Eye Health and Macular Disease

Andrew Gwynne Excerpts

Tuesday 11th January 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Nokes. I commend the hon. Member for Strangford (Jim Shannon) for securing this important debate. We have had some powerful contributions. I pay particular tribute to the hon. Member for Great Grimsby (Lia Nici) for setting out her personal experiences. It is those experiences that make for such an informed debate, and I thank her for putting those on the record.

The RNIB estimates that there are currently more than 2 million people living with sight loss in the UK. Fight for Sight estimates that by 2050 that number will reach 4 million. Without support, ophthalmology services will be stretched to capacity. As we have heard in the debate, eye health and macular disease are important issues. I am grateful to have been given the opportunity to respond to this debate on behalf of Her Majesty’s Opposition.

As has already been made clear throughout the debate, the demand for ophthalmology services has risen at a rapid rate. Referrals from primary care were up by 12% in December 2019 compared to 2013-14. With an ageing population, it is likely that referrals will increase still further. Around 600,000 people are living with age-related macular degeneration in the United Kingdom. Degenerative sight loss not only is physically traumatising but can have a severe long-term impact on mental health and quality of life. Some 90% of vision impairment is treatable, but treatment must be fast and accessible to limit impairment.

Back in 2018, the all-party parliamentary group on eye health and visual impairment published its report, which found that the current system of eye care is

“failing patients on a grand scale”.

It found that services are delaying and cancelling time-critical appointments, resulting in some patients not receiving sight-saving treatment and care when they need it most. The Government promised to consider the recommendations of the report, yet here in 2022, people are still suffering sight loss on an unprecedented scale.

Nationally, almost 35% of patients—more than 592,000 people—are waiting longer than 18 weeks to start ophthalmology treatment. Shockingly, at the end of October 2021 around 28,000 patients in England and Wales have been waiting a year or longer to begin treatment. It is important to note that there is stark regional inequality in access to eye health services. At the Tameside and Glossop trust, one of two that covers my constituency, over 50% of patients wait more than 18 weeks to begin treatment. That is around 15% higher than the national average. Those figures represent individuals whose eye health is deteriorating rapidly, and who are incredibly anxious and scared about what their future may hold. If they do not receive adequate treatment and care, they will suffer a permanent alteration to their vision and quality of life.

The Government have to tackle this situation, because we know that the figures largely represent the state of the NHS before the pandemic. Waiting lists for treatment have got worse because of the pandemic, but the situation was far from perfect before the covid storm hit these shores. The problem in eye health care is not new; for several years, many organisations and people, including Members of this House, have been calling for the Government to act on it. It is too easy to simply point to the pandemic to excuse lack of action. It will not wash with us or with members of the public, who understandably are frustrated and worried about their own treatments.

I would be grateful to the Minister, whom I respect a lot, if she could outline the Department of Health and Social Care’s current assessment of ophthalmology waiting times and what her Department plans to do to ensure that patient safety and care remains a priority over the next few months, particularly given the acute staffing challenges that the health sector is facing.

In December 2019, the getting it right first time programme’s national specialty report was published. The report was endorsed by the Royal College of Ophthalmologists, and is the product of two years of painstaking work. Over 120 trusts were visited across England and several recommendations were made. I am sure many Members are familiar with the contents of the report, but I want to highlight just a few key points that I believe are instructive to the debate.

The two most common medical retina conditions are diabetic and age-related macular degeneration. Despite how common age-related macular degeneration is, it is important to note that macular disease can affect people at any age, including children. The getting it right first time report recommended that attention be paid to improving the accuracy and efficiency of diabetic retina screening. By utilising cutting-edge 3D imaging techniques, we can generate more detailed images of the retina and thereby increase referrals for diabetic maculopathy. However, the report found that in 2019, only 45% of providers utilised optical coherence tomography to refine referrals.

What we do know—I would be grateful to hear the Minister’s thoughts on the recommendations—is that the Government and her Department need to improve access top treatment and referrals for eye conditions. Specifically, I would be interested to hear what the Department makes of calls to train more staff to deliver specialist AMD injections.

I would also like to draw attention to the proposed Health and Care Bill, and specifically its provisions relating to new integrated care systems. For those to be effective in tackling the crisis in eye health, the Government must ensure that ICSs can co-ordinate community optometry and hospital ophthalmology services, to ensure that patients are seen promptly and at the right time. I would be grateful for any clarity that the Minister could give on how ICSs can be best placed to deliver those important changes.

