Death Certification Reform: Medical Examiners

Andrew Gwynne Excerpts

Monday 29th July 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

The Parliamentary Under-Secretary of State, Department of Health and Social Care, my noble Friend Baroness Merron, has made the following written statement:

I wish to inform the House of the Government’s plan to continue with the reform to death certification and introduce a statutory medical examiner system on 9 September 2024. By law, all deaths will become subject to either a medical examiner’s scrutiny or a coroner’s investigation. The changes will put the existing medical examiner system’s obligations, duties and responsibilities on a statutory footing. Regulations were laid on 15 April 2024 including the Medical Certificate of Cause of Death Regulations, the Medical Examiners Regulations and the National Medical Examiner (Additional Functions) Regulations, and will come into force on 9 September 2024.

The changes will put the bereaved at the centre by providing an opportunity for them to raisequestions or concerns with a senior doctor not involved in the care of the deceased. This will improve practice and communication, support the right deaths being referred to coroners for further investigation and help deter poor practice and criminal activity.

The introduction of medical examiners is part of a broader set of reforms to death certification, coronial and registration processes. We are working closely across Government to ensure we are supporting the professions involved with relevant communications and guidance. This will be published on 9 September when the reforms come into force.

[HCWS31]

Pharmacy Provision: Hampton

Andrew Gwynne Excerpts

Friday 26th July 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

May I start by welcoming you to the Chair, Madam Deputy Speaker? I congratulate you on your election earlier this week. I also congratulate the hon. Member for Twickenham (Munira Wilson) on securing a debate that is absolutely crucial, not just given the specifics of the case in her constituency, but for the precedent that it sets as we plan community pharmacy provision across England. I assure her that although Lyle missed out on his week in London for Whitsun half-term, because somebody called a general election, he is on his way to London as I speak, with Allison, so that we can do London as tourists this weekend.

I am responding on behalf of the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), who leads in this area. I start by paying tribute to pharmacists. It is a credit to them that surveys show that nine in 10 people who visit pharmacies feel positive about their experience. Colleagues appreciate how accessible pharmacies in towns and villages across our country are, but for too long, Governments have failed to recognise their essential role in safeguarding the nation’s health, not least in my constituency of Gorton and Denton. This Government know that people who work in pharmacies are highly trained specialists, and we are committed to helping pharmacists and pharmacy technicians reach their full potential.

Pharmacies already provide vital advice on prescriptions, over-the-counter medicines and minor ailments, but they do not just dispense medicines and proffer advice, important though that is; they must do much more than that. Many already offer blood-pressure checks, flu and covid-19 vaccinations, contraception consultations and treatment for the seven conditions covered by the Pharmacy First service. I supported Pharmacy First when I was in opposition, as I think the hon. Lady did, and my party pledged to build on the programme by making prescribing an integral part of the services delivered by community pharmacies. For that reason, in the next two years, we will ensure that every newly qualified pharmacist has a prescribing qualification, while we train up the existing workforce.

This year, NHS England is working closely with all integrated care boards on pilots to test how prescribing can work in community pharmacy, because like the hon. Lady, we want pharmacies delivering services that help patients to access advice, prevention and treatment more easily; services that ease the pressure on general practice and in other areas in the NHS; and services that unlock the knowledge and expertise that our pharmacists have to offer. This Government take the view that pharmacies can and should play an even greater role in providing healthcare on the high street. That is why we stood on a manifesto that promised to shift resources to primary care and to community services over time. Community pharmacies will play an important part in moving our health service from hospital to community, from analogue to digital, and from sickness to prevention. But we have only been in office for three weeks; this cannot happen overnight, and colleagues have been absolutely right to raise concerns with Ministers about the closure of pharmacies.

As we speak, well over 10,000 pharmacies in England are dispensing medicines, offering advice and delivering care, and despite closures, access to pharmacies remains good across most of the country. Four out of five people live within a 20-minute walk of their local pharmacy, but as we have heard in this really important debate, that is not the case everywhere in the country. I know, having listened to the hon. Lady, that in Twickenham it is higher than four in five, but in other parts of the country it is below one in two. In the most deprived parts of England there are almost twice as many pharmacies—a good thing—than in the least deprived, but we need better access across the country. To take the example of my own constituency, where access to pharmacies is fairly good, almost the entire population is within a 20-minute walk from a pharmacy. However, in certain rural areas, and in a growing number of urban areas because of the closure programme, that is not the case. In those rural areas, there are dispensing doctors who can supply medicines to patients, and patients across the country can access around 400 distance-selling pharmacies that deliver medicines to patients’ homes free of charge. It is true that experiences vary depending on where people live, but I am aware of the specific problem in Hampton following the closure of the two Boots pharmacies that she described.

[Munira Wilson]

On the point about the 20-minute walk and the four in five statistic, does the Minister recognise that a 20-minute walk for me or him is actually much longer for an elderly person or somebody with multiple health conditions or mobility issues? We have to work out what measure we are using. Yes, the Twickenham constituency may have many pharmacies, but we must look at that highly localised level. That is why we need the local authority and local health boards to be involved, because actually in Hampton, as a community, the transport links are terrible.

