, as a society that purports to respect disabled people, we act to prevent their very existence in this way. These are arguments open to anyone who values human life and deplores discrimination against disabled people.

My final request of the Minister is whether she would be good enough to take time after this debate to consider the 2013 parliamentary inquiry into abortion on the grounds of disability and respond to the recommendations within it, not all of which I have been able to touch on tonight for reasons of time.

Hospices (Children and Young People)

Lord Dodds of Duncairn Excerpts

Wednesday 18th December 2013 Westminster Hall

[Mr Barron]

I am a member of the all-party group—indeed, I am an advocate of all-party groups—and I believe that bringing together professional people from the hospice movement leads to advancement and educates us about what is happening out there in the real world.

Bluebell Wood has 90 employees, including the care team and administrative staff, and currently more than 350 active volunteers. The hospice and I are extremely proud of them. It would not be the place it is today without them. They work on reception and in the kitchen, they help with the housekeeping and administration, they dig the gardens, paint rooms and help in the shops, to name but a few tasks they carry out. The hospice has eight shops in the surrounding region which raise funds. They are based throughout south Yorkshire, and there is also one over in Derbyshire, in Bakewell. I want to point out to the Minister that it costs more than £3 million for Bluebell Wood.

[Mr Nigel Dodds (Belfast North) (DUP)]

I join in congratulating the hon. Member for Pudsey (Stuart Andrew) on securing this important debate. Would the right hon. Member for Rother Valley (Mr Barron) allow me to offer my thanks and support, on behalf of my constituents, to the Northern Ireland children’s hospice, which looks after 600 life-limited children and young people, and to the volunteers and staff there? The recent announcement by the Minister of Health in Northern Ireland to allocate £2.3 million towards the hospice movement, including the adult hospice in my constituency, has proved an enormous boost to all those involved in looking after the terminally ill in Northern Ireland.

[Mr Barron]

The right hon. Gentleman makes his case very well. As I was saying, Bluebell Wood costs £3 million a year. I notice that my hon. Friend the Member for Rotherham (Sarah Champion) is in the Chamber today; she was the chief executive at Bluebell Wood hospice until what I think I could call her “elevation” to become the hon. Member for Rotherham just over 12 months ago—I see that she is not too sure about that phrase. Bluebell Wood costs £3 million a year and as we know, adult hospices in England receive an average of about 34% of their funding from Government. Children’s hospices typically receive much less Government funding—somewhere in the region of 15% of their running costs—although some get next to nothing, and I have to say that Bluebell Wood falls into that category. It receives 5% of its funding from Government and, were it not for the volunteers, the rest of it would not be there at all. It certainly would not be in the shape that it is now, providing that vital service, not only in the hospice itself, but at home.

In the summer of 2010, the Government set up a review of palliative care funding and in July 2011, they published a report, which I recognise stated that there is

“a stunning lack of good data…for palliative care in England.”

I know that finding a tariff, finding out the right costs and what should be paid is very difficult, but the national health service is, far too often, taking decisions without evidence. I see a need for that evidence to be collected.

Pilot sites were offered in November 2011, and I do not know how many sites were set up in March 2012. Can the Minister say when those pilots are likely to have enough good data that we are able to take real decisions about how the NHS, although it should not take over hospices such as Bluebell Wood, should perhaps contribute a bit more to the vital care that those children, young adults and families receive in hospices?

Rare Diseases

Lord Dodds of Duncairn Excerpts

Tuesday 17th December 2013 Westminster Hall

[Jim Shannon]

I cannot speak about other places, but I do not believe that that has been the case in Northern Ireland—I am not aware of it. In my area, there are young people with Duchenne muscular dystrophy, and I met some young people with Duchenne at an event held every year in the Methodist centre across the way. I have been to the past couple of events, and there has been only one person from Northern Ireland there. With my background information, I would say that what the hon. Gentleman describes does not happen in Northern Ireland, but he says that it does in England, and that needs to be addressed. I hope that the Minister will take that point on board when responding.

The United Kingdom Primary Immunodeficiency Network, or UKPIN, is a professional organisation for all doctors, nurses and scientists working in this field, and it covers six rare diseases. UKPIN—I need to be careful how I say that, because UKIP has no role in this matter whatever—has stated that its aims are the registration and accreditation of specialist immunology centres for primary immunodeficiency, or PID; the development of a national patient registry, to which the Government have given a commitment in the rare diseases strategy; and the development and dissemination of guidelines and standards for best clinical practice. The UK PID registry has been supported by the Healthcare Quality Improvement Partnership, and has engaged the participation of 95% of UK centres since its establishment in 2008. To date, nearly 3,000 patients have been registered, making it the second largest patient registry in Europe, after the long-established French registry.

