Health

Lyn Brown Excerpts

Monday 9th June 2014 Commons Chamber

[Priti Patel (Witham) (Con)]

It is a pleasure to speak in the debate because it is a Queen’s Speech that will help to deliver a stronger economy for this country and better and stronger public services. Four years ago, this Government embarked on a radical and necessary programme of measures to turn the fortunes of this country and our economy around. For 13 years, my constituents were betrayed and let down by the previous Government, as taxes rose while unemployment soared, the economy went into meltdown and public services wasted taxpayers’ money on a colossal scale.

It is a tribute to this Government’s economic focus and policies that we have been able to turn things around. Ministers have implemented many clear measures. For example, unemployment in my constituency is now almost half the level it was when it peaked under the previous Government in 2009. These are the positive policies that I bring to today’s debate on the NHS. It is a testament to this Government’s commitment to the NHS that we are now seeing an increase in spending.

I heard the opening speeches in the debate, including by Labour Members. It is appalling that the Labour party likes to talk as though it owns the NHS politically. That is wrong. Labour should listen to some of the facts not just in my constituency but in the eastern region. The fact is that Labour went into the last general election with plans to cut NHS spending—we have heard about the impact of that in Wales—while we have continued to invest in the NHS. While Conservatives recognise the increasing pressures that the country faces from demographics and the health care needs of the public—

[Lyn Brown (West Ham) (Lab)]

Will the hon. Lady give way?

[Priti Patel]

I want to develop my discussion and go into more detail on the NHS. More investment in the NHS is required. This is not about cutting services, including front-line services, or funds. It is about expanding the NHS in the right way and, as the Secretary of State said, putting patients first and moving away from the bureaucratisation of the NHS.

[Lyn Brown]

Will the hon. Lady give way?

[Priti Patel]

Let me continue.

There were classic examples of that not just in my constituency but more widely in Essex. We heard earlier about Basildon hospital. In my constituency, one primary care trust saw its number of managers and senior managers increase tenfold over a decade. At the same time, it failed miserably to recognise the health needs of my constituents; we have a growing population as well as an ageing population. I had cases in 2010 where patients were denied access to life-saving hospital treatment and access to drugs because the PCT sought to prioritise spending on the bureaucracy of the NHS, rather than front-line patient care.

In Witham town, at the heart of my constituency, there is a chronic shortage of locally accessible health care facilities. All the talk by Labour and the slogans referring to “record investment” under Labour translated into nothing in my constituency. Under the previous PCT and the previous regime, we had consultation after consultation but no new services were created.

[Lyn Brown]

Will the hon. Lady give way?

--- Later in debate ---

[Gordon Birtwistle (Burnley) (LD)]

The health service is very close to everyone’s hearts, and there are a lot of political gains to be made from it. I have to say that, as the Member of Parliament for Burnley, my election chances were boosted when Labour’s Secretary of State closed down our A and E unit. I am delighted to say that the coalition Government have now delivered us a brand new emergency centre in Burnley, which shows that the coalition Government have delivered good things, especially for the people of Burnley.

There is one issue that I really want to talk about today. I have been a councillor for 31 years—I stood for election only last month and increased my majority over Labour in my ward—and the issue that has become very close to my heart is the care of elderly people. I am talking about elderly people who are on their own. People from companies call on them in the morning to get them out of bed. They stay for 10 minutes to make sure they are up and have had some breakfast. They then come back at lunchtime to make sure they have eaten some lunch, and then again in the afternoon to make sure they have had their tea. They come back in the evening. As one elderly man said to me, “They come back at 8 o’clock and tell me to get ready for bed.” He said, “I don’t want to go to bed at 8 o’clock in the evening. I am 87 years old. I fought for this country, and now they are telling me that I have to go to bed at 8 o’clock. I don’t want to do that.” What he wants is for someone to come and see him in the morning and talk to him. He is housebound, and he does not have a family. He is not the only one in that situation. There are many more like him in Burnley.

We are a poor town and people cannot afford to pay for private services. These people want to talk to somebody in the morning when they get up; they want a bit of conversation. They do not want staff running in with their meals-on-wheels food in a foil container saying, “We’ll come back and see you later.” They want to talk to someone. They want to know that there is somebody who cares for them; somebody who is interested in listening to them. This elderly man has some fantastic stories about his life; I have seen him many times. When the staff come back in the evening, he is not asking them to stay all night. He is asking them to show a little bit of interest in him, and he certainly does not want to go to bed at 8 o’clock at night. He has never gone to bed at that time and for someone to tell him that he has to do so, “or he’ll be on his own” is wrong. I am not being political here. All I am saying is that we should care more for the elderly people of this country. I am talking not about people who are in their 60s, but about people who are in their 80s and 90s who, unfortunately, have been left on their own. They might be elderly ladies whose husbands have died. These are people who have worked for this country all their lives and fought for this country, and are now, certainly in my constituency anyway, being left alone. I find that hard to accept. I might be unusual. There might be people who think it is tough and bad luck, but I do not think that. We should be looking after these people and showing them some compassion. We are a wealthy country. Apparently, we are the fourth or fifth wealthiest country in the world, and the contribution that these people have made over their lives has helped to put us in that position.

Burnley is an industrial town; we had the pits and the mills. Now we have high-tech industry where young people work and create wealth. Fortunately these days, they are able to put something aside for their pension, which will help to look after them in their old age. The elderly people from the ‘70s, ‘80s and ‘90s could not do that; they were on poor salaries. In the main, the wives did not work. My mother never worked. My father brought up our family, and my mother never worked. All right, my mother and father are dead, but there are still people around who were in the same position. Many have lost a partner and in the main their children are out of the area, and they need us to care for them. Is it a lot to ask for someone to turn up and say, “Hello, Mr Jones. How are you?”

[Lyn Brown]

The whole House is listening very quietly to what the hon. Gentleman is saying because it resonates. My father is 87. He pays for carers to come in from an agency. What has upset us is the fact that his life savings are paying the wages of people who drive Lamborghinis, who employ people on the minimum wage and who provide very poor care to the people the hon. Gentleman is talking about. This Government need to act to ensure that the care offered to our people, which they pay for out of their meagre savings, is of the quality that they deserve.

--- Later in debate ---

[Lyn Brown (West Ham) (Lab)]

It is wonderful to follow the hon. Member for Totnes (Dr Wollaston), and I totally and utterly agree with her concluding remarks.

Some may say that the absence of any reference to health legislation in the Queen’s Speech is a blessing; after all, the unwanted top-down reorganisation foisted on the NHS by the coalition and the previous Secretary of State is said by many to have put such a strain and stress on the NHS that it has been brought to its knees. Many Members present will know from their casework, inboxes, surgeries and personal experience that there is a rising tide of public concern about the NHS because of the lack of accountability and because decisions are being made upstream from local services. Our constituents may well view the absence of any mention of health in the Queen’s Speech as evidence of complacency, disinterest and unconcern. I have to say that I would agree with them. The Government have taken away the local means to secure improvements in services, and in this Queen’s Speech they have missed an opportunity to bring back local focus and accountability.

I want to look first at GP provision. One of my constituents wrote to me in April out of “sheer despair” at her inability to get an appointment at her surgery for an issue that she has said is not urgent. She has a busy job, is at work at the times she needs to call the surgery, and cannot leave work at the drop of a hat should she be offered an on-the-day appointment. As she put it,

“the current system is an absolute joke, to put it mildly…this current NHS system is completely useless”.

My constituent needs and deserves Labour’s GP access guarantee. Is there anything like that in the Queen’s Speech? The short answer is, “No, there is not, but there should have been.”

My constituents do not have the same access to GPs as people in other areas. Building on NHS England’s most recent survey, the Royal College of General Practitioners shows that 16.82% of patients in Newham were not able to get a GP appointment when needed, compared with 5.36% in Bath and North East Somerset. The Government should adopt the GP access guarantee to address those inequalities, and the Queen’s Speech would have been the right place to introduce such proposals.

