Sudden Adult Death Syndrome

Andrew Percy Excerpts

Monday 25th March 2013 Westminster Hall

[Steve Rotheram]

All I can tell the hon. Lady is that if I can use a defibrillator, anyone can use one. We had people come into the House to demonstrate what an AED does. I was under the illusion that it was like something out of an episode of “Casualty”: someone picks up two paddles, says, “Stand back—clear,” and applies the shock to the person through that method. It is not like that. An AED is a small computerised unit that talks someone through the process, so believe me, literally anyone can use one. That will destigmatise the use of these devices for certain people who think that if they do it wrong, they will cause further complications.

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

I declare an interest as a first responder who on a number of occasions has had to attempt resuscitation. Defibrillators are indeed incredibly easy to use. One of the saddest things is turning up at someone’s house and finding people just standing around, worried or frightened that if they attempt cardiopulmonary resuscitation, they will cause more damage. Actually, the training that is necessary is minimal. I therefore commend not only the e-petition, but the words of the hon. Gentleman up to now. This is something that is very simple. It is so sad to turn up two or three minutes in and find that people have not started CPR, at which point the chance of survival is so much less.

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

I congratulate the hon. Member for Liverpool, Walton (Steve Rotheram) and everybody who signed the e-petition on securing this debate; 100,000 signatures is an incredible amount to reach. I pay tribute to everybody who signed. It is good to have the Minister and the shadow Secretary of State here. I am happier seeing the shadow Secretary of State here than I was to see him attend a college in Goole recently. As welcome as he is, normally, perhaps he can stay here in future; that would be more beneficial. Alas.[Interruption.] That was a back-handed compliment, by the way.

I also want to pay tribute to the OK Foundation and the British Heart Foundation for the work that they do in raising awareness. It is fantastic to hear about the work that has been undertaken in Liverpool. I do not necessarily agree that where Liverpool leads, the country always follows, or indeed that Liverpool always leads, but on this occasion I pay tribute to what has been achieved on the wrong side of the Pennines.

I intervened on the hon. Member for Liverpool, Walton and talked about the work that I do with the Yorkshire ambulance service as a community first responder. I want to talk about that and how that has got me alive to the issue and really changed my views. It has made me quite passionate. Becoming a first responder has been the thing that I have been most proud of in my life. I am prouder of that than getting elected to this place. Before that, my proudest achievement was passing my driving test on the sixth or seventh occasion. Being a first responder has become the thing that I am most proud of.

I set up a scheme covering Goole, Hook and Airmyn: only three of the 75 communities that I represent, sadly. We did not have a scheme there. We had terrible ambulance response rates. I met the ambulance service and it set me a challenge to do something about it, so we set up a scheme. We have 10 volunteers. My staff in the Goole constituency office have all been trained and they provide cover during the day as first responders. In the evening, members of the community provide cover. We have all become good friends. We are all from different walks of life in the town. They cover evenings and I cover weekends, along with one of my councillors, who lives just round the corner.

I pay tribute to all the volunteers who put themselves forward for first responding in my constituency, both with Yorkshire ambulance service and in the Lincolnshire part of my constituency through LIVES, the Lincolnshire Integrated Voluntary Emergency Service. The volunteers do a fantastic job. They get no publicity for it, which perhaps we as MPs get. They deserve all credit for the lives that they save and the impact that they have. I have seen the impact in my short time doing such work. We set up the scheme about six months ago. We never expected to be as busy in our community as we have ended up being, having attended about 45 calls in our first four months, which is significant.

I want to talk about the training to prove how easy it is. We did our training as first responders over a weekend. It was two full days. The training included oxygen therapy and training for the other types of incidents that we attend. The CPR and defibrillator training took place on the first day. We practised scenarios and it was incredibly simple and easy. It is as simple as the hon. Gentleman said. The defibrillators spoke to us. The first thing they say is, “Tear open packages. Place one pad upper left.” I do not like hearing that now. It strikes fear into me, having had to use them. They talk people through the procedure and the training really is simple. I came away from that training thinking to myself, “How on earth can people not know how to do this?” It is staggering that we require people to be trained in all kinds of other things in their work environment. People have to learn the inside-out of all sorts of health and safety legislation for various jobs, but we do not teach people something as simple as starting chest compressions on somebody. As the hon. Gentleman said in his speech, people fear that they can do more harm than good, but if someone is in cardiac arrest, people can do no more harm than that.

So, we got our scheme up and running and we had our weekend of training. We do ongoing training every month. We have just had a weekend at the Hull York medical school in Hull going through various scenarios to try to enhance our skills, but that is an add-on to the basic training. I thought that we would not get many calls to begin with, but we were very busy. One of the first calls that I attended was a cardiac arrest, which, sadly, was at the furthest point of the three-mile radius that we cover. I got there first, within about six or seven minutes. Even though we had done all our training, I thought that six or seven minutes would be all right. It was a pretty terrifying drive on the way there for my first cardiac arrest.

I turned up in my first responder uniform and all of a sudden everyone was looking at me. However, the training kicks in and straight away I was doing chest compressions, getting the defibrillator up, getting the oxygen going and barking instructions at people to get what was needed from the bag. I thought, “If I can do this, anybody can.” It was the confidence gained from that weekend of training that led to my trying to resuscitate somebody. Unfortunately, it was not successful. I drove away that night, got home and thought about it. It had taken me a few minutes to get there. When I arrived, people were already there. A neighbour had tried to start CPR, but of course that was done through instructions over the telephone. The gentleman was not old and I thought to myself, “If only somebody had been there to start instantly. Why don’t we all know this?” I became passionate about it. Most of our calls tend to be for heart attacks, diabetics and strokes, which can end in a slightly more positive outcome.

The second cardiac arrest that I attended was in a nursing home. A responder from the neighbouring scheme and I were the first people on the scene. On that particular occasion, nursing home staff had not commenced CPR, for whatever reason, and I thought, “Well, why—in nursing homes?” There are so many calls—just on Saturday night, my phone went at 2.30 am about a cardiac arrest at a nursing home in Goole—and they increasingly tend to be from nursing homes. I thought, “Why do we not have a defibrillator in every nursing home?” I notice that the state of Texas passed a law in 2009 to require a defibrillator in every nursing home.

The Minister obviously cannot respond about the curriculum, although I am sure that she will pass such comments on to the relevant Minister, but she could do something about nursing homes. One of my requests is that she simply requires every nursing home, at its own expense—for heaven’s sake, most of them are private organisations—to have on site a defibrillator, which costs less than £1,000, including for the training.

I live two doors away from a nursing home in my village. As a result of reading about what we have been doing locally, the parish council is proactively trying to get a defibrillator in the nursing home for general community use. That is something that we can achieve simply and without great cost to the taxpayer. The same goes for assisted living centres or sheltered housing complexes, where we should require there to be defibrillators.

I have to say—playing a little to the gallery—that, since I started first responding, I have become such an admirer of our ambulance crews and their work. I am playing to the gallery, but of course we are not allowed to refer to people in the Public Gallery. I have seen how busy those guys are. They are constantly called out and they are called out more and more, for which they do not necessarily get credit. They are the true last emergency service: when all else fails, the ambulance service is called on. They sometimes struggle to respond to all the calls in our areas, and there is no doubt that we must do something about that. Demand on our ambulance crews for service is increasing every year, and we must follow through on that with proper resources so that we do not end up with their taking too long to get to a cardiac arrest or other emergencies.

As a result of that work and becoming quite passionate about it, I started to think about the role in schools. The hon. Member for Liverpool, Walton said that 270 young people die of sudden cardiac arrest every year. I worked in government in the United States about 10 or 12 years ago, when we put through the legislature of New Jersey a requirement for a defibrillator to be placed in every school in the state. That happened, and a several other states followed suit, but that was back in 2000, and here we are in 2013, debating this issue in the House—probably for the first time in a long while—with no requirement in this country. Frankly, that seems bonkers to me.

I talked to the East Midlands ambulance service, which covers the other part of my constituency, a few weeks ago after having seen the ITV programme about sudden cardiac arrest and life-saving skills in Norway, and we put in a bid to the local council. Just this morning, my local North Lincolnshire council considered my grant application for defibrillators, and I am told that it has approved the bid to put one in all secondary schools in the north Lincolnshire part of my constituency and in the schools in that of my hon. Friend the Member for Cleethorpes (Martin Vickers). Indeed, it will go further: the council portfolio holder rang me this afternoon to say that it will guarantee a defibrillator in every secondary school, not just those in my constituency and that of my hon. Friend, and that will happen soon.

[Karen Lumley (Redditch) (Con)]

May I pay tribute to my constituents Robert and Maggie Underwood, who lost their daughter to SADS? They have managed to raise £18,000 to put defibrillators in 15 of my schools in Redditch.

[Andrew Percy]

I, too, congratulate my hon. Friend’s constituents. I always think that it is a bit easier for us, as MPs, to bang the drum and to get people behind us, but it is fantastic for residents to do so and to raise such an amount of money, so I pay tribute to them as well. A lot of that is going on around the country, but frankly there needs to be more.

