Rare Diseases Strategy

Andrew Bingham Excerpts

Tuesday 28th March 2017 Westminster Hall

[Ben Howlett]

I think the sector agrees on that point, from patient groups to the constituents whom the hon. Lady represents, as well as all the people with an undiagnosed condition who might access the services of that facility in future and many others throughout the country. The Government need to rethink the implementation and ultimately introduce an impact assessment on that basis.

I know that several hon. Members want to speak, so I will conclude by welcoming the commitment and dedication of this Minister and the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon, in providing a solution to our long-standing problems with the implementation of the rare diseases strategy in England. Following the publication of our report, I hope that the Minister will be able to provide clarity on the questions that I have asked. The UK is doing superb work and leading internationally on rare diseases.

[Andrew Bingham (High Peak) (Con)]

I commend my hon. Friend on securing this important debate. My constituent Will Newman contacts me regularly about his granddaughter Ellie, who lives outside my constituency. He wanted me to come to this debate and thank my hon. Friend and the Minister for the work that they are doing. We think that rare diseases do not affect many people, but those whom they affect, they affect hugely. Does he, like me, take heart from the Prime Minister’s words in September? She said at Prime Minister’s questions:

“We are committed to ensuring that patients with rare conditions get access to the latest medicines”. —[Official Report, 7 September 2016; Vol. 614, c. 334.]

As she also said, we are taking the necessary steps to get those to them.

[Ben Howlett]

I thank my hon. Friend for that intervention. He is a great champion for his constituents. I share his hope in the Prime Minister’s commitment, made at an early stage in her office, and in a Minister who obviously understands rare diseases, having one herself, and who has made a clear personal commitment to resolve the issue. Having worked alongside the Department of Health for many years, I have been wanting to see this come to fruition. I am glad that we now have a leadership commitment in place to deliver it for the first time, at least in my memory of working alongside the NHS.

The UK is doing superb work and leading internationally on rare diseases. I hope that our all-party parliamentary group’s report will make a significant difference and help to steer the Department of Health to a place conducive to both the Minister’s requirements and ours. I look forward to hearing his response.

Young People’s Mental Health

Andrew Bingham Excerpts

Thursday 27th October 2016 Commons Chamber

[Andrew Bingham (High Peak) (Con)]

Thank you for calling me to speak in this important debate, Madam Deputy Speaker. The report was brought to my attention by Lucy Broadman, my local member of the Youth Parliament, who has been in the Chamber for Youth Parliament debates. Lucy is in the Public Gallery to listen to the debate today and has even assisted me in formulating my remarks today—I will return to that later. As a result of the contact from Lucy, I made my own application for a Westminster Hall debate, but owing to an administrative error somewhere behind the Chair it was unable to be heard. I therefore congratulate and thank the hon. Member for Dulwich and West Norwood (Helen Hayes) for bringing this debate to the Chamber today.

Before I address the subject directly, I would like to applaud not only the hon. Lady but the Backbench Business Committee for granting this debate, not just for the seriousness of the issue but for the legitimacy it confers on the Youth Parliament. As we all try to engage with young people more and more, it is imperative that the efforts of the Youth Parliament get acknowledged and debated in here. As Lucy, now a former member, tells me, when the Youth Parliament casts out for subjects, mental health is very often in the top five or six that concern young people, so it is important that it is considered. The report is excellent, but it is also important that we debate it today.

The report is thorough and makes several conclusions and recommendations, as highlighted by the hon. Lady, but I wanted to get a better understanding of the issues facing young people in the modern age that can lead to the mental health issues laid out in the report. It is a long time since I was a young person—[Hon. Members: “No!”]—thank you—so I thought the best way for me to understand the issue was to make use of the expertise of young people, as highlighted in recommendation 17 of the report. I decided to do that off my own bat, so I had a conversation not only with Lucy but with another 17-year-old young lady I know very well, Martha Banks Thompson. I asked them to tell me what their thoughts and experiences of life as a teenager were and about the pressures that they and their friends have to face in the modern-day world. Both girls are A-level politics students, but from different ends of the country. Lucy is from my constituency of High Peak and Martha lives in the constituency of my right hon. Friend the Member for Surrey Heath (Michael Gove). My remarks today are very much—although not completely—based on the conversations we have had.

Mental health issues in any person, of any age, are very often difficult to diagnose. As has been highlighted, they are not like a broken leg, which can be seen; they are not as tangible as that. Mental health issues can often be mistaken for a temporary emotional upheaval or distress, but in the young they can often be put down to other things: pure teenage angst, raging hormones or just plain old teenage moodiness—or, as some people say, the Kevin and Perry syndrome. Consequently, these issues go unspotted and unnoticed and therefore untreated. By the time it is realised that there is a problem, it has manifested itself to such a degree that it becomes even harder to treat.

