Diabetes: Tailored Prevention Messaging

Debate between Paul Girvan and Jim Shannon

Thursday 24th October 2019 Westminster Hall

[Jim Shannon]

I know the Minister will reply to that, because that is one of the questions that I had hoped to get an answer on.

On the Monday before last, we had a diabetes event in the House. Before I came over, some of my constituents said, “Will you go along to this event about diabetes? It is really important, because some great things are being done in some parts of England and we would like to know about them.” When I got there, the people were most helpful and informed me that Northern Ireland has one of the better type 1 diabetes schemes, which is reaching out to 70% of people. As we often do in Northern Ireland, in this case we have a scheme in place that is almost voluntary. We have an un-functioning Assembly, which is disappointing, but we have a system whereby that scheme is working. Some of the things that we are doing, we are doing quite well.

There are 4.7 million people living with diabetes across the UK, each of whom should be treated as an individual. In Northern Ireland, we have 100,000 people with diabetes in that 17-plus bracket, but obviously it is more than that when it is all added up. Every day across the United Kingdom of Great Britain and Northern Ireland, 700 people are diagnosed with diabetes; that is one person every two minutes.

I had a good friend—he is not in this world any more, but that is not because of diabetes—who was a type 1 diabetic. He ate whatever he wanted and I always said to him, “You cannot eat all those things.” He said, “Oh, I can. All I do is take an extra shot of insulin.” I said, “That’s not how it works!” I do not know how many times I told him that. My three hon. Friends—my hon. Friends the Members for East Londonderry (Mr Campbell), for South Antrim (Paul Girvan) and for Upper Bann (David Simpson)—will know who it is, so I will not mention his name. He was very flippant about the control of his diabetes, but it seemed to work for him. I could never get my head around the idea that an extra shot of insulin seemed to cure the problem.

[Paul Girvan (South Antrim) (DUP)]

I thank my hon. Friend for bringing this important debate to the Chamber. My wife is a type 1 diabetic who is insulin-dependent. She has already—she is a bit younger than me—lost a kidney, because of lack of control, which can cause problems. That needs to be identified: control is vital, and it is important for people to monitor regularly. New technology is available that can actually give readings constantly, as people go. It is important that people start to use the available technology, so they do not have to take more insulin than they need, but can take it only when it is needed.

[Jim Shannon]

Like my hon. Friend, my wife is younger than me. It must be a Northern Ireland DUP MP thing—we look for younger wives to keep us young. I am not sure if that is right or wrong, or if it is politically correct to say that, but my wife is nine years younger than me. She understands the issue of me and diabetes.

Some 10% of people with diabetes have type 1 and 90% have type 2. I will refer to both throughout my speech, and I encourage hon. Members to do the same and to acknowledge the different factors at play with each. We can manage type 2 with medication, provided we control what we eat and what we put in our bodies. Of those living with diabetes, we have the broadest cross-section of society. The condition affects all genders, ages, ethnicities and financial situations. However, too often I see that policy makers and clinicians fall into the trap of treating people with type 1 or type 2 diabetes as homogenous groups that will respond to the same approach and message, but they respond in different ways.

During this debate I want to focus on four things: the primary prevention of type 2 diabetes; the need to offer different messaging to ensure that the support is appropriate for each individual living with diabetes; the necessity of preventing the complications of all forms of diabetes; and innovations in technology—there is marvellous technology —and patient pathways that can improve outcomes for people living both type 1 and type 2 diabetes. I wish that I had known 12 months before I was diagnosed that the way I was living—the lifestyle, the stress—was putting me at risk. We all need a bit of stress; it is good and keeps us sharp, but high stress levels with the wrong eating and living habits is harmful. I do not drink fizzy lemonade any more because it was one of the things pushing me over the edge. That was probably why I lost most of the weight fairly quickly.

Let us talk about prevention. Today more than 12 million people are at increased risk of type 2 diabetes across the UK. More than half of all cases of type 2 diabetes could be prevented or delayed. If I had known a year before my diagnosis, I could have stopped the downward trend in my health, but I did not know, and I wish that I had done. Many in this House offer leadership on type 2 diabetes prevention; the right hon. Member for Leicester East is certainly one of them. England is a world leader on this front, having recently committed to doubling its national diabetes prevention programme.

I was pleased to attend a roundtable discussion last summer, chaired by the hon. Member for Enfield, Southgate (Bambos Charalambous), at which we considered the link between obesity and diabetes and the importance of tailored messaging for the different subsets of the population. During the discussion I met the inimitable Professor Valabhji, the national clinical director for obesity and diabetes at NHS England, whose leadership in this space should be celebrated. I put that on the record because his knowledge and help for those around him, and his research into and development of how we deal with diabetes, are incredible.

For people with type 2 diabetes, there is the additional aspiration of achieving remission. I echo colleagues’ congratulations to the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson). We watched him almost shrink. One day I stopped him and said, “Tom, is everything all right?” He was losing so much weight, but it was his choice to diet as he did. He is an inspiration for many people because of what he has done, and I commend him for it. The concept of remission can be alienating, however, because it is not possible for every person with type 2 diabetes.

Central to the effectiveness of all types of support for the individual and the wider population is the messaging used, which is what this debate is about. Tailored messaging should be developed for the sub-groups most at risk of type 2 diabetes. For example, those in the most deprived areas of the country are nearly 50% more likely to be obese and have type 2 diabetes than those in the most affluent areas: there is type 2 diabetes in areas where people do not have the same standard of living.