The figures for Northern Ireland suggest that PID is as common as cystic fibrosis. A first report on the matter is at the presses, and we will soon have the opportunity to read it. Perhaps the most pressing point that has been raised is that there is a need for meaningful national and international collaboration on both research and development of clinical practice to ensure maximum benefit for patients. Let us not disregard international collaboration: if something good is being done in France or Germany, it would be good to exchange expertise, so that we can all improve and move forward. Groups such as UKPIN can take the lead in some of these matters. The UK has already led in the development of novel treatments—for example, with gene therapy—and in implementing novel technologies such as next-generation sequencing. It is crucial that there is ongoing investment to maintain that research.

Rare Disease UK has welcomed the promise of greater co-ordination of care for people with rare diseases. As we hear all too often, patients and families have nobody to co-ordinate the multiple elements of care and treatment that their condition necessitates. How often have we heard that, when it comes to health care? It is not just about care for rare diseases. Members here today all regularly contribute to our discussions on health issues in the House, and all too often we hear of people who do not know where to go or who to speak to, and are not quite sure who they need to be in touch with to help them. That is a key issue; if we could address that, it would be helpful.

[Mr Nigel Dodds (Belfast North) (DUP)]

I am grateful to my hon. Friend for raising this important issue. He touched on support and services for families, particularly at the early stages of diagnosis of rare diseases. That is especially important when the case involves a child, as many do; we heard that earlier. Does he agree that that is one of the most critical matters that needs to be addressed in any UK strategy, and that it is particularly important in Northern Ireland? He and I have shared some experiences of the deficiencies in that regard.

Sudden Adult Death Syndrome

Lord Dodds of Duncairn Excerpts

Monday 25th March 2013 Westminster Hall

[Andy Burnham (Leigh) (Lab)]

We have heard some outstanding speeches this afternoon, and a good deal of consensus, which I am sure will be encouraging for the thousands, indeed millions, of people throughout the country who are campaigning on the issue that we are discussing. We must not forget that we are here for this debate because 110,000 people have signed a petition, in the belief that lives can be saved if Parliament will give the issue more attention and make changes. The debate would not be happening without the outstanding campaigning efforts of the OK Foundation and other heart organisations. I pay tribute in particular to Councillor Jake Morrison, one of the youngest councillors in the country and a shining example of the difference that councillors can make when they dedicate themselves to a campaign.

If it does nothing else, today’s debate will have achieved something, because the official record will contain a permanent memorial to Oliver King, and to the other young people mentioned in the debate, whose lives have tragically been lost. I want the debate to achieve far more than that, however, which is why I am leading for the Opposition today. I want today to be the start of a parliamentary journey in which the issues we are debating here will soon move to the Floor of the House and then, finally, into legislation supported, I hope, by a cross-party campaign. The debate is changing in the country. Every Member of this House will have seen campaigns in their local paper when lives have been lost, and those campaigns are calling for something to be done. It is now time for Parliament to show more leadership on the issue, which we have brought up the parliamentary agenda, and to make changes that will save lives.

We have heard from many hon. Members today, and the attendance of so many Members, not all of whom have spoken, shows the level of interest within Parliament. My hon. Friend the Member for Liverpool, Walton (Steve Rotheram) introduced the debate with a customarily outstanding speech, and he set out the issues very clearly. The hon. Member for Brigg and Goole (Andrew Percy) spoke from personal experience, and given his commitment, we should all listen to what he has to say. My right hon. Friend the Member for Knowsley (Mr Howarth) and my hon. Friends the Members for West Lancashire (Rosie Cooper), for Bassetlaw (John Mann) and for Bolton West (Julie Hilling) have all made outstanding speeches.

The reason why people talk with such conviction and passion is that we have all seen the devastating effect of the unexpected loss of a life, particularly of a young person, but not necessarily so because this affects young and old. People have seen the inexplicable grief that a family feel when someone is brought down in their prime, often at the peak of their powers, playing sport.

That was certainly the case with Daniel Young in my constituency. He died in 2005 playing football for Leigh RMI football club. He was an outstanding young footballer, and at the time his mother, Dionne, told me that she bought everything for him to make his young football career a success. He had all the latest gear, but she said, “If somebody had just told me to pay for a screening test, it would have been the best £30 I could ever have spent, but I didn’t know anything about it. I didn’t know he was at risk.” My journey began there, and I started to look into the issue.

