Penrose Inquiry

Yasmin Qureshi Excerpts

Thursday 26th March 2015 Commons Chamber

[Jane Ellison]

That is a rather harsh response. It is worth noting that the terms of reference given by the Scottish Government to the Penrose inquiry do not make reference to compensation. Yesterday’s written ministerial statement referred to an amount that is specifically intended to help with transitional arrangements while the next Government consider how they might want to take forward the reform of the various payments systems. We explored that in the Backbench business debate.

The report runs to many thousands of pages and has considered all of the many documents and statements, as I set out. All the relevant documents held by the Department of Health on blood safety covering the period from 1970 to 1985 have been published, in line with the Freedom of Information Act, and are available on the National Archives website. As part of our response to Lord Penrose’s report, we are releasing all the relevant documents on blood safety that we hold for the period 1986 to 1995. The Government have been completely transparent and open about that, and given the inquiry all the documents it asked for. We are now releasing all the relevant documents, subject to that. Some of the issues the hon. Gentleman refers to are, I am afraid inevitably, because of the timing of this report, a matter for the next Government to consider in detail.

[Yasmin Qureshi (Bolton South East) (Lab)]

My constituent David Fielding has suffered as a result of this and his whole life has been ruined. I ask this Government and any successive Government to compensate these victims properly.

[Jane Ellison]

As I have said, those are matters for the next Government to consider. Compensation was not in the terms of reference of the Penrose inquiry, but it was important, given the extent of the inquiry, that we waited for it to report. Unfortunately, it has reported too late for us to be able to make substantial progress in this Parliament, but I am quite certain that the next Government, held to account by the next Parliament, will return to these matters as a priority.

National Health Service

Yasmin Qureshi Excerpts

Wednesday 21st January 2015 Commons Chamber

[Yasmin Qureshi (Bolton South East) (Lab)]

I wish to start by thanking NHS staff. I agree with the Secretary of State that they should be recognised for all their work, so I ask him to consider giving them the 1% pay rise that has been recommended by an independent body. That would be a real way of recognising all their hard work.

I wish to talk about the Royal Bolton hospital in my constituency; it is the third largest accident and emergency department in the north-west. Last year, it saw 114,510 people. A and E admissions numbered 26,267 and in 2013-14, elective operations stood at 14,865 and non-elective at 1,407. The staff—porters, cleaners, care assistants and clinical staff—do an excellent job in a very difficult situation. My hospital needs more resources.

As I attend regular meetings with the chief executive officer and the chair of the Royal Bolton hospital, I also often visit the A and E department to see the situation at first hand. Recently, the hospital declared a major incident when it could not take in 76 patients. By cancelling non-emergency elective operations, it managed to free 40 beds. However, as a consequence of cancelling those operations, it lost £600,000.

As the hospital will now no longer be able to meet the target of the clinical commissioning group, it will end up getting penalised as well. To meet that target, the hospital may have to resort to using private companies, which may cost it even more. Whichever way we look at it, the hospital stands to lose quite a lot of money. Over the past two years, it has had to make £40 million of cost savings, and it will have to carry on cutting in light of the demands that it is facing.

The main reason for the long waits in A and E was that many people could not get GP appointments or go to walk-in centres, so they had to go to A and E as a first port of call rather than as a last one. Secondly, many elderly and frail people could not be discharged, which then led to bed blocking. There were 94,046 acute delayed days last November, which then created even bigger blockages. The hospital is caught bang in the middle of the problem—there are problems at the start, before people go to hospital, and there are problems at the end, because people are not being transferred or discharged. That situation must change. One reason for the delays in transfers and discharges is the cut in the budget for social services and adult care. More than 300,000 people no longer receive state funding for social care.

In 2009-2010, the Labour Government spent 8.2% of GDP on the NHS, whereas in 2013-14, the figure was 7.9%. It is quite clear, therefore, that less money is going into the sector. It has been recognised in this Chamber that, with more people living longer and with growing health needs, that money has to go up. To say that nothing further can be done with regards to putting more finance into hospitals is completely wrong.

In Bolton, the local authority, the hospital and the clinical commissioning group are trying to work together. When I recently visited my local A and E, 17 cubicles were in full use and two people were on trolleys. The situation is not good enough, because Bolton is an incredibly large area, serving about 300,000 people. People from Wigan and other surrounding areas also use the hospital.

Another problem is the shortage of GPs and the fact that walk-in centres have been closed down. We know that we need at least another 400 GPs and more walk-in centres. If we had an increase in those areas, the problem would not be so acute. Finally, not enough nurses are being trained, which will lead to a big shortage. That is another tsunami waiting to happen.

[Mr Speaker]

I am immensely grateful to the hon. Lady.

