Covid-19 Update

Tom Randall Excerpts

Tuesday 20th October 2020 Commons Chamber

[Matt Hancock]

On the contrary, we are working hard across party lines and trying to rise above that sort of political attack to work for the benefit and the public interests of everybody in this country.

[Tom Randall (Gedling) (Con)]

In Gedling, which does not have a large student population, there continues to be a worryingly high number of coronavirus cases. It is concerning to hear that the general picture appears to be moving upwards in the population, particularly among the over-60s, where we know the risks are higher. Does my right hon. Friend agree that this demonstrates the importance of acting fast, with targeted action if it is available, to help save lives?

[Matt Hancock]

Yes, I strongly agree. I praise my hon. Friend’s leadership in his local community in making this case. The number of cases in Nottingham and increasingly across Nottinghamshire is worrying. Nottinghamshire went into level 2 last week, and talks are ongoing about what more might be needed. I praise the people of Nottinghamshire for what they are doing to try to slow the spread of this virus. It may be that more needs to be done, and we will be driven entirely by the data, working closely with the local authorities.

Covid-19 Update

Tom Randall Excerpts

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

The hon. Lady has taken a close and repeated interest in this very important subject. We have put in place updated guidance on visiting care homes, which is a very important and sensitive balance we need to strike, working with local directors of public health. I cannot give the guarantee she seeks in all areas because it is a matter for the judgment of the director of public health locally, because in some parts of the country the virus is more prevalent than elsewhere. I wish I could, but I cannot. I look forward to continuing to work with her to try to get that balance right.

[Tom Randall (Gedling) (Con)]

I welcome the news that the Queen’s Medical Centre and City Hospital will be rebuilt in Nottingham. On PPE, the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), told the Public Administration and Constitutional Affairs Committee in July that in the early days of the pandemic the Government

“went from supplying PPE to about 250 or 260 hospitals…to 58,000 organisations”

such was the pace of change. With the measures the Government have recently taken, and with 32 billion pieces of PPE, can my right hon. Friend assure me that the Government are now in a much better position to deal with PPE should there be any increase in cases as we go into the winter?

[Matt Hancock]

Absolutely. The PPE distribution system was described by the head of the armed forces as the biggest logistical exercise he had seen in his professional lifetime. It has been a mammoth effort to get it into decent shape, but it is now in decent shape, I am very glad to say. We have been preparing to solve not only the current problems, but preparing in case of a second peak. We have said that PPE will be free to NHS institutions and care homes for the remainder of this financial year to remove that worry. I strongly support what my hon. Friend said about the warm welcome to the rebuilding of the QMC and City Hospital in Nottingham. It is a place I know well from my family, many of whom are from Nottingham. It is really great that we are able to put in that huge investment.

Axial Spondyloarthritis

Tom Randall Excerpts

Thursday 17th September 2020 Commons Chamber

[Tom Randall (Gedling) (Con)]

I am grateful for the opportunity to hold this Adjournment debate. I have been a Member of this House for nine months. One of the great privileges of being a Member of Parliament is the opportunity to sit in this Chamber. The more astute observers might have noticed that I occasionally sit slightly awkwardly on these Benches. I admit that, sometimes, I slouch. One of my waggish Twitter correspondents recently juxtaposed a photograph of me and a photograph of my right hon. Friend the Leader of the House reclining on the Treasury Bench, with the caption,

“great to see Gedling MP getting comfy in parliament and following in the footsteps of his fellow parliamentarian”.

I admire the Leader of the House very much—there is much to admire about him—but on this, alas, I do not seek to emulate him. Rather, my awkward posture arises from the condition I have: ankylosing spondylitis.

Ankylosing spondylitis is one of three sub-types of a type of inflammatory arthritis called axial spondyloarthritis. Axial spondyloarthritis is a chronic inflammation of the spine and joints. It is a painful and progressive long-term condition for which there is no cure. It is unlike conditions such as osteoarthritis, which is often associated with older people and the wear and tear that comes with ageing.