Our bid in north Lincolnshire was also to ask schools to filter training down to young people, as part of the deal of their accepting a defibrillator paid for from the grant, so it does not only relate to use on school sites. I hope that if there is a cardiac arrest—not that I hope for one, but if there is—a young person from north Lincolnshire with that training will be there, so that they can put their training into use, although I would prefer them not to have to do so. The Scunthorpe Telegraph, the local newspaper, rang me today to say that it is quite keen to get behind that and might want to run a campaign about it, so I shall wait to hear more. We can try to use the National Citizen Service to filter down that training.

[Stephen Twigg]

I congratulate the hon. Gentleman on his excellent speech. He mentioned the Scunthorpe Telegraph, and does he agree that the media have a crucial role? Will he join my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) and me in praising the brilliant work done by the Liverpool Echo with the OK Foundation?

[Andrew Percy]

Members of Parliament are never backward in coming forward to praise their local newspapers, not least in the hope that it guarantees them a friendly quote next week, but the hon. Gentleman makes an important point. Newspapers can be part of our going out to challenge—I do not want to say “shame”—businesses. I am a Conservative and I love businesses, but businesses make profits and do so on the back of their workers, to whom they have responsibility. [Interruption.] Well, I think that I am a Conservative. Of course, I am; or just the Brigg and Goole party these days, perhaps. [Interruption.] Well, I am certainly not a Liberal Democrat—no offence to my hon. Friend the Member for Southport (John Pugh)—because my views on Europe count me out.

Newspapers have a responsibility to go to businesses and challenge them, particularly big businesses. I understand that defibrillators would be expensive for smaller ones and those employing only one or two people, but we should ask big businesses, “What are you doing for the welfare of your workers? Where are your defibrillators?” Newspapers such as the Liverpool Echo and the Scunthorpe Telegraph have an important role to play in that.

[Anna Soubry]

I am grateful to my hon. Friend, and I congratulate him on his excellent speech, which follows another excellent one. Does he agree that there is a good argument that we can build an Olympic legacy based on the great volunteers who took part in the games by considering whether we can use some of the skills that they helped to bring to the games, and take those skills into the issues of training people and campaigning for defibrillators, which he has identified?

[Andrew Percy]

Indeed. My way to address the problem is to have a multi-faceted approach. In many ways, it has to come from the bottom up. We need people in communities to say, “I will be trained and I am happy to filter down that training, and I am even happy to knock on some doors to raise some money to get defibrillators in our communities.” A lot of parish councils have money in the bank, so we should go to them as well. We need a bottom-up approach through volunteers and the Olympic legacy, as the Minister says, but there is also a role for the Government to say to nursing homes and schools, “We want and expect you to provide a defibrillator, which is relatively cheap,” and of course to say the same to businesses. Is it not true corporatism to bring all three of those elements together? As I have said, there is a role for businesses in looking after the welfare of their workers in that way.

Goole high school has a pilot this year in which everyone in year 11 has been funded to go through the National Citizen Service. I have suggested to the head teacher that, as part of the community payback for that, all those young people should be trained in CPR this summer. Therefore, 100 or 200 young people in that community in Goole will leave at the end of the summer having received training, which is 200 more advocates for the whole issue and potentially 200 more life-savers.

[Julie Hilling (Bolton West) (Lab)]

Although it is a good idea to provide emergency life-saving skills within the National Citizen Service, does the hon. Gentleman not agree that if we legislated for every school leaver to learn CPR, we would make a huge difference?

[Andrew Percy]

I would be quite happy to see that happen. We can leave it to schools to decide how to deliver such learning, but even if we cannot put it in the national curriculum, we should say to schools that they should look to offer such training as an add-on.

I was clearly going to say something about Wisconsin next, as it is written here on a note, but it has gone out of my head. Something jolly good is happening in Wisconsin, which we should look at and perhaps copy if indeed it is a good thing.

Another way to address the matter is through teacher training programmes. Again, that is in the gift of Government and is relatively inexpensive to do. Simply put, we should require teachers, as part of their teacher training, to go through a morning of CPR training.

I end my contribution where I began, by congratulating the hon. Member for Liverpool, Walton on securing the debate. I congratulate, too, all those who have taken part in the debate through the e-petition and who support this campaign. This is a matter of life and death, and a matter where not just minutes but seconds count. We all have a responsibility to do what we can to ensure that we improve the appalling rates of survival for out-of-hospital cardiac arrest in this country.

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[Grahame M. Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Amess.

I congratulate my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) on securing this debate. It is a privilege to follow my hon. Friend the Member for West Lancashire (Rosie Cooper) and other Members who have made constructive contributions. Compared with some other debates that I have been involved with in recent weeks and months, the unanimity today is a refreshing change.

I pay tribute not only to my hon. Friend the Member for Liverpool, Walton and the other Members who are in Westminster Hall today, but to the people—more than 110,000 of them—who signed the online petition that was set up by the Oliver King Foundation. Indeed, I pay tribute to the King family, Jake Morrison and all those who have been instrumental in taking forward the campaign. I also thank the Minister for agreeing to meet campaigners; that is very important. It shows the public interest in and the importance of the issues that we are debating today.

As you might be able to tell from my accent, Mr Amess, I am not actually from Merseyside, Liverpool or the north-west.

[Andrew Percy]

No?

[Grahame M. Morris]

Well, I am fifth-generation from that area actually, so I have a connection with it. However, I am from the north-east and I know that many colleagues from the north-east and from across the whole country are concerned and share the aims of the OK Foundation, so I hope the Minister will support the campaign to provide defibrillators in all public buildings.

My hon. Friend the Member for Liverpool, Walton referred to the protection that we enjoy here in the Palace of Westminster. I tried to find out precisely how many defibrillators there are in the Palace. There are notices about them at the end of every corridor, including my corridor, and I found that there are actually 16 defibrillators in the Palace. Somebody here obviously knows the importance of early defibrillation in the event of a cardiac arrest, and they are to be complimented for that. The general public should enjoy a similar level of protection.

This is a matter of life and death. As my hon. Friend said, an estimated 60,000 out-of-hospital cardiac arrests occur each year and, incredibly, of the 30,000 cases attended by medical professionals, fewer than one in five of the people affected receive the life-saving intervention they need following a survivable cardiac arrest. I did not realise until I looked at the numbers involved quite how mind-boggling they are. There are nearly 100,000 deaths each year in the UK due to cardiac arrest, which is more than 250 a day, making it one of the UK’s biggest killers.

Hon. Members have already mentioned the British Heart Foundation’s high-profile “Staying Alive” campaign and information film on hands-only CPR. The House will be relieved to know, Mr Amess, that I shall not attempt to sing it or repeat it, but that was a successful campaign. It is reported that in November 28 lives were saved by people who learnt how to administer CPR from the advert headed up the footballer Vinnie Jones, or were inspired by it to take further lessons and coaching, and I imagine that that number is even higher today.

I was surprised by the UK’s record on emergency life-support skills. A British Red Cross survey found that only 7% of people in the UK have first aid skills, compared with 80% of people in Scandinavian countries and a similar figure in Germany. I was surprised, because in the area where I grew up and have always lived, there was quite a strong tradition with the St John Ambulance, and so on, so I expected the figures to be higher, but perhaps it is a function of the society in which we live. That is a major omission and I hope that the Minister takes note of it.

A further survey of public support carried out by the British Heart Foundation found that 73%—almost three quarters—of schoolchildren wanted to learn how to resuscitate someone and give first aid, and more than three quarters of teachers and parents agreed that it would be a good thing to be taught in schools. I hope that the Minister will speak with her counterparts in the Department for Education and press for these life-saving first aid skills to be a core part of the national curriculum, to ensure that all young people leave school equipped with the ability to save a life. That would be really worthwhile.

We know that time matters when cardiac arrest occurs. For every minute that passes following a cardiac arrest and before CPR is administered, the chances of survival are reduced by around 10%. Although CPR can buy more time, defibrillation is the only effective treatment for cardiac arrest caused by ventricular fibrillation, where the heart quivers and stops pumping blood around the body. The British Heart Foundation has found that, for every minute that passes without defibrillation, chances of survival decrease by 14%. We have heard how CPR can improve the chances of survival. We have also heard about research that shows that applying a controlled shock within the first five minutes of collapse provides the best chance of survival. It is therefore essential that defibrillators are readily available, particularly in places where there is higher incidence of cardiac arrest or where it might be difficult for emergency services to arrive quickly.

I applaud the efforts of one of my local newspapers, The Northern Echo, which has been running the “A Chance to Live” campaign in my region, promoting the use of defibrillators in public places, particularly gymnasiums, where there is a greater risk of cardiac arrest occurring both before and after strenuous effort. I am pleased to note—we did a bit of a survey—that all the local authority and council-run gyms in the north-east have defibrillators and staff trained to use them. It has been reported, however, that 80% of private gyms do not have some form of life-saving equipment available; it does not seem to matter whether it is a small gym or one of the larger, more up-market leisure gyms. When challenged about the lack of defibrillators in their gyms, Bannatynes, headquartered in Darlington, issued a statement explaining that they did not have defibrillators because

“they are a specialist piece of medical equipment, which should only be operated by a qualified medical professional.”

