Healthcare (International Arrangements) Bill (First sitting)

Maggie Throup Excerpts

Committee Debate: 1st sitting: House of Commons
Tuesday 27th November 2018 Public Bill Committees

[Julie Cooper]

Q Thank you. Mr Jethwa, would you like to comment on the same issue?

Raj Jethwa: It is important that an agreement can allow a seamless operation, but there are some well-established ethical principles and safeguards in relation to this. First, it has to be relevant data and it has to be accessed on a need-to-know basis, and only when it is in line with patients’ expectations. Data sharing has to be transparent. We would be absolutely concerned that any safeguards meet those criteria and principles. I do not think the details in the Bill make that clear at the moment. We would like to see more clarity and detail about that in future.

[Maggie Throup (Erewash) (Con)]

Q Mr Jethwa, when you look at the current regulations, do you think the powers in the proposed legislation are proportionate?

Raj Jethwa: We would like to see much more emphasis on scrutiny of all the discussions in the arrangements going forward. There are some negative procedures—I think that is the term. Given the weight of the issue and the number of people that could be affected by it—I have mentioned the 190,000 UK pensioners who live abroad at the moment, but there are close to 3 million people from the European Union who access healthcare in this country, and there are many more than that who travel across the European Union at the moment—there probably needs to be greater scrutiny of any arrangements going forward.

[Matt Western (Warwick and Leamington) (Lab)]

Q Mr Henderson, I think you described the existing arrangements as pretty well universal. Could you explain a little more what the gaps are?

Mr Henderson: I am not actually sure I have all the detail. My understanding is that the European health insurance card and such arrangements work for all emergency situations, certainly, and most normal circumstances. I think, and Raj may know better than I, that there are some areas that are not covered particularly, but as I understand it, it is fairly universal. I am not an absolute expert in that, I am afraid.

Raj Jethwa: We can write to the Committee. My opinion is that it is pretty universal. There are probably niche areas that may not be covered. We can look into that and get back to the Committee if that would be helpful.

Junk Food Advertising and Childhood Obesity

Maggie Throup Excerpts

Tuesday 16th January 2018 Westminster Hall

[Maggie Throup (Erewash) (Con)]

I beg to move,

That this House has considered the effect of junk food advertising on obesity in children.

It is a pleasure to serve under your chairmanship, Ms Dorries, for what I think is the first time. I thank colleagues across all parties for supporting my bid for this debate to the Backbench Business Committee, and I thank the Backbench Business Committee for understanding the importance of junk food advertising and its impact on childhood obesity and for granting this debate.

If hon. Members will excuse the pun, the size of the issue is getting bigger. Some 23% of children in reception are overweight or obese, rising to 34% of children in year 6, and the prevalence is higher for boys than girls in both age groups. Over the last 30 years, there has been a substantial increase in average weight in the UK and, at the same time, a decline in the quality of diets. It is predicted that if current trends continue, half of all children will be obese or overweight by 2020, which is just two years away.

Obese children are about five times more likely to remain obese in adulthood, so acting early can protect them from a lifetime of avoidable ill-health and disease. Obesity can lead to a number of serious and potentially life-threatening conditions, such as type 2 diabetes, heart disease and cancer. Recently, cases of type 2 diabetes have been reported in teenagers, although until now it has been recognised as a disease of older age. Obesity costs the national health service an estimated £5.1 billion and the UK economy £27 billion each year, so it is of the utmost economic importance that the obesity epidemic is addressed. I fear that those costs are grossly underestimated.

Obesity is strongly linked to socioeconomic deprivation. Findings from the most recent national child measurement programme show that inequalities in obesity prevalence between the most and least deprived quintiles of children in reception are widening faster than expected. Obesity is also twice as prevalent among children living in the most deprived parts of England than among those in the least, and patterns are similar across Scotland and Wales. That reflects the fact that families from lower socioeconomic backgrounds across the UK have the poorest diets, high in saturated fat and low in fruit, vegetable and fibre consumption.

Research also shows that the poorest UK households are exposed to twice as many television food adverts than the most affluent viewers. That exposure is problematic. Food advertising in the UK disproportionately features unhealthy food items, and young children are especially vulnerable to marketing techniques that promote unhealthy food. The pervasive harms of adverts place untold pressures on the poorest in society. Children with low nutritional knowledge are more likely than those with higher literacy to select unhealthy meals after seeing junk food adverts. Junk food marketing exacerbates health inequalities, especially among very young children and adolescents.

