The National Health Service

Tonia Antoniazzi Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

There is no doubt that when looking at the facts of the delivery of the NHS in Wales we see what happens to an NHS under Labour control. I support all those who work in the NHS in Wales—they do a great job—but, sadly, it is harder to deliver the NHS in Wales. There is another argument too: we know that we can fund good public services and the NHS only with a strong economy, and the plans of the Labour party would ruin it.

[Tonia Antoniazzi (Gower) (Lab)]

It is absolutely disgusting that the Secretary of State can stand there and say that about the NHS in Wales, when it is his Government who underfund the NHS in the whole of the UK.

[Matt Hancock]

I did find it surprising that the hon. Member for Leicester South did not mention the £33.9 billion largest and longest funding settlement in history, but I would also note this: funding for the NHS under the Welsh Government in Wales has risen more slowly than it has in England, because we have funded the NHS properly.

The National Health Service

Tonia Antoniazzi Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

It is an honour to follow my hon. Friend the Member for Reading East (Matt Rodda). I have listened to much of the debate, and it is clear that the NHS is a treasured institution under threat from a hard Tory Brexit, and that having a Labour Government is the only way to secure its future and keep it wholly in public hands.

Today I want to speak about a specific issue that I have been involved with since I was elected in 2017, when I was approached by families in my constituency about getting access to medical cannabis—a medicine that could change the lives of children living with intractable epilepsy. I really could not understand what the problem was until I spoke to my late friend Paul Flynn, who had done a lot of work on this issue, and he explained how it has been an uphill struggle.

[Jonathan Ashworth]

It was remiss of me earlier in the debate not to pay tribute to the leadership my hon. Friend has shown on this campaign, as well as the right hon. Member for Hemel Hempstead (Sir Mike Penning). She brought a group of campaigners to see me earlier in the year. I put on record our thanks for the tremendous work she has put into the campaign.

[Tonia Antoniazzi]

I thank my hon. Friend; I look forward to keeping on working with him.

It has been an uphill struggle. While thousands of people across the world have access to medicinal cannabis, the law was preventing patients in the UK from accessing it.

We have worked with the amazing families of the End Our Pain campaign, spearheaded by the amazing Hannah Deacon, who is mum to Alfie Dingley. Hannah’s campaigning meant that she got a special licence for Alfie to continue to use the cannabis that had transformed his life in the Netherlands. Then Sophia Gibson and Billy Caldwell were given prescriptions for medical cannabis. The highlight came last year, on 1 November, when there was a change in the law to reclassify cannabis so that it was available for medical use.

At the time, we thought that would mean that the children who were suffering would be able to have cannabis prescribed by specialist consultants. It turned out that that was not the case, so many other children were not given access to this life-changing medicine. Children from all over the UK continue to suffer because the Government are dragging their feet. The medicine is proven to work for many types of sufferers, but children are still being pumped full of steroids and unlicensed drugs that leave them severely impaired. The effect on the families has been terrible—on the children, the siblings and the parents. It is just not fair.

No one claims that this is a miracle drug. It is not a cure for epilepsy, but it does make a huge difference to the quality of children’s lives. Everyone has a right to live their best life.

I have worked closely with the parents of Bailey Williams from Cardiff, Rachel and Craig. I have seen at first hand the difference that this medicine has made to their son. When I called at their house one evening, Bailey got out of the chair, picked up a bunch of flowers and brought them to me. I actually cried to see a child who previously could not get out of bed get up out of a chair and give me a gift of thanks.

A lot of other children have the same story. Alfie has been riding a bike and a horse—something that would never have happened when he was on his previous drugs. The problem is that Alfie is getting to a point where the efficacy of this type of medicinal cannabis is dulling. As with all long-term medication, he needs a review and to be put on a new strain. However, the strict restrictions mean that even Alfie will not be able to access a new strain. As his tolerance to his medication builds, he is beginning to have more seizures. What next for Alfie? What will the Secretary of State do?

As we approach the anniversary of the law change, I want to reflect on what has happened to the lives of the families I have worked with, as co-chair of the all-party group on medical cannabis under prescription along with the right hon. Member for Hemel Hempstead (Sir Mike Penning). At the End Our Pain campaign event on 19 March, the Secretary of State told the families that he would make sure they got the medicine they needed. However, more than six months on from that promise and nearly a year on from the law change, not one new NHS prescription has been made, not one child has benefited from medical cannabis, and not one family have been able to move on with their lives.

[Sir Mike Penning]

Will the hon. Lady give way?

[Tonia Antoniazzi]

I will give way, but I will not take the extra time.

[Sir Mike Penning]

This issue shows the House how people from different parties, with very diverse views on politics, can work together for the good of children. There are children who are getting medical cannabis on prescription, but their parents or grandparents are paying for it. The NHS is free at the point of delivery. Surely that is how it should be.

[Tonia Antoniazzi]

I absolutely agree with the right hon. Gentleman.

I made a personal choice to go to the Netherlands with some of the parents to pick up the cannabis they need for their children—parents such as Emma Appleby who has a prescription for her daughter, Teagan, that costs thousands of pounds. She can afford to fly to the Netherlands to get the prescription because it costs less over there. The Government have created a two-tier system. Parents are forced to fundraise for medicines. One mother has put her house up for sale to pay for the next round of drugs. These families have run out of time, run out of money and run out of patience. All 20 families will go on hunger strike because they are at the end of the line.

I will move on swiftly. On 19 September, six months after the Secretary of State had made his promises, the families were continuing to fight for their kids. They took a bill to the Secretary of State showing the money they had spent on their private prescriptions, and they have delivered letters to the Prime Minister begging him to do something, but they have been ignored. They have not had a response, and that is absolutely disgraceful.

These families are being pushed to the end of their tether, and I honestly believe that it is time for the Secretary of State either to consider his position or to get this sorted. As a mother, if I was faced with this inaction, I would be fighting and fighting to get these life-saving drugs from the NHS—for free. I would be doing everything I could, and that is why I will continue to do everything I can to help these children who are needlessly suffering. I will raise this at every opportunity, and I will not stop until we have the good news that we need.

Electromagnetic Fields: Health Effects

Tonia Antoniazzi Excerpts

Tuesday 25th June 2019 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered the health-related effects of electromagnetic fields.

I am honoured to serve under your chairmanship, Mr Hollobone. This Westminster Hall debate is timely. It comes on the back of an historic decision by Glastonbury Town Council to oppose the roll-out of 5G because of a severe lack of evidence about its effect on the health of those living and working around 5G sites. In the words of Martin Pall, emeritus professor of biochemistry at Washington State University:

“Putting in tens of millions of 5G antennae without a single biological test of safety has got to be about the stupidest idea anyone has had in the history of the world.”

We saw the roll-out of 5G postponed in Brussels when Céline Fremault, Environment and Energy Minister, identified that it was not compatible with Belgian radiation safety standards; and a planned upgrade to 5G in Geneva has been stopped, through application of the precautionary principle, until independent findings on possible health damage become available.

I was approached by an old friend who is now a constituent about how a sensitivity to electromagnetic fields seriously affects her health and the way she lives her life. Annelie lives in France for part of the year and has to return to Wales as her health deteriorates while working as a university lecturer. I was intrigued by the effects and wanted to know more, so I have been in contact with a number of people who either have concerns about the health-related effects or are suffering at first hand. Following discussions with others, I was keen to secure a debate on the subject, because the Government are sweeping the health concerns under the carpet and there appears to be an absolute refusal to acknowledge that the health-related effects even exist.

Initiating a conversation about electromagnetic sensitivity has had members of my own team and family telling me that it is all made up. That in itself motivated me to keep reading and to speak to as many people as I could in Wales and beyond who were suffering. What shocked me was the number of people who have ES but are too afraid to talk publicly about their illness, because they are really wary of being humiliated and ostracised.

Electrosensitivity is the symptomatic sensitivity to electric or magnetic fields of any frequency, including radio frequency transmissions. The condition was first described in 1932. It is when a person’s physiology is affected by external electromagnetic fields, giving rise to a spectrum of symptoms, which are often neurological. It is therefore an illness caused by environmental agents—essentially, an environmental toxic pollutant. The condition can arise because of continued exposure to an environment polluted by man-made EM and RF wireless signals at levels at orders of magnitude below those that produce heating effects, and it is well understood in many other countries. Symptoms include headaches, fatigue, disturbed sleep, tingling, pains in limbs, head or face, stabbing pains, brain fog and impaired cognitive function, dizziness, tinnitus, nosebleeds and palpitations. As we saw with chronic fatigue syndrome, however, there was disbelief about those presenting with symptoms of this condition. Indeed, it was construed by others, through a lack of knowledge and difficulty in diagnosis, as a psychological illness. I believe that electrosensitivity will be recognised in years to come—sooner than that, I hope—and that the Government will have to own up to their part in it.