Who would, should or could identify the problem? In all likelihood it would be an adult—a parent, a guardian or even a teacher. Because of that, there is a generational gap. I am sure anyone in the Chamber or listening today will have heard from a teenage the line, “You don’t understand”, and in this case I think that, as adults, we do not understand. So what should we look for and how does the problem manifest itself? There are various symptoms and they are all too easy to miss. As we have heard, there could be anxiety, depression, eating disorders, contemplation of suicide or maybe even self-harm. Self-harm can sometimes be seen as a cry for help or attention, but more often it is a symptom of a much deeper problem. When can it occur? In days gone by, the pinch points for stress among teenagers were usually exam times: January for their mock GCSEs—they were O-levels when I took them—or May for their final exams. However, in the modern world there are so many more pressures that can impact on young people and bring about problems.

How are things different from when we were young? What are the extra factors and circumstances that we did not have to contend with that the modern-day young person or teenager does? There are many, but it would be a derogation of our duty to consider this question without looking at the impact of social media, whether it is Facebook, Twitter, Instagram, WhatsApp or Snapchat, or the many more that those of us in the Chamber have probably not heard of. Only a few years ago, they were a figment of the imagination—in my day they were science fiction—but now not only are they part of everyday life, but for the modern teenager they are often the preferred method of communicating with each other.

These technologies have much to commend them and have many advantages, not just for the teenager but for all of us in the Chamber. I am sure many of us tweet and have Facebook pages, and I am sure we all have websites. Indeed, I would venture to say that most of our communication as Members of Parliament with our constituents comes via email, making us more accessible than we have ever been. It is good that we are, and so is communication between young people. Again, I am going to betray my age now, but the days of sending notes to the object of our affections across the classroom with “SWALK” written on the back of the envelope—

[Tim Loughton (East Worthing and Shoreham) (Con)]

SWALK?

[Andrew Bingham]

Exactly. I mentioned this to Martha and Lucy and they did not know what SWALK was. I can tell my hon. Friend that it stands for “Sealed with a loving kiss”. Those days are long gone. Now everything is done via social media. It is out in the open for everyone to see and it is also there forever. The SWALK letter is read. If it is not reciprocated, it is thrown away; if it is reciprocated, it is replied to. On social media, it remains there forever.

That brings with it perils and pressures. Relationships, appearance, fashion, style—all are analysed in the public glare. Relationships, attitudes and opinions once shared privately between friends are now put out for the world to see, with every comment seemingly soliciting a further comment or response and the rhetoric growing from that. With, for example, chat groups on applications such as WhatsApp, it is very easy for what could be seen as a little verbal leg-pulling or teasing to take on a sinister complexion. We increasingly hear stories of cyber-bullying and the posting of revenge pictures. I am sure all of us in this House have at one time or another been on the receiving end of comments online that we would see as offensive or upsetting. However, for a teenager, maybe uncertain, vulnerable or lacking in confidence, such remarks can have a shattering effect on their self-confidence and in turn their mental state.

Let us look at the media in general. The modern media seem to present all young people in reality programmes such as “Made in Chelsea” as perfectly formed human beings, which puts pressure on so many young people to be absolutely perfect. The slightest imperfection, perceived or otherwise, can become a major issue. We hear a lot about body image, too, and young people’s attitude towards it. Again, the desire to be perfect crops up, so when a perceived imperfection is not only remarked on but ridiculed via social media, it can be amplified and re-tweeted, when “likes”, “unlikes” and “comments” can become very cruel, particularly to uncertain and vulnerable teenagers. This can severely damage the self-esteem and mental health of a young person.

Our consumer society is another issue. As we see with mobile phones, clothing and computers, everywhere we look there is a thirst for the latest, the best, the biggest, the fastest and the shiniest, while anything less than the optimum is seen as a problem. This is another issue that ratchets up the mental pressure on young people. I am not saying that a young person’s not having the latest iPhone will lead to mental health problems, but I am saying is that if someone is vulnerable and has low self-esteem, this sort of thing can work to enhance those insecurities and push someone into the territory that we are discussing today.

We need to remember, too, that all these pressures—I have mentioned only a few—are impacting on young people at a time when their minds, brains and characters are still growing and forming. As we get older, we form our minds and personalities, and we develop our own resilience to many of these outside pressures.

[John Glen (Salisbury) (Con)]

My hon. Friend is putting forward a pertinent case and providing an accurate analysis of the pressures on our teenagers. Does he agree that it is important to recognise that we need an integrated solution, which requires education and NHS response, so that schools can get in very early and start tackling some of the behaviours that lead to poor mental health outcomes?