[Andrew Gwynne]

I completely understand the case the hon. Lady is making. I ask her please to understand that she is pushing on a bit of an open door. It is a completely different subject, but I have had exactly the same arguments about bank closures in my constituency. I am told that as long as the nearest bank branch is half an hour away by public transport, that is acceptable. Unfortunately, computer says no when it is two buses that do not meet up in between. I agree with her that there are complexities around drawing up arbitrary limits, but generally access to pharmacies is good. We need to maximise the use of the pharmacy network so that we get more pharmacists coming in.

[Alison Bennett (Mid Sussex) (LD)]

I welcome the Government’s support for strengthening the pharmacy sector. The Minister talks about the workforce. Residents in my constituency have raised concerns about the pressure on pharmacists to take on more and more services that might traditionally have been provided by primary care. What assurances can he give me that he will make sure that the workforce plan for pharmacists is robust enough to cope with the extra demand?

--- Later in debate ---

[Andrew Gwynne]

We are very committed, as I hope the hon. Lady knows, to the workforce plan being as robust as it can be, so we do not just get the pharmacists of the future but the doctors, nurses, healthcare workers and so on too. On the journey to a national health service that is much more community focused and much more aligned to prevention rather than to curing sickness—we want to prevent people from becoming ill in the first place—we must ensure that at its heart is how we can deliver medicines and treatments closer to where people live. Having well-trained capabilities in the pharmacy sector to do that is very much a priority for this Government.

Returning to the issue of the two Boots closures in Hampton, the Minister for Care is aware of the closures. He asked me to communicate to the hon. Lady the fact that he will keep a very close eye on what is happening on the ground in her area.

On the hon. Lady’s specific point about bureaucracy, I assure her that the regulatory framework is always under review, and as a new Government we are keen to make improvements wherever we can. I am sure that my officials will have heard the case that she has made.

After the hon. Lady kindly reached out to me prior to the debate, I instructed officials to ask her ICB to consider her concerns again. I hear that she has had a reply that was not particularly helpful. Again, I hope that her ICB is watching this debate, and listening to her case and to me as the Minister saying from the Dispatch Box that we take these issues seriously. Good access to pharmacy services is important to her constituents and to the constituents of Members right across the House. We need to make sure that the network is protected and enhanced.

On funding, NHS England has commissioned an economic analysis of the cost of providing pharmaceutical services. That work is happening right now with the pharmacy sector and we look forward to seeing the outcome. Previous Governments dithered and delayed on finding a sustainable and long-term solution. The consultation around this year’s funding and contractual arrangements with Community Pharmacy England did not make it over the line before the election was called, so we as Ministers are looking at that as a matter of urgency.

All that we are speaking of today is against the backdrop of the most challenging circumstances since the second world war. That is why the Chancellor is carrying out an urgent assessment of our spending inheritance and will be presenting the results to Parliament before the summer recess, so that the findings can inform every spending decision we make.

In the meantime, I am afraid that I cannot update the House on this year’s arrangements. I understand that that will be frustrating to the hon. Lady, but the Prime Minister has asked me and every Minister of this Government to be honest and open about the state of the nation’s finances. I intend to keep that promise, but I look forward to working with pharmacy stakeholders to discuss not just how we solve these problems, but how we seize the opportunities for transformation in the sector, and how we deliver health and social care in the community, closer to where people need it, providing the new, innovative treatments from pharmacies where that is appropriate. This Government will always put patients before politics.

In the spirit of the friendship that we have developed over the years, particularly over the kinship issue, I look forward to working with the hon. Lady on this and other health-related issues, and on making our country a better, fairer and more equal place for her constituents and mine, with better access to health services, including community pharmacy. I hope to work with her in the years to come, and let us hope that we can improve the pharmacy services for Hampton and other parts of England.

Question put and agreed to.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Adam Jogee (Newcastle-under-Lyme) (Lab)]

4. If he will hold discussions with the Secretary of State for Environment, Food and Rural Affairs on the potential effects of toxic air from landfill sites on people’s health in Newcastle-under-Lyme constituency.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I warmly welcome my hon. Friend, the new Member for Newcastle-under-Lyme, and thank him for raising this important issue. The UK Health Security Agency works with the regulator, the Environment Agency, to advise on health risks from landfill sites. In relation to the site in his constituency, the UKHSA undertakes monthly risk assessments using air quality data. A multi-agency group, including Government agencies and local authorities, meets regularly to review the situation and any interventions needed. I will, of course, raise his concerns with my counterparts in the Department for Environment, Food and Rural Affairs.

[Adam Jogee]

I thank the Minister for his answer, and welcome him to his place. Walleys Quarry landfill in Newcastle-under-Lyme is an environmental crisis and a health one too, and my constituents Sheelagh Casey-Hulme, Jan Middleton, Lee Walford and many others are rightly scared and angry about the impact of toxic levels of hydrogen sulphide on the health and wellbeing of local people. Will the Minister come to Newcastle-under-Lyme to listen, to learn and to smell, and to help us finally stop the stink?

[Andrew Gwynne]

Public health and prevention are priorities for me and this Labour Government. Obviously, the Environment Agency takes the lead in this specific instance, but I am more than happy to jump off the train at Stoke—if my hon. Friend will pick me up—and visit his constituents to listen to their concerns, and to ensure that the public health considerations are amplified to Environment Agency colleagues.

[Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)]

5. Whether he is taking steps to ensure the provision of fracture liaison services in all hospitals.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I thank the learned and gallant hon. Member for his question. More than 500,000 fragility fractures occur every year, and up to 40% of fracture patients will suffer another fracture. I praise the campaigns by the Sunday Express, The Mail on Sunday and the Royal Osteoporosis Society for their campaigns on this. I am pleased to reiterate the Government’s commitment to expanding access to fracture liaison services. The Department is working closely with NHS England to develop plans to ensure better quality and access to these important preventive services.

[Dr Shastri-Hurst]

First, I congratulate the Minister and the rest of the Front-Bench team on their appointments. As a former orthopaedic surgeon, I am mindful of the impact of osteoporosis on many of our constituents, including my own in Solihull West and Shirley. In England, more than 67,000 people suffer a fracture every year, and a disproportionate number of those are women. What we do know, however, is that fracture liaison services, where they are delivered well, can prevent many of those fractures. Currently, half of the country has access to such services. The last Conservative Government made a commitment to roll them out to the whole country by 2030. Will the Minister honour that commitment?

[Andrew Gwynne]

The hon. Gentleman makes a really important point, and we are absolutely committed to ensuring that these services across England are better than those we have inherited. Of course, I completely agree with him about the need to improve these services in specific parts of the country, which is something we will be looking at in detail. However, I have to say to the hon. Gentleman that the one thing those of us on this side of the House will not be doing is what he has written about in “ConservativeHome”, which is health rationing and cutting back on treatment.

[Uma Kumaran (Stratford and Bow) (Lab)]

7. What assessment his Department has made of the effectiveness of NHS urgent and emergency care services.

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[Sean Woodcock (Banbury) (Lab)]

12. Whether he plans to hold discussions with NHS staff and patients on his plans for reforming NHS health and social care services.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I thank my hon. Friend the Member for Banbury—words I did not think I would ever say—and welcome him to his place. The answer to his question is yes. We do not just want to discuss with patients and staff; we want them to help shape the 10-year plan for the next decade of reform, which will take our NHS from the worst crisis in its history and make it fit for the future. Social care also needs to change. We will work with care workers and care users to build consensus for and shape a new national care service.

[Sean Woodcock]

Does the Minister agree that the voices of frontline staff, whether in hospitals such as the Horton general hospital in Banbury or carers like my mum, are still often ignored when it comes to whistleblowing? More worryingly, those voices are silenced by threats to report them to regulatory bodies. Does he agree that we need to level the field of accountability for managers who ignore whistleblowers, and that there should be a regulatory body with oversight of medical managers?

[Andrew Gwynne]

My hon. Friend is absolutely right. We have previously said that bank managers are more regulated than NHS managers. This Labour Government will pursue an agenda of greater accountability, transparency and candour when it comes to those making managerial and executive decisions in our national health service.

[Dave Doogan (Angus and Perthshire Glens) (SNP)]

In integrating health and social care it is vital to take the staff component along with you. It is also vital to have sufficient funding. We integrated health and social care in Scotland in 2012 and it has been a difficult road, but health in Scotland is funded £323 per head more than it is in England. Will the Minister commit to put his hand in his pocket and make sure English people enjoy the same health funding as people in Scotland?

[Andrew Gwynne]

I welcome the hon. Gentleman back to the House, but I politely say to him that he needs to be a little bit patient. There will be some announcements in the near future on this Government’s plans for social care. He should rest assured that we on the Labour Benches understand the integration agenda. We understand the need to fix both the NHS and social care, and this Labour Government will do that.

[Mr Speaker]

I call the shadow Minister.

[Sir John Whittingdale (Maldon) (Con)]

I congratulate the Minister and his Front-Bench colleagues on their appointments. I welcome the suggestion that the Government are considering the possibility of a royal commission on social care and intend to address the issue on a cross-party basis, but that will take time. Can the Minister therefore confirm that, as was suggested during the election campaign, the Government will take forward the Dilnot reforms, and in particular that they will introduce a cap on social care costs, as was planned by the previous Government?

[Andrew Gwynne]

It was, of course, the right hon. Gentleman’s Government who kicked the can down the road on these issues. They allowed the system to spend the transformation money that had been provided precisely for the purpose of the Dilnot reforms on fixing their broken national health service. He should just be a little bit patient, as we will announce our proposals for social care shortly. He should rest assured that, as I have said to him before, this Labour Government are determined to fix both the broken NHS and the broken social care system that we inherited from 14 years of Tory failure.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Andrew Gwynne]

I thank the hon. Lady for the way in which the Liberal Democrats approached the issue of health and social care during the election campaign. As my right hon. Friend the Secretary of State has already said, we will work with all in the House who want to fix our broken health and social care system. Of course we will work collegiately across parties, and of course all issues relating to how we fix our broken social care system will be discussed during those cross-party deliberations.

[Carolyn Harris (Neath and Swansea East) (Lab)]

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

--- Later in debate ---

[Simon Hoare (North Dorset) (Con)]

Nearly 10 children a month die from brain tumours, and I know that the public health Minister takes this issue seriously. He was familiar with the work of the Brain Tumour Charity’s HeadSmart campaign. Will he agree to meet me and my fierce campaigner constituent Sacha Langton-Gilks, who lost her son to a brain tumour, to discuss how NHS England could be persuaded to do more to inform and educate parents to identify the symptoms, so that collectively we can reduce the number of deaths?