Over the last couple of years, there has been much focus on the impact of sugar on children’s health and the growing problem of obesity. However, we must not lose sight of the role that foods high in fats and salt play in the epidemic of obesity sweeping our nation. I am sure that Jamie Oliver’s visualisation of the amount of sugar in fizzy drinks in teaspoons helped the public to understand the issue, but we need to go further. The salt content of processed food has decreased over the past decade, mainly as a result of successful campaigning, and it is now common to find low-fat alternatives on supermarket shelves, but there is more still to do. As we focus our minds on trying to rid ourselves of those few extra pounds we mysteriously gained over the festive season, it is the right time to focus the Government’s mind on continuing measures to continue to tackle the obesity epidemic.

[Paul Blomfield (Sheffield Central) (Lab)]

I congratulate the hon. Lady on securing this debate, and she is making a powerful contribution about the scale of the crisis. Prevention is clearly more important than cure, but given where we are now, does she acknowledge that we also need to focus on cure? Does she share my concern that too few clinical commissioning groups are commissioning tier 3 services, which can make positive interventions to support seriously obese children?

[Maggie Throup]

I agree completely. We need to consider prevention, cure and treatment. It is a huge problem, and it will not go away unless we tackle every aspect of it. The hon. Gentleman makes a good point.

The debate in Parliament on the impact of junk food, by which I mean food high in fats, salt and sugar, is not new. I talked to somebody just last week who gave me the insight that we have been discussing it for getting on for 15 years—probably more than that, if we backtrack even further—and we still do not have the courage to ban the advertising of products with such a major impact on the health of our nation and our future generations.

Recently, the Select Committee on Health held an inquiry and produced a report, “Childhood obesity—brave and bold action”, followed up in a short report early last year. Both reports contained a strong call for a ban on junk food advertising before the 9 o’clock watershed, yet that was sadly missing from the Government publication “Childhood obesity: a plan for action”, introduced in August 2016.

I am delighted that new rules on advertising were introduced by the Committee of Advertising Practice in July 2017—their impact is still being analysed. The rules banned the advertising in children’s media of food or drink products high in fat, salt or sugar. The restrictions now apply across all non-broadcast media, including print, cinema, online and social media, but that does not solve the problem. In 2015, Public Health England recommended extending current restrictions to apply across the full range of programmes that children are likely to watch, rather than limiting them to children-specific programming. Yes, restrictions apply to advertising high fat, salt and sugar products during prime time, but only when the audience is made up of 20% children or more.

A recent study commissioned by the Obesity Health Alliance found that 59% of food and drink adverts shown during family viewing time would be banned from children’s TV, yet hundreds of thousands of children are exposed to them every week. In the worst-case example, children were bombarded with nine adverts for products high in fat, salt and sugar in one 30-minute period. Adverts for fast food and takeaways appeared more than twice as often as any other type of food and drink advert, while adverts for fruit and vegetables made up just over 1% of food and drink adverts shown during family viewing times. The study also showed that the number of children watching TV peaks between 7 pm and 8 pm, definitely not when children-only programmes are shown.

Although I recognise that advertising restrictions in the UK on high fat, salt or sugar products are among the toughest in the world, we need to be even tougher. The childhood obesity plan published by the Government in August 2016 states that it is only the start of the conversation. This debate aims to help continue that conversation and focus on other measures that the Government can take to stop and reverse the obesity epidemic.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Lady on securing this debate, which is similar to one that I secured six years ago in Westminster Hall. The situation has worsened considerably in that time. Does she agree that the plan that she just elaborated on needs action points from the Government along the lines that she has intimated? We need outcome targets so that the next generation of children will see a significant improvement, rather than the deterioration in the current generation.

[Maggie Throup]

I agree completely, and I thank the hon. Gentleman for that intervention. I was always taught that measures put in place with no targets or goals to meet are meaningless. We need to know where we want to be, and by when.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my hon. Friend on securing this debate. I am sure she will agree that the obesity problem is growing and that measures to tackle it have been wholly inadequate. As with smoking, when we know something is harmful, we need a step change in measures to deal with it. An out-and-out ban on advertising—other hon. Members may comment on that—and a consideration of how we could severely restrict how high fat, salt and sugar foods and drinks are sold may be ways to take the strategy forward.

[Maggie Throup]

My hon. Friend is right—his background makes him an expert in the field—that no one measure will solve the problem. The Health Committee has called for “bold and brave action”, but we are a long way from seeing that.

No one measure will successfully tackle childhood or adult obesity. It is more than just sugar—many different aspects of food are causing the obesity epidemic. The soft drinks industry levy will play its part, as will Public Health England’s message, which was well publicised over Christmas and new year, that children should have only two snacks a day. Tackling junk food advertising is an important part of the jigsaw.

[Conor McGinn (St Helens North) (Lab)]

When the sugar tax was introduced, Vimto, which has its headquarters in my constituency, would have avoided it on 60% of its products because they were already sugar free. That figure is now 100% because industry growth has been led by the fact that 70% of demand is for sugar-free drinks. In contrast, £200 million was taken from the public health budget in 2015-16, £85 million was taken in 2016-17, and 3.9% will be taken each year up to 2020. In some respects, the industry and the public are ahead of the Government.

