Sudden Unexplained Death in Childhood

Andrew Gwynne Excerpts

Tuesday 17th January 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Twigg, and to speak on behalf of the shadow Health and Social Care team about this tragic and vital issue. I pay tribute to the work of the right hon. Member for Spelthorne (Kwasi Kwarteng), who has been such a strong advocate in addressing sudden unexplained death in childhood. I extend my sincere condolences to his constituents, Julia and Christian, who lost their son Louis to SUDC. Their work, alongside representatives of the charity SUDC UK, to raise awareness of this tragic cause of death has been extraordinary. I would like to place on record my recognition of the work that they and others have done.

As has been outlined, SUDC is the unexpected and unexplained death of a child. Data from the Office for National Statistics estimates that around 40 children are affected by SUDC in the United Kingdom each year. As we have heard in other Members’ contributions, it is the fourth leading category of death in children aged between one and four. SUDC is similar to SIDS—sudden infant death syndrome—but whereas SIDS applies to a child who dies before they are 12 months old, SUDC can occur between the ages of one and 18. Another important difference is that SIDS research has resulted in vital safer sleep guidance, whereas there is currently no guidance and there are no recommendations to mitigate the risks of SUDC in children aged one to 18.

I cannot even begin to imagine losing a child—there can be nothing worse and no pain more unimaginable. The additional cruelty of SUDC lies in its inexplicability, because we do not know what causes it. As it stands, these deaths are unpredictable and largely unpreventable. I know I speak for those on both sides of the Chamber when I say that it is incredibly important that the Government do everything they can to support research, awareness and understanding of this tragic disease. We also need to ensure that families burdened with grief after such an enormous loss have access to the mental health and emotional support that is undoubtedly necessary after losing a child.

The National Child Mortality Database has done amazing work to improve understanding of the scale and risk markers associated with SUDC. A recent study conducted by the NCMD highlighted the role that poverty plays in a higher risk of SUDC. Some 42% of unexplained deaths of infants happened in deprived neighbourhoods, as opposed to 8% in the wealthiest.

I would appreciate it if the Minister could outline what work is ongoing to understand SUDC and what action his Department is taking to support parents and families who have lost a child to it. I would also like to impress on him the importance of tackling socioeconomic inequalities, which we know drive poorer health outcomes for those living in the most deprived communities. If we are to build a happier and healthier future for every family, irrespective of where they are born, we must get a grip on these endemic inequalities across England. I would be grateful if the Minister could update the House on the Government’s work to tackle health disparities, with SUDC particularly in mind.

We must ensure that every child gets a healthy start in life—something that has informed Labour’s commitment to train 5,000 additional health visitors. Health visitors are skilled in spotting where there may be a problem with a child’s health and are therefore key to prevention and providing that support to families.

We also need to raise awareness. In preparing for the debate, I was incredibly surprised to discover that there is currently no information about SUDC on the NHS website, as we have heard from other Members. There is no co-ordinated national research and very little public awareness. I want to use the debate to support the calls for improved public awareness, information and research, and I hope the Minister will join me in that respect and set out what discussions he will have with the NHS to improve the availability of SUDC information and support.

In closing, we owe it to the families who have lost children, the campaigners who have raised awareness and the researchers who work around the clock to better understand and ultimately defeat SUDC.

Draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023

Andrew Gwynne Excerpts

Tuesday 17th January 2023 General Committees

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

It is a pleasure to serve under your chairmanship, Mrs Latham and good to be speaking on behalf on the shadow health and social care team.

As the Minister has outlined, the regulations effectively abolish the Health and Social Care Information Centre, which we all refer to as NHS Digital, and transfer those functions to NHS England. The SI essentially creates a single statutory body that is responsible for data and digital technology. The clear intention of the merger between NHS Digital and NHS England is to streamline data-sharing processes. It is noteworthy that in their own explanatory note, the Government recognise that

“leadership of digital transformation has been disjointed…the fragmentation of national bodies had made it hard to achieve”

an integrated and accessible digital health system. That view has been informed, of course, by the Laura Wade-Gery review, which was published in 2021. Ensuring that patients can access transparent data easily and effectively is crucial not only to informing patient choice but to monitoring whether relevant standards are adhered to.

The Department of Health and Social Care has said that NHS Digital staff and assets will transfer to NHS England before going through the wider “Creating a new NHS England” change programme. That will ensure that

“the necessary talent and expertise of NHS Digital”

is maintained.

The maintenance of high-level expertise is essential, especially when we consider the concerns that have been raised about the shrinking workforce in NHS England. Can the Minister tell us how long he anticipates the change programme will take? Can he also expand on his assurances that talent and expertise will be retained? As the transfer begins, the Opposition will hold the Government to their assurance that all expected standards governing the protection of patient data are maintained. That is an essential aspect of good data management and I have no doubt that the Minister recognises that.

New duties on NHS England include a requirement for the body to report on how effectively it discharges its relevant data functions, as well as a new duty on the Secretary of State to issue guidance to NHS England about the exercise of its “relevant data functions”. When does the Minister expect that guidance to be published? What expertise has he drawn on to generate that guidance? Can he also take this opportunity to assure Members that the acceleration of the merger, originally planned for April 2023 but now brought forward to January, will not have an adverse effect on IT continuity or staff preparedness? Will he also outline what level of communication current NHS Digital staff have received about the merger, and has that process been impacted by the acceleration?

