Giving Every Baby the Best Start in Life

Sharon Hodgson Excerpts

Tuesday 9th November 2021 Commons Chamber

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

I would like to start by thanking the hon. Member for Richmond Park (Sarah Olney), the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for securing this debate at this incredibly important time. I also offer my thanks to the right hon. Member for South Northamptonshire for her tireless campaigning on this issue over many years, for her recent leadership of the early years review and for her success in securing funding for the sector in the recent Budget. All those are to be welcomed. It is not easy getting money out of a Chancellor, as we all know. She also knows my dismay at the short-sighted cuts that preceded this funding, making it all the more necessary. I know she agrees that we need to ensure that no Government cut valuable services such as Sure Start or family hubs ever again.

I stand here as a former shadow Minister for children and families, a role now most ably held by my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq). It has been said that once anyone has been a children’s Minister, like the hon. Member for East Worthing and Shoreham (Tim Loughton), or a shadow, they can never quite leave the issue alone. It is sort of like an “Order of the Babies” maybe, or a ministerial Hotel California.

Covid-19 has had a profound impact on all of us, but the effects of the lockdown restrictions and social distancing measures were keenly felt in the early years sector. I welcome the “Babies in Lockdown” survey report published today by the Parent-Infant Foundation, Home-Start UK and Best Beginnings. The pandemic is, sadly, far from over, and the report offers signs that the early years sector has developed a form of long covid, if you like. The survey found that nearly a third of mothers questioned reported that health visitor drop-in clinics that existed before the pandemic were no longer operating. I urge colleagues to read the report.

But let me take Members back to 1970, well before Zoom and Teams. Back then, fewer than a quarter of mothers worked; society expected a full-time mother. Without a central focus on the early years, and no talk of the 1,001 critical days or adverse childhood experiences, the education of very young children was neglected. Baroness Blackstone, writing in 1974, highlighted the fact that only 10% of three and four-year-olds attended state nursery schools or classes in 1971, with some areas receiving no service at all.

To combat the lack of state nursery education, the mothers did it themselves. Belle Tutaev set up a playgroup with her neighbour which eventually bloomed into the Pre-School Playgroups Association. This has since become the Early Years Alliance. But the state should have taken up this mantle, rather than the already burdened mothers. Not everyone was convinced of that principle, however. In 1980, George Young, then the Conservative Secretary of State for Social Services, said that he did not

“accept that it is the state’s job to provide day care to enable the parents of young children to go out to work”.

Listening to the debate today, 40 years on, we can see how far we have come from that thinking.

It was the last Labour Government who finally addressed this problem. I have spoken before, as others have today, about the late Tessa Jowell’s Sure Start programme being a beacon of early years policy. Sure Start brought children’s services together under one roof, uniting healthcare with wellbeing, education with childcare, babies with other babies, and parents with other parents. There were 3,620 Sure Start centres in 2010 under Labour. That has fallen, as we heard from the hon. Member for Richmond Park, by more than 1,300 in the past decade or more of Conservative Governments. Those that remain have been effectively hollowed out, offering only skeleton services with minimal opening hours. While the Government’s pledge to fund 75 more family hubs is obviously welcome, it does little to make up for that loss. I know the hon. Member for East Worthing and Shoreham said it is not all about the buildings but, when we have lost 1,300 and replaced them with 75, it is trying to get a quart into a pint pot, as they used to say.

[Dame Andrea Leadsom]

It has been such a pleasure to work with the hon. Lady on this topic for so many years. I just want to put on the record that it is not 75 family hubs, but 75 upper-tier local authorities; it will be for them to decide, but it could be hundreds or thousands of family hubs. The hon. Member for Newcastle upon Tyne North (Catherine McKinnell) drew the same conclusion, so I really want to set the record straight on that point, if the hon. Lady will forgive me.

[Mrs Hodgson]

I am very grateful to the right hon. Lady. That is an important clarification, and we must ensure it is out there that maybe it will not just be 75, but that they can make it many more. Let us hope it is 1,300; I am sure she will agree with that. That said, I warmly welcome what I think is the Government’s tacit admission that they got it wrong when they defunded the Sure Start programme, even though, as we all remember, on the eve of the 2010 election, David Cameron promised it would be safe in his hands.

However, we are where we are. Earlier this year, I also co-chaired a cross-party early years commission alongside the hon. Member for Eddisbury (Edward Timpson), who, as a former children’s Minister, is also a member of the “Order of the Babies” and a resident of the ministerial Hotel California. The commission heard from a wide range of stakeholders, including educators, academics and policy professionals. I will take the House through some of the recommendations in the comprehensive report.

First, there should be integration of health and education support for children, ensuring that every child receives the health visitor appointments they are entitled to and a new health visit when the child is 18 months old. Secondly, because too few families have access to essential services, a locally relevant and dedicated parent support service is needed in every community in every area. Thirdly, we should upskill early education practitioners by investing in continuing professional development, so that the workforce stay fit to face the challenges of the future. Those proposals could easily be made reality. I sincerely hope that, as part of the £500 million brought forward in the Budget, the Government will deliver all of what we seek in this debate.