Before its abolition, Newham primary care trust had a clear plan to tackle and improve the challenging local situation, of which I was an active and enthusiastic supporter. Today, I am far less sure that mechanisms are in place locally that have the capacity and motivation to root out poor practice and promote the best. My misgivings were confirmed when I asked who now decides what to do when, for example, there is a vacancy at a GP practice in Newham. The answer came back—I still find this astounding—that the decision rests with NHS England. What is more, I was told that the London office of NHS England has a small number of people who deal with the provision of GPs, dentists, opticians and pharmacists. They must struggle to keep up with the paperwork, let alone have any capacity to look at proactive work on quality, improvement and service development.

What local knowledge can NHS England have about what is happening on the ground in Newham? How can that make any sense, and how is NHS England accountable to Newham’s people and its clinicians? What does it say about the reality of this Government’s commitment to localism? It is surely a matter of great regret that the Secretary of State did not seek to use this Queen’s Speech to address some of those very real issues.

In his response, the Secretary of State will no doubt include fine rhetoric about control being in the hands of GPs locally through the clinical commissioning group. He will laud to the skies their skills, commitment to patients and the NHS, and their virtue in all respects. I have talked at length to my CCG in Newham and worked closely with it, and I assure the Secretary of State that I share his opinion of its estimable qualities. In fact, I would add more approving words to his glowing testimony. I also know, however, of the CCG’s absolute frustration at the straitjacket that the new NHS structure requires it to wear, and I share its recognition that the reality of local empowerment is very different from that described by the Secretary of State and enforced with the diktats of NHS England.

The new structures leave decisions in the hands of NHS England. Surely the current Secretary of State can see that that is nonsense. In his calm, perhaps even reflective moments, I think that he knows and would admit that, if only to himself. What a shame that he did not use the Queen’s Speech to intervene and turn his rhetoric of localism into more local control over NHS decisions.

--- Later in debate ---

[Mr Andy Slaughter (Hammersmith) (Lab)]

I am sorry that this debate began with a speech that was smug and complacent even by the standards of the Secretary of State for Health. I thought we had reached a low point until I heard the hon. Member for Thurrock (Jackie Doyle-Price) using a speech on the NHS to promote the tobacco industry. I am glad that those speeches have been balanced by those we have just heard from my hon. Friends the Members for Walsall South (Valerie Vaz) and for Westminster North (Ms Buck). Indeed, the speech from the shadow Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham), reaffirms Labour’s commitment to the health service, which is fairly lacking from this Government.

I am going to speak about the crisis in the west London health service, partly because it is such a major crisis and partly because I think it indicates the way the Tories are dealing with the health service generally. It began two years ago, almost exactly, with the announcement of the biggest hospital closure programme in the history of the NHS. Since then we have had sham consultations with 100,000 people petitioning and being ignored, U-turns, confusion, incompetence, refusal to answer questions and political chicanery to make what happened in Ilford, as we heard from my hon. Friend the Member for Ilford South (Mike Gapes), look like a model of probity. Now we have the contamination of the whole NHS locally, including the primary care sector.

When the closure programme began, the medical director of North West London NHS said, candidly, that if it did not close four A and Es and two major hospitals, it would literally run out of money and go bankrupt. Those are the words he used. I suppose we should be grateful to him, because those statements galvanised the population of west London to engage in “save our hospitals” campaigns, and they have been campaigning for two years in rain and snow. Despite huge disinformation paid for by the taxpayer, by a Conservative council and indeed by the NHS, when I now stand in Lyric square in Hammersmith on a Saturday, I can be sure that 99% of my constituents know what is actually happening. I pay tribute to those campaigners from all political parties—including a lot of ex-Tories, as well people from minor parties, Labour supporters and others. They have really made the running on this issue.

Yes, there were changes. Initially, for example, we were going to lose the whole of Charing Cross hospital. Now there will be a local hospital on the site. When that was first mooted, a senior member of the local Conservatives and a Cabinet member said:

“This is an enormous teaching hospital with a 200-year history. You can’t make the Charing Cross hospital into a local hospital. It’s absurd. People won’t put up with that.”

Within weeks, they were spending ratepayers’ and taxpayers’ money putting out leaflets saying that Charing Cross hospital had been saved. That was compounded last October when the Secretary of State for Health stood here and effectively said, “Oh, it won’t just be an urgent care centre. It’ll be a second-tier emergency department.” Let me clarify the three differences between those two: recovery beds, X-rays and GPs. I thought we had GPs on duty in urgent care centres, but apparently not; we can just have nursing cover. It is an urgent care centre by any other name; to call it an A and E is misleading. It will lead to people with serious medical conditions going there and risking their and their family’s lives—as we have already seen at Chase Farm and elsewhere. Charing Cross and Hammersmith will not have blue-light emergencies—except for heart attacks in the case of Hammersmith. We will not have a stroke unit; we will not have the 500 emergency beds; we will not have intensive treatment. This is a second-class, second-tier health service.

The worst transgression happened in only the past few weeks during the local election campaign. I am not making this up, Madam Deputy Speaker. After the postal votes were opened and the Hammersmith Conservatives saw that we were ahead in some of their safe wards, the Prime Minister was brought down at short notice and locked in the basement of the Conservative party offices with a local journalist and came out with this pronouncement:

“Charing Cross will retain its A&E and services”.

I believe that the Prime Minister is an honourable man, and that he was misled into making that statement. The statement is demonstrably false because the NHS has clearly said that most of those services—other than treatment services, primary care services and elective surgery—will not exist at Charing Cross hospital under any analysis.

I thus went to see Imperial. It was the day after the election and I had been up for 30 hours and was not in a terribly good mood. I went to see the new chief executive of Imperial, and I tried to persuade her that Charing Cross should stay open. I said that I would take the new Labour leader of Hammersmith council to see her, as he might be able to persuade her better than I could. I then left and went home. That evening, she e-mailed to say, “Oh, I forgot to tell you when you were here: we are closing the other A and E in your constituency on 10 September. It was just a short meeting and I did not have time to tell you about it.”

At the same time, as my hon. Friend the Member for Westminster North said, the CCG is writing to tell us that it is good news that in year—in the middle of a financial year—it has decided to pull together £140 million from the CCGs around north-west London and to redistribute it into primary care. In other words, they are panicking and having to take desperate measures because the primary care services are so short of money and cannot pick up the slack from the closure of A and E services. We might think, “At least they are doing something”. A substantial proportion—they will not say how much—is going out of my CCG and into other CCGs because, they believe, that is a fair way to distribute money. We are losing not only both A and Es, but our primary care funding and, with the closure of Hammersmith A and E—if we cannot prevent it from going ahead in September—Imperial has admitted in its own board papers that there is insufficient capacity at St Mary’s hospital.

[Lyn Brown]

Has my hon. Friend conducted any analysis that could reveal whether the redistribution of funds among the CCGs will take money from the more deprived areas and give it to those that are better off?

[Mr Slaughter]

I thank my hon. Friend for that intervention. In exactly the same way, the Government are choosing to close the A and E department at Hammersmith hospital, which is slap bang in the middle of one of the most deprived areas of London, covering White City, Old Oak, Harlesden, north Kensington and east Acton. That means that 22,000 people who rely on those A and E services every year will have to travel to St Mary’s hospital in Paddington. They will not be directed to Central Middlesex hospital, which will be closing on the same day, and they will not be directed to Charing Cross hospital, because the plan is to close that within a year or two. They will be told to go to St Mary’s, where there are not enough beds and not enough capacity in A and E to cope with the current demand. That is contrary to undertakings given in the House that there would be no closures of A and E services until alternative services were provided. There will also not be enough acute services to provide a training base for students at Imperial college.

