Oral Answers to Questions

Andrew Percy Excerpts

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

We are, on the NHS, the most transparent Government in history, and I can see no reason why we would not publish that. We are very proud of what the CDF has achieved. We are very proud that the level of cancer diagnoses has increased by more than 50% compared with what it was under the previous Labour Government, and so we are finally starting to win the battle against cancer.

[Andrew Percy (Brigg and Goole) (Con)]

We all remember the horror stories before the CDF existed locally, and all Government Members certainly support its continued use. Before any drugs are delisted from the CDF, will the Secretary of State make available the scoring of those drugs? Will he also outline what the provisions will be for consultation with patients and their families?

Special Measures Regime

Andrew Percy Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

I absolutely recognise that issue, which is something we will have to think about in terms of the long-term sustainability of the trust. Let me reassure my hon. Friend and the hon. Member for Barrow and Furness that the CQC chief inspector will not say that a trust can come out of special measures unless he can see a long-term sustainable future for that trust, so part of the purpose of the regime is to force everyone in the system to confront those issues so that we bite the bullet quickly.

[Andrew Percy (Brigg and Goole) (Con)]

The positive progress of the Northern Lincolnshire and Goole NHS Foundation Trust is to be welcomed and is a direct result of the work of health care assistants, nurses and doctors. On the issue of social care, may I commend North Lincolnshire to the Secretary of State and ask him perhaps to visit again? The local council has not only refused the request by the Labour opposition on the council to cut social care in the budget, but has actually increased funding for elderly and disabled people by £1 million in this year’s budget and is opening up a network of well-being centres to support older people in their own homes, as well as constructing a £3.2 million intermediate care facility, so that a lot of our residents do not have to go into hospital in the first place.

[Mr Hunt]

I thank my hon. Friend for the warm welcome he gave me when I visited the trust—including the visit to a not particularly healthy, but delicious bakery as part of the trip. I welcome what is happening in social care, and I think it is something on which we can agree at the national level across the House—that cuts in social care can be very counter-productive, leading to more pressure on the social care system and more pressure on the NHS.

Patient Safety

Andrew Percy Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I do not know the answer to that question, so I will look further into the matter and get back to the hon. Lady.

[Andrew Percy (Brigg and Goole) (Con)]

As the hon. Member for Scunthorpe (Nic Dakin) mentioned, local GPs raised concerns last week about a cluster of cases at Scunthorpe and Grimsby hospitals—not at Goole hospital, which was also revealed last week never to have breached its four-hour waiting target. There is still a lot more to be done, so does the Secretary of State share my concern at the evidence received by the Health Select Committee last week from the Care Quality Commission, which stated that all too often, members of staff who raise concerns are dealt with by the human resources department rather than in a proper way that allows their complaints to be properly aired?

[Mr Hunt]

That is a very good point, and I thank my hon. Friend for welcoming me to Goole hospital; I had a very good visit. That hospital is in special measures but it is making real progress. It was interesting to talk to staff at the front line. I do not know when the hospital will be ready to leave special measures, but the staff on the front line felt that things were changing, and they welcomed that. My hon. Friend is absolutely right that if someone raises a safety concern, it should not be viewed as an HR issue; it is a patient safety issue, and trusts need to treat it as such.

Care Homes

Andrew Percy Excerpts

Thursday 1st May 2014 Commons Chamber

[Norman Lamb]

The hon. Lady is absolutely right, and that is why we are introducing the fit and proper person test for every director of every care or health care provider. If they have been complicit in unacceptable standards or prosecuted for unacceptable care, the CQC can require them to be removed from the board of a care provider. The new standards should help considerably.

[Andrew Percy (Brigg and Goole) (Con)]

Nobody who uses schools is unaware of Ofsted and its job. Should we not look for a similar situation with regard to the CQC, and is there not a big public information job to be done to ensure that people know better what the CQC is there for and how to access it?

[Norman Lamb]

My hon. Friend is absolutely right. The CQC needs to build a reputation so that everyone has confidence in its ability always to represent the patient’s interests. I believe that the CQC’s leadership understand that mission and are well on the way to achieving it, but it will not happen overnight.