[Andrew Bingham]

My hon. Friend is absolutely right, and his point about the need for a whole school approach is acknowledged in the conclusion of the report. It states that when children leave school, they should be conversant with all the issues around mental health, which the hon. Member for Dulwich and West Norwood also mentioned in her speech. As I was saying, as we get older, we develop our own resilience, but in young people that development is not complete. That is the issue that we need to be aware of, and it is where schools need to play a part in helping to develop that resilience.

As we know, a stigma is attached to mental health—and nowhere more so than with young people. No young person wishes to admit to it for fear of being labelled, and people often are labelled in this society. Parents are similarly affected, so this leads to a situation of potential denial—I am not sure that “denial” is exactly the right word—which further exacerbates the problem. There seems to be a lack of willingness to say, or a fear of saying, “Look, I have a problem, and I need some help.” There should be no stigma attached to any young person admitting that they are struggling with certain issues, and neither should there be any barrier to parents making a similar plea.

Young people should have somewhere to go to ask for help—the report mentions a counsellor—without fear of ridicule. They should not be judged or labelled either by their peers or by society. Parents can be the strongest help and support for any young person, and we should look to families and family support units as well. We need to enable parents to play as full a part as they can. A young person who is getting some help at 15 can find on turning 16 that they are suddenly deemed to be an adult and their parents can be almost excluded from playing a full part. An attentive parent who is trying to help can face being told, “We can’t discuss this with you, because your girl or boy is now 16.” We should look to see whether there is a way around that problem.

In conclusion, I would like to thank Lucy Boardman and Martha Banks Thompson for their help. They have given me an insight into the world of the modern teenager and into how 21st-century pressures impact on their lives in a way that did not impact on my life as a teenager or that of many other Members here today. It was a very illuminating and educational experience for me, and I pay tribute to both of them for their candour and their honesty. As I have said, talking about these issues freely takes a lot. Many of my remarks today have come as a result of their contribution.

I say gently to the Minister that we must not in any way fall into the trap of dismissing mental health issues in the young as mere growing pains. This is a serious matter. I know she understands, but let us recognise that to provide the help needed, it needs to be not only readily and easily available, but available for as long as it is needed for each person according to their individual needs.

Baby Loss

Andrew Bingham Excerpts

Thursday 13th October 2016 Commons Chamber

[Antoinette Sandbach]

I am very grateful to the hon. Lady for her words; I know how important this debate is to her. She has done important work in the all-party group in helping to set out these aims and this vision so that other parents can benefit from our experiences. We know that the energy and commitment of a number of brilliant charities could be brought together with NHS trusts to help deliver the care pathway that is so badly needed for parents such as the hon. Lady.

By breaking the silence and the taboo of talking about child death, the APPG, which is composed of parents who have suffered loss, hopes that the debate will lead to better scrutiny of what is happening in maternity units and primary care relative to child loss. We welcome the additional focus from the Government in this area, but there is more to be done if other families are not to suffer the same grief and loss as so many parents in the UK.

[Andrew Bingham (High Peak) (Con)]

Will my hon. Friend give way?

[Antoinette Sandbach]

I am sorry, but I am about to conclude my speech.

The time has come to act and to see real change in the rates of child loss. I thank all the charities and the bereaved parents who have worked with us and whose expertise has helped to inform this debate. I know that other Members will have their own personal contributions to make.

Defending Public Services

Andrew Bingham Excerpts

Monday 23rd May 2016 Commons Chamber

[Andrew Bingham (High Peak) (Con)]

There are 21 Bills in the Queen’s Speech, and I could talk quite a lot about most of them, but I want to focus predominantly on the digital economy Bill. The announcement of that Bill will resonate in my constituency, because it creates the right for every household to have access to a high-speed broadband facility. I represent a very rural area, where people will be watching this with interest.

We use the phrase “a digital economy”. It is a nice slogan and a nice catchphrase, but in a world that is more reliant on the internet and mobile communication—as I look around the Chamber, I see that many colleagues have their iPads and their mobiles with them, and we are all using the internet—I argue that there is no other form of economy. Without the internet, we will struggle, and it is the rural economy in the High Peak that I am concerned about.

When we came into office six years ago, only 45% of the country had access to superfast broadband. To date, we have provided superfast broadband to 90% of the UK—an extra 4 million homes and businesses. By the end of next year, we will have reached 95%. That is the result of a huge investment by the Government, local councils, devolved Administrations and BT, which totals some £1.7 billion. That is no mean achievement. However, we cannot stop there; we need to continue working to connect significantly rural areas such as the High Peak. The progress made since 2010 is welcome, but the rurality of the High Peak makes it crucial that we continue to drive this forward. We cannot rest on our laurels thinking, “Aren’t we clever?” and congratulating ourselves on a job well done.

