HIV Action Plan Annual Update 2022-23

Nicola Richards Excerpts

Tuesday 18th July 2023 Westminster Hall

[Nicola Richards (West Bromwich East) (Con)]

I beg to move,

That this House has considered the HIV Action Plan annual update 2022-23.

It is a pleasure to serve under your chairmanship, Dr Huq. I was pleased to be successful in my application for this debate, and I thank colleagues from across the House for attending. I start by thanking the Government for fulfilling their commitment to update Parliament on the progress they have made on the HIV action plan—which I fully support—as it is crucial that Members are given the opportunity to scrutinise the progress that we are making on tackling HIV.

We are the generation that has the golden chance to end new cases of HIV by 2030. It is vital that we do all we can to ensure that that becomes a reality. Positive progress has been made to that end, as highlighted in the report. However, there remain further opportunities to stop new HIV transmissions in this country. That would certainly be a lasting legacy the Government could be proud of.

Two measures, in particular, will help to ensure that the Government fulfil their mission to turn the tide on HIV once and for all. First, opt-out testing is the hidden tool in our armoury that is waiting to be unleashed. Last December, I spoke in the House during the World AIDS Day debate about how effective opt-out testing was in those places that had already introduced it.

[Scott Benton (Blackpool South) (Ind)]

My hon. Friend will be aware of how health practitioners in Blackpool have led the way on opt-out testing to achieve great results. The focus on that in high-prevalence areas is of course particularly important, but does she agree that, although the NHS is making solid progress in this regard, it needs to up its game if it is to achieve its own targets by 2025?

[Nicola Richards]

I thank my hon. Friend for his intervention. I know that opt-out testing is already making improvements and that that will benefit his constituents in Blackpool. We have the blueprint for how to do this; we just need to roll it out further.

The numbers do not lie. The annual update revealed that more than 2,000 people have been diagnosed with HIV, hepatitis B and hepatitis C in 12 months alone. It is very likely that without opt-out testing many of these people would not have been diagnosed until a much later stage. That includes diagnoses in parts of London classed as having a “high” rather than a “very high” prevalence of HIV. Let us imagine what can be achieved if we now extend the roll-out to areas of high HIV prevalence, such as in my constituency of West Bromwich East.

The west midlands have several high-prevalence areas outside Sandwell, including Wolverhampton, Coventry and Birmingham. That is why, for World AIDS Day last year, West Midlands Mayor Andy Street joined the calls to fund this scheme in the west midlands. The way to end this virus is to find exactly these people—those who are unaware that they are carrying the disease but who are in fact passing it on to others—so that they can get the care they need and do not increase transmission further.

Opt-out testing in London, Blackpool, Brighton and Manchester has also revealed a quiet but growing crisis by identifying people who have previously been diagnosed with HIV but are not receiving the treatment they need. The UK Health Security Agency estimates the number of people who have fallen out of the HIV care system since 2015 to be an alarming 22,670. The Terrence Higgins Trust, which I take this opportunity to thank for all its excellent work, estimates the number of those who are alive and remain living in the UK as somewhere between 10,650 and 13,006. They are all at risk of becoming seriously ill and further transmitting the virus. In fact, hospitals in London are reporting that this has overtaken undiagnosed HIV as the primary cause of HIV-related hospital admissions.

This is totally preventable. Once someone living with HIV is on effective treatment, they can live a long, healthy life and do not pass on the virus. The annual update shows that more than a third of those found with HIV by opt-out testing were previously lost to care. That is another 473 people who can access treatment, prevent further serious illness and help to stop the spread of HIV. This is an important step forward, but we should not only be finding people when they need emergency care; we should be supporting them to stay in care in the first place. Without finding and providing treatment to those people, we cannot realise our ambition of ending new cases by 2030.

Opt-out testing is helping not only to save lives, but to save money in our health system. The initial investment to set up opt-out testing is dwarfed by the amount saved by providing treatment earlier and preventing serious illness. There is a huge saving to be made, and it is truly making a difference to health outcomes in the places in the country that already have opt-out testing.

[Dame Caroline Dinenage in the Chair]

Furthermore, the Elton John AIDS Foundation has done fantastic work with hospitals in south London on a pilot scheme that can inform a national programme to re-engage people who have been diagnosed with HIV but who are lost to care. Clearly, finding and restarting treatment for those lost to care is an urgent consideration and, at a cost of £3,000 per person, it would be significantly cheaper than providing emergency care if their condition worsened.

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

The hon. Lady highlights an important study from the Elton John AIDS Foundation, which found that, with a low amount of money, people can be returned to care. The problem is that sexual health and HIV services are under strain. That money needs to be ringfenced and provided by the Government so that we can spend now to save later.

