Ambulance Services and National Heatwave Emergency

Steve McCabe Excerpts

Wednesday 13th July 2022 Commons Chamber

[Maria Caulfield]

As someone who has suffered a stroke myself, I am very aware of the urgency of seeing stroke patients on time. I am not going to give clinical advice at the Dispatch Box. It is important that, if a person suspects a stroke is occurring, they dial 999 immediately. The ambulance callers will normally stay on the line with that person, advise them on what to do, depending on their symptoms, and get an ambulance to them as quickly as possible. Once they arrive in hospital, if a stroke is suspected, they will be seen immediately—we are not seeing reports of stroke patients being delayed once they are in hospital. It is crucial that those patients are seen urgently, and the advice is to dial 999 and clinical advice will be given to them over the phone.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

The West Midlands Ambulance Service says that it has been at resource escalation action plan 4—the highest level of alert—for several months now, which is almost unprecedented. Has the new Secretary of State spoken to the chief ambulance officer for the west midlands yet about that terrible situation?

[Maria Caulfield]

The hon. Gentleman is absolutely right: ambulance trusts are under record pressures, the sorts of pressures that we would normally expect in winter. We are seeing them in the summer months, which is usually their down time, a fact that is extremely concerning for the months ahead as we head into winter.

As I said, I will meet all 11 ambulance trusts over the coming days. In the first few days of his appointment, the Secretary of State has already been out with ambulance crews to hear from them directly about the pressures they are facing. I hope the hon. Gentleman is reassured that we are both taking the issue extremely seriously.

Oral Answers to Questions

Steve McCabe Excerpts

Tuesday 19th April 2022 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

4. What recent assessment he has made of the adequacy of access to NHS ear irrigation and microsuction treatments.

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

Ear wax services are the responsibility of local commissioners, who are responsible for meeting local healthcare needs. Depending on a local area’s arrangements, services should be undertaken either at local primary care practices or through referrals to appropriate local NHS services.

[Steve McCabe]

Well, I obviously want to thank the Minister for that answer, but I was recently contacted by a constituent who complained that she was told by her GP surgery that such services were no longer available on the NHS and that she should consider obtaining them privately. This is happening despite recent studies that link the effect of impacted cerumen with cognitive decline and dementia. Will the Minister consider writing to clinical commissioning groups to remind them of their obligations and patient entitlements?

[Maria Caulfield]

I thank the hon. Gentleman for his question. There has been no national removal of ear wax services, which can still be commissioned locally. NICE guidance is clear on the types of services that should be commissioned. Traditional methods of manual ear syringing are no longer offered for safety reasons, but electronic irrigation and microsuction should be being offered. If his local CCG is not commissioning such services, I am happy to meet him and them to discuss why not.

Asthma Outcomes

Steve McCabe Excerpts

Tuesday 7th December 2021 Westminster Hall

[Steve McCabe (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings when not speaking in the debate. This is in line with current Government and House of Commons Commission guidance. Members are also asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done either at the testing centre in the House or at home. Please also give each other and members of staff space when seated, and when entering and leaving the room.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered asthma outcomes.

Thank you very much for calling me to speak, Mr McCabe. This is an issue that is close to my heart and close to the hearts of others here. There are few families in the whole of the United Kingdom for whom asthma has not been a key issue; it has been an issue for my own, and I want to speak about that as well. I am grateful to the Backbench Business Committee for agreeing to have the debate. I am chair of the all-party parliamentary group for respiratory health, which recently completed an inquiry into this issue, so I am delighted to be able to raise the issue of improving asthma outcomes in the UK. I very much look forward to the response from the Minister. I am also very pleased to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place, and I wish her well in her new role.