The Opposition will not oppose the regulations, because we are committed to streamlined data processes, as long as that does not come at the expense of expertise or patient access.

--- Later in debate ---

[Neil O'Brien]

Some excellent questions have been asked. My hon. Friend the Member for Amber Valley asked about the vision that the proposal is part of. It is certainly the case that there is a process of simplification of organisations, of which the transfer is another major step. The Health and Social Care Act 2022 also gave Ministers powers of direction over NHS England that did not exist before. None the less, that basic operational independence and structure still stands, so there is change but not a wholesale one compared with the 2012 arrangements.

My hon. Friend the Member for South Thanet asked a really important question about interoperability across the UK. As well as trying to promote that in the NHS, a piece of work is being done by the Department for Levelling Up, Housing and Communities and the Cabinet Office about comparability of data not just in health, but across the work of Government. I am sure that my hon. Friend would find that interesting.

The Opposition spokesman, the hon. Member for Denton and Reddish, asked who we have discussed the transfer with, and the answer is that we have discussed it with the devolved Administrations, the Information Commissioner’s Office, the National Data Guardian, medConfidential and, of course, NHS England and NHS Digital. The staff of those latter two organisations have been fully consulted and know all about the plans. In terms of the speed of the merger, the powers in the SI come into effect immediately, so that the merger can take place towards the end of the month.

I am trying to remember the hon. Gentleman’s other question—

[Andrew Gwynne]

Staff involvement.

[Neil O'Brien]

Absolutely. All the staff know about what is happening and have been consulted fully about the streamlining.

The SI will bring together NHS Digital and NHS England. It will not only preserve existing safeguards around people’s data but will establish slightly stronger ones. Effectively, it will deliver the preservation of the existing regime governing data protection as we bring the two organisations together and it will create all the efficiencies that that process will enable. I commend the regulations to the Committee.

Question put and agreed to.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 6th December 2022 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

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

In 2019, the Tories promised to extend healthy life expectancy by five years, but on this they are failing. In the last year, the health disparities White Paper has disappeared, the tobacco control plan has been delayed and they have chickened out on implementing the obesity strategy because the Prime Minister is too cowardly to stand up to his Back Benchers. Health inequalities are widening as a consequence. Does the Minister plan to revive any of these strategies, or have the Conservatives completely given up on prevention?

[Neil O’Brien]

I have already talked about some of the things we are doing to crack on with improving public health and narrowing inequalities, but I will add some more. We are driving up blood donations from shortage groups and vaccine uptake in areas with the lowest uptake. I mentioned the extra £900 million for drug treatment, taking the total to £3 billion over three years. I will not repeat all the things I mentioned but, across the board, we are working at pace to improve public health and narrow health inequalities.

World AIDS Day

Andrew Gwynne Excerpts

Thursday 1st December 2022 Commons Chamber

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

I, too, congratulate both my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) on securing this debate, and the Backbench Business Committee on granting it. In thanking my hon. Friend, I want to say that we listened intently to his opening contribution. It was full of wisdom, insight and personal advocacy and showed the commitment that he brings to the issue in this place. The House of Commons is a better place when we speak openly and challenge those in power about the issues that still prevail, not just in this country but across the world when it comes to HIV/AIDS.

On this day, we remember the 40 million people who have lost their lives to the worldwide AIDS pandemic and related illnesses since the disease was first found in the 1980s. In this debate, Members from across the House, in a small, but perfectly formed manner, have raised some important issues. I particularly thank the right hon. Member for Romsey and Southampton North (Caroline Nokes) for the way in which she always challenges inequalities around the world, especially inequalities facing women and girls, and, of course, this is an issue that affects women and girls around the globe. It is an equalities issue, and I thank her for her contribution. I also thank the hon. Members for West Bromwich East (Nicola Richards), for Heywood and Middleton (Chris Clarkson), and for Strangford (Jim Shannon) and even the SNP spokesman, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), for their contributions. The great thing about this issue is that it brings us together in unity on World AIDS Day. This is not a party political issue. As with covid, if we are to defeat the first pandemic, we must work together across party lines, and this has been a good debate because of that.

We all recognise the extraordinary work of those who have fought to eradicate the virus. As has already been said, we have come a long way since the first World AIDS Day in 1988. Here in the UK, we have seen unprecedented scientific advancement. We understand more about HIV, and we have legislated against discrimination to better protect those living with HIV. We have seen some long-overdue justice delivered to victims of the contaminated blood scandal, with interim payments being granted for some—but not all—of those impacted. This victory is a testament to the unstinting work of campaigners and, indeed, colleagues from both sides of the House. However, as has been made clear in the Chamber today, there is still much more work to do with regards to this injustice. I hope that, in his response, the Minister will provide an update to the House on when the Government will respond in full to the 19 recommendations laid out in Sir Robert Francis’s framework for compensation.

