O’Neill Review

Virendra Sharma Excerpts

Tuesday 7th March 2017 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

It is a great pleasure to see you in the Chair, Mr Streeter, and I congratulate the hon. Member for Thirsk and Malton (Kevin Hollinrake) on securing this important debate.

The O’Neill review is a fundamentally important look at the future of medical treatment not just in this country, but globally. TB is one of the most dangerous diseases worldwide and the most lethal infectious disease in history. As has been mentioned, 5,000 people die from it every day around the world and, as the review indicates, more than 10 million people will die from it annually by 2050 if we are not careful and do not contribute to the development of future research and vaccinations.

I am proud of the work of the all-party group on global tuberculosis and that of my co-chair of the group, the right hon. Member for Arundel and South Downs (Nick Herbert)—I think he has left the Chamber. We have had fantastic support from the Global TB Caucus and RESULTS UK. Both groups worked tirelessly to ensure the proper replenishment of the global fund last year. Eighty per cent. of the funding for the global fight against TB comes from the fund and Britain is the second largest donor. Still, at current rates, eradication will only be possible by 2167, which is not good enough—the speed we are going means that it will take 150 years to eradicate the disease. We have committed to eradication by 2030 but we are not doing enough to achieve it. Hopefully, the O’Neill review will be enough to drive forward the agenda that we need.

We have to work towards not just treatment, but vaccination. The standard treatment currently takes six months and 4,000 pills; it is no wonder that fewer than half of those who start the treatment complete the course. The difficulty of treatment drives AMR and the widespread nature of the epidemic. Hopefully, Lord O’Neill’s review will go some way towards raising awareness of how acute the issue of AMR is for some of the world’s poorest, even in this country. This and previous Governments have led the world on action on resistance. Let them again take up the mantle and drive forward the fight against AMR and help to secure a real vaccination against TB.

Duodopa

Virendra Sharma Excerpts

Tuesday 31st January 2017 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I beg to move,

That this House has considered access to Duodopa.

It is a pleasure to serve under your chairmanship, Sir Edward. I thank the Minister for sparing the time to respond to this limited debate this afternoon. The subject is a serious one, especially for those people who contend with advanced Parkinson’s disease and have so few effective medications on which they can rely to give them some control over their symptoms.

For the benefit of anyone who might not be familiar with the condition, I will briefly explain what Parkinson’s is. Parkinson’s disease is a degenerative neurological disorder. It affects all aspects of daily living, including talking, swallowing and writing. People with the condition often find it hard to move freely, but there are also other issues, such as pain, depression, dementia, hallucinations and continence problems. The severity of symptoms can fluctuate from day to day, and people can experience rapid changes in functionality in the course of a day.

There is no cure, but there is a small selection of treatments suitable for a few people in the advanced stages of the condition. Those treatments include the drug Duodopa. I was involved in the campaign to allow routine prescribing of Duodopa without recourse to special, case-by-case requests by clinicians. Since 2015, the treatment has been available to those people in England who are deemed suitable.

I called today’s debate to discuss the new proposal by the National Institute for Health and Care Excellence to advise clinicians not to offer Duodopa at any stage. That recommendation is being made despite the scarcity of treatment options and the proven effectiveness of Duodopa. I accept that the Minister has no control over NICE recommendations, but I wish to highlight some anomalies.

First, in clinical practice, Duodopa is used only when all other interventions have been shown to be ineffective, or clinically unsuitable options. Despite that, evidence presented in the draft guideline compares Duodopa to deep brain stimulation, which is another treatment for advanced Parkinson’s, and to the best medical treatment, which for advanced Parkinson’s is often apomorphine.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this matter to Westminster Hall for consideration. I hope that the Minister will be able to respond positively. As a result of the background information that I got in relation to this issue, I would like to ask this question: does he agree that the evidence from clinicians and experts that NICE made a pivotal mistake in comparing Duodopa to treatments such as deep brain stimulation means that the institute needs to step back now and withdraw the proposal before even more anxiety and turmoil is caused to people with Parkinson’s?

[Mr Sharma]

I thank the hon. Gentleman for that intervention. I will come to that point later and respond to it.