[Maggie Throup]

There has been a step change in the industry. It has realised that if it does not take steps itself, more punitive measures may be imposed. Hopefully, debates such as this one will help the industry and other corporate bodies to take responsibility, which is a good way to address the issue.

It is well recognised that children and young people are particularly vulnerable to junk food advertising. Evidence shows a link between advertising and the types of food that that group prefer to buy and eat. Restrictions to advertising in or around programmes specifically made for children were introduced 10 years ago, but no Government since have made any effort to update the broadcast rules, despite widespread recognition of the health harms of junk food advertising. Anybody watching “Newsnight” last night will have seen that advertisers are finding ways to circumvent the rules, which is not what rules are there for.

By applying broadcast restrictions only to children’s programming, the pattern of TV viewing by children today is not taken into account.

[Louise Haigh (Sheffield, Heeley) (Lab)]

The hon. Lady makes a powerful case about advertising. Evidence suggests that children as young as 18 months old can recognise branded products, so it has a significant and pernicious impact on very young children. Many people may not expect that. Does she agree that the rules need to be extended, not just for broadcast to ensure that they affect family viewing time, but to online advertising as well?

[Maggie Throup]

I completely agree. Some of the new restrictions imposed by the Committee of Advertising Practice in July aimed to do that, so that whatever method a child is viewing by, whether it is gaming or whatever, it is controlled. At a meeting just before Christmas, the committee said that it had still not been able to analyse the impact of the restrictions. Hopefully, in a few months’ time, we will get some feedback as to whether they are working or not—let us hope that they are.

Children are viewing TV—and lots of other media, as the hon. Lady said—in different ways, so we are calling for that to be taken into consideration to ensure that legislation is up to date. The rules are outdated and we urgently need an update to reflect changing viewing patterns.

We could debate whether restrictions on advertising are the responsibility of the Department of Health and Social Care or of the Department for Digital, Culture, Media and Sport, but ultimately we are discussing the health of our future generations. The Department of Health and Social Care should grasp that responsibility and make a difference.

The soft drinks industry levy, which has received a tremendous amount of attention, is a matter for the Treasury, but it appeared in the childhood obesity plan published by the then Department of Health in August 2016. There is no reason why introducing advertising restrictions for the sake of our nation’s health should be deemed to be under the DCMS remit.

The Minister indicated to me that it was too early to have this debate as he may not be able to give any concrete answers, but it is never too early to have a debate on an issue that affects our children’s health. “Childhood obesity: a plan for action” states that it is just the “start of a conversation”. It would be wrong of us, as parliamentarians, not to take every opportunity to continue that conversation. I hope that this debate influences the next stages of the measures to tackle childhood and adult obesity.

We have passed the stage of assuming that the implementation of further restrictions to the advertising of food and drinks high in fats, salt and sugar is part of a nanny state. There is now consensus across the House that responsibility and duty of care needs to be shown to our children and young people through bold and brave actions that will have an impact not only on future generations but on people today.

Before I finish, I have two more thoughts to throw into the mix. First, we should be mindful that there must be an element of personal and parental responsibility. Secondly, it is not a coincidence of scheduling that these adverts run alongside some of our biggest TV shows, such as the “The X Factor”, “Britain’s Got Talent”, “I’m a Celebrity”, “Hollyoaks” and “The Simpsons”. If we are to truly effect change, we need some of that star magic, as Jamie Oliver demonstrated.

The power of celebrity cannot be underestimated. With that in mind, I call on household names such as Simon Cowell, Ant and Dec, Dermot O’Leary and Amanda Holden to take some corporate responsibility, stand up to broadcasters and say that they will no longer be used as a hook to sell harmful junk food to our children and theirs.

[Dr Poulter]

My hon. Friend has made excellent points throughout her speech. Certain sports teams and events are sponsored by junk food advertising and companies such as KFC. In that context, corporate responsibility is important, but do the Government need to look at banning such advertising, as they did with tobacco advertising in Formula 1 many years ago?

[Maggie Throup]

As ever, my hon. Friend makes a good point. Everybody has responsibility: the Government have responsibility for their legislation and how it is implemented, and there is corporate responsibility.

Finally, perhaps we will start to see organic change from within the industry itself, rather than needing the Minister to formally effect change through regulation. That is the most effective way to get the change that we need, as we have seen with the reformulation that is going on already. If the industry gets the message loud and clear, it can do it on its own terms rather than being forced into it.

--- Later in debate ---

[Maggie Throup]

I thank you, Ms Dorries, and all hon. Members who have contributed to the debate, including the Minister for his response.