As we take part in this debate, we are mindful that the babies and children themselves will not be listening. They will not be tweeting their agreement or penning letters to our offices. I will spare a moment to mention how, beyond their value on their own terms, reforms to the early years offer can be instrumental in improving the lives of those without children, via the economy.

The Early Intervention Foundation found that the cost of late intervention in 2016-17 was £17 billion, owing to the need for services to help with mental health issues, youth crime and exclusion, including a £5.3 billion spend on looked-after children. Early intervention can offset that cost. The Carolina Approach to Responsive Education programme provided intensive, high-quality childcare for ages 0 to 5 in the United States of America and delivered a 13% return on investment per child each year. It netted IQ gains, higher wages, increased likelihood of home ownership and higher scores on achievement tests.

For the family unit, the economic returns are clear too. As the hon. Member for Richmond Park said, parents in areas with Sure Start local programmes moved into paid work more quickly than those without, reducing the benefits bill to the taxpayer and increasing tax receipts for the Treasury. But that is not the full picture: the economic benefits are often only modelled on specific, targeted interventions, whereas the benefits of intervention fan out across a range of factors, such as reducing the later burden on the public purse— the whole point of early intervention—and greater participation in the economy over many years. As such, it is practically very difficult to model the effects of a web of measures applied at once. So just imagine the results we could achieve if those interventions were provided simultaneously, with wholesale improved outcomes delivered via intensive early years support. Britain’s early years offer has the potential to be much greater than the sum of its parts.

To conclude, I would like to look to the world we are creating as legislators in this place. As we speak, delegates from around the world are discussing the means of preserving the planet and protecting the environment in Glasgow at COP26. It is incredibly important that we limit climate change to an increase of 1.5°. Missing, I believe, is leadership for those who will grow up into these environments. The pursuit of climate justice is in no small part to ensure that our children and their children’s children do not face an uninhabitable, hostile world. As those at COP26 work for the future of the planet, let us, here and now, seize this golden opportunity to help those who will inherit it.

Independent Medicines and Medical Devices Safety Review

Sharon Hodgson Excerpts

Thursday 8th July 2021 Commons Chamber

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

I thank my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) and the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) for securing this very important debate. As we have heard, today marks one year since the independent medicines and medical devices safety review was published. I was speaking virtually that day and I have to say that I am thrilled to be able to speak in the Chamber today; thankfully, it is starting to feel a bit more normal. I wholeheartedly thank Baroness Cumberlege and her team for their excellent work; it is great to see her with us today. I also thank the right hon. Member for Maidenhead (Mrs May) for commissioning the review in the first place. It was a brave and bold thing to do—and the right thing to do, as she has so often done in this place.

The problems with the medicines and medical devices that the review reports on—Primodos, valproate and vaginal mesh—have been ongoing for much, much longer than just the past year, as we all know. I have had the privilege of working with campaigners over many years on these issues; I pay tribute to Janet Williams, Emma Murphy, Marie Lyon and Kath Sansom, to name just four, for their dedication and expertise. They are normally with us for these debates, and it is sad that they are not able to be here.

I first spoke in this House about surgical mesh implants in October 2017, as shadow Minister for public health—there were always lots of debates in that brief, as my hon. Friend the Member for Nottingham North (Alex Norris) will know. My mam always likes to see my speeches, so one Saturday, while I was making lunch, I showed her that speech and said “Oh, thank goodness you’ve never had any of this awful mesh put in.”

That was when our world was turned upside down. She said, “No, no, I only had a bit of tape put in a few years ago, before all my troubles started”—the “troubles” she refers to being numerous health problems that appeared one after the other. She had had scans and cameras everywhere, with no diagnosis. Obviously there was no solution that could be found. Does that sound familiar to those who have had constituents with mesh problems get in touch?

Fast-forward three and a half years—coming up to four now—from that first debate, and my mam still has all sorts of complications. She is now in constant pain all the time. She is 76 this year. She has all sorts of autoimmune reactions and she just wants her mesh removed, no matter her age. She was very healthy and had a great life before, and her life now is a shadow of its former self. She wishes constantly, every day, that she had never had it put inside her.

She is not alone. I know that there are tens of thousands of women in exactly the same position, so I support all the recommendations of the excellent Cumberlege review. Recommendation 5 calls for specialist centres to be established, which is excellent; it has happened, they are open and I think some have actually started to do some of their work. But therein lies the issue that I want to specifically mention today—I am pleased that my hon. Friend the Member for Kingston upon Hull West and Hessle and the right hon. Member for New Forest East (Dr Lewis) have already raised it, so I am not alone in being concerned.

The issue is that the very surgeons who implanted this awful, life-devastating mesh are in most cases the very same ones now offering to remove it. As the right hon. Gentleman said, after gaslighting women and telling them that their pain was in their head or that they just had to learn to live with it—or to lie back and think of England when they tried to have sex, as was once mentioned in Westminster Hall—they are the very same surgeons these patients, including my mam, are expected to trust again to remove this mesh. That trust is, unsurprisingly, all gone.