Two weeks ago we won the election in Hammersmith, against the expectations of, at least, the Conservatives, and we won it on this issue. If the Government will not listen to the 100,000 people who petitioned, perhaps they will listen to the people of west London who, on the issue of the NHS, overwhelmingly voted Labour and against the policies that are being pursued by the Conservatives. They should listen, and they should think again about hospital closures that will cost the health and the lives of my constituents.

Cervical Cancer Screening

Lyn Brown Excerpts

Thursday 1st May 2014 Commons Chamber

[Alison McGovern (Wirral South) (Lab)]

It is an honour to contribute to this important debate, and I welcome to the House of Commons today Sophie’s mum, Peri, her sisters Chelsea and Ashleigh, and other members of her family. I have been very proud to be involved in this campaign to highlight what happened to Sophie, who was my constituent. I think I am right in saying that this has been the biggest ever e-petition, which I think represents a real change in the way we do our politics in this country. Long gone are the days when only certain people in this place could call on us to hold debates here and only the Government said what we would talk about. In Sophie’s name, her very many friends and family have brought us here to talk about these issues today. That is a massively important change in our politics, alongside the important issue we are discussing.

I congratulate my hon. Friend the Member for Liverpool, Walton (Steve Rotheram)—even though he keeps saying that I am the hon. Member for Wirral West, which I am not; I’ll have a row with him about that later—on having initiated this extremely important debate. As I have said before, it is very important for men in Britain, as well as women, to care about women’s cancers, and I will say more about that and about awareness. I make a plea, however, for all my male colleagues, as dads, brothers and friends of women as much as anything else, to ensure that they know the symptoms of cervical cancer and other women’s cancers, and to support their sisters, friends and mums if they have any concerns. That is important.

I begin my contribution by borrowing the words of Peri, Sophie’s mum, which she has allowed me to do. She characterised what Sophie was like in a really brilliant way:

“She was an amazing daughter, sister, girlfriend and friend, a live wire with a huge heart, the glue that held our family together. Her attitude to life was to live it to the best and her positivity shone through to everyone so as you couldn’t help but smile”.

I think those are lovely words about Sophie, and it is in her name that we all come here today. I know I represent all my constituents when I offer their condolences to Sophie’s friends and family, and I feel sure that the many thousands of people who signed the e-petition did so because they wanted to show that they cared about what happened to her. Members might be interested to know that friends and family have also organised fundraising events—they did so before Sophie died—and are taking care of all her family. That is a truly great thing.

Sophie had high aspirations for her life, and she had hopes and plans. She was clearly a vibrant, clever, beautiful young woman with her whole life ahead of her. She attended her GP surgery as she had been suffering for months with symptoms such as stomach pains and various things, and it seems that her request for a smear test was refused on the basis of her age. My hon. Friend the Member for Liverpool, Walton has gone through those issues in some detail. It seems that Sophie was diagnosed with Crohn’s disease, but her health continued to deteriorate until she was eventually diagnosed with cervical cancer and very tragically died in March, just 19 years old.

The disease is rare in younger women, but in this case a smear test would have been important. Sadly, this is not the first case to come to light in which a young woman has died of cervical cancer following such events. Mercedes Curnow died aged 23 in 2011, and reports suggest that she too had requested a smear test. Another young woman, Becky Ryder, was 26. Thankfully, such cases are few and far between, and we are grateful for that; none the less we will all understand the tragic scenario that friends and family face when a young woman faces such a serious disease. Even though the numbers are relatively small, it is important that we take the issue seriously.

Approximately 3,000 cases of cervical cancer are diagnosed in the United Kingdom every year. While there are groups of people such as women under 25 among whom cervical cancer is rare, it does occur. I understand that there are approximately 2.5 cases of cervical cancer for every 100,000 women under 25 years old. It is thankfully rare, but very serious for those people who face it. How can we help GPs to pick up the symptoms of something so rare? A balance has to be struck, but it is important to raise GPs’ awareness of such conditions—rare though they are, they do happen.

There are potential risks in screening women under 25, which have been mentioned. The consequences of unnecessary screening can cause problems in later life, which is why the medical community has had such a discussion about the point at which screening should be done. As politicians, our first regard must be for the medical evidence, and we would never ride roughshod over that, but one thing that we have perhaps not always got right is making information available to people and accepting that people should be trusted with that information. The NHS is very good at giving advice and telling people what they should be doing, but much less good at giving information to help people to make their own informed decisions. The e-petition is about choice and how we ensure that people have the information they need to make the choice for themselves. I understand that Dr Moss of the Advisory Committee on Cervical screening has argued that volunteering to have the test should be an option. If someone does make that request and is turned away, it could cause a very negative response when they are invited for the test later. I know that Sophie was one of the youngest victims of this devastating disease, and such requests would be rare, but people should have the choice.

The debate is an opportunity to talk about the importance of smear tests. We have all had the invitation and thought, “Oh goodness, I’m not really sure I want to go for that.” But it is vitally important that people have the test if invited, and I hope this debate will make people think about the importance of having a smear test. Cervical cancer is a real problem, and the hon. Member for Basildon and Billericay (Mr Baron) rightly talked about early diagnosis and said that that was a problem across various types of cancer. The biggest challenge we face in fighting cancer is getting people to come forward early, and my view is that that is more of a problem in areas of social deprivation. I know from Merseyside, my home patch, that in such areas people are likely to have busy lives, perhaps less awareness, and a bit less confidence and are perhaps working shifts. They may be concerned about symptoms but put their concerns aside, for whatever reason, and the possibility of diagnosis gets later and later.

We need to recognise the differential prevalence of late diagnosis in different areas, and we should ask what we can do to recognise and address the various social and economic factors that can cause late diagnosis.

[Lyn Brown (West Ham) (Lab)]

I am listening to my hon. Friend’s speech with interest and she anticipates many of the points that I want to make. Does she agree that women often put themselves last, behind their family, and there are always other pressing issues to be dealt with rather than a routine cervical smear? Somehow we have to get it across that the smear test is as important as anything else they have to do.

[Alison McGovern]

In my slightly cack-handed way, that is what I was trying to say. Women are incredibly good at putting off things that concern our own health, which is why it is important that our brothers, fathers, husbands and friends encourage us to be concerned about our health and to look after ourselves. It is also important that we make the point today about the importance of smear tests. People should have a choice and be able to talk to their GP about having a test if they need one, and if invited to be screened, they should take up the invitation.

--- Later in debate ---

[Lyn Brown (West Ham) (Lab)]

Let me begin by offering my condolences to Sophie’s family, and thanking the Backbench Business Committee for scheduling the debate.

As we have heard, cervical cancer, although rare in women under 25, can be far more aggressive than cancers developed by older women. As we saw in the tragic case of Sophie’s death, her cancer had a devastating effect although she was only 19. The smear test that Sophie requested would have shown abnormal tissue growth in her cervix, and, although it might have been too late to save her life, the fact that she was refused that test is tragic. We must all learn the lessons of her death, and seek new and better ways of dealing with such cases.

Newham has a lower incidence of cancer than many other areas, but, sadly, our mortality rate is higher, owing mainly to late presentation. In 2012 the London-wide mortality rate was about 112 deaths per 100,000 cases, while in Newham it was 123 deaths per 100,000 cases. There have been instances in which stage 4 cancer has presented itself for the first time in A and E departments, and we know that there is no stage 5.

As we heard from my hon. Friend the Member for Wirral South (Alison McGovern), there is a relationship between deprivation and death from cancer. Social and economic deprivation have a severe impact on health, as has been shown by countless reports and studies. The figures for London and England clearly demonstrate that deprivation contributes to the incidence and types of cervical cancer, and to the survival rates of sufferers. The mortality rate among those in the 30 most deprived areas is nearly double that among those in the 30 most affluent.