A and E (Major Incidents)

Yasmin Qureshi Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

Those are exactly the kinds of initiatives that can make a big difference—indeed, they are recommended by the College of Emergency Medicine. Of course, the long-term solution is to ensure that people are better looked after at home so that they do not need to end up at the door of a hospital. That is why more proactive care by GPs—we plan to recruit 5,000 more GPs over the next five years—should mean that that becomes less of a pressure point.

[Yasmin Qureshi (Bolton South East) (Lab)]

The Royal Bolton hospital in my constituency yesterday declared a major incident. As of 1 pm yesterday, there were 53 people in the A and E department, 15 waiting for a bed, some for more than 12 hours, and a number of non-urgent operations were cancelled. I thank the hospital for all its hard work, because there have been problems for the past few weeks. I would like the Secretary of State to deal with the crisis by immediately reopening walk-in centres, because their closure is the reason so many people are going to A and E, and have proper funding given to local authorities so that they can put in place a proper health and social care budget for the elderly and vulnerable.

[Mr Hunt]

There have indeed been pressures at the Royal Bolton hospital, particularly in relation to bed capacity and intensive care unit capacity. All patients on the wards have been reviewed and discharges have been created—the plan was to discharge between 30 and 50 patients before the end of yesterday. We are doing a lot to support the hospital. It has been given £3 million in winter money, £350,000 to create extra bed capacity and £100,000 for extra A and E staff.

Oral Answers to Questions

Yasmin Qureshi Excerpts

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

We hope to have a public consultation on the matter. We are not seeking to restrict access to dialysis—far from it. We want to make it easier for people to access those vital services, and we have been putting more money into the NHS budget because we recognise just how important they are.

[Yasmin Qureshi (Bolton South East) (Lab)]

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

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

As we look forward to world AIDS day next Monday, the whole House will want to pay tribute to the 30 NHS volunteers who left for Sierra Leone at the weekend to help in the fight against Ebola. They stand for the very best of the NHS and make us all proud. Last week I formally launched the MyNHS website. It contains 395,000 pieces of information and is the first website of its kind anywhere in the world. It will help people compare vital information about the performance of their local hospitals, GP surgeries, councils, mental health trusts and residential care homes. It will be a vital way to ensure that patients are not kept in the dark about the quality of their NHS services.

[Yasmin Qureshi]

Further to the Secretary of State’s answer to the hon. Member for Worsley and Eccles South (Barbara Keeley), he must know that treating renal failure requires complicated, integrated care and that no one part of it can be separated. He must also know that there are 23,000 dialysis patients in the UK, and transplant patients have overlapping clinical needs. Handing responsibility for commissioning dialysis to commissioning groups is unacceptable, especially as it has been done without any consultation. Can he explain the rationale for all this, and will he meet me and colleagues from the all-party kidney group to discuss the matter?

Oral Hormone Pregnancy Tests

Yasmin Qureshi Excerpts

Thursday 23rd October 2014 Commons Chamber

[Yvonne Fovargue (Makerfield) (Lab)]

My constituent, the wonderful campaigner Marie Lyon, has doggedly pursued this issue, and I think we can fairly say that that has led to my hon. Friend getting this excellent debate. I am aware of two constituents who have been affected by this drug. Mr and Mrs Tilley’s son Stephen was born with brain damage, and when they asked for Mrs Tilley’s medical records, they found they were missing. This is not the first case I have heard about of records being lost or destroyed in this regard. Is my hon. Friend as concerned as I am about this apparent cover-up?

[Yasmin Qureshi]

I entirely agree with my hon. Friend about the cover-up.

We have recently discovered another document in the Kew archive: a letter from the 1960s about the minutes of a meeting of the General Medical Services Committee, in which Dr Inman was involved. It says that there was worry about a request by the Committee on Safety of Medicines that doctors should be monitoring adverse reactions to medication. Doctors were a bit concerned about that in case they might be liable for negligence actions. The minutes say that doctors should stop recording adverse reactions, and, even more significantly, that those who have recorded any such evidence should have it destroyed. That fits in with the constituents, including mine, who have said that when they, as parents, have gone to their doctors to get their records, they are somehow mysteriously missing.

A British medical director of British-based Schering Chemicals, which is a subsidiary of Bayer Schering in Berlin, urged the withdrawal of the hormone pregnancy drug primodos in 1969, but his plea was rejected by the company. In the same year, the author of a survey for the Royal College of General Practitioners also recommended the withdrawal of the drug, but he, too, was turned down. Until this day, Bayer has refused to take any responsibility.

Jason Farrell, the Sky News reporter I mentioned, has met the statistician, Dennis Cooke, who was contracted by Schering in the ’60s. In a report, of which he still has copies, he compared the increase in the sales of primodos with the number of recorded deformities in newborns, which, he says,

“show a rather alarming direct and strong correlation.”