Oral Answers to Questions

Andrew Percy Excerpts

Tuesday 1st April 2014 Commons Chamber

[Andrew Percy (Brigg and Goole) (Con)]

Every weekend, as a first responder volunteer in the NHS, I see too many people taken off to hospital unnecessarily. One way of addressing that is to have a proper strategy for community paramedicine. We have had a trial running in Goole, which the Secretary of State has seen, where an emergency care practitioner delivers care in people’s homes, thereby reducing visits to hospital. Do we not need a national strategy on community paramedicine?

[Jane Ellison]

I know of my hon. Friend’s extraordinary work as a first responder, and we all greatly admire it. He makes another great point about how we tackle this long-term challenge of the sustainability of our acute services. I am happy to draw his comments to the attention of NHS England. I am sure that it is one part of all the things it is looking at as it addresses this issue.

Care Bill [Lords]

Andrew Percy Excerpts

Tuesday 11th March 2014 Commons Chamber

[Andy Burnham]

I am not writing a budget at the Dispatch Box this evening. I will stand by our record of giving real-terms increases to local government. I warned at the start of this Parliament that if the effect of the Government’s promise of real-terms increases for the NHS—which have actually never materialised—was a raid on local government, that would be a short-term policy. It would mean more older people ending up in hospital and who then could not be discharged because there was not the care at home. That is exactly what is happening. It is a false economy. That is what we warned them about and they failed to listen.

[Andrew Percy (Brigg and Goole) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

No I will not, as the hon. Gentleman has not been here all afternoon.

The third area is the claims that the Bill will improve regulation. Let me ask a direct question: if this is about improving the quality of services, why remove from the CQC the responsibility to provide oversight of local authority commissioning? Why do that if this Bill is about improving regulation? Why leave local government free to do what they like at a local level—to commission for 15-minute visits or for staff on zero-hours contracts—when we have seen the failures at Winterbourne View and other places? Why remove that important role from the CQC?

Children and Families Bill

Andrew Percy Excerpts

Monday 10th February 2014 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I quote:

“I would ban smoking in cars where children are present. I would do that for the protection of children. I believe in protecting children. I would see it as a child welfare issue.”

Those were precisely my feelings when I introduced the Smoking in Private Vehicles Bill under the ten-minute rule exactly 964 days ago. I did so after a briefing from the British Lung Foundation, with which I have been proud to work ever since. My thoughts have not changed in the two and a half years since, and I am delighted that the day has come when hon. Members have the opportunity for a decisive vote to make life healthier for half a million children. Although I share the sentiment and could hardly have put it better myself, the words I started with are not mine; they date from February this year and are those of the then public health Minister, the hon. Member for Broxtowe (Anna Soubry).

In Committee in the other place, an amendment was tabled and supported by all political parties, with eight peers speaking in favour of the ban. Such is the cross-party nature of the measure. This will be the fourth time that Members of this House have asked for a definitive vote on the issue. After my ten-minute rule Bill failed to get a Second Reading, the noble Lord Ribeiro’s private Member’s Bill won support in the other place but failed to make progress in the Commons. In this Chamber, we tried to amend this Bill, but we failed again. Now, after sustained pressure from a cross-party group of Back Benchers and Lords, four measures are proposed in the Bill—including powers to bring in standardised packaging of cigarettes and to prevent smoking in cars with children present—and I welcome them all.

It is not just parliamentarians who support such a ban—quite the opposite. The changes are backed by many professional bodies and research groups. I have been delighted to work closely with other organisations, as well as the British Lung Foundation. The list is too long to name every person and organisation, but it includes Cancer Research UK, Action on Smoking and Health, the British Medical Association, the British Heart Foundation and Fresh, our own campaigning organisation that has done so much in north-east England. We must not forget the royal colleges and the 700 health professionals, who have already been mentioned.

Facts, figures and statistics in abundance have highlighted the appalling dangers of passive smoking, particularly to children and young people, and specifically in relation to smoking in vehicles. A plethora of studies have returned the same results: smoking in a vehicle significantly increases children’s exposure to harmful toxins and particulates. Numerous surveys and opinion polls have consistently shown that the public support such recommendations. I have no doubt that my fellow Members will draw attention to them as the debate progresses.