Although the deprivation in Newham means that poor health is more prevalent there than it is in other areas, excellent work has been done in the borough, especially in our schools. Newham is also building on its current 90% coverage of the human papillomavirus vaccination programme. It is one of only two areas to have achieved that target, thus helping to prevent cancer despite the barriers to screening uptake. However, as we know, HPV immunisation does not entirely eliminate the risk of cervical cancer. That should be explained clearly to young women who take part in the programme, which is what is being done in Newham.

Regular smear testing is the only way in which individuals can be sure that their health needs are being met. In the case of cervical cancer, the take-up of screening services in Newham was just 22% in 2012-13. That is nearly 2% less than the figure for the previous year, and below the average figures for London and England, which, sadly, are only marginally better. Poor survival rates in deprived areas are arguably due to low take-up of screening, which results in the cancer presenting itself at a later and more advanced stage.

I am pleased that the Government have said that they aim to match European survival rates and, in doing so, save approximately 5,000 more lives, but it worries me that no indication has yet been given of how that will be measured, or, indeed, whether the targets are being met. Cancer networks, which were established in 2000, are currently being replaced by strategic clinical networks, which will deal not only with cancer but with maternity, mental health and dementia. Many professionals have suggested to me that, given that the new networks will cover a wider clinical range and a larger geographic area and will retain fewer dedicated cancer network staff, the overall decrease in funding may well lead to an inconsistent and unreliable service. I think that the Government should heed those fears and examine the allocation of resources to ensure that the areas with the greatest need receive appropriate funding, thus reducing the disparities in life expectancy and survival between the least deprived and the best off.

There is ample evidence of the need for awareness of conditions such as cervical cancer to be kept at a high level, and that requires continual effort. Following the death of Jade Goody in March 2009, 70% more women than the normal average were given smear tests, and I must admit to being one of them. I am sure that I am not the only woman in the Chamber today who has found other things to do rather than nipping down to the doctor for that very quick, clear test. Most of those who were tested were aged between 25 and 39, which is the age group with the lowest rates of attendance for screening. That is understandable, given that smear tests can be very uncomfortable and even painful in some instances, but we still need to have them.

Owing to the nature of the populations of Newham and, I assume, similar areas, national awareness campaigns struggle to have a fully effective impact in our communities. We need to understand why that is, and take action to deal with it. I am grateful to Newham’s fantastic Community Links charity, whose awareness campaigns have been very proactive. It has been instrumental in driving up screening rates, and its work in schools has ensured that its message reaches not only children throughout the borough, but their families at home. Children are a great way of getting to parents, and nagging them to pieces.

I know that the aim of this debate is to ensure that other girls, unlike Sophie Jones, can have their concerns heard. Much more needs to be done to educate young women about the detectable symptoms of cervical cancer, and it is imperative for the NHS to remove as many of the barriers to screening as possible. I urge the Minister to look at the excellent work of Community Links, and to consider whether the action that it has taken on behalf of my community can be learnt from and prove relevant in other parts of the country.

--- Later in debate ---

[Jane Ellison]

As I said, the hon. Gentleman presented quite a detailed statistical submission and I shall respond to him after the debate rather than off the cuff. His statistics deserve better than that.

Cervical cancer is thankfully very rare in women aged under 25. As has been said, there were 47 cases in England in 2011, the last year for which we have figures. That is less than 2% of all cases and there were two deaths. Obviously, we will consider the statistics presented by the hon. Member for Cheltenham (Martin Horwood), but we are aware that in 2009-10—this also relates to the points made by other hon. Members, and most strongly by the hon. Member for West Ham (Lyn Brown), about health inequalities—an extra 600,000 women came forward for screening, many as a result of the publicity surrounding the death of Jade Goody. Many of those women were from lower socio-economic and hard-to-reach groups, and they are more often at risk. That is an important statistic and we need to consider that again.

It may help the House if I briefly run through the science behind the abnormal screening results in younger women. Primarily, they are caused by the fact that they have a high rate of HPV infection, as the cervix in young women is more prone to infection with transient HPV, both because it has not yet matured and because younger women might be exposed more often to different types of HPV. Furthermore, some of the few cancers found in young women are unusual and rare tumours that differ from the type we screen for, such as small cell tumours that can develop rapidly and are very dangerous. However, some are HPV-associated tumours that develop at a young age and sometimes simply as a rapidly developing cancer. The key thing in such cases is rapid referral and an appropriate medical response.

In its 2009 report, the ACCS was concerned that young women presenting to primary care with symptoms of cervical cancer were not always given the best advice. I know that that will be a concern not only to Sophie’s family but to all of us in this House and to the NHS. We know that for many GPs, seeing a patient with cervical cancer is rare, and potentially only one GP in 16 will see a new case each year. That is quite a statistic. To help GPs make the right clinical decisions, new guidance for primary care on the management of young women with gynaecological symptoms was developed and sent to all GPs in England in March 2010. The guidance was developed by a multi-disciplinary group, and supported by all the relevant royal colleges. I undertake to raise the issue again with the Royal College of Obstetricians and Gynaecologists and the Royal College of General Practitioners to explore the best way to remind GPs of the guidance.

I reiterate that whatever her age, if a woman is concerned about abnormal symptoms she should contact her GP, who will be able to examine and refer her urgently to a gynaecologist if clinically appropriate. The House might not be aware that the guidance is explicit that in any case where a woman is showing symptoms, best practice is that she should not be referred for screening. That is because a cervical screening test is aimed at women without symptoms. It is a screening, not a diagnostic test, and waiting two weeks for the result could delay examination by a gynaecologist. That is a really important point to bring out in the debate. If someone has symptoms, we want to get them urgently from symptom to diagnosis via a referral, and a screening test could further delay that.

I want to talk a little, as others have, about the human papilloma virus, or HPV. Many Members have mentioned the fact that we have identified high-risk types of the virus and that the vaccination programme sprang from that identification of risk. The programme was introduced in 2008 for girls aged 12 to 13. Its aim was to prevent cervical cancer related to the HPV types covered by the vaccine, which covers about 70% of all cervical cancers. The programme has been a big success. More than 7.8 million doses have been given so far in the UK since 2008, and we have among the highest rates of HPV vaccine coverage in the world, with 86% of girls eligible for routine vaccination in England in the 2012-13 academic year completing the three-dose course, and 90% receiving at least two doses.

It may be of interest to Members to hear that the Merseyside area team reports a higher than national average take-up of the HPV vaccine, with 87.8% of girls vaccinated with all three doses in 2012-13. In Wirral and Sefton, that figure was 90%. However, we cannot be complacent and we want to get the fullest possible coverage. That is something about which MPs, as well as Ministers, can do a lot to spread the word. When we go into schools, a good question to ask might concern the coverage and whether there are particular groups of parents or people from particular backgrounds who do not take up the vaccine.

It is expected that the programme will eventually save more than 400 lives a year from cervical cancer. The first indication that the programme is successfully preventing infection with HPV types 16 and 18 in sexually active young women in England was published in the scientific journal Vaccine, and showed that the proportion of infected rates in 16 to 18-year-olds fell from 17.6% in 2008 to 6.6% between 2010 and 2012. That is major progress, so the take-up of the vaccine is really important.

We encourage all girls, irrespective of religion or ethnic background, to receive the HPV vaccination. NHS England is responsible for making arrangements to implement the programme for eligible girls and young women in the local area, taking into account local circumstances, such as the number of independent or special schools and the number of girls who are not in school. Interestingly, I was informed that Surrey has a much lower take-up, so perhaps we need to consider how to deal with girls in independent schools, or other local circumstances. NHS England is also responsible for ensuring that local programmes meet the national specifications.

We are using our growing knowledge of HPV to modernise the NHS’s cervical screening programme by considering HPV infection alongside the screening programme and looking for abnormalities and seeing how they can interact. Public Health England is also promoting the use of the HPV test as a primary screen, which is very interesting. A lot of work is going on, and the first evaluation report of the pilot is due in spring 2015. Cancer Research UK has estimated that, when fully implemented, HPV primary screening could prevent hundreds of cancers a year.