To be honest, this is not a subject that I ever thought I would stand here and talk about, even though as a mother, I have always been keen to charge my son’s phone outside his bedroom but have never applied the same rule to myself. Parents seem to care about this in relation to their children, and we hear that masts—one was recently fitted to a school in Haringey—are no longer being put up on primary schools. There is something in this.

I also worry about the impact of social media on mental health, and about the smartphones’ increasingly addictive nature, which is impacting on the lives of the youngest of children. There is some evidence about the effects of radio frequency signals on mental health and behaviour in children and young people, but those effects are not considered in current attempts to address the increase in mental health and behavioural problems in the UK. I ask the Minister to include the effects of wireless signals when considering solutions for such problems in children and young people. The recent advice from the UK chief medical officers on screen time and wellbeing in young people has ignored evidence for the adverse effects of wireless signals.

[Geraint Davies (Swansea West) (Lab/Co-op)]

I want to ask about the wider environmental impact. My hon. Friend will know that 4G has the same carbon footprint as all of aviation, and 5G will be a lot more. What is more, we are now hearing that 5G will have a detrimental impact on insect life, which is decreasing globally at 2.5% per year. Given that insects are essential to humanity because they are required to pollinate all fruits and vegetables, does she agree that before hurtling ahead for commercial reasons, we should apply the precautionary principle until we know precisely what the impact will be on insects and our carbon footprint?

[Tonia Antoniazzi]

We do need to take climate change and insect life into consideration when we discuss the impact of electromagnetic fields.

As MPs, we have a duty of care to our constituents. There is no escaping the fact that when MPs, schools, local authorities and others ask questions about the safety of new technologies, Government’s give a standard reply. People who question the health-related effects of electromagnetic fields come up against a brick wall, and today I want to break through that brick wall and ask the Minister several questions. I like to think that the smart way to move forward is to consider safety and sustainability when developing products.

[Mr Jim Cunningham (Coventry South) (Lab)]

Many years ago, the Trade and Industry Committee investigated the matter with all sorts of experts, but nobody could come to a conclusion. That is not to say that my hon. Friend is wrong, but it was looked at about 20 years ago. Is there any evidence that electromagnetic fields can affect the behaviour of animals?

[Tonia Antoniazzi]

There is evidence about the effects on animals. I cannot quote from it now, but I have read about it. We must remember that animals do not use screens, but there is evidence of the impact on them of electromagnetic fields from things such as smartphones and 5G. I would have to find that evidence and send it on to my hon. Friend.

[Geraint Davies]

On that point, there is clear evidence that with high-frequency 5G—there is some denial about the idea that the frequency may be so high—there will be an enormous loss of insect life. To get the necessary coverage we need to place masts every 150 metres. The coverage will be enormous, and there is an incredible risk of substantial damage. Surely we should apply the precautionary principle, even if all sorts of commercial threats are being made to the Government behind closed doors about what will happen if they do not go ahead.

[Tonia Antoniazzi]

We need to apply the precautionary principle when we look at anything. Many councils and the Government have embraced 5G, which has come up on us so quickly, as a solution to connectivity. To be honest, given the potential impact, I would rather see fibre broadband—fixed, wired broadband—in all the houses in my constituency and across Wales, rather than having masts put up everywhere just because that seems to be a cheaper solution.

I will not accept the response that electrosensitivity does not exist; studies show that it does. It has many effects that are not at all subjective, including effects on proteins and DNA, cell death, altered brain activity and effects in animals, as my hon. Friends have mentioned. Those effects can be measured, and they cannot be dismissed as being all in the mind.

We all know that decisions relating to technology can have unintended consequences. We are discussing one such consequence: the impact on our health. Similarly, it could be argued that the effects on our mental health are being caused by online contact or screen time, but in combination with studies about animals, we can see that the signals themselves have effects. Animals do not look at screens or use social media.

In the past, no matter what questions, evidence or concerns have been put to Public Health England or the Department of Health and Social Care, they have responded with their standard reply, which includes them saying that they have thoroughly assessed the evidence in the 2012 report by the independent Advisory Group on Non-ionising Radiation. The World Health Organisation International Agency for Research on Cancer classified all radio-frequency signals as possible human carcinogens in 2011, based on significant increased risks of gliomas and acoustic neuromas associated with mobile or cordless phone use in humans, as well as animal and mechanistic studies. Subsequent studies have strengthened the evidence in humans and provided clear evidence of tumours in animals. Some scientists are even calling for the classification to be upgraded to a definite carcinogen.

Why, then, has Public Health England removed all mention of the IARC classification of radio-frequency signals from its website? It informs people about other possible carcinogens. People cannot make informed decisions or protect those they are responsible for if the information is withheld. Will the Minister commit to ensuring that Public Health England informs people on its website and in leaflets, communications and presentations that all radio-frequency signals are a possible human carcinogen?

Following the publication of a paper on the AGNIR 2012 report in Reviews on Environment Health, the AGNIR was quietly disbanded. However, the inaccurate report is still on its website and is used to justify its advice to MPs and the public. When will the 2012 report be retracted because it is scientifically inaccurate and out of date?

The Department for Education in England and the Department of Education in Northern Ireland have said that it is the responsibility of schools to carry out risk assessments before technologies are introduced and used. However, schools cannot safeguard pupils or staff through a risk assessment if they have been given inaccurate information. Can schools be accurately informed about the risks, so that they can fulfil their responsibilities to safeguard children?

Schools and parents could have been informed that wireless signals are a possible human carcinogen; that there is evidence of damage to fertility; and that there are adverse effects on brain development. Schools could have been advised to use wired technologies to prevent possible harm to children’s health and development. The EU has sent a cautionary message about wi-fi in relation to schoolchildren, but only France has removed wi-fi from its primary schools.

The Cyprus Government have produced short, practical videos warning teenagers and pregnant women about the risks of radio frequency signals and offering simple actions. When will children, young people, parents and pregnant women in the UK be offered similar advice so that they can take steps to stay safer?

By denying the existence of adverse effects and providing inaccurate information, Public Health England and the Department of Health and Social Care have prevented the UK public from living and working in safe environments. When will the Government listen to the warnings from scientists and doctors to help MPs to better protect their constituents?

If we are to develop safer technologies in the future, we need to be honest about the risks. We must not ignore the fact that people have ES; those people exist, and their lives are being ruined. Others without ES also have genuine concerns about the roll-out of 5G. People do not need to suffer to be concerned, because the name 5G is deceptive: it implies a simple upgrade from the current 4G, or fourth generation, wireless, but it is so much more than that. It is a massive experiment, and the consequences of our actions are largely unknown.

One thing I feel very strongly about is that for people with ES there is literally no escape—they will have nowhere to go. Can we create safe public spaces and living and working environments so that everyone has somewhere to exist? That is extremely urgent, particularly with the introduction of 5G smart cities, smart roads, the internet of things and thousands of 5G satellites.

I would like the Government to give a commitment to creating white zones, where people can have respite when they need it; to pledge to provide up-to-date, transparent and independent research on the impact of electromagnetic fields; and to replace the 2012 AGNIR report. The science needs to be reviewed—no one can disagree that the technology moves on so quickly that there is even more need to keep up to date with the science.

Finally, I recently received a letter with a heartfelt request from a mum in west Wales:

“I’m told you think the only way forward is a white zone, I agree but also to get ES recognised as a disability. I have spoken with my MP and he agreed that if ES could be recognised as a disability, other things such as access to education would fall into place.”

I agree with Sarah. Her struggle is real, and so are the lives of many people who are largely ignored and belittled. Electromagnetic fields have had a dramatic impact on the life and health of my old classmate Annelie over the past 10 years. We can no longer hide and pretend that this is not happening. It cannot be swept under the carpet, especially in the light of the future impact of technological advances at the expense of people and our environment.

