DRAFT GENERAL FOOD HYGIENE (AMENDMENT) (EU EXIT) REGULATIONS 2019 DRAFT CONTAMINANTS IN FOOD (AMENDMENT) (EU EXIT) REGULATIONS 2019 DRAFT SPECIFIC FOOD HYGIENE (AMENDMENT ETC.) (EU EXIT) REGULATIONS 2019 DRAFT GENERAL FOOD LAW (AMENDMENT ETC.) (EU EXIT) REGULATIONS 2019

Sharon Hodgson Excerpts

Tuesday 5th March 2019 General Committees

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is indeed a pleasure to serve under your chairmanship this morning, Ms McDonagh; I hope I give you no trouble.

I thank the Minister for providing a summary of these statutory instruments and for his letter in advance of the Committee, which gave me further details about them. As he has heard me say many times before, this is not the first group of no-deal SIs that we have debated. We are just 24 days away from Brexit day and are yet to agree a deal with the EU. I wonder when the Government might start to become concerned about the clock ticking down. I am greatly concerned, and I know that many others across the country are too. We do not have a deal yet, but we are rushing through so many statutory instruments in such a short period of time that it is deeply concerning for accountability and proper scrutiny. As legislators, we have to get it right, and I deeply regret that we have been put in this position by the Government, but here we are again.

The safety of our food is of the utmost importance to our health and wellbeing. We cannot get it wrong; food safety must be protected at all costs. There is also the element of consumer trust. We must not allow that to break down in any event, particularly if there is any relaxation of regulations, which I hope will not happen. I share the Government’s commitment to ensuring no change in the high-level principles underpinning the day-to-day functioning of the food safety and feed safety legal framework. Ensuring continuity for business and public health bodies is important in the interests of the public. As the Minister would expect, I have questions and concerns about these statutory instruments, which I will set out for the Committee.

When food is found to be unsafe for human consumption, we need a quick and effective mechanism to ensure that it is withdrawn from the market. In 2017 alone, the rapid alert system for food and feed issued more than 3,800 “original notifications”, of which 942 were classified as an alert. It is crucial that any food warnings are communicated quickly and effectively. Will the Minister revise the explanatory memorandum for the General Food Law (Amendment etc.) (EU Exit) Regulations 2019 and ensure that alternative arrangements are made to receive food safety warnings that are quick, clear and effective?

As a result of these regulations, the Food Standards Agency will have additional responsibilities in the result of a no-deal Brexit. I am aware of additional funding being made to the FSA, but is the Minister confident that it will have enough funding and staff to take on those additional responsibilities? Will he outline how many additional staff have already been recruited, when they started work and what roles they are currently undertaking? Will the FSA have the ability to work and communicate with European bodies to ensure that information and intelligence is shared?

Regulation 19(c) of the general food law regulations assigns the Secretary of State for Health and Social Care the power to make provisions considered “necessary or expedient”. Will the Minister say whether there will be any oversight over such decisions and whether the Secretary of State will justify any decisions made under those powers in the House?

All the regulations must be easily amendable, if and when necessary, to respond to any emerging threats or changes in safety standards, but I hope that any changes will be justified and overseen by the relevant bodies. What will the arrangements be for collecting data, monitoring the effectiveness of the regulations and regularly reporting? What bodies will be able to scrutinise performance and delivery, and what assessment has been made of their capacity to take on such work?

Concerns were expressed in the public consultation on these statutory instruments about the additional burden on industry and enforcement authorities to communicate changes. Will the Minister reassure me and the Committee that communications with respect to the proposals outlined in these SIs will be delivered with sufficient time to make the necessary preparations to minimise the impact of any changes?

Businesses and food business operators have raised concerns about the lack of information given to them, as well as about their own understanding of the information. Will the Government make their information clear to the public, and if so, when will they do this by? Sufficient transition periods will be required for these statutory instruments. Can the Minister provide some clarity on the transition periods that will be in place to assist businesses and industry in complying with any changes? The explanatory memorandum states that there will be

“an Equivalent Annual Net Direct Cost to Business…of…£600,000.”

Can the Minister explain how those costs will be accrued and by whom, and if they have been communicated to those affected?

Respondents to the consultation on the Specific Food Hygiene (Amendment etc.) (EU Exit) Regulations 2019 raised concerns about the cost of changing their labels. Some respondents estimated that that could cost between £200,000 to £500,000. Has the Minister made any assessment of the impact that that could have on businesses?

In the public consultations, local authorities expressed concerns about the need for them to make the required updates to legal references in official documents and online, which will take significant time and effort and will naturally have cost implications for local authorities, which is concerning in the light of budget cuts. Can the Minister confirm whether the Government will fund any additional burdens on local authorities, especially in the event of a no-deal Brexit?

It is estimated that it will take local authorities less than 60 minutes to read and familiarise themselves with the new regulations and to disseminate them to staff and keyholders—they must be able to read a lot faster than me. Is the Minister convinced that that is a realistic assessment?

Is the Minister confident that, from day one of Britain’s exit from the EU, the high standards of food safety will be maintained? Can he explain what implications a no-deal Brexit would have on the future monitoring of food safety standards and legislation in this country? As I have said, the safety of our food is hugely important and we cannot get it wrong.

[Caroline Flint]

Does my hon. Friend agree that if we agree a deal, there will be no change to any of the systems that we currently share and enjoy? Does she also agree that more should be said publicly about how many of the regulations that we enjoy and support in the House—I have sat on many of these Committees—will continue to be in place as we leave the EU?

[Mrs Hodgson]

My hon. Friend is entirely correct.

[Caroline Flint]

Right hon.

[Mrs Hodgson]

I do apologise. If we leave with a deal, all this will have been for naught. We have some of the highest food standards and regulations, and they would continue to exist. That is all the more reason why it is such a disappointment to us all that we are at the eleventh hour and the 58th or 59th minute and we still do not have a deal. I sincerely hope that one is brought before the House next week that a majority of the House can vote for.

[Craig Mackinlay (South Thanet) (Con)]

I am sure the hon. Lady is aware that the pages of regulations that we are trying to transpose into UK law have never had parliamentary scrutiny. They are regulations, so as soon as the ink is dry in Brussels, they become the law of the land whether we like it or not, with no debate in this place. Uniquely, in future, we will have the opportunity to shape our regulations.

As the hon. Lady is aware, the EU operates a precautionary principle. Many think that the standards that come out of Brussels are somehow gold-plated holy writ, but she will be aware of the problems that we have faced in past years, such as the Fipronil scandal in August 2017, which affected eggs. That happened under the regulations that are meant to be the gold standard, but I certainly hope that the UK will be able to do better in future. Can she comment on the fundamental principle that it is better that this place decides food safety, rather than it being decided by regulations over which we have no authority?

[The Chair]

Order. I would like us to concentrate on the detail of the regulations, rather than straying into the territory of whether we should be leaving the EU.

[Mrs Hodgson]

With that advice in mind, Ms McDonagh, I would say that, given that the hon. Gentleman had quite a lot to say, perhaps he should have considered making a full speech and graced us with his further thoughts on these matters. I am sure that we would all have enjoyed that immensely. However, I disagree with the fundamental principle of what he said, which is that these regulations were passed in Europe with no scrutiny here.