This World AIDS Day is not just about recognising and celebrating how far we have come, but about issuing a call to action. There can be no room for complacency in the late stages of this campaign. Today, we stand on the brink of achieving something extraordinary: ending all new HIV transmissions in England by 2030. That goal is ambitious, but achievable, and it is one that Labour is proud to support and to push the Government on to achieving. None the less, too many opportunities are still being missed, and sexual health services are struggling to keep up with demand. A total of 46% of people diagnosed with HIV are still diagnosed too late, and 38% of people attending sexual health services were not offered an HIV test last year. That is not good enough. Some 20% fewer people were tested for HIV in 2021 than in 2019, and research shows that 57% of people have waited more than 12 weeks for PrEP.

Shockingly, in 2021, no local authority in England—not one—reported more than five women accessing PrEP, and there are still stark racial disparities in treatment and in support that must be addressed. I wish to use this debate to press the Minister on what steps the Government are taking to tackle unequal access to sexual health services and, in particular, to PrEP.

In a recent study, 40% of people surveyed reported difficulty in booking a sexual health appointment online; 23% of people were turned away due to a lack of available appointments. With that in mind, what assessment have the Government made of sexual health accessibility levels, and what consideration has the Minister made of making PrEP available beyond sexual health services—for example in GPs, gender clinics, pharmacies and abortion clinics? I assume that that work would be included in the promised PrEP action plan, but that has yet to materialise. Will the Minister commit to an implementation date for this plan today, and if not, why not? Furthermore, what recent assessment has the Minister made of the eligibility criteria for PrEP, and are there any plans to expand it?

PrEP is one side of the coin, but we do not often talk about the other side anymore—partly because of the success of PrEP—and that is access to post-exposure prophylaxis. The publicity has fallen for that, but it is still an important tool in the box for people who are fearing that they may have been inadvertently exposed to the HIV virus. There is a small window for those people who fear that they may have been exposed, or who have been exposed to HIV, to get access to PrEP for it to be successful. What are the Government doing to ensure that there is adequate advice and information on the availability of post-exposure prophylaxis?

Sexual health services are under unprecedented pressure due to mpox. Service displacement means that appointments for PrEP, STI testing and long-active, reversible contraceptives have been cut. That has also led to reported hesitancy by clinics to deliver mpox vaccines. What action will the Minister take to ensure that all those who need the mpox vaccine can access one, and not to the detriment of other vital sexual health services?

Moving to testing, the Minister will no doubt be aware that yesterday, NHS England released its report on HIV and hepatitis opt-out testing in areas of very high prevalence. Labour has been proud to support that for several years. The report shows that because of the tests, more than 800 people living with undiagnosed HIV and hepatitis have been identified in these areas. We have saved an estimated £6 million to £8 million on treatment costs. Put simply, opt-out testing has been a huge success. With that in mind, can the Minister set out whether there are any plans to change the current scope of HIV opt-out testing to include all areas of high prevalence?

Finally, I want to touch on stigma. A study recently published by the Terrence Higgins Trust found that just 38% of people knew that those living with HIV and on effective treatment cannot pass the virus on to partners. Only 30% of people said that they would be comfortable dating somebody with HIV. The HIV epidemic is exacerbated by stigma, ignorance and misinformation. If we want equitable access to HIV treatment, we must proactively tackle the myths and bigotry that still permeate discussions around HIV. I am sure that the Minister will agree wholeheartedly with me about that.

I would be interested to hear the Minister’s assessment of current legislative barriers affecting those living with HIV. A clear example is the fact that LGBT+ people with HIV are still not allowed to access fertility treatment, despite the fact that heterosexual people with HIV are able to do so. That is an out-of-date barrier and it needs scrapping. I am proud that the next Labour Government will equalise access to fertility treatment for LGBT+ people living with HIV. Will the Minister join us in committing to that, and pledge to introduce legislation now—before the general election—to end the restrictions that prevent people with HIV from starting a family?

Labour is committed to the HIV 2030 pledge. It is more than prepared to work on a cross-party basis to make this ambition a reality. But we must address some incredibly concerning trends in HIV treatment and access, and not become complacent because of the progress that has come before us. No new transmissions of HIV by 2030 is still possible. We want to succeed, but there is no time to waste. As my hon. Friend the Member for Brighton, Kemptown said, let us all, together, sprint to that finish line.

Smokefree 2030

Andrew Gwynne Excerpts

Thursday 3rd November 2022 Commons Chamber

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

It is a pleasure to speak in this important debate. It has been a small but, I think, perfectly formed debate, in which there has been a large degree of consensus throughout the House on our ambition for England to be smokefree by 2030.

I commend the hon. Member for Harrow East (Bob Blackman) not just for the work he has done on this subject over a long period, particularly in the all-party parliamentary group, but for the way in which he introduced the motion, which, as my hon. Friend the Member for Stockton North (Alex Cunningham) observed, enabled us to say, “We agree with Bob.” I congratulate my hon. Friend for his own work on the subject. I thank the hon. Member for Erewash (Maggie Throup) for her contribution, and also thank her for her time as the public health Minister: I used to enjoy our debates across the Dispatch Box, and I wish her well in whatever comes next.

