Oral Answers to Questions
Alistair Carmichael Excerpts(7 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Speaker
Hoping for an un-lawyerlike brevity, I call Mr Alistair Carmichael.
Mr Alistair Carmichael (Orkney and Shetland) (LD)
The Minister of State, Department of Health (Mr Philip Dunne)
The NHS currently employs 21,030 nurses from the EU—6.6% of the total number of nurses in the workforce—while a further almost 90,000 EU citizens work in the social care sector across the UK. They all do a fantastic job, and we have been clear that we want them to be able to stay post-Brexit.
Alcohol Consumption Guidelines
Alistair Carmichael Excerpts(7 years, 10 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Byron Davies
I am grateful for that guidance, Sir Alan. The proposed new guidelines do not reflect the full international evidence base on alcohol and health, and actively downplay decades of epidemiological evidence that shows the protective effects of low to moderate drinking against cardiovascular disease, stroke, type 2 diabetes and cognitive—
Byron Davies
If the right hon. Gentleman will forgive me, I really need to move on.
To quote a no less august body than the Harvard T.H. Chan School of Public Health in the United States:
“More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk.”
The US Government’s National Institute on Alcohol Abuse and Alcoholism supports that position.
One crucial point is not scientific, but about responsibility. I am a proud Conservative. Therefore, like most sensible people, I believe that, by and large, people can make their own decisions about their lives. I am not advocating that people go out and smoke 100 cigarettes, drink heavily, eat mountains of butter or consume mounds of sugar. However, if people want to enjoy the company of their friends with a fine pint of British beer that has been brewed using British ingredients following a fine art that has been honed carefully over our history, who are we to stop them? The medical advice I have listed remains clear indeed.
Curtis Ellison is professor of medicine and public health at Boston University School of Medicine, and director of the International Scientific Forum on Alcohol Research. He says:
“Statements suggesting abstinence is better than light drinking in terms of health and mortality are erroneous and do not reflect current scientific literature, with well-conducted studies showing that mortality is lower for light-to-moderate drinkers than for lifetime abstainers.”
As a nation, we have always believed in the fundamental good sense of the British people and, although my confidence was shaken by last week’s events, we have allowed people to decide what is best for their own lives. The pub is a crucial part of the social and cultural fabric of the UK. There are few things that are as crucial a part of our identity and history as the casual, relaxed pub culture that Britain has enjoyed over hundreds of years. Indeed, the importance of the pub—casual and social drinking—to people’s mental and physical wellbeing is marked.
The Oxford University and CAMRA-instigated report, “Friends on Tap” acknowledges the benefits of pubs to wellbeing. By telling people there is no safe level of drinking, we could be denying millions the positive social effects of going to the pub and the positive effects on the community. The results from the pub surveys suggest that people who go to small community pubs have more close friends and feel that their communities are better integrated. Indeed, small community pubs are now vital in supporting community services.
Pub is The Hub has supported many pubs across the length and breadth of the UK to stay open, become community owned and offer vital services. The services on offer include internet lessons and provisions, restaurants, post offices and shops. The pubs have been transformed into a social hub and are providing services that are vital to communities’ very survival. I fear that alarmist advice threatens not only pubs but the threads with which our communities are weaved together.
To further support my case, the findings of Oxford University suggest that pubs in general, and local community pubs in particular, may have unseen social benefits. Pubs provide us with a venue in which we can serendipitously meet new and, in many cases, like-minded people. They offer an opportunity to broaden our network of acquaintances, which has advantages. There is a potential to translate acquaintances into new friendships and to widen our contact with a greater diversity of cultural groups by bringing us into contact with people from other walks of life and other cultures, whom one might never otherwise meet.
Pubs allow us to engage in conversation with, and get to know better, other members of our local communities. By extension, they allow us to mix, meet a wider range of community members, and interact with a greater diversity of social classes and cultures than would otherwise be the case if our social world was confined to work and home.