That incorrectly assumes that the populations given the treatments are the same, which is not the case, as UK clinicians recommend Duodopa only if their patient cannot have deep brain stimulation or apomorphine. It is therefore illogical to say that deep brain stimulation or apomorphine is better value for money, as they are not suitable for direct comparison. As one person with Parkinson’s explained,

“I was at the end of the road before I had the Duodopa. I was literally wheeled into hospital to have the pump fitted and the Duodopa titrated, and about a week later I came out walking. I responded very quickly and noticed a huge improvement in my quality of life, and I always live in dread that it will be taken away.”

In these circumstances, I very much hope that something can be done to bring NICE to the mainstream view on the subject.

[Glyn Davies (Montgomeryshire) (Con)]

I have been involved for 15 or 20 years in supporting Parkinson’s disease patients or those living with Parkinson’s disease, and I think it is terrific that Members of Parliament initiate debates that raise its profile, raise awareness and ask the Minister to come before us and share views on where we are. I therefore congratulate the hon. Gentleman on securing and introducing the debate.

[Mr Sharma]

I thank the hon. Gentleman very much for his kind words and support.

This issue is of great importance to a relatively small number of people, but given that the treatment is currently available through NHS England, to withdraw it on the basis of an apparently flawed assessment would cause concern among a much wider community, as it might be seen as setting a precedent for decisions on other treatments in future. I would welcome the Minister’s comments on that.

Secondly, although it is well known that Duodopa is more expensive than some other therapies, it is not offered to everyone, and we believe that some of the economic modelling does not take into account the discounts that the manufacturer offers NHS England.

Duodopa was classified by the EU as an orphan treatment, meaning that the number of people for whom it is a suitable treatment is fewer than five in 10,000. There are known issues with using standard health technology assessment methodology to evaluate the efficacy of orphan medications—issues that are thought to place orphan medicines at a disadvantage compared with treatments in more widespread use.

In Scotland, Duodopa was considered by the Scottish Medicines Consortium and approved on the basis of its processes for evaluating orphan treatments. NICE concluded that for Duodopa the cost per quality-adjusted life year—the generic measure of the value for money of medical interventions, based on quality and quantity of life lived—was more than £500,000, but the SMC concluded that the cost was less than £80,000 when using a calculation appropriate for an orphan drug. Indeed, a recent parliamentary question revealed that, from July 2015 to December 2016, just 75 people in England had been given Duodopa.

Thirdly, if Duodopa treatment is denied, that means there will be increased costs from social care and other things on which the person with Parkinson’s will become dependent, to say nothing of the quality of life or dignity of that person, which cannot be so easily reduced to a monetary figure. As Professor David Burn, the national clinical director for the UK Parkinson’s Excellence Network, has commented:

“To not offer Duodopa as a treatment option is putting people with Parkinson’s in England at a disadvantage compared with other developed countries.”

I acknowledge that the Department of Health has no direct control over NICE, and I recognise that NICE needs to be independent of political considerations. However, since NHS England has in recent years determined that Duodopa can be routinely used for patients where appropriate, and both NHS Scotland and the SMC consider the treatment to be appropriate, NICE appears to be out of step with the prevailing opinion. Specifically, I look forward to the Minister’s guidance on what options are open to the Government when the basis of a proposal made by NICE is so flawed. The consequences of these proposals going ahead would be catastrophic for the dozens of people for whom this drug was their last resort, and would add pressure to an already buckling social care system.

Oral Answers to Questions

Virendra Sharma Excerpts

Tuesday 15th November 2016 Commons Chamber

[The Minister of State, Department of Health (Mr Philip Dunne)]

As I said to my hon. Friend’s parliamentary neighbour, my hon. Friend the Member for Kettering (Mr Hollobone), we are aware that Kettering hospital has put forward a proposal. The outline business case is due to be discussed with NHS England in the coming weeks. In the meantime, we are looking at an interim solution for relieving pressure on A&E services in the area.

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

T2. Diabetes is a big problem in my constituency, and the number of unnecessary lower limb amputations due to diabetes is on the rise. Will the Minister ask clinical commissioning groups to provide fully staffed community podiatry foot protection services to avoid amputations, keep people in work and make huge cost savings?