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I am grateful to the hon. Gentleman for that question. He knows that I met his constituents when I was a shadow public health Minister, and I can confirm that I am more than happy to meet him and his constituents now that I have dropped the “shadow”.

[Dan Tomlinson (Chipping Barnet) (Lab)]

T8. I am sure the whole House will want to celebrate the fact that the NHS is safe in Labour hands once again. Specifically in the Royal Free trust area, which covers the community that I now have the honour of being the MP for—Chipping Barnet in North London—there are 100,000 people on the NHS waiting list, so what steps will the Minister take to reduce the waiting list in places such as mine so that we can see more people getting the treatment and support that they need from the NHS?

Respiratory Syncytial Virus Immunisation Programmes

Andrew Gwynne Excerpts

Thursday 18th July 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I am today confirming that the new immunisation programme to protect infants, with a vaccine during pregnancy, and older adults against respiratory syncytial virus will start this September.

RSV is a common respiratory virus that usually causes mild cold-like symptoms but can cause severe illness, especially for young infants and older adults. There is a significant burden of RSV illness in the UK population which greatly impacts NHS services during the winter months. RSV accounts for over 30,000 hospital admissions for children under five and is estimated to cause around 9,000 admissions among adults over the age of 75 each year. The programme could free up thousands of hospital bed days and help to prevent hundreds of deaths each year.

In June 2023, the Joint Committee on Vaccination and Immunisation advised that an RSV immunisation programme that is cost-effective should be developed to protect both infants and older adults. From September, a routine programme will begin in England for those turning 75 and for pregnant women, who will be offered vaccination from 28 weeks of pregnancy until full term to protect their baby during the first months of life when they are most vulnerable to RSV. A one-off campaign will also run from September 2024 until 31 August 2025 for all older adults aged 75 to 79 years old on 1 September 2024.

The UK Health Security Agency is now working rapidly with the NHS to ensure we are ready, in September, to deliver the UK’s first RSV vaccination programme. The programme will save lives and protect people most at risk. We are delighted that the RSV vaccination programme will begin soon across all four UK nations.

His Majesty’s Government are encouraging eligible members of the population to come forward for their vaccination when they have been invited to do so by the NHS, to protect those most vulnerable to RSV illness and to reduce NHS winter pressures.

Older adults will be invited to come forward when they turn 75 and will be able to book their vaccination appointment with their GP.

Older adults aged 75 to 79 years old on 1 September 2024 will be invited to receive their RSV vaccination with their GP in a timely manner to ensure as many people as possible are protected this winter.

Those that are at least 28 weeks pregnant should speak to their maternity service or GP surgery to get the vaccine to protect their baby.

[HCWS7]

Draft Human Medicines (Amendments relating to Registered Dental Hygienists, Registered Dental Therapists and Registered Pharmacy Technicians) Regulations 2024

Andrew Gwynne Excerpts

Tuesday 21st May 2024 General Committees

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Hollobone. I want to start by echoing the Minister’s comments about pharmacies and pharmacists; I will even go so far as to thank the Prime Minister’s mother. We rely on our pharmacists to do an awful lot and Labour supports the concept of Pharmacy First. We think that pharmacies could and should play an even greater role in providing healthcare services in the closest places where people can most easily access them. In our towns, cities and villages, that is often on the high street, in our pharmacies. We would roll out more services to pharmacies and have proposals to do that, should we be fortunate enough to form the next Government.

I have to say, though, that the least said about NHS dentistry the better. I do not recognise the Minister’s description of her dentistry recovery plan. It does not go far enough for us. We want to see a proper, concerted effort in dentistry and in getting NHS dentistry back to where it should be. Even the professional bodies say that the dentistry recovery plan does not go far enough, and we echo their concerns. We can and should do more.

We support the overall terms of the draft regulations, particularly the measures on pharmacy technicians and dental hygienists. In particular, we think that dental hygienists are a useful tool to deliver timely and quality care to patients where it is safe and suitable for them to do so. The dental profession is supportive of the intention to enable dental hygienists and dental therapists to supply and administer the vast majority of the medicines listed in the regulations.

However, the inclusion of two medicines on the list—minocycline and nystatin—was not supported by the British Dental Association or the College of General Dentistry. These bodies tell me that for a number of reasons, including antimicrobial resistance and, in the case of minocycline, efficacy, they are not recommended in any national clinical guidelines and their use in dentistry is no longer accepted practice. Will the Minister be able to explain whether the concerns of key dental stakeholders were taken into account when the decision was made to retain these two drugs on the list? Will she also assure us that there has been full and proper consultation with both the British Dental Association and the College of General Dentistry on ensuring that the regulations are compliant with both national practice and existing clinical guidelines?

Efforts to increase the skill mix in our NHS dentistry workforce and across pharmacy more generally are welcome, but the Minister will forgive me for thinking that we need to go much further than technical tweaks if we are to reverse the crisis in which NHS dentistry finds itself. I know that she wants to do more—I want her to do more—but it will likely be left to the next Labour Government to fix NHS dentistry. We will support the regulations, and I hope that the Minister can reassure us about the medicines that are included in the list when they perhaps should not be.