[Alec Shelbrooke]

I am most grateful to the hon. Lady; I really appreciate all the work that she has done on the issue alongside us. To take what she says one step further—she may be coming on to this point—does she agree that the other problem is that the evidence we have had in APPG meetings is that the very same surgeons still think that this is the best cure for women? They are not actually accepting some of the problems that are blatantly obvious.

[Mrs Hodgson]

The right hon. Gentleman makes a very good point; I was not moving on to it, so I am glad he has made it. They are very keen to start reimplanting and reusing the mesh; they still say that it is great and that it transforms 90% of women’s lives. For the 90% whose body can tolerate it, that is great, but for the 10% who cannot, it devastates their lives. It transforms their lives in a devastating way; in many cases it can leave them crippled and unable to work.

Not all these women are of pensionable age like my mam, who is 76 this year. Some are still of working age and have all the problems associated with trying to get recognition in the benefits system when so little is still known, not just by GPs but by the Department for Work and Pensions people who are dealing with them. The last thing we want to do is create more victims of this terrible medical device. Mesh-injured women are between a rock and a hard place: either they have their mesh removed by the very same surgeon who implemented the mesh, often—in the case of my mam as well—after it was widely known that it was devastating some women’s health, or they do not have it removed at all. This should never be a choice, so I call on the Minister to work with NHS England to reconsider that and put patients first by giving them a genuine choice about where they go for their mesh removal and who removes it. There are only eight of these centres, so this is not often as easy as saying, “Oh well, you can go to Manchester or London,” as was said to my mam; obviously, I will bend over backwards to enable that to happen, but some women just will not have the wherewithal. There must be a way for surgeons from other parts of the country to travel to where those women are, so that they do not have to face and deal with the surgeon who put the mesh in them.

I want to briefly mention valproate and Primodos. Since the review was published a year ago, very sadly 10 members of the Association for Children Damaged by Hormone Pregnancy Tests have died, still suffering with the enormous guilt of feeling, even though it was not their fault, inadvertently responsible for the damage to their babies. This has been an ongoing battle for them since 1978 and we have heard and will hear further this afternoon how devastating this drug has been for those who took it in all innocence, with full trust in their doctors to do them no harm.

On valproate, I have huge respect for the noble Lord O’Shaughnessy. When he was the Health Minister responsible he put in train excellent guidance and safeguards and tried to help more than anyone before him, yet shockingly still around 400 babies are born per year who have been exposed to valproate—even now, after all we know and all that the noble Lord put in train. That is truly shocking. Some 15,000 women in England alone are prescribed valproate in their child-bearing years with the majority still not receiving the pregnancy prevention programme or given a change of medication should they seek or want to become pregnant. This is without even beginning to estimate the additional tragedies of stillbirths, miscarriages or terminations that are due and necessary because of valproate.

This Minister’s lasting legacy could be to right these historical wrongs once and for all. We must ensure that everyone in the healthcare system is protected and treated with care, and when there are failings, as will happen—they cannot all be prevented, much as we would like it to be so—the Government must take action to ensure that those harmed are treated with respect and given proper healthcare and restorative surgery where possible and are, if they can be, properly compensated. But mostly we need to ensure that this sort of harm from medicines and medical devices never happens again.

Independent Medicines and Medical Devices Safety Review

Sharon Hodgson Excerpts

Thursday 9th July 2020 Commons Chamber

[Ms Dorries]

In the Department of Health and Social Care, we work daily and continually on improving patient safety to make our NHS the safest healthcare system in the world. Procedures such as the national guardian scheme, which my hon. Friend mentioned, and others that have been put in place all work towards that goal. This report, as tragic and harrowing as the stories in it are, will go a long way towards enabling us to develop systems that enable the patient’s voice to be heard earlier.

That is the core issue. The thread that runs through is how long it takes somebody who has a complaint to have their voice heard and their complaint acted on. That is something that we need to resolve. If we can do that—if patients’ complaints can be heard and can be resolved as soon as they are raised—no Minister will, hopefully, ever have to come to the Dispatch Box in the future, because situations will have been dealt with effectively and promptly, and lessons will have been learned.

My hon. Friend will also be aware that we have introduced the Health Service Safety Investigations Body, and there are other measures that will help us to take the learning from incidents and move forward. Work therefore happens daily on improving patient safety and getting to the place he outlined, where a Minister will never have to come here and apologise again.

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

I thank the Minister for her statement today. First, may I express my sincere gratitude to Baroness Cumberlege and the review team, who have shown such empathy and understanding to patients, their families and campaigners who have campaigned tirelessly on these issues for years? My mam is one of the thousands of patients who had her life and her health ruined because of this quick fix with a bit of tape. She was never warned of the damage that this plastic mesh could cause her body.

The review recommends setting up a network of specialist centres to provide comprehensive treatment, care and advice for those affected by implanted mesh, and that is to be welcomed. Does the Minister agree, however, that it would be abhorrent for any of those centres to be led by any of the surgeons who promoted mesh or put it into women, knowing it damaged them? For some women, it has caused the most unimaginable pain and life-changing damage.