We have had some informative, passionate and wide-ranging speeches, for which I thank everyone. The House is truly at its best when it speaks with one voice. I know that the Minister will take note of the strength of feeling on this important issue and act accordingly. Childhood obesity is a ticking time bomb of public health. The Minister has acknowledged that it is a challenge and a cost both to the individual and to the NHS.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) highlighted some working examples of where bold and brave action has taken place. The Amsterdam example is something that we should all be looking at, bringing together not only national Government but local government, industry and local people. That is so important and the issue is definitely not going to go away.

The health of our nation must be put at the top of our agenda. I believe that by taking a simple but tough stance on junk food advertising now, we will start to make real progress on the issue that will pay dividends in the years to come. As chair of the all-party group on obesity and a member of the Health Committee, I will continue to push for every measure possible to tackle the obesity epidemic well into the future.

Question put and agreed to.

Resolved,

That this House has considered the effect of junk food advertising on obesity in children.

NHS Winter Crisis

Maggie Throup Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I am glad that the hon. Lady has referred to the social care Green Paper, because that will be published this year, providing an opportunity for all Members to participate in it. It does not sit within my set of responsibilities, so I will come back to the hon. Lady on exactly who will be leading on it.

[Maggie Throup (Erewash) (Con)]

My constituents can access Derby and Nottingham hospitals. The two trusts have been allocated an extra almost £7 million for winter preparedness. Will the Minister reassure me and my constituents that there will be a full analysis of how that extra money is spent, so that we can learn lessons to make sure that we build on good practices for next year?

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 19th December 2017 Commons Chamber

[Jackie Doyle-Price]

I am grateful to the hon. Gentleman for raising this with me today, because I hope to reassure the House, and anxious people with loved ones in care with Four Seasons, that there is no immediate threat to continuity of care. I and my officials are keeping a very close eye on the situation, so that, with the Care Quality Commission, we ensure that there is a stable transition and that the commercial issues are dealt with in an appropriate way. That is leading to some very challenging conversations, but I can assure him that I and my officials are on it.

[Maggie Throup (Erewash) (Con)]

Given that health and social care are intrinsically linked, even more so now as sustainability and transformation plans are rolled out, does the Minister agree that now is the time to put health and social care under one roof in a combined department?

[Jackie Doyle-Price]

I have always thought that a silo culture was the enemy of good public policy, which means that integrating policy making across Government will tend to lead to better outcomes. I can assure my hon. Friend that I have regular conversations with the Department for Communities and Local Government and, as we approach the long-term funding pressures, we will be very much working in tandem.

Stroke Services

Maggie Throup Excerpts

Tuesday 5th December 2017 Commons Chamber

[Sir David Amess]

I absolutely join the hon. Lady in celebrating the work of all those charities.

The European Stroke Journal found that improving access to thrombolysis and early supported discharge services alone can contribute to reducing the financial burden of stroke on health and social care services. When the benefits of treatments such as mechanical thrombectomy are included, the costs can be lowered significantly. What measures are the Government taking to address the rising costs associated with strokes in England? I very much hope the Government are considering the widespread use of mechanical thrombectomy, which is a new and effective way of treating some of the most serious strokes caused by a blood clot.

[Maggie Throup (Erewash) (Con)]

I have heard first-hand stories about the impact of mechanical thrombectomy and just how fantastic a treatment it is. It can enable people who might have had lifelong disabilities to lead normal lives. I gather it is being rolled out throughout the NHS through specialised commissioning, but does my hon. Friend agree that the roll-out needs to be speeded up, and that we need more people in place to carry out the treatment so that more individuals can benefit from it?

[Sir David Amess]

Even though money is tight, I absolutely agree with my hon. Friend. I have seen a video of the operation, and it is just extraordinary that a catheter can be inserted into a patient’s artery to access the clot, which is then mechanically removed. The technology is extraordinary.

Mechanical thrombectomy significantly reduces disability rates after strokes. It removes clots that are too big to be broken down by drugs alone. For each six-minute delay in the delivery of mechanical thrombectomy, there is a 1% increase in the proportion of people who become disabled. Royal College of Physicians guidelines for stroke care label it as the best recommended practice. It is an effective procedure with very low complication rates. It is highly cost-effective, too. The Stroke Association has calculated that over a 10-year period, the net monetary benefit of 9,000 eligible patients receiving the treatment would be between £530 million and £975 million.

Mechanical thrombectomy enables more stroke survivors to live independently in their own homes, which is crucial, and then to return to work and take control of their lives again, thereby saving the NHS money. It really is a game-changing treatment that could revolutionise stroke victims’ experiences, yet despite NHS England’s agreeing to fund it, it is delivered for only 0.008% of the 85,122 acute stroke admissions, versus the EU benchmark of 3%, so we are really some way behind.

