Diabetes: Tailored Prevention Messaging

Martyn Day Excerpts

Thursday 24th October 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the hon. Member for Strangford (Jim Shannon) for securing this debate and for his personal account of his experience. He covered diet, control and tablets in his general summary of the issue. He highlighted the importance of prevention, the correlation between poverty and lifestyle, the importance of messaging to different sections of our society and the value of digital solutions.

We also heard from the hon. Member for Heywood and Middleton (Liz McInnes), who also has direct experience of the issue. She emphasised the importance of the difference between types 1 and 2. Most of my comments will be about type 2. The right hon. Member for Leicester East (Keith Vaz), a very knowledgeable Member, covered a range of points. It is impossible to disagree with anything I have heard today. I thoroughly enjoyed the presentations.

I am not diabetic, but when I phoned my office to tell my office manager that I had a debate about diabetes today, she thought I said that I had diabetes. She said, “I’m not surprised, with your lifestyle and diet.” There may be some lessons there that we all need to take away. We need to look at our diets, in particular.

We have heard about the scale of the problem in Northern Ireland and England, and I have to say that the Scottish situation is not dissimilar. In 2016, more than 257,000 people were living with a diagnosis of type 2 diabetes across Scotland, and every year 17,000 people are diagnosed with it. It is estimated that about 10% of cases of type 2 diabetes remain undiagnosed. Diabetes Scotland estimates that more than 500,000 people in Scotland are at high risk of developing type 2 diabetes. The NHS spends about 9% of its total health expenditure treating type 2 diabetes.

It is estimated that more than one in 16 people across the UK has diabetes, whether diagnosed or undiagnosed. Around 80% of diabetes complications are preventable, so just think how much we could save the NHS by tackling the problem, as well as the benefits that could be brought to people’s lifestyles. We should not short-change ourselves by cutting back on the diabetes spend—it is a spend-to-save area. Many of those complications are preventable or can at least be significantly delayed through early detection, good care and access to appropriate self-management tools and resources.

Being overweight is the most significant risk factor for the development of type 2 diabetes. Diabetes can be prevented with targeted weight management interventions that provide individuals with the support, skills and resources to improve their health and delay the onset of type 2 diabetes. As we have heard, recent studies have shown that it is possible to reverse a recent diagnosis of type 2 diabetes through intensive weight management programmes, which would enable the individual to achieve remission.

As obesity and lifestyle are such significant factors, what we do with our young people is critical. The SNP Scottish Government have a plan to halve childhood obesity by 2030, and that sits at the heart of the diet and healthy weight delivery plan. The Scottish Government’s commitment to legislate on the restriction of point-of-purchase junk food promotions will be a major help. I hope that we will see action from the UK Government on advertising, particularly on TV and in the media, because that would make a big difference. In 2019-20, the Scottish Government invested an additional £1.7 million in weight management services for children and young people. Targeted messages are a key component of the Scottish Government’s diabetes prevention, detection and intervention framework.

The Scottish Government’s framework “A Healthier Future: Framework for the Prevention, Early Detection and Early Intervention of type 2 Diabetes” was published in 2018—the Library briefing contains links to it, so hon. Members can see the full details. The framework is supported by £42 million until 2023, and it was produced in collaboration with the prevention sub-committee of the Scottish Diabetes Group, which comprises informed specialists in diabetes, dietetics, maternal health, public health, primary care and obesity.

Wider support should be available for all individuals who have been identified as at risk. Health and social care professionals should signpost individuals to the support groups that are available to them. A Local Information System for Scotland, or ALISS, is a programme funded by the Scottish Government and delivered by the Health and Social Care Alliance Scotland. The objectives are to increase the availability of health and wellbeing information for people living with long-term conditions, disabled people and unpaid carers, and to support people, communities, professionals and organisations who have information to share. The sharing of information is critical. The Scottish Government also published the diabetes improvement plan in 2014, with prevention as its No. 1 priority.

It is important to get the right messages to people, and methods of communication must also be considered. Modern-day flexibility and the use of mobile phones in everyday life means that they are an ideal tool to support people with diabetes, whose conditions needs constant management. Additionally, they can provide effective methods of support to patients in rural and remote locations where access to healthcare providers is limited. However, we must be careful when adopting such practices because there are drawbacks, such as the digital divide. Mobile phone use is lower among some groups, such as the elderly, the poorest and people with disabilities, so face-to-face contact remains a vital communication tool.