The Health and Social Care Front Bench is a bit like a whirling dervish at the moment. We had the hon. Member for Erewash a few months ago, then the hon. Member for Sleaford and North Hykeham (Dr Johnson)—she was in post for just six weeks, and I want to thank her as well for the work she did in that short time—and now we have the new Under-Secretary of State for Health and Social Care, the hon. Member for Harborough (Neil O’Brien), whom I welcome. Let me also echo the words of the hon. Member for Harrow East in wishing my hon. Friend—indeed, my friend—the Member for City of Durham (Mary Kelly Foy) a speedy recovery after her hospital treatment.

It is now nearly five months since the release of the Khan review. Both the hon. Member for Erewash and I spoke at the launch, and I think the review was universally welcomed. It was generally agreed that we must move apace in ensuring that we meet the ambition of a smokefree 2030. In those five months we have had three different Health Secretaries, and we are now on our third Prime Minister. I do not blame the current Minister for all this chopping and changing, but it is little wonder that the Government have failed to find time to respond to the Khan review amid the endless changes. I hope that when the Minister responds to the debate, we will finally be given some clarity. I hope he will set out a timetable for when the Government will respond to the Khan review, and will outline which measures in the review itself the Government are currently considering. I also hope he will be able to reassure Members on both sides of the House that the Government stand by their commitment to create a smokefree England by 2030.

The importance of that smokefree 2030 cannot be overstated. Tobacco is the primary driver of health inequalities throughout the United Kingdom. In 2019-20, there were more than half a million hospital admissions and more than 74,000 deaths attributed to smoking. My constituency of Denton and Reddish straddles two local authorities, Tameside and Stockport in Greater Manchester. The public health charity Action on Smoking and Health—ASH—estimates that smoking costs those two local authorities about £172 million in lost productivity and health and social care costs. That is unsustainable.

Behind those stark economic figures, however, are individual lives that are being harmed or lost as a direct result of smoking. We know that more than 50% of people over the age of 16 who smoke say they want to quit—in fact, many say that they wish they had never started in the first place—and it is therefore imperative that the Government support them in their efforts to do so. Unfortunately, stop smoking services have suffered a 33% real-terms cut in their budgets since 2015-16. There is a drastic need for that to be reversed.

The Government have made a commitment to a smoke- free 2030, which is commendable. We support them, and we want them to succeed. However, a commitment alone is not enough: we want to see action to get there, and we need to see that action fast. The former Secretary of State had an interesting relationship with the tobacco industry, to put it mildly. She had previously accepted hospitality from the industry, and had voted against several sensible public health tobacco measures. During her brief but eventful tenure, it was reported that she had scrapped the Government’s proposals to publish a tobacco control plan, as well as the health disparities White Paper. I asked the Minister about the White Paper earlier this week during Health questions, and received something of a non-answer. I will therefore ask my questions again today, in the hope of getting some clarity. Are the Government planning to scrap the health disparities White Paper—yes or no? Are they planning to scrap the tobacco control plan—yes or no? We need transparency, as there seems to be an information vacuum in the Department of Health and Social Care. If the Government are indeed rowing back on their public health responsibilities, they should have the guts to say so, and face scrutiny for that decision.

By doing everything from inviting tobacco lobbyists into the heart of No. 10 to accepting gifts from the big four tobacco firms, the Government have shown themselves too willing to ally themselves to an industry that is damaging the health of the nation. However, the damage done by the tobacco industry is not confined to public health. Recent analysis conducted by The Daily Telegraph has revealed that the Russian Government have received almost £7 billion from tobacco companies in taxes since Putin’s invasion of Ukraine. That is despite several tobacco companies pledging to cut ties with Russia. I would be interested to know what the Minister makes of this revelation. Will the Government make it crystal clear to tobacco companies that they are expected to follow the lead of those companies that have ceased trading with Putin’s tyrannical regime?

Labour Members believe that if we want to ease pressure on our NHS and improve public health, we need to get serious about prevention. That means ensuring equitable access to smoking cessation services, and taking on tobacco companies that profit at the expense of public health. Smoking prevalence is not a problem that the Government can ignore and hope will magically go away. As a Greater Manchester MP, I have been really encouraged by Greater Manchester’s “Make Smoking History” strategy. If the Minister has not looked at that, I encourage him to do so, because it really is best practice. Indeed, it is cited as best practice in a case study in the Khan review.

Greater Manchester’s comprehensive approach to tobacco control means that smokers in Greater Manchester have more offers of support in quitting than ever before. Thanks to the scheme, smoking rates among people in routine and manual jobs have reduced faster in Greater Manchester than in any other region of England. If these strategies can work regionally, they can, with the political willpower, be scaled up to national level.

I urge the Minister to take the brave decisions. They are sometimes tough and often very unpopular with a significant vocal minority of people, but taking those decisions is the right thing to do, as history often shows. Smoking has gone up among young adults aged 18 to 24 in the past three years. To put that in context, in 2007, around 41% of young people said that they had smoked. By 2019, that had fallen to just a quarter, but in the short space from 2019 to 2022, that increased to a third. That is going in the wrong direction. Between 2007 and 2020, smoking fell, as successive Governments really ratcheted up the regulation of smoking and introduced smoke-free laws. They increased the age of sale from 16 to 18; banned the display of tobacco products; introduced standardised packaging and large, graphic health warnings; banned smoking in cars with children; and, lastly, banned menthol in 2020. Those measures worked, but they have to continue, as does the pace of change, if we are to meet the goals of Smokefree 2030.