[Ms Dorries]

I thank my hon. Friend—I do regard her as a friend because she is such a principled campaigner on issues such as this. I hope she does not mind my saying that I know that her mother gave evidence to the review and went along to one of the hearings. I thank her for that, because it was a very brave step to take. This is not an easy thing to talk about, so that was incredibly brave of her. We owe her for her bravery in coming forward, and I thank the hon. Lady for mentioning that.

I completely agree with the hon. Lady. I cannot comment on the specific point about individual doctors with expertise because work has to go forward on removals of meshes and on where we go in the future. However, on specialist centres—I think she is aware of this—NHS England is assessing bids from NHS providers to become specialist centres and to provide treatment for women with complications from mesh inserted for urinary incontinence and vaginal prolapse. Following the covid-19 pandemic, during which some of this work has unfortunately been halted, every effort is now being made to finalise the centres quickly. Stakeholders will be kept up to date with progress, but we do want to see more of that work.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 23rd June 2020 Commons Chamber

[Dr James Davies (Vale of Clwyd) (Con)]

What progress his Department has made on the establishment of a test and trace service for covid-19.

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

What his timetable is for the operation of the NHS test and trace service nationwide.

[The Secretary of State for Health and Social Care (Matt Hancock)]

NHS Test and Trace was introduced on 28 May, working with local authorities to prevent and contain the spread of covid-19. I am encouraged by the early results, which show that in the first two weeks of operation 87,000 people were contacted by NHS Test and Trace and agreed to self-isolate.

--- Later in debate ---

[Matt Hancock]

That is an incredibly important question. Of course, I would add Northern Ireland to that group. We have regular meetings. I have a weekly call with my counterparts in the devolved Governments. Of course, the devolved Governments have a huge role to play in this. I will give whatever support I can to help the Welsh Government to make sure that they can deliver contact tracing, and indeed the wider testing programme, as well as possible.

[Mrs Hodgson [V]]

Will the Minister urgently set out a plan to support local authorities to implement local lockdowns if needed, along with providing them with all the resources they need to implement this?

[Matt Hancock]

Yes.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 10th March 2020 Commons Chamber

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

The Secretary of State keeps saying that local authorities do not need to worry about any of this, as the Government have said that they will be giving local authorities more money. Well, I asked my local authority on Friday whether that reassured it, and, surprise, surprise, it did not. That is because “more” can mean anything. Is it a penny more? Is it a pound more? Is it £100 more? Is it £1 million more? There is a bit of a difference. When will he let them know? He has now said that “imminently” means in a couple of days’ time. Exactly what is he waiting for? Is it the Budget?

[Matt Hancock]

As I say, the good news is that local authorities can all plan, with confidence, on the basis that these budgets are going up in real terms, and the exact details will be set out imminently.

Health Protection (Coronavirus) Regulations 2020

Sharon Hodgson Excerpts

Monday 9th March 2020 General Committees

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

It is an honour to serve under your chairmanship this afternoon, Sir Graham.

I thank the Minister for introducing the statutory instrument and summarising it so clearly. More generally, on behalf of the Opposition I thank the Government for their co-operation on covid-19 and for regularly updating the shadow Secretary of State for Health and Social Care, my hon. Friend the Member for Leicester South (Jonathan Ashworth). It is very important that we work together as much as we can on this issue and I know that the Minister has been leading that process.

First and foremost, our thoughts are with the loved ones of the four people in the UK with covid-19 who have sadly died and with all those who have contracted the virus. I pay tribute to all health staff, as well as to the chief medical officer and the chief scientific adviser, who have shown exceptional leadership.

Public health and safety must come first, which is why the Opposition will not push for a vote on this SI. We will support and co-operate with the Government where decisions are based on scientific and medical advice, and of course we support the strategy to contain, delay, research and mitigate the disease.

That brings me to the SI that we are considering. I agree that the transmission of covid-19 constitutes a serious and imminent threat to public health, and I know that this outbreak will already be alarming to many people across the country. The Government must therefore ensure that their response is proportionate and timely.

We are not yet at the delay stage, but I understand that we are moving away from the contain stage. We have seen evidence of transmission within communities—that is, a number of people have contracted the virus who have not recently returned from an at-risk country. Given that, is the SI perhaps not already out of date? The Minister said that there will probably be further legislation in the weeks to come, and I am sure that the process will be ongoing. If the virus has already begun to spread, will quarantine alone deliver the ongoing delay that we all hope to see? If we are to move officially on to the delay stage in the coming days, can the Minister please outline what steps the Government will take in terms of emergency legislation?

The regulations mean that any patient who is deemed by a health professional to be at risk of spreading covid-19 must stay in supportive isolation before the quarantine period of 14 days is complete. Can the Minister please elaborate on how that will be enforced on a mass scale? The prospect of staying in quarantine for 14 days can understandably be alarming for some people, not least if they have a family to care for or a job that helps them to make ends meet. I will come on to that point more widely in a moment.