Schering stopped promoting primodos in 1970, and prescriptions fell from 120,000 in that year to 7,000 by 1977, when it was withdrawn. National statistics show that birth deformities declined during that period as well.

Another person I want to allude to is Professor Briggs. Many times, whenever it has been contacted about this, Bayer has referred to the court case of 1982. It is important to explain to the House that the damage claims brought by the victims were discontinued in the 1980s because some of the medical witnesses defected to the defendants, Schering Chemicals, so the case had to be withdrawn. Some of the victims say that the so-called experts who went over to the Schering side had an interesting story. One of those was Professor Briggs. Some years after the case collapsed, The Sunday Times published an interview with Professor Briggs by Brian Deer, a journalist, in which he accepts that he had in the past “fabricated” studies and carried out

“scientific fraud on a large scale”.

That is on the internet and can be read by anyone.

On a CD that has been kept under lock and key—there is an injunction on it—Professor Briggs is heard confessing:

“Difficulties would be encountered if doubts expressed about hormone pregnancy tests were made public. These were exactly the same hormones as the contraceptive pill and would have cast doubt on the safety of hormones which would extend doubt on the safety of the Pill. This would have a major influence on worldwide family planning which could be a real human disaster. It could cause panic among millions of women worldwide which could result in thousands of pregnancies.”

Later he claims:

“Drugs such as these would never be allowed to be on the Market today, given what we ‘now know’ and following what we know about Potential Hazards to the developing Foetus.”

Those comments were made in a documentary called “The Primodos Affair”, which has never been aired because Schering took out an injunction. Why did it do that? What did it have to hide?

There is further curious evidence regarding other witnesses. Dr Smithills approached a drug company for which he was doing research work on the drug Debendox. He suggested that he would approve the drug and that a funded research project would be an appropriate reward. Dr Inman opened a research centre soon after the case, after he left the Committee on Safety of Medicines. And guess what? Professor Briggs also opened a research centre in Australia soon after the case.

I have no hesitation in saying that those witnesses were bought off by Schering. It is amazing how all of them ended up opening research centres, which, as everybody knows, costs money.

Obviously, the situation is not this Government’s fault, but no Government have taken action over the years. Given the weight of evidence, why did the regulators not warn the doctors? According to internal correspondence from the Committee on Safety of Medicines, it admits that it has

“no defence for the 8 year delay”.

Interestingly, the authorities in Sweden, Finland, Germany, the USA, Australia, Ireland and Holland issued warnings and took action on the drug as early as 1970, five years before any warning was issued in the UK, despite the fact that the first group that knew about the problem was the Committee on Safety of Medicines.

One of the things thrown at the victims is the claim that there is no link, but there is a link: so many statistics show a correlation and so many doctors saw what happened. There seems to have been a complete failure on the part of the body appointed to monitor medication. It could have taken action but failed to do so, so the Government of the day were culpable.

Interestingly, Schering discontinued the product and stopped using it for pregnancy tests. Surely that suggests that something was wrong with the drug; otherwise, it would not have been taken off the market.

It is said that justice delayed is justice denied. We have found out in recent years about cover-ups in relation to so many tragedies, including thalidomide, Hillsborough and the sexual abuse of children in care homes and institutions. The 1960s and ’70s seem to have been an era of cover-ups, wherever we look, and victims in those cases campaigned for years and years to get an inquiry. The case under discussion has been going on for 30 to 40 years. Is it not about time for the victims—there are thousands of them—to get the justice they deserve?

[Nick de Bois (Enfield North) (Con)]

I congratulate the hon. Lady on the work she has done to secure this debate and her work with campaigners. She is drawing a contrast between this and previous cover-ups. To support her point, I should like to point out that, in this new age of transparency, we seek not a public inquiry but an independent panel, which should be well within the Government’s gift.

[Yasmin Qureshi]

I entirely agree with the hon. Gentleman. I thank him for all the support that he has given me and all the work that he has carried out in the campaign on behalf of his constituents.

I want to end by paying tribute to Marie Lyon, who has already been mentioned, and the victims association for all its work, as well as hon. Members who have given their help and assistance. I want to name-check two hon. Members who, because of their positions, are not able to speak in the debate: one is my hon. Friend the Member for Garston and Halewood (Maria Eagle), who is in the Chamber; and the other is the Minister for Government Policy and Chancellor of the Duchy of Lancaster, the right hon. Member for West Dorset (Mr Letwin), who is not here today.

--- Later in debate ---

[Yasmin Qureshi]

I thank all the hon. Members who have spoken in the debate today. I particularly thank all the members of the all-party parliamentary group on primodos, all those who signed my early-day motion and everybody who participated in the petition that was presented to No. 10 Downing street. I also thank the association.