When I held office in the Department of Health, I asked the Department to look at the issue and to consider the case for screening, as proposed by my hon. Friend the Member for Liverpool, Walton. While that work has been taking place, we have sadly seen further tragedies. Of course, we have spoken today about the loss of Oliver in Liverpool. He was another outstanding young sportsman whose talent was taken away from us. Oliver’s dad, Mark, was in a similar position to my constituent: he was not warned about the potential risks and, obviously, I am sure he now thinks about that all the time.

Close to my constituency, we have also recently lost a very young boy. Ciaran Geddes was seven years old, and he died in April 2012 playing football on his own. He was a member of the Winwick junior football club, who play in the same Warrington junior league in which my son used to play. That brings it very close to home, and it was such a young life. Ciaran’s mum, Marika, is now campaigning through the Ciaran’s Cause charity, which has given 27 defibrillators to schools across Warrington, with 10 more to be given soon. Marika says that, with every defibrillator the charity gives, she feels that Ciaran lives on. Three of the defibrillators donated to schools by the Oliver King Foundation have already been used, which brings home just how important it is to support those campaigns.

As my hon. Friends the Members for Bolton West and for Liverpool, Walton have said, we all saw the case of Fabrice Muamba—what an inspiring story that is —which shows just what can be achieved, but as my right hon. Friend the Member for Knowsley said, he was saved only because he fell at a premier league football ground. Obviously, he did almost die, but he survived because he was at the ground and because back-up was on hand. The poor kids who fall at grass-roots football locations are not so lucky, but simple support could be in place that might save many more lives.

[Mr Nigel Dodds (Belfast North) (DUP)]

I tried to be here for the start of the debate to hear the speeches that have been made on this most important subject.

There have been a number of high-profile deaths of young sportspeople on playing fields in Northern Ireland, where we have a very high rate of death by cardiac arrest anyway. I am sure that the right hon. Gentleman would agree that there have been positive outcomes from those tragedies—we have heard of examples from across England—and in Northern Ireland a new community resuscitation strategy has been launched that aims to train people in emergency life support and to provide more defibrillators. So, positives are coming out of those tragedies, and we must all redouble our efforts, as the hon. Member for Bassetlaw (John Mann) said, to press people to really deliver.

[Andy Burnham]

The right hon. Gentleman is absolutely spot on, because we see incredible activity across all four nations of the United Kingdom in the wake of those tragedies. Communities are pulling together, raising funds and donating defibrillators to schools and sports clubs, which brings me to my main point: leadership is now needed at national level to co-ordinate that activity and to bring clarity to the whole situation so that the public know where to find a defibrillator and how to use one. I hope I can persuade the Government to work with Opposition Front Benchers on that. There is no politics involved here; this is about saving lives where we can and doing things to make human progress in this country. Other countries are more focused than we have been, and because of that they are saving more lives.

My feeling is that provision is too random at the moment—it is happening in some places and not in others—and we need clarity on policy at a national level so that we can piggyback on all those local campaigns to make progress. I do not think there is a funding issue, because communities will find the money to put these things in the right places, but we must know where they need to go.

It is crucial to understand that, with the best will in the world, the ambulance service is often unable to make a difference for the people who sadly fall in a busy shopping centre, railway station or sports ground. Why? Because they are unable to get there within the Government target time of eight minutes, which is too late. As my hon. Friend the Member for Bolton West said, it is about that chain of survival; it is about equipping people with the knowledge and the kit at local level to start making a difference so that, when the professionals arrive, there is somebody there to save. That is what we have to do.

If we look at the statistics, 12 young people, as my hon. Friend the Member for Liverpool, Walton said, die from sudden cardiac arrest in the UK every week. We underplay that problem. Until recently, the Department of Health NHS Choices website stated that the figure was 12 young people a year. The figure was corrected after it was pointed out to the Department, but it is important that the problem is not underestimated.

The clinching fact for why we should do more is that across the world, survival rates are very variable. According to the British Heart Foundation, in this country between 2% and 12% of people who suffer a sudden cardiac arrest survive, which is way too low. Elsewhere, in Seattle, as has been said, 50% of people survive, and in Japan, a public access campaign for AEDs has resulted in an immediate increase in rates of survival with minimum neurological impairment for out-of-hospital cardiac arrests.

The evidence is absolutely clear, so what about policy? What did we do while we were in Government? We must be honest. I am not here to say that we did everything right, but we did something. On the back of the focus on heart services, we introduced the national defibrillator programme in the middle of the last decade. It made a modest amount of funds available to purchase defibrillators to give to local organisations. However, I think that a mistake was made. As the programme was wound down, responsibility was passed to ambulance services.