Obesity is responsible for around 85% of someone’s risk of developing type 2 diabetes. Additionally, south Asians are six times more likely to develop type 2 diabetes than Europeans are. It is a well-known cliché that men are not so open or proactive—I can say this is true—about their health needs, and men are 26% more likely than women to develop type 2 diabetes. I am willing to speculate, as one who fell into that category, that that is in part due to messaging not being in a format that reaches men. I did not know what it was, did not know what it meant, did not know what the symptoms were, but it was happening.

We need to focus some of the messaging on the importance of prevention and the risk of type 2 diabetes for men. Will the Minister commit to ensuring that all messaging to support those with type 1 and type 2 diabetes, as well as for type 2 diabetes prevention, is tailored to the relevant sections of our society?

I have to manage my diabetes every day. I take my tablets in the morning and at night. I am careful about what I eat. By and large, I manage it. I check my sugar levels every morning. The doctor tells me to check and I do it every day so that I know where I am. I am a creature of habit; I do it all the time so that I know exactly where I am. Some days it is out of kilter, probably because I transgressed and had a cream bun when I knew it was the wrong thing to have. None the less, we do such things.

On self-management, the average person with diabetes will spend just three hours a year with a healthcare professional. That means that they will spend most of their time managing the condition themselves and will need appropriate education. The right hon. Member for Leicester East chairs the all-party parliamentary group on diabetes. He organised a seminar where we looked at healthcare professionals and how people manage their own condition and therefore need appropriate education. The current delivery of structured education does not reflect the varying needs of each individual living with diabetes. We are all different.

The best efforts of healthcare professionals and those who provide education often focus on perfect self-management or no self-management at all. In reality, the daily struggle of living with a long-term condition means that every marginal improvement should be seen as a true achievement. We have to manage it and encourage ourselves as we move forward. We have to make sure that by moving a step forward we can then move forward again. There has been an admirable drive to increase the uptake of education, but education alone will not help an individual manage the ups and downs of living with the condition. They need the tools and confidence, as well as the education, necessary to manage their condition.

When I speak to people in my constituency who live with diabetes, they often highlight the feeling of isolation. I am sure we can all agree today that there is a need to provide each of those individuals with the support they need to take away the isolation. Being a diabetic can be lonely if someone does not know how to manage it. They might think they are doing the right thing when they are not. Issues have been highlighted to me about the delivery and format of education programmes. Digital solutions and coaching services should be explored. The Minister referred to that in a conversation that we had prior to this debate. I look forward to her response. We always get something positive from her, and we will certainly get something positive today.

Will the Minister commit to ensuring that the delivery, format and content of structured education programmes is improved through the use of digital solutions, and that national guidelines are adapted to accommodate that? Health apps could also be used to refine and augment diabetes training programmes by enabling clinicians to learn from patients about what motivates them and therefore what support to provide.

I want to congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on her leadership on how health apps can be used to improve care and patient self-management. Many MPs in this House are diabetic or have an interest in diabetes. That is why we are here today. We are either diabetic or interested in the matter and here to make a contribution. I commend and thank right hon. and hon. Members for their commitment.

Will the Minister commit to undertaking an extensive public engagement and education programme, using digital platforms where appropriate, to showcase effective and evidence-based health apps and encourage their wider usage? Support needs to be tailored to individuals’ particular needs, in recognition that no single solution works in self-management for everyone. Everybody’s needs are different. I was the first diabetic in my family. When the doctor diagnosed me as a diabetic he asked me about my mum and dad and my wife’s mum and dad, and whether there was anybody in my family tree with the condition, but there was no one there. Unfortunately, my condition was caused by my diet and my lifestyle, so I created the problem. It was not hereditary, but it is how we deal with such things and tailor our responses that matters.

I have recently been convinced that health coaches—the Minister will comment on this—can play a key role in this space. Coaches can bring a distinct non-clinical skillset that poses questions for patients to help them devise the solutions that work for them, to help build their self-confidence and self-motivation—in stark contrast to the more prescriptive approach taken in clinical settings. Coaching needs to be clearly defined, and the full range of support that coaches can provide to support tailored prevention messaging needs to be identified. I look to the Minister’s response, because I believe it will have some positivity in relation to what we seek and what will happen.

It has been brought to my attention that the health service may ultimately need to decide whether to adopt a population-based approach to support improved outcomes across the entire population, or a more targeted approach aimed at those facing the greatest barriers to effective self-management. Will the Minister ensure that the health system explores the full range of ways in which health coaches can support people living with long-term health conditions, as well as carers and family members, through the development of an NHS definition of health coaching? Does she agree with me—and I hope with others in the House—that the UK has an opportunity to be an exemplar in the use of health coaches? It is an excellent opportunity and I hope that through the Minister we can make those changes.

I want finally to discuss the potential of innovations and technology in addressing issues related to self-management. That is what I do—I self-manage my diabetes. A flexible approach to the provision of structured education is vital to support self-management. Once equipped with the information and skills necessary to self-manage, people must have access to, and choice from, a range of proven technologies to help them manage their condition in everyday life. There has been a big investment in technology recently in the NHS.