Let me blow the trumpet for Southend, following on from what my hon. Friend the Member for Rochford and Southend East (James Duddridge) said earlier. Southend has been developing an interventional neuroradiology service alongside a hyper-acute stroke service providing thrombectomy. Our service is led and delivered by an interventional neuroradiologist. It has been developed with the local trust board since 2013, but due to a current recommendation that only interventional neuroradiologists can perform the procedure, she is the only person who can perform thrombectomy at the moment, so the service is provided on a “best endeavours” basis and is not, unfortunately, a regular service. The service is currently available only at Southend and nowhere else in Essex. We need to expand it to provide a 24-hour service. The only other place where it is provided is at St George’s Hospital in London.

Mr Paul Guyler, who is a lead consultant in stroke medicine at Southend University Hospital, tells me that less than 1% of ischaemic stroke patients receive endovascular treatment and that, despite around 9,000 patients being eligible for mechanical thrombectomy, only 400 patients received the treatment last year. He has argued that the barriers to this treatment revolve around skills and education, resources and attitudes.

This is not a criticism of my hon. Friend the Minister, because he cannot wave a magic wand and solve all these problems, but Mr Guyler has advised me that there are not enough trained specialists to be able to provide a 24/7 service in all areas. Unfortunately, we also have a postcode lottery, with not enough neuro- radiologists and only 80 interventional neuroradiology operators in the United Kingdom.

[Maggie Throup]

My hon. Friend is being very generous with his time. He has hit the nail on the head: the treatment is very specialist and is carried out by surgeons and neurologists who are not normally there to treat stroke victims. The change in the way in which stroke centres work has been fantastic. Stroke services have been centralised, but we need to go a step further and to make sure that we get the right training for these neurologists so that we can continue to save lives.

[Sir David Amess]

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

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

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

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

--- Later in debate ---

[Steve Brine]

I echo the hon. Gentleman’s sentiment that that work is critical. I mentioned the Act FAST campaign, which was a heavily evidenced public health campaign showing that the quicker we act after the event, the better the outcome, so he is absolutely right to highlight that issue. However, I am conscious of time, so I am going to press on.

My hon. Friend rightly spoke about mechanical thrombectomy, which he called a game-changer, and he is absolutely right. To continue and build on our stroke service success and to address the costs associated with stroke in England, which was one of my hon. Friend’s first asks, it is imperative that we keep identifying and developing innovative treatments and cutting-edge procedures.

In mechanical thrombectomy, or MT as we shall know it, we have an innovation that we believe can significantly improve patient outcomes, and my hon. Friend spoke about that. In April this year, NHS England announced that it will commission mechanical thrombectomy so that it can become more widely available for patients who have certain types of acute ischaemic stroke, which is a severe form of the condition. My understanding is that work by NHS England is now under way to assess the readiness of 24 neuroscience centres across the country. It is expected that the treatment will start to be phased in later this year and early next year, with an estimated 1,000 patients set to benefit across the first year of introduction. Overall, this will benefit an estimated 8,000 stroke patients a year and save millions of pounds in long-term health and social care costs—my hon. Friend was absolutely right to point out the rising costs to NHS England around this condition.

As the clinical director for stroke at NHS England has said, we are committed to fast-tracking new and effective treatments that will deliver long-term benefits for patients. For me, this treatment is just one example of many that we believe have the potential to tangibly improve patient care and to address rising costs.

[Maggie Throup]

Will my hon. Friend give way?

[Steve Brine]

I am going to press on, because we have to finish at a certain time, but I thank my hon. Friend for her contribution earlier.

Stroke services are an important part of the range of vital services delivered in the part of Essex represented by my hon. Friend the Member for Southend West. It is important that his constituents have the right access to the right care at the right time, which in this case means specialist acute and hyper-acute stroke units. As he knows, and as we have discussed in Adjournment debates previously, there is a lively debate in his local area about the best way to configure services in order to meet these needs. As ever, he makes a powerful case for Southend, which he says has shown itself to be both safe and effective, and I have no reason to doubt his word.

My hon. Friend’s second big question was about what we are doing to transform services. Sustainability and transformation partnerships are absolutely key in this regard. STPs cannot but help in improving stroke services; they have a huge part to play. STPs should bring the local population, NHS organisations and local authority bodies together to propose how they, at a locally designed level, can improve the way that their local health and care is planned and delivered. These local areas have been encouraged to take a collective view of the local health system so that they can explore how best services within the local area, including stroke services, can be streamlined and centred around the patient, and determine what configurations are necessary within each local area to deliver the best possible care. My hon. Friend’s description of turf wars does not surprise me, although it does disappoint me. If he wishes to raise anything specific with me, I ask him to write to me about it. As the Minister responsible for STPs, I do not want to see this happening, and if I can help with it, I will certainly do so.