The last Labour Government implemented one of the biggest and most significant public health interventions in modern political history. I am most proud of it, but it was not popular in all quarters; I was almost banned from holding surgeries at Denton Labour club. It was the ban on indoor smoking. When we go abroad to countries that still have smoking indoors in public places—in bars, restaurants and cafes—we wonder how on earth we put up with that in our country until fairly recently. Absolutely nobody with a modicum of common sense would want to reverse that legislation.

When we were in government, we supported taking the bold steps necessary to protect public health, and many thousands of lives were saved as a result. That is why we want the Government to commit to Smokefree 2030. They will miss that target unless they up the pace of change, accept the recommendations of the Khan review, and legislate to put measures in place. For far too long, public health has been an afterthought, or a battleground on which to have ideological arguments. We have had obesity strategies scrapped, tobacco strategies binned, and health inequalities widened. This neglect cannot continue. We will support the Government in being brave on public health. We will give the Minister the majority he needs, if he does not have one, to pass the right measures in this House. Labour Members will do right by Britain, and encourage the Government to do the same. Be brave, and build a healthier, happier and fairer Britain; we will support you.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 1st November 2022 Commons Chamber

[Mr Speaker]

I call shadow Minister Andrew Gwynne.

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

We know that, if poorer communities cannot afford to heat their homes, health inequalities will worsen significantly over the winter months and beyond. Despite the seriousness of this issue, the previous Health Secretary—that is the right hon. Member for Suffolk Coastal (Dr Coffey), in case Members are struggling to keep track—planned to ditch the Government’s long-promised health disparities White Paper. Does the current Minister intend to do the same? If he does, how will he seriously address the dreadful health inequalities that have widened after 12 Tory years?

[Neil O’Brien]

The hon. Gentleman implies that I disagree with him about this. In fact, the Government are working hard to clamp down on squalid housing. That is exactly what we were doing in my previous Department, DLUHC, and I have just mentioned some of the things that we are doing: the £37 billion we are spending to help people to meet the cost of living, the £15 billion of that that is targeted on the very poorest households, and the £12 billion that we are investing in making people’s houses easier to heat. We will continue to tackle health disparities across the board.

Draft Adult Social Care Information (Enforcement) Regulations 2022

Andrew Gwynne Excerpts

Monday 31st October 2022 General Committees

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

It is a pleasure to serve under your chairmanship, Sir Edward. I welcome the Minister back to her place in the Department of Health and Social Care. Hopefully, there will not be too many issues still on her desk from her previous time as a Minister; let us hope that those who served in between managed to clear the in-tray.

I am pleased to speak to this statutory instrument on behalf of the shadow Health and Social Care team. We see no reason to oppose the measures before us; it is sensible that adult social care providers will be required to supply the Department of Health and Social Care with important data. It is striking that prior to the pandemic there was no comprehensive national data from providers on workforce status, bed availability or the number of people in receipt of care. As the Minister said, having access to that crucial data will no doubt improve policymakers’ ability to judge risk in the care system, which we know to be under significant stress. Without the requisite data, they are unable to make those detailed assessments right now.

I am reassured by what the Minister said about the data being subject to GDPR restrictions, and the fact that data will be shared appropriately with local authorities and integrated care systems. It is right that when a provider is persistently in breach of its data obligations and has not made appropriate attempts to rectify them, financial penalties will be scaled to the provider’s type and size. That is common sense.

The Department of Health and Social Care has indicated that it will consider improving the accessibility of data available to providers and any opportunity to link the capacity tracker to other data sources. In her closing remarks, could the Minister provide a short update on that work and whether the capacity tracker data will be publicly available, so that the state of the social care sector can be robustly assessed in the public domain?

You will be pleased to hear, Sir Edward, that those are the remarks of the official Opposition. We do not oppose this instrument—indeed, we actively support measures to improve transparency in our social care sector.

Covid-19 Vaccines: Safety

Andrew Gwynne Excerpts

Monday 24th October 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Roger. I, too, commend the way the hon. Member for Carshalton and Wallington (Elliot Colburn) opened the debate, and I thank him for his candid support for the vaccine programme.

At the start of September, we had a debate in this very Chamber about the covid-19 vaccine damage payment scheme. I want to begin my speech in the same way as I started my speech in that debate, by saying that the covid-19 vaccine is safe and effective and has saved countless lives. I and the entire shadow Health and Social Care team remain extraordinarily grateful to those who sacrificed countless hours to facilitate our vaccine roll-out.

We are here debating this petition because of the vaccine. Without it, we would probably still be dialling in from our homes—me in Denton, frantically trying to sort my dodgy wi-fi and battling my dog for custody of the study chair. Some 51 million people have been fully vaccinated, and more than 151 million doses have been given in the United Kingdom. Without the vaccine and the extraordinary work of scientists, volunteers and NHS staff, we would not have been able to reclaim the liberties that we were forced to forfeit over the course of the pandemic.

Members from across the House will be aware that all vaccines go through rigorous and ongoing testing procedures. The covid-19 vaccines went through several stages of clinical trials before being approved, and met strict independent standards for safety, quality and effectiveness.