[Nicola Richards]

The hon. Gentleman does a lot of work in this area and is a voice to be listened to.

I have shown that the key benefits of extending opt-out testing and further lost-to-care work are threefold: saving lives, saving money and reducing the pressure on the NHS at a time when every effort must be made to reduce waiting lists.

At the time of the World AIDS Day debate last December, I was assured that the Minister would look closely at the outcomes of the trial once 12 months of data was available. I hope that he agrees that the trial has been a success, as the annual report states, and that we should extend the roll-out without delay.

We already have an excellent programme in place, ready to support the expansion of combined blood-borne virus testing. After the Government initially invested £20 million in opt-out A&E testing through the HIV action plan, funding from the hepatitis C programme made it possible to add hep B and hep C to the programme. The success of that has been remarkable, and the hepatitis C elimination programme is already funding opt-out hep C testing in further areas. However, without specific funding for HIV we are missing an opportunity to save even more lives by testing for HIV at the same time.

For example, a pilot programme that took place in the Leeds Teaching Hospitals NHS Trust, where opt-out HIV testing was rolled out alongside hepatitis testing, found 25 people with HIV in just 17 months, along with a combined 297 people with hep B and C. After the end of that pilot, the hospital has been able to secure funding from NHS England to reinstate hepatitis C testing in the emergency department whenever blood is taken. However, it is disappointing that no funding has been provided for HIV testing to go alongside that, especially when the area is one in which there is a high prevalence of HIV. These opportunities to test are currently being wasted.

If we are to expand HIV testing further, it has to be combined with blood-borne virus testing—there is no hierarchy when it comes to the elimination of viruses, and it is important that we make progress against both. We are showing that combining testing is not just better; it is cheaper, more effective and de-stigmatising. I would therefore appreciate it if the Minister could confirm that a national expansion of opt-out hepatitis C testing would include HIV and hep B, as should be the case.

Another way in which we can stop the spread of the virus is by better utilising PrEP, which has been proven to be very effective at preventing the transmission of HIV. As part of the HIV action plan, we committed to an innovation in PrEP delivery to improve access for key groups, including provision in settings outside sexual and reproductive health services. However, we continue to await a date for when that will start, and I strongly urge the Department to outline when that will be as soon as possible.

The Prime Minister recently committed to making other prescription medications, including contraception, available directly from pharmacies. Please can the Government consider doing the same for PrEP, which would make a massive difference to so many? By making it easier to access, we can prevent those most at risk from ever being infected with HIV. PrEP needs to be available to people in GP surgeries, pharmacies and online to truly harness its potential to stop HIV spreading and to end the inequalities in access to the drug. I hope that that is something the Minister can provide an update on when responding to this debate.

[Lloyd Russell-Moyle]

The hon. Lady is dreadfully kind for giving way. I hope she will acknowledge to the Minister that many people end up buying PrEP online, anyway, so there is already a market for it where people access it outside of clinics. The Government are taking a cautious approach, and the people have already marched two miles ahead. The Government should take a more reactive approach, follow where the people are and allow them to buy it over the counter, with advisory blood tests rather than compulsory ones.

[Nicola Richards]

I thank the hon. Member again for his intervention, and I totally agree.

I would also like to raise the plight of those who are living with HIV but who feel unable to access healthcare for a variety of reasons—mainly as a result of the stigma surrounding the virus and concerns over their mental health. Engagement with this group is an important part of the action plan. Can the Minister please use this opportunity today to reassure colleagues that people living with HIV have the opportunity to seek support, and that tailored measures will be introduced to combat the issues I have raised?

Finally, all parts of the health system are responsible for delivering on the action plan. Shortly this will change, with adult HIV services moving from NHS England to integrated care systems in April 2024. As may be evident, the lines of responsibility are somewhat blurred. For that reason, it is key that we clarify as soon as possible the exact lines of authority, so that work can be accelerated to deal with the disparity in HIV support across different areas of the country. Again, I strongly encourage the Minister to provide the House with information on what the Government are doing to deal with this issue.

It is vital that we deliver on the HIV action plan, which gives us a genuine opportunity to be the first nation in the world to end this epidemic, which has both taken and harmed so many lives. By working together and implementing the reforms the action plan sets out, some of which I have mentioned today, we can stop the spread of the virus and, instead of allowing transmission to go undetected, we can stop the virus in its tracks. Many of these measures are non-burdensome but highly effective, so it is vital that we act before it is too late. We have a social responsibility to do all we can now and not to delay the implementation of the plan. I look forward to hearing the Government’s response.