We welcome the Government’s commitment to the extra spend on health, which we talk about regularly. All us in the House are particularly appreciative of the Government commitment. People with type 2 diabetes are now provided with glucose monitors; my hon. Friend the Member for South Antrim (Paul Girvan) referred to those in an intervention. However, people are offered little education on how to use them appropriately. There may be something more that we can do about that. It is good to have the technology, and to be taking steps forward, but it is also good for people to understand how to use it appropriately for management.

The level of investment in innovative hardware for people with type 1 diabetes is substantial and should be commended. However, individuals can be left lost if timely support is not available to help them to interpret and utilise those tools as a means of preventing complications. Many people with type 1 diabetes choose not to access the technologies now available to them. Why is that? I do not know the reason, but it is a question we must ask. I believe that it is partly because of a lack of individual awareness. In the case of my diabetes, that would be right. It could, potentially, be linked to a lack of information. If information is not being provided, I should hope that something could be done about that.

Later in the month an event is being held in Parliament, chaired by the right hon. Member for Knowsley (Sir George Howarth). The event, held in partnership with the type 1 diabetes charity JDRF, is to do with the development of a new report on access to technology for people with type 1 diabetes, “Pathway to Choice”. I look forward to reading the report when it is published, and I know the Minister will be keen to read it.

All of us with an interest in diabetes—and that is why Members are here for the debate—will be interested to read it. Can the Minister inform colleagues here today what measure will be introduced to ensure that all people living with either type 1 or type 2 diabetes can access the latest proven technologies that are right for their situation?

Baby Loss Awareness Week

Debate between Paul Girvan and Jim Shannon

Tuesday 8th October 2019 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), in her absence, for moving the motion. It is always a pleasure to follow the hon. Member for Rotherham (Sarah Champion).

We have heard some marvellous speeches today about personal experiences, and every one of them has been very poignant and has encapsulated what this is all about. I have spoken to previous motions on baby loss, and I am happy to continue doing so in remembrance of those little lives lost.

The fact of the matter is that, since last year, more hearts have been broken, more arms have been left empty and more grief has entered homes throughout the United Kingdom of Great Britain and Northern Ireland. That deserves recognition in the House this year and every year, as the hon. Member for Banbury (Victoria Prentis) said.

This does not take away from anyone else who has contributed to the debate, but I would particularly like to mention the hon. Members for Thirsk and Malton (Kevin Hollinrake), for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince). In our debates in this House they have told us their personal stories and have helped us to understand exactly what it means to lose a child. One thing that came out of those Adjournment debates and those contributions in this House was the need to have a separate room in hospital where people can grieve and have privacy, and the hon. Member for Brigg and Goole (Andrew Percy) talked about the one in his constituency. [Interruption.] I hope Members excuse me; I have a bit of a chest infection and am trying to keep it off if I can.

I mentioned the next thing to the hon. Member for Colchester and he can probably remember it: the importance of having faith involved, as people can use that to help get to the other side of the grieving process. Where there are rooms where people can have privacy, it is important that they can call upon someone of faith to come to give support. The hon. Member for Rotherham spoke about how important it is to have someone to speak to, relate to and understand.

Most miscarriages happen in the first 12 weeks, which is known as “early pregnancy”, and an estimated one in four pregnancies ends in miscarriage—it is one in five if we only count women who realise and report the miscarriage. About 11 in 1,000 pregnancies are ectopic. About one in 100 women in the UK experience recurrent miscarriages—three or more in a row—and more than six in 10 women who have a recurrent miscarriage go on to have a successful pregnancy. The risk of miscarriage greatly reduces in the second trimester—miscarriages then are called “late miscarriage”. My mother miscarried on three occasions, and seven in our family have had this happen; my sister also miscarried on three occasions. The girl who is, in effect, my Parliamentary Private Secretary and writes my speeches in this House—she is a very busy girl, as people would understand, given the contributions that are made—has also had two miscarriages.

[Paul Girvan (South Antrim) (DUP)]

On the number of people who have had difficulties, the problem we have perhaps relates to the level of focus on care, aftercare and counselling. I am not saying this is inevitable and will always be the case, but we do not have the necessary focus on counselling for the individuals and families who have gone through this traumatic experience. Unfortunately the fear of what they have been through sometimes means that they do not want to have another child and go through this again, so they are denied the opportunity to have a family because of what they have experienced; a lack of counselling means that that can sometimes be a fear.

[Jim Shannon]

I thank my hon. Friend for that intervention and I can relate it to my constituency and the people I have spoken to. The thing that sustained my sister, my mother and my PPS was their faith, which is why I come back to the importance of having faith, as I said to the hon. Member for Colchester. In the past year, I have known of two women in my constituency who knew that their baby would not live for more than a couple of hours after the birth yet they carried their baby to its full nine months and enjoyed those few hours together. I am a member of many organisations, one of which is the Royal Black Preceptory. We helped the father of a young child who was lost with a charity event at the bowling club in Ballywater to raise money for this issue, and we raised some £1,000.

I wanted to say all that because it is important, as everyone deals with things in their own way. About one to two in 100 women have a miscarriage in the second trimester. According to one study, once a pregnancy gets past six to seven weeks and there is a heartbeat, the risk of having a miscarriage drops to about 10%. Those are the facts and they are worthy of noting, but they cannot begin to deal with the process of grief that is suffered. It may sound comforting for people to understand that one in four pregnancies ends in a loss and so they are not alone, but, as one lady said, “I don’t want to be the one in four, I want to be the three who live their life as normal and don’t have this emptiness inside.”