Closer to home and on the benefits of moderate alcohol consumption, Dr Richard Harding was a member of the Government’s 1995 inter-departmental working group on sensible drinking. In written evidence submitted to the Science and Technology Committee in 2012, he outlined the changes in available evidence since 1995, including the strengthening of the evidence base around the range of health benefits of moderate alcohol consumption. He said that the key findings are:
“Clear evidence that the frequency of drinking is as important as, or even more important than, the amount of alcohol consumed. All epidemiological studies show that the more frequent drinkers, including daily drinkers, have lower risks for many diseases than do individuals reporting less frequent drinking… Firmer evidence for the protective effect of moderate alcohol consumption for coronary heart disease, as well as further clarification of the mechanisms for the protective effect…Evidence for an approximately 30% reduction in risk for type 2 diabetes for moderate drinkers…Evidence that moderate drinkers have less osteoporosis and a lower risk of fractures in the elderly compared to abstainers…Evidence that light to moderate drinking is associated with a significantly reduced risk of dementia in older people…Increasing evidence that moderate drinking should be considered as an important constituent of a ‘healthy lifestyle’”.
Dr Alexander Jones of the University College London Institute of Cardiovascular Science says:
“There have been a couple of studies which showed that if they were randomised to either just eating a Mediterranean diet or eating a Mediterranean diet and drinking a glass of red wine a night, that those who drank a glass of red wine a night had better cardiac function over time.”
That international consensus is rejected at a stroke by the CMO’s proposed new guidelines in favour of a “no safe limits” narrative. The statement of no safe levels sends out confusing and contradictory messages to consumers and will serve only to generate public mistrust in the health service.
David Shaw, senior researcher at the Institute for Biomedical Ethics at the University of Basel says that
“the ‘no amount is safe’ message undermines the new recommended limit for men and the retention of the limit for women. Why should people attempt to adhere to the new limits rather than the old ones if they are also being told that the new recommended levels are not safe? Giving such a mixed message further increases the likelihood that the guidelines will not be taken seriously.”
Dr Augusto Di Castelnuovo, professor of statistics and epidemiology at the Institute for Cancer Research in Italy says:
“The new recommendation that there is no ‘safe’ alcohol limit is misleading: low to moderate consumption up to one-two units a day in women, up to two-three in men of any type of alcohol—with the possible exception of spirits—significantly reduces the risk of cardiovascular disease. Moderate drinking is associated with a modest excess risk of oral and pharyngeal, oesoph”—
I will forget that word—
“and breast cancers. But the balance between these two different effects is in favour of drinking in moderation.”
As well as concerns about the language of “no safe level”, considerable concern has been expressed about the communication to consumers of the level of risk associated with alcohol consumption. It is really important that we put risks in context so that consumers can make informed choices.
Ignorance of the international evidence has been heavily criticised by the Royal Statistical Society. In the key points in its response to the consultation, it states:
“We are concerned that, in their recent communications about alcohol guidelines, the Department of Health did not properly reflect the statistical evidence provided to the Expert Guideline Group, and this could lead to both a loss of reputation and reduced public trust in future health guidance…We are concerned that scepticism concerning the guideline process might apply to future pronouncements concerning arguably much greater health risks associated with inactivity, poor diet and obesity that, unlike alcohol consumption, are increasing problems. Once public trust has been lost, it is extremely difficult to win back, and you will have lost a key tool in managing future behavioural change.”
Those key points are on not just alcohol consumption but how we will view future medical advice from the Department of Health. The public must have confidence in our great institutions and be of the belief that they are serious and sober in their analysis while also realistic about people’s life choices and lifestyles.
We have worked so hard as a nation, with industry and Government working hand in hand to reduce serious problem drinking. Do not misunderstand me: I know there is some way to go on this matter and I am fully supportive of the efforts to curb problem drinking and tackle its health effects, but we must not remove industry from this process and we cannot let serious medical advice be tainted by alarmist and prescriptive guidelines that threaten to undermine the whole process we have embarked on.