As a new MP, as I am sure a number of us were at one time or another, I had the huge pleasure of serving on the European Scrutiny Committee. Week in, week out, we would be sent reams of documents containing EU directives and regulations that our esteemed Clerks would have rated as politically or financially sensitive. They gave us advice, but we had to read all those documents and sit and scrutinise them all, week in, week out. We could then refer them for further debate in a European Standing Committee or on the Floor of the House, if we thought something needed scrutiny. I know for a fact that we scrutinised all EU directives that came to this House. Nothing was passed without proper scrutiny. It is a shame the hon. Gentleman has not had a chance to serve on that Committee, because he might never get a chance.

[Craig Mackinlay]

I have.

[Mrs Hodgson]

Oh, he has; because I was going to say, the hon. Gentleman has missed a treat.

I hope the Minister will respond to my concerns, either now or in a letter. I know he always sends a letter if he is unable to respond on the day. I know, too, that many others, not only in this room but across the country, will be looking forward to his response.

Draft Nutrition (Amendment etc.) (EU Exit) Regulations 2019

Sharon Hodgson Excerpts

Thursday 28th February 2019 General Committees

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is indeed a pleasure to serve under your chairmanship, Mr Evans, and to be here discussing this draft amending regulation. I thank the Minister for writing to me in advance and for his summary this morning. However, I have started all of my speeches on Brexit SIs with a caveat, and I will do so again this morning. I apologise for any repetition.

We are now just 29 days away from Brexit day, 29 March, as I am sure everyone is well aware. It is deeply concerning that we are still planning for a no-deal scenario when we are so close to the deadline. I know that we have many, many more public health SIs to get through in that time, and I am worried that we simply will not have enough time to prepare properly. I hope the Government will take no deal off the table.

I thank the Minister for his letter asking for my support on the regulations. He does have my support, but as always I have some questions, and as always I know he will try to answer them. The explanatory memorandum says that there will be a low level of impact on businesses, but no impact assessment has been made. It admits that there will be some additional administrative burden on businesses, but that it will only be an extra 30 minutes of additional paperwork for applications to make health claims in both the UK and the EU. Is the Minister convinced that that is a realistic assessment? The consultation response document says:

“Some respondents raised concern that the consultation under-estimated the additional burden caused for submitting a new claim.”

Has the Minister made any assessment of that since the consultation document was published?

The consultation document was published sooner than anticipated, and I thank the Minister for that, but I am concerned about how short the consultation period was—only 10 working days. I know that we are fast approaching Brexit, but allowing such a short time for businesses, stakeholders and the public to participate in a consultation is alarming, particularly when legislation is drafted as a result. If we are going to get no-deal planning right, we need more time and expertise to look into such detailed legislation.

Throughout the consultation response paper, it is clear that respondents wanted more detail from the Government. We need more detail on risk assessments, management processes and on how mirroring EU regulation would work in practice. The devil really is in the detail and the Government have failed to provide any detail at all. Will the Minister tell us when we will have that crucial detail at our fingertips? Concerns were also raised about integrated supply chains, particularly if the UK failed to be aligned with EU lists on product labelling. Will the Minister address those concerns?

The UK has a long tradition of collaboration with the European Food Safety Authority. Does the Government have a commitment to working with EFSA in the event of a no-deal Brexit? I know the Government are in the process of establishing the UK nutrition and health claims committee, the UKNHCC—not a very catchy acronym or easy to say. What relationship will EFSA have with the UKNHCC in the event of a no-deal Brexit?

[Mr Goodwill]

The hon. Lady is painting a grim picture of a no-deal Brexit. Surely it is within her power to vote for the deal on 12 March and take the instruction that 61% of the people in Sunderland gave her at the referendum?

[The Chair]

Order. Let us not go too wide in our discussions.

[Mrs Hodgson]

I didn’t start it.

[The Chair]

No, the shadow Minister did not start it.

--- Later in debate ---

[Mrs Hodgson]

I think the former Prime Minister, who has a very fancy hut where he is writing his memoirs, may be the one who started it, but perhaps it goes even further back than that. I will follow your advice, Mr Evans, and not get drawn into such a fascinating debate on who started it, and what we might be asked to vote for on 12 March, because we still do not know what that will be. I will tell the right hon. Gentleman my decision when I know what we are voting for.

There has been a recruitment process for that catchily-named organisation, the UKNHCC. If somebody could come up with a way to say that, that would be helpful, seeing as we could be talking about it in the future. When will the names of the members be made public? What will their expertise be? Will they be subject to any scrutiny?

Finally, I understand that we are only half implementing the Commission delegated regulation 2016/128. Most of that regulation, which relates to foods for special medical purposes, came into force in February 2019 and will be transferred into UK law, but the part that relates to food for special medical purposes developed to satisfy the nutritional requirements of infants will not apply until 22 February 2020. As a result, the UK will not implement that part of the regulation. Can the Minister confirm whether that is the case?

Page 35 of the regulations makes no reference to infants. Is that intentional, and can the Minister elaborate on what will happen to infants who need food for special medical purposes? If the UK does not implement that law, we will have different standards from the rest of the EU. Will that gap be bridged immediately?

Any changes to the legislation must be communicated effectively and in a timely manner to the agencies affected by the SI. As I said earlier, I am concerned that the clock is ticking much quicker than we would like. I hope therefore that the Minister will work urgently to ensure that any changes are made quickly and communicated clearly. With that, and without being drawn into a whole debate on Brexit, I look forward to hearing the Minister’s response.

--- Later in debate ---

[Steve Brine]

Maybe it is set in stone. Members can work out what I mean by that.

The hon. Lady asked lots of different questions. About the impact on business, we appreciate that there may be an additional administrative burden on companies that would have to submit claims to the UK and the EU if they wish to make the claim in both areas, but our intention is that procedures for submitting claims in the UK will closely follow those already in place for the EU. We have been in that family for some 40 plus years.

Leaving the European Union is a complex process, to put it mildly. It is not just about trade deals, reciprocal healthcare and citizens’ rights. It is about complex supply chains at every level of business, and there is a complex supply chain around nutrition regulation. It would be an act of foolishness on our part to diverge too far and we do not intend to do that. We estimate that the application paperwork should take only 30 minutes to complete, and rightly so.

In terms of future divergence with the EU, we will make sure that we continue to review the situation to make sure we stick to regulatory alignment with the EU, as deemed appropriate by the Government and ultimately by this House, which holds the Government to account. I am content, as is the Government, that the SI maintains regulatory standards and nutrition policy in a no-deal scenario, and therefore an impact assessment is not required. I have already said that businesses will have to spend a short time on administration.

We completed an equalities impact assessment. We found that the measures set out in the instrument do not have an impact on any of the protected characteristics as defined in the Equality Act 2010.

The hon. Lady asked why the consultation period was just 10 days. To be factual, it was not. It was 11 days—[Laughter.] That is #factualnews. A consultation’s duration is generally determined by the proposals it contains, and in this case we are proposing to mirror the existing regulatory regime as closely as possible, ensuring minimal disruption to business. With that in mind, we consider the consultation period to be entirely appropriate and in line with Cabinet Office consultation principles.