At what point will the regulations be enforced: when someone expresses a desire to leave quarantine, or when they actually attempt to leave quarantine? Will there be police on hand at each isolation facility to ensure that patients do not leave quarantine without permission? If so, have the Government made an assessment of what that will cost police forces? Will the Government be providing extra forces and funding to police forces to carry out that role? What guarantees can the Minister give to health professionals and police officers that they will be protected from the virus during this time?

I am grateful that the SI includes an expiry date, but can the Minister tell the House what assessment was made in choosing two years?

As has been mentioned, many people will be concerned about not only the virus, but the implications that the regulations could have for them. The gig economy, zero-hours contracts and earnings thresholds mean that around 2 million workers are ineligible for statutory sick pay. It is unacceptable that some of the lowest-paid workers who need to self-isolate will be forced to make the choice between health and avoiding financial hardship. What regulation are the Government bringing forward to guarantee statutory sick pay from day one, and will it be backdated for people who have already self-isolated due to covid-19?

The Prime Minister suggested that those not entitled to SSP would be eligible for universal credit, but the Government’s own guidance says that it takes about five weeks to get the first payment. That clearly is unacceptable. As I said during the debate on health inequalities last week:

“The Government’s inaction to improve these inequalities in our society will not only continue to hurt the poorest and most vulnerable; in turn, the rest of society will also suffer.”—[Official Report, 4 March 2020; Vol. 672, c. 945.]

I hope that the Minister can answer those questions. I urge the Government to address the question of statutory sick pay and universal credit as a matter of urgency.

Health Inequalities

Sharon Hodgson Excerpts

Wednesday 4th March 2020 Commons Chamber

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

This has been an excellent debate and one that I hope has been enlightening to the Government Benches especially. I thank all hon. Members who have contributed; I counted 24 Back Benchers in total. In particular, I pay tribute to my hon. Friends the Members for City of Durham (Mary Kelly Foy) and for Coventry North West (Taiwo Owatemi), who made exceptional maiden speeches and will be powerful advocates for their constituents.

I highlight the other excellent speeches by my hon. Friends the Members for Coventry North East (Colleen Fletcher), for Bristol South (Karin Smyth), for Mitcham and Morden (Siobhain McDonagh), for Hornsey and Wood Green (Catherine West), for Bradford South (Judith Cummins), for Ealing, Southall (Mr Sharma), for Lewisham East (Janet Daby), for Blaydon (Liz Twist), for Putney (Fleur Anderson) and for Enfield North (Feryal Clark), although time will not allow me to comment on them in detail.

As we have heard, “The Marmot Review 10 Years On” report confirmed what many Labour Members have been warning—that life expectancy is declining and inequalities are widening. The stalling of life expectancy is not a trend that we see worldwide. It does not have to be this way. The Nordic countries, Japan and Hong Kong all have life expectancies that are greater than ours and which continue to increase. But here in the UK, for the first time in more than 100 years, life expectancy is stalling and even declining for the poorest 10% of women. As the Marmot report says,

“if health has stopped improving it is a sign that society has stopped improving.”

There is no doubt that there is a link between austerity and stalling life expectancies. It is disgraceful that rates of premature deaths in poorer areas are twice as high as those in the more affluent areas. The Secretary of State has always said that prevention is one of his top three priorities, yet we have seen no evidence of that. The cuts to public health budgets have not been reversed. There has been no investment in children’s services, addiction services or social care, and no attempt has been made by successive Conservative Governments over the past 10 years to improve the standard of living for people living in cold and damp houses, working in unstable jobs or on zero-hours contracts, which have increased to more than 1 million people under their tenure.

The vulnerability of those on zero-hours contracts—sometimes with no rights to statutory sick pay—has come home to roost now that we are looking at a pandemic requiring two weeks of self-isolation, and possibly long periods off sick if the virus is contracted and takes hold. The same applies to the self-employed and those working in the gig economy. Although we welcome what the Prime Minister announced earlier today about scrapping the three-day wait for statutory sick pay, trying to live on £94.25 a week, which is about a quarter of the national minimum wage, will only exacerbate the existing inequalities, and could vastly compromise the nation’s attempts to contain the coronavirus if people choose to work, instead of self-isolating, due to the need to pay their bills and eat. The Government’s inaction to improve these inequalities in our society will not only continue to hurt the poorest and most vulnerable; in turn, the rest of society will also suffer. It is for those very reasons that Opposition Members believe in caring proactively for the most vulnerable. It really does benefit us all to do so.

Not doing something to make life fairer and more equal has real measurable affects. According to the Royal College of Physicians, children growing up in damp, mouldy homes are between one and a half and three times more likely to experience symptoms of asthma and other respiratory diseases than children living in dry homes. A study by the Nuffield Trust found that young people in the UK are more likely to die of asthma than in any one of the other 13 European countries studied. That is totally disgraceful, and the Government really must do something urgently to reverse this trend.

Holly Worboys died tragically at the age of 19 from an asthma attack in January 2016. She was using her inhaler sparingly to save on prescription costs. A prescription currently costs £9—a price that is just too high for many people who are living on squeezed or inadequate incomes. People should not be priced out of health. That is why we on the Labour Benches are committed to rolling out free prescriptions for everyone. Has the Minister considered this as a means to prevent illnesses worsening and early deaths?