There are many advantages to living and working in the countryside, and particularly in the High Peak. We have fabulous countryside, outdoor pursuits, clear air and breathtaking scenery. The area could be called the playground of England. However, there are challenges, and some might say that there is a price to pay for all those benefits. Things that many urban areas take for granted are not as readily available in rural areas. When I was elected to this place six years ago, I was struck by the fact that when I leave the flat to come to work, there is a bus every five or six minutes. In rural areas, we get one every half hour or every hour.

Some things are very different in rural areas, and fast, efficient broadband is one of those things. It is crucial to a successful business. No matter how beautiful the surroundings, how breathtaking the scenery or how clear the air, if a business cannot operate profitably and successfully, all those wonderful things pale into insignificance. Rural areas such as mine need businesses. We need them to be successful, so that they can create jobs and support the local economy. We have a fantastic tourism industry, but in the winter we need other businesses to support our local economy.

Although we have made great strides in rolling out faster, better broadband, the last 5% that we talk about is just as important as the first. A new broadband universal service obligation that gives all citizens and businesses the legal right to a fast broadband connection is something that I would welcome with open arms. My hon. Friend the Member for Harrow East (Bob Blackman) mentioned it. He used to work for BT, so he will have greater knowledge of this than I do, but I agree with everything he said.

I have said in this Chamber and elsewhere on many occasions that, in my view, broadband is now the fourth utility. Many years ago, we had a small business based in my home village of Chapel-en-le-Frith. In those days, we used to advertise in the Manchester Evening News and the Exchange and Mart, and the phone number was the main thing that people looked for. The phone number at the time started with 0298—it was before the 1 was put in—and we moved the business to Greater Manchester, which was only a few miles down the road, to get the 061 area code so that people would see the phone number and think, “Ah, that’s Manchester.” Somebody in, say, Bolton would look at it and think, “They are just down the road,” although actually we were not that close. Those were the sorts of decisions that people made then; that was in 1982.

Things have changed hugely since then—as, I suspect, have most of us. Businesses that want to start up or relocate look for different things, but one of the first things that they consider nowadays is the availability and speed of internet access. Existing businesses have also contacted me to express their concerns about broadband provision. This is about not just attracting new investment and new businesses to rural areas, but retaining the businesses that we already have.

There is an industrial estate in Buxton, in my constituency, called Tongue Lane. Several companies trade on the estate, employing many local people between them. I want to touch on two briefly. Bells Shoes exports hundreds of pairs of shoes around the world. Over the years, it has grown from a high street retailer—it is well known on the high street in Buxton, in Spring Gardens—to a significant exporter of shoes across the world. It is a testament to its commitment to the area that it has remained in Buxton.

Otter Controls—everybody in this room probably uses one of its products—makes thermostats. It was started after the second world war, when the founder of the company devised the bimetal strip to enable the temperature to be controlled in electrically heated flying suits for the Royal Air Force. That, in itself, is a fantastic story, but we are time-limited today, so I cannot go into it. The company operates on Tongue Lane industrial estate and employs many local people.

Both companies, and others on the estate, have contacted me recently about the inadequate broadband provision. The estate was not originally included in the Digital Derbyshire scheme, but because of savings and advances in technology, it now will be. That is good news, not only for the companies but for the many local people that they employ. As both companies are significant exporters, it is also good news for UK plc.

There will be a discussion about what is termed “fast”: how fast will it be, will it be fast enough and can it be made faster? The initial commitment, as part of the universal service obligation, is 10 megabits per second, but we need to be sure that that is future-proofed. As more and more services are provided online as time progresses, it must be possible to speed it up. I am sure that those finer details will be explored during proceedings on the Bill. I welcome the fact that Ofcom will be given the power to review the speed to ensure that it remains sufficient for the needs of the day.

We need to ensure that that commitment is matched by delivery. The last 5% will be, by its nature, the most difficult. It will be a challenge, and it will not be easy, but if we give people the legal right to such broadband, we have to be able to deliver it. What is more, it must be available at an affordable and competitive rate. I recently met BT and Digital Derbyshire in the village of Chinley, where a new fibre-enabled cabinet has been fitted. That is a welcome move, but there are still areas of the village of Chinley that will not be served by the cabinet. In other areas of the High Peak, Councillor Sarah Helliwell, who was newly elected last year, is already dealing with requests from her residents in the Hope valley who are desperate for faster broadband. Other constituents of mine, such as Andy Byford and Steve Otty, who has corresponded directly with the Minister, are eager for a faster, better and more viable internet connection. Although we are getting better and faster connections in the High Peak, they are by no means universal. The coverage is still varied and patchy. The word that has been used is “universal”, and the coverage must be just that. As I have said, to achieve that will be difficult, challenging and, in places, expensive. I stress again that as well as being universal, it must be affordable.