[Several hon. Members rose—]

--- Later in debate ---

[Nicola Richards]

I thank all hon. and right hon. Members for taking part in today’s debate. We all said very similar things, and I hear from the Minister that the first year’s data from the opt-out testing trial is still being analysed. I think he will agree with us that it looks very promising so far, and I want to reiterate that we have all the knowledge we need to end new transmissions of HIV in the UK by 2030. We have the tools and the knowledge to do it. We just need to get on and do it, so I urge the Minister to speed up the work on this issue, because it will be an incredible achievement if this Government can end new transmission by 2030 through the programmes we have set up. It is possible, we can do it and we have to get on with it.

Question put and agreed to.

Resolved,

That his House has considered the HIV Action Plan annual update 2022-23.

Cancer Care

Nicola Richards Excerpts

Tuesday 14th March 2023 Westminster Hall

[Nicola Richards (West Bromwich East) (Con)]

I beg to move,

That this House has considered the future of cancer care.

Cancer will affect every single one of us here today, and every single person in this country, in some way. Statistically, half of us will get cancer in our lifetime. When that happens, both we and our families should expect the best possible care and support from our health service. This time last year, my family and I were coming to terms with losing my mum to secondary breast cancer that spread to her liver. She passed away in April 2022, only six years after her younger sister passed away with the same diagnosis. Their brother, my uncle, has since bravely fought cancer too, and I am pleased to say—not least because he tells the worst dad jokes known to man—that he is doing well.

My family know all too well what the statistics mean in real life. I would like to think that I am one of the few to have lost their mother at an young age, but that is not true. A member of my team, Bradley, reminded me that his mother, Sharon Langer, would have been 58 today. She died in December 2018 from lung cancer.

Thanks to our health and care services, we have taken great strides in improving cancer survival rates. Over the last 40 years, the survival rate has doubled in this country, and now half of the people diagnosed with cancer in England and Wales survive their disease for 10 years or more. However, the number of cancer cases will only rise in the years ahead. Modelling by Cancer Research UK suggests that cases will rise by around a third, with as many as 506,000 people being diagnosed with cancer between in 2038 and 2040. That is not wholly because of a growing and ageing population, as incidence rates are also due to rise, meaning that individuals will be more likely to be diagnosed with cancer than they are now.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

My condolences to the hon. Lady on the loss of her mum, which must have been horrendous. One of my constituents, Jo Taylor, has received an advanced breast cancer diagnosis; hon. Members may have seen her on social media. She is campaigning to make sure that secondary breast cancer, as it is also known, is counted, because currently we only estimate the number of women—and men—with secondary breast cancer. We know that figures drive care. Does the hon. Lady think that that is something the Government will take on board?

[Nicola Richards]

I totally agree. Any statistics and data that we can gather will help us to improve services and understand the landscape when it comes to who is affected and when cancer can recur, and it is important that we take all that into account. It is important to have a long-term plan for making our cancer services fit for what is to come. They need to cope with the increased demand, and deliver the world-leading outcomes that patients deserve.

Last year, the Government declared war on cancer. They announced a 10-year plan to ramp up our cancer services and make them the world leader that they ought to be. However, we now know that our plans for cancer care will become part of the five-year major conditions strategy. Although it is clearly important to take a holistic approach to caring for people with life-threatening diseases, there is no killer like cancer. We must ensure that our strategy addresses the key elements of what would be a world-leading cancer care system: research, prevention, diagnosis, treatment and care. I will first discuss one of the most important elements that we need addressed in the strategy: diagnosis.

Finding cancer early and commencing treatment is key to survival rates. For instance, 90% of people diagnosed at the earliest stage of bowel cancer will survive for five years or more, compared with just 10% of those diagnosed at the latest stage. Furthermore, almost everyone diagnosed with breast cancer at the earliest stage can receive treatment and live for five years or more, whereas only three in 10 women diagnosed at the latest stage survive for more than five years. The picture also varies by region. Unfortunately, if someone lives in the west midlands, they are statistically less likely to survive for five years or more after being diagnosed with lung cancer than those across England on average, and all combined mortality rates are significantly higher than average, too. Those stark figures hammer home the need to make sure that we detect cancer and commence treatment at the earliest opportunity.

I welcome the commitment from the Secretary of State for Health and Social Care that the strategy will shift our model towards the early detection and treatment of diseases. I also welcome the ambitious target set to diagnose 75% of cancers early by 2028. I look forward to reviewing how the strategy will address the need for greater capacity in the breast screening programme, ensure that all women at elevated risk of breast cancer are included in the national breast screening programme, and raise the proportion of all cancers that are diagnosed early; at present, just under 60% are.