International Health Regulations

Andrew Gwynne Excerpts

Tuesday 14th May 2024 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

This country has a role and a responsibility in protecting global health. It is a part we played during the covid pandemic. British science stood tall on the world stage, and our country donated 84 million vaccine doses to help vaccinate the world. We learned from the omicron variant that, when it comes to global pandemics, none of us is safe until all of us are safe. We also benefited from researchers around the world sharing early knowledge about covid-19, collaboration that was crucial in protecting British people and ultimately in developing the vaccine. However, there is a clear principle when it comes to national security. It is the same one we follow when we get on to an aeroplane: we apply our own oxygen mask before we help others apply theirs. The Minister says the draft text is not acceptable, and I want to be clear that a Labour Government will not sign anything that would leave our population unprotected in the face of a novel disease.

We are debating a treaty that is still being negotiated by member states, and none of us knows the final content or wording, so can the Minister reconfirm for the House that the Government will not sign up to anything that would compromise the UK’s ability to take domestic decisions on national public health measures? Has he consulted the UK’s life sciences sector ahead of these negotiations, and what conversations has he had with international counterparts and our allies about this treaty and our joint pandemic preparedness? As we work with colleagues around the world to bolster our efforts to tackle novel threats, it is vital that we get the balance right between sharing knowledge and protecting intellectual property, so can he set out his approach to any requirements for time-limited waivers of intellectual property related to vaccines and therapeutics in the event of a global disease outbreak? Finally, it is vital that we are led by science and evidence when tackling the threat of global disease epidemics, so can the Minister tell us what his Department is doing to tackle misinformation about pandemics and vaccines?

[Andrew Stephenson]

I thank the shadow Minister for his remarks. I confirm that we are firmly fighting in Britain’s interests for an accord and strengthened international health regulations that fully respect national sovereignty but can save lives and protect people both in the UK and around the world. They have to fully respect national sovereignty, and that is at the heart of our negotiating position. It will therefore always be up to nation states to decide what is implemented within their own borders.

Just to answer a couple of the hon. Gentleman’s specific points, yes, I have met representatives of the life sciences sector to discuss this and some of the specific proposals—the last meeting we had was last week. With regard to dealing with international counterparts, I will be attending the World Health Assembly in Geneva myself.

My final point is that the hon. Gentleman is right to pay tribute to what this country did globally during the pandemic. Of course, in 2021 we used the G7 presidency to mobilise G7 countries to donate surplus vaccines, and by May 2022 the G7 had donated 1.18 billion doses against the target of 870 million. The UK alone donated over 80 million doses, benefiting 40 countries.

World ME Day

Andrew Gwynne Excerpts

Wednesday 1st May 2024 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is always a pleasure to serve your chairmanship, Dame Siobhain. I congratulate the right hon. Member for Bromsgrove (Sir Sajid Javid) on securing this important debate and on the work he not only did as Health Secretary, but continues to do as a Member of Parliament on ME, which we know is a profoundly debilitating and chronic condition that affects various systems across the body. Figures estimate that at least 250,000 people in the UK live with it. However, it is estimated that upwards of 1.3 million people live with ME or ME-like symptoms following a covid-19 infection. As we have heard, women are five times more likely to develop ME than men, and they experience more symptoms than men.

Many parallels have been drawn between ME and long covid, given that research has indicated that at least half of those living with long covid have symptoms that directly mirror those of ME. As someone who continues to suffer from the effects of long covid, those symptoms are all too familiar to me: a draining fatigue that never seems to go away; constantly disturbed sleep and an endless feeling of exhaustion; and a debilitating brain fog that can strike at the most inconvenient of moments.

I just want to place on the record that I have managed to control my long covid for the best part of two years, but this week has been a very bad week for me; I was in bed for all of today, and I have only come in to give this speech. The reason that there is a bundle of tissues here is because the sweats just hit me while walking into work. I do understand—I have lived with the experience of symptoms similar to ME—and I agree with my right hon. Friend the Member for Hayes and Harlington (John McDonnell) about the impact it has on people in work, because we do not know which days will be our good days and our bad days, and sadly we are judged against our bad days. That is true.

We need to educate employers about ME and long covid so that reasonable adjustments can be made, and about changes to the welfare system. When I was on my very worst of days, very early on after I contracted covid-19, I would have been signed off work if I had turned up for a work capability assessment, because it was obvious to all. On my best days, though, people would think, “There’s nothing wrong with him,” so if I had the misfortune of having a work capability assessment on one of my better days, I would then be put into work when I was not capable. We must attend to those issues across Government.

We know that ME costs the UK economy about £3.3 billion a year, and that number is growing. We need far better understanding of this debilitating condition and its impact on the day-to-day lives of too many people. That is why Labour is committed to putting Britain at the front of the queue for treatments by boosting clinical trial activity in the NHS. We will speed up recruitment to trials and give more people the chance to participate. We will link up clinical trial registries to create national standing registries, and harness the power of the NHS app to invite eligible participants to take part in research studies for which they are eligible. We also need to rebuild the system so that it recognises the impact of post-viral conditions like ME and equips people with the tools needed to work with it.