I should also mention a couple of other people. My hon. Friend the Member for Hayes and Harlington (John McDonnell) mentioned Valerie Williams, who campaigned on this issue many years ago. When my constituent Nichola Williams first contacted me I went to see her at her home. At first glance, she appeared to have nothing wrong with her. It was only on talking to her that I found out about all the internal damage that she has.

The campaigners have found a raft of documents that I went through with my researcher and my office. We thought that something was very wrong and that there had been a miscarriage of justice, and that is why we started the campaign. I am glad that after two years we have finally received an undertaking from the Government that they will appoint an independent panel to look not only at the documents held by the Department, but all the documents that we have. We have a lot of information that we think shows a medical and legal cover-up.

On the causal link, the Minister said that the victims’ association will be consulted. Every lady who took primodos said that it was the pregnancy during which they had taken that drug that resulted in abnormalities in children. Other children those same ladies went on to have were perfectly healthy—in those pregnancies, no primodos had been taken. This is important research and it needs to be looked at.

The Minister said that the numbers of victims may not be in the thousands. It is fair to say that as the campaign has gone on over the past two years, with limited coverage and publicity in my local newspaper and in the national media, I have received letters and e-mails from more and more people coming forward and saying, “This is what happened to us.” I think there are a lot more people out there. Perhaps this is something the independent panel can look at, because we think there are many more people who are unaware of what is happening.

I thank the Minister for what he has said at the Dispatch Box, which is that he will release and look at the documents, set up an independent panel, work with the victims’ association and also look at our documents.

[George Freeman]

What we might do is set up an expert working group and invite one or two patients’ representatives from the victims’ association to sit on it. If hon. Members are happy, I will write around with a suggestion for how we might do that. I want to just remind the House that those from the Medicines for Women's Health Expert Advisory Group are independent experts in their field. They currently advise the Commission on Human Medicines on issues relating to medicines for women’s health. All members must fully disclose any conflicts of interest and are disbarred from any discussions of issues where they hold a personal interest. I think the House can therefore be confident that these are independent experts. If we set up an expert working group and have patients on it, that should give the House confidence that victims’ and patients’ voices will be properly heard.

[Yasmin Qureshi]

I thank the Minister for that reassurance. I am sure that those from the victims’ association who are watching the debate will be reassured too.

I thank the Minister again for what the Department has offered to do. We hope it will be done speedily and that there will be a resolution. As we know, many of the victims are now approaching their 40s and 50s. Their medical conditions are worsening and some have died. It is important that they understand what has been happening. They have never, ever asked for this—they have never even suggested it—but perhaps after the investigation we could think about some kind of financial settlement or compensation. As I have said, this is something that I am saying. I think that that would be only fair after all their suffering.

Finally, I have spoken in the Chamber from time to time, but today is the first time that, when I came into the Chamber, I got a little butterfly in my stomach. It reminded me of when I was a barrister before I became a Member of Parliament. I would have that feeling when going into court for a special case of particular significance. When I came in I almost felt that I was going to present a legal case to ask for—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. Does the hon. Lady intend to talk her own proposal out? If not, perhaps she should allow me to put the question now.

Question put and agreed to.

Resolved,

That this House notes that children were born with serious deformities due to hormone pregnancy test drugs taken by expectant mothers between 1953 and 1975; also notes with concern that as the surviving victims enter their forties and fifties many of them face a host of new problems as their bodies continue to suffer; further notes that no official warnings were issued about these drugs until eight years after the first reports indicated possible dangers; further notes that some doctors continued to prescribe the drugs for pregnant women after official warnings from the Committee on Safety of Medicines; calls on the Secretary of State for Health to fully disclose all documents relating to the use of Hormone Pregnancy Tests held by the Department from the period between 1953 and 1978; and also calls on the Secretary of State to set up an independent panel to examine these documents.

Obstructive Sleep Apnoea

Yasmin Qureshi Excerpts

Tuesday 2nd September 2014 Westminster Hall

[Julie Hilling]

I thank my hon. Friend for that intervention. It feels as though she has looked at my speech, because I am going to cover in detail a number of the aspects that she has raised.

OSA can reduce a person’s ability to work and impair the quality of life of the person and their family. The story of Steve, one of my constituents in Bolton West, shows only too well what can happen when OSA is not diagnosed. When Steve was 36, he started to get lots of daytime sleepiness; indeed, he was sleeping all the time. He became very aggressive and went to his doctor, who treated him for depression. The first medication did nothing, and the second medication made him even more aggressive. He managed to maintain his job, but with great difficulty, often having to slope off for a sleep, and he was being threatened with dismissal. He did not have a relationship with his young daughter; between the ages of four and six years old, she had no relationship with her dad at all. He could not play with her or interact with her, except to snarl at her. Indeed, he did not have a relationship with his wife or anyone else at that time. The family went on holiday, but his wife said that she would never go away with him again because he slept the whole time. Eventually, he had to take sick leave from work, and for five months he never left his bed. He was so bad that his wife had to change the bedclothes around him. He had a constant headache and felt worthless as he was not contributing anything to society or his family. He could not eat properly and just could not function. He attempted suicide twice.