I want to focus on the arguments about enforcement and intrusion. It is important to remember that the police already have a number of duties with regard to private vehicles, and to recognise that the additional enforcement costs of a measure to outlaw smoking when children are present are minimal.

[Andrew Percy (Brigg and Goole) (Con)]

Will the hon. Gentleman give way?

[Alex Cunningham]

I will not.

Other hon. Members have mentioned the non-wearing of seatbelts, which is a tricky misdemeanour to spot if ever there was one. It needs an eagle eye, but the police routinely monitor drivers and passengers alike to ensure compliance with the law. The introduction of legislation in 2006 to make the use of appropriate child restraints mandatory for children under the age of 12 were also considered very complex, and similar concerns were raised at the time. However, implementation went ahead and has been successfully enforced.

To argue that it would be too difficult and burdensome for officers to spot the act of smoking in a car, or to identify whether a child is being carried at the same time, is therefore no excuse. Indeed, I argue that such actions are markedly easier to recognise than gauging the height of a seated child to ascertain whether correct restraints are used. To suggest that officers would be unable to identify such instances is to underestimate their competence. I take much comfort from knowing that when educational campaigns on seatbelts accompanied the legislation, seatbelt use shot up from 25% to 91%, and from knowing that Department of Health figures indicate that there was 98% compliance from the moment the smoke-free legislation was introduced. I hope that the instances of such rules being flouted would be few and far between as a result of Britons’ law-abiding nature. I remain confident that, as with compliance on seatbelts, such regulations would become largely self-enforcing. Let us not forget that it is the role of the police to enforce the law.

Unlike most adults, children lack the freedom to decide when and how they travel, and do not know how harmful second-hand smoke is. Other hon. Members have already covered that point, so I will not repeat it.

There are international precedents for action: South Africa, Mauritius and Bahrain have all outlawed smoking in cars with a child present, as have seven of the eight states or territories of Australia, nine—I understand it is soon to become 10—of the 13 states in Canada and six of the 50 states in the United States. One published study from Canada has documented a positive impact on reducing second-hand smoke exposure in the relatively short term after implementation. Positively, it did not find any displacement effects of smoking being shifted to the home. It is time that we followed suit, heeded public and medical opinion, and got out of the slow lane.

I am only too aware that a positive decision for a ban still requires the Government to introduce the necessary regulations. I hope that the Minister will indicate when that is likely. The evidence strongly supports the Lords amendment, and I urge that Members on both sides of the House do likewise and stand up today for the protection of children.

--- Later in debate ---

[Mrs Main]

I have never heard of a more illiberal, nonsensical and unenforceable proposal than Lords amendment 125. I am sorry that it is being proposed by the Government and that Members are being asked not to consider the detail, because the devil is in the detail.

As has been said, the word “vehicle” refers to a broad spectrum of containers, if I may put it like that, including motor homes, Traveller caravans and, potentially, narrow boats. The proposal suggests that smoking while driving an open-top car, to which my hon. Friend the Member for Shipley (Philip Davies) referred, is more injurious to health than a mother smoking while pregnant. I find that impossible to accept.

I do not know how the police will arbitrate between two 17-year-olds in a car if one of them has been smoking. I do not think that we should be considering using this resource if we are not banning cigarettes, full stop. I do not smoke and have never smoked. I am a mother of four children. I fundamentally believe that we should not make bad, unenforceable law.

If the Labour party represented the working class far more than it suggests it does, it would be making a very different argument, because a huge tranche of the population will see itself criminalised. We should be advising people not to smoke in front of their children. We have been winning the argument on smoking. The Government have adverts on the television that show a mum blowing the smoke out of the door and then say, “What if you could see what it does to your child’s lungs?” We will not stop those adverts because we are trying to educate people.

Under the proposal, we will be saying that a child can get into a fog-filled car after their mum has been smoking in it. As long as she is not still doing it, that will not be an offence. We will be saying that it is an offence to smoke in a van if Traveller children or others who live in transit are sitting in the back. However, if I sit in my kitchen and people can see me through the front window, fag in hand and baby over my shoulder, comforting the child, that will not be an offence. It would be easy to track down such behaviour, so why do we not say that smoking in front of children should be banned or that smoking should be banned? It is because we think that it would be illiberal to go into people’s homes. However, some people’s homes are vehicles. I look forward to people explaining that to the communities that will be affected disproportionately.