In conclusion, it is evident that the Government need to ensure that the research is independent. They need to recognise electrohypersensitivity as an occupational disease, as a French court did earlier this year, and put guidelines in place for employers to make reasonable adjustments so that their employees can continue to work in a healthy environment. I remember the days when we made plans to meet without mobile phones to say that we were running late or could not make it. Advances in technology have swept through our lives. Before I am accused of being a luddite, I stress that I think the technology is wonderful and offers a great many benefits to all, but we cannot continue to deny that there is an impact on some people’s health and wellbeing. This is not about stopping progress; it is about making sure that there are no health concerns about the technology, and about doing what is best for our constituents.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Gower (Tonia Antoniazzi) for securing the debate and giving us the opportunity to discuss this important subject.

People are exposed to radio waves in the home, at work and throughout their daily lives. As the hon. Member for Gower mentioned, people have been talking about the issues for about 100 years, since early in the last century, but the numbers of devices and transmitters have increased rapidly, and the pace of change in how this technology becomes part of our lives can be very unsettling to some. People ask whether radio wave exposure levels are increasing and whether there could be health consequences, and I want to put on record right at the beginning that, very importantly, radio waves are non-ionising radiation. That means that the packets of energy that form the radiation are too small to break chemical bonds: the radiation cannot damage cells and cause cancer in the same way as ionising radiation. Even so, there are concerns that this type of radiation could have health effects, and a great deal of research has been done in the United Kingdom and around the world to clarify the matter, which is something the Government take very seriously.

A number of issues, both for my Department and for colleagues in others, have been raised during the debate, and I will try to address them. I will also pass them on to colleagues.

Health concerns about electromagnetic fields have been raised in relation to each successive wave of new communications services, from 2G to 3G and 4G mobile phone networks, and with wi-fi, smart meters and now 5G. I have certainly noticed the growing number of letters I have received from parliamentary colleagues, passing on their constituents’ concerns, and I am grateful for the opportunity to address some of them today.

Concerns about telecommunications networks first came to the fore in the late 1990s. A report containing an evidence review and recommendations was prepared for Government by the independent expert group on mobile phones, under the chairmanship of Sir William Stewart. A major research programme was undertaken and the international exposure guidelines were adopted, with a commitment from industry that they would be followed. Although many new services and technologies have been launched, the basic way they are delivered—by radio—has not changed, and the science of how radio waves affect the body does not change when a new technology is launched. However, the Government take people’s health concerns about electromagnetic fields very seriously. They have committed, and continue to commit, significant resources to supporting research and analysis on the topic, and policies are in place to ensure the exposure guidelines are followed.

Public Health England monitors the health-related evidence and collaborates internationally to ensure that any important new evidence is identified and responded to.

[Tonia Antoniazzi]

Will the Minister give way?

[Seema Kennedy]

The hon. Lady might be about to refer back to her speech. I was going to respond to a comment she made, but I will happily give way.

--- Later in debate ---

[Tonia Antoniazzi]

I thank the Minister for allowing me to ask this question: is she able to point out where the recent evidence that the Government and Public Health England have is? Is it in the public domain?

[Seema Kennedy]

I think the hon. Lady talked about accurate information, and about honesty concerning the information put out by Public Health England. Public Health England conducts extremely rigorous research, all based on the best available international evidence and on monitoring assessments of expert reviews. Some of those things will, of course, be in the public domain, and others will not. I will happily write to the hon. Lady with all the evidence that is available in the public domain.

The Committee on Medical Aspects of Radiation in the Environment has a watching brief on non-ionising radiation. It assesses all the available data to give health advice. Many scientific studies have been done over several decades, and a wide range of health topics have been investigated, including cancer, reproduction, cognitive effects and electrical hypersensitivity.

[Seema Kennedy]

The hon. Lady is talking about risks and hazards. [Interruption.] Yes, we are talking about two different sorts of radio wave, but she said that I would not want to go in a microwave oven. I am not suggesting that I would put myself or anyone else in a microwave oven, so we are talking about hazards and risks. The best scientific evidence given to Government is that the radiation is safe, and I was going to go on to talk about the evidence that Government have used before addressing some of the points that the hon. Member for Gower raised. I apologise if I have not quite understood the point made by the hon. Member for Glasgow North West (Carol Monaghan); I will happily discuss it with her later.

Expert groups in the UK and around the world have examined the evidence and published many comprehensive reports. In the UK, the Advisory Group on Non-ionising Radiation produced reports in 2003 and 2012. The Government have played their role in the international effort to learn more about the health effects of radio- wave exposure. They supported the dedicated mobile telecommunications and health research programme that ran from 2001 to 2012 and they continue to fund research.

A challenge in understanding the evidence is that some studies report effects, while others do not. Sophisticated analyses are needed to draw studies together, considering their strengths and weaknesses and working out what they mean collectively, which is the role of expert groups. Simply counting or listing studies that have found effects is not an adequate way of assessing where the overall evidence lies.

An expert group reporting to the European Commission delivered a review in 2015, and the World Health Organisation is currently carrying out a major review on radio waves and health, which will include studies performed over the past 25 years. Overall, those expert groups have not found any clear evidence of adverse health effects occurring if the International Commission on Non-Ionizing Radiation Protection exposure guidelines are followed. The ICNIRP exposure restrictions have been incorporated into a 1999 European Council recommendation on limiting public exposures to electromagnetic fields. The United Kingdom and Public Health England support that recommendation.

Since 1996, the World Health Organisation has been running an international electromagnetic field project that provides a forum for countries to gather together, discuss and share knowledge on this topic. The WHO’s main conclusion is that electromagnetic field exposures below the limits recommended in the International Commission on Non-Ionizing Radiation Protection guidelines do not appear to have any known consequence for health. However, as the hon. Member for Gower and other Members have mentioned, that does not mean that people who have electrical hypersensitivity do not have symptoms. Those symptoms are real and can be very debilitating, and the Department’s guidance is that those people should seek medical advice, so that their personal situation can be taken into account and the best possible treatments found.

I will also address the points raised by many hon. Members about the effects of screen time on the mental health of children; as any parent can attest, there are some effects. The shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), referred to SCAMP, and the Government conduct research that looks at the effects of technologies on schoolchildren.

Exposure levels reduce very rapidly with increasing distance from transmitting antennae, which means that being in immediate proximity to the transmitting antenna of a mobile phone handset held next to the head is different from living near a base station. There is long-standing precautionary advice from Public Health England and the NHS for mobile phone users, and research is continuing. We are continually looking at the evidence and updating our advice.

[Tonia Antoniazzi]

What work has been undertaken by Public Health England to look for evidence of risk in mobile phone usage? Is it looking at what damage it is actually doing, rather than saying, “Well, it is not really hurting anybody”?

[Seema Kennedy]

Public Health England takes its role very seriously, and is always monitoring the evidence. Since perhaps 10 years ago, there has been a lot of research into having mobile phones next to one’s ear. Of course, the way we use our phones is changing, but Public Health England is always looking at this issue and reviewing the best available evidence.

There has been a general trend from 2G through to 5G for transmitters to become smaller, to be mounted nearer to the ground, and to use less transmitted power. The hon. Member for Stroud (Dr Drew) raised a point about the electronic communications code, which I think is a matter for colleagues in the Ministry of Housing, Communities and Local Government. The hon. Member for Swansea West (Geraint Davies) has left, but I do not think we are cutting down trees; in fact, I am sure that the Government have committed to planting more trees. I know that the Secretary of State is very keen on them, so I will write to him on that issue.

To answer the questions that were asked about radio frequency fields and cancer, a working group of the International Agency for Research on Cancer reviewed the health effects of exposure to RF fields and concluded that such exposures are possibly carcinogenic to humans—group 2B, based on IARC’s classification scheme. There was a minority opinion in the working group that current evidence for humans was inadequate, and therefore there was no conclusion about a causal association. In terms of the different classes of carcinogens, there is a statement on the PHE website that responds to the IARC classification. PHE has summary advice statements that it sends to inquirers with a full explanation of different carcinogens; there is a broad spectrum, including petrol engine exhausts, bracken fern and talc-based body powder.

Since 2001, the Office of Communications has been carrying out an audit of the emissions from mobile phone base stations. The Advisory Group on Non-Ionising Radiation’s 2012 report contained a summary of over 3,000 measurements made at over 500 sites by Ofcom. The maximum exposure found at any location was hundreds of times below the international guideline levels, and typical exposures were much lower still. Public Health England advises that there may be a small increase in overall exposure to radio waves when 5G is added to an existing network or a new area, but that is expected to remain low relative to guidelines.