We received 31 responses to the consultation—a case of quality over quantity. We are pleased that they included responses from a broad spectrum of groups, including manufacturers, trade bodies, members of public and one local authority. The response was supportive of the proposals to mirror the existing regulatory framework, as I have already said. We are working with the Department for Business, Energy and Industrial Strategy’s business insight group—now there is a catchy title—to sight the industry on proposed guidance and to obtain its feedback.

Infants are deliberately not mentioned in the SI, because the issue does not apply on exit day. Our current policy intention is to make domestic legislation that is consistent with regulation 609/2013. That includes requirements for foods for special medical purposes developed to satisfy the nutritional needs of infants and for infant and follow-on formula, which are important. The Department will issue further advice on that once the EU exit position is clarified, which clearly is yet to happen.

I was asked whether the UK will continue to be a member of EFSA after we leave the EU. I have said no. The nature of our future relationship with EFSA will be subject to negotiation with the EU, and that is not just in terms of the withdrawal agreement. The SI provides for the appropriate expert committee—I appreciate that the acronym is not ideal—to assume EFSA’s functions in a no-deal scenario, which will guarantee certainty.

The hon. Member for Glasgow South West asked what will happen in relation to products banned in the EU after exit day. As I said in my opening remarks, products that EFSA approves after exit day will be for it to approve for the remaining member states. In terms of the relationship between our new committee and EFSA, we have a long tradition of close scientific collaboration with EFSA in this country. We value it greatly and very much hope and intend that to continue in the future. If EFSA makes a decision on a product, it would be most unlikely that our new committee, whatever it is called, would not take notice of that. We want to continue close regulatory alignment in this policy area so that the public have confidence and so that, returning to my first point, businesses do not face an undue burden in getting products covered in both areas.

Public Health England is in the process of recruiting specialist members for the UKNHCC, including the chair. The recruitment was open and transparent: it was advertised on gov.uk from 8 November to new year’s eve; high-calibre applications were received and the shortlisted candidates were interviewed last week. The committee is ready to come into effect if required. I do not have the names here, but I know that recommendations for appointments to the committee have been shared with the devolved Administrations. They have confirmed that they are content with the calibre and experience of the recommended individuals. Appointment letters will be issued shortly; once accepted, they will be published. I have already said I will publish that to members of the Committee.

Finally, guidance is being developed and tested with industry to ensure that it is fit for purpose, is closely aligned and clearly communicates to business any changes in the process that would occur in a no-deal scenario. That guidance will be published shortly—certainly before exit day, which we still hope will be 29 March.

[Mrs Hodgson]

On a point of clarity on the lack of mention of infants, I heard what the Minister said, but there is a lack of clarity on whether there will be a gap between the situation in the EU and the regulations here. Will that gap exist? Will there still be a difference? I know he is sort of saying that he cannot say what the position will be at the moment, but will he seek to ensure that there is no gap?

[Steve Brine]

Not only will I seek to ensure that there is no gap, but I will very much take that as feedback from Her Majesty’s Opposition on the regulations and ensure that it is fed through to the new committee as it is formed. I understand the concerns expressed by the hon. Lady and the Scottish National party spokesman in that regard.

Question put.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

It is being implemented as we speak. I am very happy to talk to my hon. Friend about when it will be rolled out in Colchester.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I welcome the Government’s commitment to end the transmission of HIV in England by 2030. However, HIV reduction was not mentioned in either the prevention plan or the long-term plan. How will the Government reach that ambitious goal without a concerted and fully costed strategy?

[Matt Hancock]

We do have a concerted and fully costed strategy. Indeed, I have given the commitment of ending new AIDS cases by 2030 with a plan around that. The long-term plan goes into detail about new ways of commissioning sexual health services. This is a very important area, and, as the hon. Lady says, it is an important part of the prevention agenda, and we will make sure that we get it right.

Exiting the European Union (Medicines)

Sharon Hodgson Excerpts

Tuesday 19th February 2019 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank the Minister for bringing this legislation to the Floor of the House and for providing us with a summary of it, which helped immensely. We are expecting many more health SIs in the weeks to come, so I must make it clear again, as I will in future, that it is incredibly concerning that we are now only 38 days away from 29 March and are still preparing for a no-deal Brexit. I hope that it does not come to that, but this has taken up a considerable amount of Parliament’s time and resources. My preferred scenario would have been one in which the Prime Minister did not run down the clock for two years, and especially now when we are getting closer and closer to Brexit day. I understand the need for “just in case” legislation, but we should have secured a deal by now.

Moving on to the legislation, clinical trials will probably not be in the forefront of people’s minds, but they are crucial for the safety and efficacy of medicines, as well as for our health and wellbeing. Medicine is not something that we should get wrong, but when we do, as in the case of Primodos, valproate and vaginal mesh as a surgical procedure, we must hold up our hands and take urgent action.

While this may not be the most eye-catching statutory instrument, it is hugely important. It is about patient safety and confidence. It would mean that in a no-deal scenario, the Medicines and Healthcare Products Regulatory Agency would be able to operate as a regulator outside the EU system and would therefore take on roles formerly conducted by the European Medicines Agency and through the wider EU regulatory framework. I must put on record my disappointment that the EMA is relocating from the UK to the Netherlands next month because of Brexit. Our loss is the Netherlands’ gain, but we should not have let it come to this. However, this SI means that in the event of a no-deal Brexit, the MHRA will be able to regulate clinical trials to ensure that they continue to operate effectively.

I want to ask the Minister for clarification on a few points. The new EU clinical trials regulation was introduced in April 2014 and was expected to come into force in October 2018. I understand that owing to technical issues that has now been delayed. The Government’s no-deal guidance says that

“we’ll align where possible with the CTR without delay when it does come into force in the EU”.

Will the Minister please restate that commitment to the House today?

If the UK does leave with a deal, which I hope we do, what will the arrangements be for the CTR and the UK? Could the UK, no longer being a part of the EMA, delay the availability of new medicines in the UK? I am aware of concerns raised that, because the UK will be seen as a smaller market for new drugs than the EU, companies will be more likely to prioritise the authorisation of new drugs in the EU rather than in the UK. Has the Minister made any assessment of this risk?

Will the Minister please tell the House what the implications of a no deal would be for clinical researchers who are EU nationals? Will the UK also be eligible for EU funding for clinical trials under a no-deal scenario? The UK is currently one of the largest recipients of funding for clinical trials, and I am concerned about the implications for future trials and opportunities. The MHRA will have the power to publish its own guidance on clinical trial applications and applications for an ethics committee opinion, as well as declarations of the end of clinical trials and the content of documents forming trial master files. Could the MHRA continue to work with EU states in order to keep regulation in line with the EU? Will the Minister review important details, such as ethics, where concerns are raised?