I do not know if hon. Members have any contact with Duncan Bannatyne, or if he will get a copy of this debate, but having heard the comprehensive, complete and compelling case advanced by my hon. Friend, it is clear that it is not necessary to have comprehensive training to use a defibrillator. I hope that in the course of this debate we can put to bed this misconception.

As we have heard, modern defibrillators are designed to be used by untrained members of the public; they provide audio and visual instructions to the user and the machines will automatically diagnose the patient and deliver an electric shock only if it is necessary. To provide a medical opinion, as we have the Minister here, in my area in County Durham, Dr Harry Byrne, vice chairman of NHS Darlington clinical commissioning group, has described defibrillators as the

“single greatest advance in out of hospital cardiac assistance since the invention of chest compressions or CPR…You don’t have to be a trained first aider to use one. You just pull it out of the box and follow the instructions step by step. It even tells you what to do”,

as we have heard, from my hon. Friend and the hon. Member for Brigg and Goole (Andrew Percy).

A defibrillator is an essential life-saving piece of equipment and I hope defibrillators will become common, not just in schools, but in workplaces, too. Hon. Members have suggested that they should be in shopping centres and nursing homes. They should be in community buildings as well. Certainly, though, they should be in schools. I agree with my hon. Friend that they should be as common as fire extinguishers and smoke alarms. I hope that the Minister supports these measures and will be proactive in protecting the public and ensuring that everyone, no matter where they live and work, has the best chance of surviving cardiac arrest.

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[Julie Hilling (Bolton West) (Lab)]

I congratulate my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) on securing this important debate. I also congratulate the OK Foundation, as well as all the other small charities and groups of families and friends of people who have been saved or, sadly, lost their lives, on all the work they do in campaigning and fundraising for defibrillators and for life-saving skills to be taught in schools. I also congratulate charities such as the British Heart Foundation, the Arrhythmia Alliance, the Red Cross and St John Ambulance service for campaigning on the issue.

Each year 150,000 people die in incidents where their lives could be saved if only someone knew what to do, and 30,000 people have a cardiac arrest outside hospital. Many of those people could be saved if bystanders knew what to do, if someone started CPR immediately and if there was a defibrillator available. I want to talk about the chain of survival and the importance of someone starting CPR.

With every minute that passes in a cardiac arrest the chance of survival falls by 10%. CPR increases the chance of survival and prolongs the time a person remains in a shockable condition. If a defibrillator is used to administer a shock the survival rate increases to 50%. On “Casualty” it looks as if CPR makes people suddenly awaken and sit up. Of course, it does not. CPR simply keeps blood and oxygen pumping around the body, which means that the heart can still be shocked back into a rhythm. All the time someone is not breathing, and their heart is not pumping, part of their body and brain is dying. CPR keeps people alive and keeps them going until they can be shocked and can get to hospital.

Teaching emergency life skills in schools and the community is

“a no brainer, it’s just common sense”.

Those are not my words, but the words of Dr Andy Lockey of the Resuscitation Council. He and another 124,665 people have called on the Government to put emergency life support skills in the curriculum for all schools. With just two hours a year we could make every school leaver a life-saver. Those two hours a year could save some of the 150,000 people a year who die in situations where their lives could be saved.

The country looked on in horror just over a year ago, when Fabrice Muamba was playing for Bolton Wanderers against Tottenham and suffered a cardiac arrest. Fabrice was lucky, because he had his cardiac arrest in a public place where there were trained first aiders; because the paramedics were knowledgeable enough to give him immediate CPR on the pitch, so that his brain was saved; and because the medics did not give up, but worked on him for 78 minutes until his heart restarted. Just because he was with people who knew what to do, he survived. Fabrice is campaigning for emergency life support skills to be taught in schools, and for defibrillators to be available in public places. He joined those of us who took the British Heart Foundation’s petition, which was signed by the 124,665 people, to Downing street.

My sister’s friend Malcolm McCormick was also lucky. In April last year he went to school to pick up his grandchildren, and keeled over—effectively dead, not breathing, with his heart not beating. Malcolm was lucky because one of the people waiting to collect their children was a retained firefighter, who gave him CPR; because once a month another firefighter volunteers in the school tuck shop, and it was his Friday to work, so he came out and took control of the situation; and because a defibrillator was available, and he was rushed to a specialist hospital. Malcolm left hospital three days later with very sore ribs; but he was alive, with his brain intact. Four months later he was fit enough to be a games maker at the Paralympics.

[Andrew Percy]

Earlier I failed to mention the role of retained firefighters. An initiative by Humberside fire and rescue service is starting this month; retained firefighters in some east Yorkshire communities will respond to the issues that the hon. Lady is outlining. Does she agree that we need a broader debate about what the emergency services do? Perhaps there is a role for members of the fire service. There are some in the fire service who will not allow vehicles with defibrillators fitted to be dispatched or used in relevant situations, although they are standing there while there are no ambulances nearby. We must address that.

[Julie Hilling]

I agree that we need to maximise the use of knowledge and equipment in the community. I will talk later about the consortium in Bolton, in which the agencies are working together on getting defibrillators in place, and teaching people ELS.

There are many inspiring stories of people who have saved lives, many of whom are young people. I have talked about them several times in Parliament, but I want now to mention a young woman I met a couple of weeks ago. I was honoured to meet 15-year-old Samantha Hobbs with her parents when she came for a meeting with an Education Minister, which, sadly was cancelled, but can hopefully be rescheduled. One morning last year, Samantha woke to hear her father on the telephone to the emergency services, telling them that he thought her mum was already dead. Samantha did not hesitate. Even though her mum felt cold to the touch, she started CPR. Of course, CPR is very tiring and after a few minutes she was exhausted, so she showed her father what to do and coached him to take over, although he had never had any training. Thanks to Samantha her mum survived and is alive today; she came to Parliament with her daughter. She is alive because Samantha learned life-saving skills at her swimming club. They are campaigning for all children to be taught how to save a life.

I have been working hard to get ELS included in the national curriculum. I even introduced a ten-minute rule Bill to ask the Government to do it, but they are stubbornly resisting that common-sense move; so I am trying to ensure that every young person leaving school in my constituency and throughout Bolton leaves school a life-saver. The work is being done with the North West ambulance service, Bolton Wanderers community trust, Greater Manchester fire and rescue service, Bolton council, the British Heart Foundation and the Arrhythmia Alliance. We are enabling all schools to teach ELS, providing training in the community and campaigning for defibrillators in public places. The campaign has been wonderfully supported by The Bolton News, which has been running a campaign alongside it. We are making progress, but it would be so much better if the Government would take action.

Why cannot defibrillators be made compulsory, like fire extinguishers? Far too many companies and organisations are worried about the consequences of having a defibrillator. No one has ever successfully been sued for attempting to save someone’s life. As so many hon. Members have said, a defibrillator cannot be used on a person unless they are in a shockable condition. It tells the user what to do: where to put the pads and whether a shock can be administered. Companies, businesses and community groups should be far more worried about how they would feel about someone dying, when if they had only invested in a defibrillator and someone had known what to do, they could have saved them.

Will the Minister talk to her colleagues in the Department for Education about making the teaching of ELS compulsory? Will she ensure that health authorities provide teaching of those skills to the public? Will she work with colleagues to legislate for defibrillators in public places? The Government could save 150,000 lives a year. I cannot imagine anything worse than seeing a loved one collapse, and finding out afterwards that I could have saved them if I had known what to do. I have, I hope, made sure that that will not happen to me; I have become a Heartstart tutor. However, we need to give all people the skills, confidence and tools to save lives. As a firefighter in my area said, “When someone’s heart stops, they are dead. You can’t make them any deader, but you could save their life.”

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[Andy Burnham]

The right hon. Gentleman is absolutely spot on, because we see incredible activity across all four nations of the United Kingdom in the wake of those tragedies. Communities are pulling together, raising funds and donating defibrillators to schools and sports clubs, which brings me to my main point: leadership is now needed at national level to co-ordinate that activity and to bring clarity to the whole situation so that the public know where to find a defibrillator and how to use one. I hope I can persuade the Government to work with Opposition Front Benchers on that. There is no politics involved here; this is about saving lives where we can and doing things to make human progress in this country. Other countries are more focused than we have been, and because of that they are saving more lives.

My feeling is that provision is too random at the moment—it is happening in some places and not in others—and we need clarity on policy at a national level so that we can piggyback on all those local campaigns to make progress. I do not think there is a funding issue, because communities will find the money to put these things in the right places, but we must know where they need to go.

It is crucial to understand that, with the best will in the world, the ambulance service is often unable to make a difference for the people who sadly fall in a busy shopping centre, railway station or sports ground. Why? Because they are unable to get there within the Government target time of eight minutes, which is too late. As my hon. Friend the Member for Bolton West said, it is about that chain of survival; it is about equipping people with the knowledge and the kit at local level to start making a difference so that, when the professionals arrive, there is somebody there to save. That is what we have to do.