The Marmot review confirms what we already knew: the poorer the area, the worse the health. That means that health inequalities also exist within poorer parts of otherwise wealthy areas, which we see across London often, but it also means that health inequalities exist between the north on the whole and the south— because, on the whole, the north is less affluent than the south. Sadly, it was ever thus and it is what drove me into politics in the first place, growing up in the north-east under Thatcher. The north is often a forgotten land, not least the north-east, where the most deprived 10% of neighbourhoods have seen the largest decreases in life expectancy. This is in comparison with the largest increases in life expectancy in the least deprived 10% of neighbourhoods in London.

When it comes to healthy life expectancy, as we heard earlier, boys born in Blackpool in 2016-18 can expect to live 53.3 years in good health, compared with 71.9 years for those born in Richmond upon Thames, where healthy life expectancy is the highest. That is a gap of 18.6 years and that gap has widened by 4.7 years since 2009-11, when it was 13.9 years.

This is a deep injustice that the Government must address as a matter of urgency. So what are they going to do about it? The public health grant has been cut by £700 million since 2015, with the most deprived areas faring worst. Will the Government reverse the cuts to public health budgets? Will they today—not “soon”, not “in the near future”—publish the public health grant allocation for 2020-21, so that local authorities can begin budgeting for the financial year ahead, which starts next month?

The Marmot review should act as a huge warning sign for the Government. Health inequalities are widening and life expectancy is stalling and declining. Given everything that we have heard this afternoon, what urgent steps will the Government take to address health inequalities before they increase further?

Medicines and Medical Devices Bill

Sharon Hodgson Excerpts

2nd reading & 2nd reading: House of Commons & Money resolution & Money resolution: House of Commons & Programme motion & Programme motion: House of Commons & Ways and Means resolution & Ways and Means resolution: House of Commons
Monday 2nd March 2020 Commons Chamber

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

This has been an excellent debate—and we seem to have plenty of time left for winding up. I thank all Members from all parties who have taken part, and particularly my hon. Friends for their excellent speeches: my hon. Friend the Member for Blaydon (Liz Twist) made the case for Kuvan for sufferers of PKU, which I shall mention again in a moment, and my hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) made a powerful speech about organ harvesting that I am sure we will discuss in more detail in Committee.

The hon. Member for Bosworth (Dr Evans) raised an issue that is not currently on the face of the Bill but perhaps should be. It is something that I have discussed with Health Secretaries for well over a decade now—probably around 12 years—starting with the then Member for Kingston upon Hull West and Hessle when Labour was in government, and I raised it with the Minister only last week. The issue is the waste of prescription medication. The hon. Gentleman mentioned a possible figure of £300 million a year from the House of Commons Library, and that did not surprise me. I can well believe that that could be the figure and agree that there has to be a way to reduce that waste. As the hon. Gentleman said, we should start by measuring it, and perhaps consider the active, safe charitable donation of such medicines, because £300 million-worth of perfectly good medicines being put into an incinerator every year cannot be the best outcome. There has to be a better way. I am grateful to the hon. Gentleman for raising that issue, which the Minister will remember we discussed just last week.

I thank the Minister and her officials, who have taken the time last week and since to brief me and my team on the Bill. As my hon. Friend the Member for Leicester South (Jonathan Ashworth) said in his opening remarks, the Opposition support the principle of the Bill, but we have some concerns that I shall briefly outline and to which I hope the Minister will respond, if not now then perhaps at a later stage in the Bill’s progress through the House. The Bill deals with both human and animal health, and I shall start with human health.

Patient safety is of the utmost importance and I recognise that with the Bill the Government are taking steps to improve both patient safety and the availability of medicines and medical devices to patients in the UK after the transition period is over on 31 December this year. However, as the Minister knows, in the cases of valproate, Primodos and surgical mesh, which we have heard about already in the debate, patient safety and patients’ experiences in the past—sometimes even now, in respect of mesh—have sometimes been disregarded when they have reported issues to their GP. The independent medicines and medical devices safety review has been looking into that, and I very much look forward to seeing Baroness Cumberlege’s recommendations later this month.

I should also mention that there are questions of patient safety in respect of other devices, such as breast implants and metal-on-metal hip implants. There are a host of examples of patient safety having been compromised. We must ensure that that does not happen again.

Medical devices are not subject to the same strict regulations as medicines. Faulty washing machines are treated with far more caution than a medical device that goes wrong. A case in point is that we will all have been written to recently by Whirlpool. Regulations must be tightened for both medicines and medical devices. I am sure that the Government will consider seriously the forthcoming recommendations from Baroness Cumberlege in the review.