[Andrew Bridgen]

Surely the hon. Gentleman is well aware of the much-publicised interview of a Pfizer representative by a committee of the European Parliament only a couple of weeks ago, when they admitted that they had done no testing whatever to see whether the vaccination prevented transmission of the virus.

[Andrew Gwynne]

Yes, I heard that. Of course, the issue is that we were protecting the lives of those people who needed the vaccine to be able to get on with their day-to-day lives. The covid vaccines did go through several stages of clinical trials before approval and, as I am sure the Minister will make clear in her response, the MHRA continues to monitor the use of the vaccines to ensure that their benefits outweigh any risks. That is an important fact.

[Sir Christopher Chope]

I hear what the hon. Gentleman says, but if the vaccines were so safe, why was it necessary for the vaccine manufacturers to seek an indemnity against liability for negligence from the Government and the taxpayer?

[Andrew Gwynne]

I suspect that they wanted those assurances because of the rapidity of the roll-out. There is an ongoing process of testing the vaccines. These things are kept under review all the time by the scientists, the Government and the Department of Health and Social Care.

As the hon. Member for Carshalton and Wallington said, the MHRA operates the yellow card scheme to collect and monitor information on suspected safety concerns. A dedicated team of scientists review information daily to monitor the vaccine roll-out. For this reason, His Majesty’s Opposition and I do not view the ask of this petition—a public inquiry into covid-19 vaccine safety—as necessary.

Serious vaccine side effects are extremely rare, and catching covid-19 without vaccine protection remains overwhelmingly more dangerous than getting the vaccine itself. Where vaccine damage does tragically occur, it is right that individuals and their families can access the vaccine damage payment scheme, which I spoke at length about in September. We must ensure that this scheme remains fit for the future. I did raise some concerns about that in the previous Westminster Hall debate on this issue, because it is important that those who are eligible can access financial support.

The petition claims that there has been

“a significant increase in heart attacks and related health issues since the roll-out of the covid-19 vaccines began in 2021.”

I appreciate the strength of feeling of those who signed this petition, and I do want to understand more from the Minister about any investigations being undertaken by the health authorities and scientists.

[Andrew Bridgen]

Was the shadow Minister not listening to my speech? The report in Florida showed an 84% increase in deaths from cardiac arrest in men between the ages of 18 and 39.

[Andrew Gwynne]

I was indeed listening to the hon. Gentleman’s speech. He should have let me finish the sentence, because I was saying that I want to understand from the Minister what investigations are being undertaken by health authorities to ascertain whether this is actually the case, because there is conflicting information.

The hon. Gentleman talks about a study in Florida. It is important that we take into account all the information from across the globe. There is no data in this country from Office for National Statistics, the MHRA or any other public health body that actually backs that up. Therefore, it is important that all this data is kept under review and scrutinised. I think it is important that the Minister gives us assurances that that is being done.

As the Government made clear in their response to the petition, there have been rare reports of myocarditis and pericarditis. That has informed product information advice for healthcare professionals and patients, as the hon. Member for Christchurch (Sir Christopher Chope) pointed out. However, it is worth reenforcing just how rare these specific adverse reactions are. Across all vaccines used in the UK, there has been a reporting rate of just 0.01% for myocarditis and pericarditis. Even where this side effect has occurred, most cases have been mild and individuals have recovered.

There is an awful lot of misinformation regarding vaccine efficacy and safety, and it is vital that any debate about vaccine safety is led by the facts. Could the Minister set out what action she will be taking to tackle vaccine misinformation and to provide accurate reassurance to those who remain hesitant? How will she get robust data out there for proper and effective public scrutiny, so that we can reinforce that efficacy?

I hear a lot in my capacity as shadow Public Health Minister about concerns relating to yellow card reports. To that I reiterate the MHRA guidance, which clearly states:

“Many suspected ADRs reported on a yellow card do not have any relation to the vaccine or medicine”.

The yellow card reporting scheme allows individuals and health professionals to report any suspected reactions or side-effects, even if the reporter is not sure that they were caused by the vaccine. It is often the case that events recorded via the yellow card scheme would have happened anyway.

I feel passionately about tackling vaccine misinformation head-on, because the truth is that we are not in a position to be complacent. In the UK, people are still dying because they have not been vaccinated, and uptake among certain communities is still far too low, but the challenge is also global. More than 20 nations across the world have first-dose vaccine rates of lower than 20%. In Burundi, just 0.2% of people have received their first dose. The United Kingdom has an important role to play in ensuring that low-income countries can access vaccines, but also in making the argument, domestically and on the world stage, that vaccines are safe and effective. That will ensure that we remain better protected not only against covid-19 and potential mutations, but against future pandemics, where trust is a key tool in protecting people and communities across the globe.

This has been an important and wide-ranging debate, and one that I am glad we were able to facilitate. We in this House may have different views on this subject, but we also have a responsibility to protect the health of the people we represent, and that means using our platforms to make it clear that covid-19 vaccines are safe and effective—something that I am sure the Minister will wholeheartedly agree with.

NHS Dentistry

Andrew Gwynne Excerpts

Thursday 20th October 2022 Commons Chamber

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

I thank the Backbench Business Committee for granting this important debate, and congratulate the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins) on having secured it. We support the motion in the form in which it has been moved; there is nothing in it that we disagree with. If some of the political arguments are removed from the debate, I think there is consensus across the House as to what the problems are and what needs to be done.