There are two ways of looking at that. On the one hand, ambulance services have been doing brilliant work ever since as they have taken on the responsibility to improve communities’ capacity to respond. It is fantastic to see representatives of the ambulance service here today. I have certainly been impressed by what I have seen in the north-west. The team there is working with communities across the region to build their capacity to respond. The ambulance service has done good work, but national focus on the issue was lost when responsibility was passed down to the ambulance services, and we must acknowledge that.

That brings me to the crux of what I wanted to say, particularly to the Minister. I think that, between us, we can develop a set of simple policy calls that could make a difference and save lives. I will identify three in particular. As hon. Members have said, there is a compelling case for putting emergency life skills on the national curriculum and for making time available, perhaps as part of the personal, social, health and economic education component, to provide training for all young people. No young person should leave school without knowing how to provide CPR and use a defibrillator, because it is not all about defibrillators or CPR—the two together are important. If we train young people in those skills, as my hon. Friend the Member for Bassetlaw said, they will go home and talk to others about them.

I have seen what the British Heart Foundation does in schools. The courses that it delivers for young children are outstanding. It would be easy to add such courses to the national curriculum. My children tell me all the things that they are doing in school: the things that they are learning to make in home economics, and the kings and queens that they know about. It is odd that we do not ensure that every young person in this country leaves school at 16 knowing how to save a life. What more basic skill could we give them during their school years?

Suicide Prevention

Lord Dodds of Duncairn Excerpts

Wednesday 6th February 2013 Commons Chamber

[Norman Lamb]

I am grateful to my right hon. Friend for that intervention, and he is right to say that ensuring that youngsters know exactly where to go to find help is really important. Gaining a better understanding of that must be a priority.

[Mr Nigel Dodds (Belfast North) (DUP)]

I wish to support the point made by the hon. Member for Bridgend (Mrs Moon) a moment ago about the reasons why suicide is more prevalent among men. It was backed up for me by a recent piece of work carried out in my constituency that showed it is much more difficult to get young and middle-aged men to visit a GP or confide in someone about their health problems than to get women to do the same. The work showed exactly the same problem: a lack of willingness to seek out help early enough. That is a major problem and it needs to be dealt with by more education and information, particularly for young men.

[Norman Lamb]

I thank the right hon. Gentleman for that constructive intervention, and he is absolutely right.

The suicide prevention strategy also recognises that the media have a significant influence on what children do and think. As well as promoting responsible reporting in the media, the strategy emphasises the importance of working with the industry to tackle websites that encourage suicide. That is, in a sense, at the heart of the motion and of the points raised by the hon. Member for South Antrim.

Misuse of the internet to encourage vulnerable people to take their own lives is utterly wrong. It is deeply worrying that young people can easily be exposed to such pernicious material, but we should not dismiss the internet as a source only of harmful material. It also provides an opportunity to reach out to vulnerable people who might otherwise refuse support or information, including those young men who might not come forward. It is worth remembering that when used well the internet can be an incredibly valuable way of helping vulnerable people.

Only last week, I convened a meeting bringing together internet security companies, charities and Departments to explore how to protect children and young people from harmful suicide-related internet content. The industry representatives at the meeting told me about some of the good work they are already doing. For instance, McAfee informed me that it has valuable learning to share from its work with the Australian Government on an online safety campaign in schools. I think my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes) will be interested to hear about that. McAfee has campaigned to get the message out to schools in Australia so that youngsters have information about how to seek help. There is a lot we can learn from that.

At that meeting—

--- Later in debate ---

[Mr Nigel Dodds (Belfast North) (DUP)]

I am pleased to follow the hon. Member for Pudsey (Stuart Andrew), who spoke about the impact that suicide can have. He mentioned a memory of his school days. In preparing for this debate, I, too, reflected on my first acquaintance with suicide. At school one day, we discovered that a chap in my class in the third year had died by suicide. I experienced feelings of absolute bewilderment and shock that someone who had been with us only the previous day—playing a normal role in school and taking part in normal activities—was gone from us. I remember racking my brains and feeling totally bewildered. What had caused it? Were we missing something? That vivid memory, which will never leave me, had an enormous impact on me.