Axial spondyloarthritis, often abbreviated to axial SpA or AS, tends to present in the late teens or early 20s, with the average onset being just 24. In my own case, I first presented with symptoms at 16. As well as the stiffness and pain that one might expect from an arthritic condition, axial SpA is also associated with a range of complications and comorbidities, including uveitis and psoriasis. But it is perhaps the less visible complications of AS that can be the most debilitating. Many suffer from severe fatigue, as well as flare-ups and stiffness.

The condition presents itself in a period when most people are at a crucial stage of their lives, looking to build careers, start families and forge social relationships. I well remember my early 20s, when I was starting out in my first job after university, before I was prescribed the treatments that I am on now. When I got home after doing an eight-hour day in the office—something that most people would take in their stride—I crashed out on the bed, completely exhausted from a normal day at work.

[Munira Wilson (Twickenham) (LD)]

I congratulate the hon. Member on securing this important debate. My husband also suffers from ankylosing spondylitis. Like the hon. Member, he started getting symptoms when he was about 20, and it took him about 10 years to get diagnosed. He was exhausted and struggling to work, and there were days when I had to help him put his socks on because he could not bend over. Does the hon. Member agree that the shocking delays in getting a diagnosis have a massive impact on quality of life, as do the difficulties that people have in accessing the right treatment? We need to improve awareness, particularly of the National Institute for Health and Care Excellence guidelines on the treatments available.

--- Later in debate ---

[Tom Randall]

The hon. Lady is absolutely right. What I and her husband have experienced is sadly not a rare phenomenon.

The name axial spondyloarthritis will be unknown to many, if not most, people, but it is not uncommon. It affects about one in 200 of the adult population in the UK, or just under a quarter of a million people.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing forward this debate. I spoke to him this morning to seek his permission to intervene. He is aware of the massive eight-and-a-half-year delay in diagnosing this awful illness. I read an article in my newspaper back home in May about a young mum in Northern Ireland and her battle. We must all be determined to secure extra funding so that early diagnosis can happen, for adequate research into this life-changing debilitating disease, and for more support groups. In Northern Ireland, we have only two—one in Belfast and one in Londonderry—for a population of 1.8 million spread across the whole Province.

[Tom Randall]

In last night’s Adjournment debate, the hon. Member for Pontypridd (Alex Davies-Jones) said that she felt like a proper MP after the hon. Gentleman intervened on her in an Adjournment debate, and I echo those sentiments. He is completely right about the delay, which I will come on to in a moment, and about the role that support groups can play in showing that people are not alone in having the condition and in providing moral and practical support. I hope that now awareness has been raised, there will be more than two groups in Northern Ireland in due course.

As I was saying, there are a quarter of a million people with AS, which makes it more prevalent than multiple sclerosis and Parkinson’s combined. Hon. Members may say, “Well, so what?” AS is incurable and it can be managed through medication, physiotherapy or exercise, but what makes it worthy of particular concern and debate is, as outlined earlier, the delay to diagnosis.

The symptoms of AS can be difficult to diagnose. I was passed between neurologists, geneticists and other specialists as various conditions were ruled out, before a rheumatologist finally diagnosed AS when I was about 20. I was very lucky that I had to wait only a couple of years before getting my diagnosis, but on average, there is a delay of eight and a half years between the onset of AS symptoms and diagnosis in the UK.

[Gareth Bacon (Orpington) (Con)]

I commend my hon. Friend’s bravery in refusing to allow the condition to prevent him from gaining a place in this House and in attempting to draw more attention to the condition. How does the UK compare internationally in terms of the delay that various hon. Members have discussed between the onset of symptoms and diagnosis?

[Tom Randall]

I think in comparable countries such as Germany, France and Italy it is four, five or six years. Certainly, I think the delay to diagnosis in the UK is one of the longest in Europe, and that is something that needs to be remedied. Obviously, during that delay of eight and a half years, the condition can deteriorate considerably. One does not need to be an expert to understand the clinical, economic and human burden of delayed diagnosis.