I have great confidence in the ability of the Minister and the Government to deliver this huge commitment. I look forward to the day when I can tell prospective businesses that I am trying to attract to the High Peak that we can offer them fast, effective broadband that is suitable for their needs. I look forward to being able to say to High Peak residents who tell me that they want faster broadband that they, too, can receive a broadband service that lives up to their expectations and requirements, no matter where they are.

There is much else to talk about in the Queen’s Speech, but I will leave it there on the digital economy Bill, because other colleagues want to speak and I am conscious of the time. I congratulate the Government on the measure and I look forward to its being delivered as quickly and efficiently as possible.

Access to Medical Treatments (Innovation) Bill

Andrew Bingham Excerpts

Friday 16th October 2015 Commons Chamber

[Chris Heaton-Harris]

Absolutely, my hon. Friend is completely right.

The Minister will be pleased to hear that I have been working closely with some of the excellent officials in his Department to ensure that there is a little more detail in the Bill specifically to deal with some of the concerns that have been raised with me. First, after a great deal of thought and research, I suggest that the database is held by the Health and Social Care Information Centre. The HSCIC has experience of dealing with big data, and although a number of details would have to be worked out, it seems that it would be the obvious place in the existing health infrastructure to hold such a database.

How the database would work would be detailed outside my Bill by those best placed to do so. However, it is envisaged that a registered medical practitioner, having consulted with his or her patient, would flag up on the patient’s notes that they were innovating. I recognise the pressure that medical practitioners are under, so I am determined that this database should not add much to their already heavy workload, and, hopefully, through this system it would not.

The Health and Social Care Information Centre already has in place a strong set of legal safeguards to protect privacy and confidentiality, which, again, makes it an ideal organisation to host the database. Clearly, privacy issues will be a core part of any consultation that takes place on the detail of the database.

Importantly, the Bill stipulates that outcomes, not just the process of innovation itself, will be on the database. Successes and failures would be recorded on an ongoing basis. There are a number of very, very good reasons for doing that. Of course sharing success is simple to explain. Sharing ideas is in itself a great idea. Letting others see that a treatment has been a success when that treatment might not be widely known is clearly helpful, perhaps even lifesaving. When we know that treatments can differ between NHS trusts and between individual surgeries, it seems clear that we should be encouraging a spread of the good innovation that comes from every individual medical practitioner, such as the surgeon I mentioned earlier and his use of the drug, Glivec.

We must also realise the potential of transparently sharing all outcomes of innovation—not just successes, but failures too. Critics of Lord Saatchi’s Bill were rightly concerned about “quackology”—their term, not mine. There are some doctors who sell to desperately sick people treatments that do not work and that, in some cases, are dangerous. Having a database on which the whole of the registered medical practitioner community can see what an innovation is and then watch the results come in removes quackology from the database in a stroke.

I might well be on the lookout for someone who can cure my male-pattern baldness. Undoubtedly, it would require an innovative treatment; some would say a miracle cure. Currently, there are many treatments on offer to people such as myself. Many adverts will offer me an innovative cure, but there is no way of checking on the successes or failures of the treatments on offer.

[Andrew Bingham (High Peak) (Con)]

My hon. Friend is making quite a powerful case. I do not wish to dwell on his receding hairline, but let me touch on the adverts that we all see for receding hairlines or whatever. Does he envisage an advert carrying a quality mark to say that the treatment is on the database with results that are proven, which would give it more credibility?

[Chris Heaton-Harris]

I am not particularly worried about what is going on up top, but what I would envisage is that if I wanted to get an extra bit of thatch put on I could go to my doctor, have a conversation with him and he would be able to look on the database and say, “There is nothing there. This is all pie in the sky, hokum pokum stuff and not worth going for.” The database gives people a way of checking on the success or failure of the various treatments on offer, and if innovations such as this miracle cure for baldness are not there at all, there must be questions to be asked.

Perhaps some of the treatments on offer do work, but I doubt that the quacks out there would want their supposed innovations placed under the spotlight of transparency in both practice and outcome that the database would offer. There is another much more compelling reason for having a database that records the outcomes of medical innovation, be they successes or failures. It is impossible to learn, to move forward or to spread best practice if innovation is conducted in a silo and if no one else in the health community knows what is going on.

Hospital Services (South Manchester)

Andrew Bingham Excerpts

Tuesday 8th September 2015 Westminster Hall

[Andrew Bingham (High Peak) (Con)]

I congratulate the hon. Gentleman on securing the debate. I apologise, but I cannot stay; I have a Select Committee to go to. I am concerned, as he is, about the initial consultation, which we debated in this Chamber in the previous Parliament. For the record, however, I should say that I am delighted that Stepping Hill was chosen; in High Peak, we are outside Greater Manchester and I was concerned that we had been forgotten. Choosing Stepping Hill means an awful lot to my constituents.