There are some particular matters to which I would like to draw the attention of the House, as I have a little time. The Prime Minister’s £50 million GP access fund will support more than 1,400 practices covering every region to offer extra services for those who struggle to find appointments that fit in with family and work. That is important and responds to one of the points made by the shadow Minister.

I hope we can show that despite tragic cases such as Sophie’s, the age at which screening starts in England is based on sound evidence. It has been carefully considered by members of expert committees pretty recently. However, I am very aware that we need to keep all evidence under review. I have already had a brief conversation with the chief medical officer about this. Members may be aware that one of my fellow Ministers is a specialist in this area of medicine, so we will make sure that we look again at the points that have been made in the debate.

There is much we can do as a House and as a country to reduce the number of women who suffer from this devastating disease. I urge every woman invited to screening to take up the opportunity, as we know that 25% of women in the 25-to-30 age group do not. On screening, I do not have time to describe the work in detail, but I can assure Members that Public Health England has work under way specifically to look at low coverage in certain areas and to work on local action plans to improve that coverage.

I want to do more to urge employers to support their staff. Again, evidence from Jo’s Cervical Cancer Trust, representatives of which I met on Monday evening and discussed some of these issues with, suggests that many younger women do not want to ask an employer for time off for a smear test. I will look at what we can do through work that is already going on with employers to see how we can encourage them to make it clear to young women that they do not have to go through an embarrassing conversation to get time off for that. I will be looking at that further with Jo’s Cervical Cancer Trust.

If Members who called the debate and spoke in it have the appetite for it, I am happy to devote a special day in Parliament to what we can do on take-up of screening and of HPV vaccination. I would love to do that piece of work with hon. Members if they want to work with me on that, because much of this is down to local and specific community factors. A one-size-fits-all national programme is not adequate. As part of Be Clear on Cancer, we have a pilot programme on ovarian cancer which will be running this spring, so we are moving into those gynaecological issues. We will look at the review of that to see whether there is more we can do in this area. Work is under way, but there is so much more we can do working together.

[Lyn Brown]

I am grateful to the Minister and I will certainly take her up on that. May I remind her of the hysteroscopy campaign, which we could perhaps dovetail into that work?

[Jane Ellison]

Of course. I remember that I responded to the hon. Lady on the detail of that.

I have started to write routinely to the chairmen of health and wellbeing boards to make them aware of issues that are of interest to parliamentarians and changes in law or guidance. I undertake to mention this subject, particularly in the context of Sophie Jones’s case, in my next letter to health and wellbeing board chairmen, to draw it to their attention. There is a 1 million study under way by the National Institute for Health Research under its health technology assessment programme to look at the issues of effective interventions for younger women on the take-up of screening, so work is in progress.

Oral Answers to Questions

Lyn Brown Excerpts

Tuesday 25th February 2014 Commons Chamber

[Mr Hunt]

I know that my right hon. Friend showed great interest in this issue when he was in my Department. When I say that the strategy is here to stay, I mean that it is here to be refreshed and updated. We are subscribing to some big new ambitions, including that by the time of the next election two thirds of people with dementia will be diagnosed and have a proper care plan and support for them and their families. That is a big improvement on the 39% of people who were diagnosed when we came to office. There is much work to do, but I assure him that we are absolutely committed to delivering.

[Lyn Brown (West Ham) (Lab)]

Some hospitals are making a virtue out of quick discharge for their stroke victims. Is the Secretary of State convinced that elderly stroke victims, perhaps those without people to advocate on their behalf, are getting appropriate care and that their care and rehabilitation are not being scrimped on or rationed?

[Mr Hunt]

No, I am not convinced. We need to do much better when it comes to the discharge of vulnerable older people, especially when they leave hospital not cured and still with a long-term condition. They may be recovering from a stroke or dementia or any other condition. We need to have much better links between hospitals and GPs and to have named accountable GPs in the communities looking after those very people.

Health Care (London)

Lyn Brown Excerpts

Wednesday 8th January 2014 Westminster Hall

[Lyn Brown (West Ham) (Lab)]

I will take the suggestion with the severity with which it was meant, Mrs Main. I congratulate my hon. Friend the hon. Member for Westminster North (Ms Buck) on securing this debate.

I want to reflect on some of what my hon. Friend said at the beginning of her speech and on the sentiments of a letter to The Guardian before Christmas from GPs, emergency doctors and nurses, midwives, physiotherapists, psychotherapists and NHS trusts. Their plea was for a page to be turned in the way we talk about the NHS. We need to talk about the failures in patient care, but we must also recognise that we have some extraordinary abilities in the NHS to reach and look after our communities as well as they do. Sadly, I have been close to the NHS in the past three years, and I have seen excellence and the pits. However, in general, the people who work in our hospitals do a fantastic job.

I wholeheartedly endorse the sentiments of that letter because I fear that the driver for the relentless daily trashing that the NHS receives comes from base political motivation—the softening up of public opinion so that marketisation and privatisation become acceptable. It will not be acceptable. It is not acceptable now and I do not believe it will ever be acceptable, so let us just stop it.

I am not the only one to mistrust the motivation and outcome of the coalition’s top-down, unwanted and wasteful reorganisation of the NHS. I did a survey of my constituents—I like to find out whether my impressions are the same as theirs—and 97% of those who responded said that the NHS would undoubtedly get worse under the new system. When they were asked about their main concern, 60% thought that the money intended for NHS staff and services would end up as profit for private companies. My constituents are very astute.

I want to turn to local circumstances before I am coughed at. In 2006-08, life expectancy for men in Newham was 75.8 years, lower than the London average of 78.2 years. In the same period, life expectancy for women was 2.3 years below the London average at 80.4 years. Even within my borough, there are variations that make the local situation much more complex and challenging. Life expectancy in some wards is 8.1 years shorter than in others. That is massive.

In primary care, the recommended ratio of GP provision is 1.8 GPs per 1,000 of population. In Newham, the ratio is appalling and equates to not much more than half that, at 0.56 of a GP per 1,000 of population. It is small wonder that in my survey, 35% of respondents reported that it is never easy to get a GP appointment, and just 10% said that it is always easy. Many practices—too many—are operated by single GPs, so it is no surprise that the patient experience in Newham is the worst in north-east London.

The primary care trust, before its abolition, had a clear plan for tackling that challenging situation and I enthusiastically endorsed and participated in it. Now, there are no mechanisms in place to root out poor practice and promote the best. I would like to hear from the Minister how she will ensure that Newham has the number of GPs to which we are entitled and that we have performance and outcomes that are the same as other areas of London.

Incidentally, I would be interested to hear whether other hon. Members here are experiencing the new phenomenon that we have in Newham: dial a diagnosis. When people contact their GP to arrange an appointment, they are initially offered a telephone conversation with the GP. Is that because GPs must bolster the failing 111 non-clinical service, which is now contributing to the difficulties of our A and E departments? Is it to save money, to sift out or deter patients or to ration GP time? Has there been a risk assessment of what that might entail, and does it contribute to the problems that my community is facing? Again, I would like to hear from the Minister about that.

Another statistic from Newham that should be good news is that the incidence rate for breast cancer is 104.6 per 100,000 of population, significantly lower than the UK average of 123.6. However, disturbingly and distressingly, the percentage of women alive five years after diagnosis—the five-year survival estimate—is, at 75%, also significantly lower than the UK average of 83.4%. The reason in part is the take-up rate of breast screening services, but there is anecdotal evidence of women who were part of Barts hospital’s preventative health services being encouraged to go away and become part of the general population, and to present sometime in the future. That encouragement not to continue to attend for breast screening gave a rosy picture of health needs.