Of course, it is not enough to detect cancer in its earliest stage. We also have to make sure that people receive treatment promptly, especially after urgent referrals. Much work still needs to be done in that area. Only 54.5% of people starting their treatment after an urgent referral do so within the 62-day target, and around 2,100 people have waited more than 104 days to begin their treatment. In my constituency of West Bromwich East and the wider Sandwell area, there is a mixed picture when it comes to meeting those important targets. It is welcome that our local health service met the two-week target for referring urgent suspected cancer cases to a specialist. However, like much of the rest of the country, other targets, including the 62-day standard, were not met. When I compare those statistics with the survival rates that I mentioned, it is obvious that we have to do more to ensure that people start treatment as early as possible. A critical element of that is ensuring that cancer services are sufficiently well staffed.

It would be remiss of me not to honour the people who work day in, day out, providing care for cancer patients across the country. We have all relied on them to care for us and our loved ones, in sometimes the most desperate circumstances, and to provide comfort for us in our time of need. I put on the record my thanks to the Mary Stevens Hospice in the constituency of my hon. Friend the Member for Stourbridge (Suzanne Webb); it looked after my mum in her last days, and held a last-minute wedding blessing for me and my now husband at my mum’s request.

We need to address the shortfalls in the workforce that are affecting our success in improving cancer outcomes. We have a shortfall of both clinical oncologists and radiologists, who are vital to the effort to diagnose and treat cancer patients in the earliest stages. It is so important to tackle the workforce issues with long-term plans to recruit and train the staff we need to tackle cancer properly. I welcome the Government’s NHS long-term workforce plan, which commits to addressing those and many other issues across the NHS workforce. I ask the Government to ensure that the necessary funding is provided to meet those commitments.

On the major conditions strategy, I hope that the Government will take into account the wealth of views expressed by Cancer Research UK and other key organisations in the cancer community in last year’s call for evidence, and ensure that the strategy lays the groundwork for a longer-term strategy on cancer that also tackles inequalities.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate. Four in 10 cancers across the UK are preventable. We all know that. Action to prevent cancers will save lives. Northern Ireland—this is not the responsibility of the Minister, by the way—has no smoke-free target. We need a strategy to stop people smoking, to encourage young people not to start smoking, and to fund research and support programmes. Does the hon. Lady agree that we must have a UK-wide smoke-free target? Despite health being a devolved issue, we have to be on the same page to create a national target to prevent some of the deadliest cancers that so many people suffer from and lose their lives to. She is very much committed to that, as am I.

[Nicola Richards]

I completely agree. It is important that we do wider work around prevention, so that when someone who has a history of cancer in their family presents themselves to the NHS, they are taken seriously and their health is evaluated at the earliest stage. That could save the NHS a lot of money and the individual and their family a lot of pain and suffering.

In my constituency of West Bromwich East and the wider Sandwell area, we have worse health outcomes than other areas of the country, as I mentioned. Combined mortality rates for all cancers are higher in the west midlands than the English average. That situation must improve. We have a fantastic opportunity to level up healthcare in our area through the new Midland Metropolitan University Hospital, which will open to my constituents in West Bromwich in the coming year. It is one of a number of new hospitals that this Government are delivering to help level up healthcare. It is vital that we properly equip new and existing hospitals, so that we can tackle waiting times and improve outcomes for patients.

One of the more high-tech solutions, of which we need to see more, is radiotherapy. I recently attended an event in Parliament hosted by Radiotherapy UK and learned more about this form of treatment, which is known to be extremely cost-effective and less invasive. It costs around £3,000 to £7,000 to cure a cancer patient using radiotherapy. West Bromwich Albion legend, Bryan Robson, also attended the event in support of radiotherapy, and I had the opportunity to have a brief chat with him to discuss how the treatment saved his life. During the event, I signed the declaration asking for more action to tackle waiting times and in support of radiotherapy.

The major conditions strategy is an opportunity to refocus on this type of treatment and to ensure that it receives the necessary investment, so that many more people around the country have the option of radiotherapy to treat their cancer. Although having world-leading facilities is vital, they must be backed up with the world-leading strategy we need, and staffed with the people who provide the excellent levels of care that we know our workforce can provide when they are given the right tools. I therefore welcome the Government’s plans to ensure that we tackle the health inequalities between our regions, and I look forward to hearing more about what that means for cancer patients across the country.

I welcome the positive steps that we have already taken to improve cancer care in this country. Evidence suggests that countries with the best cancer outcomes are those that adopt long-term cancer-specific strategies. I therefore hope that the major conditions strategy will commit to improving outcomes for cancer patients and their families, as well as paving the way for a long-term strategy on cancer care that will make our services the best in the world.