I cannot believe that we are not supposed to inquire about the detail.

[Andrew Percy]

Will my hon. Friend give way?

[Mrs Main]

No, I will not give way because many colleagues who have been here from the very beginning wish to speak. I am sorry if my hon. Friend is one of them.

I cannot think that this proposal will be enforceable. We all want to protect children. In that case, perhaps we should get out the fat callipers when we see very lardy children walking down our high streets because their parents feed them junk of an evening. Perhaps we should ban fattening foods because there are more than a million people with type 2 diabetes, as has been said in the media today. Where will it stop? We need to educate people. We need to ensure that parents do what is best for their children because they believe in doing what is best for them. We cannot legislate every single risk and danger out of existence.

Oral Answers to Questions

Andrew Percy Excerpts

Tuesday 14th January 2014 Commons Chamber

[Dr Poulter]

That is a very good question. Local health and wellbeing boards are an excellent vehicle for the adoption of a more joined-up approach throughout health care, enabling other key players in the health and wellbeing sector to drive forward improvements. It is for the boards to consider the local issues outlined by the right hon. Gentleman, such as increasing obesity and other public health challenges, and to ensure that they work with and direct funding towards local communities. The Government have provided 40% of their public health funding for that purpose.

[Andrew Percy (Brigg and Goole) (Con)]

My constituency is served by the Yorkshire and East Midlands ambulance services. Could we not make better use of our ambulance services and benefit those who require emergency admission by enabling paramedics to convey fewer patients and provide more care from the back of ambulances? I realise that that will probably necessitate tariff reform.

[Dr Poulter]

It is true that many parts of the medical and health care work force can contribute to the delivery of high-quality care, and paramedics have an opportunity to do that. As part of our “Refreshing the mandate for Health Education England” initiative, we will be considering how we can make progress in that regard during the coming months and years.

Accident and Emergency

Andrew Percy Excerpts

Wednesday 18th December 2013 Commons Chamber

[Andrew Percy (Brigg and Goole) (Con)]

There is doubtless concern on both sides of the House about A and E and the health service in general, but there is also more than an ounce of political opportunism, some of which we have heard today. Not once did we hear any reference made to the Nicholson savings, which have put local acute hospital trusts under huge pressure, with £160 million taken out of the budget for the Humber area alone.

If we talk to the chief executives of the hospitals, we find that they say that it is not top-down reconfigurations or policy changes since the general election that have placed them under such pressure, but the Nicholson savings. I know that there is cross-party support for those savings, but we should all be as honest as possible in this place and ensure that we all accept a degree of responsibility for that challenge and the funding that it has taken out of our acute trusts, resulting in pressure on A and E departments—not just this year, but last year and in future years.

As I say, there is a huge degree of political opportunism going on about the NHS. It is clear that the Labour party has decided that this is going to be an issue at the general election. In my own constituency, the very people who stood silent when our hospital was losing its beds, when we were losing our hospital wards, when all our mental health beds were being taken away from us—these were the people who represented the town for the Labour party—now suddenly find themselves standing up and pretending to be NHS campaigners. The public see through it—and I am sure they will at the next election, too.

Similarly, we have heard not a single apology from any Labour Member about the 50,000 beds cut under their Government. We have heard a lot about how people turning up at hospital often find that there are not enough beds, but not once did a Labour Member defend the 50,000 hospital beds lost when their party was in government. That tells us all we need to know about the reason for this debate and for the general comments we have heard about the NHS recently. It is all about political opportunism; it is about the next election. I am sorry that our hard-working staff in the NHS—I work with them every weekend when I volunteer as a community first responder—are being placed in the middle of a dirty political game.

In my remaining minute and a half, I would like to talk about a couple of examples from my constituency that are helping to address the problem.

[Alex Cunningham (Stockton North) (Lab)]

Does the hon. Gentleman have the same problem in his area as we have in Stockton-on-Tees, where GPs tell me that people are being denied registration because their lists are unofficially being closed? If that is happening across the country, surely it is no wonder that there is unprecedented pressure on A and E departments.