Let me turn to the new CMO 14-unit weekly prescription for men and women, which would effectively make 2.5 million more of our male constituents problem drinkers overnight, classed as increasing risk from low risk by virtue of the fact that they might drink more than one pint a night in the pub. Immediately following this announcement, we saw The Guardian’s front page article asserting that as we now have in excess of 10.5 million people “drinking harmfully”, further regulatory interventions were needed. That was backed up by members of the Guidelines Development Group, including the chief executive of the Institute of Alcohol Studies. Job done—they moved the goalposts and scored straight away. But the established international precedent in 30 countries worldwide is that men and women are set different guidelines reflecting differences in alcohol metabolism due to body size and weight as well as the lower body water content and higher body fat content of women. Aside from the UK, there are only five other countries that recommend the same guidelines for men and women: Australia, the Netherlands, Albania, Guyana and Grenada.
Dr Erik Skovenborg from the Scandinavian Medical Alcohol Board and board member at the European Foundation for Alcohol Research said:
“I am surprised to see the same limits for weekly alcohol consumption for men and women, in spite of the well-established greater susceptibility of women. The danger is that the new guidelines will give women the false impression they are on a par with men in their ability to tolerate alcohol.”
The CMO told the Science and Technology Committee that the guidelines were primarily informed by new evidence on alcohol and cancer:
“the science has moved on...we know a lot more about the impact of alcohol on the development of cancer and on the risk of cancer”,
yet guidelines for women have remained the same, while guidelines for men have been reduced based on modelling of acute harms such as accidents and injuries. I simply cannot concur that that is sound medical advice on a number of levels.
Those of us who favour a partnership approach to these matters are very concerned that this triple lock—of proceeding with the language of “no safe level” in the face of international evidence to the contrary, of promoting the notion that men and women have equal tolerance levels to alcohol and of Britain needing to have the most stringent alcohol guidelines in the world, despite the positive recent developments in tackling alcohol harm—is a triple whammy that threatens to undermine the significant recent progress we have made, with industry and Government working together to tackle alcohol harm.
Brain Tumours
Alistair Carmichael Excerpts(8 years ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Alistair Carmichael (Orkney and Shetland) (LD)
It is frustrating to have to restrict my remarks to four minutes because this is a subject about which there is so much to say, but I am delighted to do so because the restriction is an indication of the widespread interest that this debate has raised. If the Minister takes no other message from today, I hope that he will leave the Chamber understanding that this issue is now well and truly on the agenda and is not going to go away.
My interest in this matter was first piqued when the daughter of a friend was diagnosed as having a brain tumour. Her sister emailed me today:
“At age 34, my precious sister Louise was diagnosed with a meningioma brain tumour in January 2012. I felt like my heart had been ripped out my chest when I discovered this. Nothing can prepare you for the shock of dealing with such news.”
She went on to describe the treatment:
“We did not know until she woke from this surgery if she would be able to speak again because of the location of the tumour. A terrifying experience for us let alone for Louise as a wife and mother of three children.”
Of course, that was a benign tumour and, as a result of the surgery, Louise has made a full recovery, but it gives some flavour of the human cost.
Another way in which this subject came to my attention was through a constituent in Orkney. Caroline Kritchlow runs the Friends of the Neuro Ward at Aberdeen Royal infirmary, and her husband also has a brain tumour. She is a remarkable fundraiser, having raised £120,000 for the neuro ward, and I am sure she is as frustrated as I am to hear that, yet again, after three years of delays, the refurbishment of that ward—it is the last ward at Aberdeen Royal infirmary to be refurbished—has had to be put off until next year. Perhaps those responsible for that decision will see something of this debate and take the obvious lesson to be learned, which is that there really can be no further delays.
The Minister has heard the hon. Member for Warrington North (Helen Jones) give a full exposition of the recommendations of the Committee’s report, which he should have. The recommendations run to three pages, and he should have them printed out, laminated and kept on his desk—they should never be far from his elbow. It would be fairly easy to make early progress on a number of the recommendations, such as on raising awareness among general practitioners, which would lead to a greater likelihood of early diagnosis. It will take longer to see the real change that we want on other recommendations, such as the recruitment of PhD students, which is an area where we see opportunity for change and where spending would make a real difference.