Social Care Funding

Martyn Day Excerpts

Tuesday 1st October 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Sir Charles. I am grateful to the right hon. Member for Twickenham (Sir Vince Cable) for securing what has been a well attended and thoughtful debate.

The Office for Budget Responsibility assessed the UK’s public finances as potentially £30 billion worse off each year in a no-deal Brexit scenario of medium disruptiveness. That sum is significant because it is more than the entire sum spent on adult social care, plus investment in NHS buildings and equipment, across the United Kingdom in 2017-18. Much of the responsibility for social care is, of course, devolved, with respect to Scotland. The Scottish National party Scottish Government are currently working with a range of partners to take forward a national programme to support local reform of adult social care support. Scotland continues to be the only country in the UK that delivers free personal care. That currently benefits more than 77,000 older and disabled people in Scotland.

In England since 2010 the number of people receiving publicly funded social care has decreased by 600,000, because of funding cuts. In 2019-20 the SNP Scottish Government are increasing their package of investment and social care support and integration to exceed £700 million, up from £550 million in the previous year. In England a boundary has always existed between the NHS and social care, contributing to fragmented and unco-ordinated care. In Scotland the SNP Scottish Government successfully integrated health and social care, which is the most significant change to health and social care since the creation of the NHS in 1948. Last month the First Minister announced that everyone diagnosed with cancer will have a dedicated support worker, provided through a new £18 million partnership fund.

Of course, the devolved Administrations do not operate in isolation. Policy decisions from Westminster continue to have an impact on social care. The independent expert advisory group in Scotland deems that changes set out in the UK Government’s immigration White Paper would reduce net migration to Scotland by between 30% and 50% in the coming two decades. That is extremely significant. It states that social care would be severely affected as fewer than 10% of those in caring personal service occupations in Scotland earn above £25,000, and almost no one earns over the £30,000 immigration threshold. Average earnings of adult social care workers are higher in Scotland than they are elsewhere in the UK, coming in at about £18,400 as opposed to £17,300. Yet people are thinking about a £30,000 immigration limit. Just let those figures sink in. Thanks to Scottish Government funding, staff can be paid at least the real living wage, but it is still nowhere near the immigration threshold. That is a serious worry in respect of future provision throughout the UK, not just Scotland.

The number of Scots over 80 with social care needs is set to increase by 68% by 2036. That is probably an even faster rate than the English figures that we have heard from some hon. Members. My hon. Friend the Member for Argyll and Bute (Brendan O'Hara) called for an independent evaluation of the impact of Brexit on the health and social care sector, through his private Member’s Bill, the European Union Withdrawal (Evaluation of Effects on Health and Social Care Sectors) Bill. The Bill was supported across the House and by 102 organisations, but I wonder whether the UK Government are listening.

On 18 August The Sunday Times, citing UK Government planning assumptions under Yellowhammer, stated:

“An already ‘fragile’ social care system is expected to be tipped over the edge by a no-deal, with providers starting to go bust by the new year”.

The report quoted the document as saying that “smaller providers” would be

“impacted within two-three months and large providers four-six months”

after Brexit. The negative economic impact of a disorderly Brexit, including an increase in inflation and an economic recession, will augment the pressure on providers and will shift the burden of care work on to unpaid family carers, the majority of whom are women. I look forward to hearing the Minister address those points, particularly on the issue of migrant staff and the £30,000 immigration limit.

[Sir Charles Walker (in the Chair)]

I want to give Sir Vince Cable two minutes at the end, so if the other Front-Bench colleagues could maintain a 12-minute discipline, or just under, that would be great.

Health Infrastructure Plan

Martyn Day Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

I know that my hon. Friend’s local hospital trust and her constituents have no greater champion in this place than her. She is right to highlight the allocation to Royal Cornwall Hospitals NHS Trust. The seed funding was announced yesterday and is there now, so we hope that the trust will get to work using that money to develop plans to improve services at local hospitals.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the Minister for advance sight of his statement.

UK Government decisions on pension costs and funding already result in a shortfall of £48.4 million for the NHS in Scotland, which comes on top of the UK Government making wider budget reductions in health funding for Scotland of £42 million compared with their previously claimed level of consequentials. Scotland now faces a shortfall of £90 million for its health services as a result of UK Government decisions. Now that the UK Government have apparently opened the spending taps, will they pay back the moneys due to Scotland, or will we continue to be short-changed? When will the full Barnett consequentials of this new investment be published?