Much guidance has been issued to the system from us at the centre to help support STPs in making these crucial local reconfiguration decisions. My hon. Friend’s associated STP, Mid and South Essex, is making good progress and has recently been rated through our STP dashboard as being in the top half, so it is a top-half-of-the-table team among STPs. Mid and South Essex’s stroke services compare very well with the best, in many ways, but, as he says, we could be doing much better. One area that it has identified for improvement is that none of the three existing hospitals currently has the right number of specialists to provide the level of specialist stroke unit care that is being proposed. That goes to the heart of some of the examples that he gave from the consultant he has been speaking to.

I welcome the fact that organisations within my hon. Friend’s area, and other STP areas across England, are working in partnership to develop proposals that can really benefit those who matter most—the patients. There are proposals currently out for consultation in his area, which obviously my hon. Friend the Member for Rochford and Southend East (James Duddridge) takes a very close interest in as well. I look forward to seeing the results of that consultation in due course. Knowing my hon. Friends, I feel almost certain that we will be back here discussing that at some point.

I mentioned the tangible progress that has been made in improving both the quality and delivery of stroke services, with evidence-based public health campaigns and really strong, well-organised local services, but there is so much more to do. Patient mortality has indeed fallen, compliance with the standards has risen, and patient experience and satisfaction continues to improve. This is a pathway on which I expect us to continue. New services that my hon. Friend is absolutely right to raise, such as mechanical thrombectomy, can really help us in achieving this. He said what a fascinating piece of medical technology that is. Putting the mesh into the groin for it then to travel through to have such an impact is truly incredible. We are very clever, in many ways.

How this is being delivered is changing, and that is important. The STPs are providing a new way of working. They can be controversial because they involve difficult decisions around reconfiguration, but they should involve local organisations, local services, local people, and local MPs. Local MPs who are not involved in their STPs should ask themselves why not. STPs, and the whole reconfiguration process, are a huge opportunity for us. Locally led commissioning enables local need to be taken into account in decision making about the shape of all services. It can result in very strong local services that can meet these needs, and nowhere is that more important than in stroke care. It is a system that drives improvement in all patient care, and that is what we are about. I thank my hon. Friend for bringing this debate to the House, and other hon. Members who have contributed.

Question put and agreed to.

NHS Continuing Care

Maggie Throup Excerpts

Monday 27th November 2017 Commons Chamber

[Norman Lamb (North Norfolk) (LD)]

I suspect that I will not be alone in the House in having concerns about how NHS continuing care is operating these days. Concerns about the process will have been raised by the constituents of many hon. Members on both sides of the House. It is worth recognising that the process of NHS continuing care has always been fraught because a lot of money often turns on the outcome, and the families affected are often going through a very difficult time as they cope with a loved one with serious care needs. However, particular things are happening in the system now that seem to justify our spending some time on considering whether the current situation is acceptable.

As the NHS and the care system struggle with what I think are impossible finances, some wholly unacceptable practices are emerging around the country, some of which I want to deal with this evening. First, it is clear that a postcode lottery is emerging, with no democratic legitimacy at all. The massive variation in the acceptance rate for applications for NHS continuing care has no apparent justifiable explanation. The BBC’s “Inside Out East” programme made a freedom of information request about the period between July 2016 and July 2017. It found that Birmingham South Central clinical commissioning group rejected 75% of those assessed for NHS continuing care, whereas the figure for Tameside and Glossop CCG was just 5%. Given that this is public money, how can we possibly justify such an extraordinary variation without any democratic legitimacy? The BBC’s figures also showed that 73% of people in my constituency were turned down, but that the figure for Manchester was just 17%. These are not odd examples—there are enormous variations across the country. I would be grateful if the Minister could explain how these extraordinary variations are happening and what she and the Government intend to do about them.

[Maggie Throup (Erewash) (Con)]

In my experience, this depends not just on the postcode, but on how the referral is made. If a referral is made through a hospice, the process is clear and transparent, but with other mechanisms, it is more smoke and mirrors.

[Norman Lamb]

The hon. Lady might well be right. That does not justify the variations, but it is a possible explanation for part of the problem.

Secondly, the number of people nationally who are found to be eligible is falling. The National Audit Office found that the proportion of people assessed as eligible for standard continuing healthcare by CCGs reduced from 34% in 2011-12 to 29% in 2015-16.

--- Later in debate ---

[Norman Lamb]

If it were happening, I would. I totally agree that we need to bring health and social care together in localities, with a single budget and single commissioning. I think that we need to work across parties to come up with an ultimate long-term settlement for the NHS and the care system.

Families are also in the invidious position of being asked to provide, in effect, a top-up for care if they want their loved one to remain at home, rather than being forced into a care home. That is fine for those who can do it, but not good for those who cannot afford it. It is also completely contrary to any notion of personalisation —the concept of the person, what is important to them and their priorities being at the heart of decision making—which the Government accept. When I was working with the Conservative party in coalition, we passed the Care Act 2014. Its fundamental principle was the individual’s wellbeing, yet now are saying to people, “No, you’re going to go into a care home because it’s cheaper.” That is not acceptable, but it is happening around the country.