Steve was referred to a mental health consultant at Royal Bolton infirmary who immediately asked whether he had been tested for sleep apnoea and he was referred to Wythenshawe sleep clinic. There are three stages of sleep: a top layer, a lower layer and deep sleep. The sleep clinic discovered that every minute and 43 seconds, Steve went back to the top of the sleep cycle and was never getting into a deep sleep. He was given a continuous positive airway pressure—CPAP—machine. He went home, slept for 11 hours and was back at work the next day. Eight years later, he still uses the machine every night and has never looked back. It does have its downsides. He will not go abroad because he has a great fear of electricity cuts and he cannot sleep in the same room as his wife because of the noise of the machine, but he believes that that is a small price to pay for getting his life back. Steve feels like he suffered two years of torture. Let us not forget that sleep deprivation is listed as a proscribed method of torture. However, with a very low cost treatment, he can now function and live life to the full.

My friend’s sister, 52-year-old Jean, also had difficulty in getting her GP to take her issue seriously. She went to him because she was very tired all the time and kept falling asleep in work and on the bus home. She would go to bed and sleep all night, but wake up feeling just as drained and tired. After three visits, her GP started to take her problem seriously and, after running a number of tests with no result, referred her to Wigan infirmary. She got an appointment within three weeks, had her sleep monitored and then got a CPAP machine. It has not solved her problem completely, but it has much reduced the number of times she wakes up and she is able to enjoy life again.

[Yasmin Qureshi (Bolton South East) (Lab)]

I congratulate my hon. Friend on securing this Adjournment debate. On the point that she raises about how long it takes for people to be diagnosed, is it not correct that about 1.5 million people in this country probably suffer from this condition, but only about 330,000 people are ever diagnosed? Presumably, therefore, one thing that we need to do is to make medical practitioners aware that this condition is perhaps a lot more prevalent than we think it is.

[Julie Hilling]

I thank my hon. Friend for that intervention. She is right. We need to make both the public and medical practitioners aware. Also, we need to ensure that the services are in the right place. I will talk more about that in a moment, but first let me tell hon. Members about one more person. My office manager, Noelene, also surprised me by saying that she suffers from OSA; I never had any inkling that she did. She has an underactive thyroid and was extremely tired and forgetful. She would have no recollection of doing something or no memory of how she had got somewhere. She just blamed her thyroid, but her endocrinologist told her that her thyroid levels were fine and that she could not keep blaming everything on her thyroid. He referred her to his friend the sleep specialist. She collected a monitor that afternoon and less than four weeks later was given a CPAP machine. As the specialist said, if the mask works, it is OSA, and if not, it is something else and they will have to continue to investigate. She had problems with the mask initially and found it very uncomfortable but persevered. She could not get on with the full mask, because, as she said, a full mask and hot flushes are not a great combination, so she tried two other masks and now has a nose mask. Occasionally she does not use it, but immediately feels bad. She is now four years on from diagnosis and treatment.

I guess I am not surprised that I did not know that people had the condition, because snoring and falling asleep all over the place are still treated as a great joke, and the first reaction of most of us when we are told that we snore is immediately to deny it. The cost of undiagnosed sleep apnoea is enormous, however. Up to 80% of cases of OSA remain undiagnosed. Awareness of the condition is poor, and the risks associated with it are underestimated even by doctors. The British Lung Foundation led a three-year project to raise awareness of the condition and to campaign for the setting of quality standards for the treatment and care that OSA patients can expect. The OSA patients’ charter, published in 2012, was designed to do that, and it calls on the Government to prioritise OSA by increasing awareness, ensuring adequate data are collected for good service planning and investing more research into the condition.

Progress has been slow, however. The British Lung Foundation commissioned a report on the health economics of OSA, which will be published later this week, to demonstrate the economic and social arguments for greater focus on, and treatment of, the condition. The report finds that treating OSA can generate direct health benefits to OSA patients, and reduce costs incurred by the NHS, in comparison with not treating the condition. Currently, only 22% of OSA patients are treated across the UK, but increasing diagnosis and treatment rates to just 45% could yield an annual saving of £28 million to the NHS, as well as 20,000 quality-adjusted life years. That includes savings that result from reductions in road traffic accidents, heart attacks and strokes, as well as the positive impact on patients’ quality of life and improved survival rates over time. Other sources suggest that NHS expenditure on undiagnosed patients is estimated to be approximately twice that of people of the same age and the same gender. It is estimated that if everyone in the UK with moderate to severe OSA was treated, approximately 40,000 road traffic accidents could be prevented—accidents that not only affect sufferers of OSA, but cause injury and death to so many others.