In July 2017, the then Health Minister, Lord O’Shaughnessy, said that in the event of a no deal the Government would ensure that any system put in place would not impose additional bureaucratic burdens. Can the Minister reaffirm this commitment today? I know that this instrument was subject to consultation and that because of concerns raised amendments were made. Will she please say whether any further amendments are expected and whether there will be further consultation? Finally, will she please confirm that any changes made by the instrument will be communicated effectively to stakeholders in a timely manner?

Sunbed Use: Health Implications

Sharon Hodgson Excerpts

Wednesday 13th February 2019 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank the hon. Member for Mid Derbyshire (Mrs Latham) for her passionate and excellent speech and for so bravely sharing her own experience with melanoma, which makes it all the more delightful that she is with us in such fine health this morning. I am very sorry to hear about her brother, but I am pleased that her diagnosis was found early and was successfully treated. I also thank the hon. Members for Ayr, Carrick and Cumnock (Bill Grant) and for Linlithgow and East Falkirk (Martyn Day) for their excellent contributions.

It is fair to say that the health implications of using sunbeds once dominated public consciousness. Almost 10 years ago, when the Sunbeds (Regulation) Act 2010 was introduced by the former Labour MP for Cardiff North and passed by a Labour Government, the health risks that came with using sunbeds were well known and well talked about. I remember a parliamentary reception with celebrities such as Nicola Roberts from Girls Aloud speaking out loud and clear about the dangers of sunbeds.

Roberts spoke as someone in the public eye who felt compelled to be tanned—despite being of ginger complexion and very fair skinned—and to constantly use tanning products. She bravely said that she was coming to a point in her life where she wanted to be her natural colour. However, that was 10 years ago, and we should have come a lot further, but owing to vanity or whatever, everyone still goes in search of that elusive tan. As the hon. Member for Mid Derbyshire says, we do not need a tan; it should not be something that we desire.

The issue has certainly not been talked about in a long time, not least in the House, where between January 2011 and February 2019—more than eight years—the word “sunbeds” has been said only 16 times. It is therefore very welcome that the hon. Lady has brought this issue to the fore once again, because there is a generation of young people who will not really understand the risks of sunbed use. They will not know that the short, high-intensity exposure to UV radiation provided by sunbeds is dangerous and can dramatically increase the risk of skin cancer. Looking tanned might seem desirable when we are young, but I doubt, as the hon. Lady said, that looking aged with skin damage several years along the line will be as desirable. I invoke the dried-up prune analogy once again: we have all seen them on the beaches, haven’t we?

It is important that we get the message about the health risks across to young people, particularly because people frequently exposed to UV rays before the age of 25 are at a greater risk of developing skin cancer later in life. I have to admit that that statistic greatly worries me. I confess that, as a young woman in the 1980s, before we knew what we know now, I used sunbeds, although not as often as some. It was obvious that they could not be that good for me, but I did not realise how bad they were for me. I often used them to get a base tan before going on holiday, because we all believed that we would look after our skin better if we got a base tan before going abroad. As the hon. Lady said, that is a total fallacy. Has the Minister therefore made any assessment of how many young people know the risks of sunbed use, and does he have any plan to address the issue?

All the Government information on sunbed use dates back to 2009 and 2010, despite more relevant information being published since. For example, the WHO published a 2017 report entitled “Artificial Tanning Devices: Public Health Interventions to Manage Sunbeds”. The IARC also assessed UV-emitting tanning devices as “carcinogenic to humans” based on consistent evidence of a positive association between their use and the incidence of melanoma.

As we have heard, melanoma is on the increase in the UK, and it is estimated that the NHS will spend £465 million on treating skin cancer patients by 2025. I pay tribute to charities such as Melanoma UK and MelanomaMe., which was set up in my constituency in 2017 by Kerry Rafferty and Elaine Taylor—I met them in 2017 when opening an awareness event for them in Sunderland—after one of them suffered from melanoma and the devastation it wreaked on her life and body. Charities such as Melanoma UK and MelanomaMe. support patients and their families and raise awareness of skin cancers and the risks of sun exposure and, of course, sunbed use.

The Minister knows how strongly I feel that the Government have an obligation to prevent cancers, and I know he is passionate about doing so. That is why I believe that the Government must look at sunbed regulations again, to assess whether they need to be updated almost 10 years on since they were first published. It must be a priority for the Government to ensure that people know the risks of sunbed use before using them, as well as during and after their use. For example, people are told that smoking is harmful before they take it up, but guidance does not disappear once they have started smoking or even once they have stopped. Even though they may carry on smoking, everyone who smokes will admit to knowing the health risks. We are not at that stage with sunbed use.

It is easy to shrug off health warnings when it comes to sunbed use, because the symptoms of skin damage may not appear for up to 20 years. However, skin damage can have very serious implications, as we have heard, so the warnings must not be shrugged off. The hon. Member for Mid Derbyshire called for a ban on sunbeds across the UK, like in Australia and other countries. Although I can see why she calls for a ban, I feel that we must first allow the Government to look at all the most recent evidence and make an assessment. They should definitely update the regulations if necessary and ensure that younger generations are made aware, at the earliest stage, of the risks of sunbed use.

As I said at the beginning of my speech, this issue was very much in the public consciousness almost 10 years ago, and perhaps it is time to ensure that it is again. I am sure the Minister will take on board all that he has heard this morning, and I look forward to his response.

World Cancer Day

Sharon Hodgson Excerpts

Wednesday 30th January 2019 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I start by thanking the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this timely debate, and the other hon. Members for their excellent contributions: my hon. Friends the Members for High Peak (Ruth George), for Lincoln (Karen Lee) and for Coatbridge, Chryston and Bellshill (Hugh Gaffney), and the hon. Members for Strangford (Jim Shannon) for Ayr, Carrick and Cumnock (Bill Grant), and for Central Ayrshire (Dr Whitford).

World Cancer Day gives us an opportunity to come together and celebrate how far we have come in cancer diagnosis, treatment and care. It also gives us a chance to reflect on what more needs to be done to fight cancer. The Minister and I have previously worked closely together as co-chairs, as we often say in debates, on breast cancer, as I also have with the hon. Member for Central Ayrshire. That shows that all the main parties’ spokespersons are committed to working together on this issue.

Cancer is a very emotive issue, as we have heard in this debate in some passionate contributions. One in two of us will be affected by it in our lifetime. Most of us in this Chamber will be here today because of the personal effect that cancer has had on our or our family’s lives. In the UK alone, more than 360,000 people are diagnosed with cancer every year. That figure is expected to rise to more than half a million cancer cases every year by 2035. That is equivalent to one new case every minute. That makes the Prime Minister’s commitment to diagnose three in four cancers at an early stage by 2028 all the more ambitious.

Our NHS workforce do a fantastic job every day in caring for us and our loved ones, but as we have heard, there are chronic staff shortages across the NHS. There are vacancies for 102,000 staff, including 41,000 nurses. That makes it harder and harder for them to do the jobs that they want to do. I agree with my hon. Friend the Member for Lincoln, who as a former nurse powerfully made the point about the effect that the lack of the bursary has on the situation. Cancer Research UK has also pointed to the chronic shortages in the diagnostic workforce, with over one in 10 positions unfilled nationally. This is a worrying trend, as more people are expected to be diagnosed with cancer over the years and the NHS cancer workforce are already struggling to keep up with demand.