--- Later in debate ---

[Nicola Richards]

Thank you, Mr Paisley. I also thank everyone who has taken the time to participate in the debate. At the start, I said that cancer will somehow affect every single one of us present. We all have our own experiences of how cancer has touched our lives. It has taken some of those we held most dear and profoundly changed the lives of those who have survived it. In particular, I thank the hon. Member for Westmorland and Lonsdale (Tim Farron), who also lost his mother far too early. I thank all other hon. Members who intervened and contributed.

It is crucial to remember that behind every statistic, there are thousands of people whose lives have been turned upside down. With every stride we take towards earlier diagnosis and more effective treatment, there will be fewer families out there grieving for the loss of a loved one. I know that the Government and the Minister understand that completely. I thank her for responding, and the Government for declaring a war on cancer. I look forward to working with her to ensure that this country becomes a world leader in cancer care.

I also thank Cancer Research UK, without whom my mum would not have been diagnosed early. In 2016, when I attended a Cancer Research race for life, a lady bravely stood on stage and talked about finding a dimple as the first sign. I went home and told my mother, and that is how she was diagnosed early. I thank all the charities for all their work, including CoppaFeel! and Breast Cancer Now. Finally, I thank you once again, Mr Paisley. It has been a pleasure to serve under your chairmanship.

Question put and agreed to.

Resolved,

That this House has considered the future of cancer care.

World AIDS Day

Nicola Richards Excerpts

Thursday 1st December 2022 Commons Chamber

[Nicola Richards (West Bromwich East) (Con)]

I thank the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) for leading this debate and for his commitment to this cause. As the number of new HIV cases in this country falls, the importance of the issue does not. We stand on the shoulders of giants and of the 38 million globally lost to AIDS-related illness. Their early passing will not be forgotten. In fact, it inspires us to work harder and quicker.

This Government are proud to be one of the first in the world to commit to ending new HIV cases by 2030, and we are proud to put our money where our mouth is. This time last year, my right hon. Friend the Member for Bromsgrove (Sajid Javid), as Health Secretary, provided £20 million to fund opt-out testing in London, Brighton and Manchester. Thanks to the campaign of the Terrence Higgins Trust and my hon. Friend the Member for Blackpool South (Scott Benton), Blackpool was also rightly included. This investment has had remarkable results and is already garnering savings for the NHS.

In the first 100 days of this programme, around 128 people were newly diagnosed and roughly 65 people who were previously diagnosed returned to the care of an HIV clinic. On top of all the standard HIV testing, that is almost 200 people who no longer have HIV attacking their immune system and who cannot pass on the virus to others. What a triumph. Adding that half the hospitals also tested for hepatitis and found 325 cases of hepatitis B and 153 cases of hepatitis C, the success only builds. Well over 500 people have been prevented from becoming very unwell on our watch.

Having spent about £2.2 million on four months of testing, the savings are calculated at between £6 million and £8 million. These are not pipe-dream savings but a real reduction in the pressure that accident and emergency departments and hospitals face this winter. When Croydon Hospital started opt-out testing, the average hospital stay for a newly diagnosed HIV patient was 34.9 days. Two years later, it is 2.4 days. I know a few hospitals that could also do with such pressures being released.

In the west midlands we have five areas of high HIV prevalence, and my borough of Sandwell is among them with a prevalence of 2.92 cases per 1,000 adults, which is well above the national average. The National Institute for Health and Care Excellence says that areas such as Sandwell should

“offer and recommend HIV testing on admission to hospital, including emergency departments, to everyone who has not previously been diagnosed with HIV and who is undergoing blood tests for another reason.”

Such testing is not yet happening in Wolverhampton, Coventry, Sandwell, Birmingham or Walsall. We have to find our undiagnosed and lost-to-care residents and get them into treatment as soon as possible.

The Mayor of the west midlands, Andy Street, has written to the Health Secretary asking for this “invest to save” resource for our region, and I add my voice to his call and ask the Minister if he can help level up the HIV response outside London. With funding for opt-out HIV testing, we can put the west midlands on track to end new HIV cases by 2030.

Andy Street rightly said

“This is not a World AIDS Day stunt but a serious call for action. I don’t want ‘The Ribbons’ to simply be a tribute. It needs to be a reminder that HIV is still happening to many”.

I know my hon. Friend the Member for Birmingham, Northfield (Gary Sambrook) and local councillors in Sandwell, such as Councillor Scott Chapman, join Andy and me in asking for an extension to opt-out testing to cover my West Bromwich East constituency.