Just today, a friend of mine related to me the sad news of the death by suicide overnight of a mutual acquaintance, and again those feelings of shock and bewilderment came back. I am sure that every hon. Member can relate to this issue in some shape or form. I know that some have experienced personal loss through death by suicide. It is very painful, but it is right that we talk about it, so I am glad of this opportunity to say a few words. Only by highlighting this issue of suicide and talking about its causes and what prompts people to take their own lives can we in some way help others not to go down this path. We need to talk about what we can do in government and society and through working with voluntary community groups to help these vulnerable people.

I want to talk from my perspective as the Member for Belfast North, which has been mentioned a number of times. It has one of the highest suicide rates of any part of the United Kingdom, with 25.2 deaths per 100,000 in the period 2006 to 2011. In the last five-year period for which we have figures, from 2007, that figure crept up to 25.9 per 100,000. As has been said, only the constituency of Belfast West has a higher rate. Those rates are high for Northern Ireland, which has high rates compared with the rest of the United Kingdom. I therefore know about this issue from my constituency surgeries, as well as from meetings with the Minister of Health in Northern Ireland, Edwin Poots, from delegations that I have led of families bereaved by suicide and from my work with groups such as PIPS, which my hon. Friend the Member for South Antrim (Dr McCrea) mentioned—I commend him on his excellent speech in introducing this debate—and others that do such tremendous work in Belfast North. They include Lighthouse, FASA—the Forum for Action on Substance Abuse—and many other charities and Churches.

Those working in such organisations do enormously dedicated work in difficult circumstances, often volunteering and bearing a great emotional burden every day, as they cope with young people, middle-aged people and older people who are going through difficult times, as well as counselling and helping in a practical way families who have been bereaved. This work takes a great toll on the volunteers and others working in such organisations. I commend them publicly for the work they do on behalf of us all.

[Mr Kevan Jones (North Durham) (Lab)]

I have similar organisations in my constituency doing the kind of work the right hon. Gentleman describes. One of the questions they are asked by many relatives is: “What did we do wrong?”, which is a very difficult issue to deal with.

[Mr Dodds]

The hon. Gentleman is absolutely right. When I speak to people working in those organisations, I am told that this issue comes up time and time again. It is very difficult to give answers to families who are struggling to cope with the nature of the passing of their loved one. Often it is hard to find any answer that can satisfy—it is just not possible to do that—but in the long run, the work these organisations do provides enormous consolation, help and support. The work of the Samaritans has been mentioned. The right hon. Member for Bermondsey and Old Southwark (Simon Hughes) mentioned Papyrus, and there are many, many others. It is right to put on record our tremendous debt to such organisations and the people who do such tremendous work.

The new suicide prevention strategy, which was launched in September 2012 here in England and Wales, is excellent. The chair of the advisory group, Professor Appleby, who has been mentioned, has said:

“Suicide does not have one cause—many factors combine to produce an individual tragedy.”

Therefore,

“Prevention too must be broad—communities, families and front-line services all have a vital role.”

That is absolutely right, and that is why our motion today talks about government, community and society—all of us—working together to try to prevent suicide. The Samaritans chief executive, Catherine Johnstone, has made an important point—I suppose this sums up what we are trying to get at today—which is that

“suicide can be prevented by making sure people get support when they need it, how they need it and where they need it.”

We know that that is very difficult and complicated to put into practice, because as has been said—the hon. Member for Bridgend (Mrs Moon) mentioned this and the Minister reiterated it—75% of those who die by suicide were not known by, or in contact with, social services. This is not just a simple matter of saying that it is about people who are having mental health problems and who are known to the various agencies; that is often not the case at all.

As I have said, we have a particular problem in Northern Ireland, where death by suicide has gone up by 100% in less than 15 years. Some 300 people each year are dying by suicide in the Province, with men three times more likely to die in that way than females. I shall discuss some of the reasons for men being more prone to taking their lives and for their reticence in coming forward.

The hon. Member for North Down (Lady Hermon) asked the Minister a question about the amount of money that was being spent. I am glad to say that the Department of Health, Social Services and Public Safety in Northern Ireland has spent £32 million over the past six years on suicide prevention under the Protect Life strategy. That money has been extremely helpful, and it has been well spent on helping some of the groups that I have mentioned.

Of course, money can do only so much, because of the broad range of reasons that lie behind suicide. I will not go over all the issues that have been mentioned, but I will deal with one or two of them. As well as social isolation, there is the problem of drug misuse, which my hon. Friend the Member for East Antrim (Sammy Wilson) mentioned. In Rathcool and elsewhere in my constituency, good work is being done to try to reach young people with drug problems and to counter those problems. We are finding that a lot of young men—again, it is particularly young men—who get themselves into that situation end up attempting to commit suicide or actually dying by suicide. Problems with alcohol abuse are also a factor.