In conclusion, we cannot continue to overlook the challenges that ophthalmology is facing. It is the busiest outpatient service and was under extreme pressure before coronavirus. The Opposition have repeatedly called on the Government to be straight with the British public about the current strain in the NHS and to urgently set about addressing it. We have time and again urged the Government to undo some of their more damaging policies on the NHS. Waiting times have soared and patients have been let down before covid, yet there is no detailed plan, and patients, staff and people across the country are now looking to the Government to deliver on their promise to improve NHS care and to drive down waiting times and waiting lists. We look forward to seeing the detail, but as has already been mentioned in the debate, there needs to be a real consideration in the plan for eye health and how waiting times can be driven down. I ask that the Minister reflects on the points made during the debate, because people who are suffering poor eye health need to have reassurances from the Government that they are doing everything possible to address the concerns of healthcare leaders, staff and patients.

Public Health

Andrew Gwynne Excerpts

Tuesday 14th December 2021 Commons Chamber

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

This has been a passionate debate that has reflected the gravity of the situation. I sincerely thank hon. Members on both sides of the House for their heartfelt contributions.

Since the start of the pandemic, Labour has been crystal clear: we will not play party politics with people’s lives, especially when it comes to something as grave as covid-19. The precautionary measures before us have been recommended by the chief medical officer and the chief scientific advisers and are based on scientific evidence. They are proportionate, necessary and will give us time to get people boosted and better understand the omicron variant.

We have always said that the Government should not have scrapped guidance on mask wearing, and we have repeatedly stressed the importance of allowing people the flexibility to work at home. These measures will help us to have a safer Christmas, as well as protecting our NHS from being totally overwhelmed by the new variant. We are also pleased that the Government have taken our advice and our suggestion to include an option to present a negative lateral flow test as an alternative to vaccination status; I am grateful to the Government for that, and for providing the necessary assurances that the restrictions will not impede any access to essential services.

We have always supported measures that have been necessary to keep people safe. We will not alter that approach, but nor will we pretend that we are in any way satisfied with the conduct of Government Members—the Prime Minister in particular—over the past few weeks. The Prime Minister has done irreparable damage to public trust and has thereby undermined vital public health messaging. We know that, when the country was most in need and ordinary people were doing the decent thing and sticking to the rules, the Prime Minister and his tinsel-clad advisers were making a mockery of the British public.

Neither I nor other Labour Members will let the Prime Minister’s failure undermine necessary public health measures, however, because we know that the omicron variant is much more transmissible and that getting two doses of the vaccine seems less effective in tackling it. The booster jab provides an increase in protection, so it is essential that the boosters be rolled out and that all those who are yet to have their primary course come forward as soon as possible.

Throughout the pandemic, vaccination has proven to be the effective tool against the virus, and that remains the case. We have repeatedly called on the vaccines Minister —the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup)—to put a rocket under the booster roll-out, but we are concerned about the mixed messaging from the Government over the past few days. In his televised address on Sunday night, the Prime Minister said that people

“will have the chance to get their booster before the New Year.”

However, the Secretary of State for Health and Social Care indicated in his statement yesterday that the aim instead is to “offer” the booster to every adult by the end of the month, meaning that delivery will wait until January or even February. When is it? Can the Minister clarify once and for all whether the Government are rowing back on the target set just two days ago?

We are concerned about the shambolic lack of tests available for people across the country. How do we expect fully vaccinated contacts of cases to take daily tests if they cannot get hold of any? What is more, the regulations requiring vaccination status or a negative lateral flow test for entry to certain venues come into force tomorrow. If people are unable to get a lateral flow test, we have a big problem—I hope the Minister will address that.

On vaccinations for NHS staff, our position is that we want everyone working in the NHS to take up the vaccine. The vaccine is safe and effective and we should focus on driving up vaccination rates through persuasion, education and support. Vaccination not only protects vulnerable patients, but will protect staff from severe disease. The Government must urgently meet the royal colleges, the NHS providers and the unions to agree a framework for how any changes agreed tonight will be rolled out.

Finally, I want to highlight where the Government are still falling short, in the hope that the Minister will take these points on board before it is too late. First, will the Government confirm that we will not waste the Christmas holidays, and ensure that all children who are eligible to be offered a vaccination before the end of this month will have one? Furthermore, will the Minister advise why, more than 19 months since SAGE first highlighted the crucial role of good ventilation, the Government are still failing to act on its advice? With these measures being laid before the House, the Government should also reconsider their position on sick pay provision; nobody should have to choose between feeding their family and doing the right thing by isolating.

I appreciate that no Government ever want to bring in measures such as these, and I fully appreciate the frustration of Members across the House and people across our country that we are here again, being forced to change our way of life to fight this virus, but I am afraid that the alternative is far more serious. If we do not take steps to protect the NHS, it will face a wave of infections that will likely overwhelm it. Labour opposes this Prime Minister and this Conservative Government, but we will support them on these measures because we support our NHS and we support the science; and when we are faced with a crisis, Labour will always put people and the health of the nation above party politics.