In total, the Tories’ decade of austerity has cumulatively cut the Scottish block grant by more than £12 billion in real terms. With the economy already faltering, the Chancellor’s predecessor warned that a destructive no-deal Brexit could inflict a £90 billion hit on the Exchequer and suggested that no new money would be available. How then can the Minister guarantee that this money will come to the NHS?

[Edward Argar]

I will not stray into the politics of the NHS in Scotland. The hon. Gentleman asks specifically about Barnett consequentials. I can confirm that they will apply, and if it would be helpful I will write to him with details.

Hernia Mesh in Men

Martyn Day Excerpts

Thursday 5th September 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship today, Mr Hanson. I am grateful to the hon. Member for Strangford (Jim Shannon) for introducing the debate. He has a brought a number of debates to the House over the years, and I have learned an immense amount about issues that I did not know about. This, however, is one of which I have had some personal experience. Indeed, in my personal life since I have been in Parliament I have had two such hernia mesh operations—in my case, both successful. However, 2015 and 2018 are well within the timeframe that the hon. Gentleman highlighted, in which people have developed complications. So far, touch wood, everything has gone fine.

Hernias are fairly common operations. They usually go without any problem, but not everyone has the same experience, and I am grateful to the hon. Gentleman for highlighting the issue as it affects men. Health issues are, of course, devolved in Scotland, and the Scottish National party Scottish Government have a strong record of ensuring that no one suffers unduly from mesh. In 2014, the SNP Government requested a suspension of the use of medical mesh by the NHS in Scotland, pending safety investigations, and in 2015 the Cabinet Secretary for Health and Sport, Shona Robison, apologised to women who had been left in severe pain by such operations. Between 2009 and 2016, the number of women receiving mesh surgery in Scotland fell from 2,267 to just 135.

An independent review published in March last year in Scotland made eight recommendations—notably that surgical mesh implants should be used only after all other appropriate alternatives have been exhausted. Scotland’s chief medical officer accepted those recommendations in full.

The hon. Member for Strangford mentioned people not being told adequately about the potential complications. I have to be honest: having been through the process myself, I probably agree. We were told some things, but a patient suffering from a hernia is more concerned about when they will get their operation and be able to get back on with their life, so they probably do not pay appropriate attention to what is a fairly minor risk. Perhaps that risk needs to be emphasised to people, or they need to be reminded at a later stage in the process; as I know from experience, it can take a while after having seen the consultant to get the operation.

Although health is devolved, the regulation of mesh is a reserved matter. We therefore call on the UK Government urgently to review its effects and to legislate accordingly. Although regulation of these devices is reserved, we really need a UK-wide clinical audit database for recording device identifiers. We were pleased with the review of the guidelines for mesh following the finding by the National Institute for Health and Care Excellence that the evidence for the long-term efficacy of vaginal mesh implants was inadequate in quantity and quality, but we would like to see a review of the use of mesh to repair hernias.

Scottish Government officials are working with UK colleagues to consider the possibility of an automated implant registry, which would allow unique device identifiers to be entered on the patient’s electronic record. The SNP hopes that Ministers will be willing to work with their counterparts in the devolved Administrations and consider a UK-wide summit on that issue.

It is imperative that the highest possible standards for mesh are maintained. EU regulation 2017/745 on medical devices will change mesh implants for long-term or permanent use from class IIb to class III devices, meaning they are generally regarded as high risk. Those regulations will not take effect until 2020, after the date on which the Government desire to leave the EU. How will important EU regulations to monitor the use of devices across EU territories be implemented or reflected in UK law and regulation after Brexit? I reiterate that it is important that we maintain the highest possible standards, and I look forward to the Minister’s comments on that.

When I saw the title of the debate, I knew my Whips would be in touch because I had personal experience; having missed various other engagements while waiting for my operations, I knew I could not get out of doing this. In some parts I feel more mesh than man, but as I say, so far, so very successful.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

Thank you very much, Mr Hanson. I will certainly take no longer than three minutes. I had that advantage earlier on—I may have taken advantage of it, but there we are. Three minutes is more than enough.

First, I thank the hon. Member for Linlithgow and East Falkirk for his contribution. If we wanted a headline for the hon. Gentleman, it would be “More mesh than man” because of the number of operations he has had, if he does not mind me saying so.

[Martyn Day]

I have said it.

[Jim Shannon]

It was the hon. Gentleman’s quotation, so I am just quoting him again. He has personal knowledge of what has taken place. Again, to be fair, his operation has been successful. The shadow spokesperson, the hon. Member for Washington and Sunderland West, brought a lot of information to the debate. The problems are really real.