[Sir George Howarth]

I am sorry to interrupt my hon. Friend so soon. I agree with him about the motion, but I did make the point that there were some short-term measures that could, and should, be taken within the three-month period that the motion envisages before the Government report back on progress.

[Andrew Gwynne]

My right hon. Friend is absolutely right. There is no reason why the Government cannot expedite action on the issues he mentioned in his contribution and get those improvements in place.

I pay tribute to my right hon. Friend and to my hon. Friends the Members for Blackburn (Kate Hollern) and for Bootle (Peter Dowd), as well as the hon. Members for Bath (Wera Hobhouse), for Mole Valley (Sir Paul Beresford), for Berwickshire, Roxburgh and Selkirk (John Lamont), for Gloucester (Richard Graham), for Salisbury (John Glen), for North Devon (Selaine Saxby) and for Loughborough (Jane Hunt), for their contributions.

I welcome the Minister to his place. I am not sure how long he is likely to be at the Department of Health and Social Care, but I hope he is there long enough to implement some of the changes. I am all for a bit of stability in the Department. He is a good person and a good friend, and I wish him well. However, when he comes to the Dispatch Box, he will no doubt seek to deflect from the situation that has been described my Members across the Chamber by saying that we are here today because of the pandemic.

The backlog has not helped—we all acknowledge that; it goes without saying—but the Government’s spend on general dental practices in England has been cut by more than a third over the past decade, with the number of NHS dental practices in England falling by more than 1,200 in the five years prior to the pandemic. My hon. Friend the Member for Bradford South (Judith Cummins) raised that, and it cannot be ignored. It creates the regional imbalances and dental deserts we have heard about. This is not a rural-urban thing; it is a rural and urban thing, sadly. My right hon. Friend the Member for Knowsley (Sir George Howarth), the hon. Member for North Devon (Selaine Saxby) and the right hon. Member for South Holland and The Deepings (Sir John Hayes) spoke about those dental deserts, which are very real.

The Minister’s next line of defence, if I were to guess what the officials have put in his red folder, will be, “It’s all because of the dental contract.” There is some truth in that. It is 16 years since that dental contract was introduced, and it was introduced for a perfectly good reason. There was no golden age of NHS dentistry before it. There is a reason why people of my age have a mouth full of fillings and my children do not. It is not because I did not brush my teeth as much as my children do, and it is not because I ate more sweets than my children do. It is because the emphasis for paying dentists prior to the introduction of the changes was on early treatment that was perhaps not necessary—“drill and fill” is what they called it. We recognised in 2010 that the contract had not worked in the way we hoped it would, and we proposed changes. Of course, we lost that election, but after 12 years of this Government, I am afraid the line will not wash that it is solely the contract, because they have had plenty of time to make changes to that contract and have not.

We hear about the ABCD plan, and I certainly welcome the “D” in it; at least there is a recognition of dentistry. However, like my right hon. Friend the Member for Knowsley, I worry that this kind of “Sesame Street” strategy does not come close to tackling the scale of the emergency that is gripping dental care. All we have heard from the Secretary of State is sticking-plaster solutions that tiptoe around the edges while failing to address the root cause. That is apparent in the Government’s “hit and hope” approach to dentistry. The £50 million of emergency funding announced earlier this year is a prime example. As my hon. Friend the Member for Bootle said, it is a time-limited, inaccessible pot of money that has done precious little to improve access. In fact, figures obtained by the British Dental Association showed that just 17.9% of that funding was drawn down. This is indicative of a sector that has completely lost faith in the Government’s ability to act, and to be frank, I do not blame them, because when we do see action, it does not meet the scale of the crisis, and in some cases it makes things worse.

As we have heard, the geographic, ethnic and socioeconomic disparities affecting access to NHS dentistry are becoming starker by the day. What does the new Health and Social Care Secretary do in response to that problem? She scraps the health disparities White Paper. It is beyond bizarre that in the face of such overwhelming evidence, the Government will not even consider possible solutions—let alone implement them.

I fully support what the hon. Member for Waveney and other hon. Members on both sides of the House have said about education. Dentistry in schools, a prevention strategy and an emphasis on good oral health is absolutely crucial. We would support the Government in implementing that—hopefully sooner rather than later. The consensus and mood is there to get that done, so I hope the Minister will take that up and get going on that opportunity.

As for many issues facing our NHS, much of the problem with NHS dentistry can be traced back to one thing: workforce. Several hon. Members raised that point. Any hope of an NHS recovery must be underpinned by a comprehensive workforce strategy. Where is that strategy? Was it accidentally shredded with the mini-Budget? I am sure the Minister will hail the fact that NHS stats show an increase of 539 dentists practising in 2021-22, compared with the year before. When we drill down beneath the surface, however, there is not much to be positive about.

Those stats are rendered worthless by the fact that a dentist performing a single check-up on the NHS in a 12-month period is weighted the same as one with a full cohort of NHS patients. BDA survey data shows that for every dentist leaving the NHS altogether, a further 10 are significantly reducing their NHS commitment. No matter how much Ministers might try to fudge the numbers, they simply do not add up. We cannot afford more bluff and bluster. We need action, which the Opposition will support.