I hope I have demonstrated that the Government take seriously the potential health effects of the introduction of 5G, and that Public Health England is well placed to identify and respond to any important new evidence that may emerge. I reiterate that the public’s levels of exposure to electromagnetic fields from telecommunications networks are currently very low in relation to the international guideline levels, and are expected to stay that way after the deployment of 5G.

[Tonia Antoniazzi]

I thank the Minister for her response and Members from all parties who have taken part in the debate.

I have concerns about the international guidelines, and I think that the effect of exposure to electromagnetic fields should not be underestimated. When my hon. Friend the Member for Stroud (Dr Drew) asked the Department for Digital, Culture, Media and Sport a written question, a Minister replied that her belief was that the next-generation network would not endanger the public, and added that Public Health England had found no evidence of any significant risk and that the Government

“anticipate no negative effects on public health.”

I am afraid that those statements are far from reassuring. Belief and anticipation are insufficient grounds for making such statements; we have to think about the precautionary principle. To state that there is no evidence of significant risk prompts the questions of what level of risk is acceptable, and at what stage an unknown risk moves from being acceptable to significant.

Question put and agreed to.

Resolved,

That this House has considered the health-related effects of electromagnetic fields.

Oral Answers to Questions

Tonia Antoniazzi Excerpts

Tuesday 18th June 2019 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend will wish to know that we are collaborating fully with the inquiry, and it has raised with us several issues about payments. We have made available an additional £30 million to give to those affected and will consider any conclusions the inquiry ultimately draws.

[Tonia Antoniazzi (Gower) (Lab)]

As the Minister will know, two weeks ago I went to the Netherlands with Teagan Appleby’s mother, Emma, to collect one month’s supply of medical cannabis. The Department laid down the requirements for Emma to meet with Border Force, and she met them by providing a UK prescription. Will the Secretary of State and Ministers meet me to ensure that there is no more ambiguity in a policy that currently criminalises parents in possession of a UK prescription bringing their much-needed medicine into the country?

[Matt Hancock]

As the hon. Lady and other colleagues know from having worked on this important issue, we acted swiftly to change the law to make sure that medicinal cannabis was available. Those patients for whom it is clinically appropriate can now be prescribed medicinal cannabis. As she knows, whether to prescribe is a clinical decision, but those prescriptions are available and flowing and are being issued where it is judged clinically appropriate for the patient. We will continue to work on this to make sure we get it right.

Medical Cannabis under Prescription

Tonia Antoniazzi Excerpts

Monday 20th May 2019 Commons Chamber

[Tonia Antoniazzi (Gower) (Lab)]

I thank my co-chair of the all-party group on medical cannabis under prescription, the right hon. Member for Hemel Hempstead (Sir Mike Penning), for securing this Back-Bench debate and the Backbench Business Committee for granting it on the Floor of the House. It is an honour to follow the hon. Member for Henley (John Howell).

I am committed to campaigning for medical cannabis under prescription not only for my constituents but for everyone in the UK who would benefit from access to whole-plant medical cannabis. Whole-plant cannabis contains CBD and THC. It is the interaction of both extracts taken together that provides significant relief from symptoms such as seizures, because it provides the entourage effect. The two extracts interact with the human body and produce a stronger influence than any one component alone.

We must remember the number of desperate families passed from pillar to post and blocked at every turn. Is the Minister going to sit back and watch them continue to suffer? We have families watching us from the Gallery, and their turn is now.

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

The hon. Lady makes a good point. I first became involved in this campaign in 2002 when I met my constituent, the late Biz Ivol, who had severe advanced multiple sclerosis and who told me that the pain she suffered was like having somebody draw barbed wire through her spine. For the last 17 years, we could have been exploring all the issues being ventilated tonight, but we have not. Does that not illustrate the urgency?

[Tonia Antoniazzi]

The right hon. Gentleman is absolutely right, and I will go on to talk about a very good friend of mine who suffers with MS.

[Michael Fabricant]

I have a constituent who is suffering from very advanced multiple sclerosis. She has been unable to obtain the medication she needs, and her husband is growing small amounts of cannabis to relieve her pain. However, it is not just her who is suffering. Staffordshire police do not want to act, although technically the family is breaking the law. That is an impossible position, is it not? It really is up to the Department of Health and Social Care to find ways in which cannabis can be prescribed more widely and more quickly.

[Tonia Antoniazzi]

The hon. Gentleman is absolutely spot on. The issue of the law and people who are using cannabis as a medicine to relieve their pain is especially relevant to those with multiple sclerosis.

My very good friend Chris Reilly has progressive MS, and this week he had to go to hospital. His wife Beth called an ambulance, and it took an hour for the paramedics to be able to give him the correct amount of pain relief so that he could be taken to hospital. He is in touch with me all the time. When I was selected as the parliamentary candidate for Gower, he was the first person to contact me and tell me that this was a subject very close to his heart, and that he wanted me to become involved with it. I thank him for that, but it makes me cry that I cannot help him and cannot provide the medical cannabis for him. I know that I am standing here and making comments as a politician, and that I am not a medical expert, but we all know that when our constituents and their families visit our surgeries we share their pain and their tears because they cannot access something that would, quite simply, make their lives a lot better.

[Michael Fabricant]

The hon. Lady is being very generous in giving way, and I totally agree with what she is saying. Is it not the case—cruel as it may seem to say this in the Chamber—that for those who are is suffering from advanced multiple sclerosis, there can be only one end to it? Is it not therefore cruel in the extreme that when something could mitigate the pain and the discomfort and is not going to do any more harm to the patient because there is no cure for advanced multiple sclerosis, that palliative care cannot be administered?

[Tonia Antoniazzi]

I completely agree. The families of children with intractable epilepsy are in exactly the same position, as are so many other people throughout the United Kingdom. My friend Chris is a very good example of how wrong it is that people with MS or epilepsy have no access to whole plant medical cannabis. As we know, it will never be a cure for everyone, but, as Chris told me yesterday, it provides the chance of a better quality of life. That is what people want. It is what the parents of children with intractable epilepsy want. They are at the end of the road. They have tried everything from the ketogenic diet to unlicensed drugs, which make the children unreceptive and do not improve their quality of life.

[Sir Mike Penning]

I pay tribute to my co-chair of the all-party parliamentary group: without her support, we would not be here today. I feel for her constituent as well as mine. They are asking us to help, and we are doing everything we possibly can, but we are not medics and we cannot prescribe. Doctors seem happy to sign off and prescribe off-label drugs for purposes that have absolutely nothing to do with what those drugs were licensed for, but they are not willing to license medical cannabis. Does the hon. Lady not agree that that is an imbalance?

[Tonia Antoniazzi]

I do agree. It just does not make sense, which is infuriating, because I like to apply sense and logic to most situations, and the current situation is not logical.

Not being able to access medical cannabis leads people such as Chris and the parents of children with epilepsy to consider alternative ways of accessing cannabis, which—as has already been pointed out—is fuelling a dangerous online trade in which, for all we know, they could be buying anything. That is dangerous and wrong. Clinicians to whom I have spoken often ask parents what they have given their children in addition to over-the-counter drugs. Access to CBD alone has great health benefits that are not recognised by many in the medical profession. The right hon. Member for Hemel Hempstead has referred to its being described as homeopathy. When I say that one of my interests lies in medical cannabis, there will always be someone—even a politician—who will make the pun about wacky baccy, and it is really not appropriate. ‘

There seems to be a theoretical concern about the exposure of children to THC, but that is about recreational use; it is not about medical cannabis. Discussions about the legalisation of cannabis for recreational use and about the rescheduling of cannabis for medical use under prescription must not be conflated in the House. Let me put the position into perspective. The law changed because of one boy, Alfie Dingley, and the campaign spearheaded by his mum, the fantastic Hannah Deacon, who is in the Visitors’ Gallery today.

[Crispin Blunt]

And Billy Caldwell.

[Tonia Antoniazzi]

And Billy Caldwell, yes.

Alfie’s life has been transformed. He has been seizure-free for as long as 300 days, riding a bike and riding a horse. Hannah continues to campaign for parents who cannot gain access to medical cannabis for their children, who need the same treatment for their intractable epilepsy. The fact is that although the law has changed, the rules on access to medical cannabis are even more stringent as a result. Under the guidance provided by the British Paediatric Neurology Association, Alfie would not be eligible for his prescription, which beggars belief. The Government were aware that they were opening the floodgates by providing access for Alfie, but the push-back from certain areas of the medical profession is what is preventing any advance. We have seen that with a number of patients, and it is extremely unfair.