One mechanism in the Bill to increase patient safety is the provision to establish a database for medical devices and provide the Secretary of State with new powers to share information about medical devices in limited circumstances. However, there are approximately 80,000 different medical devices on the UK market. Will every device be entered into the database? What steps have been taken to establish such a database? Will the Minister please provide some more information about the point at which the Secretary of State will be mandated to share the information held on a medical device with the public? I wholeheartedly agree that there should be a database of this nature, but it must be fit for purpose and healthcare professionals must be able to access an updated database to make sure that they can provide the best treatment and care for their patients that is safe. I hope that the database would go further and become a register or even a registry, as the hon. Member for Central Ayrshire (Dr Whitford) suggested. A barcode could be included on each device that is scanned into a patient’s records so that a register or registry is created.

As I have mentioned, the Bill makes provisions for access to medicines and medical devices after 31 December. However, it is causing concern for some patients who are currently participating in EU-wide clinical trials and for patients who fear that they may miss out on future trials. Can the Minister provide any assurances today about access to EU-wide clinical trials, especially for those patients who are already on them? Access to such clinical trials would especially benefit patients with rare diseases, who have a small patient group here in the UK. Will the Minister please set out what provisions will be made for patients with rare diseases who could benefit from participating in a clinical trial?

As this Bill comes into force on 1 January 2021, will the Minister reassure the House that the supply of medicines and medical devices will be maintained in the run-up to the end of the transition period? This Bill could enhance access to medicines, but what does that mean for patients with rare diseases? For example, as we heard from my hon. Friend the Member for Blaydon, who spoke so passionately about PKU, patients have been waiting for more than 10 years for the drug, Kuvan, to be made available on the NHS. We know that Kuvan works for patients with PKU, because some have raised funds for it and been paying for it privately. Although it is expensive, the cost is not outwith the reach of some patients, but patients in the UK should not have to go without effective drugs. I am sure that we have all had constituents who have brought these cases to us. I therefore hope that provisions will be made to improve access to medicines, particularly for those people with rare diseases.

I welcome the Government’s announcement today about faster access to cannabis-based medicines, and I would be very grateful if the Minister could please expand on that announcement and how that relates to this Bill in particular. I also welcome the provisions in the Bill that allow for prescription powers to be granted to some bodies within the healthcare system—for example, to physiotherapists. Will the Minister set out what she envisages this system will look like, who will be able to prescribe, and what they will be able to prescribe and under what circumstances? Will these new prescribers be trained sufficiently to fulfil this role? Where will they get their information from about medicines and medical devices that they are prescribing, especially if there are new warnings on them, as we have seen, for instance, with Valproate.

The Bill also allows for pharmacy hubs to be established under a Henry VIII power, so will the Minister give the House a timescale for this power to be used? I would also be grateful if she outlined how these pharmacy hubs will work in practice, as I am concerned that this could open up an Amazon-style prescription service.

Let me move on to animal health and veterinary medicine. Although this subject is more likely to come under a DEFRA brief, I know that there is a link between human health and animal health, not least when it comes to antimicrobial resistance. Keeping our animals fit and healthy and ensuring that vets have the medicines that they need to provide treatment and care for animals is, of course, crucially important to many of us. Will the Minister please assure the House that the supply of veterinary medicines in the UK will be maintained in the run-up to the end of the transition period and that standards for veterinary medicines will be upheld to ensure that animals are given the best possible treatment after the transition period.

The Bill gives powers to relevant bodies to amend regulations as necessary, so will the Minister assure the House that the regulators are equipped with the right finance and resources to take on these new responsibilities? I am pleased that, in non-urgent cases, there will be consultations held before any regulations are changed, but can the Minister outline how long these consultations will run for and how soon after the consultation closes the new regulation will be implemented? What formal processes will be put in place to ensure that industry is involved in these consultations and, finally, how will the Government monitor the effectiveness of the regulations? What bodies will be able to scrutinise the performance and delivery of the regulators?

As I mentioned at the beginning of my speech, we do not want to find ourselves in several years’ time with news that a medical device or medicine is causing serious harm to patients—more than we have already, given what Baroness Cumberlege is looking into. Regulators must be held to account on this as much as the manufacturing industry and healthcare system.

In closing, human and animal safety is of the utmost importance, which is why we on the Labour Benches welcome this Bill, but I would be grateful if the Minister could answer these questions. If that is not possible in the time available tonight, especially given the rate at which I have put these questions to her, then perhaps in writing or indeed, during the passage of the Bill in Committee.

Acquired Brain Injury

Sharon Hodgson Excerpts

Thursday 6th February 2020 Westminster Hall

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

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

I begin by congratulating my hon. Friend the Member for Rhondda (Chris Bryant) on securing this very important debate, on his excellent speech, and on his continuing honesty and willingness to share details of his personal experience, in order to further the vital campaigning on acquired brain injuries.

I also thank the other right hon. and hon. Members who have taken part in the debate: the right hon. Members for South Holland and The Deepings (Sir John Hayes) and for Hemel Hempstead (Sir Mike Penning); my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh); and the hon. Member for Airdrie and Shotts (Neil Gray), who spoke for the Scottish National party. It has been an excellent debate and I am definitely looking forward to hearing the Minister’s response to it.