The main treatment for OSA, continuous positive airway pressure, is very cost-effective. NICE usually values a treatment as cost-effective if it costs £20,000 to £30,000 per quality-adjusted life year gained, but the main treatment used for OSA costs the NHS only £5,000 per quality-adjusted life year gained. Because OSA is associated with other conditions such as heart disease, stroke and diabetes, some savings may also be made in the reduction of medication for those conditions. A Canadian study found that 38% of patients being treated for OSA reported a reduction in their intake of medicines to manage their other conditions.

What do we need to do? In July 2012, the Department of Health set up a working group on OSA to look at areas for improvement in care and services for the condition. However, the group was disbanded early in 2013 during the NHS restructure, and no one is responsible for taking forward the recommendations from the group’s work. The Department of Health should appoint a body to take forward those recommendations. In 2012, NICE was asked to produce a quality standard on sleep-disordered breathing. That has not been developed, and it should be taken forward as an immediate priority so that those with OSA know what to expect from their care.

Everyone who has symptoms of OSA should be diagnosed quickly and accurately, and they should receive the highest standard of care. That will help to reduce NHS costs and improve patients’ quality of life, and it could reduce the number of road traffic accidents that are caused by sleepy drivers. The level of risk of OSA varies across the UK depending on the prevalence of risk factors, and there is a mismatch between the geographical distribution of need and the regional distribution of services. Local commissioners must ensure sufficient availability of services in areas such as Bolton West that have a high estimated OSA prevalence. OSA screening and specialist referral should be introduced into the quality outcomes framework. Doing so would allow for more accurate data on the number of referrals being made from primary care and provide an immediate financial incentive for early intervention that would reduce costs and improve outcomes in the long term.

Finally, let me return to where I started on my journey of interest in OSA. Those who drive for a living, frequently on monotonous roads and motorways, are at risk of falling asleep at the wheel. Their lifestyle also puts them at increased risk of developing sleep apnoea. Those who fear that they have the disorder are often worried about seeking treatment, because they are concerned about losing their livelihood. I hope that the Minister will support the call of the sleep apnoea partnership group to expedite the treatment of vocational drivers so that they can be driving again within four weeks of referral.

Hospital Car Parking Charges

Yasmin Qureshi Excerpts

Monday 1st September 2014 Commons Chamber

[Yasmin Qureshi (Bolton South East) (Lab)]

I congratulate the hon. Member for Thurrock (Jackie Doyle-Price) on securing this debate. I start with the point on which she finished, which is that the NHS is supposed to be free at the point of use. When we set sometimes exorbitant charges at different hospitals, we are effectively taxing the ill and their families.

Members have talked about the families of patients in hospital for the long term, with all the costs involved for relatives who visit them. This is honestly not a party political point, but in 2009, when my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown) was Prime Minister, the Labour party suggested that those who had family members in hospital for a long time should get special permits to enable them to visit without having to pay each time, but that was scrapped in 2010 when the current Government came in. I ask them to reconsider that proposal. One way in which they could act very positively would be to have a similar provision such that the family of those in hospital for the long term can get and use special permits. That would certainly deal with the problem of the long-term ill.

There is another group of people whom we have not mentioned. We now have an elderly population and most older people have not just one health issue, but several health complications, so they often end up having to go to hospital to see consultants and doctors for six, eight or nine different illnesses or health issues. Each time they go, they or the person accompanying them has to pay hospital parking charges.

I give the example of my mother, who is 82 years of age. She has several different health issues, and every time I take her to my local hospital—I am her carer—it costs £3, just for five or 10 minutes. I am in the privileged position of being able to afford that, but there are many people in my constituency, who have caring responsibilities for adult and often elderly family members, who may only be on the minimum wage.

[Lilian Greenwood (Nottingham South) (Lab)]

Does my hon. Friend agree that for the many elderly people who do not drive, public transport is a really important issue, just like parking charges? Is she aware that Queen’s medical centre in Nottingham is soon to have the first dedicated hospital tram stop, which will improve access for older and disabled people in particular?

[Yasmin Qureshi]

I did not know about the Nottingham tram, but I am pleased that people there will have a tram stop to deal with the problem. Something like that would be brilliant in my constituency. There is a bus that goes to my hospital, the Royal Bolton, but because of its location the service is not frequent, so getting there is quite difficult. Such public transport solutions can help people as well. My hon. Friend is absolutely right that many older people cannot drive, so they also have that challenge.

Perhaps we do not think enough about the number of appointments most older patients have, as do those who are generally ill and have to go in and out of hospital for appointments numerous times. The way forward may be to abolish car park charging full stop, so that a scheme can be applied nationally. The minute we have a discretionary system and leave each hospital trust to decide for itself, some—perhaps because where they are located means they have a large parking space—can charge a small amount, such as 50p, while other hospitals that lack space because of where they are must charge a bit more. Leaving things to discretion means having, as everyone says, a postcode lottery. A better solution might be to make special dispensation, across the whole country, for those going to hospital appointments or those who are in hospital for some days.