If we look at the statistics, 12 young people, as my hon. Friend the Member for Liverpool, Walton said, die from sudden cardiac arrest in the UK every week. We underplay that problem. Until recently, the Department of Health NHS Choices website stated that the figure was 12 young people a year. The figure was corrected after it was pointed out to the Department, but it is important that the problem is not underestimated.

The clinching fact for why we should do more is that across the world, survival rates are very variable. According to the British Heart Foundation, in this country between 2% and 12% of people who suffer a sudden cardiac arrest survive, which is way too low. Elsewhere, in Seattle, as has been said, 50% of people survive, and in Japan, a public access campaign for AEDs has resulted in an immediate increase in rates of survival with minimum neurological impairment for out-of-hospital cardiac arrests.

The evidence is absolutely clear, so what about policy? What did we do while we were in Government? We must be honest. I am not here to say that we did everything right, but we did something. On the back of the focus on heart services, we introduced the national defibrillator programme in the middle of the last decade. It made a modest amount of funds available to purchase defibrillators to give to local organisations. However, I think that a mistake was made. As the programme was wound down, responsibility was passed to ambulance services.

There are two ways of looking at that. On the one hand, ambulance services have been doing brilliant work ever since as they have taken on the responsibility to improve communities’ capacity to respond. It is fantastic to see representatives of the ambulance service here today. I have certainly been impressed by what I have seen in the north-west. The team there is working with communities across the region to build their capacity to respond. The ambulance service has done good work, but national focus on the issue was lost when responsibility was passed down to the ambulance services, and we must acknowledge that.

That brings me to the crux of what I wanted to say, particularly to the Minister. I think that, between us, we can develop a set of simple policy calls that could make a difference and save lives. I will identify three in particular. As hon. Members have said, there is a compelling case for putting emergency life skills on the national curriculum and for making time available, perhaps as part of the personal, social, health and economic education component, to provide training for all young people. No young person should leave school without knowing how to provide CPR and use a defibrillator, because it is not all about defibrillators or CPR—the two together are important. If we train young people in those skills, as my hon. Friend the Member for Bassetlaw said, they will go home and talk to others about them.

I have seen what the British Heart Foundation does in schools. The courses that it delivers for young children are outstanding. It would be easy to add such courses to the national curriculum. My children tell me all the things that they are doing in school: the things that they are learning to make in home economics, and the kings and queens that they know about. It is odd that we do not ensure that every young person in this country leaves school at 16 knowing how to save a life. What more basic skill could we give them during their school years?

[Andrew Percy]

On the right hon. Gentleman’s attack on kings and queens, as a former history teacher, I attach importance to learning about them. An easy way to do what he suggests without crowding the curriculum too much would be simply to require all PE teachers to have the training, so that they can disseminate it as part of PE, which is required all the way through school. It would be a simple way to teach it without crowding the curriculum.

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[Anna Soubry]

That, again, is a good point. Clearly, one size does not fit all. Every area has different needs.

[Andrew Percy]

The problem with looking to the ambulance services is that they do not have the money to provide defibrillators to each of their communities. I would also question whether they necessarily know their communities all that intimately, being organisers, as they are, on large, regional scales.

We have discussed areas of responsibility outside those of the Minister’s Department, but will she undertake to look at the situation of nursing homes, particularly in Texas? Will her officials contact the health department in Texas to see what impact there has been as a result of requiring defibrillators in nursing homes? Then we can come to an evidence-based decision on the matter.

[Anna Soubry]

My hon. Friend’s point is, again, good and well made. I am glad that we worked out which part of the United States it was that something good could be said about in this respect. I am more than happy to take his point away, as one of the many ideas that hon. Members have suggested in this debate, and see whether we can consider in any way, be it making provision mandatory or issuing guidance to nursing homes and other institutions—[Interruption.] I think my hon. Friend the Member for Brigg and Goole said that he was going to send it to me. I will be interested in anything that ever comes across my desk. I will give it due consideration and pass it on, if necessary, to those who have responsibility for nursing homes in the Department of Health. As I said, it is a good idea.

One could argue that only a limited number of hon. Members have participated in today’s debate. We should stop here for a moment, because all the Members who have spoken have come from the standpoint of having experienced someone—normally a child—dying suddenly from a heart attack. That touches people in a raw way, because it involves a child. Mercifully, out of all the horrors and badness invariably comes something good, which is a point raised by the right hon. Member for Belfast North (Mr Dodds). Hon. Members have raised many examples of the good that has come out of the terrible and tragic loss of a young life.

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[Anna Soubry]

I have given my reasons for why I do not believe legislation, at the present time, is the answer. I agree with the hon. Lady that a lot of the matter depends on luck. Certain areas seem to offer a better service than others because of some unfortunate tragedy that has befallen them. With the Oliver King Foundation and many other charities that we have heard about today, people have come together and raised money to install defibrillators or to ensure that school children receive the right sort of training.

We heard examples of the work of mayors. The hon. Member for Barrow and Furness (John Woodcock) talked about the work of the mayor in his constituency, and the hon. Member for West Lancashire (Rosie Cooper) spoke about the work that had been done in her constituency by the mayor. She also mentioned the death of a young man and the work that his family has done as a result to ensure that other youngsters did not suffer a similar fate, and that the things that should be in place were there.

[Andrew Percy]

Again on legislation, I agree with the Minister’s point that we want a mixed approach to the matter, but if we expect communities to take charge of the matter themselves, we must understand that some communities do not have the capacity to do so. They might not be able to raise money quite as easily as more middle-class and better-off areas can. Some communities might be slightly better organised because they have a parish council speaking for them. We must bear in mind that not every community will have the resources or the individuals who feel confident enough to raise money for such provision.

[Anna Soubry]

My hon. Friend’s point is another well made point.

I will return to where this debate started—the subject of sudden adult death syndrome. Starting with screening, often when there has been a case of a sudden cardiac arrest, many people say, “Screening will have a big impact in the future.” As the right hon. Member for Leigh will know, the UK National Screening Committee, an independent expert body that advises Ministers about all aspects of screening, assesses the evidence for screening against a set of internationally recognised criteria. No doubt that is why the right hon. Gentleman listened to and followed its advice, which is that, while screening has a potential to save lives, it is not a foolproof process. The footballer Fabrice Muamba suffered cardiac arrest, and many of us will remember what happened to him at the game. We have heard many people describe the amazing medical assistance that he was given—I cannot remember for how long he was unconscious, but it was an incredibly long time—and that young man has made a remarkable recovery. However, I am told that he had received several screening tests throughout his career.

In 2008, the UK NSC reviewed the evidence for screening for the most common cause of sudden death in those under the age of 30, hypertrophic cardiomyopathy, including looking at athletes and young people who participated in sport. A number of the cases that we have heard today involved, invariably, young men or boys who died while playing sport, notably football. The UK NSC concluded that the evidence did not support the introduction of screening. Sudden cardiac death is a complex condition and is difficult to detect through screening; there is no single test that can detect all the conditions, nor is it possible to say which abnormalities will lead to sudden cardiac death. However, in line with its three-yearly review policy, the UK NSC is again reviewing the evidence. This time the review will go further than only looking at the evidence for screening for HCM and will cover screening for the major causes of sudden cardiac death in young people between the ages of 12 and 39. The review will take into account the most up-to-date international evidence, including evidence from Italy, where screening is currently offered to athletes between the ages of 12 and 35.

There will be an opportunity to participate in the review process later this year, when a copy of the latest review will be open for public consultation on the UK NSC’s website. No doubt, a number of the organisations and charities that we have heard about today will take part in that consultation. I am told that although screening is not routinely available in England, work to prevent premature death from cardiovascular disease is a priority, as it should be.

On 5 March, the cardiovascular disease outcomes strategy—not exactly words that trip off the tongue—was published. It sets out a range of actions to reduce premature mortality for those with, or at risk of, cardiovascular disease. The NHS Commissioning Board will work with the Resuscitation Council, the British Heart Foundation and others to promote the site mapping and registration of defibrillators, and to look at ways of increasing the numbers trained in using them. I pay tribute to the foundation, which a number of hon. Members have mentioned, and rightly so, as we are all grateful for its work in, for example, placing defibrillators in Liverpool primary schools. That is, no doubt, because of the outstanding work of the Oliver King Foundation.

Ambulance trusts have had responsibility for the provision of defibrillators since 2005, and in my view they are best placed to know what is needed in their local area. However, it is important to recognise that defibrillators help only in a minority of cases. The majority of out-of-hospital heart attacks—up to 80%—happen in the home. Bystander CPR doubles survival rates, but it is only attempted in 20% to 30% of cases. It is clear that although defibrillators play an important part, we have to bear in mind, as I said, that 80% of heart attacks, if they do not happen in hospital, happen at home, and I absolutely concede that there is a real need for an increase in the amount of people trained in CPR, because we know that that also plays a hugely important part in ensuring that people who have a heart attack survive it.