[Maggie Throup]

rose—

[Norman Lamb]

I will give way for the last time.

[Maggie Throup]

The right hon. Gentleman is very generous. He makes a strong case, but sometimes people’s healthcare needs are so great that it is impractical for them to be looked after in their own homes, so things are not quite as cut and dry as he is indicating.

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

I am afraid that the hon. Lady will have to wait until the Chancellor delivers his Budget. There are huge financial pressures on the NHS. We inherited a financial recession but, if she looks at this Government’s record she will see that, unlike her party, we refused to cut spending on the NHS; we are now increasing it.

[Maggie Throup (Erewash) (Con)]

6. What plans his Department has to improve care for people with lung disease.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Me now, Mr Speaker. Improving care for people with lung disease is crucial to this Government. We do not need reams of new plans or strategies, but continued action to implement existing plans, including the NHS outcomes framework, which details NHS priority areas and includes reducing deaths from respiratory disease as a key indicator. Key initiatives include the implementation of quality standards on idiopathic pulmonary fibrosis, asthma and chronic obstructive pulmonary disease, and a national pilot to improve care of breathlessness.

[Maggie Throup]

I thank the Minister for that answer, but I think that more probably still needs to be done. Last month, I launched the British Lung Foundation’s latest report into idiopathic pulmonary fibrosis. Delayed access to diagnosis, support services and care is still commonplace for people with IPF and other lung conditions. Will the Minister agree to meet me and the British Lung Foundation, which is leading a taskforce for lung health, to establish what more can be done to address the issue?

[Steve Brine]

I thank my hon. Friend, who speaks with great passion—I know that she has tragic personal experience. I will be meeting the British Lung Foundation shortly, and I am happy for my hon. Friend to join that discussion or part of it. As I said, one of the NHS’s priority areas, as set out in the outcomes framework, is reducing early deaths from respiratory diseases such as IPF. I understand that the number of cases has risen in recent years, which is rightly a cause for concern. She is right to raise the matter, and I look forward to meeting her.

Children’s Oral Health

Maggie Throup Excerpts

Tuesday 31st October 2017 Westminster Hall

[Maggie Throup (Erewash) (Con)]

It is a pleasure to share my thoughts and experiences under your chairmanship, Mr Bone. I congratulate the hon. Member for Birmingham, Selly Oak (Steve McCabe) on securing this debate. As he said, it is Sugar Awareness Week, so this debate on tooth decay is timely.

It is well recognised and accepted that the amount of sugar that children eat has an impact on both oral health and obesity rates, and that there is a link between poor oral health and some of the most deprived parts of the country. Poor oral health and obesity are both issues of health inequality. Tooth decay and obesity also represent major public health issues. If we put measures in place to tackle one, we will tackle the other at the same time.

Tooth decay is the leading cause of hospital admissions for young children. Local data show that one in five children in Erewash suffers from tooth decay by the time they are five years old. That is better than the national average of one in four, but children in my constituency are still twice more likely to have tooth decay than their peers in the parts of the country with better performing local authorities; even though the data are better than the average, they are still not good enough.

In the last five years, 170 children in Erewash have been admitted to hospital to have their teeth extracted under general anaesthetic. That is 170 too many. Nationally, about two thirds of such hospital extractions are due to extensive tooth decay. When I looked further into local data, I found that almost half of children in Derbyshire did not see an NHS dentist in the year to April 2017. I find that extremely disturbing because children should have check-ups at least once a year. Tooth decay is 90% preventable; as has already been said, NHS dentistry is free for under-18s, so there is no excuse. Stopping tooth decay would prevent a great deal of pain and stress for children and the potential for bullying. If tooth decay was made a priority for the NHS, a great deal of money would be saved.

I am extremely concerned about the impact of sugar on our nation’s teeth, but I want to expand a little about the impact of sugar generally. Almost a year ago, Cancer Research UK revealed that, on average, teenagers drink almost a bathtub full of sugary drinks a year. Hopefully, such a visualisation—a bathtub full of sugary drinks—will shock some teenagers into changing their habits rather than suffering the consequences that we have heard about. The average five-year-old consumes their own weight in sugar every year. That is horrendous. There is no doubt that such sugar consumption will have an impact on dental health, but also it will have an adverse effect on the current and future health of our nation.

Sugar, tooth decay and obesity are linked. Obesity is now recognised as a major cause of type 2 diabetes, which is now a disease seen in teenagers rather than just the elderly. Obesity is also a major cause of cardiovascular disease and cancer. If young people’s sugar consumption continues and our young people manage to escape tooth decay, there are other health issues waiting for them down the road.