The medical cannabis that is being prescribed is in line with manufacturing practice, which means that it meets European standards. However, these products will have to be subjected to trials that could take three to four years, which is not acceptable to the families with whom we work at End Our Pain. It is not acceptable to the parents of Bailey Williams, who are also in the Gallery. They cannot wait any longer. They did use a CBD, and I think that they are still using it, but it is not working; it has worn off. That is why they need the THC.

These products are available, and they need to be made available to everyone now. There is currently a two-tier system. There are those who have access to medical cannabis because they have the funding, and those who do not because it is not available on the NHS. We must change that.

[Crispin Blunt]

I pay tribute to the hon. Lady for the work she is doing. The situation is worse than that, however: we are driving a number of people into the hands of a criminal supply chain so that they can obtain their medicine, and that cannot be right.

[Tonia Antoniazzi]

I entirely agree, and I am very concerned about it. We have heard in the House this evening that people are growing their own cannabis, and there is a growing trade. There is an online family of people who are helping each other to obtain the most THC possible from different combinations of different plants. It is a complete industry. Why are the Government not getting a grip, and providing a proper, GMP-standard, pharmaceutical product for people?

I also want to talk about the cost, which is extraordinary. Has the Minister or anybody in her office done a cost-analysis? Alfie Dingley’s case provides a classic example: how much has he saved the NHS by not having emergency medication and not using the ambulance service to go into hospital? It seems nonsensical that we are not going down this road.

I want to talk about a couple of my constituents. Only a few weeks ago I had a visit from the parents of a 14-year-old son. My son is 14 too, so their situation struck a chord with me. Their son has intractable epilepsy. Mum has given up her job to look after him—he has a very efficient system around him. He benefits from a ketogenic diet and the next available medicine is Epidiolex. Epidiolex does not contain THC but she wants her child to be on a trial, and the trial is limited. A mum should not come to me begging for her son to be on a trial, but when I spoke to her about medical cannabis with THC she was reluctant to engage because of a fear of breaking the law and of not following the system properly. All our families are following a system. They are at the end of the road in terms of what medicine they can be given, so I want them to be given medical cannabis with THC as soon as we can.

NHS England is drafting terms of reference, and as co-chair of the APPG I appreciate its efforts. These children must have access, however; they must not be waiting three or four years. I urge NHS England to work collaboratively with the devolved nations because we need our children in Scotland, Wales and Northern Ireland to have the same benefits.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I congratulate my hon. Friend on her excellent speech and the excellent work she has been doing with the APPG. I also congratulate the End Our Pain campaign, which has done so much to raise this issue. Does my hon. Friend agree that NHS England needs to improve its guidance on intractable epilepsy and fast-track it so that children can get the THC they need?

[Tonia Antoniazzi]

I totally agree that a completely different approach is needed if we are to get the medicine to our families now.

It is very upsetting that families are risking getting criminal records by bringing in medical cannabis and are having to fundraise for prescriptions. I pay tribute to families that are fundraising in the public domain—to the parents and the friends, such as Craig who has cycled many, many miles up Pen y Fan recently to raise money for Bailey. I say to all those families that are raising money, “Don’t give up; there is hope, and hopefully we will be able to get you the medicine you need on prescription from the NHS.”

It would be very remiss of me to stand here and not pay tribute to the late Paul Flynn, former Member for Newport West. Paul was an absolute inspiration. I was a patron of an organisation with him and he was inspirational when I went to Birmingham to speak with him. His knowledge of and passion for medical cannabis was second to none, and I know that, as Madam Deputy Speaker mentioned, he is watching over us now and hoping we will get the breakthrough he was working so hard towards.

My hon. Friend the Member for Manchester, Withington (Jeff Smith) spoke of a bespoke medical response and creative thinking, and I ask the Minister to work with us: pull groups of families out of local trusts and set up an immediate observational trial with the 18 families that we have at End Our Pain; get the NHS to pay for the costs of the medicine when a private prescription has been issued until NHS prescribing is more routinely accepted; and allow the guidance from medical cannabis experts to be used. Some excellent UK experts have come together to form the UK Medical Cannabis Clinicians Society, and they have issued prescribing guidance, too. I say, “Please, work with the NHS to give clear central guidance that medical cannabis is legal and that there is an expectation that it will be prescribed as a normal unlicensed medicine when appropriate.”

--- Later in debate ---

[Seema Kennedy]

Of course I could as a parent, but again, I am not a doctor, and I am not here to make that call. What I would say is that I am very happy to meet the hon. Gentleman to get more of the facts he is presenting to me.

What is needed to support such prescription is evidence of efficacy, and for public funding evidence of cost-efficacy. That is the system we apply to all medicines and medical devices in the UK, and cannabis should not be treated any differently. The current evidence base has been summarised by the professional bodies in their interim clinical guidance, and it will be further examined and reported on by NICE shortly.

[Tonia Antoniazzi]

I have one question for the Minister: has the cost analysis been done on a particular case? When I spoke earlier, I spoke about Alfie Dingley. It would be very interesting to see the impact of his case financially–the benefit that has been gained to the NHS and the money that it has saved the NHS since he has been taking the drug.

[Seema Kennedy]

I apologise to the hon. Lady, because she did ask me that, and I am afraid I forgot to send a note to the Box. I am happy to write to her about whether that analysis has been done.

Many hon. Members, including my hon. Friend the Member for South Suffolk, talked about funding. Funding decisions are local decisions with clear local procedures. The process review is looking at this, and as I have said, it will report shortly. I call on the industry to invest in more trials, and to publish the results and the full underpinning data, because we all want to see licensed products that doctors can use with confidence.

Where there is supporting evidence, the Government and the NHS will work with companies to make the products available. Indeed, more than 110 patients are now being treated with a pure CBD extract product—Epidiolex, which numerous hon. Members have referred to—on an early access programme, ahead of a licensing decision by the European Medicines Agency. In developing a licensed product, the evidence has been generated on the safety profile and effectiveness of the product. It is this that provides clinicians with the confidence to prescribe and the system with the evidence it needs to make decisions on routine funding. The NHS does not routinely fund any new medicine until it has been through a process of evaluation to ensure that it is safe, effective and represents value for money.

On another point that the hon. Member for Gower brought up, about one of her constituents going on the Epidiolex trial, the specialist centres around the country are referring patients to GW Pharmaceuticals. There are certain criteria and a certain number of places, but if she wrote to me, I would be happy to meet her and we could discuss that further.

We need to develop further our knowledge base on these products. That is why good-quality clinical trials are imperative. We need to know more about the scale of the benefit of cannabis-based products across a wide range of indications. We also need to understand how this compares with existing treatments and, indeed, other promising new drugs that may be as effective.

Access to Medical Cannabis

Tonia Antoniazzi Excerpts

Monday 8th April 2019 Commons Chamber

[Mr Speaker]

Another ex-Minister to compliment. I am bit surprised by the Secretary of State. He is slipping from his usual standard. I thought that he would be busily cultivating his hon. Friend. [Laughter.]

[Tonia Antoniazzi (Gower) (Lab)]

I congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning), my co-chair of the APPG on medical cannabis under prescription. The situation is, frankly, intolerable. I have spoken with all of the families requesting medicinal cannabis with THC—let us not forget the THC. I am sure that Teagan will get a second opinion and that she is another child who will get access to medical cannabis, but what about all the others? They cannot wait. My right hon. Friend the Member for Exeter (Mr Bradshaw) spoke truthfully about the inquiry and the evidence it has taken. The BPNA has not spoken as it should have and it has not done enough to support the families.

[Mr Bradshaw]

It lied.

[Tonia Antoniazzi]

I will not use that word, but I totally agree with my right hon. Friend. I say to the Secretary of State that this has got to stop. We cannot wait for clinical trials. There is medicine out there—get it to the children who need it.