[Andy Slaughter (Hammersmith) (Lab)]

I congratulate the hon. Gentleman on this timely debate. I have the honour to have the National Axial Spondyloarthritis Society based in my constituency, which is why I have some knowledge of the matter and am involved in the all-party parliamentary group on axial spondyloarthritis. I am sure that he will join me in praising its work and the extraordinary expertise that it brings. The danger is that if people do not have that association or contact, as many medical practitioners do not, it is difficult to diagnose, and therefore, heartbreakingly, young people suffer in pain and do not get a diagnosis when they should. Will he praise the NASS’s work and agree that the NHS needs to communicate about it much more widely?

[Tom Randall]

I pay tribute to the hon. Gentleman’s work. He was an active member of the APPG long before I was in this place. On the issues that he identifies, on which I will go into more detail in a moment, he is absolutely right.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Gentleman for bringing forward this debate. Before coming to this House, I was a physiotherapist. I ran an AS group for swimming and exercise and really know the benefits of that. The Chartered Society of Physiotherapy was in touch with me just this week to say that, because of covid, it is experiencing a real shortage of physios for the future and that 2,339 more physios are needed. Does he agree that we need to look back at the NHS work plan to ensure we have the right practitioners in place to support people like him?

[Tom Randall]

Physiotherapy can play a key role in managing the symptoms of AS, and we should all support the work that physiotherapists do with patients.

[Anthony Browne (South Cambridgeshire) (Con)]

I congratulate my hon. Friend on securing the debate on this important issue, and I pay tribute to his bravery in overcoming his condition and ensuring it did not prevent him coming to this House.

I have a family member, a friend and a constituent who suffer from AS, and I know well the problems with delayed diagnosis. My constituent Frances Reid started having symptoms 10 years ago. She went from doctor to doctor to doctor but did not get diagnosed. She was diagnosed only one year ago, and she now has pains across her entire body and needs joint replacements. She is in so much pain that she wakes up eight to 10 times a night. In contrast, a friend from Canada was diagnosed really early. With treatment and exercise, he leads a full life. What lessons can we learn from countries that have quicker diagnosis and what would my hon. Friend like to see here?

[Tom Randall]

My hon. Friend neatly explains the consequences of delayed diagnosis. A recent systematic review of the available literature found that, overall, patients with a delayed diagnosis of AS had worse clinical outcomes, including higher disease activity, worse physical function and more structural damage compared with patients who had an earlier diagnosis. Those with a delayed diagnosis also had higher healthcare costs and a greater likelihood of work disability, as well as a worse quality of life, including a greater likelihood of depression. Those are the consequences of not giving a prompt diagnosis.

We spoke earlier about the National Axial Spondyloarthritis Society, or NASS, which has identified four factors that contribute to delay: a lack of awareness among the public that AS might be the cause of their chronic pain; GPs failing to recognise the features of AS; referral to non-rheumatologists who might not promptly recognise AS; and failure by rheumatology and radiology teams to optimally request or interpret investigations. AS cannot be cured, but reducing the eight-and-a-half-year average delay in diagnosis will lead to better outcomes for those living with the condition.

The all-party group for axial spondyloarthritis, of which I am a vice-chair, suggests three steps that would help to reduce the delay in diagnosis. The first is the adoption of a local inflammatory back pain pathway to support swift referral from primary care directly to rheumatology. Low levels of referral to rheumatology from primary care represent one of the key barriers to achieving an early diagnosis of AS, and a national audit by the APPG found that 79% of clinical commissioning groups do not have a specified inflammatory back pain pathway in place, despite NICE guidelines recommending that.

[Jerome Mayhew (Broadland) (Con)]

My hon. Friend makes reference to the NICE guidelines and the quality standard on spondyloarthritis not being implemented by 79% of clinical commissioning groups. Does he agree that that simply relates to primary carers referring directly to rheumatology departments, which is not a cost issue but one of professional education?