We have made such incredible strides. As well as remembering the devastation that HIV has caused for so many around the world, we have to celebrate how far we have come. We have preventive drugs available on the NHS—drugs that stop any trace of HIV so that those who contract it cannot pass it on to others—and we are now seeing the major success of opt-out testing in some of the country’s worst HIV hotspots. In an odd way, the medical question is not really the problem; it is the stigma.

I recently met Harry Whitfield, also known as Charity Kase, who last year made his debut on “RuPaul’s Drag Race UK” to showcase his incredible talents. He talked about how hard it was to deal with his HIV diagnosis. For last year’s World AIDS Day, Harry said:

“The stigma around HIV is far worse than the disease itself. I take one tablet per day to stay healthy and completely undetectable so I can’t pass the disease on. I’m thriving in my life every day, but that’s not the narrative that gets told when talking about HIV.”

Last year, like so many, I was completely engrossed in “It’s A Sin.” Until then, I had not thought that much about HIV. Probably because of my age, I had not properly considered how terrifying that period of time was for so many. When I was sent an HIV test to raise awareness during testing week, I took the test and posted about it on social media. I knew it had the potential to create some odd feedback, but I felt it was important. Some of the comments came from people who thought HIV was a thing of the past, and they accused me of talking about it only as a means to control people now that we are out of the covid pandemic. It showed me the importance of keeping this issue alive.

My experience is similar to that of my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), with people questioning why I thought it was necessary to take a test and what I had been up to. However, one constituent thanked me. He said:

“I’m a victim of this myself. I was fortunate to be born at the right time for effective treatments. But only just. These new tests were not around when I was diagnosed. I just happened to randomly find out through routine MOT as they call it.”

He also said told me that the stigma is the main issue.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

I congratulate my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) on securing this important debate on World AIDS Day. Like the hon. Member for West Bromwich East (Nicola Richards), my Slough constituency has a relatively high prevalence of HIV. It is vital that our town is properly supported in the fight against HIV and AIDS in order to meet the 2030 target, which is why I wrote to the Health Secretary to request that Slough be included in the opt-out HIV testing scheme.

Does the hon. Lady agree it is important that the Government support areas like ours so that we get the right level of support? Without that support, we could experience a resurgence that none of us wants.

[Nicola Richards]

I completely agree with the hon. Gentleman. Opt-out testing is one of the easiest ways to end the transmission of HIV and become the first country to be HIV-free by 2030, which would be incredible. Opt-out testing is clearly a great route to do that.

“It’s A Sin” has helped to bring this issue back to life, not just as a reminder of the 38 million people around the world lost to AIDS-related illness, but as a reminder of how far we have come. The series also makes it glaringly obvious that we have more to do to tackle the stigma.

I place on record my thanks and appreciation for the Terrence Higgins Trust. It is 40 years since the death of Terry Higgins, one of the first to die of an AIDS-related illness. The trust does incredible work to end the stigma around HIV, which is one of the biggest barriers that stops people getting testing, and therefore one of the biggest barriers to ending the transmission of HIV by 2030.

HIV is no longer a death sentence. It is no longer the terrifying disease that “It’s a Sin” so intensely brought to life for people like me who did not live through those incredibly difficult times. I thank the Government for supporting opt-out testing, and I call one last time for the pilot to be extended to other hotspots, including the west midlands.

Oral Answers to Questions

Nicola Richards Excerpts

Tuesday 19th July 2022 Commons Chamber

[Maria Caulfield]

The hon. Lady says there is no excuse for missing those waiting times, but perhaps she can explain why the Labour Government in Wales are also missing those times.

[Nicola Richards (West Bromwich East) (Con)]

8. What steps he is taking to improve cancer outcomes.

[Mr Speaker]

I welcome you to the Dispatch Box, Minister.

[The Parliamentary Under-Secretary of State for Health and Social Care (James Morris)]

Thank you, Mr Speaker. The Government are focused on improving the early diagnosis of cancer in England to aid cancer outcome rates. That was set out in the NHS Long Term Plan, setting an ambition of seeing 75% of people diagnosed within stages one and two by 2028. Progress has continued on delivering the Long Term Plan. That includes increased investment and public awareness campaigns, rolling out targeted lung health checks, and introducing non-specific symptom pathways to speed up diagnosis.

[Nicola Richards]

Very sadly, in April this year I lost my mum to a sudden diagnosis of secondary breast cancer in the liver, and so like many, I understand that cancer outcomes are not just statistics. In my constituency of West Bromwich East our outcomes are significantly poorer than the national average, and I know what that means for families. When will my hon. Friend publish the 10-year cancer plan, and confirm the levels of investment going into that?