[Matt Hancock]

The BPNA is going to have to answer for itself about the way in which its representatives conducted themselves in front of the Select Committee. It is independent. Understandably, in medicine the bodies that make clinical guidance do not direct the answer for that clinical guidance to the Secretary of State. I understand the hon. Lady’s strength of feeling and that of others. I also understand the strength of feeling of the parents. I understand what a desperate situation they are in, and I am trying to make sure that it can be resolved and that they can get the drugs. I make one point to the hon. Lady: the very exercise of a clinical trial requires us to get the drugs to some children. I very much hope, therefore, that the start of a clinical trial can help to get the drugs to the people who need them. We do not have to wait for the results.

Services for People with Autism

Tonia Antoniazzi Excerpts

Thursday 21st March 2019 Commons Chamber

[Thangam Debbonaire (Bristol West) (Lab)]

It is a pleasure and an honour to follow the hon. Member for Bexhill and Battle (Huw Merriman) and, in spirit, the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan), who we truly salute today and all of this year as we mark the 10th anniversary of the Autism Act 2009. Both he and she will agree with me that there is still a lot to be done. I am proud to be one of the all-party group’s officers chairing one of the commissions marking that anniversary and measuring progress; the one I am chairing is on employment and autism and that will be the subject of my remarks today. I also thank my staff Mike Davies and Ravina Shah, who lead for me on autism, and the work of the National Autistic Society, particularly our regional rep Henry and the Bristol Autism Spectrum Service.

According to a recent report by the National Autistic Society, only 16% of working-age people with autism are in full-time employment, and only 32% of people with autism are in any kind of paid employment. That contrasts with the fact that 47% of working-age disabled people are in employment and 80% of working-age people without disabilities are in employment.

[Tonia Antoniazzi (Gower) (Lab)]

Will my hon. Friend give way?

[Thangam Debbonaire]

I am sorry, but I am going to try to stick to the time limit. A lot of Members want to speak.

The 2017 Tory manifesto pledged to see 1 million more disabled people in work by 2027. However, I am not sure that the Government are currently measuring the employment gap for people with autism, so I ask the Minister whether she is able to record the number of autistic people in work in the labour force survey and if not whether some progress can be made.

More than half a million people in the UK are on the spectrum, which is more than 1% of the population. More and more people are being diagnosed, with a twenty-fivefold increase in recent years. People often, although not always, need specific help to be able to find and keep a job, so I ask the Minister to urge Jobcentre Plus to provide adequate autism awareness training.

The National Autistic Society campaign “Too much information” launched in 2016 was the UK’s biggest ever campaign aimed at improving public understanding of autism. The campaign’s report found that 77% of unemployed autistic people want to work and that 40% currently working part-time wish to work more hours. People with autism want to work in a wide variety of roles and respondents to the survey found that ideal work environments vary hugely, from the arts and museum work to scientific research and development. We need to break stereotypes about autism and employment and recognise that the underemployment of people with autism is an issue as well as unemployment.

More needs to be done to improve the lives of people living with autism. I have changed my own employment practices by altering job descriptions to be more accessible, and I am very proud of the two fantastic members of staff I have employed as a result; they are brilliant. I was also, I believe, the first MP to hold a surgery specifically for people on the autism spectrum. I know others have followed suit, which is fantastic, and no doubt they have done a better job. I am committed to making Bristol an autism-friendly city; I made that commitment when I was first elected.

My constituents tell me that many people on the autistic spectrum encounter barriers to finding employment. It is right that we do everything we can to end social isolation. One way of doing that is to ensure that autistic people have the same access to employment as everybody else. Employers, trade unions and public services can all play a part in this. Unfortunately, that exclusion leads not only to autistic people feeling left out but to us missing out on their skills and qualities. They have potential which is too often untapped. This is also about their families and the wider economy. We should all pledge to do everything we can to increase the employment of people on the spectrum.

However, employers say they feel under-equipped and the National Autistic Society survey found that 60% worry about getting it wrong and do not know where to go for support and advice about this. As an officer of the all-party group on autism chairing the commission on employment of people with autism, I will be involving people with autism but there will also be discussions for us there about practical measures and the ways to get people with autism into employment that make sense and fit their potential, but do not discriminate.

I will continue to campaign for Bristol to become a truly autism-friendly city. I am delighted that so many of Bristol’s employers are so keen to join me in achieving this goal. I have spoken to many employers over the last year or so about that. Every single one I have met has taken various steps to make their employment practices more accessible. So may I ask the Minister what the Government will do in turn to help to close the autism employment gap? If she is not able to answer that today, will she consider coming to our commission inquiry to discuss it further?

I thank all those people on the autistic spectrum who have not just inspired me but helped me, taught me and frequently challenged me on how I as a politician and an employer can do better. Autism is in my family. My autistic teenage nephew is doing really well and has so much to offer and many talents, but he is going to need employers to understand his autism and that may in turn mean that they need help. So I want every one of us here to take that away from today’s debate: the need to help employers to do better to close the autism employment gap.

--- Later in debate ---

[Kevin Brennan (Cardiff West) (Lab)]

May I, too, congratulate the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan), who, sadly, cannot be here because of that family situation, on her speech? I also congratulate the hon. Member for Bexhill and Battle (Huw Merriman). I think he would agree that he proved that, as the old song says, there’s nothin’ like a Dame, but he did an admirable job in delivering her speech and in answering interventions from colleagues from across the House.

I take an interest in this subject, as do many Members, through constituency casework, and I have particularly focused on adults with autism. Understandably, there is often a lot of debate about children with autism, but those children grow up to be adults, and often many of the difficulties can arise when that cliff edge comes and children with autism become adults. Sadly, this often ends up with adults with autism coming into contact with the criminal justice system, as happened in the case of one of my constituents, whom I will not name for obvious reasons. The trait of stimming is shared by many people with autism, but it is not generally understood by the general population. It is the repetitive behaviour of some with autism in order to calm a situation, but it can be misinterpreted sometimes as a criminal action. In the case of my constituent, that led to his being arrested on two different occasions by the British Transport police when he became nervous travelling on public transport. This ended up with his being inappropriately cautioned and that remaining on the record, despite the fact that that caution was later withdrawn, in recognition of the fact that he had not been given the appropriate support that adults with autism are supposed to get when they come into conjunction with the criminal justice system.

[Tonia Antoniazzi]

What has been highlighted is that travel is also traumatic for people with autism. Will my hon. Friend join me in congratulating Cardiff airport on training its staff to support children and adults with autism when they are travelling through the airport?

[Kevin Brennan]

I absolutely join my hon. Friend in congratulating Cardiff airport on that. Going through an airport, with its security and everything that comes along with it, is a stressful enough situation for anyone, so the fact that the airport is doing that is very much to be welcomed.

Lord Bradley, a former Member of this House, produced a report in 2009 on how not only people with autism but other individuals with mental health issues come into contact with the criminal justice system. At the end of last year, he and I, along with some families of adults with autism, arranged to meet the new head of the new Independent Office for Police Conduct to talk about the way the police often deal with adults with autism when they come into contact with them, and with the complaints that then come when those adults with autism have been treated inappropriately and not according to the guidelines originally envisaged by Lord Bradley back in 2009.

Michael Lockwood, the IOPC’s new head, is to be given some credit for engaging seriously with this issue. We can see a sea change in attitude on this issue from the new IOPC when compared with the former Independent Police Complaints Commission. For example, he has agreed to meet and engage with the families of those who have had cause to raise complaints with the IPCC and the IOPC, and to involve them in designing the ways in which the IOPC will respond. There is a recognition that often these sorts of inquiries can be confrontational, whereas what is really needed is to get to the heart of the matter and the truth, and to make sure that lessons are learned and spread throughout the criminal justice system, particularly in the police force.

One thing that is being done by the IOPC, which I welcome very much and think should be done in other organisations, is that it is recognising that employees in these organisations will often have children with autism or relatives with autism, and that they can bring some expertise to the organisation when they are interacting with those with autism. For example, the IOPC recognises that many members of its staff are from families that have experience of autism and that they can bring an expertise within the organisation when looking at these cases where complaints are raised. I welcome that, because that sort of learning is what needs to take place across the police, the courts, the prison system, adult and children’s services across the country, and the NHS.

My hon. Friend the Member for Bristol West (Thangam Debbonaire), who is no longer in her place, was talking earlier about what was going on in Bristol. In the case of my constituent and a couple of other families, I welcome the fact that, as I understand it, adult services in Bristol have agreed to review some of the cases they have dealt with in recent years, with a view to publishing a report, appropriately anonymised, that can provide lessons learned to people right across the country. That is very much to be welcomed.