We need to refocus our services away from hospital settings to be rooted in the community, so that patients can access care when and where they need it, and we need to bolster a workforce that can better understand ME so that people can get timely care. Above all, we need to get that delivery plan published sooner rather than later. I implore the Minister for World ME Day: he has cross-party support, so let’s get it published ASAP.

Glaucoma and Community Optometry

Andrew Gwynne Excerpts

Tuesday 30th April 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered glaucoma and community optometry.

First, a special thanks to the Backbench Business Committee for selecting the debate for this morning. I am my party’s health spokesperson—it is no secret—and am particularly interested in health issues. As such, I secured this debate off the back of a number of people who had contacted me. What I am particularly pushing for—I am sorry for the short notice; I put the request in the Minister’s hand only two minutes ago—is that we do something now so that we can save sight further down the line. If I were pushing for one thing only, that is the one thing I would wish to have.

Optometrists in my Strangford constituency—I will send them a copy of this debate in Hansard afterwards—asked me to secure this debate. A number of bodies here on the mainland asked me the same thing. That is my purpose, but the issue of sight and sight-loss problems affects every constituency equally throughout this great United Kingdom of Great Britain and Northern Ireland. Therefore, the approach to making the system more fit for purpose must also be UK-wide.

I am pleased to see the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), in his place. We are sparring partners, although when I say that I do not mean that we hurt each other—we fight things together. I am also especially pleased to see the Minister in his place. He has a deep interest in this subject, as well as a deep interest in Northern Ireland, which I much appreciate. He has told me about his times in Northern Ireland in the past month or so, and how much he loves going there. Indeed, every MP who visits Northern Ireland—including you, Dame Caroline—always comes back with the most wonderful memories of the occasion and of the people they meet. Just this morning, a Conservative Whip was telling me that he was in Hillsborough two weeks ago, and about how much he enjoyed it.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I want to place on the record the fact that a month ago I made my first visit to Belfast. I had an incredible time meeting Members of the Assembly at Stormont, and going to Harland & Wolff, around Belfast and to an inclusive school. It is a remarkable place, and I just wanted to add, as the hon. Gentleman is putting on the record that everyone else has been to Northern Ireland, that so have I—although I know that is not the subject of our discussion, Dame Caroline.

[Dame Caroline Dinenage (in the Chair)]

Order. I gently remind Members that, charming as it is to hear about Northern Ireland—we are all wildly in favour of going there at every available opportunity—this is a debate on glaucoma.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

I start by passing on the apologies of my hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill), who leads for the shadow health team on the issues we are focusing on today. She is otherwise detained on the Tobacco and Vapes Public Bill Committee, which is taking place at the same time.

I sincerely thank my hon. Friend the Member for Strangford (Jim Shannon)—I know that the custom in this place would be for me to call him “the hon. Gentleman”, because he is not of my party, but he is a friend—for securing this crucial debate and for the positive spirit he always brings to these proceedings. Glaucoma is a common yet serious condition that, if left untreated, can cause real damage. Anyone is at risk of developing glaucoma at any age, but it particularly affects people as they get older.

I declare a bit of an interest here: my grandmother had glaucoma. Because my mum died at the age of 50, they do not if the condition was hereditary, so every time I go to my opticians I have to have the glaucoma test in case it is hereditary. However, it is really important that people are tested routinely, because it is a serious condition that, if left untreated, can cause real damage.

Several factors increase an individual’s risk of glaucoma, including a family history of the condition; being of African, Caribbean or east Asian origin; and having long or short sight, diabetes or blood pressure problems. Glaucoma tends to develop gradually, and it is often entirely symptomless for a long period. As a result, many glaucoma patients are diagnosed only during routine eye tests. The impact of glaucoma can vary greatly, ranging from misty or blurry patches in vision to struggling to complete day-to-day tasks such as reading, and permanent sight loss.

When it comes to accessing basic care, many glaucoma patients face significant challenges. Across eye care, more than 600,000 patients are currently on waiting lists for treatment. Given the risk that glaucoma poses if left untreated, such extensive waiting lists are a serious threat to patient outcomes. Sadly, that statistic shows no sign of changing, and demand for ophthalmology services is set to increase by more than 40% in the next two decades. Given an estimated annual cost to the economy from sight loss of more than £25 billion, the case for action could not be clearer.

I have a degree of frustration with the Government’s approach to the issue. Given the statistics, I would like to see the Minister commit today to turbocharge access to ophthalmology services and make eye tests more commonplace for people who do not routinely test their eyes, but also to get people access to eye care services once conditions have been diagnosed.

The next Labour Government are committed to reforming the system so that those with glaucoma and other eye health conditions can access care when and where it is needed. We will provide 2 million more operations and appointments on evenings and weekends, paid for by clamping down on tax dodgers, so that patients can be seen on time again. We will have a laser-like focus on prevention, tackling the social determinants of ill health and ensuring that eye conditions such as glaucoma are tackled at source. We will ensure that the NHS shifts from an analogue to a digital service, embracing the latest developments in technology and artificial intelligence to provide the best possible care and deliver the best possible patient outcomes.