It is important to note the facts, but it is more important to acknowledge the grief and the right to grieve. Long gone are the days of, “Just don’t talk about your loss.” We have learned that for those who wish to express themselves it is healing to do so. Some people need to talk about it, but some decide that they may not. Of course many women will never talk of their loss, and that too is part of their process and is to be respected. For others, the symbolism of a balloon release or the lighting of a candle is a way of acknowledging a life that did not blossom but was most definitely there.

We do not understand why many miscarriages take place, but with an NHS under such pressure—I say that really gently, because we have a wonderful NHS that does great work—we do not investigate until the third miscarriage. That in itself is incredibly difficult. I know of one lady whose parents, after encouragement by the midwife after her second miscarriage, paid for private care and for private tests and all the rest, to learn that taking baby aspirin would increase her chance of keeping the next little one. A baby aspirin once a day saw her have a beautiful baby girl. There could well have been another miscarriage had she not been able to seek private advice. When it comes to that example of how that lady dealt with a miscarriage and then had a child, I wonder whether the necessary advice is there in the system and throughout the process. I have said it before and I shall say it again: three miscarriages but no investigation is too much. I sincerely urge change in the NHS procedure. Perhaps the Minister will be able to respond to that point or give me some idea of where we are.

This debate cannot solve the issue of baby loss and grief, but it can validate the fact that a miscarriage was a loss. It happened and should be remembered, and we as a nation should mourn. The fact that a death certificate cannot be issued until 24 weeks must be reviewed. I find that quite incredible. It does not mean that it is not widely understood that someone has suffered through a death. And it is not simply the mother who suffers, but the father and the would-be grandparents, too. The hon. Member for Eddisbury referred to it, and although the hon. Member for Colchester has not spoken today, I remember his previous contributions. The wider family suffer as well. It is like throwing a stone into a pond: the ripples go right to the edge—they touch everyone in the family circle and all the friends. Everyone should remember that.

We must do more to recognise and support those who suffer from a miscarriage. A pamphlet in a cold, sterile procedure room is not enough. I read a little quote that touched my heart. This lady said:

“I carried you for every second of your life—and I will love you for every second of mine…Let sweet Jesus hold you until mummy and daddy can hold you”—[Interruption.]

Persecution of Christians Overseas

Debate between Paul Girvan and Jim Shannon

Thursday 18th July 2019 Commons Chamber

[Jim Shannon]

My hon. Friend is most generous. I have been working to raise the issue of the persecution of Christians, people of other faiths and people with no faith.

[Paul Girvan (South Antrim) (DUP)]

I have a sister who is a missionary in Africa. Her team encounter persecution on a daily basis and have faced particular difficulties in the Democratic Republic of the Congo. Some of this persecution has sometimes been called tribal violence. It is not tribal violence; it is tribes rising against Christians, and it has been covered up by the world media. We also need to highlight that issue.

[Jim Shannon]

I thank my hon. Friend for his intervention. My hon. Friend the Member for Belfast South (Emma Little Pengelly) said that it is the job of Members of this House to raise awareness, and she is right. But it is also our job to speak out for those who cannot speak for themselves.

Mental Health: Assessment

Debate between Paul Girvan and Jim Shannon

Tuesday 22nd January 2019 Westminster Hall

[Jim Shannon]

I thank the hon. Lady for that intervention, and congratulate her on all she does, and on her interest in the issue.

Mental health issues have caused 300,000 people to lose their jobs because they cannot cope with the stress of their career. In Northern Ireland, one in five adults show signs of mental illnesses in their lifetime. We can see clearly that more funding needs to go towards helping those who cannot work because of mental health problems. People who cannot hold down a job owing to such problems must be treated with compassion and understanding. I have had several meetings with Capita. As the hon. Member for Glenrothes said, the staff are excellent and work hard. Frances, the manageress of the social security office in Newtownards, is extremely supportive and helpful, as are all the staff when anyone phones about an issue. However, that does not stop the problems that we are having. In my meeting with Capita, I outlined some cases where benefits were withdrawn, but in conjunction with its staff, we were able to overturn the decisions. I was glad that those constituents had come to see me and my staff, and that we could use medical evidence, supplied by doctors, to persuade Capita of the adverse effect on their mental health, wellbeing and, at times, physical safety. Things must change.

[Paul Girvan (South Antrim) (DUP)]

The point that my hon. Friend is making relates to the fact that some people are so depressed that they do not want to contact anyone who could help them. They fall through the gaps. When people are willing to go forward, we have a high success rate for overturning decisions on appeal, but unfortunately some of the neediest bury their heads in the sand, as they do not have the will or drive to go ahead, or the support behind them.

[Jim Shannon]

I agree wholeheartedly. What my hon. Friend described is the reason why we are charged, as elected representatives, with delivering our views, in debates such as this and in offices.

People suffering long-term mental health issues should be supported financially because of the challenges that they bring in their career. Those with severe and enduring mental illnesses are exposed to premature mortality of up to 15 to 20 years; the situation affects their health, wellbeing and the length of time they will be in this world. Those people need support. We should not assume their health will improve over time, as it will improve only with rest and coping mechanisms, and the ability to work in a place where there is understanding of the needs of people with mental health issues, and a preparedness to work with them. Such jobs are few and far between. The question is how to achieve that, which is why the debate has been brought forward today.