[Mike Kane]

The Healthier Together commissioners left us in a binary situation, so it became a competition between two hospitals. That should never have been the case.

The aim of Healthier Together—to give patients throughout the region the same standard of excellent service wherever they live—is the right one. The challenge is huge: Manchester has the highest premature death rate of any local authority in the country. There can be no doubt that healthcare services in Greater Manchester need to change.

Healthier Together Programme (Greater Manchester)

Andrew Bingham Excerpts

Tuesday 22nd July 2014 Westminster Hall

[Kate Green (Stretford and Urmston) (Lab)]

It is a great pleasure to speak in this debate, and I am grateful to my hon. Friend the Member for Blackley and Broughton (Graham Stringer) for introducing it.

I am here to express the concerns of my constituents in relation to what my hon. Friend has rightly described as a consultation that people are either completely unaware of, or, if they are aware of it, unsure what they are being consulted about, what the next steps might be, where decisions will be taken and by whom. As he said, everyone understands the pressures that we face within the NHS in Greater Manchester and across the country.

[Andrew Bingham (High Peak) (Con)]

I know that the consultation is about Greater Manchester, but may I just put it on the record that the impact of this consultation will go far beyond Greater Manchester? My constituency is split between relying on Stepping Hill hospital and Tameside hospital, so this consultation affects us as well. I just wanted to put that on the record, so that people are aware of it.

[Kate Green]

The hon. Gentleman is absolutely right, and I am pleased to see that the hon. Member for Macclesfield (David Rutley) is also present this afternoon. The ripple effect of the consultation, on hospitals in neighbouring areas and indeed—as I will go on to talk about—on the wider north-west and northern region of the country is quite significant in one reading of what is going on.

It is true that the pressures of rising demand on the NHS are well recognised, as are the cost constraints on social care provision. However, my constituents in Trafford were told all that three or four years ago, and we went through our change programme. We feel that we have been here before and, for us, this is groundhog day and a bit worse than that. We underwent the consultation “A New Health Deal for Trafford”, which took place in 2012 and culminated in the downgrading of Trafford general hospital. Looking at how the current consultation has been launched, I am concerned that a number of lessons that were learned from that Trafford process are being totally ignored.

I say clearly that I am not against sensible reconfiguration of acute services. I am very much in favour of concentrating expertise and specialisms in a small number of expert sites. I am entirely in favour of as much provision as possible being pushed into the community to front-line, preventive, community-based care, and of keeping people at home to receive that care for as long as possible.

However, if this is a consultation about the provision of integrated community-based care, it is not possible to go down the road of consulting about that provision and withdrawing services in acute settings before we are clear what the landscape and the reality of that community provision is. Nor is it possible to go down the route of suggesting that some acute services might be rationalised or closed when existing acute services are under so much pressure already. In particular—I know that my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) will talk about this issue too—one consequence of the downgrade of Trafford general hospital’s accident and emergency provision is that during the past nine months the waiting times and queues at Wythenshawe hospital have been significant, with little sign yet that they will be reduced.

In addition, I point out that we have some real uncertainty. My hon. Friend the Member for Blackley and Broughton mentioned the uncertainty that exists around trauma services, maternity services and so on, but we also have uncertainties in Trafford in relation to some of the primary provision that will be in place. We know that the NHS local team and the clinical commissioning group envisage a two-hub model of primary care and community-based care for our borough. The provision in the south is largely established, but in the north—including in my constituency, where we have some of the worst health outcomes in the borough—we are still completely unsure what sort of hub will be put in place, as the NHS local team and NHS England are quite unable to tell us what the funding for that kind of hub model will be.

I know that the Secretary of State for Health is aware of that particular situation and I am grateful to him and his office for what they are doing to try to unscramble it, but from the point of view of my constituents the idea that they will be consulted on a major reconfiguration, either of primary care or of acute services, does not inspire their confidence, because currently they simply see deficiencies in those services and particularly because they believe that their voice counts for little when it comes to the decision that will ultimately be taken.

Not only is there pressure in the system, but the NHS seems to make some really perverse decisions as it goes along, because of its rather hand-to-mouth approach to planning this kind of reconfiguration and strategic change. When the decision was taken to downgrade the A and E services at Trafford general hospital, the hon. Member for Altrincham and Sale West (Mr Brady) and the late Paul Goggins, my good friend and former colleague, managed between them to secure around £11 million of new investment in Wythenshawe hospital to provide for the extra capacity that it would need. We are now unclear, of course, about what will happen with that £11 million of investment; it would be good if the Minister could put it on the record today that it will continue. Given that the hospital cannot envisage even its short to medium-term future, that is a worrying situation.