What does asthma mean to me? My second son, Ian, had asthma. He was born with very severe psoriasis, which meant that we had to apply cream to him three times a day when he was a wee boy. The doctor told us that the psoriasis would eventually go away, but that it would be replaced by asthma. I am not sure of the medical connection—I am not medically qualified to understand it—and I know only what the doctor told me and my wife. Ian has had asthma all his life now—he is 30 years old—and has used salbutamol, the wee blue inhaler, which is always there. It is very clear, from our family’s experience, that those salbutamol inhalers are really important. They are important for Ian. Asthma did not stop him participating in sports, but it meant that he always had to have that inhaler close by, should he at any time feel shortness of breath or need a wee helper.

In Ian’s class at school, there were many others who had asthma issues. As an elected representative, whenever I help constituents with benefit forms, whether for attendance allowance, personal independence payments or whatever, I always ask them about their medical circumstances. More often than not, asthma features among the ailments that they confirm they have—even for those of a different generation. They have often had it for many years. Asthma is an incredibly important issue.

I am pleased to see the Minister in his place. I always like dealing with him, because I always find his answers helpful. He has a passion for the health issues that we bring to his attention, and he always tries to give, and indeed succeeds in giving, the answers that one wishes to receive. Today, we are going to ask a number of questions, and we very much look forward to his responses. I am pleased to see hon. Members in their places. I had hoped that more Members would be able to attend, but I understand that last night was a late night for Members and that there are other pressing matters today.

I have always had a particular interest in respiratory health. This debate has arisen as a consequence of the APPG’s report, which we published last year: “Improving asthma outcomes in the UK”. We looked at the UK mainland, but we also had contributions from Scotland, Wales and Northern Ireland. Obviously, I bring the Northern Ireland perspective to any debate, wherever it may be about, and bring in Strangford too. I am my party’s health spokesperson in this place, and I work closely with my colleagues back home in the Northern Ireland Assembly, particularly with Pam Cameron, my party colleague. She and I work on many things together, including this topic.

Last year, the APPG produced a report investigating the reasons behind the UK’s poor asthma outcomes. We were pleased, honoured and humbled that recognised experts in fields relating to asthma responded to our invitation to take part. The experts ranged from clinical experts from primary, secondary and tertiary care to patient advocacy groups, national asthma champions and patients.

The inquiry was incredibly helpful and detailed. I thank Hugh McKinney of the APPG secretariat and his team for bringing together all the people who wanted to contribute. As a result of the inquiry and the report, many countries in the world now look towards us to learn about how we deal with asthma. They want to learn something from us here in the United Kingdom, and perhaps do things that wee bit better.

Covid-19 Update

Steve McCabe Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to raise that, and I hope she will agree that the JCVI has acted very quickly since the emergence of this new variant. If there are other things that can be taken forward to help to vaccinate the population, we will certainly be looking at that with great interest.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

I think that the Secretary of State briefly mentioned hotel bookings in answer to an earlier question. He will be aware that over the weekend there have been reports of a shortage of quarantine hotel spaces. How will he ensure that this does not undermine his reasonable attempts at a rapid response to the new variant, and where can someone currently find reliable information about the capacity and availability of such accommodation?

[Sajid Javid]

The Department already had contingency plans in place for countries being rapidly added to the red list. I believe that more than 600 rooms were made available on Sunday morning, and that will rapidly increase during the next few days. I think it has already increased since then. I believe that most of the information is available on the Government website.

Covid-19 Update

Steve McCabe Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

That is such an important issue in respect of the safety and efficacy of the vaccine. One of the strongest reassurances we can give to everyone is that the decision about whether this vaccine, or any vaccine, is safe and effective is made independently of the Government and Ministers by world-leading clinicians in our independent regulator, the MHRA. They look at the very best evidence available and continue to monitor the data and information. As I mentioned in my statement, when it comes to the vaccination of, for example, 16 and 17-year-olds, one reason why the JCVI was very comfortable in recommending to me that we offer a second dose to that cohort was the continuing close working together of clinicians and the MHRA. I hope that helps to reassure my hon. Friend.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

I note that when the Government were trying to extend their vaccine delivery programme earlier this year, they were keen to promote the benefit of mobile units, but they did not figure at all in today’s statement. How many mobile units are currently deployed?