We covered a lot of this ground with the Minister in the debate earlier this month, in which we also discussed the long-term plan. The Minister said that,

“we must ensure that we have the right staff with the appropriate skills and expertise to ensure that patients receive the best care.”—[Official Report, 8 January 2019; Vol. 652, c. 60WH.]

I agree with him. Therefore, will he tell the House when he plans to publish the workforce implementation plan and when the budget for Health Education England will be set? Patients have a right to the best possible care and it is crucial that the NHS workforce are able to provide that. That is why I believe the Minister should consider it—as he probably does—a top priority.

It will be World Cancer Day on Monday, and I am proudly wearing my wristband. We must recognise the contribution the UK in particular has made to cancer diagnosis, care and treatment around the world. For example, Cancer Research UK has played a role in developing eight of the world’s top 10 cancer drugs. More than a quarter of the clinical trials that Cancer Research UK funds involve at least one other country. Cancer Research UK’s international grand challenge scheme brings together researchers from the UK, Europe and around the world on three five-year programmes, to take on some of the toughest challenges in cancer research. Cancer is an international challenge, which is why we should all unite together against cancer.

It is not just about surviving cancer. As we have heard today, it is about living well with cancer. According to Macmillan, 70% of people with cancer are living with one or more other serious health condition, often as a result of cancer and its treatment. Similarly, a third of people who have completed their treatment in the last two years say that their emotional wellbeing is still affected. As we have heard, during and after treatment, the cost of cancer can be a major issue with regard to not just loss of earnings, but travel and transport costs, and the increasingly expensive parking charges.

I have supported Macmillan’s Cost of Cancer campaign for over 10 years now. It is sad that we still need to debate and discuss this, but it is still a major issue. The issue of parking could be very easily solved. The cost of cancer also includes access to benefits, as we heard from my hon. Friends the Members for High Peak and for Lincoln. That can also be solved easily by some joined-up action across Government. That is why, when thinking about cancer, we must not forget about after-care, advice and support, especially when it comes to further symptoms that could become secondary cancer. In this regard, I believe that it is vital important that GPs are aware of all symptoms of secondary cancer, so that it can be picked up as soon as possible.

Finally, in this World Cancer Day debate, I want to pay tribute to all the NHS cancer workforce for all the hard work they do, day in, day out. Whether diagnosing, treating, caring or advising, they do a difficult but fantastic job, which we are all very grateful for. I also pay tribute to the scientists and researchers who discover the groundbreaking new treatments and information. Finally, I thank the campaigners and volunteers. We cannot beat cancer alone, which is why we must all come together to do so. As always, I look forward to working with the Minister to do just that.

Cervical Cancer Smear Tests

Sharon Hodgson Excerpts

Monday 28th January 2019 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I begin by thanking my hon. Friend the Member for Warrington North (Helen Jones) for introducing this debate on behalf of the Petitions Committee. I, too, pay tribute to Natasha Sale, who started this important petition. As others have said, it is so sad that she did not live to see this debate take place. Her family, I am sure, are very proud of her.

I thank all hon. Members who have spoken in the debate: the hon. Member for Henley (John Howell), and my hon. Friends the Members for Rotherham (Sarah Champion), for Darlington (Jenny Chapman), for City of Chester (Christian Matheson), and for Kingston upon Hull West and Hessle (Emma Hardy), whose speech was excellent and we will not forget any time soon. I thank the hon. Members for Livingston (Hannah Bardell), and for Lanark and Hamilton East (Angela Crawley), who spoke on behalf of the SNP. It has been an excellent debate with very good contributions and lots of sharing. I am a classic oversharer, but I will try to resist the urge. Finally, I thank the 167,000 people who have signed the petition so far.

This is a very timely debate, because Cervical Cancer Prevention Week concluded only yesterday. The age to start screening is a very emotive issue. Every year in the UK, more than 3,000 women are diagnosed with cervical cancer. As we have heard, 15% of those women are under 30. Last year, 12 of those under 30 died from cervical cancer. The number of cervical cancer deaths has fallen in recent years, but it remains the most common cancer in women aged 35 and under. That is why I welcomed preventive measures such as the introduction of the HPV vaccination, which was offered to adolescent girls in secondary school.

My daughter was one of the first to receive the vaccination when she was 13. I was very pleased to give that permission; I would not have hesitated for a second to give it, although as my hon. Friend the Member for Warrington North said, a number of people do not give permission. That is very concerning; genuine concerns will have led them to that decision, but we must do what we can to allay their fears. We heard about the catch-up programme at the time, to ensure that all girls up to the age of 18 were vaccinated.

At that time, I looked extensively into this policy area, following a campaign by Washington constituent, Claire Walker Everett, and her family. Claire led the campaign before her untimely death at the age of 23 in 2008, and her family continued it for some time afterwards. I called for a further catch-up programme to address what I called the “seven-year gap”, so that women between 18 and 25 could be vaccinated until they were eligible for smear tests. I said that the gap would close each year until almost all under-25s had been vaccinated, as is now the case. That was 10 years ago, so that gap has closed. Many of those first vaccinated are approaching 25 and are eligible for a smear test, so we should have a whole generation of young women and girls who mostly have been vaccinated against the HPV virus, to help protect them from cervical cancer.

The vaccination programme has been very successful on the whole, with a high national uptake of around 85%. However, I have previously raised with the Minister the significant regional differences in the uptake of the HPV vaccination, which need to be addressed. The lowest uptake for the two doses is in Stockton-on-Tees, at 48.3%; the highest uptake is in East Renfrewshire, at 95.6%. That is curious, and flies in the face of the screening statistics cited by hon. Members, which show that the north-east reached higher rates than others. Perhaps the differences are in pockets rather than whole regions.

I therefore ask the Minister what steps he is taking to investigate and address the regional inequalities in HPV vaccinations and screening. How do the Government ensure that the HPV vaccinations are taken up by the vast majority of girls? Otherwise, the reassurance of my earlier statement that a whole generation of women and girls approaching 25 have been vaccinated falls short in certain areas, which is extremely concerning. Cervical smear tests are available to women aged 25 to 64, yet cervical screening is at a 21-year low. Last year, it was discovered that more than 40,000 women had missed out on crucial information about cervical screening appointments and test results. Has the Minister made any assessment of the impact that has had on uptake? Can the Minister give assurances that this issue has been solved?

According to Jo’s Cervical Cancer Trust, which I commend for its tireless work and campaigning, one in four women across the UK do not attend cervical screenings. That proportion increases to one in three among those aged 25 to 29, when they are first eligible for screening, and to one in two in some of the most deprived regions in the UK. That decline can be for a host of reasons, such as fear or embarrassment.

I pay tribute to TV shows that show the medical equipment involved in a smear test; the “Victoria Derbyshire” show even showed a smear test live on the show on Friday, in an attempt to address those reasons. There was no wincing or obvious cries of pain, so it will have been reassuring to someone who has not had one, although I am sure some viewers complained that it was not suitable daytime viewing. Aside from doing more of that, will the Minister tell me what steps he is taking to increase take-up? Additionally, what steps is he taking to educate women on the need for cervical smears and what the tests are for? I understand that some women believe that a cervical smear will also detect ovarian cancer—as he knows, that is not the case.