We saw something similar in Trafford, when investment of around £300 million in the intensive care unit was pretty well written off two years later when the new health deal for Trafford was implemented and the ICU was closed down. That may have been the right decision, but it was certainly a waste of money if investment was being poured into a hospital just two or three years before the whole status of that hospital was changed.

--- Later in debate ---

[Kate Green]

I am grateful to the hon. Gentleman for that contribution.

I am sure that my hon. Friend the Member for Wythenshawe and Sale East will talk particularly about the situation at Wythenshawe hospital, which is in his constituency, and our particular concern for the status of that hospital as a fixed-site specialist centre of excellence for a number of specialisms that matter not only to the population of south Manchester, or even to the population of Greater Manchester, but to the whole population of the north-west region. Some of those specialisms matter to the whole population of the north of England, and parts of Scotland too. It is deeply concerning to us that the Healthier Together consultation appears not only to be unaware of the difficulty of protecting those specialisms in the proposed process of remodelling hospital configurations, but to be completely unaware of the interdependency of specialisms and general acute and medical provision. If one element is removed from a cocktail of clinical support that is available to support high-level specialisms, those specialisms are completely undermined and eventually will probably be unable to survive.

I have a particular example of that process that I will draw to the Minister’s attention; it arises from my visit last week to Wythenshawe hospital and its highly regarded cystic fibrosis unit. The doctors and clinical staff there told me that the unit benefited from being part of a much broader, fixed-site specialist team, and indeed survived on that basis. It draws on a range of other specialisms around the hospital, including interventional radiology, transplantation, urology, nutritional support teams, gastroenterology, diabetes, endocrinology, ear, nose and throat services, obstetrics, extracorporeal membrane oxygenation and so on. Picking out some specialisms and moving them cannot be done in isolation, but Healthier Together does not seem to be aware of that at all.

Finally, as my hon. Friend the Member for Blackley and Broughton said, there are concerns about process—about how the public are being engaged in this debate. He said that we have a consultation taking place over the summer holidays, exactly as happened with the new health deal for Trafford, although we told them not to do that again, and during the working day. I understand that few people attended the public meeting in Trafford; I am not surprised, because it was difficult to know that it was even taking place. I would not be able to tell when it happened, because I was not notified directly, let alone my constituents.

[Andrew Bingham]

I thank the hon. Lady for giving way again; she is being generous. I tend to agree. There is a consultation meeting in the High Peak as we speak, although it is a Tuesday afternoon. I, for one, should have liked to be there. I just wonder: next week during the recess would have been a lot easier for me.

[Kate Green]

I agree.

Meanwhile, Healthwatch Trafford says that there is concern about whether the committee-in-common model in Manchester is sufficiently transparent, regarding its ability to engage with and represent the concerns of local people and to oversee, in the wider public interest, what is being proposed.

I am utterly unconvinced that local people are aware of or understand the steps that are being put forward now that could result in major changes to health care provision in our area.

Tobacco Products (Standardised Packaging)

Andrew Bingham Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

I thank the hon. Gentleman for those generous comments. I think that many people in the House will have had their personal family situation touched in the way that he mentions. I never knew my grandparents, so I recognise the power of what he says. We are proceeding, as I hope the House can see, in a sensible but robust way. I have signalled my view that I am minded, as a Health Minister, to accept Sir Cyril’s report and the evidence therein, but there are other considerations, and we will take those into account and bring a final decision to the House as soon as possible.

[Andrew Bingham (High Peak) (Con)]

Is the Minister aware of the anti-counterfeiting measures that are taken in relation to the current packaging of cigarettes? Is she worried, as I am, that the introduction of plain-paper packaging would remove those measures and thus increase the possibility of counterfeiting and misrepresentation of—let us say—illicit tobacco?

[Jane Ellison]

The report is not about plain packaging but standardised packaging, which is quite different. Sir Cyril’s report helpfully pulls apart the differences and makes them clear for the reader. The issue that my hon. Friend raises is addressed in the report, and it was given a lot of consideration in the 2012 consultation. I can pay testament to the fact that that was an exhaustive and very thorough consultation, because I have spent much of the past few days, as has my right hon. Friend the Secretary of State, reviewing the evidence and submissions to it. These points have therefore been put on the record, but there will be a final opportunity in the forthcoming consultation to make them again, and they will be considered.