[Nicola Blackwood]

The hon. Gentleman is absolutely right that diabetes is a major health risk in the UK. That is why we have rolled out the first ever NHS diabetes prevention programme this year on 27 sites, covering nearly half of England and referring nearly 10,000 people. Next year, the second wave of the programme will reach a further 25% of the English population. The aim is for the NDPP to be rolled out across the whole of England by 2020 to support 100,000 people at risk of diabetes each year.

Ealing Hospital

Virendra Sharma Excerpts

Tuesday 3rd May 2016 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I beg to move,

That this House has considered services at Ealing Hospital.

It is a great pleasure to have secured this debate and I am delighted to serve under your chairmanship, Mr Stringer. I am grateful to you and to Mr Speaker for providing the opportunity to debate this important matter. I am also delighted to see the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), here in Westminster Hall today.

Last week, on 26 April, I presented in the main Chamber a petition organised by a local group in my constituency and signed by more than 100,000 people, which said:

“The petitioners therefore request the House of Commons urges the Government to reconsider the impact of the Shaping a Healthier Future programme on Ealing Hospital, Ealing and the surrounding boroughs that rely on Ealing Hospital to deliver high quality emergency care 24 hours a day.”—[Official Report, 26 April 2016; Vol. 608, c. 1404.]

I have outside the room quite a few organisers and other constituents who are visiting from Ealing and hope to see some outcome from the debate today.

The London Borough of Ealing is one of the fastest-growing areas in the city of London. West London is experiencing fantastic population growth, as people flock to join our vibrant multicultural business hub. Ealing, and Ealing hospital, are at the heart of that growth. London is a demanding city—we know that from living here—but it is not just demanding regarding lifestyle and culture, it makes demands on health and the population demands a lot from its healthcare providers. Across the west of the city, in particular, we have a high level of young people, but the area also suffers from one of the highest levels of lifestyle-led premature death. It is a scandal that we in this great city preside over such a high rate of child poverty, while London drives the British economy.

In 2011, in what I can only assume was a well-meant but ill-founded attempt to improve the situation, the “Shaping a healthier future” programme was implemented across Ealing and the surrounding boroughs. “Shaping a healthier future” looked to combine services in certain hospitals to make savings and to improve 24-hour care, but the reconfiguration and rationalisation were often little more than cover for closing services. For the past few years, local people—the Minister can see that many of them are here today—including people from different walks of life and different political backgrounds and beliefs, west London MPs, Ealing Council members and Dr Onkar Sahota, the Labour spokesperson on health in the London Assembly and chair of its health committee, have repeatedly spoken out against what is being done to Ealing hospital.

We were threatened with the loss of four of our local 24/7 blue-light A&E units. Ealing hospital is expected to lose its full A&E service and have it replaced by a service that is not fit for purpose and cannot guarantee the safety of Ealing residents. Despite the increasing birth rate across our area of London, we lost our maternity unit last summer. That loss means that no more children will be born in the London Borough of Ealing. I must declare my interest in Ealing hospital. Two of my three grandchildren, Aatish and Riah, were born there, and I can vouch for the quality services provided. The paediatric unit is scheduled to lose in-patient services this summer. The iniquity of cuts that threaten the health and wellbeing of our youngest is a betrayal of every Ealing resident.

Shirlyn, a single working mother in my constituency, wrote to me last week to ask me to

“do [my] best to fight this”.

She cannot believe that vulnerable children are being put at risk by cuts. Shirlyn is worried, just as every parent across Ealing must be, that in the case of an emergency the increased travelling time risks increasing the danger children are in. The loss of that key community asset means that the most vulnerable families, those that have children with serious long-term medical conditions, will spend longer travelling, which will threaten their ability to both work and see their sick child. What kind of society can stand by and make someone choose between putting food on the table and seeing their sick child? As Shirlyn says, we in Ealing have paid our taxes and we have not been listened to.

As each successive round of downgrades and closures is announced, public trust in the London North West Healthcare NHS Trust falls further. Public confidence is so low, and people so frustrated at being ignored, that many are worried the hospital will be completely closed and sold for housing. That creates an unsafe situation for the people of west London, and for my constituents in Ealing, Southall.