As I mentioned, most women under the age of 25 have received the HPV vaccination, giving them excellent protection from the HPV virus. That means that the reason that once may have existed to lower the screening age no longer does. However, I say again, that reason falls down in low take-up areas. Additionally, I worry that lowering the eligibility age for a cervical smear test to 18 would cause additional problems and worries for young patients, as my hon. Friend the Member for Warrington North detailed so well in her excellent speech. False positives are more likely in younger women, as they often undergo natural and harmless changes in the cervix that a smear test would identify as cervical abnormalities. In most cases, those abnormalities resolve themselves without any need for treatment.

Treating false positives as cancer can damage the neck of the womb, which can cause a woman to give birth prematurely in any future pregnancies. In women under 25, therefore, the risk is deemed to outweigh the benefit. However, as my hon. Friend said, women should be provided with that information, to make judgments for themselves. Wider education should start in school; my hon. Friend the Member for Kingston upon Hull West and Hessle called for that to start as early as possible, to tackle the fear and embarrassment as soon as possible. I also believe that much more research should be done on the age so a decision can be made that is best for all women.

Cervical cancer is very rare in women under 25, with under three cases per 100,000 women. However, every such case is an awful ordeal for the woman and her family, and sometimes it becomes a tragedy, as it did in the case of Natasha Sale. That was also true for Claire Walker Everett from Washington in my constituency, who died at 23 and whose case first brought this issue to my attention, and more recently for Amber Rose Cliff from the neighbouring Sunderland Central constituency, who died in 2017 at the age of 25. If a young woman has abnormal bleeding or symptoms that she is concerned about, she should be taken seriously by her GP and offered a smear test as soon as possible as part of the health investigations into what is causing her symptoms.

I believe that is part of current guidance and best practice, but we have heard clearly that that guidance is not always followed. That was the case in the short life of Amber Rose Cliff. Between the ages of 18 and 21, she went to the doctor around 30 times, complaining of worrying symptoms and asking for a smear test, only to be told 30 times that she was too young and sent away. When she was 21, her mum paid for her to have a smear test privately. The results were devastating. It was cancer, and the cancer had spread. She died just four years later, aged 25. Young women should not be excluded from a valuable screening service just because of their age if they have symptoms, as Amber obviously did. GPs should be aware of cervical cancer symptoms and know that they should refer young patients who present with such symptoms for smear tests as part of wider investigations.

With all I have said in mind, I conclude that the age for cervical smear tests should remain at 25, on the condition that further research and debate is conducted and tests are offered to those under 25 who present with symptoms. The Government must also ensure that preventive measures such as the HPV vaccination are taken up as fully as possible, and that women who are eligible for a cervical smear test attend their appointments when they are invited or as soon as possible thereafter. I know the Minister cannot drag them all there personally, but I look forward to his response.

Appropriate ME Treatment

Sharon Hodgson Excerpts

Thursday 24th January 2019 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I start by thanking the hon. Members for Glasgow North West (Carol Monaghan) and for Cheltenham (Alex Chalk) and the right hon. Member for Loughborough (Nicky Morgan) for securing this important debate. I thank all hon. Members who spoke; it was great that so many did so. Due to time, I shall not list them all.

I thank the charities—MEAction, Action for ME, the ME Association, the M.E. Trust and ME North East—and all the patients who have been in touch with me to share their thoughts, feelings and experiences of living with ME. The ME Association estimates that approximately 250,000 people in Britain are affected by ME; we have heard plenty of moving stories about those individuals today. However, an article published in the British Medical Journal in July 2018 reported that 90% of cases are thought to go undiagnosed, and that people with ME are substantially undercounted, underdiagnosed and undertreated. As we have heard, patients are often passed from pillar to post with dismissals and misdiagnoses, and sometimes left waiting over a year for a diagnosis. I am sure the Minister does not need me to tell him that that does not meet NICE guidelines of diagnosis within four months of the onset of symptoms. The Government should therefore do more, and considering that they are not doing much for patients with ME at the moment, I do not think that that is too much to ask.

The Government do not fund research and clinical care for people with ME at the rate they do for other serious prevalent diseases. As we have heard, the average spent on research for a person living with ME is just £1 a year. According to Action for ME, that represents just 0.02% of all active grants given by the mainstream UK funding agencies. I am therefore concerned that the Government recently confirmed in a written answer that ME research funding is lower now than it was even in 2013-14.

Current treatments of graded exercise therapy and cognitive behaviour therapy have been found to be harmful to patients with ME, and continue the narrative of disbelief and neglect of them, which we have heard about from a number of hon. Members. NICE has already recognised that its guidelines are outdated, and that patients do not receive the full picture on recommended treatments. NICE is updating its clinical guidance on the diagnosis and management of ME, but that is not expected to be published until October 2020. Patients and their families have already waited long enough, so will the Minister work with patients, charities, researchers and NICE to ensure that treatment and care for ME is appropriate?

We have heard today why funding for biomedical research into ME is so desperately needed. According to MEAction, the only year in which the Medical Research Council invested any meaningful sum in biomedical research was 2012, when £1.5 million of funds were ring-fenced. However, no funds have been allocated for biomedical ME research since then.

In the Westminster Hall debate in June last year, I called on the Government to consider funding research, because it is long overdue. Will the Minister commit to doing that today, or will the Government continue to leave it up to the charity sector to do so? Projects such as Invest in ME Research, which has four PhD students researching ME, have been financially supported by patients and their families via crowdfunding in excess of £870,000. That is fantastic, but it should not be left to patients to crowdfund research. More funding for research will enhance healthcare professionals and clinicians’ understanding of ME, which will improve the patient experience and debunk the myths of ME being a primarily psychological condition, as we have heard about today. Clinicians must have access to up-to-date research and information so that they can give patients the best possible care and advice.

In some areas, however, that is not the case, as Jennifer Elliot, the CEO of ME North East, has brought to my attention. Jennifer told me of the diminished services available to patients with ME in the north-east region. There are no services at all for young people with ME in the entire north-east. Adult services in Sunderland are closed to patients altogether, and have been for some months, with no date for them to be reinstated. For 20 years, ME North East has been doing all it can to help and support ME patients but, with a severe lack of funding, it is now at crisis point. I am sure that other regions have similar stories, as we have heard today, so will the Minister please consider the loss of services in his response? Will he ensure that the services are reinstated and supported financially by the Government?

Finally, we must ensure that the stigma of ME is tackled. Funding and research will help, but it cannot be right that, as found last year, more than one in five families caring for a child with ME have been referred for child protection proceedings due to school absences and a lack of understanding by the school, as we have heard. I am pleased that the vast majority of those accusations are dismissed in less than a year, but the added stress and burden to families with children suffering with ME can be overwhelming. We therefore need more funding for research, so that we can understand, care for and treat ME, and break down the stigma.

Diabetes

Sharon Hodgson Excerpts

Wednesday 9th January 2019 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship this morning, Mr Robertson.