I also want to draw attention to a piece of research recently carried out by Mike Tomlinson of the school of sociology at Queen’s university. The key finding of his study entitled “War, peace and suicide: the case of Northern Ireland” was that

“the cohort of children and young people who grew up in the worst years of violence…have the highest and most rapidly increasing suicide rates”.

Those generations were the most acculturated to division and conflict, and to externalised expressions of aggression. The report continues:

“The transition to peace means that externalized aggression is no longer socially approved. It becomes internalized instead.”

My constituency of Belfast North probably suffered more than any other constituency in Northern Ireland—that could be true of Belfast West as well, but I can speak only for my constituency—during the period euphemistically known as the troubles. That was a heinous, horrible period of our history, with its violence, blood-letting, murder and mayhem. Today in Belfast North, and in Belfast West, we are still paying the price for that period of violence and bloodshed. Young men and women are still dying, as are middle-aged men and women, as a result of the troubles in Northern Ireland. Nowadays, they are dying not as a result of murders committed by paramilitaries, but as a direct result of the troubles because, having been brought up in a culture of violence, they cannot cope in this period of relative peace.

[Bob Stewart]

Is the despair of some of those people accelerated by the fact that they are lonely? Does the fact that they are away from their families and from society, for example, act as a catalyst? Does their loneliness gear up the despair that makes them take their own lives?

[Mr Dodds]

It is difficult to be too specific, as every individual’s case is different. Undoubtedly, however, one of the biggest factors, particularly in my constituency, is loneliness and isolation, along with drugs and alcohol. That combination, together with the context in which people have grown up, can often become a too powerful and overwhelming set of circumstances with which to cope.

Particular issues, then, arise in Northern Ireland and my constituency, and they might be different from many cases in England, Wales and Scotland. We have this added problem and pressure of coming out of the period of awful violence that we suffered. Only today, as we look back at the research and work done, do people realise that that period was so awful that we are still living with the consequences. Indeed, people are still dying, even today, as a result of what happened in that period. The hon. Member for Beckenham (Bob Stewart) talked about the experience of soldiers—he was right to highlight that—and it applies to people who served in the security forces, too.

On the issue of how this affects family members, I am thinking particularly of a dear lady who had lost a number of her family members, including two children, to suicide. She told me that she feared for other members of her family because of the increasing prevalence of family members copying what other family members or their close friends had done. The problem is exacerbated not only by sites on the web that encourage suicide but even by Facebook, when an insidious form of peer pressure can be applied.

[Mrs Moon]

One big problem is when anniversaries are marked. We must do some work to highlight the risk of anniversaries and the fact that they are not best marked by further deaths. That key piece of work must be undertaken.

[Mr Dodds]

The hon. Lady is absolutely right, and some families have told me that they dread an anniversary coming up. They sometimes sit up for days on end watching over their loved one in case something happens. They are very aware of this problem as anniversaries are approached.

I want to mention the excellent work done by the integrated services for children and young people programme on the Shankill road in my constituency. The Secretary of State for Northern Ireland visited that project just last week, and the shadow Secretary of State, the hon. Member for Gedling (Vernon Coaker), who I am pleased to see in his place on the Front Bench, has also visited the Spectrum centre in the Shankill, and is aware of the great work done by Nicola Verner and others. Immensely important work is being done trying to help families that have all sorts of problems and needs. Intervention at an early stage is carried out, helping and supporting families as youngsters go through school and into the teenage years. Excellent work is being done by many organisations, much of it helped by Government. We just want to see that work consolidated and, if possible, increased.

I am conscious that other Members want to contribute, so I shall make my last point. A number of families raised with me the point that when young people go to an accident or emergency centre or to their GP and are concerned about their state of mind and vulnerability, it would be a good idea for them to have somewhere like a place of safety—somewhere they can go to and be put in contact with others who understand what they are going through. They should not just be given a piece of paper as a prescription and told to come back in a week’s time. They need somewhere to go to where they can talk to people; that is vital. I commend the Minister from the Northern Ireland Department of Health, Social Services and Public Safety for taking this issue on board.

[Mrs Moon]

One of the most helpful developments has been the engagement of the Samaritans in A and E departments. That has really made a difference, especially in self-harm cases. Where the nursing staff might be too busy to give up time, the Samaritans might be able to provide that time and support, which would be an excellent move forward.

[Mr Dodds]

I agree. That shows the importance of the excellent work the hon. Lady does as part of the all-party suicide prevention group to share best practice, as there are bound to be lessons we can learn from each other.