When there is a sudden cardiac death, we need to take action to ensure that potentially affected family members are identified and offered counselling and testing to see if they are also at risk. We know that that does not always happen. There are continuing discussions with the chief coroner for England to determine how coroners’ services might help in the identification of potentially affected family members, so that more lives can be saved. The national clinical director for heart disease, Professor Gray, will work with all relevant stakeholders to develop and spread good practice around sudden cardiac death.

In conclusion, I will wait to see the latest recommendation from the UK NSC, following its latest review of evidence. The national clinical director for heart disease will continue to promote good practice and awareness around sudden cardiac death. However, as I have said before—forgive me for repeating myself—I will ensure that I speak to the relevant Minister at the Department for Education about all the arguments that have been advanced today for training in CPR and life-saving techniques to be part of the national curriculum. It is my understanding that that particular part of it is under review, and I will impress on him or her how strongly Members have spoken today.

Again, I thank everybody, especially those who signed the petition, for bringing the debate into this place and, effectively, for shining a spotlight on the matter. I hope that hon. Members will take the issue to their local press, as I am sure they will, and that the national press might also look at it. It is absolutely right that the more we ventilate it, the better the situation will be.

Social Care Funding

Andrew Percy Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

These proposals will go some way to addressing that problem. First, children who reach adulthood— the age of 18—with care costs will continue to receive the support they need without any qualification at all. Adults who become disabled during their working life will have a cap, but it will be a lower one. So we will be able to offer very important support to both those groups.

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

I welcome this statement as it moves the system on from where it is today. However, for a lot of communities the social care costs are so much more expensive, particularly in rural areas with very elderly populations, and they are more likely to hit that cap more quickly. So can my right hon. Friend assure us that everything will be done to ensure that the cost of care in these more expensive areas is brought down to something more in line with the rest of the country?

[Mr Hunt]

We think that these proposals will be particularly effective in such areas, because the higher the costs the sooner someone will reach the cap and the sooner they will get the support they need.

Progressive Supranuclear Palsy

Andrew Percy Excerpts

Wednesday 23rd January 2013 Westminster Hall

[Andrea Leadsom]

I will address that later, but my hon. Friend is right to make that point, because it is believed that more people suffer from PSP than from MND, despite the fact that the latter disease is much more commonly known in general society.

PSP and CBD are similar diseases, and PSP is often used as shorthand for both conditions. In progressive supranuclear palsy, progressive means that it gets steadily worse over time; supranuclear means that it damages parts of the brain above the pea-sized nuclei that control eye movement; and palsy means that it causes weakness. Members may never have come across PSP before, but, sadly, it takes many lives.

PSP is caused by the progressive death of nerve cells in the brain, leading to difficulty with balance, movement, vision, speech and swallowing. Over time, PSP can rob people of the ability to walk, talk, feed themselves and communicate effectively. The average life expectancy is seven years from the point of diagnosis. Those who are diagnosed with PSP suffer severe and unpredictable impairments that have an enormous impact on the individual and their family. PSP is a dreadful disease.

I am pleased that since 2010, having written several times to the Department of Health, there is now better recording of PSP on death certificates, giving a clearer indication of the number of sufferers. Our attention, however, must now turn to diagnosis. Statistics show that some 4,000 people are living with PSP in the UK, but because diagnosis is still so uncertain, neurologists believe the figure could be as high as 10,000. Astonishingly, as my hon. Friend mentioned, there may be more PSP sufferers than sufferers of MND in the UK today.

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

I congratulate my hon. Friend on securing this debate. She has mentioned the relatively small number of people living with PSP, but is not part of the problem that many health care and social care professionals do not fully understand the condition?

Oral Answers to Questions

Andrew Percy Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Speaker]

No, no. Order. I must say to the Minister that when a retraction is required, that is what is required and that is all that is required. We move on.

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

3. What representations he has received from clinicians in Yorkshire and the Humber on the decision to close the children’s heart surgery unit at Leeds children’s hospital.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I know that some are disappointed at the decision by the Joint Committee of Primary Care Trusts and want to see children’s congenital heart surgery continue at their local hospitals. However, the Safe and Sustainable review was an NHS review, independent of Government. Under the circumstances, and given that legal proceedings and a review by the independent reconfiguration panel are under way, my hon. Friend will understand that it is not appropriate for me to comment further.

[Andrew Percy]

One hundred and seventy clinicians from across Yorkshire and northern Lincolnshire have written to express their dismay at the decision, stating that for time-critical transfers it

“exposes a number of children to the risk of death,”

largely because it will require transfers to Newcastle, where services are not co-located. Does that not prove that the decision does not enjoy clinical support in Yorkshire and north Lincolnshire and that it is simply not true that this has been a clinically led review?

[Mr Hunt]

I have seen the letter to which my hon. Friend refers and I understand that these are extremely complex issues. Let me reassure him that when I take my final decision, it will be on a clinically led basis. I will do that when I have received the IRP’s report, which I am due to receive by 28 March.

Leeds Children’s Heart Surgery Unit

Andrew Percy Excerpts

Tuesday 30th October 2012 Westminster Hall

[Martin Vickers (Cleethorpes) (Con)]

It is a pleasure to take part in a debate under your chairmanship again, Mr Hollobone. I, too, congratulate my hon. Friend the Member for Pudsey (Stuart Andrew). This is something of an action replay, not only for you, Mr Hollobone—you were in the Chair last week for the debate on Glenfield hospital in Leicester—but for the Minister. I apologise to her that some of the points that I am going to press her on now are identical to those that I raised last week. One is the point about distance.

It is noticeable that three out of the four representatives from northern Lincolnshire are here to take part in the debate. We are the remotest part of the area served by the hospital. That does not just present problems for people visiting. As we have heard in previous debates and meetings, getting babies to a unit has actually made the difference between life and death, and that cannot be ignored. In the Cleethorpes area, there are a large number of parents and grandparents whose children have received treatment here. We held a public meeting in July and the strength of opinion was evident.

In last week’s debate on the Leicester unit I was slightly disappointed by the Minister’s response. I appreciate that she is walking a tightrope, but she is noted for being an independent voice. She showed signs of being sucked into the departmental bureaucratic nonsense that we often hear, but I am sure she will rectify that in half an hour’s time. Commenting in her reply on something that I said, she made the perfectly valid point that in cases of the kind that we are considering we want

“fewer, but much bigger units.”—[Official Report, 22 October 2012; Vol. 551, c. 186WH.]

That is the opinion of some experts, but equally, of course, other experts disagree. If we are to be ruled by expert opinion, there are two possibilities. One is that we pack up and go home, because we are superfluous. The other is that because experts always disagree, someone democratically accountable is needed to arbitrate between them. My hon. Friend the Member for Brigg and Goole (Andrew Percy) wishes to intervene, as usual.

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

I want to intervene to defend the Minister. My hon. Friend is entirely right about the geographical problems in our area; but even if we accept the argument that we need bigger units, is not the core issue the fact that the population—the patient base—is in our region, not in the north-east? If we must go along this line—let us assume that we must—we should move the doctors to where the patients are, not the other way around.

[Martin Vickers]

As usual, my hon. Friend and neighbour is correct. Because of the remoteness and so on, the assumption that all patients in northern Lincolnshire will transfer to Newcastle will simply not be borne out. They will choose alternatives and I suggest that most will gravitate south. Therefore the Newcastle target of 403 will not be achieved.

There are expert opinions on both sides of the argument. The significant point is that the parents and grandparents of the children who receive the treatment are not convinced about the alternatives, because they have seen surgeons and other experts in Leeds performing miracles on their children with modern medical technology. That is their doubt: they do not have confidence in the alternatives when they have seen the Leeds centre of excellence in action.

My hon. Friend the Member for Pudsey stole a line from me because I too was going to quote the point that my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) made in last week’s debate. I will take another line from his speech:

“The Secretary of State has the levers of power in this question and he must pull them—he must exercise them”.—[Official Report, 22 October 2012; Vol. 551, c. 188WH.]

That is what we expect. We do not want the question shuffled off to a panel of experts, with automatic acceptance of what they say. Different experts come up with different decisions.

Time is pressing. In Leeds we have a centre of excellence. It deserves our support, and already has the support of those we represent. I am sure that the Minister and the Secretary of State would not want to be responsible for destroying it.

Mental Health Act 1983

Andrew Percy Excerpts

Monday 29th October 2012 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. As a result of the new structures in the NHS, responsibility for ensuring that all patients who are threatened with detention receive the advocacy to which they are entitled under the Mental Health Act will be transferred from primary care trusts to local authorities. We will use this opportunity to review the arrangements, talk to local authorities, and do all that we can to ensure that those functions are discharged in the way my hon. Friend seeks.

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

Two mental health trusts that do a fantastic job in my constituency, Humber NHS Foundation Trust and Rotherham, Doncaster and South Humber NHS Foundation Trust, have been involved in this. Can the Secretary of State tell us how many patients have been affected by what has happened in trusts, so that if families approach us we can offer them the information that they require?