Accompanying investments were supposed to balance the situation, but as costs have spiralled to more than £1 billion, promised investments have been threatened with withdrawal. Part of the deal for Ealing hospital had been that a new, fit-for-purpose, community style hospital would be built, providing high-quality services in a modern, clean and safe environment. In 2014, Ealing Council, along with others served by the London North West Healthcare NHS Trust, established a commission headed by Michael Mansfield, QC. The independent commission almost universally condemned the results of “Shaping a healthier future”. It found that cuts were affecting the poorest in society most acutely, and that the public had not been properly consulted. Plans had been drawn up that just could not deliver for Ealing. There was no sustainable business plan and the reconfiguration did not offer value for money, and was not affordable or deliverable.

The most important adjustment that can be made now is that the Secretary of State step in and halt the current programme, which is risking lives. The experiment is failing my constituents in Ealing, Southall. Michael Mansfield, QC and his independent commission recommended that a full A&E service be reintroduced at Ealing hospital, and that the maternity unit be reopened. The report also noted that local GP and out-of-hospital services were overwhelmed. Investment in public health is the only way we can end this shame, and give back to Ealing residents the healthcare they deserve. By helping young people and those who are mentally ill, and not allowing thousands more to slip into homelessness—as the Mayor has across all of London—we can help the health of everyone.

In January last year, I asked the Prime Minister to consider implementing Labour’s plan to employ a further 8,000 GPs to ease the workload for the most stretched services. Despite agreeing that GP care is fundamental to providing proper healthcare, he dismissed the plan and we are now seeing the results of his complacency.

London does not just have younger people putting pressure on healthcare services. The population at the other end of the spectrum is growing, and by 2031 there will have been a 40% increase in the over-80s population. That means that London, and Ealing, have to be better than many other parts of the country. We have to face the challenges not as problems but as solutions to the significant health inequalities that exist in our city. In 2013, the Mayor of London launched the London Health Commission, which published its report near the end of 2014. Although it suggested many important changes to NHS services, and outlined many noble intentions, the picture for London is only worsening.

That is why the Government have to step in. I ask the Government, on behalf of the more than 100,000 people who signed the petition and the many more who could not sign it but are worried about the services, that the current programme of rationalisation be halted. Services that are not adequately supported must be supported and reopened. Patient safety has to be the ultimate litmus test, and currently that cannot be guaranteed. As my constituent said:

“Every child is important and this move is putting the lives of these children at risk. Children need A&E.”

The people of the London borough of Ealing and surrounding areas need fully resourced and supported hospitals that provide a full service. Those hospitals need to be supported by the Government for the benefit of the local community.

[Several hon. Members rose—]

--- Later in debate ---

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate my hon. Friend and parliamentary neighbour, the Member for Ealing, Southall (Mr Sharma), on securing this important debate. It was the consolation prize for a petition that had more than 100,000 signatures. Initially, that petition went to the Petitions Committee. The number of signatures demonstrates how the Ealing hospital issue has gone beyond being a little local difficulty. It is now a national scandal.

Mr Stringer, I do not know what it says in your diary for 18 May. For MPs from all parts of the House, it says, “State opening of Parliament”. Despite the legislative programme coming our way, it is usually a joyous occasion. It has pomp and circumstance, and we may get a sighting of Her Majesty the Queen. It is also, however, the day when the Ealing clinical commissioning group will take the decision to shut the door on children’s services at Ealing hospital. For people in Ealing, it will be a sad day.

It is not yet a year that I have been a Member of Parliament, but some of the subjects that come up in relation to Ealing hospital seem depressingly familiar, even to me as a newbie. We seem to have this common situation when the Government just will not budge. Their intransigence makes it all seem a bit like groundhog day. I was a Labour candidate for 18 months before I was elected, and the NHS was the No. 1 issue on the doorstep. We were told that we were fearmongering. I remember we had a big march—a demonstration—from Ealing hospital to Ealing common, which is a number of miles on the map. We warned that the A&Es at Hammersmith and Central Middlesex would be closed, and we were told that we were fearmongering. They have both gone now, closed in September 2014. That was euphemistically called “changes”. Everyone had a leaflet through the door talking about “changes” when it meant “closures”.