[Sajid Javid]

It is all about making access as easy as possible. As well as the national vaccination centres and the grab-a-jab offers, we do have mobile units. I am afraid I cannot tell the hon. Gentleman exactly how many are out at any one time—the number changes day to day and depending on location—but they remain an important part of making access as easy as possible for people.

Covid-19 Update

Steve McCabe Excerpts

Thursday 22nd July 2021 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab) [V]]

Further to the question from the hon. Member for Southend West (Sir David Amess), what does the Minister suggest that a constituent of mine who has had the Indian-manufactured Covishield jab should do if they are planning to travel to Portugal or Italy in the next two weeks?

[Nadhim Zahawi]

The MHRA, our regulator the EMA and, of course, officials are working with the Commission. Wherever we spot these inaccuracies we address them—we have addressed them with Malta and now France. I am assured, as of last night, that pretty much the whole of Europe, other than the Italian authorities—which we are working with—will accept the AstraZeneca vaccine from any batch, because all batches, all factories, are approved by our regulator before they enter the United Kingdom.

Oral Answers to Questions

Steve McCabe Excerpts

Tuesday 13th April 2021 Commons Chamber

[Helen Whately]

I agree with the hon. Member that it is essential that we value social care staff. Just as we have valued NHS staff during the pandemic, so we have rightly recognised the vital contribution of the social care workforce. We must continue to value our social care workforce, for which we plan to bring forward proposals as part of our social care reforms.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

What steps he is taking to ensure patients are consulted on the provision of their local health services.

[The Minister for Health (Edward Argar)]

The Government are committed to putting patients at the centre of our health service. Patients are consulted on their local health services in a wide variety of contexts, including through Healthwatch England, the independent national champion for patients. When a major or substantial reconfiguration or change to services is proposed, the local clinical commissioning group is legally required to hold a consultation with local people.

[Steve McCabe [V]]

I wrote to the Secretary of State for Health and Social Care about this issue a month ago. Last December, amid the pandemic, Birmingham and Solihull clinical commissioning group decided to close Goodrest Croft GP surgery—which has more than 6,000 patients—in my constituency. The CCG did not consult anyone because apparently it is not required to do so. Does the Minister find that acceptable?

[Edward Argar]

Although I am not familiar with the detail of the specific local case the hon. Gentleman raises, I am happy to meet him to discuss it if that is helpful to him.

Patients with Heart Failure

Steve McCabe Excerpts

Thursday 11th March 2021 Westminster Hall

[Steve McCabe (Birmingham, Selly Oak) (Lab) [V]]

It is a pleasure to see you in the Chair, Mr Mundell.

As chair of the newly formed all-party parliamentary group on heart valve disease, I congratulate the hon. Member for Strangford (Jim Shannon), a co-founder of that new all-party group, on securing the debate. The aim of the all-party group is to increase awareness of heart valve disease in the United Kingdom, and help ensure that patients receive timely diagnoses and the optimal management and treatment of their condition.

Heart valve disease affects approximately 1.5 million people in the UK. As we have heard, patients can experience fatigue, shortness of breath and chest tightness and/or pain. The most common form of heart valve disease is aortic stenosis, which affects about one in eight people over the age of 75. Unfortunately, awareness and knowledge of the condition in the general population is alarmingly low: in a recent survey, only 3.8% of people really knew what aortic stenosis was. People with heart valve disease have poor survival rates without prompt treatment, and longer waiting times inevitably lead to worse outcomes. However, as we have heard, heart valve disease is a very treatable condition, particularly if patients are diagnosed early.