We set out two subjects in this debate: No. 1 was awareness, which is important, but No. 2 was that everyone should understand, before they have the operation, what the implications could be. That does not mean that they will not go ahead with the operation, but it ensures that they understand it. The hon. Lady referred to the “devastating” effect that this can have on lives. It is not a quick or cheap procedure, either, and patient safety is critical.

I thank the Minister for her response. She first confirmed in her contribution that we are raising awareness, and secondly referred to a safety review. I appreciate that and understand why. That does not in any way dismiss—no one can dismiss—those problems that have arisen out of the hernia mesh operations in men as not real. I ask her, if she has the opportunity, to perhaps look at the Australian investigation, although maybe she has already done so.

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Matt Hancock]

My hon. Friend is dead right. This is an important part of the work that Baroness Dido Harding is leading in the NHS people plan to ensure that we can make careers in the NHS—whether as doctors, other clinicians or more broadly—the most attractive that they possibly can be. This week we announced a pay rise for doctors and earlier this month we announced a long-term agreement with junior doctors, which I am delighted they accepted in a referendum with over 80% support. But there is more work to do.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The rules around annual and lifetime allowances are having an impact on the NHS workforce in Scotland, and the options contained in the recent consultation on doctors’ pensions do not provide the level of flexibility necessary to resolve this situation. We know that the solution lies with the Treasury, so what pressure can the current Secretary of State put on the Chancellor to ensure that urgent reform takes place to stop this terrible impact on our NHS workforce?

--- Later in debate ---

[Caroline Dinenage]

First, I pay tribute to the hon. Lady for her work in the APPG on adult social care. It is really important that we have an APPG that represents this really important issue. As I said, the fact that we have an ageing population is a growing issue that we have to face as a nation, and, in fact, as a world. Her area of Wolverhampton will receive an additional £22.1 million for adult social care in 2019, but we know that that is not a long-term solution and we will be publishing a Green Paper at the earliest opportunity.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The Government’s utter chaos over Brexit has already impacted on recruitment in the social care sector. Scottish Care told the Scottish Affairs Committee that providers have lost 67% of their intake from the European economic area. The fact is that this Government’s actions are putting the health of the sick and elderly at risk. Will the Government make an assessment of how the staffing crisis in social care is impacting on the rate of hospital admissions?

[Caroline Dinenage]

The hon. Gentleman is right: we do have a number of vacancies—a large number of vacancies—in adult social care. That is why, earlier in the year, the Government announced a recruitment campaign, “Every day is different”. It ran for a few months, with enormous success. There have been 14% more apply clicks on the relevant Government jobs site as a result, so we have just announced that we are going to expand and extend that recruitment campaign, with an additional £4 million of funding.

Acquired Brain Injury

Martyn Day Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I am delighted to take part in this important follow-up debate on acquired brain injury. I am grateful to the hon. Member for Rhondda (Chris Bryant)—I hope I have managed to pronounce the name properly this time—for securing the debate. Being in Parliament is a learning experience. I took part in the previous debate with the information that I knew about acquired brain injury, and it prompted different groups and individuals in my constituency to get in touch, so he will be pleased to know that I have some new material today.

We have heard in this debate that the symptoms of ABI are often completely invisible, which echoes a point made to me by one of my constituents since the previous debate. He discussed his own ABI and said that he felt there was often more public and employer sympathy and support for an obvious injury such as a broken leg than there was for a broken brain, which is something we undoubtedly need to address. The importance of speech therapy to avoid people being assumed to be drunk and to get their self-confidence back are highly important points. Since it affects every aspect of our country across all our nations, the financial savings of getting it right give us a financial incentive as well as a moral responsibility to tackle the issue. Fundamentally, for me, the issue is about ensuring that people with disabilities such as ABI can live as independently as possible. Disabled people should have the freedom, dignity and choice to control their own lives. We need to help remove the barriers that stop them from enjoying full and equal access to full citizenship.

It is estimated that ABI is the most significant cause of disablement for people of working age in Scotland. We know that only around 40% of working-age disabled adults are in employment, compared with more than 80% of those without a disability, so we really have to address the employability gap. Many of those with ABI have complex rehabilitation and support needs. The Scottish Government have recently run a consultation on their first draft national action plan on improving the care, treatment and support available to the neurological community. The consultation closed on 8 February this year. They aim to publish their report this summer, and the final national action plan on neurological conditions later this year. I look forward to seeing what comes out of that.