Covid-19 Update

Andrew Gwynne Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

There are many communities where vaccine take-up is lower than others. That has particularly been the case in the black African community in Britain and in some other black and minority ethnic communities—that has improved significantly over the past two to three months. The same is also the case in many other European countries and the US. A huge amount of work is being done through community leaders and communication campaigns, and by offering access to the vaccine in as many different ways as possible to encourage take-up.

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

Will the Secretary of State talk a bit more about the transmissibility of the omicron variant and the efficacy of vaccines on it, given that Australia has some of the toughest entry requirements of any country in the world, yet the variant has basically got through a concrete wall?

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 23rd November 2021 Commons Chamber

[Maria Caulfield]

Local commissioners are responsible for meeting the health needs of their local population and should continue to ensure appropriate access to ear wax services. However, should a CCG not routinely commission ear wax removal or the suction method that my hon. Friend refers to, a patient can request an individual funding request. I am happy to help my hon. Friend if that is not happening locally.

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

Cancer targets are not being met. This September had the worst figures on record for both the 31-day and the 62-day targets; the 62-day target has not been met since 2015. Extra funding is welcome, but where is the detailed implementation plan that was promised to follow?

NHS Update

Andrew Gwynne Excerpts

Wednesday 21st July 2021 Commons Chamber

[Helen Whately]

As I have said, we are considering the recommendations of the NHS pay review body. This is an extremely important decision for the Government; it clearly has consequences for a very large number of NHS staff. We will be announcing our decision on pay as soon as we can.

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

Let me start by commiserating with the Minister, who is clearly grabbing a short straw at the moment. I am not sure what the point of this statement actually is. It seems as though pages 2 to 4 have been torn out at the last minute, and she has just read out the preamble and the end, with nothing in between. However, as this is an opportunity to raise NHS issues with her, may I draw her attention to a growing concern for my constituents, which is the difficulty in getting a GP appointment? Is she aware of that growing issue across parts of Greater Manchester and, no doubt, the rest of England? What is she doing about it?

[Helen Whately]

I thank the hon. Gentleman for taking the opportunity to raise that point. I am well aware of it, as my constituents in Kent raise the issue of that challenge in my area, and I know others do the same in many other parts of the country. That is why we are working to increase the number of primary care appointments available to people, knowing that demand is going up and that we must make sure that people’s need for local healthcare, which is so important, is met.

Covid-19 Update

Andrew Gwynne Excerpts

Monday 19th July 2021 Commons Chamber

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

We all want to see the back of this pandemic and life return to normality. History will no doubt judge the wisdom or otherwise of “freedom day” at this point in time. I wish to focus on long covid, because it is a fact that the more covid there is, the more long covid there will be. At its worst, it is debilitating. It is just awful, and I know that because I am still suffering with it, after 16 months. If the balance of risk is more long covid, may I ask the Minister what more his Government will do to help those with it in their health recovery, to help employers impacted by an ill workforce and in providing social security for those on the long-term sick with long covid?

[Nadhim Zahawi]

I am very grateful to the hon. Gentleman for his excellent question and I wish him a continued recovery. I know from the work that I have seen that it is not easy. I believe there are just over 900,000 people suffering from different forms of long covid. We have made an additional £150 million available for the NHS, both in terms of looking at long covid, and having an infrastructure to be able to deal with it and help support GPs to diagnose it.

Covid-19 Update

Andrew Gwynne Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

I believe I have answered this question a number of times during this session.

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

It is 16 months since I contracted a fairly mild bout of coronavirus, which, unfortunately, developed into terrible long covid, and the symptoms still persist all these months later. The vaccination programme has been a game changer and I want a return to normality, like everyone else, but does the Secretary of State understand that the consequence of his decision may well be more people with long covid? The money for research is welcome, but what more is he planning to do to support those with long covid with health, rehabilitation and social security measures and to support employers with the reality that sections of their workforce might be unfit for work for periods, too?

Covid-19 Update

Andrew Gwynne Excerpts

Monday 7th June 2021 Commons Chamber

[Mr Speaker]

Welcome back Andrew Gwynne.

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

Thank you, Mr Speaker. In his statement, the Secretary of State mentioned the rising cases of the delta variant across north-west England, and the impact of the vaccination programme on reducing hospitalisations. That is positive news, but the consequence of increasing covid rates, even without hospitalisations, is not totally positive. May I ask him about long covid—something that is close to my heart, having had it for 12 months? Beyond the actions he has already taken, what more will he do to help those who, inevitably, will develop long-term consequences and symptoms of covid from the latest wave of the delta variant?

[Matt Hancock]

This incredibly important subject is close to my heart too, and perhaps we can work with the hon. Gentleman, with his personal experience of long covid over such a period, to ensure that we drive that agenda as hard as possible. The NHS has stepped forward and we have put more money into research, but this is an unknown condition as a result of a novel virus. It is a complicated condition and there are many different types of long covid. I would be keen to ensure that the hon. Gentleman engages with the NHS work on this.