--- Later in debate ---

[Andrew Percy]

The Montague medical centre in Goole had to close its lists down, but if we ask why, we find that it was due to the large uncontrolled immigration we had from the A8 countries. [Interruption.] That is a fact. That is why the lists had to be closed—due to the previous Government’s failure to plan for the number of people coming here—so I thank the hon. Gentleman for that helpful intervention.

Let me deal with a couple of issues in my own constituency. [Interruption.] If Labour Members want to intervene, I am happy to take an intervention rather than be chuntered at. I want to refer to some positive moves locally, which I hope can be rolled out nationally.

First, I called on the NHS ambulance trust in my area to provide advanced paramedics, so that we could use our ambulance service better—a point I have made through the Health Committee—not just to convey people, but to treat them in their homes. We established an emergency care practitioner in Goole, which in the first six to eight weeks saved 56 double-crew manned hours and numerous transfers to Scunthorpe A and E. That has proved to be an effective use of our ambulance services, and I hope that we can start to see it moving through. [Interruption.] Am I running out of time? I am just looking at the clock, Madam Deputy Speaker, and following the time indicated there. I will conclude if the Front Benchers need to sum up—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The hon. Member is quite right in his watching of the clock, but I am sure that he will have a mind to other hon. Members who wish to speak this afternoon.

[Andrew Percy]

Because it is Christmas, I am willing to forgo my remaining minute.

Cancer Patient Experience

Andrew Percy Excerpts

Wednesday 30th October 2013 Westminster Hall

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I would like to think that I take the message, Mr Owen. It is a pleasure to serve under you.

It is also a pleasure to congratulate the new Minister, my hon. Friend the Member for Battersea (Jane Ellison), on her appointment. She has a reputation as a listening Minister and I am sure that, when she makes her closing remarks, she will prove to have listened to all of us here today.

I start off in a very partisan situation. As the hon. Member for Strangford (Jim Shannon) said, we are getting to the “cancer world”, as I call it; it is like a separate world that involves different people, often through personal experience. My experience of it is personal, but also through being secretary of the all-party group on pancreatic cancer. If I may, Mr Owen, I will give a little plug here—the all-party group is producing a report, which the Secretary of State for Health has agreed to take at a meeting on 25 November. All hon. Members will be invited to that meeting.

The report is about improving outcomes. I congratulate my hon. Friend the Member for Hertsmere (Mr Clappison) on securing this debate at this timely moment. What we in the all-party group are trying to see is a further improvement in outcomes, at a time when outcomes for cancer patients are improving. When I was growing up in the 1950s and 1960s, if somebody mentioned the word “cancer” it was almost as if a life sentence had been passed. We are in a different situation now.

Pancreatic cancer is seen as perhaps the most difficult cancer, and there are issues connected with that. I will cite some statistics to demonstrate the situation that pancreatic cancer patients often find themselves in. My hon. Friend the Member for Basildon and Billericay (Mr Baron) is far more experienced in this area than I am, and he put his finger on the issue by stressing the importance of early diagnosis.

I will give the figures from the national cancer patient experience survey: 40% of pancreatic cancer patients visited their GP three or more times before diagnosis; and 25% visited their GP five or more times before diagnosis. Those figures compare with 75% of all other cancer patients who are referred to hospital after one or two GP visits.

From the investigation that the all-party group made, I can cite the specific example of someone who came to us to give their own personal experience. They said:

“With regard to early diagnosis, the most important aspect for us was the fact that Gemma went to her GP on a total of 10 separate occasions between the middle of April 2009 and the end of August, when she was finally referred to a specialist”.

That is the experience of most people with pancreatic cancer. In my own case, I think that my partner went to the GP six or seven times before somebody then said, “Better go to a hospital.”

Then, when a patient gets to the hospital situation, quite often there is no access to a specialist in pancreatic cancer. If a clinical nurse specialist is not available, the patient is even more lost. I underline the importance that the all-party group attaches to the clinical nurse specialist in almost holding the hand of somebody with cancer as they go through the system.