The London Health Commission, under the chairmanship of Lord Darzi, has a remit that includes healthy lives and reducing health inequalities. I will be interested to hear what the Minister says in anticipation of the commission’s report, and what assurance she can give that the Government will act on health inequalities.

Let me refer to the Barts health care trust, which is the largest in the country and incorporates Barts, the Royal London, Whipps Cross and Newham general hospitals. Our patch is the growing part of London, with growth in population, complexity, the number of homes and, of course, opportunity. I was therefore grateful to hear the hon. Member for Cities of London and Westminster (Mark Field), who made a well balanced speech, talk about resources being sucked into the large university hospitals in the centre. Even though those of us on the far-flung borders of the east belong to the same trust as one of those hospitals, we experience the difficulties he talked about in relation to Romford.

Rumours abound at the moment that Newham general, as part of the Barts trust, is under threat of reconfiguration—a fascinating new word—to secure the viability of the trust as a whole. When I talked to the trust’s chief executive, he told me that the PFI represented only 10% of the trust’s entire budget and that, given that the budget was large, he did not see the PFI as having major consequences for the delivery of services.

However, there is an accusation that the trust is being a little disingenuous in its public statements that the A and E at Newham general will not be closed. Assurances have been sought that there will be no downgrading without full consultation, but those look weak in the face of a shortage of anaesthetists, for example, who are essential to support a viable emergency service.

Almost half of London trusts are struggling to achieve the 95% standard for patients waiting in A and E. Barts trust is just about achieving that target, but that is because Newham general performs well and helps the trust’s overall performance—a good example of how a local acute hospital catering for a place such as Newham can perform well, while larger hospitals struggle. Given that the future of Newham general’s A and E is under threat, the irony of the situation is not lost on me, and nor will it be lost on my constituents.

In that scenario, it is essential that we maintain Newham general as a fully functioning major acute hospital with a full range of services, including A and E and maternity. Given that we are seeing growth out to the east, it would be irresponsible and downright dangerous for us not to do that. It would also be a complete distraction from the absolute priority of putting in place improved, integrated care services in the community and in primary care.

Finally, I seek assurances from the Minister about the funding formula for CCGs being rolled out across England. In the London context, it is shifting resources from inner-London boroughs, with their younger populations, to boroughs further out, which have older populations.

Newham just happens to have the youngest population in the whole of Europe, apart from some tiny canton somewhere that is almost irrelevant. We will therefore lose substantial amounts, while London as a whole is losing 2.3% of its funding to other areas. I would like reassurance from the Minister that the funding formula will fully take account of deprivation, as the hon. Member for Cities of London and Westminster said, as well as of our population’s high mobility, with the health problems that brings with it, and diversity, with the specific demands that that puts on health care.

Accountability and Transparency in the NHS

Lyn Brown Excerpts

Thursday 14th March 2013 Commons Chamber

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Before the hon. Lady responds—[Interruption.] I am sorry, but does the Opposition Whip have something to say?

[Lyn Brown (West Ham) (Lab)]

No.

[Mr Deputy Speaker]

Thank goodness for that.

We need short and concise interventions, because many Members wish to speak and I do not want to have to reduce the time limit further, but that is what will happen if we are not careful.

--- Later in debate ---

[Kate Hoey (Vauxhall) (Lab)]

It is a pleasure to follow the right hon. Member for Charnwood (Mr Dorrell), who speaks with a breadth of experience and history in the national health service, and I congratulate the hon. Member for Bristol North West (Charlotte Leslie) on securing this long debate, providing an opportunity to all of us to say a few words.

I agree wholeheartedly with everything my hon. Friend the Member for West Lancashire (Rosie Cooper) said, particularly about what seems to me, too, to be a growing public body desire for secrecy. This is happening not in the national health service alone, but in many other bodies. Indeed, as my hon. Friend well knows, it is happening in this House. I am concerned about a number of issues—how staff are treated, getting rid of the telephone exchange and a whole number of other decisions taken up there somewhere. We, as Members who work here, have very little say.

It is important for us to remember the Nolan principles of public life to which every public body is meant to sign up—accountability, openness, honesty and leadership. I do not want to say much specifically about what happened in Mid Staffordshire, but it was appalling. As someone who has had a good and well-led hospital in my constituency for many years, I find it almost unbelievable that all that could have happened in the Mid Staffordshire hospital with so few people seeming to know what happened or to speak out about it. Then, when it was pointed out, no one listened. That provides a terrible warning about what can happen. We all think that we know what is happening in our constituencies, but we do not always, as this episode has shown.

Let me talk about my local hospital Guy’s and St Thomas’, King’s College hospital and SLAM—the South London and Maudsley hospital. What has been called the “King’s Health Partners” has sought to bring together the research work at King’s College medical school with others, and the body is now growing to be almost an entity in itself, making decisions, sending out publicity and getting further and further away from the foundation trust.

Looking back to when my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) was Secretary of State for Health, some of the decisions he made in the Health Act 1999 were more about accountability than anything that has been done since by any Government. For example, he instructed NHS chairmen to hold their board meetings in public, while non-executive directors were required to live in the area served by the trust—a crucial step that fundamentally changed St Thomas’ hospital when we had a local chairman who knew the area, was involved in the hospital and cared about it. She spent all her time as chairman wandering around the hospital trying to find out about everything that was going on: she was accountable to everyone. That was crucial to the public, too, as they knew that they had people on the board who knew what was happening in the locality.

I believe that one of the first responsibilities of non-executive directors—they are not part of the management —is to visit the wards, to talk to patients, to collate local concerns and to talk to MPs, local councillors and the local authority. That was always happening. We had a very good system. There were concerns about the treatment of the elderly at one stage in one of the wards for elderly people at St Thomas’, but they got dealt with very quickly because we had a responsive chairman and a responsive board. A lot of that happened when my right hon. Friend the Member for Holborn and St Pancras was the Secretary of State. The Health Act 1999 also gave the chief executive officer absolute personal responsibility for clinical governance standards—another important reform—in addition to the responsibility to be the accountable officer.

Later we had foundation trusts, although I have to say that I did not vote for them. I have had a well-led foundation trust up to now, but I did not feel that this was the right way ahead for the national health service at the time. We have got them, however, and some foundation trusts saw fit to erode the principles as financial considerations took precedence over clinical standards on many board agendas. The foundation trusts still remain the chief executive officer’s responsibility.

One thing the King’s Health Partners are doing in the name of foundation trusts is steamrolling ahead to bring about a merger of Guy’s and St Thomas’ hospital, which is a huge trust, King’s College hospital, which is another huge trust, and the South London and Maudsley trust. It is believed that the merger will somehow lead to a “world-class”—I do not know how many times Members have heard the term—hospital.

I am furious and angry—as are, I think, all five of the MPs representing the area at how this merger has been handled. The lack of openness has been appalling and there has been no public board meetings or disclosure of information about the proposed changes. The proposals have been either badly put forward or not put forward at all. The board at St Guy’s and St Thomas’ has an occasional surreal meeting as a showcase for public involvement, but it never discusses the real issues. It opens meetings for the public only when it suits the board.

[Lyn Brown]

Does my hon. Friend agree that the plans for reorganisation of the trusts south of the river need to be put on hold?

[Kate Hoey]

That is precisely what the five Members of Parliament have asked for. Recently, on 28 February, we heard from the chairman of Guy’s and St Thomas’, who was previously a permanent secretary at the Department of Health. That takes me back to one of my earlier points about people moving around within the health service. It is always somebody who has been someone else in somebody else’s patch that gets a job with another NHS trust. This chairman wrote to say that the project is forging ahead with a full business case. William McKee, who brought together trusts in Northern Ireland, has been appointed and we are told that he is going to spend at least £5 million to bring about the business case to show why this will be such a wonderful idea. The right hon. Member for Bermondsey and Old Southwark (Simon Hughes) and I have written back asking who is actively responsible, how the money from the different bodies is being allocated, what the precise budget will be and how it will be spent by whom. The whole accountability thing is there in a nutshell. Who is actually accountable? Does the Secretary of State have any say whatsoever? No. Apparently he is only interested if the move will clearly not be good for patients in clinical terms.