As a member of the Health Committee and chair of the all-party parliamentary group on adult and childhood obesity, I was disappointed by the “Childhood obesity: a plan for action”, published by the Government in August last year. The Committee asked for bold and brave action, but sadly we did not get that. Tackling obesity also tackles tooth decay, so I welcome the sugary drinks levy and the ring-fencing of the moneys raised from that for children, but I want to go one step further. Could some of that money be dedicated to teaching children how to clean their teeth—perhaps through the breakfast clubs some of that money will be dedicated to?

The levy is only a drop in the ocean. I want to take the opportunity to ask the Minister, first, to work with retailers to limit price promotions on high-sugar food and drinks and to encourage the removal of those products from the point of sale—to consider legislation if necessary. Secondly, will the Government update broadcasting regulations, to ensure that high-sugar products cannot be advertised on TV before the 9 pm watershed? Thirdly, will the Government build on the new rules from the committee of advertising practice, to prevent high-sugar products from being advertised in non-broadcast children’s media and to close the loopholes?

Let us really show that we care about both the dental health and the general health of our future generations, and take action now.

Social Care

Maggie Throup Excerpts

Wednesday 25th October 2017 Commons Chamber

[Maggie Throup (Erewash) (Con)]

It is a pleasure to follow my fellow east midlands MP, the hon. Member for Leicester West (Liz Kendall).

Like many Members from across the House, I was compelled to speak in today’s debate because of my personal experience with the social care system, and because of my deep respect for all who work in it and contribute to it. For five years, my father has been in the care of a nursing home in Keighley. At age 94, my dad is still in good spirits, but he has significant care needs as a result of a massive stroke in 2012. It is a testament to the fantastic work of our NHS that we now find ourselves in a position where every care home in the country has residents who 10, 20 or 30 years ago would not have survived serious health issues such as a stroke, a heart attack or cancer. For the Government, however, this success in the NHS can be seen as a double-edged sword, with successive Administrations failing to prepare our social care system adequately for an ageing population living with co-morbidities.

Let me be clear, when I talk about adequate preparation, it is not just about additional funding. As we have heard, the Chancellor has already announced an additional £2 billion of funding for local authorities to fund social care over the next three years and has also introduced a precept. That must be welcomed, as it rightly acknowledges the significant extra pressure that our social care system, and consequently our NHS, is now under.

Opposition Members seem to want to blame the Government, whereas successive Governments, going back to when they were in government, failed to act. They failed to act on the royal commission they set up, and they failed to act on the Wanless report and their own Green Paper. As my hon. Friend the Member for Totnes (Dr Wollaston) indicated, we now have the opportunity to effect radical change to the current system, as the Government embark on their comprehensive consultation on adult social care. Others have alluded to the fact that Britain needs a sustainable programme of social care for the long term. We need to stop thinking short term. To achieve that, I would like to explore the idea of removing the social care remit from local authority responsibility and instead placing it under the wider umbrella of the Department of Health, which would become the Department of Health and Care. This stems from the fact that health and social care have now become intrinsically linked, but are currently administered in vastly different ways. If the two are unified, it would allow for closer integration of services and a greater understanding of what demand there will be for future needs from both the social care and health perspective.

It would also protect the social care system from political manipulation, which has happened in Derbyshire at county council level, where the new Conservative administration found itself facing a social care bombshell left by Labour. Over the previous four years, and despite holding around £233 million of Derbyshire taxpayers’ money in its reserves, Labour failed to maintain care homes such as Hazelwood in Cotmanhay in my constituency, in order to trot out the same old line about Tory Government cuts. As a result of this shameful political practice, the county council must now consider closing the care home altogether, because of the significant repairs required to make it safe and warm for residents. I urge the Minister today to do all he can, from the local government point of view, to help Derbyshire County Council to keep this much-loved care home open. There is no doubt that Derbyshire County Council and others face more tough decisions over the next five years. As the MP, I will continue to do everything in my power to ensure that Erewash residents remain well provided for, for both their health and social care needs.

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 10th October 2017 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman is quite right: many people would elect to die at home, if the opportunity were available. We need to ensure provision to allow people to do that, if that is their choice, because we should be supporting people to honour their choices at the end of their lives, and it enables us to treat more people in hospitals and hospices.

[Maggie Throup (Erewash) (Con)]

Hospices, such as Treetops Hospice Care in my constituency, provide outstanding end-of-life care. Although these services benefit from generous charitable donations that enable them to operate on a day-to-day basis, what more can the Government do to help support hospices when capital investment is needed to improve the current setting of new build?

[Jackie Doyle-Price]

One of the strengths of our hospice movement is that it relies heavily on charitable donations, which shows that people are generous and that they want to support good, locally focused care. However, CCGs should look at where they can support hospices with their care costs, and we will certainly consider including that in the end-of-life care programme.