The all-party group receives secretariat support from Heart Valve Voice, with which I have worked closely on several projects. Most recently, I have been working with Wil Woan, its chief executive, on the “100,000 Conversations” initiative, a campaign focused on improving awareness by encouraging people to discuss their condition with friends and relatives, particularly the symptoms, as well as access to diagnosis and treatment. I should perhaps confess that I had open heart surgery for a repair to my mitral valve back in 2012, and so feel very familiar with many of the issues people raise. I recently had the opportunity to hold one of these conversations with the shadow Health Secretary, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), and I know Heart Valve Voice would be delighted if I could persuade the Minister to also take part in one.

We are also working on a campaign called “Just Treat Us”, which concentrates on encouraging patients to see their doctor if they are experiencing symptoms such as breathlessness, dizziness or fatigue, as well as encouraging care centres to treat patients, especially as the country starts to move out of lockdown. A simple stethoscope test is often all that is needed to identify a heart valve problem. Delaying treatment leads to worse outcomes, but with timely treatment, people can go back to a good—or even a better—quality of life.

As we have heard from the hon. Member for Strangford, covid-19 has had a significant impact on the investigation and care of people with heart valve disease, as with many other conditions. It has been reported that 100,000 fewer heart operations were carried out in 2020 compared with 2019. It has also been reported that 45,000 cardiac procedures have been cancelled.

When I had my mitral valve repaired, I was in an operating theatre for over seven hours. I was in intensive care for three days and spent another two weeks in hospital, and it took me approximately six months to fully recover. Transcatheter aortic valve implantation—TAVI— has been introduced as an alternative therapy to replace damaged aortic valves in patients who are considered high risk for traditional open-heart surgery. The procedure is less invasive, and patients can be discharged from hospital in a short period, allowing them to return to normal life while also saving hospital resources. As the hon. Member for Strangford said, he and I once witnessed a transcatheter procedure carried out on an 85-year-old gentleman at St Thomas’s. He had a local anaesthetic and was largely alert during the procedure. He was able to return home and was working on his allotment within three weeks of the procedure.

The “Valve for Life” initiative, run by the European Association of Percutaneous Cardiovascular Interventions, aims to promote transcatheter valve interventions, which could be crucial in rapidly reducing the waiting list that has been built up during the covid-19 crisis. It has four main goals: to raise awareness of valvular heart disease; to facilitate access to new therapies, such as TAVI; to increase educational standards; and to reduce obstacles to therapy and discrimination in access to care. The overall objectives of “Valve for Life” are to address inequalities in patient access and the disparities between countries in Europe, as well as to inform Government officials, healthcare administrators and healthcare providers about the clinical and economic value of transcatheter heart valve therapies in the management of valvular heart disease.

The UK has the second lowest rate of TAVI procedures per million people in Europe. Even within the UK, there is a large geographical disparity regarding access to treatment, as I think we heard earlier. We are very lucky in this country to have Dr Daniel Blackman, one of our leading interventional cardiologists, spearheading the campaign to raise the volume of transcatheter procedures. As we learn the lessons from the pandemic, I hope this is one area where we might be willing to entertain new thinking.

Heart valve disease is extremely common among older people and will obviously continue to place huge demands on our health service, but with early diagnosis and increased use of TAVI procedures, it need not be a killer. Indeed, it need not impair the quality of life. I hope that in the months and years ahead we can work to increase the use of new treatments and interventions, so that those suffering with heart disease can, in large part, look forward to a long and productive life following timely treatment and prompt rehabilitation support. Once again, I thank the hon. Member for Strangford for securing the debate and for making such an informed contribution.

Covid-19: Community Pharmacies

Steve McCabe Excerpts

Thursday 11th March 2021 Westminster Hall

[Steve McCabe (Birmingham, Selly Oak) (Lab) [V]]

It is a pleasure to see you in the Chair, Sir Graham. I congratulate the hon. Member for Thurrock (Jackie Doyle-Price) on securing the debate. As we have heard, most community pharmacies have remained open throughout the pandemic, and many have worked extra hours because they have often been the only available source of medical advice. The pandemic delivery service has ensured that those shielding have been able to receive their prescriptions. Last winter, community pharmacies administered 2.6 million flu jabs. I had mine at Kings pharmacy in Cotteridge, administered by pharmacist Ameet Pancholi.