[James Morris]

I am sure I speak for the whole House in expressing condolences to my hon. Friend for the loss of her mother. I know she is a doughty champion for addressing health inequalities in her constituency. While the publication of the 10-year cancer plan is under review, we remain committed to tackling inequalities and levelling up outcomes, experience and access. That is a key focus of the NHS Long Term Plan and 2022-23 planning guidance, and it remains a priority for the Government and the NHS cancer programme. Approaches to support that are embedded throughout the programme —for example, increased accessibility for the cancer quality of life survey, to help increase representation results and, as I mentioned, the targeted lung health check programme is focused on areas with high lung cancer mortality, where typically there are also high levels of deprivation.

Oral Answers to Questions

Nicola Richards Excerpts

Tuesday 18th January 2022 Commons Chamber

[Maggie Throup]

I would like to reassure the hon. Lady that the Joint Committee on Vaccination and Immunisation is monitoring this all the time, and we take advice from the JCVI.

[Nicola Richards (West Bromwich East) (Con)]

11. What steps his Department is taking to reduce waiting times for face-to-face GP appointments.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

In October last year, the Government announced a plan to improve general practice capacity, backed up by £250 million of winter access funds to help GPs and their practices. That can be used to fund more sessions from existing staff, or indeed increase the physical premises at a practice. For my hon. Friend’s area, the Black Country and West Birmingham clinical commissioning group expects an award of £6.5 million from the winter access fund.

[Nicola Richards]

My constituents in West Bromwich East have been raising concerns with me about their ability to access face-to-face GP appointments at local surgeries. Given the significant £250 million winter funding package for general practice announced towards the end of last year, what assessment has the Minister made of whether that support is making a real difference on the ground?

[Maria Caulfield]

I thank my hon. Friend, who is pushing me constantly to improve access for her constituents, but can I reassure her that the announcement, the funds and the support are making a difference? In November last year, there were on average 1.39 million general practice appointments per working day, compared with 1.31 million in November 2019, but crucially, 62.7% of those appointments were face to face, so this is really making a difference for patients.

Breast Cancer Screening

Nicola Richards Excerpts

Wednesday 16th December 2020 Westminster Hall

[Nicola Richards (West Bromwich East) (Con)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for High Peak (Robert Largan) for securing this important debate.

Finding breast cancer early will save lives—that is the bottom line and has always been the case. The earlier breast cancer is diagnosed, the more likely it is that treatment will be successful. That is the messaging that needs to be harnessed moving forward. Fifty-five thousand women and 370 men are diagnosed with breast cancer in the UK per year. We are doing much better, but those figures are a stark reminder of the prevalence of this type of cancer in our communities.

In my local patch, West Bromwich East has about 141 per 10,000 people developing breast cancer, compared with 168 per 10,000 across England. That means 284 people in my constituency are diagnosed with breast cancer every year. In West Bromwich, 67.5% of women aged 50 to 70 are invited to attend a screening within six months—a figure that is significantly worse than the 72.4% across England. The uptake of screening appointment invitations is also significantly worse than the England average.

Aside from screening appointment uptake, we have a wider issue that affects the entire NHS. As an increased percentage of the population becomes eligible for breast cancer screening, the existing infrastructure needs to evolve to meet that demand, in terms of both a trained workforce and diagnosis machines. Indeed, Professor Sir Mike Richards’ independent review of adult screening programmes in England, which was committed to in the NHS long-term plan, made some incredibly interesting findings when it was published last year. Most strikingly, according to the review, screening programmes are constrained by the size and nature of their workforce and by the equipment and facilities available to them. That will act as a barrier to implementing the review’s recommendations.

The breast cancer screening workforce are being put under increasing strain as the populations eligible for breast screening increase. Creating the capacity for that change is key to ensuring that screening programmes are fit for the future. The Chancellor’s spending review announcement committing £325 million for the NHS to invest in new diagnostics machines such as MRI and CT scanners was clearly welcome, but that is only a short-term fix to address the current backlog. Ultimately, it comes down to education about the importance of the issue and of the process of getting women to be screened. We also need to move away from the idea that only the over-50s are diagnosed with breast cancer; young people are affected too.

Various online petitions to lower the age at which breast cancer screening services are offered outline a crucial point. Research shows that the X-ray mammogram test used in the breast cancer screening procedures, which can spot cancer when it is too small to see or feel, is much less effective in younger women due to their tissue density. Therefore, educating young women to check for anything abnormal in their body has never been more important, mainly because we know that they have a much higher chance of survival if it is caught early.