The Scottish Government initiated the National Prisoner Healthcare Network’s report on brain injury and offending, which was published in 2016. The subject of offenders came up in the previous debate, and I admit that I was not fully aware of it at the time. The programme in Scotland was led by Professor Tom McMillan of the University of Glasgow, and it is now in implementation and has developed an empirical basis for the development of a service in all Scottish prisons. The benefits will be to improve the management of people with brain injury throughout the criminal justice system and to reduce the risk of further brain injury in prisoners.

Around 75% of male prisoners and 66% of female prisoners have multiple head injuries. Benefits will also see reduced reoffending—around 70% of those with head injuries reoffend—and improved community reintegration. Those stark figures are striking. It is also worth noting that prisoners with a history of multiple head injuries are more likely to be convicted of violent offences, so there is a lot of work to do. I am grateful that I have learnt that information since the previous debate, so the hon. Member for Rhondda gets full marks for increasing my education.

In May I spoke about the Scottish Acquired Brain Injury Network and I want to discuss more of its work today. SABIN is a managed clinical network based within the NHS in Scotland, comprising clinicians, third sector organisations, patient representatives and non-clinical staff all working to improve the access to and quality of care for patients with an ABI across Scotland. Scotland remains the only country internationally with a single set of concussion guidelines across all sports at grassroots and amateur level. The Scottish sports concussion guidance has been in place since 2016, with the most recent update in 2018 contributed to by SABIN. In addition, research into the consequences of sports brain injury, in particular the study “Football’s InfluencE on Lifelong health and Dementia risk (FIELD)”, is set to provide the first understanding globally of the late consequences of contact sports participation through a series of publications in the next few months.

SABIN was delighted to take part in the Scottish Trauma Network’s second annual conference last week, which took place on 26 and 27 June. Over those two days it was able to highlight to clinical colleagues and Government stakeholders the importance of ABI care within a trauma setting and beyond. Patients with an acquired brain injury are some of the most seriously ill trauma cases; patients are often young, with many years of rehabilitation ahead of them. The need for early access to intensive rehabilitation is a message that needs to be relayed to one and all to support investment in rehabilitation. We cannot emphasise that point enough.

SABIN is currently involved in a geographical mapping of NHS services for acquired brain injury patients across Scotland. It previously did that in 2009, and it will be interesting to see how services have changed over time. Preliminary results from the service mapping highlight key challenges across Scotland: the same key challenges that we heard about from colleagues south of the border. They include a lack of access to rehabilitation; workforce shortages, particularly in relation to staff trained in managing patients with an ABI; the difficulties of managing patients with challenging behaviour; and the need for dedicated ABI units. A full report will be circulated to NHS boards in Scotland and will be available on the SABIN website. It is due for completion at the end of August, and SABIN is keen to work with NHS boards to assist them in planning rehabilitation services. It is worth pointing out that the first of four major trauma centres opened in Aberdeen in October, and those services have not been included in the mapping exercise. Things are improving, but the report will still be of significant interest.

Alcohol Health Alliance, in advance of today’s debate, has highlighted the link between alcohol and injuries and accidents that can cause an ABI, and also the link between ABI and problem alcohol consumption. Actions taken in Scotland to reduce alcohol abuse have seen the number of alcohol-related emergency hospital admissions fall by more than 17% since 2007, so there is good practice out there. One of our more recent innovations has been minimum unit pricing. It is probably too early to say how it has affected ABI or other health issues, but sales have dropped by 3% since it was introduced last year. Alcohol sales per adult in Scotland are now at the lowest level for 25 years, so the Minister might wish to consider something similar for England, as I am sure it will have many benefits for health and not just for ABI.

It has been a pleasure to take part in the debate, and I am grateful to the hon. Member for Rhondda for securing it.

Electromagnetic Fields: Health Effects

Martyn Day Excerpts

Tuesday 25th June 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Hollobone.

I thank the hon. Member for Gower (Tonia Antoniazzi) for securing this debate and for the interesting comments she made about electrosensitivity, highlighting the issue of the 5G roll-out, in particular with relation to electromagnetic fields. As she pointed out, 5G operates on different frequencies and with much higher ranges than those we have seen before with previous roll-outs.

Of course, exposure to electromagnetic fields is not new, but due to technological advances it is now far more common for people to be exposed to man-made electromagnetic fields than it ever was in our parents’ or our grandparents’ time. In recent decades, we have seen the public becoming concerned about potential health issues involving numerous electromagnetic field sources, ranging from overhead power lines to computer or TV screens in the home, as well as from radars, microwave ovens and mobile phones, to name just a few other sources.