[Tom Randall]

My hon. Friend is absolutely right, and that neatly leads me on to the APPG’s second proposal. I appreciate that the NHS is rather busy at the moment with public health messaging of one kind or another, but awareness of AS remains low and support for an awareness campaign would help to significantly raise the visibility of the condition not only among the public, but for example among GPs.

Thirdly, the APPG suggests encouraging the routine adoption of minimum service specifications across the NHS to help to reassure patients, particularly in the context of covid-19 and the difficulties many patients face in accessing key services during the recent lockdown. I would welcome any opportunity to meet Ministers separately to discuss those proposals in detail, if that were possible.

I will leave the last word to Zoë Clark, who addressed the APPG’s last physical meeting in January. She told attendees how, after getting AS symptoms aged 20, incorrect diagnoses and the impact of her condition left her socially isolated and unable to live independently, at a time when she was trying to complete a demanding four-year master’s degree in osteopathy. She said that living with undiagnosed AS was a frightening time and she ended up having to largely sacrifice her social life, due to the difficulties of balancing her degree with the pain and fatigue she regularly experienced.

No one should have to wait eight and a half years to find out what is wrong with them. I hope that we can begin to put that right.

Covid-19 Update

Tom Randall Excerpts

Thursday 10th September 2020 Commons Chamber

[Matt Hancock]

I welcome the hon. Gentleman’s enthusiasm for mass testing. He might want to have a word with his Front-Bench colleague, the hon. Member for Leicester South (Jonathan Ashworth). Of course the specificity of the test is incredibly important, so that we do not get false positives. There are ways to deal with it, and those are taken into account in the moonshot programme.

[Tom Randall (Gedling) (Con)]

As children return to school, there is understandable anxiety among parents in Gedling about getting ready access to testing if they require it. The head of Richard Bonington school wrote to me this morning saying that delays and difficulties accessing testing keep children away from school. Will my right hon. Friend assure me that as well as access to testing centres, parents can continue to apply for home-testing kits to get prompt results?

[Matt Hancock]

Someone who has symptoms can of course apply for a test in a drive-through centre or to have the home test. Of course, those are available; it is just that demand has gone up, especially demand from those who do not have symptoms. Those who do not have symptoms but have been in close contact with someone who has tested positive should not be applying for a test, because, as was mentioned earlier, they may get a false negative and actually need to self-isolate. We are really clear about who should be getting a test and who is eligible for a test. In a way, though, my hon. Friend’s question demonstrates why mass testing is also so important—it means we can roll out testing even further. The hon. Member for Leicester South used to be a great supporter of Tony Blair—

Covid-19 Update

Tom Randall Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

I will respond right away. I am very glad that the hon. Lady has raised this issue. It is something that I have been doing a huge amount of work on, along with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill). We have been working on it intensively and, as I say, the backlog has come down by about half, but clearly there is much more to do.

[Tom Randall (Gedling) (Con)]

Testing is a vital line of defence against coronavirus. Although we have one of the best testing systems in the world, I appreciate that there is much more that can be done. What steps is my right hon. Friend taking to explore the benefits of repeat population testing; and if that is effective, will he look to scale that up throughout the country?

[Matt Hancock]

We are looking at the asymptomatic testing of parts of the population where the virus is rife. Testing roll-out is about the prioritisation of what can be done with the capacity that we want to grow. As the capacity grows we could do more, but also it is necessary to prioritise within that capacity. It is not impossible to envisage reaching a point where everybody tests, say, weekly or more regularly, but there are very many steps along the way.

Health and Social Care Workers: Recognition and Reward

Tom Randall Excerpts

Thursday 25th June 2020 Commons Chamber

[Tom Randall (Gedling) (Con)]

Thank you, Madam Deputy Speaker, for calling me to speak in this important debate. The “Protect the NHS” slogan represented the very real danger, at the beginning of this pandemic, that the health service might be overwhelmed. That did not happen, I believe, for two reasons: because the public adhered to the strong public health messaging and because our NHS staff stepped up to the challenge.