[Mr Hunt]

I shall try to give my hon. Friend that information later.

Health

Andrew Percy Excerpts

Tuesday 17th July 2012 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab)]

Like many other Members, I should like to say a few words about the outcome of the Safe and Sustainable review. Children’s heart surgery services in Glenfield, in the constituency of my hon. Friend the Member for Leicester West (Liz Kendall), have been earmarked for closure—a decision that came as shattering news when we heard it the other week to many of the staff who work there and many families of patients who have been treated there.

Many of my constituents have got in touch with me, and I have also been contacted by people across Leicester and the country. I do not have time to go through everything that they said, but Stacey Whiteley from Lincoln has contacted me. People have contacted me from Corby, Coalville and Northampton to express deep concern and opposition to the decision. Many of them said that there were a number of questions that they wanted answered and, as I think that they are legitimate concerns, I want to put them on the record.

My constituents have asked me, for example, why the extra options I to L were not presented for public consultation. Other constituents have pointed out that option A was the most popular, but was apparently ignored. Some constituents have questioned the impartiality of some advisers to the panel and others have pointed out that, in the consultation document, option A was described as being consistently the highest scoring option. Why was there a U-turn and option B chosen? It is right that those decisions should be made by clinicians, but these are legitimate questions from people concerned about the decision.

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

The hon. Gentleman makes an important point, but the decision was made not by clinicians but by commissioners, who have left the eastern side of England between Newcastle and England without a heart unit. Many of my constituents would have gone to Leicester in preference to Newcastle. Now they will probably travel to London or Liverpool.

[Jonathan Ashworth]

Indeed. Many of the hon. Gentleman’s constituents would have been welcome in Leicester. He is quite right: where do our constituents in the east of the country, between Newcastle and London, go? That is something else that many of my constituents have raised with me.

I wish to concentrate on the biggest deficiency of the decision, which is the impact on our world-class ECMO—extracorporeal membrane oxygenation—service. On Friday, the Secretary of State announced that he would accept the recommendation to shift our ECMO service from Leicester to Birmingham. In Leicester, we have had a brilliant, world-renowned ECMO service for 20 years.

--- Later in debate ---

[Stuart Andrew]

I am extremely grateful to my right hon. Friend for that clarification. I hope that the independent review body will look at the issues that I raise.

Logical health planning clearly dictates that services should be based on where the population live. Doctors should travel to where the patients are, rather than the other way around. Even the British Congenital Cardiac Association has said that:

“Where possible, the location of units providing paediatric cardiac surgery should reflect the distribution of the population to minimise disruption and strain on families.”

After all, it is not buildings that perform operations, but the doctors and surgeons within them. That definition seemed okay in the case of Birmingham. The review stated:

“The Birmingham centre should remain in all options due to the high level of referrals from the large population in its immediate catchment area.”

Why on earth does the argument about the large immediate population not apply equally to Leeds?

The independent analysis of patient flows states that many of the people in west and south Yorkshire and in Lincolnshire will probably go to Birmingham, Liverpool or even London instead. The JCPCT reaches the figure of 403 surgical procedures for Newcastle on the basis of only 25% of the patients going there. Even that is doubtful. How was the figure of 25% arrived at?

[Andrew Percy]

It is very convenient that the 25% figure gets Newcastle just over the 400 mark. However, my constituents in east Yorkshire and north Lincolnshire will not travel to Newcastle at a rate of 25%. They will go straight up the M62 to Liverpool or head south to Birmingham or even London, which are much easier to get to.

[Stuart Andrew]

My hon. Friend is right. I am sure that that is the case for constituents across Yorkshire and the Humber.

National Health Service

Andrew Percy Excerpts

Monday 16th July 2012 Commons Chamber

[Andy Burnham]

The Bill that the Government brought through is an attack on the N in the NHS; that is what it was designed to do. It was designed to break national standards; to break national pay; to break waiting time standards; and to allow primary care trusts to introduce random rationing across the system. That was the intention of the Bill that they brought through; they wanted an unfettered market in the health service, and my hon. Friend is absolutely right. That is why we are saying that we will repeal this Act and restore the N in NHS at the earliest opportunity.

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

On 28 June, in response to misinformation put out by Labour councillors, the medical director of my local hospital trust, a doctor of 30 years, wrote an article in my local paper under the headline “NHS faces greatest challenge”. She talked about staff costs, treatment costs and the 2008 Nicholson challenge. She said that the trust’s problems date “back to 2008”, and she continued:

“Having been a doctor for nearly 30 years, the 2008 Nicholson challenge is, by far, the greatest challenge the NHS has ever faced”.

What should we believe: the picture being presented by the right hon. Gentleman or this article?

[Andy Burnham]

The hon. Gentleman is making my point; if he was listening to what I said at the start of my speech, he would have heard me say clearly that the £20 billion Nicholson challenge, which I set, was always going to be a mountain to climb for the NHS. Let us be clear that it was. What was unforgiveable was combining that Nicholson challenge with the biggest ever top-down reorganisation in history, when the whole thing was turned upside down, managers were being moved or made redundant and nobody was in charge of the money. That was what was so wrong, and that is what the hon. Gentleman should not be defending if he is defending staff in the NHS.

The third area where we need action from Ministers is on protection for staff. The Deputy Prime Minister said recently:

“There is going to be no regional pay system. That is not going to happen.”

But we heard yesterday that a breakaway group of 19 NHS trusts in the south-west has joined together to drive through regional pay, in open defiance of the Deputy Prime Minister. They are looking at changes to force staff to take a pay cut of 5%; to end overtime payments for working nights, weekends and bank holidays; to reduce holiday time; and to introduce longer shifts. We even hear that if staff will not accept this, they are going to be made redundant and re-employed on the new terms. So let us ask the Secretary of State and the Minister to answer this today: do the Government support regional pay in the NHS and the other moves planned by trusts in the south-west? If they do not, will they today send a clear message to NHS staff in the south-west that they are prepared to overrule NHS managers?

Fourthly, I shall deal with reconfigurations. The House will recall the promise of a moratorium on changes to hospitals and the Prime Minister’s threat of a “bare-knuckle fight” to resist closure plans. In 2010, the Secretary of State set out four tests that all proposed reconfigurations had to pass. They related to support from general practitioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice. He said:

“Without all those elements, reconfigurations cannot proceed.”

So let me ask the Minister: does he think that the A and E units closing at Ealing, Hammersmith, Charing Cross and Central Middlesex pass that test? How about St Helier, King George, Newark and Rugby? Is it not clear to everyone that the Prime Minister’s bare-knuckle fight never materialised? Is it not also clear that no one told the Foreign Secretary, the Work and Pensions Secretary or even the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is responsible for care and older people and who has launched a campaign against his own Department? What clearer sign could there be of the chaos in the Department of Health and of the chaos engulfing the NHS? Will the Secretary of State now take action to stop reconfigurations on the grounds of cost alone?

That brings me to my fifth and final area for action, which is NHS spending. The coalition agreement said:

“We will guarantee that health spending increases in real terms in each year of the Parliament.”

That is health spending, not the health allocation. Official Government figures show that actual spending has fallen for two years running and the underspend has been clawed back by the Treasury. Of all the promises the coalition has broken, people will surely find that one the hardest to understand given that the Prime Minister appeared on every billboard in the land, on practically every street in the land, promising to do the opposite just two years ago.

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[Mr Burns]

I do not like to contradict the right hon. Gentleman, but I will. What I said was slightly different from what he accused me of saying. What I said was that rather than praising the NHS in a year of change, the Opposition denigrate it. That is slightly different.

To pick up on a point that the right hon. Member for Leigh mentioned from a sedentary position, GP referrals for 2011-12 were 1% lower than in the previous year, but outpatient referrals were, as I said, slightly higher.

[Andrew Percy]

Will my right hon. Friend give way?

[Mr Burns]

If my hon. Friend will allow me, I would like to make some progress. If the opportunity arises, I will give way to him then.

I could stop after reporting all that good news, but I do not see why I should when there is so much more to praise the NHS for. It gets little praise for its performance from the Opposition. I want to praise the fact that patients are reporting better outcomes for hip and knee replacements and for hernias, and the fact that the latest GP patient survey showed that 88% of patients rated their GP practice as good or very good. MORI’s independent public perceptions of the NHS survey shows satisfaction with the NHS remaining high at 70%.

In the patient experience survey, 92% of patients who had used the NHS in the past year rated their care as good, very good or excellent. Mixed-sex accommodation breaches are down an incredible 96% since we came to power, although of course the Opposition often claimed to have eradicated that problem—not so, alas. MRSA infections are down 24% in the year, and C. difficile infections down 17%. More than a million more people have an NHS dentist. No reasonable person could look at the performance of the NHS over what has been a challenging year with anything but admiration and pride. I, too, would like to take this opportunity to praise NHS staff for their hard work and dedication and the excellent results they are delivering for patients.

[Mr Burns]

I promised to give way to my hon. Friend the Member for Brigg and Goole (Andrew Percy).