Of course there are some significant differences between these sources. With some of them, people can self-select to take a precautionary effect: we do not need to have a microwave in our home; we can limit our mobile use; and we do not need to have a TV screen in our bedroom. With other sources, such as overhead power lines or telephone masts, people are pretty much stuck with them if they are outside their home. It is different with those sources.

The evidence so far seems to show that electromagnetic fields do not have detrimental health impacts. However, more research is always being undertaken, which is especially important as the technology changes and the frequencies involved change—that point has been made by a number of hon. Members. There is current research on the effects of the long-term use of mobile phones. The World Health Organisation has said that, as yet:

“No obvious adverse effect of exposure to low level radiofrequency fields has been discovered.”

However, as has been pointed out, the frequencies of the new 5G technology are significantly higher than those used before, and therefore the research into that new technology is somewhat different than earlier research.

Over the years, the WHO has identified some “25,000 articles” on electromagnetic fields that

“have been published over the past 30 years.”

The WHO says of that body of scientific knowledge—indeed, it is undoubtedly the case—that

“scientific knowledge in this area is now more extensive than for most chemicals.”

However, the WHO also says that there are still

“some gaps in knowledge about biological effects”

and so there is a need for “further research”.

The European Union Scientific Committee on Emerging and Newly Identified Health Risks published a lengthy report in 2015—that is not so long ago in terms of years, but in terms of technology it is almost a generation ago. That committee’s final opinion was:

“The results of current scientific research show that there are no evident adverse health effects if exposure remains below the levels recommended by the EU legislation. Overall, the epidemiological studies on radiofrequency EMF exposure do not show an increased risk of brain tumours. Furthermore, they do not indicate an increased risk for other cancers of the head and neck region.

Previous studies also suggested an association of EMF with an increased risk of Alzheimer’s disease. New studies on that subject did not confirm this link.

Epidemiological studies associate exposure to Extremely Low Frequency (ELF) fields, from long-term living in close proximity to power lines to a higher rate of childhood leukaemia. No mechanisms have been identified and no support from experimental studies could explain these findings, which, together with shortcomings of the epidemiological studies, prevent a causal interpretation.

Concerning EMF hypersensitivity…research consistently shows that there is no causal link between self-reported symptoms and EMF exposure.”

The evidence is a little conflicted, but we would definitely benefit from having further evidence.

The role of the Government when it comes to the effects of electromagnetic fields is to ensure that policy is supported by the latest scientific research, so I do not envy the Government in considering the opposing research that has been published. According to the WHO, the heating effect of electromagnetic fields is the current focus of guidelines and regulation. The WHO has said that, to date, no adverse health effect from low-level, long-term exposure to radio frequency or power frequency fields has been confirmed. However, that is not to say that research into the effects of prolonged low-level exposure to these fields should not continue. We must always make sure that the policy is expertise-led.

With the seemingly exponential increase in the rate of technological innovation, the regulation and monitoring of the effects of these technologies on our health needs to continue. However, we must bear in mind not only the physiological impact of technology but the psychological impact of huge amounts of screen time, which can affect mood and sleep, which in turn can have an impact on mental health. This psychological impact must also continue to be monitored.

In conclusion, I concur with the hon. Member for Gower on the need for independent research into the 5G technology, because without public confidence in and understanding of that technology, we will all be faced with many people campaigning against it when it comes into their areas, and we need to know the answers now, before the technology is rolled out.

Acquired Brain Injury

Martyn Day Excerpts

Thursday 9th May 2019 Commons Chamber

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am delighted to take part in this important, wide-ranging, informative and consensual debate, and grateful to the hon. Member for Rhondda (Chris Bryant) for securing and opening it. I thank the all-party parliamentary group on acquired brain injury for its considered work, and the United Kingdom Acquired Brain Injury Forum for its report. The hon. Gentleman covered much of the ground in his opening remarks, which included a thorough summary of the subject. He reminded us that ABI affects nearly every Department and has a major impact on the families and support networks of those affected.

On behalf of my colleagues in the SNP, I welcome the publication of the report and congratulate the APPG on its amazing work. I encourage anyone who has not read the report to do so. The infographic on ABI key facts is an eye-opener; it informs us that 1.3 million people are living with traumatic brain injury-related disabilities, at an estimated annual cost of £15 billion. The right hon. Member for South Holland and The Deepings (Sir John Hayes) covered many other facts in that report. I recommend the report for that graphic alone, but the whole publication is fantastic and contains lots more information. Indeed, it may even underestimate the position, because much of the published information relates to traumatic brain injuries, not just to ABIs; none the less, it puts the scale of the problem in perspective. We have heard a number of case studies today, and I am grateful to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for his personal anecdotes, which helped to bring this subject home. I cannot help but think, “There but for fortune,” as such a thing could happen to any of us at any time.