My constituent has got together with other families to help set up an organisation called autisminjustice.org. I recommend that Members look at the stories on the site about the way in which these families have come into contact with the criminal justice system. The organisation’s long-term aims are to ensure:

“That criminal justice and care professionals are aware of and follow existing guidelines and policy relating to autistic people in a way that properly safeguards them.

That these professionals, as well as the general public, understand autism so that autistic people’s appearance and/or behaviour is not misunderstood and misrepresented in a way that puts them at risk of serious harm.”

Those are very laudable long-term aims.

I appeal to the Minister to engage with those families, with that organisation and with other Departments across Government to make sure that government is working in a joined-up way on this. Those of us who have been Ministers understand that it is not always easy to get out of the ministerial silos that Whitehall imposes upon us, but government works best when Ministers from different Departments get together with a common purpose. Surely on this issue of all issues, where there is cross-party support in this House and general agreement on what should happen, we should in no way be inhibited by Ministers not being able to work together. I urge the Minister to do as much as she can to work across Whitehall on this issue.

Organ Donation (Deemed Consent) Bill

Tonia Antoniazzi Excerpts

Committee Debate: 1st sitting: House of Commons
Wednesday 12th September 2018 Public Bill Committees

[Peter Heaton-Jones (North Devon) (Con)]

It is a pleasure to serve on this Committee. I start by paying unequivocal tribute to the hon. Member for Coventry North West for his stewardship of the Bill. There are many others who have played a significant role in getting us to this stage, and it is testimony to the fact that the Bill has received literally all-party support that the names of signatories from all seven parties represented in the Chamber appear on this private Member’s Bill. The fact that the Front-Bench teams of both Her Majesty’s Opposition and the Government support it is extremely significant. It shows the widespread support, and how important the measure is. It is truly a cross-party endeavour.

I share the hope that has been expressed that Committee stage will not take long, because there is such unanimous agreement. I will briefly share a story that I had the privilege of telling when we debated the Bill in the Chamber back in February, because it is very significant. I recognise that doing so will perhaps bring back some difficult memories for those involved, but I hope it will be inspiring. It is the story of Keira Ball.

Keira and her family were involved in an accident on 30 July last year. There was a road traffic collision on the A361, the North Devon link road in my constituency, only about five miles from my home. Sadly, despite the best efforts of the emergency services and paramedics, young Keira passed away two days after the accident. Her mother and brother were very seriously injured, leaving her father to take on his own the agonising decision that he wanted his daughter’s death to give life to other people, and therefore that young Keira’s organs should be donated. In that inspirational moment, Keira’s parents, Joe and Loanna Ball, have given hope to so many more people. They have also given life to the Bill and seen it get as far as it has. I hope it will proceed without much further ado.

Four people are alive today because of the decision taken by Keira Ball’s father after that accident. Keira donated her kidneys, heart, liver and pancreas. One of her kidneys was given to a man in his 30s, who had been on the waiting list for two and a half years. The other kidney was given to a woman in her 50s, who had been on the waiting list for nine and a half years, and a young boy received Keira’s pancreas and liver. Keira’s heart was given to a 10-year-old boy, who in many ways, has become the figurehead of the excellent campaign. I speak of course of Max Johnson, who is alive today because of the brave decision made by Keira’s father in the aftermath of that awful accident. This is, in many ways, Max’s law and Keira’s law.

Those two young people are an absolute inspiration and show why this excellent Bill, which I hope will become legislation before long, will genuinely help to save lives. For that reason, I am delighted to be serving on the Committee and to be a part of this excellent Bill’s truly cross-party support. I hope that we can move forward so that it reaches the statute book, because if there is one important job that we should be doing in this place, it is saving lives, and that is what the Bill does.

[Tonia Antoniazzi (Gower) (Lab)]

I welcome the amendments described by my hon. Friend the Member for Coventry North West, to whom I am grateful for taking this important Bill forward.

As the only Welsh MP serving on the Committee, I can speak from experience about the positive difference that a similar law is making in Wales—I am glad to see a Welsh Labour Government leading the way. More and more families than ever before are talking about organ donation, and the importance of talking to families about organ donation was highlighted when, sadly, we lost my father nearly seven years ago. My family’s highest priority was the conversation about organ donation.

Since 2015, when the Welsh Government’s presumed consent law was introduced, there has been a big increase in the percentage of families who feel that they can say yes at an extremely difficult time, honouring the wishes of loved ones who wanted to donate their organs after death. The figure was 58%; it has now increased to 70%. To put that in context, the number of families in England giving permission for the organ donations of their loved ones has not increased during the same period. Hundreds of families in England are still vetoing transplants even when their loved ones have opted into the organ donor register.

The Bill will hopefully spark a cultural change in England as a similar law has done in Wales, but the legislation needs to go hand-in-hand with a public awareness campaign that asks people to have the conversation; that is what happened in Wales. I welcome the cross-party support for the Bill.

[Julie Elliott (Sunderland Central) (Lab)]

I thank you Mr Wilson, as well as my hon. Friend the Member for Coventry North West, who introduced this private Member’s Bill, and I take pleasure in the cross-party support for the Bill.

There is no doubt that the Bill will make more organs available for transplant, which, as many people here know, is a very personal issue to me, as my daughter is on the kidney transplant list. Only if more organs are made available can lives be both changed and saved. We must always remember those who donate their family members’ organs, because that is such an act of selflessness. Having spoken to many donor families, seeing that lives are saved or improved by doing that hopefully gives them some comfort in what must be the most horrific of circumstances.

I draw the Committee’s attention to a couple of important points. For the Bill to work, there must be an appropriate public information exercise, there must be education, and there must be a triggering of conversation in families, workplaces and schools, about the issue of transplantation. It is a very real issue that can affect anybody, in any walk of life, at any time. Only by talking about the issue openly do people gain a real understanding of what others want and realise that there is nothing to be frightened of in transplantation. Adequate time and resources must be given to the health service and other bodies for the Bill to be implemented properly and successfully—it is important for all concerned that that happens.

I will not go on any longer because there is cross-party agreement. It is very positive when a measure passes through the House and there is genuine cross-party agreement for improving the quality of lives and, literally, making the difference between life and death of people in this country.

Lymphoedema Services

Tonia Antoniazzi Excerpts

Tuesday 27th March 2018 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered provision of lymphoedema services.

It is a pleasure to serve under your chairmanship, Mr Gray, and I thank the Minister for being here to respond. This is the first Westminster Hall debate I have secured, and I am proud it is on an issue that affects many people in the United Kingdom. It was first drawn to my attention by my constituent Melanie Thomas MBE.

Lymphoedema or chronic oedema is a chronic swelling due to the lymphatic system failing. It mainly occurs when the lymphatic system is damaged by surgery, radiotherapy, trauma or infections. People can also be born with lymphoedema if the lymphatics have not developed properly. It affects people of all ages, and the swelling can occur in any part of the body. People think it is rare, but it is not, and research suggests that about six people per 1,000 have lymphoedema which, to put that into perspective, is about 400,000 people in the UK. If we look at the legs and feet of people in supermarkets or even here in Parliament, we will see swollen oedematous legs.

The problem of chronic oedema is getting worse as we get fatter and live longer with the consequences of other health conditions. Fifty-five per cent. of the average community district nurse case load is people who have swollen oedematous legs, with or without wounds. Such nurses, however, are not lymphoedema experts, and most do not have the skills in lymphoedema bandaging or prescription of compression garments.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on achieving this Westminster Hall debate. She referred to 400,000 people suffering from lymphoedema. Macmillan Cancer Support has estimated that there are 124,000 sufferers in the UK. Does she agree that there must be a better NHS support system, including more practice nurses, and specific training in lymphoedema care? The Government need to allocate the funding to support those suffering from this chronic condition.

[Tonia Antoniazzi]

I wholly agree with the hon. Gentleman. I will discuss training needs later—there is a definite need.

Lymphoedema can affect people physically, psychologically and socially. It has a significant impact on quality of life and prevents people from undertaking the normal activities of daily living. Reported issues include: massively swollen limbs that leak through clothes and soil carpets and beds; poor mobility; the inability to find shoes that fit and a limited choice of clothes; increased pain; inability to work; frequent admissions to hospital with cellulitis; stigmatisation and people being scared, anxious and depressed; and inability to cope and a feeling of lost control.