As the Member of Parliament for Gedling, I receive regular updates from Amanda Sullivan, from NHS Nottingham and Nottinghamshire CCGs, and Tracy Taylor, the chief executive of Nottingham University Hospitals NHS Trust. I would like to thank them for their work in updating me. I was amazed in those updates at the very hard work being done throughout the county at work such as working rapidly to expand intensive care capacity, and for ensuring that the demand for PPE across the county was being met.

I would like to put on record my thanks to the doctors, nurses, GPs, pharmacists, care home workers and other key workers who have worked hard for their dedication. It is clear to me that that dedication and hard work is widely appreciated. As I have walked through my home town of Arnold, I have been amazed at the drawings of rainbows in front windows, showing support for key workers and offering hope for a better time to come.

That better time will, of course, require a strong economy to generate revenues for our public services. I am pleased that, because of that, we have been able to offer a 6.5% pay rise for all staff on the “Agenda for Change” pay scales, including nurses, and the implementation of a five-year GP contract framework. I am also pleased that we have been able to deal with the thorny issue of pension tax rules and the change to the taper allowance at the last Budget, which I know had been a big concern for consultants and made additional work prohibitive. As the British Medical Association has acknowledged, the vast majority of doctors have now been removed from the effects of that taper.

We have faced what is possibly a once-in-a-century event, and I think it is right that we recognise that in some way. A constituent of mine, Elizabeth Gull, has proposed the creation of a medal for NHS workers. When I raised this with the Prime Minister last month at Prime Minister’s questions, I was pleased to see that he considered it to be an excellent suggestion, and I understand the Cabinet Office is looking into the measure.

We should also recognise that NHS staff and others have been working at full capacity for several months now. I hope that there will be some reflection by employers and others about giving assistance not only in pay, but to help them rest and recuperate so that, going forwards, they will be able to work at their full mental and physical strength.

Oral Answers to Questions

Tom Randall Excerpts

Tuesday 10th March 2020 Commons Chamber

[Matt Hancock]

This is also an incredibly important issue that we are considering and working on. We will make sure that we address any barriers to social care operating. In all contingency plans on the reasonable worst-case scenario, plans are needed for being able to operate with a 20% reduction in workforce, but making sure that the best care can be provided in what is going to be a difficult time for social care is a really important part of the effort that we are making.

[Tom Randall (Gedling) (Con)]

T5. When he announced the medicines and medical devices safety review of, among other things, vaginal mesh implants, the then Health Secretary, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), described the response to these tragedies as “not good enough”. Will the Secretary of State assure me that women who now need mesh removal are receiving all the support that they need and that adequate resources are in place for the treatments that they require?

[Matt Hancock]

My hon. Friend is quite right to raise this—it is true that that the NHS has had to rise to address the scandal over mesh. There is a lot of work still to be done.

Oral Answers to Questions

Tom Randall Excerpts

Tuesday 28th January 2020 Commons Chamber

The Secretary of State was asked—

[Tom Randall (Gedling) (Con)]

1. What steps he is taking to improve access to GPs.

[Sally-Ann Hart (Hastings and Rye) (Con)]

4. What steps he is taking to improve access to GPs.

--- Later in debate ---

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

With your permission, Mr Speaker, I will answer Questions 1, 4, 6, 11 and 20 together. [Interruption.] General practice is a popular subject.

We will create an extra 50 million appointments a year in primary care so that everyone can go to the GP when they need to.

[Tom Randall]

There are many families with children in Gedling. What is being done to ensure that patients, particularly families with young children, can access GP appointments when they need them?

[Matt Hancock]

Obviously this is an incredibly important subject, and I know the frustration many families feel at not being able to access a GP appointment when they need it. We have a whole-scale programme of work to improve access. This includes recruiting 6,000 more GPs and 26,000 primary care staff other than GPs— increasingly patients at GP surgeries can be treated by nurses—and increasingly enabling people, especially those who find it difficult to travel, to use technology to get the treatment they need.