Hospital Mortality Rates

Andrew Bingham Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

The right ratio of patients to nurses depends on the type of patients in a ward, because different wards have different requirements. Salford Royal has a good model through which it ensures that it has the right number of nurses. As I said to the hon. Member for Rotherham (Sarah Champion), I accept what Francis says about safe staffing, but he did not recommend the Labour party’s policy of minimum mandated national staffing levels. I am following the recommendation of the Francis report, which I think is the right way forward.

[Andrew Bingham (High Peak) (Con)]

My constituents in Glossop use Tameside hospital. For too long, people such as Liz Degnen have highlighted their worries about Tameside, and the recent departure of its chief executive was called for and welcomed by several hon. Members. Does my right hon. Friend agree that the Keogh report is a vindication of many of my constituents’ long-held beliefs?

[Mr Hunt]

Yes it is, but I hope that we can give them confidence today that the problems will finally be addressed.

East Midlands Ambulance Service

Andrew Bingham Excerpts

Monday 21st January 2013 Commons Chamber

[Anna Soubry]

As ever, my hon. Friend makes an important point, and it is one that I will certainly look at further. I hope that those in EMAS who are listening to the debate will take that comment on board.

In response to the points made by the hon. Members for Ashfield (Gloria De Piero) and for Chesterfield (Toby Perkins), I do not think that it is as simple as saying that the closure of an ambulance station will de facto reduce the service available. Ambulances do not sit in ambulance stations waiting to respond to a local incident. They spend most of their time out of ambulance stations on the road so that they can respond to emergency calls. EMAS reported—these are important facts that should be widely publicised; I am sure the hon. Member for Bassetlaw will ensure that they are—a total turnover of £169.5 million in its 2011-12 final accounts and a £1.4 million surplus. It has also reported surpluses in the previous three years. I understand that for 2012-13 the trust received £3.5 million funding as its share of the EMAS contract from Bassetlaw primary care trust. As I have said, my concern is not so much about the money, but about the way the service is being operated.

Let me turn to the “Being the Best” review. EMAS tells me that it recognises that its response times in rural areas do not match the response times in city centres. In response, EMAS published its “Being the Best” change programme in 2012, which outlined plans designed to ensure that response times and the service provided to all the people of the region were improved. As the hon. Member for Bassetlaw described, EMAS has consulted clinical commissioning groups, overview and scrutiny committees and local people on its proposals. As we have been told, it received substantial feedback from the people of Bassetlaw, with a petition from some 9,000 people. The business case should be presented to the board on 25 March, allowing the trust additional time to review alternative options and develop final proposals for the board to consider.

I am told that a number of options are being considered. They include the “do nothing” option, which involves making no changes to the configuration of ambulance stations; the “do nothing-plus” option, which involves making no changes to the configuration of ambulance stations, but making an additional resource investment in more ambulance vehicles and staff; and the “do minimal” option, which involves making the minimum changes necessary to deliver current service standards in a safer and more effective manner. That option would retain all the current stations and introduce the 118 new community ambulance posts. The fourth option would establish 13 hubs, plus 118 community ambulance posts—I know that my hon. Friend the Member for High Peak (Andrew Bingham), along with many hon. Members, has expressed his concern about that option. The fifth option—a new option—would establish 27 hubs, plus 108 community ambulance posts, and is being considered as a direct result of the consultation feedback.

[Andrew Bingham (High Peak) (Con)]

Does my hon. Friend think, like me, that although the hub and spoke model has merit, the key is where the hubs go? High Peak is very rural; we need a hub, as I am sure the hon. Member for Bassetlaw (John Mann) feels he does.

[Anna Soubry]

That is a very good point. My hon. Friend has summed it up—we are having an outbreak of cross-party unity. As he says, the key point is the positioning of the hub. One of the attractions of the hub approach is that the mechanics would be in place to ensure that the vehicles were ready at the beginning of a shift. At the moment, paramedics are responsible for that, which does not seem to be a very good use of their time. There is therefore much merit in establishing 27 hubs in the right areas to ensure that we have a service that is fit for purpose.

There is something else that needs to be, not so much explored, perhaps, as exposed. The hon. Member for Bassetlaw has quite properly commented on the difficulty of having targets, and I could not agree with him more. This debate is a good example of where top-down, Government-led targets have blighted an ambulance service—no doubt there are many other examples in the NHS. That is why, when this Government were elected, for many of us it was on the basis that these targets, far from freeing up services and making them better, were strangling them and making them worse. This debate is an example of targets doing all the things they were designed not to do, constricting a service and making it worse. It is worth bearing it in mind that it was in 1997, I believe, that the ambulance service suffered from such targets. I hope that there will be more cross-party agreement and moving forward, so that although there are laudable aims that all services should have, we should not necessarily set rigid targets, which then create exactly the sort of horribly sad cases that the hon. Gentleman told us about.