We might think that people can get treatment, but they cannot—that is the problem. Lymphoedema services are scarce. People suffering with lymphoedema cannot access the treatment they need or deserve. There is wide variation in the organisation and delivery of lymphoedema services throughout the United Kingdom. Some areas have commissioned full lymphoedema services—services for both cancer and non-cancer patients—others offer cancer-only services, and others provide no lymphoedema services at all.

Lymphoedema services that have been commissioned range from lone practitioners to small teams, so waiting and treatment times vary, as do treatment options. That diversity is not a result of patient need and is not patient-centred. Most people with lymphoedema go undiagnosed and untreated for long periods as a consequence of the poor level of knowledge among health professionals and the limited support from healthcare managers and commissioners. Lymphoedema is a growing condition, so what support are the Government providing to develop pre-graduate and postgraduate education for healthcare professionals to raise awareness of the condition? Something has to change.

Becoming aware of the lack of lymphoedema services in Wales, the Welsh Government listened to its members. I am very proud of that. The Conservatives might slate the Welsh NHS in the Chamber, but this is a wonderful area of work that has been developed in Wales, and I want to hail it. In 2009, the Welsh Government commissioned a lymphoedema strategy for Wales, which sets out clear aims to enable access for all lymphoedema patients to the appropriate services at the right place, at the right time and with the right person, regardless of whether their lymphoedema is related to cancer. Lymphoedema strategies have also been written in Northern Ireland and Scotland. England is the only nation not to have one.

In 2011, the Welsh Government invested £1 million to implement their lymphoedema strategy. The funding enabled lymphoedema services to be set up under every health board in Wales, managed by Lymphoedema Network Wales to maintain strategic oversight of the strategy for lymphoedema in Wales. Services are also made available in the more rural areas of Wales by the Tenovus Cancer Care mobile unit, which works closely with Lymphoedema Network Wales and the Abertawe Bro Morgannwg University Health Board.

Lymphoedema has always been a chronic, incurable condition, but new evidence suggests that significant improvements can be made for patients. In Japan and Europe, a super-microsurgical technique, which joins the defunct lymphatics to a functioning vein, has seen a 96% reduction in cellulitis episodes, and 70% of treated patients have stopped utilising compression garments as a result. The technique—lymphatic venous anastomosis, or LVA for short—is available on the NHS only in Wales. The Welsh Government supported the investment to make that happen and 42 patients per year can now have the innovative surgery that has the potential to cure their lymphoedema.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I have a constituent called Caroline, who is in her late 30s. She has had lymphoedema affecting her leg for several years. She recently had an infection and had to go to accident and emergency three times. She now has to wear surgical stockings for the rest of her life. Had she been diagnosed earlier, she would not be in that situation. Does my hon. Friend agree that, if a strategy had been in place, my constituent would not have needed to go to the NHS so often, saving money by controlling the condition when she was first diagnosed?

[Tonia Antoniazzi]

My hon. Friend makes a valuable point about the waste of money. The money is wasted on services because the lymphoedema is not being treated properly with the correct garments. We hope that that will be addressed so that the NHS can save money and be more effective.

We want better outcomes for patients as well as to save the NHS money. LVA is available privately in the UK, but not everyone has the £15,000 needed to have the surgery. LVA has the potential to cure lymphoedema and stops the need for admissions to hospital for cellulitis and for expensive compression garments. When will this surgery be available on the NHS for England, Scotland and Northern Ireland?

Wales also leads the way in developing a national paediatric lymphoedema service. Children can have lymphoedema, and in Wales 260 have the condition. Last summer I had the opportunity to meet some of them in Margam at an event organised by the Lymphoedema Wales Network. I saw them participate in a wide range of sports—that is important, because having lymphoedema does not mean people cannot participate in sport, and those young people were being actively encouraged to play football and rugby. The most important thing that came out of that day was the opportunity for young people to meet people like them, and for parents to meet one another. It was absolutely invaluable for those young people and their families to discuss things and have a support network.

Hon. Members should not think that Wales has it easy, because it does not. When it got the funding, the prevalence of lymphoedema was two per 1,000. It has now tripled to six per 1,000. It is the same story in Northern Ireland—when the Lymphoedema Network Northern Ireland was started, the prevalence was 1.33 per 1,000; it is now five per 1,000.

A small change can make a difference. If Wales and Northern Ireland can do it, why can we not have an equitable service among all nations? In England, I have been made aware that Herefordshire, Bedfordshire, Tamworth, Coventry, Luton, Southport and Aintree have services available only for cancer patients. Warrington, Barking and Bolton have no lymphoedema services at all. Morecambe bay’s services were under threat, but there was good news of additional funding. What is NHS England going to do to support its clinical commissioning groups in commissioning lymphoedema services, to end the inequity of service provision and patient suffering?

The NHS is wasting money trying to treat lymphoedema patients, as well as having a huge impact on patients’ lives. Many tell stories of wasted time, of being referred to numerous hospital specialties, of inappropriate wound dressings, with bandages often used, and of patients being admitted to hospital with cellulitis because the lymphoedema has not been treated. We need to save money and start treating patients with lymphoedema better. Let us improve education on chronic oedema, get more clinical expertise in the community to prevent complication and admissions, and ultimately, stop the current postcode lottery as well as the non-cancer inequity.

In 2002, a debate was held in this place. Very little has changed in the 16 years since. What will the Government do to support our constituents to gain the lymphoedema services they so rightly deserve? I would welcome the opportunity to facilitate a meeting between Lymphoedema Network Wales and the Minister at his earliest convenience.

Surgical Mesh Implants

Tonia Antoniazzi Excerpts

Wednesday 18th October 2017 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

Thank you, Mr Owen, for chairing this debate. I congratulate my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing this important Westminster Hall debate on International Menopause Day.

Women are always reluctant to speak out about the personal and intimate medical issues that they experience. Sadly, they are highlighted only when things go wrong. Two women in my constituency have spoken out about their experiences, but I urge all women who have suffered as a result of a mesh implant to get in touch with their MP, because we know there are many other cases. As we have heard, there are women suffering whom we do not know about.

Recently I met a constituent of about my age whose life has been devastated. She had a mesh fitted in December 2011 and knew immediately that something was wrong. She could hardly move her right leg. She had pain all across her lower abdomen and back and in the right side of her groin. She had infections in the operation sites and was given three lots of antibiotics. Three weeks later the consultant said that she had mesh exposure. She was admitted on 3 February for what she thought was a removal, but it turned out to be for steroid injections, which did not alleviate the pain.

She was then sent for internal physiotherapy. I imagine that was very painful. She has also received physio on her back because of back pain. She saw numerous consultants and had many scans. Eventually, after bursting into tears during a physio session because of the pain she was in, she ended up seeing another consultant, who decided she should be admitted to remove the mesh. The operation was in August 2012 and she was pain-free for about a year after, but then it started again. She had constant pain in the groin, back, and across the lower abdomen, and she went back and forth to the doctor in the familiar scenario that we are hearing about today. It was even thought she might have bladder cancer, but all the scans were clear and still she was in constant pain.

My constituent was under the impression that the mesh had been removed, so when they were all scratching their heads and saying they did not understand why she was in pain, she was told she should try and manage it better. Understandably, she did not know where to turn. Eventually she saw a different consultant who asked her what she could feel inside, and she said it was the mesh. It turned out they had only cut the mesh in half. It was still there—no wonder she was in so much pain. Again, she went in for removal in August 2015. Unable to pass urine for three weeks, she had to self-catheterise at home.

About nine weeks later she started to feel as though she was getting on her feet again and was relatively pain-free for about a year, but it flared up again. She had another round of video urodynamics done, which was not pleasant. She was told that the corner pieces of the mesh were still there and it was too risky to remove them. After a recent flare-up with severe inflammation, she was sent for an urgent scan. Having spent the past six years in constant pain and discomfort, she does not have a partner because so much time is taken up looking after herself and her son and working.

During a visit to the consultant this year he asked what she wanted him to do. She said, “I came to be under your care because I was incontinent. I am still under your care six years later, still incontinent, and in pain as well now, so you tell me what you are going to do.” We must realise these women need help. As the MP for Gower, I have talked about my constituent and the plight of mesh-injured women. Many women do not like to discuss this topic and they do not want to complain. We cannot wait until 2019 for NICE to bring out guidance. I echo the words of the shadow Minister for Public Health, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), by asking the Government to hold a public inquiry into the numbers of women adversely affected.