The Minister no doubt has a long queue of people outside his office all asking for more money. This is one instance, however, where we can say that any money spent will be transformative. Expenditure on such research will mean the change that we all want to see.
Contaminated Blood
Alistair Carmichael Excerpts(8 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Jessica Morden
My hon. Friend makes a fantastic point [Interruption.] And it is very well received. He anticipates the point I am coming to.
There was some hope last year when the Prime Minister made the much-needed apology for the contaminated blood disaster. He promised then to improve the financial support for the victims and their families. As he said, we are a “wealthy and successful country” and we should be helping these people more. There was some hope, and the consultation was launched into what the support should look like.
A year on, however, the victims have been let down again. Despite the headline announcement about the additional budget of up to £125 million in support, not a penny has been spent, as has been said. The majority of people currently receiving financial support will be worse off under the new scheme. Removing discretionary payments may mean that many lose to the tune of thousands of pounds a year. They will be significantly worse off than those affected in Scotland. Individual assessment could reduce financial security. Widows, partners and dependent children who have been bereaved will receive limited or no support. Lastly, the proposed reforms would just not deliver the sustainability and security the affected community so desperately needs. This is not the package that is needed. It is also not clear whether payments under the new proposals will be exempt from tax and benefit assessment.
What has been proposed is very different from what will be offered by the Scottish Government. For widows who have lost their loved ones, the difference is not just stark—the proposals are poles apart. I will leave it to SNP Members to elaborate on that, but the difference is very pointed.
Mr Alistair Carmichael (Orkney and Shetland) (LD)
Does the hon. Lady not accept that this is one occasion when there should be close working across the Administrations? I offer her the example of a constituent who was infected 35 years ago in Staffordshire. Although he has lived in Scotland for all that time, he will get compensation under the scheme devised by the Department of Health in England. Where is the sense in that?
Jessica Morden
I thank the right hon. Gentleman for his intervention. He is absolutely right and I am sure he will get the chance to elaborate on that point later. For parents and families who have gone through the trauma of losing a child like Colin, there is nothing at all.
Nigel Mills is here from Wales today and he is now receiving a new treatment for hep C. He has been able to access that treatment, although, mercifully, his condition has not resulted in cirrhosis of the liver. All those in Wales who developed hep C and could benefit from those new drugs are now receiving them. The Haemophilia Society is very anxious that all those in England who could benefit should have access to them and that funding for new treatment should not be diverted to cover existing treatments.
How many times do we keep having to tell these very personal stories, and how many times do we keep having to call these debates and table questions? How many times do victims have to come to London to lobby MPs? The Haemophilia Society has responded fully, highlighting the weaknesses in what is being proposed and saying that the consultation should be withdrawn.
I ask the Minister please to reflect deeply on this, because what is proposed does not meet the needs of widows, partners, parents, children and those affected. But she should not reflect on it for too long: this has been an ongoing nightmare since the 1970s for thousands of families. The Government cannot bring back the dead or restore health, but they can award a package that will ensure that survivors and families are secure. The apology was a step forward, but let us not prolong the agony further for those who have suffered for far too long. Please listen to this campaign and give the campaigners what they deserve. Please right the wrong.
Mental Health Taskforce
Alistair Carmichael Excerpts(8 years, 2 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Alistair Burt
I thank my hon. Friend for her interest in this subject, which she had expressed to me previously, and her work on it. Yes, our determination is that the extra £1 billion a year that will be spent on mental health services will cover the training and the commitment that we have made to 24/7 cover. It is very important that such cover is there. The issue was identified when the Care Quality Commission looked at the work of the mental health crisis care concordat, which has been so successful in its first 12 or 18 months. I can assure her that I am determined to ensure that we provide these facilities.
Mr Alistair Carmichael (Orkney and Shetland) (LD)
The report adds to the consensus that arose from Lord Crisp’s commission and the cross-party work led by my right hon. Friend the Member for North Norfolk (Norman Lamb) on ending the practice of out-of-area treatments. Will the Minister commit to putting a timetable on that process so that we might know when it will happen?