In the run-up to the election, I did several hustings where I warned that maternity was next for the chop at Ealing hospital. Again we were told that we were scaring people and that it was a scare story, but on the other side of my election that closure sadly came to pass. One of the first things I did as an MP was table an early-day motion about it, which my hon. Friend the Member for Ealing, Southall signed. I think my right hon. Friend the Member for Islington North (Jeremy Corbyn) was the first non-Ealing MP to sign that early-day motion, which asked for the Government to think again and condemned the closure.

As my hon. Friend the Member for Ealing, Southall pointed out, Ealing is a young borough. It needs maternity services. Those services closed at Ealing hospital in June, and paediatrics is next, because we cannot have a children’s ward without maternity services, and maternity is gone. There is a fear that there is a domino effect—that these things consequently happen one after another. It creates a climate of fear and uncertainty among the staff and the patients. Many of the mums who had births in the middle of last year were uncertain as to whether the maternity services would be there. The closures are demoralising and out of step with the needs of the wider west London area.

As an academic by trade, I believe in evidence-based policy, and the evidence is that Ealing borough has a population of 360,000 people and rising. That is as big as a city like Leeds. The borough needs accident and emergency services, maternity and a children’s ward. There was a meeting at Richmond House, which I think my hon. Friends the Members for Ealing, Southall and for Hammersmith (Andy Slaughter) attended, along with the Minister. It was a good meeting on the whole, but the PowerPoint we were shown confirmed that Charing Cross and Ealing will be downgraded to minor hospitals. The House of Commons Library confirmed to me this morning that the population of London as a whole is projected to rise to 10 million, so surely we need more capacity, not less.

The bill for the “Shaping a healthier future” reconfiguration programme keeps rising. I think it is £235 million at present. Some £35 million has been spent on management consultants, such as McKinsey and all those people. It does not look like good value for the taxpayer. We are living in an age where every pound of public money spent has to be justified, and the end result of this programme will be fewer acute beds and fewer hospitals, with A&Es in west London decimated. It is a bad deal all round. There is other evidence of that. I am not someone who likes to trot out loads of statistics, but waiting times are massively up at Northwick Park, which is seven miles away from bits of Acton in my constituency. In the immediate aftermath of the closure, it had the worst recorded A&E waiting times in England for six out of 15 months.

My hon. Friend the Member for Ealing, Southall has alluded to the Independent Healthcare Commission for North West London headed by Michael Mansfield, who is a respected QC and who has expressed concerns about the business case. Forget all the emotional stuff; he is looking at whether it is a good deal for the taxpayer, and he has called the business case “deeply flawed”. I pay tribute to the tireless work of Eve Turner and Oliver New, as well as to my constituents Arthur and Judy Breens, who have formed an organisation—it keeps changing names: it was Save Our Hospitals, then it was Save Ealing Hospital.

The petition, which was batted back by the Petitions Committee, talks about

“a peaceful occupation at the Maternity Wing Area”.

That is how bad things have got. It also states:

“Protests are growing and the anger is reaching boiling point amongst thousands of members of the community.”

These people were not political before this issue came up. It has politicised the chattering classes of Ealing behind their net curtains, not that I am dismissing people with net curtains. They are a completely valid form of internal decoration and I love them dearly. The issue has managed to inflame people who are not usually inflamed and who have never been on a demonstration.

[Mr Virendra Sharma]

I am sorry to intervene when my hon. Friend is in full flow, but it is important to make the point that the campaign is non-partisan. All the political parties on Ealing Council unanimously support it and more than 100,000 people signed the petition. Many hundreds of people actively went around their areas asking for signatures. It is important to understand that the campaign is not led by any political party.

[Dr Huq]

My hon. Friend puts it very well. I completely accept his point. The strength of feeling about this issue is palpable. It is a non-partisan thing; they are people who have never been on a protest march before.

Talking of protest marches, a couple of weeks ago I joined the junior doctors on the picket line outside Ealing hospital. Some of those people are in the Public Gallery today. We were last together on that day, so we have been reunited. Quite aside from imposing a contract on junior doctors—a contract is not a contract unless there is offer, acceptance and agreement—there are so many other issues with the junior doctors’ strike that should be raised here, such as the fact that they are patronisingly called junior doctors, as if they are the work experience person who makes the tea. They are very experienced people with years and years of clinical experience. Calling them junior doctors is almost a way of belittling them.