Changes are needed in society, and I do not think anyone in the House would deny that. However, they must begin with a recognition that mental health issues are not an excuse not to work. They are a tunnel of darkness. What my hon. Friend the Member for South Antrim (Paul Girvan) and the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) said about this is very relevant, for each and every one of us here. We are here because we have a passion for our people and want to put that over in the debate.

That tunnel of darkness is brightened only by the light of love and compassion, and I believe that governmental dealings with those in need of help must change in a compassionate way. We ask the Minister to do that, first because we know that she appreciates, understands and has an interest in these issues, and also on behalf of our people, who beseech her to make those changes.

Finance (No. 3) Bill

Debate between Paul Girvan and Jim Shannon

Committee: 2nd sitting: House of Commons
Tuesday 20th November 2018 Commons Chamber

[Jim Shannon]

I thought the hon. Member for Torbay (Kevin Foster) was going to go before me, but he has not bobbed, so he is obviously not going to. I always follow in his footsteps—I am always glad to do so, by the way, as he knows—but on this occasion I miss his comments, which I am sure would be more than helpful to us.

We are all very aware of the reason for these amendments. It is tremendous to be in the Chamber among many Members from across the House who are of the same opinion, including—he will forgive me if I say this, but I have to say it—perhaps a wee bit belatedly, the Minister, who is also committed to where we are on this.

If she does not mind my saying so, I would like to commend the hon. Member for Chatham and Aylesford (Tracey Crouch) for her principled stand, her courage and what she has done to make this happen. The commitment she has shown does my heart good and does the heart of everybody else good. By the way, I am not surprised that she said 3,000 people had contacted her afterwards. I did not have 3,000 people contact me afterwards, but I had a large number and, for the record, every one of them commended the hon. Lady for her obvious commitment. The reason for the amendment is simple: the need for a massive lowering of stakes is clear.

I also thank my good friend, the hon. Member for Swansea East (Carolyn Harris), for all her endeavours through the all-party group on FOBTs, which has done tremendous work. The right hon. Member for Chingford and Woodford Green (Mr Duncan Smith) and the hon. Member for Inverclyde (Ronnie Cowan) have also endeavoured, through the APPG, to ensure all that hard work came to fruition.

The one thing that sits in my mind is this: why was it important to have those six months slip back from October to April? It is very simple: as has been said, 300 lives—maybe more—were saved. That is a fact.

I am mindful that last week we had the Gambling with Lives event, which the hon. Member for Sheffield Central (Paul Blomfield) referred to. I thank him for initiating that event. I was very glad to be there with other Members and to support him. There were two people there who I knew long before the start of this FOBT campaign, which began about 18 months or two years ago. They are Mr and Mrs Peter Keogh from Enniskillen, who lost their son, Lewis, to a gambling addiction and who even today feel the heartache of that event.

It is for those people that we do these things. It is for our constituents whose lives will be saved because of it, and for those who have lost loved ones and feel the great pain of the loss of someone close to them, that today we can collectively make this legislative change in this House. That is why we make the effort.

The Government accept that they need to lower the stakes; they accept that damage has been done to individuals and families; they accept the fact that the ability to bet as much as £100 every 20 seconds on electronic casino games such as roulette is shocking; and they accept the campaign by anti-gambling campaigners that highlights the fact that machines let people lose money too quickly, leading to addiction and social, mental and financial problems.

The Minister responded to the previous speaker, the hon. Member for North Ayrshire and Arran (Patricia Gibson), about things we must address, including online gambling and how it is promoted on TV. At this early stage, I would also like to put down a marker about scratchcards. I was just telling a story to my hon. Friend the Member for South Antrim (Paul Girvan). One day, I saw a lady with two children in a shop. She probably did not have £5 to spare. She was ahead of me in the queue and she put down £5. I was not being nosy, but her wallet probably only had two fivers in it, yet she spent £5 on scratchcards. She went outside to rub the numbers off them and by the time I went outside I saw that not one of the cards was successful.

I thought to myself, “How very sad.” That lady was probably looking at her financial needs for that week being provided by the turn of a scratchcard, which did not deliver. Other things need to be done, but I look forward to the things that the Minister referred to in his intervention on the hon. Lady.

Those arguments had all been accepted, but rather than looking at the human cost it appears that the Government wished to shore up the finances and allow thousands more people to gamble everything away. The situation is like cancer research finding a cure to cancer and the NHS saying, “Well, we have all the chemotherapy, which needs to be used, so we won’t pay for the life-saving drugs until stocks are down. We can’t afford to do this.” That is horrific. I say to the Minister, with respect, that the more I see of this Government's ability to put blinkers on and look only at one aspect—the pounds and the pence—rather than at the entire argument about the need to lower stakes, the more disheartened I become.

The Salvation Army, which deals with the problems that gambling brings to the community, has said:

“It is well acknowledged that FOBTs have caused concern across the political and social spectrum. FOBTs have been labelled the ‘crack cocaine’ of gambling. One gambler told us that he spent £2,000 a day on FOBTs at bookies without being challenged.”

[Paul Girvan (South Antrim) (DUP)]

I appreciate my hon. Friend’s reference to the Salvation Army. One of the other issues that I have major concerns about—I wonder whether my hon. Friend agrees—is the accounts of people being given a line of credit of £1,500 without any credit checks on their ability to pay it back. People have been given a £1,500 line of credit and unfortunately it ends up being a potential noose—and I mean that—around their neck. That problem is arising and it is caused by those who do not do checks. Any other financial industry would do checks to ensure the person had the ability to pay the money back.