Covid Security at UK Borders

Andrew Gwynne Excerpts

Monday 1st February 2021 Commons Chamber

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

It is 12 months since the first cases of covid-19 hit our shores. Back then, I doubt whether many of us could imagine how the virus would affect our lives throughout 2020 and 2021. It has tested our approach to a global pandemic to the full. It has brought out the best in our NHS, our carers and our public services, and in our sense of community, with the many heroes who have stepped up to help others. I get that the situation is unlike anything that Governments have had to deal with in modern times. Decisions are a matter of life and death, and every country has adopted different strategies to deal with covid-19.

It is easy to criticise, and we have got some things right. The approach to trialling and procuring vaccinations, and upscaling roll-out very quickly, is a real success. However, I cannot help but think that we failed to learn from others earlier in the pandemic, and their best practice. I serve on the Home Affairs Committee, and last year we took evidence from officials in Honk Kong, Singapore and New Zealand—three common law jurisdictions that took different, tougher public health approaches early on. They were much quicker at locking down than us, and they all placed strict restrictions on their borders, with enforced quarantine. We knew back then that it was working, which prompts the question why a similar approach was not taken here. For months, our borders have effectively remained open.

We have been lucky so far. The new strains that have been identified still react to the vaccines, but a future strain might not do so. Until we have some control over international spread and global immunisation there remains a risk here in the UK. Life in New Zealand is nearly back to normal: people can gather, kiss, hug, go to pop concerts, fill stadiums, and enjoy life. Our southern hemisphere cousins called it right: tough—very tough—measures at the start; and strict controls at the border to help control the virus in the country and get back to ordinary life more quickly.

We opted for looser lockdowns, polite requests to self-isolate, allowing international travel to continue in large part, an endless cycle of local restrictions, tiers and national lockdowns—but never getting the virus down sufficiently to stop it bouncing back. Tragically, there are over 100,000 dead, each number a real person. The vaccine offers the first ray of light in over 12 months, but it is still not too late to tackle the border issue, alongside a sectoral support package for aviation. The cross-infection of a new mutant strain will set back any progress that we have made in defeating the virus, and that is why I support the motion.

Long Covid

Andrew Gwynne Excerpts

Thursday 14th January 2021 Commons Chamber

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

I begin by thanking the hon. Member for Oxford West and Abingdon (Layla Moran) for her superb opening to the debate and for her leadership of the all-party group.

My experience with covid began in early March, when I started to feel grotty and run down. I just wanted to rest, but as a precaution I phoned NHS 111, which suggested to me that it could not possibly be covid because no cases had been reported in M34, even though I explained to them that I worked in hotspot SW1. Eventually, typical covid symptoms developed, so I spent the next fortnight in self-isolation. The illness lasted for about 12 days, by the end of which the country was in lockdown 1, but the reality is that, although the coronavirus passed, the effects are still with me today.

Thankfully, research is now being carried out and the Government recognise long covid as being real. That has been a battle. I was lucky: my GP is brilliant, and from an early stage recognised my condition—long before it had the name “long covid”. My condition is not as severe as it was even just a few months ago. There have been real improvements, but it has been a hard slog to get here. For the first seven months or so, the exhaustion came back frequently and to the point where just doing simple tasks around the House brought me out in massive sweats as if I had run the London marathon. I had lots of dizzy spells; I have never had vertigo before this. And oh, the brain fog! In a job where we have to be razor sharp, my short-term memory is shot to pieces. I have had to learn to pace myself. Trying to push my limits would set me back. I still have to remind myself not to overdo it.

The lasting symptom is still the brain fog. When it is bad, taking in information and processing it is so difficult. It is physically and mentally tiring, often triggering headaches, dizziness and vertigo. I am fortunate in having been able to balance work with my disabilities. Virtual participation and proxy votes have helped. I talk about the difficulties of doing my job, but what about the mechanic, the builder, the emergency worker, the teacher, the nurse—people who do not have the luxury of virtual participation, aides-mémoire, and an efficient and brilliant office to hide deficiencies? They are left to struggle and make the most of it, or to lose their jobs. On that point, the Department for Work and Pensions has to do more to recognise the condition for work capability assessments and other interviews.

I am so grateful to some of the representatives from long covid support groups for meeting me earlier this week. They want the Government to acknowledge that children can also get long covid. Of course children often present with symptoms different from adults’, so an awareness campaign is required, but children should also have access to treatment in long covid clinics and throughout the NHS.

The problem of long covid is not going away; it is growing as the number of people catching covid grows. I would like to hear from the Minister about a holistic approach, with research, treatment and support in the health sense, but also in the wellbeing sense, the workplace sense and the family sense too. Let us support people and their families—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I thank the hon. Gentleman for his speech.