Although I have a legal background, I am not normally an advocate for a lot more law, because it is not always a good idea to have loads of legislation. In this case, however, it is worth thinking about having legislation or a directive with the even more novel approach of abolishing such charges altogether. At the end of the day, nobody goes to hospital for pleasure; they go out of necessity and because they are unwell. Therefore, a hospital that raises £500,000 or £1 million, with all the budget it has—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order.

NHS

Yasmin Qureshi Excerpts

Wednesday 5th February 2014 Commons Chamber

[Margot James (Stourbridge) (Con)]

rose—

[Yasmin Qureshi (Bolton South East) (Lab)]

rose—

[Andy Burnham]

I will make a little progress and then I will give way.

There have been record levels of hypothermia this year and thousands of over-75s have been treated in hospital for respiratory or circulatory diseases. That brings me to the second underlying cause of the increase in attendances at A and E. The ageing society is not a distant prospect on the horizon. Demographic change is happening now and it is applying increasing pressure on the front line of the NHS.

We all need to face up to the uncomfortable fact that our hospitals are increasingly full of extremely frail elderly people. Too many older people are in hospital who ought not to have ended up there or who are trapped there because they cannot get the right support to go home. That situation is unacceptable and it has to be addressed.

[Andy Burnham]

The hon. Lady wants me to answer that question, but I direct her to her right hon. Friend, the Chairman of the Health Committee, who has dismissed the self-serving spin from the Government that says that these problem are all to do with a contract that was signed 10 years ago. I began my speech by citing figures that show an exponential rise in the number of people attending A and E since 2010. Many of those people are very frail older people. That is the issue before the House, so it does not help the debate for the hon. Lady to stand up and make a spurious political point.

[Yasmin Qureshi]

Is not one of the reasons why more elderly and frail people are going to hospital that there has been a £1.8 billion cut in adult social services and support? Those people are ending up in hospital because they are not receiving the care that they need at home.

[Andy Burnham]

My hon. Friend is absolutely right. I will come on to say that the single most important underlying cause of the A and E crisis is the severe cuts that we have seen to adult social care. That has created a situation in which older people are trapped on the ward and cannot go home because there is not adequate support at home. That means that A and E cannot admit to the ward because the beds are full. Hospitals are operating way beyond safe occupancy levels. Because of that, the whole hospital begins to jam up and the pressure backs up through A and E. When A and E cannot admit to the ward it becomes full, so ambulances queue up outside because they cannot hand people over to A and E.

That is exactly what is happening in our NHS at the moment. A and E is the barometer of the whole health and care system. If there is a problem anywhere in the system, it will be seen eventually as pressure in A and E. That is what is happening. The simplistic spin from the Conservative party, which says that it is all to do with a GP contract from 10 years ago, is discounted by expert after expert.

--- Later in debate ---

[Andy Burnham]

I agree with the hon. Gentleman. There are examples of good practice out there, but I suggest that he speaks to chief executives of clinical commissioning groups and trusts. They are telling me that the competition regime introduced by his Government is a barrier to that kind of sensible collaboration. The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive. Does the hon. Gentleman support that? Is that what he thought he was legislating for when he voted for the Health and Social Care Act? People are being held back from doing the right thing for fear of breaking this Government’s competition rules.

Recently, we heard of two CCGs in Blackpool that have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.

[Yasmin Qureshi]

My right hon. Friend might be aware that recently the trust in Bournemouth wanted to merge with neighbouring Poole trust, but the competition rules stopped the merger taking place.

[Andy Burnham]

My hon. Friend is right. For the very first time in the history of the NHS, competition intervenes to block sensible collaboration between two hospitals seeking to improve care and make savings. Since when have we allowed competition lawyers to call the shots instead of clinicians? The Government said that they were going to put GPs in charge. Instead, they have put the market in charge of these decisions and that is completely unjustifiable. The chief executive of Poole hospital said that it cost it more than £6 million in lawyers and paperwork and that without the merger the trust will now have an £8 million deficit. That is what has happened. That is not just what I say; listen to what the chief executive of NHS England told the Health Committee about the market madness that we now have in the NHS:

“I think we’ve got a problem, we may need legislative change…What is happening at the moment…we are getting bogged down in a morass of competition law…causing significant cost and frustration for people in the service in making change happen. If that is the case, to make integration happen we will need to change it”—

that is, the law. That is from the chief executive of NHS England.