I commend the work that is being done. The Health Minister in Northern Ireland, Edwin Poots, has taken a close personal interest in the issue. He recently held a workshop for workers in the community and voluntary sector, and he has also met a number of family support groups. He has tried hard to raise the profile of this issue. It is now taken very seriously across the board in Northern Ireland—by all the political parties, and in the community and voluntary sector—and I think it important for Members to take the opportunity to highlight it here as well. It is one of the biggest problems that we face, certainly in my constituency.

I commend and thank everyone who has taken part in the debate, and all those, in my constituency and elsewhere, who are dedicated to trying to prevent suicide.

Induced Abortion

Lord Dodds of Duncairn Excerpts

Wednesday 31st October 2012 Westminster Hall

[Nadine Dorries]

I thank my hon. Friend for that intervention. I am very flattered.

Due to the fact that the 1967 Act is so little discussed and its format is so archaic, over the past year we have seen a number of abortion providers flout the law. One of the reasons for that is that Parliament itself shows no respect for the law. In the past year, abortion clinics have been exposed using the law creatively to offer abortion illegally and criminally based on the gender of the pregnancy. In fact, the Care Quality Commission and the General Medical Council are now investigating, I believe, 14 cases of malpractice, and arrests have been made at other clinics. The Calthorpe clinic in Birmingham has been closed down and handed over to another provider.

Those cases point to an erosion of respect for the law by abortion providers. The culture of fear in Parliament, which is held by many MPs, on discussing abortion law has contributed, or may have contributed, to the situation. That has to stop.

[Mr Nigel Dodds (Belfast North) (DUP)]

I admire the hon. Lady’s courage and perseverance in bringing these issues to the House.

A Marie Stopes clinic has recently opened in Northern Ireland, a province where the law is very strict on abortion and where there is no support for the extension of the 1967 Act. Does the hon. Lady share my concern that the opening of the clinic may be an attempt to stretch the law, or even to get behind it?

[Nadine Dorries]

I am afraid that I have to disappoint the right hon. Gentleman—I discussed this with one of his colleagues yesterday—because I believe the law on abortion should be equal in all parts of the Union. Abortion law needs to be reformed in the UK, and there needs to be parity across the board. If any abortion provider is to come to Northern Ireland, Marie Stopes is probably the best bet. Marie Stopes is one of the most professional and non-advocacy-driven abortion providers. It has no political ideology and is concerned only for the health of the woman, and it operates in a professional manner. So I think that, if Northern Ireland is to have an abortion provider, Marie Stopes are the people to have. The law here needs to be reformed, and there needs to be parity on both sides of the water.

This year alone, three abortion clinics have been closed down. This is my last point: we must bring abortion law before the House because it needs to be reformed.

Following today’s debate, I have already applied to the Backbench Business Committee for a longer, dividable debate to be held next May. I am using today’s debate to give notice of that future debate. I want to give pro-choice and pro-life supporters ample time to prepare, to gather their research and to set their stall ready for a debate next May.

Obesity

Lord Dodds of Duncairn Excerpts

Wednesday 9th November 2011 Westminster Hall

[Mr Campbell]

My hon. Friend is absolutely right, and I hope the Minister will respond to that. I know that a small number of fast food outlets in Northern Ireland have acted responsibly, but unfortunately they are a small number. It appears that the behemoth of consumerism will simply market and promote the message of “stack them high and sell them cheap.” We have to come to terms with that reality, because it is driving many people to an early grave—it is as serious as that. In 2011, many in the younger generation are not only overweight, but will be diagnosed in 20 years’ time with health conditions that could shorten their lifespan by up to 10 or 12 years, unless we get to grips with the problem.

There is, as the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart) indicated, an educational and health problem. It is for all of us in society to promote a healthier lifestyle. That is where I think we can do more to get role models to do what they can to promote healthy eating and a healthy lifestyle. Some role models, unfortunately, do anything but promote a healthy lifestyle, but we need to ensure that more suitable role models are approached and asked to try to promote such a lifestyle, so that we can address this horrendous and difficult problem.

[Mr Nigel Dodds (Belfast North) (DUP)]

I, too, congratulate my hon. Friend on securing this important debate.

Does my hon. Friend agree that although good progress on the issue has been made on a voluntary and self-regulatory basis, the time has come for more legislation? We have seen that approach with the compulsory wearing of seat belts and the banning of smoking in public places, which was resisted on all sorts of grounds. That approach has had a beneficial effect on health and public safety. Is it not time for the Government to go further in forcing food and drink companies to act more responsibly?