I ask the Minister to update us on the Government’s plans to lower the age at which breast screening services are offered and on what the Government plan to do to help younger people identify breast cancer sooner. The NHS has a serious job on its hands to break down these barriers, where people simply think it will be okay and do not get screened. We need to be proactive in encouraging people to take this seriously.

We have made amazing progress so far, but more can be done and early diagnosis is key. I can relate to that directly. Six months after my aunt passed away from secondary breast cancer, my mum—her sister—was also diagnosed. I advised her to be on the lookout for early signs, namely dimples. She is in full health now, but if I had not told her of the signs back then, things could have been different. My mum would not have gone to see her GP and she would not have known some of the lesser-known early warning signs of breast cancer.

The coronavirus pandemic has caused a backlog in screening and treatment. Breast Cancer Now estimates that a significant backlog of nearly 1 million women requiring screening built up across the UK in the course of this year. It is unclear how long it will take to catch up. Some measures have been taken to try to ensure attendance at the reduced number of appointments available. In England, from the end of September to the end of March 2021, women will be sent open invitations to call and make an appointment for screening, rather than a timed appointment.

Research shows that the number of women making appointments is significantly lower than those who attend timed appointments. That could worsen the persistent decline that we have seen in the take-up of breast cancer screening in recent years. The impact this will have on groups among which the uptake is already low is particularly concerning—for example, women living in deprived areas and some black and minority ethnic groups. How can we reach these people, reassure them and encourage them to be screened? I would be grateful if the Minister has any ideas on this. Will she also confirm what action the Government are taking to ensure that women are sent open invitations to make an appointment for screening, and what success there has been in the take-up of open invitations?

Our NHS staff have worked tirelessly over the course of this dreadful pandemic and made sacrifices on an unimaginable scale. We need to back them in this place on breast cancer screening too. I passionately believe that it is everyone’s role to promote the importance of breast cancer screening and early diagnosis, and to ensure that we have the right number of women screened as early as possible. After covid-19 is over, this should be one of our new “saving lives” messages.

Covid-19 Update

Nicola Richards Excerpts

Thursday 10th September 2020 Commons Chamber

[Matt Hancock]

As I said in my statement, there is record testing capacity, and most people get tested very close to home. We do have a challenge, however, because some people without symptoms who are not eligible for a test have been coming forward. Thus far, I have been reluctant to place a barrier and a strong eligibility check on the front of the testing system, because I want people with symptoms to get that test as fast and easily as possible. However, given the sharp rise in the past couple of weeks of people coming forward for tests when they are not eligible, we are having to look at that. The key message to the hon. Lady’s constituents is that the tests are vital for people who have symptoms, and therefore people who do not have symptoms and have not been told by a clinician or local authority to get a test, should not and must not go and use a test that somebody else who needs it should be using.

[Nicola Richards (West Bromwich East) (Con)]

I understand the recent actions that my right hon. Friend has taken to limit gatherings to six people, and I encourage everyone in West Bromwich East and the wider west midlands to follow the new rules. Does he agree that West Bromwich should remain separate from any local lockdown in central Birmingham, given that they are two distinct areas with varying rates of infection?

[Matt Hancock]

Of course, West Brom is a distinct area and separate in its geography from central Birmingham. However, I caution my hon. Friend that we are seeing sharp rises in cases across many parts of the west midlands. We take these decisions on a localised basis; we do not take a whole local authority or area of regional geography in one go, but we do follow the data. I will make sure to keep in touch with my hon. Friend. She is a strong advocate for her local area, but sometimes action is necessary.

Covid-19 Update

Nicola Richards Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

We are doing a huge amount of work on the very issue that the hon. Gentleman raises. Ultimately, when students are off campus they are citizens like everyone else—hence the focus on the social distancing rules that we all have to follow. However, he is right that we have seen the biggest rise in infections among 17 to 21 year-olds, many of whom will be going to university in the next few weeks.

[Nicola Richards (West Bromwich East) (Con)]

I thank the Secretary of State and his team for their tireless work throughout the pandemic. Last week, I had the pleasure of visiting the Kuumba centre in West Bromwich, where I met Patricia and her team to hear about their passion for helping the local BAME community get through this difficult time, including by providing mental health support to the local area and some junior doctors. What further support can he make available to similar organisations that are supporting the community and are heroes on the frontline of the NHS?

[Matt Hancock]

This is another important question about how we can provide support locally, especially in the west midlands, where it is so important, especially with cases rising, not only that we have the national response that we are discussing in this Chamber, but that we ensure that the local community, which my hon. Friend supports so effectively, can get the support it needs. I am happy to write to her with details of the extra funding that we have put into her area and to discuss with her what more might be done.