[Andrew Percy]

Will the Minister condemn Labour party representatives in Goole who, despite the fact that under Labour we saw ward closures and mental health in-patient beds go, recently gave the media incorrect waiting list times, and will he confirm that in North Lincolnshire 93% of patients are seen within 18 weeks, which is far ahead of the national target? The Labour party needs to stop talking down our local hospital.

[Mr Burns]

I am extremely grateful to my hon. Friend and certainly condemn any misrepresentation, misinformation or talking down of the NHS in any of my hon. Friends’ constituencies.

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[Stuart Andrew]

The hon. Gentleman pre-empts the next part of my speech and I am grateful to him for that.

As this is a health debate, I am sure that my right hon. Friend the Secretary of State would expect me to talk about the safe and sustainable review of children’s heart units. Like other Members, I have received a number of e-mails from various organisations today. One of them said that some MPs should seek to reignite the debate and that I should think about the children because if I had children, I would move heaven and earth to ensure that the service was the very best. Frankly, throughout the campaign on children’s heart units, I have only ever thought about the children. Of course I want the very best service for them, as do the right hon. and hon. Members from all parts of the House who have worked on the campaign. I have always accepted that there is a need for change. That is why I want to discuss a few related points this evening. I know that I will have an opportunity to raise it in greater detail tomorrow, but it is important that I speak about it tonight.

Access and travel times are incredibly important to the families who use children’s heart services. Logical health planning surely dictates that services should be based according to where the population lies. The British Congenital Cardiac Association states:

“Where possible, the location of units providing paediatric cardiac surgery should reflect the distribution of the population to minimise disruption and strain on families.”

[Andrew Percy]

That is exactly the point that Members who represent Yorkshire and northern Lincolnshire are concerned about. The proposals will mean that patients will have to travel, and expecting families in northern Lincolnshire to get to Newcastle is simply not acceptable.

Veterans (Mental Health)

Andrew Percy Excerpts

Wednesday 7th March 2012 Westminster Hall

[Guy Opperman (Hexham) (Con)]

It is a great pleasure and a privilege to speak in this debate today. I have been in this House for nearly two years and I have not had the opportunity to raise the issue of the mental health of veterans in the way in which we have done today. I pay great tribute to my hon. Friend the Member for York Outer (Julian Sturdy) for securing this debate and for the measured and eloquent way in which he has brought the issues to the House.

I join my hon. Friend and other colleagues in passing on our respective condolences to the service men and women, and to the families of those who died in Afghanistan so recently. I endorse everything that both the Prime Minister and the Leader of the Opposition said. It is an utter tragedy and one of the largest losses of life for many a year. I remain of the view that the sooner we bring our troops home from Afghanistan, the better it will be.

This debate is certainly overdue. I want to make a declaration. I send out my thanks and support to the various charities, volunteer groups and individuals who provide support. I echo the words of support for the Royal British Legion and Help for Heroes. If I need to declare that I have raised funds for such groups while serving as a Member of Parliament, I do so. I certainly need to make a declaration that I have represented, as defence counsel, multitudes of soldiers facing criminal charges, which was a salutary and depressing experience. Many of the soldiers had committed criminal offences, which they had no desire to commit, because they were suffering from mental health problems and fundamentally from post-traumatic stress disorder.

I represented a Royal Marine who had broken down in a supermarket after he had been unable to get together the right amount of money at the till. He felt that the lady behind the counter, who had been perfectly civil to him, had not been as co-operative as she should have been and it all became too much. The nature and the prevalence of post-traumatic stress are such that it is always the very smallest things at the end of the process that result in the demise of the mental strength of people who have quite happily stormed up Tumbledown ridge, gone across the Gulf deserts and fought repeatedly in a way that very few of us in this House can even contemplate. It is how we provide support that is important. As defence counsel for some of these lads and, on one occasion, a woman, I saw very strongly how their spirit was broken. I have also seen, over the last 15 to 20 years of lawyer practice, plenty of examples of these people falling through the system.

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

My hon. Friend is making an important speech about how people fall through the net. My neighbour, the hon. Member for Scunthorpe (Nic Dakin), mentioned Charles Brindley, who has been trying to do some work around GPs. Many GPs do not seem to be aware of the military assessment programme that is available. Often if someone presents with a mental health issue, the GP is not trained or aware of the services and support that can be made available. Does my hon. Friend agree that we need to ensure that GPs are better educated and better trained in dealing with such individuals?

[Guy Opperman]

I entirely endorse that point. Although it is incumbent upon Members of this House to raise the profile of this issue and to try to disseminate information about the types of health care support that exist, it is also incumbent upon the relevant health trusts and authorities to ensure that in future a degree of information is passed down the net to individual GPs and action teams, particularly those teams dealing with alcohol abuse, so that the organisations in the regions are able to support the veterans who are out there.

I have worked with a charity called Veterans in Action. It involves some constituents of mine in Northumberland but it also involves servicemen and women who are based in Lancashire and all over the country, who are attempting to do various things. For example, they have a pilot project with the Lancashire Drug and Alcohol Action Team that involves meeting up with GPs to work with them and trying to do exactly the sort of thing that my hon. Friend the Member for Brigg and Goole (Andrew Percy) has outlined.

However, the worry is that, although individual groups in our constituencies are all doing very good work to provide a degree of assistance to veterans, there is no overarching body providing global support. What often happens, therefore—for example it has happened with Veterans in Action, which was set up in my constituency and is now working throughout the country—is that the individual soldiers effectively get fed up with the process and decide to provide support themselves.

I supported what the previous Government did. They were working to do a great deal more than had previously been done. Successive Governments have improved care for veterans over time. But the “Fighting Fit” report and the work done by my hon. Friend the Member for South West Wiltshire (Dr Murrison) have clearly taken things to the next stage and a better level.

I will digress slightly, because in my constituency I have the Albemarle barracks and the Otterburn ranges, troops from my constituency are serving on a regular basis in Afghanistan with the 39 Regiment Royal Artillery, and the Ridsdale ranges provide all the weapons that are tested before the soldiers use them. I also have a large number of constituents who have served in the forces. For example, many Falklands veterans live in my constituency and have come to see me because of the experiences that they have suffered and the lack of support that they have experienced. That was under a different Government and, frankly, I am not here to criticise any Government. However, there is no question but that the degree of support given to the Falklands veterans was limited compared with the support that we are giving to the veterans who are returning from Afghanistan now. Things have got better.

--- Later in debate ---

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

I was not planning to speak, Mr Dobbin.

[Jim Dobbin (in the Chair)]

No, I did not think that you were.

[Andrew Percy]

I will speak only for three or four minutes, which I think will give the shadow Minister and the Minister longer than they were expecting; but as there was not a line of hon. Members waiting to speak, I thought that I would add my voice to this important debate. I apologise, Mr Dobbin, for not dropping you a note.

I congratulate my near neighbour, my hon. Friend the Member for York Outer (Julian Sturdy), on securing this important debate on a vital issue. There are no party politics involved; we all agree about the sort of services that we want provided for ex-service personnel. I just want to tell the story of a constituent of my neighbour, the hon. Member for Scunthorpe (Nic Dakin). He is the gentleman whom I mentioned earlier, Charles Brindley, who is the vice-chairman of the Royal British Legion in Brigg, in my constituency. He has been trying to put together a project in the area to establish better mental health and support services for veterans. He is trying to co-ordinate through the councils, and I am pleased that North Lincolnshire council has taken him up on his offer of working with it.

There is so much involved in trying to bring everything together. The e-mails that we have had from Charles Brindley and the discussions that we have had with him have been quite enlightening. He has been trying to work with the Prison Service, and he found out that one prison does not have a dedicated individual to respond to ex-service personnel there. He has been trying to work with the primary care trusts and GPs on the very point that I raised with my hon. Friend the Member for Hexham (Guy Opperman): raising GPs’ awareness of what is available through the NHS for ex-service personnel. He has also been trying to work with other organisations that I would not even have thought of, such as Age UK, which has told him that older people may now be starting to present with mental health problems that go a long way back.

A range of organisations and institutions come across ex-service personnel at different points in their lives and provide them with services, and the fact that they are not necessarily always joined up concerns me. Some of what is happening can certainly be brought together under the auspices of the local authorities, but I echo the idea of a dedicated veterans agency. The example that is probably most similar to what we want are the incredibly dedicated services, including specialist health services, provided to veterans in the United States, where veterans seem to be provided with a lot of support that we in this country sadly do not give.

As many Members have said, it is often far down the line that mental health problems start to rear up. This summer, I met one of my ex-pupils walking through the town centre. I had not seen him since I taught him when he was about 16, and I asked him what he had been doing since then. He said, “I’ve been out in Afghanistan.” I think he was in a Yorkshire regiment. He said, “I got shot. I’ll show you.” He then rolled up his trouser leg to show me his bullet wounds. I asked him if he was okay, and he said, “I’m absolutely fine. I’m going to get paid out now. I’m going to get a better pension, and I’m going to get a house. Everything’s fine.” He may think that he is fine now, but in 10 or 15 years’ time, with his career in the military effectively ended, a mental health problem, as we know, could rear its head. What will there be to support that individual then? He is getting a lot of support from the Army at the moment—he had no criticism of that—but in 10 or 20 years’ time, that support might not be there, or he might not know how to access it.