I have suffered two head injuries in my lifetime, thankfully both fairly minor. Once I was hit by a golf ball—I was not even on a golf course at the time, which proves that such a thing can happen anywhere—and the other time was when as a child I was hit by a swing. I had listened to my mother who told me not to run in front of swings, but let me state for the record that it is equally dangerous to run behind them—that might save someone else from getting a knock. Thankfully, I was left without any lasting effects, but I know of constituents who suffered injuries that appeared to be no worse that the ones I incurred, but that had long-lasting effects that were traumatic to see.

In Scotland we are committed to ensuring that those with disabilities such as ABI get the support and care they need to live as independently as possible. The report is a welcome addition to that debate. It brings together key findings in a range of sectors, looking specifically at the impact that an acquired head injury can have on a person’s interaction with many different services. ABI can be caused by a variety of events and have a variety of implications. It is important that specific pathways are available to those who have suffered ABI and have had to go through the pain and trauma of coming to terms with the impact of that injury on their day-to-day lives. Fundamentally, this is about ensuring that people with disabilities can live as independently as possible. Our vision in Scotland is that children and adults with acquired brain injury should have equal access to highest quality brain injury care, regardless of where they live.

It is estimated that ABI is the most significant case of disablement for people of working age in Scotland. We know that around 40% of working age disabled adults are in employment, compared with more than 80% of those without a disability. Our key ambition is to reduce that gap. Many of those with ABI have complex rehabilitation and support needs.

Before I go on to mention some of the national services available in Scotland, I wish to pay tribute to some of the local work undertaken in my area by CRABIS, the West Lothian Community Rehabilitation and Brain Injury Service. CRABIS is funded by NHS Lothian and West Lothian Council, and it provides multi-disciplinary assessment and rehabilitation within the home or community settings—that is important—to those over 16 who have an acquired brain injury. The CRABIS team comprises occupational therapists, physiotherapists, clinical psychologists, speech and language therapists, and rehabilitation assistants. The model they use is being looked at by other areas within Scotland as good practice.

At national level, the Scottish Acquired Brain Injury Network—SABIN—was established in 2007 with the key objective of enabling improvements in and access to services in Scotland for children and adults with ABI. It comprises service user representatives, healthcare professionals, service providers and voluntary sector groups. SABIN published the traumatic brain injury in adults standards, which ensure a joined-up approach to immediate and long-term care for people with an acquired head injury. To achieve those aims, it works with partners to bring together healthcare professionals, service providers, parents, carers and voluntary sector groups who support brain-injured patients. SABIN undertakes events and workshops to raise awareness, including the Brain Detectives event for children who have a relative with a brain injury, which provides education on the effects of such injuries.

Last year, Scotland’s first major trauma centre opened at Aberdeen Royal Infirmary. It will treat the most seriously injured patients in the north of Scotland, and is the first of four major trauma centres to open as part of Scotland’s trauma network, with further centres due to open in Glasgow, Edinburgh and Dundee. A number of speakers have raised the point that in the case of such a traumatic event, people do not mind travelling—I certainly would not mind that should anything happen to me or one of my loved ones. The network will ensure that each year Scotland’s 6,000 seriously injured people get the best possible care and chances of recovery, wherever their location. The new centres will host dedicated trauma services, including rehabilitation support to help patients with significant injuries to recover more quickly. Backed by £15.2 million investment so far, the new Scottish trauma network will also include the Scottish Ambulance Service and existing trauma services.

I could, of course, touch on many other aspects, given the wide-ranging impact of ABI on services and public agencies, many of which—including education, the criminal justice system and health—are devolved in Scotland. I will therefore conclude with an issue that remains largely reserved: welfare benefits. The disability employment gap that I mentioned compounds the problems for those with ABI when interacting with that complex service. I echo the report’s call for less frequent reassessments and for assessors to be trained to understand the problems faced by those with ABI. I hope the Minister will cover that point when she sums up the debate.