I know that the establishment of such a large trust will be totally against the interests of people. Trusts cannot operate on such a large scale. One chief nurse cannot be responsible for all those hospitals.

NHS Funding

Lyn Brown Excerpts

Wednesday 12th December 2012 Commons Chamber

[Mr Hunt]

I will make a little progress before giving way.

[Lyn Brown (West Ham) (Lab)]

rose—

[Mr Hunt]

I said that I would make a little progress, if that is all right.

I must confess to being both surprised and delighted at this afternoon’s motion, because I would have thought that the last thing the right hon. Member for Leigh (Andy Burnham) would want to do was remind the nation of his opposition to our increasing the NHS budget. The motion is about spending, but we can spend only what is in our budget. What did he say about budget and spend during his failed bid for the leadership of his own party? [Interruption.] I think that right hon. and hon. Members on the Opposition Benches should listen to what those on their Front Bench are saying. He said:

“It is irresponsible to increase NHS spending in real terms”.

So let me ask him to clarify this to the House: does he stand by his comment that it is irresponsible to increase NHS spending?

--- Later in debate ---

[Lyn Brown]

Will the right hon. Gentleman confirm just how many nurses’ jobs have been cut on this Government’s watch?

[Mr Hunt]

I will confirm for the hon. Lady that the nurse-to-bed ratio has gone up so that nurses are spending—[Interruption.] Perhaps the Opposition will want to hear about issues of care. The average bed is getting two hours of nursing care per week more than under Labour.

Let me give the right hon. Member for Leigh another chance to clarify Labour policy on health spending. In Wales, Labour has announced plans to cut the NHS budget by 8% in real terms despite an overall settlement protected by Barnett. Given that the motion condemns an alleged cut in NHS spending, will he, once and for all, condemn the choice that Labour made in Wales? If he does not want to do that, let me tell him what the British Medical Association says is happening in Wales. It talks of a “slash and burn” situation and “panic” on the wards. Would he want that to be repeated in England? If not, he should not sit idly by but have the courage to condemn the choice that Labour has made in Wales.

While we are on the subject of Wales, the right hon. Gentleman will know that NHS patients there are five times less likely to get certain cancer drugs than English NHS patients, but the Labour Welsh Health Minister has said it would be “irresponsible”—the same word that the right hon. Gentleman used—to introduce a cancer drugs fund in Wales. Does the right hon. Member for Leigh support what Labour is doing with regard to cancer drugs in Wales—yes or no?

Mental Health

Lyn Brown Excerpts

Thursday 14th June 2012 Commons Chamber

[Lyn Brown (West Ham) (Lab)]

It is a pleasure to follow the thoughtful contribution of the hon. Member for Worthing West (Sir Peter Bottomley). I am very glad to be in the Chamber to speak alongside those who have made exceptional speeches today, including my hon. Friend the Member for North Durham (Mr Jones) and the hon. Member for Broxbourne (Mr Walker) to name just two.

I will highlight three things. The first is the key factors that are linked to mental well-being and the characteristics of my local borough of Newham. The second is what resources are available to my local health authorities and mental health services. The third is the need for those resources to be improved in the light of what we know works in improving mental health.

The need for a robust strategy to promote well-being is illustrated by the correlation between the determinants of mental ill health and some of the characteristics of the population of my borough. As my hon. Friend the Member for Vale of Clwyd (Chris Ruane), who is no longer in his place, attested so powerfully, one such determinant is age. The rates of mental illness vary across age ranges, but it is a sad fact that younger people are more likely than the elderly to experience mental ill health. A high proportion of mental health problems develop between the ages of 14 and 20. One in 10 children between the ages of five and 16 have a mental health problem, and such problems may well continue into adulthood.

The borough of Newham has one of the youngest populations in the country. The number of young people with mental health problems is therefore greater than elsewhere. Some 40% of the borough’s population is made up of people under the age of 25. As nearly 10% of people aged between five and 16 experience mental health problems, statistically we can expect 4,262 of the children and young people in Newham to experience such problems. That clearly has an impact on the needs of the population of Newham and on the type of service that it requires. It should be funded to cater for those needs.

We all know that there are other important determinants of the mental health of a community. One of those is deprivation. Common mental disorders such as depression, anxiety and obsessive compulsive disorder are more prevalent in deprived households. Again, Newham suffers from high levels of deprivation. It is ranked the third most deprived local authority in the country and 51.5% of its children live in poverty. The index of deprivation ranks the borough fourth in the country for the proportion of children aged between nought and 15 living in an income-deprived household. That is just one measure of deprivation, but I am sure hon. Members will agree that it is a worrying one.

In addition, the decline of owner-occupation and the increase in the private rented sector changes the very nature of local communities. Support networks that people rely on—their friends and family, and wider communities such as their Church and faith—are disintegrating as housing pressures force families to move home, leave their communities or remain in overcrowded, sometimes unhygienic and often poorly managed private rented housing, which is sadly a fast-growing sector of tenure in the London borough of Newham.

In my constituency, there is a high level of need for services that will enable the people of Newham to be self-sufficient and lead independent, successful lives. My concern is that the process used to allocate the resources needed to support those services is fundamentally flawed. It is skewed in a way that significantly disadvantages my community.

Since 2006, if not earlier, the population estimate for Newham has clearly been an underestimate by the Office for National Statistics. The under-count was estimated at about 60,000 people until, in November 2011, the ONS went some way towards recognising the historic underestimate by provisionally estimating the population at 272,000, an increase of 32,000. That significant increase of 13% is, by the way, the largest change in any London borough. However, the new figure still falls some 30,000 short of the population estimate made by an independently commissioned study. That is a shortfall in excess of 10%.

The real population of the borough stands at roughly 300,000. That is the figure that should drive resource allocation, because it relates to the real world and real need. However, the ONS mid-year estimates are used to determine how the national funding pot is allocated to local areas, even though they do not accurately reflect the true population of my area. Given the level of need in my constituency, to say that resources are not allocated on a level playing field is an understatement.

The effect of an inadequate allocation system is compounded by a reliance on historical spend to determine current needs. That means that my local primary care trust has consistently struggled to find resources to deal with persistent need. Figures in the House Library tell me that expenditure per head on mental health in Newham in 2010-11 was £208.93. That compares with £447.21 in Westminster and £331.81 in Kensington and Chelsea. I wish to hammer home the point that the spend for Newham is based on the ONS population estimate, so the real spend per head is even lower.

The shadow health and wellbeing board for the London borough of Newham has discussed the matter at length and agreed a robust strategy, with a clear focus on maintaining resilience within the community. It wants to support people by ensuring that they possess the skills and resources that will enable them to negotiate successfully the challenges that they experience.

Let us face it: we know from evidence what works. The health and wellbeing board has indicated that it wants to focus its activity on parenting skills and pre-school education to set up an early family environment that supports children’s emotional and behavioural development. It wants to support lifelong learning, with health promotion in schools and continuing education, as schools are a really important resource, particularly for children facing difficulties at home.

The board also wants to find a way of improving working lives in the borough, as one in six people in the work force are affected by mental health problems, and a way of supporting a good and healthy lifestyle by encouraging exercise and good diet. It wants to encourage the learning of new skills and the taking-up of creative pursuits—social participation that promotes mental well-being across the piece. The board is also supporting communities through environmental improvements. Environmental predictors of poor mental health include neighbourhood noise, overcrowding, fear of crime, poor housing and so on. Finding out what to do is frustrating, but it is also frustrating that resources are being rather unfairly allocated. Newham is poorly served in that regard.