The outgoing Prime Minister said that dentistry was in her top three priorities for her first 90 days. That now seems rather optimistic given that she is Liz of 44 days, but we really want the Government to act on that commitment. Can we have an update on how things are going?

The Labour party will fund one of the biggest NHS workforce extensions in NHS history. We will double the number of district nurses qualifying every year, train more than 5,000 new health visitors and create an additional 10,000 nursing placements every year. We will fund this transformative expansion by abolishing non-dom tax status. We will give dentistry the staff, equipment and modern technology it needs to get patients seen on time. Labour has a plan. Where on earth is the Government’s?

Motor Neurone Disease

Andrew Gwynne Excerpts

Thursday 20th October 2022 Commons Chamber

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

I congratulate the hon. Member for Northampton South (Andrew Lewer) and my hon. Friend the Member for Newport East (Jessica Morden) on securing this debate; I thank the Backbench Business Committee for granting it and I welcome the Minister to his place. I also pay tribute to the MND Association, the My Name’5 Doddie Foundation and MND Scotland for their tireless campaigning to improve the lives of people affected by MND.

This has been a short and small, but perfectly formed debate. I particularly thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for his kind words of tribute to Gordon Aikman. I also thank the hon. Members for Coatbridge, Chryston and Bellshill (Steven Bonnar), for Berwickshire, Roxburgh and Selkirk (John Lamont) and for Strangford (Jim Shannon), and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who leads for the SNP on these matters.

We know that MND impacts up to 5,000 adults across the whole UK at any one time. Tragically, MND kills one third of people within a year of diagnosis and more than half of people within two years. Many people have experienced the tragedy of motor neurone disease in their own families and communities; I know I am not alone in that. My cousin’s husband tragically died in his late 40s from amyotrophic lateral sclerosis, as it is known in the United States. He and my cousin moved there to live their dream, but sadly the dream was shattered by this dreadful disease.

Last year, my hon. Friend the Member for Leicester West (Liz Kendall) spoke on behalf of the Opposition in a Westminster Hall debate on MND. She rightly called on the Government to turbocharge investment and reform in MND research, bringing together industry, the public sector and charities to ensure the best possible outcomes for those affected by the condition.

The moral case for investment in research is clear, to help to find treatments to transform the lives of those affected by this condition, but the economic case is just as strong. Treatments in the late stages of MND are up to nine times more expensive than early intervention. Investment into research that enables earlier treatment leads to better outcomes for the NHS and better value for the taxpayer. Investment in MND research also has the huge economic benefit of building on our world-class research and science sector, delivering the high-skilled, well-paid jobs we so badly need.

In November 2021, the Government made a welcome announcement of £50 million of ring-fenced funding into MND research over the next five years. However, almost a year since the promise was made, we still have a long way to go to achieve the progress we need to support those living with MND. Unsurprisingly, given the uncertainty around the future of our economy and the future of our Government, there is also uncertainty about what the future holds for MND and those affected by it.

I will start briefly with the future of MND research. First, when the Minister rises, will he confirm that the pledge of £50 million of ring-fenced money into MND funding is still Government policy? If it is still policy, when will it be delivered? We will support him in turbo- charging that roll-out.

Will the Minister also give assurances about the wider future of R&D spending? As he knows, there are worries in the sector: we are being told that, at the current Chancellor’s forthcoming fiscal event, we can expect cuts to public services and public funding. Should we expect cuts to R&D spending, as many in the science community fear? I hope that is not the case. As the Minister also knows, soaring inflation means that funding counts for less, and the devalued pound means that the cost of the imported equipment and technologies that are crucial to running research laboratories is rising. What assessment has the Minister made of that issue?

Investment in research is crucial to treating MND, but it is not the only thing that matters: if we want to invest in a better future for those with MND, we must also invest in a better future for our NHS and social care system. If we look at the workforce, there are 132,000 vacancies in the NHS and 165,000 vacancies in social care. Given those chronic shortages, it is hardly surprising that, according to the MND Association, more than a third of people with neurological conditions such as MND have reported waiting more than a year between first experiencing symptoms and getting a diagnosis; that only 44% of adults with neurological conditions ever have an appointment with a specialist nurse; and that only 26% of people living with MND receive social care support. Those figures are further proof of the desperate need for a workplace strategy, which this Government have not yet delivered. I hope to impress on the Minister the urgency of that matter. Will the Government listen to the MND Association’s calls for a recovery and respite plan for family carers? As the Minister knows, the enormous stresses that those people are under anyway have been compounded by the impact of the pandemic. Again, if the Government produce such a plan, we will support it.

Finally, providing housing that meets the accessibility needs of people with MND is a vital part of making sure they can maintain their dignity, independence, and the choice to stay in their own home for as long as possible. A guiding principle of Labour’s approach to social care is “home first”, because the vast majority of people want to stay in their home for as long as possible, yet too many struggle to get even the basic support for home adaptations that makes that possible, with a quarter of housing authorities describing their need for accessible homes as severe. Investment and reform in research, the NHS, social care and housing are the steps needed to ensure a better future for those with MND. Labour is committed to delivering that better future, and to supporting this Government to deliver it while they remain in office. Please, let’s just get on with it.