Again, I declare an interest: being a bespectacled Member of Parliament, I obviously have routine eye tests. I am short-sighted, although age is catching up with me, and this is the first time that I have had varifocals for reading and for distance. However, my optometrist, Dr Shen of Boots opticians in Denton, has brought in and embraced some of the latest technological advances for testing different eye conditions. At my last eye test, I was amazed at the wizardry and machinery they have brought in, revolutionising the way they can diagnose.

[Jim Shannon]

The hon. Gentleman is speaking very powerfully and I endorse those comments. What I have seen with optometrists in Newtownards in my constituency of Strangford is the amount of money and investment that they have put in. They have not asked for any help from the NHS for those things. They are doing it themselves. I think there is a wonderful opportunity for a partnership with optometrists who are investing money—all they need is the people to come in for testing—and that, I believe, is a role for Government.

[Andrew Gwynne]

I could not agree more with the hon. Gentleman. Boots Opticians in Denton is a franchise, and the owner of that franchise has invested in this remarkable technology. I have now seen parts of my eyes that I never believed it would be possible to be able to see. It is incredible digital technology, and it allows opticians to diagnose eye stroke. That is particularly important for people with diabetes, glaucoma, high blood pressure and cardiovascular disease. The technology can also be used to diagnose diabetic retinopathy, in which people’s retinas are leaky, which can lead to temporary vision loss, and age-related macular degeneration. That detailed eye care allows other eye problems, which ordinarily would have gone unchecked, to be found and the appropriate treatments to be provided. I have seen how transformative the use of modern technology by my own optician can be for testing for a whole range of conditions and eye health.

That is why this debate is relevant and why changes across the system are clearly needed. That is most evident in community optometry. There is a real potential to utilise, as the hon. Member for Strangford has said, the existing capacity on our high streets and in our town centres—crucially, where people are—to get a firm grip on the crisis in eye care. That is why the next Labour Government have committed to seeking negotiations with high street opticians to strike a deal to deliver more NHS outpatient appointments. That partnership, which the hon Gentleman was rightly discussing, will underpin Labour’s eye care policy.

With 6,000 high street opticians serving communities across the country, we cannot afford to sit back and waste their incredible potential. We will work with high street opticians to beat the backlog and to get the system moving again. By utilising community capacity, we can free up specialists in the NHS to support those patients with the greatest need, providing greater accessibility, convenient care and, most importantly for all of us taxpayers, better value for money for the public purse.

This approach is backed up by evidence, proving the tangible impact of community-based eye care and eye health services. A 2014 study of the introduction of minor eye care services in Lewisham and Lambeth showed how significant that impact is. GP referrals to ophthalmology specialists in Lambeth decreased by 30%, with an even greater reduction—75%—in Lewisham. Costs in areas without minor eye care services increased, while there was a drop in costs in Lewisham and Lambeth of 14%.

Given that the sector is in clear need of reform, with patient outcomes continuing to suffer, will the Minister back Labour’s plan to unlock the potential of community optometry? With more than 550 patients suffering sight loss because of delays in the NHS since 2019, does the Minister accept that further inaction is simply not an option? These are people whose lives, and those of their loved ones, have been fundamentally changed through no fault of their own. We owe it to them to fix this system once and for all, working in partnership with the devolved Administrations across the United Kingdom, as the hon. Member for Strangford says, so that there is not a postcode lottery on these services, and we get the best outcomes for all British citizens across the United Kingdom. We owe it to them to ensure patients with glaucoma and other eye health conditions get the care they need, when they need it, and where they need it.

We will support the Government in the remaining weeks or months that they have to get this policy right, but mark my words: the next Labour Government see this as a priority and we will act.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Back in the real world, the record of the last Labour Government is that we increased life expectancy by three years. Under this Government, it has stalled for the first time in a century, with people in Blackpool, for example, expected to live four and a half years less than the national average. Is the Secretary of State proud of this shocking record, or will people have to wait to elect Chris Webb in Blackpool South and a Labour Government at Westminster to finally turn the tide on health inequalities?

[Victoria Atkins]

As someone who is proud to have gone to school in Blackpool, I do not need a lecture from the hon. Gentleman about what Labour has done to the town centre, or about the important work that Conservatives in Lancashire are doing to help communities such as Blackpool. On Labour’s record, I gently point out, as I try to do at every orals, that the record of the Labour-run NHS in Wales is lamentable. People are almost twice as likely to be waiting for treatment in the Labour-run NHS in Wales. That is not a record of which to be proud.

Hospice Funding

Andrew Gwynne Excerpts

Monday 22nd April 2024 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to respond to the debate. We have had a very thorough discussion over the past few hours, so let me start by thanking not only the Backbench Business Committee for granting the time for us to debate this important issue—albeit a week later than most of us had expected—but the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing the debate; I congratulate them on their speeches.