--- Later in debate ---

[Jeremy Lefroy (Stafford) (Con)]

First, I want to praise all those who work in accident and emergency departments up and down the country to provide a vital full-time 24/7 service locally and nationally. Many Members have already pointed out that it is almost a year since the Francis report was published. Its reception in the House demonstrated one of the best examples of cross-party respect from the Prime Minister and the Leader of the Opposition and, subsequently, from my right hon. Friend the Secretary of State and the shadow Secretary of State. I would like to see that cross-party support being built on.

I should also like to praise the Secretary of State for the work that he has done to take the recommendations forward. He has mentioned some of them today, including those relating to the chief inspector of hospitals, to social care and to general practice. Many more aspects of the report have already been mentioned, and there will no doubt be more to come. I must stress, however, that we need to have a proper debate on the Francis report now, one year on, in Government time in the House, to see where we have got to.

I also pay tribute to all those people who did the work that enabled the Francis report to come about. They include Julie Bailey, Helene Donnelly and the many others who worked with Cure the NHS, and all those in Stafford hospital who have subsequently responded to the report to make the hospital a place that I am proud to say now provides some of the best care in our region, including those in the A and E department. We have, however, lost our 24/7 A and E department; we now have a 14/7 A and E department. That is something that we are going to have to look at again; we need to look at how we are to cover the out-of-hours emergency care in our area. Nevertheless, we now have some of the best A and E care in the region, because it is consultant led. We now have sufficient consultants to cover that service.

I want to make four points that I believe need to be taken fully into account in this debate on A and E services. The first is about doctors. The Secretary of State has already mentioned the problem with recruiting people into emergency medicine. It is not seen as the most attractive career, perhaps because of the shift work involved. We need to look at the whole training structure. Perhaps it would be better for trainee doctors to spend more time in accident and emergency departments in their foundation years. Perhaps we should add a third foundation year in order to enable them to spend more time in A and E, because that is surely where they will learn most about this kind of medicine.

We also need to look carefully at the role of specialisms in the NHS. Although that would be the subject for a whole other debate, it is very important, because we have more than 60 specialisms in this country, compared with about 20 in Norway. Their increasing role means there is a need to maintain a full-time specialist rota of up to 10 consultants, which is placing increasing stress on the finances of the NHS. That is true in A and E, as elsewhere. That is a subject for another day, but it is a very important point.

Another area to mention is demographics, although I will not go on at length about it because the facts are known to us all. In Staffordshire, we are expecting the number of over-85s to double and the number of over-60s to go up by 50% in the next 25 years. There is no doubt that we have reached a tipping point, particularly as the baby boomers enter their retirement years, and that is not recognised. It is not just a straight line graph; there is a bit of exponential growth in the number of older people now coming in to our hospitals. That is to be expected.

[Yasmin Qureshi]

I agree with everything the hon. Gentleman has said so far. Will he also consider the fact that A and E waiting time rises have also been caused by: the effect of walk-in centres closing; the closure of NHS Direct and its replacement by the botched 111 system, which has not helped anyone; and a real cut in adult care, which has meant that a lot of elderly people have been taken to hospitals, instead of being cared for at home, and they cannot be released unless they have somewhere safe to go to?

Oral Answers to Questions

Yasmin Qureshi Excerpts

Tuesday 16th July 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

My hon. Friend is absolutely right to highlight such initiatives. That was why the Government, as part of the Health and Social Care Act 2012, set up health and wellbeing boards, which bring together housing providers, the NHS, the third sector and social care locally so that they can look at how to improve and better integrate personalised care, especially for the frail elderly.

[Yasmin Qureshi (Bolton South East) (Lab)]

T2. In the 1960s and 1970s, the drug Primodos was given to pregnant women, resulting in serious birth defects in thousands of babies, who are now adults in their 40s. The then Committee on the Safety of Medicines failed to act in time, the scientist at Schering, the drug manufacturing company, accepted subsequently that he had made up his research, and the solicitor Peter Todd has described the events as the biggest medical and legal cover-up of the 20th century. Will the Secretary of State meet me and the victims of Primodos so that we can present our evidence on what has happened?

[Dr Poulter]

The hon. Lady is right to highlight the fact that when we have scientific and clinical data, they must be used responsibly, as the MMR scandal also indicated. Of course I would be delighted to meet her to talk through this matter further.

Accident and Emergency Waiting Times

Yasmin Qureshi Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

The system is dysfunctional, and at the heart of the problem is Labour’s creation of a system in which GPs lost round-the-clock responsibility for the patients on their list. That is fundamentally wrong and we need to deal with it.

[Yasmin Qureshi (Bolton South East) (Lab)]

Today’s debate is about the increase in waiting times at accident and emergency departments. In 2010, when Labour left office, 98% of people were seen within four hours; three years later, after three years of Conservative Government, the number of people who have to wait more than four hours has trebled. What is the Secretary of State going to do about that?