I raised the plight of those highly experienced, yet technically junior, doctors with the Prime Minister at Prime Minister’s questions recently. The Government’s equality impact assessment of the new contract shows that it discriminates disproportionately against women because childcare costs more at the weekend, and if weekend hours are counted as normal hours, women will have to pay. Again, the issue was batted back and just shoed away, which is disappointing because the Government’s own advice tells them about the costs. It feels as though junior doctors are being stretched ever thinner, and if something is stretched ever thinner, it can snap.

I wanted to be brief today because I have spoken many times on Ealing hospital both here and in the main Chamber. This morning I asked the Library staff whether they had a briefing pack on the 1.30 debate on Ealing hospital and they said, “Again? You’re always speaking on this. You had three hours on this subject on 24 March,” for which they did prepare a briefing. One would think that after umpteen debates, I would have said all I have to say on this subject, but the tale gets worse and worse.

I have mentioned before the cases of constituents facing long waits: for example, the Khorsandi and Anand families. The last time I faced the Minister in this Chamber, I mentioned my constituent Bree Robbins’s three-year wait for breast reconstruction. She was disappointed she did not get an answer last time, but maybe we can try again today. People have legitimate concerns.

Like my hon. Friend the Member for Ealing, Southall, for me Ealing hospital is personal. It is where I would have been born, but I was born in 1972 and it did not exist then. However, I remember that hospital going up with so much hope attached to it, and now I see it constantly being downgraded. As my hon. Friend says, the suspicion is that it is on the way out. I have been to the acute medical unit in the basement with my mum; I have been to the hospital as a mum; it is where in September 2014 my father breathed his last. So this hospital is not a hypothetical thing on a spreadsheet; it is something that I and family members use.

Recently, 11 north-west London Labour MPs, led by my hon. Friend the Member for Harrow West (Mr Thomas), signed a letter calling for the National Audit Office to investigate. There is a question of economics. We want the Minister to think again, consider the business case and halt the closure programme. The case simply does not add up.

As I said, I remember the hospital going up and I remember, as will my hon. Friend the Member for Ealing, Southall, several schools in the Borough of Ealing that were closed in the ’80s when rolls were falling. The place in Greenford—I cannot remember its name—where they send school governors on training courses is a disused school, but now schools in Greenford are having to be opened. The Priory Centre in Acton was a community centre in a disused school. Now it has been razed to the ground and a brand-new primary school built, because numbers are going up. The short-sightedness flies in the face of the evidence and ignores the fact that populations are rising.

I do not have any hospitals in my constituency, although I had several on the edges: Central Middlesex, where the A&E has gone, Hammersmith hospital, where the A&E has gone, and Charing Cross, in the constituency of my hon. Friend the Member for Hammersmith (Andy Slaughter), which is going to be downgraded. Although I do not have hospitals in my constituency, all those ones that were there on the edges are disappearing before our eyes, so I urge the Minister, who I know is a reasonable person and a London MP, to think again.

--- Later in debate ---

[Mr Virendra Sharma]

I thank the Minister, and I thank all my colleagues who have given their points of view on my side and supported what their local constituents want. I do not want to give the impression that we are only talking about hard-hitting, scaremongering practice; I am representing the true feelings at the grassroots—what people think of their services.

I, too, have experienced huge numbers of cuts in services, with a long waiting list, or people not getting appointments in time, or being sent home after hours of waiting, because a service cannot be given. There is a shortage of nursing and other staff members, so hospitals are unable to provide services. Northwick Park hospital, mainly used since Ealing hospital services closed down, has been declared to be the most inefficient hospital in west London. It came the very bottom of the league.

Something is therefore wrong, which is why we are making our points and asking the Minister to reconsider those values and to sympathise with those people who will be receiving the services on offer and with how they suffer the travelling and not knowing the system, which involves long waiting and not getting the services. In addition, there is sometimes a language problem for people from different communities without knowledge and experience of English.

I urge the Minister to reconsider, as my colleagues and I have requested. Again, I thank my colleagues and, in particular, my hon. Friend the Member for Ealing North (Stephen Pound), who unfortunately was unable to attend. He sends his support, of which he has spoken many times before.

Question put and agreed to.

Resolved,

That this House has considered services at Ealing Hospital.