Draft Social Security Coordination (Reciprocal Healthcare) (Amendment etc) (EU Exit) Regulations 2019 Draft National Health Service (Cross-Border Healthcare and Miscellaneous Amendments etc.) (EU Exit) Regulations 2019 Draft Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019

Martyn Day Excerpts

Monday 25th March 2019 General Committees

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship, Sir David. I will be brief; I agree with much of what has already been said. Brexit clearly threatens the healthcare of millions of people in Scotland, and their healthcare rights when abroad are something that the Scottish people did not vote to have taken away from them.

It will come as no surprise that the House of Commons has overwhelmingly voted to rule out a no-deal Brexit, as have both the Scottish and Welsh Parliaments, yet here we are still discussing no-deal Brexit contingencies. However, I am pleased that there has been agreement with the Scottish Government on a legislative consent motion. We have never been opposed to common frameworks, but we have always believed that they must be agreed with discussion and with the consent of the devolved Administrations, which in this case they have been. I welcome that progress and that respect for the devolution settlement.

It is clear that mechanisms need to be in place to protect those currently making use of reciprocal healthcare arrangements, as they are being put under considerable psychological and, potentially, physical stress as a result of this Government’s decisions. As these measures, should we ever be in the position of having to use them, go some way toward alleviating their situation, I will not be opposing them today.

Sunbed Use: Health Implications

Martyn Day Excerpts

Wednesday 13th February 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is always a pleasure to serve under your chairmanship, Mr Hosie.

One of the great pleasures of being in Parliament is that I learn new things on a regular basis. I must confess that, prior to coming to this debate, I had, as a peely-wally, fair-skinned, red-headed Scotsman, always avoided the sun and had no experience of sunlamps. It was fascinating to learn about them, and I am grateful to the hon. Member for Mid Derbyshire (Mrs Latham) for securing this debate and for her informative presentation, taking us through the history and many of the health problems. She presented some fantastic statistics, including the fact that sunbeds are used by 3 million people and that they cause three times the DNA damage of sunlight. Her case studies brought home the very human nature of this problem.

There is no doubt that UV rays from sunbeds can damage DNA in skin cells, which, building up over time, can cause skin cancer. The International Agency for Research on Cancer—IARC—accepts that there is enough evidence to show that sunbeds cause melanoma skin cancer, and further states that sunbeds provide no health benefits. That is a fundamental point. It also highlights that sunbed use before the age of 35 significantly increases the risk of melanoma; both earlier speakers used statistics, and the statistics I found last night put the range at 59% to 79% more likely. I do not know the actual figure, and I am interested to hear whether the other Front Benchers have a firmer handle on it. Either way, those figures are frightening.

Those figures are, however, hotly contested by the sunbed industry, which points out that, when professional sunbed use is separated from home use, it has no increased melanoma risk. The industry also highlights the benefits of UVB radiation in treating vitamin D deficiency. While I have no doubt that professional sunbed use will be safer than home use, it is no safer than exposure to the sun. The World Health Organisation classifies sunbeds as a group 1 carcinogen. A WHO director, Dr Maria Neira, says:

“There’s no doubt about it: sunbeds are dangerous to our health”.

I certainly take that warning very seriously.

The Scottish National party recognises the potential harmful effects of sunbed use—or misuse—and has taken action. The Public Health etc. (Scotland) Act 2008, implemented under an SNP-led Government, contains provisions to regulate sunbed use, as well as measures that include prohibiting unsupervised use, banning the use of sunbeds by under-18s and banning the sale and hire of sunbeds to under-18s.

It is imperative that people using sunbeds realise the health implications and risks of doing so, so that they can make an informed decision about their use. The 2008 Act has provisions requiring all sunbed premises to display a health notice visible to anybody entering them and to provide information to customers on the risks, allowing them to make an informed choice.

A Scottish Government leaflet highlights those risks, and reading it earlier in the week gave me my first pieces of information about sunbed use—I have to say that it ticks quite a few of the boxes that would frighten me off ever going on a sunbed, and I encourage the public to have a serious look at it. In addition to the higher risk of skin cancer, it highlights the risk of eye damage—including the higher risk of cataracts if appropriate eye protection is not worn—and of accelerated skin damage, including premature ageing of the skin, which was well covered by the earlier speakers. The leaflet concludes:

“These health risks outweigh any potential benefits in using sunbeds to supplement vitamin D.”

There we have it. There are plenty of warnings about sunbeds, and I will certainly avoid using them. Indeed, I slap factor 50 sun cream on if I walk along Princes Street on a slightly cloudy day. I will leave my remarks at that. I thank hon. Members for an informative debate. I have learned a considerable amount about this issue.