[Jessica Lee (Erewash) (Con)]

I hope that my hon. Friend will agree that another consequence of delayed stress and trauma for veterans can be the impact on their family relationships. Representing families in courts, I have seen over the years that that has caused difficulties. It has been largely a case of fathers having a less meaningful relationship with their children and being less able to take responsibility for them.

--- Later in debate ---

[Andrew Percy]

I entirely endorse what my hon. Friend says. We have probably all seen examples in our surgeries of military service sometimes leading to breakdowns, which are then presented at our constituency surgery for assistance. I am reminded of the old saying: while the physical wounds may heal, the mental scars never quite go away. So I endorse what has been said by other Members today.

[John Pugh]

One of the themes in the debate today has been whether we do or do not have a veterans agency. Somebody said that the veterans agency is an American model, but the Americans do not have our GP system. Even with the existence of a veterans agency, is there not a problem with how that then interacts with the GP, who will often be the first port of call when problems occur?

[Andrew Percy]

That is exactly the point that the hon. Member for Hexham (Guy Opperman) accepted. In creating anything, there will always be interaction problems. We all know where we want to be; how we get there is probably a bit more difficult. Now that the shadow Minister and the Minister will have a little more time, I am sure that they will expertly plot a course forward to deal with these issues.

Health and Social Care (Re-committed) Bill

Andrew Percy Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

No, no, no.

I think that is because Liberal Democrats traditionally support choice. Is it any wonder that the person in question is now the former Member for Oxford West and Abingdon?

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

Will my hon. Friend give way?

[Nadine Dorries]

It is time to make a decision not informed by the Liberal Democrats, and without being blackmailed by a Liberal Democrat or held to ransom by the Liberal Democrats. It is time to make a decision based on our conscience. I say to hon. Members: be prepared to stand by your view today for a long time, as it will be on everyone’s parliamentary record. In weighing up whether to support the amendment, Members should bear in mind the fact that 78% of the public support it. This is why we are here as Members of Parliament—to make difficult decisions such as this, not to be blackmailed or held to ransom. This is why we are MPs—because our constituents expect us to be brave. They expect us to stand up in the face of blackmail and be accountable.

[Andrew Percy]

Will my hon. Friend give way?

[Nadine Dorries]

It does not happen very often in the House, but we have a conscience vote. It hardly ever happens, but we are all personally answerable for the decisions that we take. This decision is about nothing more than supporting an offer of counselling to vulnerable women who may need it and who may use it as a lifeline.

[Andrew Percy]

Will my hon. Friend give way?

[Nadine Dorries]

How many times do I have to say no to my hon. Friend?

This is about being accountable for our views, which is what Parliament is all about. I do not see why we should shy away from putting our positions on the record. If Members want to stand in the way of a woman’s basic right to independent counselling, then they should vote against this proposal. However, if they want to ensure that a woman can have access to very basic support, they should vote for the amendment. It is up to them—support these reasonable measures to provide all women with independent counselling, or stand in the way of that basic support.

This vote is about women. I want every woman in this country to be able to look every MP in the eye and ask, “How did you vote for me and my daughters? What was the decision that you took?” Every MP will be accountable for that vote and that decision today.

--- Later in debate ---

[Valerie Vaz]

He was: he had a very big smile on his face and he said, “I’m about to retire.” [Interruption.] With the greatest respect, the Secretary of State was not there. Sir David was asked to stay on to preside over the NHS commissioning board, which he has described as

“the greatest quango in the sky.”

I think that the NHS commissioning board is going to be the new Secretary of State for Health, with all the powers but none of the accountability. The NHS has been quangoed—not coloured orange, as in the advert, although that might happen when the Bill goes to the other place, but coloured the blue of betrayal. These are not reforms: they are a complete dismantling and looting of our precious resource. This is not selling off the family silver, but selling off the whole estate, the freehold and the family crest.

It is not just Opposition Members who are concerned about accountability. There are widespread concerns about the accountability of the NHS commissioning board and commissioning consortia regarding public money.

[Andrew Percy]

Will the hon. Lady give way?

[Valerie Vaz]

No, I will not.

I again ask the Secretary of State for Health what discussions he has had with the Cabinet Secretary about the change regarding accountability for the public money that will be transferred—£60 billion of it—to those quangos. If he is asked questions about this in the House he will say that it is an operational matter.

I want to show hon. Members what the scenario will be like, because this is already happening in my constituency and this is what it will be like throughout England. The out-of-hours GP and urgent care service provider Waldoc has just lost the contract to provide out-of-hours services after 16 years, without a right of appeal to the strategic health authority and despite a patient satisfaction rate of 95%. When the contract was lost and staff turned up to find out whether they had jobs, they did not even know whether they would have a job the next day. That is how they have been treated. This has been happening in most PCTs, as some Members will know from their constituencies. People have left, vital expertise has gone and no one from the Government side has been able to give us a figure for the redundancy costs. When I asked the Minister how much this whole reorganisation would cost, he said he did not know the figure and that there was no new money. That must mean that money has come out of services.

We have, however, had a figure—£1.4 billion—from Professor Kieran Walshe of Manchester university. No wonder waiting times have gone up. Members of the public need to know that in an increasing number of areas, consortia will be conducting competitive tenders in which, potentially, foundation trusts, the constituent members of consortia and commercial providers will be bidding. Clearly, there will also be a conflict of interest. It has been estimated that a single procurement process can cost from £5,000 to £30,000. That is a waste of public money, and the whole regime of procurement is a waste of costs.

--- Later in debate ---

[Joan Walley]

That is right and it comes back to the fact that, somehow or other, under the new regime, whatever it ends up being, there will not be the fairness or the universal provision. In certain areas—perhaps those such as mine, which have much greater deprivation and much greater health inequalities than others—things will be more difficult.

[Andrew Percy]

I do not recognise the picture that the hon. Lady is painting. The real issue with the provision and availability of services is more to do with the funding model that is in place. When my local PCT was unable to provide dental services and when the bed numbers at Goole hospital were reduced a couple of years ago, local people had no ability to influence those decisions, no matter how much they appealed to the Secretary of State, because it comes down to money.

[Joan Walley]

Of course it comes down to money, but it also comes down to fairness in how the money is allocated. That must relate to an overall sense of direction to deal with health inequalities.

I want to discuss very specifically three amendments that I have tabled, but I did not want to go into the detail without associating myself with some of the concerns that exist across the country which have not yet been resolved. I speak as an honorary vice-president of the Chartered Institute of Environmental Health. I tabled the amendments to ensure that we do not just pay lip service to environmental and public health, and that we truly get a Bill that is fit for purpose in respect of the prevention agenda and the new arrangements under which we will be operating, which should give more status and priority to environmental health.

I want to speak in favour of the Government looking either now or in the other place at the case for a chief environmental health officer for England. The reason for that is the fact that, historically, there was a post of chief environmental health officer, going back to the days before 1974 when local authorities last had lead responsibilities for public health services and when each authority had a medical officer for health.

Today, England has a chief medical officer, but not a chief environmental health officer. I heard what the Minister said about that, but I urge him to have further talks, if necessary, with the professionals to see how we could ensure that a chief environmental health officer for England was appointed. Earlier we talked about Wales, where there is a chief environmental health officer post. In all the arrangements in Wales and in Northern Ireland, there is a recognition of the role played by environmental health in promoting health and well-being, and of the importance, therefore, of ensuring there is an environmental health input to policy making at the highest level and at the strategic level. I believe that is what England currently lacks. If the Bill is to give a higher profile to public health services, and the lead in public health is to be provided by local authorities, which is where the environmental health work force is located, it is necessary to make corresponding arrangements such as my new clause could facilitate, if the Government gave it serious consideration.

--- Later in debate ---

Despite 85% of us admitting that we have problems with our vision, 37% are put off having a sight test because of worries about money. That shocking statistic shows the extent to which fear of cost is as much of a barrier as actual cost, as more than 30 million people in the UK are entitled to free eye care paid for by the NHS and many more are entitled to free eye care paid for by their employer. The result of that confusion is that more than 20 million people are putting their sight at risk by failing to have regular sight tests.

[Andrew Percy]

The hon. Lady is making an interesting argument, and I would just ask her two things. First, how is she suggesting that we should pay for the idea? Secondly, is she seriously suggesting that we should return to millionaires being provided with dental treatment and eye care free of charge?

[Caroline Lucas]

It seems to me that if Wales and Northern Ireland have been able to abolish prescription charging altogether, it is certainly possible to do it. I would also argue that although everyone collectively having a stake in our public services may well mean that millionaires get a free eye test, under the type of regime that I would like to see they would be paying an awful lot more tax than they are under the Conservative party’s regime.