[Mr Campbell]

I agree with my right hon. Friend. We also need to look at the cost of products on supermarket shelves. Again I refer to some of the correspondence that has come my way. Fizzy drinks are quite attractive to younger people, and to some who are not so young. Is it fair that their low-calorie equivalents, some of which contain one calorie, and the fully fizzed-up versions, which can contain 139 calories, cost virtually the same?

A range of approaches needs to be co-ordinated and best practice needs to be introduced. I hope that the Minister will be able to speak about the devolved Health Ministers, with whom I hope he will have discussions about the best way to promote best practice and to ensure that, wherever practical and possible, close co-ordination can take place, so that across Scotland, Wales, England and Northern Ireland we can begin to address and—I hope—reverse this horrendous and difficult problem.

--- Later in debate ---

[Dr Poulter]

That is a good point. There is good evidence that the celebrity culture around dieting causes anorexia in young girls. It would be much better for us and for many of our constituents if celebrities sometimes showed greater responsibility in the way in which they behaved. Gastric bands are an effective way of dealing with severe obesity, but they should not be used as a general method of bringing about weight loss. Weight loss is about education and people taking responsibility for their own weight and lifestyle. It is also about putting support in place in communities to let people do that, particularly in more deprived areas.

[Mr Dodds]

I have heard constituents talk about the use of statins and polypills. These medications have enormously beneficial effects for many people, and many people need them, but people almost seem to think, “Well, we have this magic pill available. We can eat and drink as much as we like, and then we can go on this pill.” Does the hon. Gentleman share my concern that we need more education about the use of such medications? At the moment, people are under the impression that there is something out there that can solve all these problems without their having to do anything to change their lifestyle.

[Dr Poulter]

Yes, certainly. There is an issue about how physicians prescribe effectively. Statins are an effective way of controlling cholesterol, and there is good evidence that they benefit people with heart disease and high cholesterol and that they increase life expectancy. There has been a lot of research, and I believe that it has been shown that statins may have beneficial effects in reducing the risk of breast cancer, although the Minister will correct me if I am wrong.

The right hon. Gentleman touches on the wider point that the emphasis in this debate needs to be on effective community-led interventions that tackle obesity and health care, and my hon. Friend the Member for North Swindon (Justin Tomlinson) discussed that very effectively. However, we need to ask how we will make those community health care measures effective.

The Government are setting up health and wellbeing boards, which are a very useful part of their health care reforms, because they will, for the first time, bring together different organisations in a meaningful way. Local councils in certain towns may run good community initiatives that connect GPs with leisure centres, exercise and sport, and some schools may encourage sport and physical activity in an effective way or have good links with local sports clubs. However, that does not often happen in a co-ordinated way across whole counties or, indeed, across the country. Health and wellbeing boards will help to bring together different organisations to address key public health problems, and obesity is a key public health challenge in all our constituencies.

As part of the health care reforms, the health and wellbeing boards will be able to address issues such as obesity. For example, if we know that there is an issue with teenage pregnancy or obesity in certain schools or among certain schoolchildren in my constituency, targeted interventions can be put in place in a much more community-focused way by getting the local authority together with health care representatives at a much more strategic level. That must be a good thing, because it allows much more targeted interventions.

The second thing I want briefly to discuss—I do not want to speak for much longer—is nudge theory. My hon. Friend the Member for Totnes has a slightly different view of it. I have more faith in nudge theory than she does, and I say that because we have had debates about agriculture—some of the Opposition Members here today were present—in which we discussed the need for corporate firms and supermarkets to show greater corporate responsibility on issues such as food labelling. We have now seen active movement from some supermarkets on honest food labelling. For example, we talk about food in a store being labelled British only if it is actually farmed in Britain, and not if it is merely processed or sliced here. We are beginning to see such initiatives come through, with supermarkets supporting British farmers. Morrisons is a good example of a supermarket where the British food stamp actually means something, and that allows consumers to make an informed choice. Supermarkets are therefore able to show corporate responsibility when they are asked to do so, although things are not entirely perfect, as we all know.

In a similar vein, the Government have introduced a public health responsibility deal, and it is a good initiative. Almost 200 different companies have signed up to the deal, including supermarkets such as Asda, the Co-op, Morrisons, Marks and Spencer, Sainsbury’s, Tesco, Waitrose and many others. Fast-food outlets such as McDonald’s, Pizza Hut and KFC have pledged to remove trans fats and introduce calorie labelling as a result of this initiative. Those are all pleasing and beneficial steps in the right direction.