[Jim Shannon]

I thank my hon. Friend for his wise intervention.

The Salvation Army also says:

“Another man who became homeless as a result of his addiction and who was helped by the Salvation Army lost over £30,000 on gambling machines.”

I do not think that there is one Member in this Chamber who would not be able to recollect a story of this kind from their constituencies. It is the story of the man who plays on a FOBT machine on a Friday night and puts all his wages on it, before going home to his wife, who is looking for the money to buy the groceries, and their children. Those are the stories of real life; those are the stories of addiction; and those are the stories that we want to stop in this Chamber today.

That is why we are keen for the Government to implement as soon as practicable the proposed maximum stake limit of £2 for FOBTs. It is of some concern that in the Budget the timeframe for implementation was to have been delayed to October 2019. We note that some campaigners said it would be possible to implement it in April 2019 and that the Government have acceded to that. That apparent delay was deeply disappointing. The right hon. Member for Chingford and Woodford Green referred to the amendment with over 100 Members’ names on it. What changed the Government’s opinion was those 100 names from across the Chamber. I am very pleased that we have achieved that change.

I agree with the change and I ask the Government simply to do the right thing. They seem to have been held to ransom by the gaming industry. Therefore, it should not have surprised me to see how the EU—I use this comparison; I am sure many Members will understand it—has held this proud nation of the United Kingdom of Great Britain and Northern Ireland to ransom, and how our Government have capitulated at the cost not of £400 million, the estimated lost tax revenue, but £39 billion, and, most importantly, the sovereignty of Northern Ireland and the sanctity of the Union.

You may not believe that the two are linked, Dame Eleanor, but they are. You may not believe that that should be mentioned in this debate, but it has been. The Government’s decision making is as flawed here as it is in selling Northern Ireland and the backstop. Do the right thing, stop allowing gambling addictions to destroy families and protect people from themselves, in the same way that people must wear a seatbelt whether they want to or not. Step in and step up. I support the amendment and I look forward to working with hon. Members to do even more in this Chamber to address gambling addiction in the years to come.

Amendment 16 agreed to.

Clause 61

Remote Gaming Duty: Rate

Amendment made: 17, page 44, line 25, leave out “1 October 2019” and insert “1 April 2019”.—(Gareth Johnson.)

This amendment is consequential on Amendment 16.

Clause 61, as amended, ordered to stand part of the Bill.

Clause 62 ordered to stand part of the Bill.

Schedule 18 agreed to.

New Clause 12

Review of public health effects of gaming provisions

“(1) The Chancellor of the Exchequer must review the public health effects of the provisions of section 61 of and Schedule 18 to this Act and lay a report of that review before the House of Commons within six months of the passing of this Act.

(2) A review under this section must consider—

(a) the effects of those provisions in reducing the negative public health effects of gambling, and

(b) the implications for the public finances of the public health effects of—

(i) those provisions,

(ii) the operation of the law relating to remote gaming duty and gaming duty if those provisions were not given effect.”—(Ronnie Cowan.)

This new clause would require a review of the public health effects of gaming provisions.

Brought up, read the First and Second time, and added to the Bill.

Clause 15

Offshore Receipts in Respect of Intangible Property

Question proposed, That the clause stand part of the Bill.

Northern Ireland (Executive Formation and Exercise of Functions) Bill

Debate between Paul Girvan and Jim Shannon

2nd reading: House of Commons
Wednesday 24th October 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

rose—

[Paul Girvan (South Antrim) (DUP)]

rose—

UK-Israel Trade

Debate between Paul Girvan and Jim Shannon

Tuesday 3rd July 2018 Westminster Hall

[Paul Girvan (South Antrim) (DUP)]

During one of our recent visits to Israel we saw how a university there had made links with cyber aspects. Is there not a great opportunity for UK universities to become joint partners on the world-leading technologies that are being brought forward?

[Jim Shannon]

My hon. Friend is absolutely right. I was going to mention education and universities, but he has done it, so I can relax on that. We can do something strong. Queen’s University in Belfast and Ulster University can be part of that partnership. Maybe the Government should be looking at how they do that with other universities across the United Kingdom of Great Britain and Northern Ireland.

Israelis see the UK as an ideal country to trade with. They are attracted by our culture, language and institutions, and by our honesty, integrity and business acumen. Those are all qualities that business people like to see, and we have them in abundance in the United Kingdom. I welcome the Duke of Cambridge’s historic visit to Israel last week and share the view that it was fitting for him to meet Israeli high-tech companies ReWalk and AlgoBrix, which have developed innovative medical solutions. They epitomise the start-up nation and we want to be part of that, as other hon. Members have said. I am also glad that he took the opportunity to visit the Palestinian territories, because it is good to reach out to both sides and try to bridge that gap. He did that in such a good way.

In the light of the Duke’s visit to Israel last week, during which he saw a showcase of Israeli technology at the British embassy in Tel Aviv, what steps are the Government taking to increase the sharing of innovation between our two countries? There are many things that we can do, and I believe that this is one of them. I welcome the growing collaboration between our two countries and recent agreements signed to increase co-operation in the field of science. How is the Minister working to strengthen that relationship?