I thank my hon. Friends the Members for Enfield, Southgate (Bambos Charalambous), for Coventry North East (Colleen Fletcher), for Birmingham, Erdington (Mrs Hamilton), for Hammersmith (Andy Slaughter) and for York Central (Rachael Maskell), my right hon. Friend the Member for Hayes and Harlington (John McDonnell) and my hon. Friend the Member for Leeds East (Richard Burgon), as well as the hon. Members for Colchester (Will Quince), for Southport (Damien Moore) and for Eastleigh (Paul Holmes), the hon. and learned Member for Eddisbury (Edward Timpson), the right hon. Member for Basingstoke (Dame Maria Miller), the hon. Members for North Devon (Selaine Saxby) and for Bolton West (Chris Green), the right hon. and learned Member for South Swindon (Sir Robert Buckland), the hon. Members for Loughborough (Jane Hunt), for Isle of Wight (Bob Seely), for West Dorset (Chris Loder), for South Dorset (Richard Drax), for Waveney (Peter Aldous), for St Austell and Newquay (Steve Double) and for Bracknell (James Sunderland)—not forgetting, of course, the hon. Members for Strangford (Jim Shannon) and for Glasgow North (Patrick Grady). I also congratulate all those who took part in the London marathon; I was not one of them.

Let me now turn to the subject that we are here to debate. End of life care is a subject that has touched the lives of most of us. It is a time when our loved ones, and the family and friends who surround them, can be at their most vulnerable and in need of the greatest support. Managed well, it can be a healing time for families to come together, but managed badly, it can leave deep and traumatic scars. I need only look at the experience of my family—the experience that I had during the deaths of my parents to know how this bears out. It was 30 years ago that I lost my mum to ovarian cancer—I was 19. Her final hours were spent at the end of an old Victorian ward with the curtain pulled around her, and she was in immense pain and suffering, which I remember vividly to this day. That was incredibly hard for our family to manage.

More recently, in 2022 I lost my dad following his own battle with cancer. Unlike my mum, he died at home, with my wife and I taking him in for the last few months of his life, and we were supported by a superb army of care staff. In fact, when the time came for my dad to decide whether he wanted to go to the local hospice, Willow Wood, or stay at home with us, the final words that he communicated to me and my wife were, “Stay here.” I come back to the point made by the hon. Member for Colchester about how we talk about death, how we deal with death and the end of life, and the fact that many people want dignified end of life services at home; we should do all we can to facilitate that.

In my dad’s case, the whole system worked. It came together in a way that, as I know from my constituency casework, it rarely does. The hospital, social services, Macmillan, Marie Curie, the GP, the pharmacy, the district nurses and Willow Wood hospice all worked together seamlessly, and my died passed away in comfort, peacefully and surrounded by those who loved him most in the world. We have heard from my hon. Friend the Member for Coventry North East and other Members that we have to get the end of life choice right for people, and hospice at home plays an important role in that.

The sharp contrast between my parents’ journeys emphasises to me, in a deeply personal way, just how impactful end of life care can be. For all of us, death should be about choice and what we want, and we should leave this planet with dignity. We talk about the integrated care boards, and the clue is in the name: they should be integrated, with both social care and other services, including hospice services. In my dad’s case, that worked, but as we have heard from Members across the House, in too many cases the integration just is not there yet. The Government have rightly devolved money to the ICBs for a specific purpose, but it is not being spent as we would want.

Hospices play such an important part in that deeply personal journey for hundreds of thousands of people and their families every year, right across the country. Working in partnership with existing local systems, hospices ensure that people receive the care that is most appropriate for them, considering all their needs. I pay particular tribute to one of my local hospices, Willow Wood hospice in Ashton, Tameside. The tireless work and dedication of its staff was a vital support when we were caring for my dad in his final days. Those staff showed hospice care at its best, and they have my immense gratitude for all that they continue to do. But they, like so many others, find themselves in a perilous financial position; Willow Wood faces a structural deficit of £750,000 this financial year. Without finding a way to plug the gap, its services will have to be reduced.

There is real pressure on all hospices to generate their own income, with Hospice UK estimating that as much as two thirds of income for adult hospices is generated through fundraising, with some, like Willow Wood, having to raise 80% of their funds themselves. Many hospices do incredible fundraising work, with armies of volunteers finding ever more ingenious ways to keep the money coming in, but with the incredibly hostile economic climate that hospices are finding themselves in, including as a result of energy costs, funds are being squeezed more than ever—[Interruption.] Someone put 50p in the meter; obviously the House cannot afford those costs now!

The sector as a whole is on track for a deficit of £77 million for the last financial year, the worst figures for two decades. As a result, hospices are starting to pare back some of their services. As we have heard, there is also a legal requirement placed on integrated care boards by the Health and Care Act 2022 to commission palliative care services in keeping with local need, and we need to ensure that that funding is passported down to the hospices where they need it. We know that delivery is far from consistent, leaving patients in some parts of the country without adequate services in their own community. The clear pressure on the sector shows no sign of letting up, because we are an ageing population and demands on hospice services are set to increase further, with Office for National Statistics data suggesting that a further 130,000 people will die each year in the UK by 2040.

It is clear that we need proper joined-up supportive policies for the hospice sector. We need to ensure that the money that the Government have ensured is there for the hospice sector gets down to where it needs it: at the hospices themselves. We need to focus on creating a health and care system that is genuinely joined up and has end of life care as part of the health and wellbeing policies for each and every one of us. This can no longer be the taboo subject it once was, and the hospice sector underpins so many care pathways that have a tangibly positive impact on patients and their families. End of life care matters. This current Government will have our support in ensuring that the hospice sector is protected and supported.