[Andrew Percy (Brigg and Goole) (Con)]

I want to tell my hon. Friend about a meeting that I had with a radiotherapist in my constituency just a week or two ago. They told me that, all too often, patients who appear for treatment tell him that they visited their GP on numerous occasions and, sadly, often they were sent home. I know that it is incredibly difficult for GPs. We are expecting a lot of them, but there is still a lot more to be done in ensuring that GPs across the country are consistent in their approach to people who present with certain symptoms.

[Eric Ollerenshaw]

My hon. Friend is absolutely right and I totally agree with him. That is the kind of information that we, as an all-party group, have been receiving from right across the country.

As I said, there is a lack of specialism, even in a hospital situation sometimes. The issue with pancreatic cancer is that there is a repetition of non-specific symptoms. Again, I cite my own personal experience from the case of my partner—he just had a stomach ache that went on and on, without a particular issue. Other hon. Members have referred to what males tend to do, and they are absolutely right; we often put these things to one side and say, “It is a stomach upset”, despite the repetition of symptoms. What we are trying to get GPs to look at is this: if they are seeing somebody who has never been to them before, somebody who never really goes to a GP but keeps turning up, an alarm bell should be sounding.

I will cite some other figures, although I am aware of the time factor. Some 33% of pancreatic cancer patients feel that they have been given conflicting information, compared with 29% of all other cancer patients. Some 13% of pancreatic cancer patients did not get answers to important questions all or most of the time, compared with 9% of all other cancer patients. Some 36% of pancreatic cancer patients felt less likely to feel that their views were being taken into account by doctors and nurses when discussing treatment, compared with 30% of all other cancer patients.

As I said, I am being totally partisan. The all-party group’s experience and my experience personally is that, for some reason, this country is way down the line on pancreatic cancer—despite it being the fifth biggest cancer, in terms of the number of people who die from it—when it comes to international comparisons for improved outcomes. There are treatments, but far too often they are far too late, because of people’s constant appearances at GPs.

Other Members have talked about dignity and humiliation. I will be utterly personal about the issue, because, in one sense, that is what has driven me to get so involved. I remember my partner’s situation. It was a case of finally going to hospital, being told that people there would do some tests and then that they would carry out an operation because they thought it was cancer. “What does that mean?” We did not know.

I can remember being sat in the hospital and my partner coming back, straight from surgery, with things wrapped round. We said, “What is it?” The doctor turned round and said, “Oh, it’s terminal.” That is the kind of situation that happens. Where is the understanding? Where are the few minutes where they say, “Let’s just go through this. Let’s look at the options”?

I understand that people working in hospitals are under pressure, but there were repeated examples of such experiences at the all-party group. As other hon. Members, particularly those from Northern Ireland, have said, a person should not have to be brain of Britain or have gone on a training course to have a little more time and to treat people with a little more dignity.

I finish with two particular demands, or requests, for the Minister. The all-party group wants consideration to be given to an awareness campaign, particularly about pancreatic cancer. I add my praise for the involvement of Macmillan and Pancreatic Cancer UK, which is the charity that backs up the all-party group and continues to support us, in terms of the campaign on awareness.

Macmillan has been piloting decision tools to help GPs assess the risk of cancer, including pancreatic cancer, and make decisions about further referrals. We would like to see those properly evaluated with consideration given to a full roll-out of the pilots that Macmillan has been spearheading so fantastically.

We have also been trying to raise awareness that pancreatic cancer is not an old man’s disease, in crude terms. The risk increases with age, but 35% of all diagnoses of pancreatic cancer occur in people under the age of 65—that is about 3,000 of the 8,500 diagnosed each year. The split among men and women is reasonably even, with slightly more cases in women than in men. I am not sure that that is clear, so that would be part of what we would request in a campaign. It would lead to greater awareness and, hopefully, earlier referrals and better outcomes.

My final request relates to the national cancer patient experience data. Pancreatic Cancer UK paid for a separation of data for pancreatic cancer patients—in fact, the Department of Health paid for that to be done once. We would like pancreatic cancer patients to be routinely separated out from all upper-gastrointestinal cancer patients as part of the system of getting such statistics. I do not see why a charity or the Department should try to do that as an extra thing. It should be part and parcel of the routine, given the nature and impact of this dreadful, increasingly misunderstood cancer.