Israel has become renowned for its high-tech capability and innovative technological solutions. The UK and Israel share a close relationship in research and development, yet there is still more that can be done. What are the Government doing to unlock that potential? The UK and Israel have a strong and growing partnership in R&D with British companies such as Barclays and HSBC—the latter launched a cyber-hub in Tel Aviv last September—but we still lie behind Canada, China and the US in utilising Israeli expertise. Does the Minister share my concern, and that of many other Members, that further co-operation on R&D should be a priority? Whether it is pre-Brexit or post-Brexit, let us get ourselves into a position in which we can take advantage of the opportunities to create jobs.

Offences Against the Person Act 1861

Debate between Paul Girvan and Jim Shannon

Tuesday 5th June 2018 Commons Chamber

[Paul Girvan (South Antrim) (DUP)]

The last time this was debated in the Northern Ireland Assembly, there was evidence that many people have multiple abortions and are using it as a form of contraception.

[Jim Shannon]

I thank my hon. Friend for his comment.

Fortified Flour

Debate between Paul Girvan and Jim Shannon

Wednesday 16th May 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I, too, congratulate the hon. Member for Pontypridd (Owen Smith) on bringing this debate to Westminster Hall. I congratulate him on presenting his case so well, as he did at the awareness day that some of us were able to get down to. As the Democratic Unionist party spokesperson for health, I am aware of this issue and very supportive of the fortification of flour.

All the speeches we have heard were tremendous. I commend my right hon. Friend the Member for Belfast North (Nigel Dodds) for telling a very personal story. Personal stories in these debates always carry substantial weight. His was a story that he and his wife have walked, and although we might have known something about this issue, we have heard a whole lot more. I commend him on that and assure him of our support. He knows that it has always been there for him, but on days when we tell personal stories we feel it a bit more.

When my parliamentary aide was pregnant, we got a surprise. In the mornings when she was under a little pressure, instead of shouts of “coffee” coming from her desk she would ask for water. By the time of her second baby, we all knew what “no coffee” meant—baby on board. You can imagine the apprehension I felt, Mr Hanson, on a Friday morning when I said to the staff in the office, “Girls, who’s for coffee?” If they said no, I knew they did not want coffee, but was there anything they wanted to tell me? That, however, is by the way. Why did my aide do that? It is simple: she told me, “Coffee makes the baby’s heart beat faster, so I need to stay away from it.” I wanted to make a contribution to the debate because she has lived through this.

Almost every mother I have ever known, as soon as they have that pregnancy test, has made changes to their lifestyle. They do it automatically, and in many cases right away, for the sake of the baby. They stop having alcohol and start on vitamins, reduce caffeine and increase their fruit and veg. By doing that, they naturally create—to use an Ulsterism—a better wee home for their child, which is what the mother is trying to achieve.

This is a personal story from my aide. They are told by the doctor to take folic acid, and of course they do, because it is important, but the problem is that ladies who have been on contraceptive pills find their folic acid store completely depleted. If they have not taken folic acid before pregnancy, it may be too late. With approximately 40% of UK pregnancies estimated to be unplanned, that is certainly an issue, so we look to the Minister for a good response. I mean this respectfully: larger ladies who have a higher body mass index should be taking more folic acid than the usual pregnancy dose. That is not talked about widely, but it is important to put on record how important folic acid is for anyone who is pregnant, and perhaps those showing signs more than others.

I read an excerpt from the NHS Choices website regarding flour and folic acid that made things very clear to me. It describes how a randomised controlled trial from 1991 first indicated that taking 4 mg of folic acid during pregnancy—10 times the current recommended dose—could prevent about 80% of neural tube defects. On the basis of that trial, it was concluded that such defects are due to a vitamin deficiency that needs correcting before pregnancy. However, it said that, despite campaigns, a study of nearly half a million women in England showed that less than a third took folic acid supplements before pregnancy. That tells me clearly that action is needed, and it is needed now.

[Paul Girvan (South Antrim) (DUP)]

On adding folic acid to flour, we have potentially been putting fluoride into water, and that has virtually no health benefits. That has only dental benefits, which are about lifestyle choice, and that is different from those suffering because they are not getting folic acid through their diet. It is great that this issue has been brought forward, and we should look to put folic acid into flour and ensure that everyone gets it, because there are no negative sides to that.

[Jim Shannon]

I wholeheartedly agree with my hon. Friend. We are already putting additives into many products we eat, to our benefit, and that is what we should be doing.

To return to taking folic acid supplements before pregnancy, of the half a million women in England surveyed, less than a third did so. The figures varied by age, with the highest use in women aged 35 to 39, of whom 38% took it before pregnancy, compared with only 13% of those aged 20 to 24 and 7% of those under 20. There was also a marked ethnic variation, with 35% of white women taking it compared with 20% of south Asian women and 18% of Afro-Caribbean women.

Just under two thirds of all women took supplements in early pregnancy, but the researchers say that that is already too late. The current strategy of encouraging women to take folic acid before pregnancy is inadequate and, in particular, putting younger women and minority groups at a disadvantage. People always talk about stats, but the fact of the matter is that they tell a story—and these stats tell a clear story. When women take folic acid before and during pregnancy, it makes a difference. However, there is clearly either no knowledge or not enough information about it. We look to the Minister and the Government to step forward and do what is right.

I would also like to mention that whenever people come to my office for benefit claims and I see what medication they are on, as we need to do—it must be the same for everybody’s offices—I find it surprising how many are, for different reasons, in receipt of folic acid. That is because folic acid helps to get their bodies back into kilter. That is important: folic acid has benefits not just for those who are pregnant but for those who are in ill health.