Measures to take pharmacies covid-safe cost money. Pharmacies have had to install door entry systems and counter screens, and buy their own PPE. They have been involved in supporting people with mental health issues, and in fielding dental and optical inquiries, for which they do not get paid. Ameet Pancholi had to employ extra drivers to ensure the delivery of prescriptions to vulnerable patients.

As with much of the health service, the Government do not seem to recognise the real costs. Pressures date back to the 2016 Budget cuts, which resulted in many closures, often in the most deprived areas. If drug prices rise, pharmacies lose out because they are tied to a pre-set NHS drug tariff. A recent Ernst and Young report concluded that our pharmacy network is unsustainable within the current framework. It projected that 72% of pharmacies would be in deficit by 2024. As we have heard, pharmacies received money to meet extra pandemic costs, but they say that they have spent rather more, and it turns out that that money was loan that will now be clawed back. What happened to “whatever it takes” and “all help necessary”?

Only 55 days ago, I received an email from NHS England extolling the virtues of community pharmacies. It told me that 200 of them were due to start delivering the covid vaccine. It quoted the Secretary of State as saying:

“It is fantastic that high-street pharmacies will now begin”

administering the vaccine. He went on to say:

“Pharmacists have worked tirelessly throughout the pandemic, often acting as the first port of call…and often staying open when all around have closed.”

It also quotes the Vaccines Minister as saying:

“Pharmacies play a vital role in caring for the nation”.

If Ministers want to keep these fantastic pharmacies, which they think play such a vital role, there is only one solution: we need a review of funding and the drug tariff, and they should be fully compensated for the costs incurred during the pandemic. That means converting the £370 million covid funding to a grant.

Covid-19

Steve McCabe Excerpts

Monday 22nd February 2021 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab) [V]]

It is all very well to bask in the success of the vaccination programme, but being in charge also means taking responsibility for things that go wrong and the response so far to the ruling of Justice Chamberlain does not suggest that the Government are ready to seize all their responsibilities. He pointed out:

“The secretary of state spent vast quantities of public money…The public were entitled to see who this money was going to, what it was being spent on, and how the…contracts were awarded.”

Why ever not?

I will focus on three areas. I look forward to hearing more about catch-up. I welcome plans for children to return to school but wonder if a rotation and phased approach might have been safer, given what happened last time. I am pleased Sir Kevan Collins has said that all ideas are on the table and I welcome his comments about sport, music and drama. I hope that catch-up will not simply mean cramming and further stress. I hope there will be space for the needs of groups such as those with speech and language difficulties, who have lost out on so much. Perhaps some thought might still be given to whether it is possible to cancel this academic year and allow catch-up without extra pressures.

As the economy reopens, the Chancellor must provide support for businesses that remain closed and address the pressures that small businesses and the hospitality sector face over rents and will face over cash flow. I hope somebody will speak to the Secretary of State for Work and Pensions and urge her to reconsider the minimum income floor. It was suspended because it was an impediment to claiming universal credit. Reimposing it when people have no idea how much of their work might return means simply depriving people of money they need. Too many of the self-employed have already had a raw deal. Do not make things worse.

Finally, I want to mention the dental profession. We need a focus on preventive treatment and allowing time for dentists to use their skills in picking up issues such as early signs of cancer, promoting children’s dental health—our pre-pandemic record on that was pretty grim—and taking action to preserve dental laboratories. A crude focus on units of dental activity will not achieve this, and the Government must work with the profession. Ministers sometimes say they want to build back better. That means accepting responsibility for things that have gone wrong and need putting right, as well as claiming credit for success.