I thank the right hon. Member for South Holland and The Deepings (Sir John Hayes) for securing this important debate, especially after the excesses of Christmas—in which I am sure we all indulged, which is relevant to the topic we are discussing—and for his characteristically informative, entertaining and articulate opening speech. I also thank all right hon. and hon. Members who have taken part: my right hon. Friend the Member for Knowsley (Mr Howarth), the hon. Member for South West Bedfordshire (Andrew Selous), who is co-chair of all-party parliamentary group on obesity and does excellent work in this area, and the hon. Members for Rochford and Southend East (James Duddridge) and for Linlithgow and East Falkirk (Martyn Day). They made excellent contributions.

As we have heard—I will repeat these facts because they are worth saying again—there are 4.6 million people living with diabetes. Over the last 20 years, the number of people diagnosed has more than doubled. Every day, around 700 people—one person every two minutes—are diagnosed with diabetes, which is really quite shocking. Diabetes UK estimates that if nothing changes, more than 5 million people will have diabetes in the UK by 2025. That is why this debate is so important, and I am pleased to be here to discuss treatment, remission and prevention.

I start with treatment and care. Once a patient has been diagnosed, it is crucial that they get the right treatment and care for them. Technology can play a role in that, particularly for people with type 1 diabetes. New technologies mean that patients can be treated and monitored, which can help to reduce diabetes-related complications in the long term. However, access to those technologies is subject to a postcode lottery, as are many other things. I have heard of huge variation of availability and use across the country. I was pleased to see the Government commit to making life-changing flash glucose monitors available for patients with type 1 diabetes by April 2019. Will the Minster please also ensure that basic technologies, such as test strips and meters, are available to all patients who clinically need them across the country? We cannot just say that everyone with type 2 diabetes would clinically need them—although I have bought myself one and they are good for monitoring—but if people need them clinically, they should be available, not subject to a postcode lottery.

Such technology can be redundant if patients do not know how to use it, or do not know enough about their condition and how to manage it. That is why educational courses, such as the one that the hon. Member for Rochford and Southend East said he attended after his diagnosis, should be widely available, to give patients the knowledge, skills, support and independence to look after their own health. I was pleased to see that get a mention in the long-term plan earlier this week. Can the Minister please elaborate on when he expects the

“structured education and digital self-management tools”

to be expanded?

It is crucial that patients know about their diabetes and the health risks associated with it. According to Diabetes UK, there are over 160 lower-limb amputations every week in England that are a direct result of diabetes. As someone with type 2 diabetes, I find that really scary. Four out of five of those cases could have been prevented. Local foot care teams help to prevent thousands of amputations each year, but diabetes-related amputation is now at an all-time high. Does the Minister have any strategy to reverse that trend?

Finally on treatment and care, one person in six occupying a hospital bed has diabetes; at some sites it is as many as one in four. The majority of patients with diabetes are admitted for treatment of a different condition, but while in hospital their diabetes should not be in ignored. When diabetes is not adequately cared for in hospitals, harm can result from the in-patient stay. Acute or long-term conditions can develop further, adding further costs to the NHS and complications for the patients.

The long-term plan includes a welcome commitment to introducing diabetes in-patient specialist nursing teams to improve recovery and to reduce lengths of stay and readmission rates. Will the Minister indicate when he expects that to begin? Will he also assure us that those teams will be available in all hospitals across the country?

On remission, as we have heard, my hon. Friend the Member for West Bromwich East (Tom Watson) has been very vocal about his own transformation—it has been huge—and the remission of his diabetes owing to exercise and changes in his diet. He has done a fantastic job, as we have all acknowledged, and I wish him all the best. Diet changes, when I stick to them, have also helped me in my management of my diabetes. When I have totally cut out sugar and reduced all carbs, as the hon. Member for Rochford and Southend East said helped him, that has made a massive difference. While there is currently no evidence that diabetes can be completely cured, even by changes to diet and lifestyle—I am told that once someone is diabetic they always will be—people can take steps to control, reduce or even reverse symptoms of diabetes, and to put their diabetes into remission.

As we heard from the hon. Member for Linlithgow and East Falkirk, research and trials by Professor Roy Taylor of Newcastle University—I am very proud that a north-east university is leading the way on this—have found that a low-calorie diet of 800 calories a day, which is low but manageable, can actually reverse diabetes, which was recently listed by MadeAtUni as one of the UK’s 100 best breakthroughs in health. That is certainly an area that needs to be explored further. However, not everyone can make those changes on their own, and patients must have access to medical support and dietary advice if they wish to try. The NHS has confirmed that it will pilot diabetes remission services in England and Scotland. Some places are already rolling out the service informally. For example, I know that some GPs in Tyneside are piloting this model. Will the Minister please tell us when expects those pilots to begin?

On prevention, 12.3 million people are now at an increased risk of developing type 2 diabetes. Of course, not all of those will go on to develop diabetes, but such a high number of people at risk is deeply concerning. Type 2 diabetes has several risk factors, but as the hon. Member for South West Bedfordshire highlighted, being overweight or obese accounts for as much as 80% to 85% of someone’s overall risk of developing the condition.

Almost two in every three people in the UK are either overweight or obese. I am obviously one of the two at the moment. I strive and hope to be like the hon. Member for Rochford and Southend East, who said he is now the one out of those three. I congratulate him on that. I am back on a diet and cutting out sugar and carbs again and trying my best. However, if it was easy, nobody would be overweight. It is hard, and Christmas is not the best time to try to diet. This is why the nudge theories introduced by Public Health England are very welcome, along with proper traffic light food labelling and the “Eatwell plate”, for example.

However, we have to acknowledge that our society has become increasingly obesogenic and sedentary, and we have to address that as soon as possible, starting with the next generation in particular. In that regard, the Government launched the second childhood obesity plan last year, which I hope will help to tackle this problem if they implement all the policies within it and do not only consult on them. Clear calorie labelling and introducing a 9 pm watershed for adverts for food and drink that are high in fat, salt and sugar are two steps that the Opposition would introduce if in government, to help to reduce the high level of obesity in this country.

However, it is not all about diet, as Baroness Tanni Grey-Thompson is always telling me, but about exercise, too. Inactive children become inactive adults, which increases their risk of long-term conditions. According to ukactive, only 50% of seven-year-olds meet recommended physical activity guidelines. We therefore need to make sure that children have the space and resources to participate in sports, activities and play, which will benefit them in a host of ways, not just their health.

Nor should we forget the over-55s—or anybody, actually. According to ukactive, a total of £80.5 million could be achieved in NHS and healthcare savings on diabetes if one third of inactive over-55s were supported to be active over the next 10 years. The Secretary of State says that prevention is better than cure, and I think that that figure alone shows that it is.

The long-term plan committed

“to fund a doubling of the NHS Diabetes Prevention Programme over the next five years, including a new digital option to widen patient choice and target inequality.”

That must target people from black, Asian and minority ethnic groups, who are six times more likely to develop type 2 diabetes. We must ensure that any prevention programme reaches those communities as a matter of urgency.