While I understand the Government’s reluctance to become a nanny state who enforce rather than guide, we should remember that flour fortification is not new. To white flour, the UK adds calcium, iron, thiamine and niacin to replace the nutrients stripped and discarded when the bran and germ are removed from the wheat grain. That was introduced after world war two to help improve the nation’s heath. We did it then for that purpose, so why in 2018 can we not do it for the purposes we are presenting to the House today? I do not agree with the nanny state argument. Sometimes, Governments have to take the initiative and do things that are important.

Today, milling is even more efficient at stripping the nourishing layers from the endosperm, which means that even less natural folate is left in white flour than there was when replacing other lost B vitamins was deemed necessary. There is, therefore, a greater need today for folic acid than there was in the past—even after world war two, when that was seen to be important.

I will conclude, because I am conscious of the timescale you gave us, Mr Hanson. The Government must consider this issue. I give my full support to the hon. Member for Pontypridd for bringing the debate forward, and to my right hon. Friend the Member for Belfast North and other speakers. We have all come here with the same message, in an attempt to highlight this issue to the Government. Anything we can do to bring healthy babies into this world should be done without any delay. This seems to be a cost-effective way of helping mothers and their babies from the earliest opportunity. I am fond of the Minister, and he knows that. I look to him for a substantial response—no pressure whatsoever—on what we have proposed, with reasons.

Birmingham Commonwealth Games and Shooting

Debate between Paul Girvan and Jim Shannon

Wednesday 21st March 2018 Commons Chamber

[Jim Shannon]

I thank my hon. Friend for saying that. He is absolutely right. The introduction to shooting sports at a very early age puts a discipline in place and an interest. I will talk later about my boys and my children and the opportunities that we have had. My son Jamie and I shoot together. I took him shooting from a very early age, and he is a much better shot than I am, by miles. My granddaughter Katie—she is the third generation—is also interested in shooting. I see the hon. Member for North Dorset (Simon Hoare) across the Chamber on the front row—he takes his son with him when he goes shooting. I know how important it is for someone to have that relationship with their child and to have the chance to introduce a fantastic sport that can do so much. I thank the hon. Member for Wyre Forest (Mark Garnier) for that intervention; it is exactly one of the points I wanted to make.

A joke often touted in my local shooting club, where I am a member, is that they have asked for a couple of my election posters for target practice. I never would say no if they wanted to do that. There were other election posters, but obviously I was in no position to offer any other than my own, so mine were used—I was just happy they were used and recycled in some way.

My local shooting club hosts a very successful event called “the Swaziland cup” at which amateurs and the more professional come together to win the cups and in the meantime raise hundreds and thousands of pounds for the children of Swaziland. The club also hosts the little choir when they come for an afternoon of safe fun and good food. We do it every year they come. I have never won the Swaziland cup, by the way, but there is always next year. That is how it works. It is the same with fishing: I have not caught that big fish yet, but I am going to catch it next year. That is how it goes.

[Paul Girvan (South Antrim) (DUP)]

The sport of shooting in my area is great. We have a rifle club not half a mile from where I live, and the young people who go along learn not only discipline but a great sense of camaraderie that they carry with them for the rest of their lives. It would be a retrograde step if they had not something to aim at—excuse the pun. Let us be honest: they get involved to improve and expand the sport and to take part in competitions—and what greater competition is there than the Commonwealth games? It is something they should be encouraged to attain to—something we should be inspiring them to achieve—so it would be a retrograde step to remove shooting from the Commonwealth games.

[Jim Shannon]

My hon. Friend, like others, reinforces what we all know: the introduction of the sport of shooting to young people from an early age develops character, friendships and accuracy—and, of course, we hope that some will attain perhaps even a Commonwealth medal.

European Economic Area: UK Membership

Debate between Paul Girvan and Jim Shannon

Monday 6th November 2017 Commons Chamber

[Jim Shannon]

Well, the people in my constituency certainly tell me that they did vote for this, and I had the impression that it is what I was voting for as well. Other Members will have a different opinion, and they have expressed that today.

Numerous businesses in my constituency have a great European market, including Willowbrook Foods, Lakeland Dairies and Mash Direct. They are major agri-food employers in my area. I seek to do all I can to help them and will continue to do so. I sought an assurance from the Prime Minister and from a former DEFRA Minister that those jobs in the agri-food sector would be okay, and they gave me that assurance.

[Paul Girvan (South Antrim) (DUP)]

In relation to those businesses, the message that I am getting—I wonder if it is coming across to others—is that the “Project Fear” agenda that is being put forward by those who are still not wedded to the idea that we leave the EU, or the idea of not getting whatever sort of deal they want, is sending out the wrong message to industry and creating fear within industry. There is inconsistency in terms of sending out a positive message.

[Jim Shannon]

I thank my hon. Friend and colleague for his comments. We hear that today from Members who have a different opinion in relation to remain and inject fear into the whole debate. I am very positive about leaving the EU and leaving the EEA. When we are out and away, we are going to be better off. Let us have a positive outlook and we will be successful.

Do I believe that the best economic benefits are to be found as a non-EU member of the EEA? The bottom line is that EEA membership involves a range of obligations, including free movement of people, financial contributions to the EU, and accepting EU rules with no direct say over them. In short, we get the immigration issues, the tariffs and the charges, but very few benefits. Some Members have referred to the comprehensive trade deal, which I believe we can negotiate—I hope so. I have great confidence in the ministerial team and in what we are trying to achieve.