First, like my hon. Friend the Member for Rhondda, I thank the charities working in this field, including the United Kingdom Acquired Brain Injury Forum and Headway, whose chief executive, Peter McCabe, I also have the pleasure of knowing well. I thank them all for their invaluable work to support people with acquired brain injuries and their families. I also give special thanks to Headway Wearside, which goes above and beyond for people in my region in the north-east, especially for people in my constituency. Headway Wearside has given me a lot of help over the years with constituents’ cases.

As we have heard, acquired brain injury is a leading cause of death and disability in the UK. A brain injury can happen in an instant at any age or at any stage of life, and the effect can be devastating and life-changing. ABI is a hidden epidemic, affecting many hundreds of thousands of people’s lives in many ways. As a result, and as we have heard, people with ABI face challenges that are related to more than just one Government Department. That is why I am pleased to echo my hon. Friend the Member for Rhondda and the all-party group on acquired brain injury in asking the Minister to work with her colleagues across Government Departments to ensure that people with brain injuries get the care and support they need, whatever that care and support might be.

As we have heard, every 90 seconds someone is admitted to hospital with an acquired brain injury. Thankfully, improvements in medical procedures and acute care have led to improved survival rates, which is welcome. However, as we also heard—I think it was the right hon. Member for Hemel Hempstead who made this point—that brings its own challenges and places further pressure on already stressed, indeed overstretched, health and social care services.

Early and continued access to specialist rehabilitation has been shown to optimise the chances of recovery and to be extremely cost-effective. However, there is an NHS workforce crisis, and we need more neurorehabilitation health professionals, such as physiotherapists, occupational therapists, speech and language therapists, and educational psychologists, to deliver services. What is the Government’s plan to attract prospective professionals to neuro-rehabilitation, and what are the Government doing to retain the current workforce, especially when service provision is variable across the UK?

It is crucial that people with ABI get the support they need, because this issue is also about the quality of their lives. What consideration has the Minister given to the APPG’s recommendation to establish a national review of neurorehabilitation provision? Also, rehabilitation prescriptions are very important in continuing communication and care across individual services, so will the Minister ensure that they are mandated across the services?

It is important that a patient and their family or carer know what care and support they need and what services they are currently accessing. That includes services provided by schools and other educational professionals, who may teach young children and young people with brain injuries. Best practice guidelines must be approved and followed for children and young people who return to education after an acquired brain injury, and operate throughout the rest of their education.

I will pick up on a point that my hon. Friend the Member for Rhondda made earlier, namely that if a child suffers a brain injury in their early years before they have even attended school—when they are under five—the school may never be aware of the link between their acquired brain injury and their behaviour in class, their educational ability, or indeed their behaviour in society, leading to all the issues that my hon. Friend mentioned with regard to youth offending and the need to screen prisoners, so that those who have slipped through the net throughout their school years can start to receive the help and support that they need and deserve.

All education professionals must have an awareness and understanding of ABI and the education requirements for children and young people with the condition. What conversations has the Minister had with her colleagues in the Department for Education about supporting children and young people with ABIs throughout their education? For those with pre-school ABIs—perhaps from a fall or meningitis—at the start of their education, what is being done to ensure that that information is captured and recorded in the child’s confidential record which that will follow them throughout their school years, in case issues begin to manifest themselves many years later?

What conversations has the Minister had with her colleagues in the Department for Work and Pensions about ensuring that all benefits assessors are trained to understand the problems that affect individuals with ABIs? A few hon. Members also mentioned that issue. I am talking not just about medical issues, but about how people’s behaviour or speech may be affected, as my hon. Friend the Member for Rhondda said,. Those effects may make them seem difficult to deal with, and that needs to be explained to assessors; otherwise, individuals with ABI could perhaps be harshly dealt with for something entirely outside their control. Will the Government ensure that a brain injury expert is on the consultation panel when changes in the welfare system are proposed, to ensure that the system works for people with ABI and their unique needs?

As we have heard, ABIs can be complex and therefore require attention from numerous Departments to ensure that patients and their families and carers receive the support that they need. I therefore hope that the Minister will consider everything that she has heard said in this excellent—small but perfectly formed—debate and will work in a co-ordinated and consistent way with her Government colleagues to deliver on the recommendations set out in the excellent all-party group report.

Health and Social Care

Sharon Hodgson Excerpts

Monday 3rd February 2020 Ministerial Corrections

The following is an extract from questions to the Secretary of State for Health and Social Care on 28 January 2020.

[Mrs Hodgson]

In October last year, the Government confirmed that the local authority public health grant will increase by 1% in real terms in 2020-21. However, this funding has not yet been allocated to local authorities. How will the Government financially support local authorities to establish the routine commissioning of PrEP by April?

[Jo Churchill]

As I said, NHS England and NHS Improvement have already agreed, within the ring-fenced funding for public health, to fund the ongoing costs of drugs for PrEP going forward. There will be an additional allocation of funds to cover the PrEP roll-out completely.

[Official Report, 28 January 2020, Vol. 670, c. 658.]

Letter of correction from the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill):

An error has been identified in the response I gave to the hon. Member for Washington and Sunderland West (Mrs Hodgson).

The correct response should have been: