Oral Answers to Questions

Vicky Foxcroft Excerpts

Tuesday 21st March 2017 Commons Chamber

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

T7. Last week, leading trauma surgeon, Dr Duncan Bew, said his surgical team sees more young patients with serious stab injuries than people with appendicitis. This is a societal problem. Will the Minister inform us of his Department’s public health approach to tackling this issue?

[Mr Hunt]

The hon. Lady is absolutely right to say that this is a serious issue. I commend the brilliant work done by NHS trauma centres throughout the country, which are world-beating, but, as well as setting up those centres, we have established much closer co-operation with local police forces so that we can work out where the crime hotspots are and help the police to prevent such things from happening.

Provision of Cervical Screening

Vicky Foxcroft Excerpts

Friday 27th January 2017 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

It is an honour to follow the hon. Member for Harrow East (Bob Blackman), who is no longer in the Chamber. He has worked incredibly hard to gest a very important and much-needed Bill through this House.

I declare an interest as chair of the all-party group on women’s health. I am thankful for the opportunity to hold this debate today because this week is Cervical Cancer Prevention Week. The phrasing is important, because cervical cancer is notable for being not only treatable but preventable, under the right screening conditions. The events of this week are all about trying to ensure that those conditions exist for as many women as possible throughout the UK.

I start by acknowledging the invaluable work of Jo’s Cervical Cancer Trust, which I believe is unique in the UK in being dedicated to this issue. I thank it for its work in raising awareness during this week, such as through its #SmearForSmear campaign—there is still plenty of time to take up the offer to do your selfies, gentlemen—in which women, and indeed men, are encouraged to take a selfie with smeared lipstick to raise awareness of smear testing. I look forward to seeing those pictures later.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

That is a fantastic idea. Only this week, I went for my own smear because of the campaign and the highlighting of the issue. All of us might want to join together to do #SmearForSmear, and tweet the pictures after the debate.

[Paula Sherriff]

I absolutely agree. I definitely expect the Minister, at least, to partake in such activity.

I thank Jo’s Cervical Cancer Trust for the work that it does all year round towards the eradication of this disease. It has been my pleasure to work with it, through the auspices of the all-party group, on issues to do with access to cervical screening, and I look forward to doing so again in the future.

I am glad that the Minister is sitting down, as I would also like to break with my habit in this House by giving a word of praise for current Government policy. As almost all cervical cancers are caused by persistent human papillomavirus—HPV—I welcome the Government’s commitment to the HPV vaccination programme, even though I feel that its effect could be amplified with compulsory sex and relationships education in our schools.

Successive Governments have developed a successful cervical screening programme and, to their credit, this Government have maintained it. It is responsible for saving an estimated 5,000 lives a year. That is to be applauded, but it should not be taken for granted. Recent years have seen a drop in cervical screening coverage, and this risks an increase in the incidence of cervical cancer and the danger of further unnecessary deaths when we have been very close to making a breakthrough. We need to be vigilant if we are to maintain the progress we have already made and make up further ground in tackling the disease.

Even with the progress that we have made on screening, some 3,000 people a year are diagnosed with cervical cancer, and an astonishing 890 a year people die of it. The figures for 2015-16 show that the coverage in England sits at 72.7% of eligible women, which is the lowest for 19 years. This is in spite of the so-called Jade Goody effect, when the TV star’s death from cervical cancer in 2009 resulted in 400,000 more women getting screened. Sadly, that effect has now been completely reversed. The numbers of screenings have been falling year on year, and they now stand at 3% lower than they were in 2011. Screening coverage rates across all age groups are falling.

I cannot stress strongly enough how significant and worrying these statistics are. They mean that more than a quarter of women in this country are leaving themselves open to a cancer that can be prevented, but that can easily be fatal if left undetected. As we all know, the general rule of cancer is that early diagnosis leads to a better prognosis, and cervical cancer is no different. The later the diagnosis, the poorer the health outcomes, and the more invasive and personally costly the treatment options. It benefits everyone involved if cervical cancer can be prevented, or detected and treated early.

Let me address one of the groups with the least coverage: young women. Women are invited for smear tests from the age of 25, but new research by Jo’s Cervical Cancer Trust has shown that more than a quarter of women in the 25 to 29 age bracket are too embarrassed to attend one. Shockingly, the same research also suggested that 70% of young women did not believe that smear tests could reduce a woman’s risk of cervical cancer. Let me be clear: they absolutely can. We know that 75% of cervical cancers can be prevented from developing through regular smear testing, yet more than 220,000 of the 25 to 29-year-olds invited for a test in England in the past year did not attend.

The research found several other causes for concern, including the fact that 24% of young women were unable to recognise a single symptom of cervical cancer, and that only just over half of them recognised that bleeding outside of periods was a symptom. That is the most common symptom of cervical cancer. Additionally, fewer than half knew that smear tests look for pre-cancerous cells, and almost a quarter incorrectly thought that the test was for ovarian cancer.

This problem is not unique to the younger generation. The 25 to 29 age group remains the group with the lowest coverage, but the 45 to 49 age group has seen the fastest decrease in coverage in recent years. Women over 50 display a similar tendency to put off or ignore smear testing, with a third having delayed or not attended their test. A shocking one in 10 have delayed for more than five years. This is particularly disconcerting because women aged 50 to 64 are the most likely to receive an advanced stage diagnosis, with half of those being stage 2 or later. As I mentioned earlier, this means more invasive treatment and risks poorer outcomes.

By far the biggest risk factor in developing cervical cancer is not attending cervical screenings, but Jo’s Cervical Cancer Trust has found that attendance declines with age. The charity’s long-term modelling has shown that if screening coverage continues to fall at its current rate, incidences of cervical cancer will have increased by 16% among 60 to 64-year-olds, and by a shocking 85% among 70 to 74-year-olds, by 2040. If screening coverage falls by another 5%, the mortality rate among 60 to 64-year-olds will double.

Age is not the only determining factor of one’s likelihood of being screened. One area of particular concern is that only 78% of black and minority ethnic women knew what a cervical screening test was compared with 91% of white women. This fell to 70% when looking at Asian women alone. Worryingly, only 53% of BAME women thought that screening was a necessary health test. This needs to be addressed, both nationally and within those communities.

The anxieties that all women were found to have about being screened, including embarrassment, worries about taking their clothes off in front of a stranger or discomfort with their body in general, are all heightened in particular ethnic communities with certain cultural norms. I have heard examples of mothers in certain minority ethnic households intercepting NHS screening invitation letters, leading to distress among younger women, who may experience cultural pressure that they should have maintained their virginity. If such factors put young BAME women off getting screened, that exposes them to significant risk of the disease. Particular focus should be paid to ensuring that mothers in those communities appreciate the dangers of cervical cancer, and that such cultural norms are not worth risking their daughters’ lives over.

We must ensure that coverage does not continue to fall. Indeed, it must be raised to an acceptable level, but the current outlook is mixed. A new report by Jo’s Cervical Cancer Trust for this year’s Cervical Cancer Prevention Week found that local provision is confused. While there is some evidence of best practice among local authorities and clinical commissioning groups, almost half of local authorities and almost two thirds of CCGs in England have not taken steps to increase cervical screening attendance in the past two years. The report also found regional disparities. In Yorkshire and Humber, 65% of CCGs had taken steps to increase screening, compared with just 18% of CCGs in the west midlands and the north-east. Similarly, 78% of local authorities in the north-west have taken action compared with just 33% in the east midlands. Perhaps most shockingly of all, in London, where coverage lags behind the rest of the country at just two thirds of women, 20 out of 32 local authorities reported no activity at all towards increasing screening coverage. That has all the appearance of a postcode lottery. We risk coverage continuing to fall in some areas of England while other areas make progress. Nobody wants a situation in which someone’s likelihood of developing cervical cancer is determined in no small part by the area in which they live. The Government should play their part to ensure that improvement happens across the board.

What can be done? We must seek to make access to cervical cancer screening as easy as possible. Screening takes five minutes and can save a life. Great strides have been made in recent years in making another simple test—blood pressure—available at every opportunity, which has been remarkably successful. There is every reason to expect that we could do the same for cervical cancer screening. However, I fear that the Government have taken a step in the wrong direction in recent years. Cuts to sexual health funding have led to a significant reduction in the provision of cervical screening through sexual health services. Jo’s Cervical Cancer Trust found that screening is available to all women through sexual health services in less than a third of areas, which again points to a postcode lottery. That seems like a grave misstep when over a third of women in the 25 to 29 age group expressed a wish to access screening through such services, while one in five women over the age of 50 wanted more flexibly timed access to screening. My GP practice offers cervical screening only every Tuesday morning, making access difficult and deterring many women from going for an appointment. I hope that the Government will look again at how much their cuts to local government funding have affected sexual health services, particularly the accessibility of cervical screening.

We must also move with the times. In addition to the cultural issues about invitation letters that I mentioned earlier, the use of letters is now old fashioned. While I appreciate that many NHS services across the country now use text message reminders, we should ensure that reminders to come in for screening are, to the greatest possible extent, accessible in the format of the patient’s choice, be that text message or email. Digital accessibility is necessary in the modern world. We must also be cautious about the wording of the reminders. It has been brought to my attention that the current NHS literature sent out with reminders reads:

“It is your choice whether to have a cervical screening test or not. This leaflet aims to help you decide.”

I fail to see how that in any way contributes to the aim of urging as many women as possible to attend cervical cancer screening. We already know that far too many women across all age groups and ethnicities are already content to put it off for a potentially dangerous length of time. I implore the NHS to reconsider the wording of the leaflets and to include a greater degree of urgency, because the phrasing will undoubtedly have an effect.

You will note, Madam Deputy Speaker, that I might not have been my usual challenging self this afternoon. Because of the gravity of the issue at hand, I happily recognise where the Government are on the right path. The inclusion of a commitment to increase cervical cancer screening in the 2015 cancer strategy is particularly welcome, as is the Government’s commitment to HPV primary screening, the implementation of which could prevent at least 400 cases of cervical cancer a year.

I will finish by asking several questions of the Government. Will the Minister commit to a national campaign to prioritise an increase in cervical screening attendance? How will the Government encourage co-operation between the different levels of the health service to ensure that we see cervical screening rates rising once again? Will the IT systems for HPV primary screening be up and running as planned, or will we experience unnecessary delays that could result in avoidable diagnoses? Will the Minister look at the quality and outcomes framework incentives for general practitioners to make sure that GP practices are really incentivised to improve cervical screening coverage? Finally, how do the Government intend to address problems with the accessibility of cervical cancer screening among particularly hard-to-reach groups, such as BAME women?

It is not unthinkable that we could see the effective eradication of cervical cancer if we take the necessary action. Although I applaud the Government’s existing programmes and their commitment to tackling cervical cancer, I hope that the Minister will take note of the research from Jo’s Cervical Cancer Trust—perhaps he will even work with it to identify where there are still gaps in provision—and take that action now.

Baby Loss

Vicky Foxcroft Excerpts

Thursday 13th October 2016 Commons Chamber

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

I want to start by paying tribute to the hon. Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince) for securing this debate. This is probably the hardest speech that I have ever had to write and deliver.

This week has been a tough week, as I had never heard of baby loss awareness week but it has been all around me. There have been online discussions and commemorative badges, and we have a debate in the Chamber today. I have struggled in a debate with myself about whether I should contribute today, as it is such a personal issue, and whether I want to share my very personal experiences. The absolute truth is that I struggle to talk to my family and very close friends about this, but during the events of this week, I can see that a large focus is on people talking about their loved ones, supporting each other and making sure that, when needed, important issues are raised and addressed.

I thank all my friends who have come into the Chamber today to support me as they know how hard this is for me. I also want to apologise to my many friends who I have not told about this. It is not because I do not want them to know or that I am embarrassed; it is just because I find it so very hard to do so. Ever since I was elected, I have always said that I want to be the kind of politician who is willing to share my experiences—not for therapy, but to empower others and to seek to change things for the better. Lewisham bereavement counselling service tells me that it has a two-to-four month waiting list, and that just is not good enough.

I guess that now is the time for me to talk about and pay tribute to my little angel, Veronica. When I was 16 years old, I became unexpectedly pregnant. At first, I was terrified and even debated having her adopted, but during my pregnancy something changed—I became so attached; I was excited; I was going to be the best mum ever. Me and my partner at the time named our baby girl Veronica. We could not wait to meet her. I went full term and was 10 days overdue, so they had to induce me. I was in labour for a long time. I was sick, tired and in a huge amount of pain.

Veronica’s heartbeat was checked regularly and everything was fine, but once I was dilated, the staff checked for her heartbeat again and could not find it. This went on for about 20 minutes, checking with different machines because the staff were not sure whether the equipment was broken. Eventually, the doctor was called and I was rushed to the emergency room. I had to push, and forceps was used to get her out. The umbilical cord had been wrapped around her throat for the whole 20 minutes. She lived for five days, but we had to agree to the life machine being turned off. I got to hold her then for the first time until her heartbeat eventually stopped. She stayed alive for hours. I never wanted to let her go.

My baby awareness week is every year from 22 to 27 February—my five days of her being alive. She was never able to cry or to smile, but I loved her and I desperately wanted her. I still love her. She is always in my thoughts—all these years afterwards—even if I do not talk about her all the time. I do not not talk about her because I am embarrassed—I am not. It is because it hurts so much to do so.

After Veronica was taken from me, my coping mechanism was to chuck myself into college and work. I could not talk about it; my heart was broken. I do not have children now because I have lived with the fear of the same thing happening again, and I just could not go through it twice. I have to say that, as a young woman going through this, I felt as if most people looked at me as if I should be grateful—I was not and I am not. It felt like every organisation I dealt with gave me that same message. Every time I wanted to campaign to highlight the problems that led to her life being taken away so unfairly, I was treated like a kid, not a grieving mum. I was her mum. I also hoped that, one day, I would be her best friend. If she was alive today, she would be 23 years old. The pain does get easier to deal with over time, but it never ever goes away.

I really welcome this debate and genuinely pay tribute to Members for bringing it forward. I hope that, one day, no one else has to endure this pain. I want my experience to be heard by young women in my constituency and across the country who have been through this, or who may go through it in the future, and to just say to them, “You’re not alone.”

Oral Answers to Questions

Vicky Foxcroft Excerpts

Tuesday 7th July 2015 Commons Chamber

[Alistair Burt]

I agree with my hon. Friend when he commends the involvement of young people in discussing their services. Only last week, the Under-Secretary of State for Education, my hon. Friend the Member for East Surrey (Mr Gyimah) and I attended a youth select committee organised by the British Youth Council to do something very similar.

There are two reasons why I think these services have not been so good in the past. First, there is the difficulty of collecting information and data; and, secondly, there is the complexity of financing for services. I hope that we will address both of those, and we will ensure that people know about this so that things do not slide back by being more transparent about both.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

The Government’s priority for the NHS this Parliament is to put Mid Staffs behind us by transforming the NHS into the safest healthcare system in the world, and in particular, through seven-day hospital care so that we end the tragedy of up to 6,000 lives lost because people do not have access to consultants or diagnostics at weekends. It means recognition that safer care costs less, not more, which is why we are cracking down on expensive agency staff who cannot give the continuity of care that is best for patients.

[Vicky Foxcroft]

Almost two years ago, Lewisham took the Secretary of State to court over the closure of Lewisham A&E and maternity services—and won. In the light of the new report, “Our Healthier South East London”, can the Secretary of State promise me that any further shake-up of the NHS in south-east London will not involve the closure of services at Lewisham Hospital?

[Mr Hunt]

What I can assure the hon. Lady is that we inherited deep-seated problems in the old South London Healthcare Trust and we have dealt with them. We have more doctors and nurses looking after her constituents, and care is getting better as a result of the difficult decisions we have taken.