To conclude, people with diabetes are sadly at greater risk of serious but largely preventable complications. For example, they are twice as likely to have a heart attack or a stroke. For those of us here who suffer from diabetes, that is a sobering fact. We must ensure that their diabetes is properly managed and cared for, so as to avoid those serious complications. What the Government do next as part of the long-term plan will be beneficial to those with diabetes, and I know that patients, campaigners and all of us here will keep a close eye on developments.

Cancer Workforce and Early Diagnosis

Sharon Hodgson Excerpts

Tuesday 8th January 2019 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Howarth. In case anyone wonders why I am shivering a bit, I have to say it is a bit cold in here.

[Mr George Howarth (in the Chair)]

But it is a very warm atmosphere.

[Mrs Hodgson]

Oh, good—we do try.

I start by congratulating my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) on securing this important and timely debate and on his excellent speech. I wonder whether he has a crystal ball and knew something that we did not; I am sure if he does, it will be much in demand, because we have an important vote next week and somebody might want to have a borrow. I thank all the other hon. Members who have spoken this morning—the hon. Members for Westmorland and Lonsdale (Tim Farron), for Eastbourne (Stephen Lloyd), for Strangford (Jim Shannon) and for Central Ayrshire (Dr Whitford), and my hon. Friends the Members for Easington (Grahame Morris), for Bristol West (Thangam Debbonaire), for Scunthorpe (Nic Dakin) and for Enfield, Southgate (Bambos Charalambous)—for their excellent contributions to the debate.

As we know, the long-term plan was launched yesterday. We had waited several months for it to be published, but I am pleased that, after a few setbacks and delays, we now have it and are able to move forward. I was also pleased to see that cancer is a key priority in the plan; I am sure the Minister played a large part in that. Cancer is important, but it is an emotive issue. One in two of us will face a cancer diagnosis in our lifetime, which is a sobering thought, and many of us in this Chamber will know someone who has been affected by cancer. Some of us, I know, have been affected by cancer individually, and no doubt some of us will have lost someone to cancer.

What led me initially to join the all-party parliamentary group on breast cancer as a new MP was losing my mother-in-law to breast cancer over 20 years ago. I notice that in this debate there is a gathering of former co-chairs of the all-party parliamentary group on breast cancer, as well as the current co-chairs of that group and the current chair of the all-party parliamentary group on cancer. Once this subject takes hold and catches our interest, it stays with us for the whole of our parliamentary career—as it should, because it is so important.

It is estimated that by 2035, one person every minute will be diagnosed with cancer. That is why cancer diagnosis, treatment and care and their workforces should play an important role in our NHS now and in the future. The Prime Minister set out in her conference speech last September the Government’s ambition to see three in four cancer patients diagnosed at an early stage within the next decade. Currently, just more than half of the people diagnosed with cancer are diagnosed early in England, so the Government have a long way to go to achieve that welcome ambition.

Early diagnosis improves the likelihood of survival, as we all know. For example, if bowel cancer is diagnosed at an early stage, nine in 10 people will survive, but if it is diagnosed late, at stage 4, only one in 10 will survive. Early diagnosis also increases the likelihood of responding well to treatment. Target Ovarian Cancer, which I am proud to say I am the chair of the all-party parliamentary group for, found that as many as one in every five women in England are too ill to treat by the time they receive their ovarian cancer diagnosis. Awareness and screening programmes are crucial to early diagnosis, but breast screening uptake, for example, is the lowest it has been in 10 years, with stark variations across the country. The percentage of women taking up their screening invitation within six months fell from 71.1% in 2016-17 to 70.5% in 2017-18. Some might say that is only 0.6%, but analysis by Breast Cancer Now has found that upward of 1,200 additional deaths could be prevented per annual cohort of eligible women if we were to increase screening uptake to the current target of 80% for individual breast cancer screening units. With 500,000 people projected to be diagnosed with cancer in 2035, it is clear that we must do more to ensure that cancer is diagnosed early so that it can be treated effectively.

The long-term plan, as I am sure everyone has read and the Minister will be aware, says:

“We will build on work to raise greater awareness of symptoms of cancer, lower the threshold for referral by GPs, accelerate access to diagnosis and treatment and maximise the number of cancers that we identify through screening. This includes the use of personalised and risk stratified screening and beginning to test the family members of cancer patients where they are at increased risk of cancer.”

That is all great, but the Government cannot make those improvements without improving the workforce, and they must not be complacent about the role our NHS workforce have to play in this. As we all know, that workforce do a wonderful job every day, treating, caring for and supporting us and our loved ones, as those who have witnessed it at first hand will attest. Unfortunately, the cancer workforce is at breaking point and already struggles to keep up with increasing demand. There are chronic staff shortages across the NHS, with vacancies for 102,000 staff, including nearly 41,000 nurses. As anyone who has ever worked somewhere with staff shortages will know, the pressure that places on an individual is huge. I cannot imagine what it is like for the NHS staff who work day in, day out under those pressures, when so much depends on their being able to do their job properly.

Cancer Research UK has pointed to chronic shortages in the diagnostic workforce, with more than one in 10 positions unfilled nationally. According to Breast Cancer Now, for every three breast radiologists who retire over the next five years, only two are expected to replace them. I know that others have already stated a lot of these facts, but they are worth stating twice. There is a similar problem with breast cancer clinical nurse specialists; Breast Cancer Care states that they are an ageing part of the workforce, with 45% of breast cancer clinical nurse specialists aged 50 or above. The Royal College of Radiologists has warned of a shortage of cancer doctors, with 5% of clinical oncologist posts vacant during the course of last year, up from a 3% vacancy rate in 2015. The Royal College of Nursing also warns that in England there are nearly 41,000 vacant registered nursing posts, and it predicts a dangerous increase to almost 48,000 by 2023 if the Government fail to take urgent action now.

The Government must take the issue of the cancer workforce incredibly seriously, as nearly every person who has spoken so far in the debate has said. Will the Minister provide a progress report on Health Education England’s cancer workforce plan, which was published just over a year ago? Additionally, will he please provide us with a date for when he expects the second workforce plan to be published? As others have said, “soon” is not good enough. The NHS long-term plan makes it clear that the funding available for additional investment in the workforce, in the form of training, education and continuing professional development through the Health Education England budget, has yet to be set by the Government. Can the Minister assure us that any workforce plan will be properly funded, so that the workforce gap can be filled as a matter of urgency?

The NHS long-term plan says:

“We will complete the £130 million upgrade of radiotherapy machines across England and commission the NHS new state-of-the-art Proton Beam facilities in London and Manchester”,

but staff will need to be trained on both how to use those new facilities and how to read the results. Education and training must be high on the agenda for the second workforce plan, including the reinstatement of the training bursary, removing any financial burdens and barriers so that we can recruit the nurses that we need for the future. It also means offering further training opportunities once qualified, so that staff can keep up to date with technological advances.

Our NHS should be the most attractive employer in the country, but without the financial backing and support from the Government we are failing to recruit and retain our hard-working NHS staff. Of course, as the Secretary of State continues to say, prevention is better than cure, but £96 million has been cut from public health budgets this financial year.

[Mr George Howarth (in the Chair)]

Order. I call the Minister.