I thank the Backbench Business Committee for creating this opportunity to discuss an issue that is often invisible, and on which there is not enough focus and debate. Poor mental health has an extraordinarily detrimental impact on huge numbers of people in our communities. We could and should be dealing with the problem in a plethora of holistic ways in our local communities.

Newham is severely under-resourced in the face of significant pressures on mental health provision. I am glad to see the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), in the Chamber. I know he has listened to me and, given that he is a former Whip, that he is a very honourable man. I shall write to him to push the case for greater funding for Newham as we continue to fight for the resources that my communities desperately need to access better life chances, which includes better mental health.

Health and Social Care Bill

Lyn Brown Excerpts

Tuesday 13th March 2012 Commons Chamber

[Jonathan Reynolds]

No, sit down and listen for once.

It is clear that the majority of non-biased, objective opinion is against the Bill proceeding. Never in the field of public policy have so many opposed so much and been listened to so little.

Should the Government not be asking themselves this: if the Health Secretary cannot convince the people who he wants to devolve power to, and if the Deputy Prime Minister cannot convince his own party members to support the Bill, maybe—just maybe—there is not that much going for it? The Health Secretary cannot even visit an NHS hospital, so low has his reputation sunk.

As has been said, the people who oppose the Bill, whether the royal colleges or Opposition Members, do not oppose all reform. Of course, NHS services will have to change over time, particularly in the provision of specialist services. The Labour Government introduced reforms, which used the private sector to the advantage of the NHS. The Bill does the opposite and uses the NHS for the benefit of the private sector. The problem is not reform, but these reforms. To say that anyone who opposes the Bill is against all reform is crass and simplistic.

Let us please put an end to the nonsense that the reforms are just an evolutionary approach following what has happened in the past. If that were the case, would there be an unprecedented groundswell of opinion against them? Once the Bill is passed, the primary care trusts and the strategic health authorities will be gone, and clinical commissioning consortia will be responsible for the whole NHS budget. Local authorities will take public health, and Monitor and the NHS Commissioning Board, not the Department of Health, will be responsible for the health system. That is a fundamental, top-down restructuring of the NHS, and no one wants it.

To justify that revolution, the Government started by rubbishing the success of the NHS. It began with the cancer survival rates and carried on from there, and every time the Government’s case has been knocked down. The King’s Fund, the respected health think-tank, in its review of NHS performance since 1997, clearly showed dramatic falls in waiting times; lower infant mortality; increased life expectancy across every social group; cancer deaths steadily declining; infection rates down, and in mental health services, access to specialist help, which is considered among the best in Europe. Again, I put it to the Government that they have no justification for the revolution that the Bill brings about.

The Government’s other justification has been that the NHS has too many managers, yet their reforms create a structure so confusing that, when an organogram of the new structure was published, it became a viral hit on the internet because it looked so ludicrous. What do the experts in the King’s Fund say about this? The myths section about the Bill on its website says:

“If anything, our analysis seems to suggest that the NHS, particularly given the complexity of health care, is under-rather than over-managed”.

[Lyn Brown (West Ham) (Lab)]

During the Bill’s passage, it has struck me just how vulnerable my constituents will be to doctors who are not as good as many of those who currently serve them well. One of our opportunities in Newham with a decent PCT was to deal with doctors who did not provide the right care. Is my hon. Friend , like me, concerned about the vulnerability of many of our constituents if the Bill is passed?

[Jonathan Reynolds]

I agree with my hon. Friend. If the Bill is passed, perhaps one of the biggest changes will be to the relationship between doctor and patient. Every time a patient is not referred for some sort of specialist treatment, they will wonder whether that is on clinical grounds or because their GP has one eye on the budget. Whatever the basis for those fears, GPs will be in a difficult position, and because NICE guidance will no longer be compulsory, the problem will be compounded when people compare their experience with that of others, using the internet or other means.

However, the most worrying aspect derives from the stories that we hear from parts of the country where individual GPs might have a financial interest in the services that they now commission. Such a relationship would not only destroy the trust at the heart of the system, but provide perverse incentives for how it might develop in future.

NHS (Private Sector)

Lyn Brown Excerpts

Monday 16th January 2012 Commons Chamber

[Andy Burnham]

The point that I am making is about how to manage the system, how to ensure proper regulation and how to ensure that NHS providers and the system work in the interests of NHS patients. If the right hon. Gentleman is arguing that there would be the same control managing the system through a series of fragmented commercial contracts, I would be interested to have that debate with him. Frankly, I do not believe that he is being serious, if that is his point.

[Lyn Brown (West Ham) (Lab)]

I have been contacted by constituents who access their cancer and cardiac care from Barts and from the London hospital. They fear that as a result of the Bill their health needs will be deprioritised in favour of private patients who can afford to pay. What would my right hon. Friend say to my constituents about their fears?

[Andy Burnham]

I wish I could allay the fears of those people, but when there is a proposal placed at the heart of the NHS for hospitals to devote half their facilities—their beds, their appointments—to private patients, how is it possible to give that guarantee to those patients, particularly when the Government are relaxing the waiting time standards that we did so much to establish in the NHS, with the two-week wait for cancer referrals and 18 weeks for elective operations, and a four-hour wait in A and E? How can we have that confidence when, effectively, the Government are taking those safeguards off the public and giving the green light for a massive expansion of private sector treatment in NHS hospitals?

National Health Service

Lyn Brown Excerpts

Wednesday 26th October 2011 Commons Chamber

[The Secretary of State for Health (Mr Andrew Lansley)]

I ask the House to reject the motion. I am sorry about the tone of much of what the right hon. Member for Leigh (Andy Burnham) said. This was his first opportunity to make a speech about the NHS and I thought that he might take the trouble to thank NHS staff for what they have achieved over the past year, rather than disparage and denigrate everything they have been doing. I also thought that he might take the opportunity to approach the issues facing the NHS from the standpoint of patients, rather than simply playing politics with the service, but he did not. Insulting me was the least of the problems in his speech. It seemed like the Burnham memorial speech—clearly no hard feelings about losing the election, then. Having spent 13 years in the House in opposition, I shall—at the risk of patronising him—give him a few words of advice: do not keep fighting the election that you lost. It is not the way to win any future election, and it will carry absolutely no credibility in the NHS.

Equally, the right hon. Gentleman will carry no credibility by wandering around telling people that he was not planning to cut the NHS budget, given that he made it absolutely clear in The Guardian last year that that was exactly what he intended to do and that he told us, in the run-up to the spending review, that it would be irresponsible to increase the NHS budget in real terms. I searched the Labour manifesto for any commitment to funding the NHS in real terms, but there is none. In March 2010, he might have said that he knew all these things, but he did not tell the public about any of it—[Interruption.] Well, it is here in his manifesto. The only reference to any kind of investment in the NHS is a plan to

“refocus capital investment on primary and community services”.

[Lyn Brown (West Ham) (Lab)]

Will the Secretary of State give way?

[Mr Lansley]

In a moment.

We know what that meant, because when we opened the books on arriving in the Department we saw that Labour was planning to slash by more than half the capital budget of the NHS. Every Member of Parliament who has a major hospital building programme in their constituency would have been affected by that. That might include my hon. Friend the Member for Harrow East (Bob Blackman), who has the Royal National Orthopaedic hospital in his constituency, or Members from Liverpool, who have the rebuild of the Royal Liverpool and Broadgreen hospitals and, all being well, the rebuilding of Alder Hey. That might also include the hon. Member for Copeland (Mr Reed). The last Labour Government, before the election, cut the capital budget, and his project—the West Cumberland hospital at Whitehaven—could have been at risk as a consequence of that. [Interruption.]

--- Later in debate ---

[Mr Lansley]

Thank you, Mr Deputy Speaker. I will now give way to the hon. Member for West Ham (Lyn Brown).

[Lyn Brown]

I am grateful to the Secretary of State for giving way. Will he now admit that this is the first time that the NHS budget has seen a real-terms fall since 1996, the last year of the Tory Government?