Hospice Funding

Andy Slaughter Excerpts

Monday 22nd April 2024 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

I welcome the debate, because it allows us to pay tribute to the wonderful work that hospices do in all our constituencies across the country, while raising the peril that some of them are in, the insecurity they are facing and the fragile nature of their funding. I am mindful of your caveat on time, Mr Deputy Speaker, so I will make just make two points, if I may.

The first point is about adult services for my constituents. For many years, those services have been provided by the Pembridge palliative care unit, which is an adult community-based specialist palliative care unit just over the border in North Kensington. It is a fantastic place—I have visited friends who have been dying there—and I am aware of its wide range of services. Those are—or at least were—not just in-patient care but telephone advice, community care nursing and therapy teams.

As I said, there was a wonderful in-patient unit; unfortunately there is not at the moment. The ICB is consulting on various options, some of which would see that unit reopen. It closed allegedly not because of funding but because the consultant left and it was not possible to recruit a consultant to fill the post. I would have some sympathy with that were it not for the fact that it closed in 2018 and we are still waiting for the NHS to provide a consultant so that we can reopen the service, which is exactly what all my constituents want.

I note that in the latest consultation, in which there are options to reopen, the NHS said:

“We have heard there is still a strong desire for the Pembridge in-patient unit to be reopened and that options from the public for how we could reopen the unit could be more widely considered than they have been to date.”

That is putting it somewhat mildly. It is an indication of the parlous state of some services around the country, despite the hugely high-quality service they provide.

The other issue is about children’s hospice services. Those for my constituency—in fact, for the whole north-west London ICB, which covers a population of 2 million people—comes from Shooting Star Children’s Hospices, which the hon. Member for Twickenham (Munira Wilson) mentioned because it is based in her constituency. It wrote to me recently and said that it supports

“700 families living across Surrey, south-west London and north-west London. Our specialist care and support are completely free of charge to families and available 24 hours a day, 365 days a year. It includes specialist nursing in the community, symptom management and pain relief, overnight respite stays, end-of-life care, specialist bereavement care and a comprehensive range of therapies, groups, and clinics for the whole family.”

The majority of its funding—we have heard this from hon. Members on both sides of the House this evening—comes from fundraising; approximately a third is funded from statutory channels. Each £1 received from statutory channels necessitates the raising of an additional £2 to sustain its service. I cannot imagine that happening in many other areas. There are other examples of charitable funding, such as for air ambulances, but I am pleased that that is not the norm in the health service. The plea that Shooting Star Children’s Hospices makes is for

“properly funded paediatric palliative care across the UK”,

to

“create a level play field in terms of funding”.

What could possibly be unreasonable about that request or—I would rather say—demand?

On the back of that request, I attended—I think a number of hon. Members in the Chamber did—the recent meeting held here, which was organised by Together for Short Lives. I was incredibly impressed by it. At the meeting I met the chief executive of Shooting Star, Paul Farthing. At his request, I have written to the head of my local ICB to request, in the first instance, simply that it meets, discusses and get to know the services that are better offered.

One of the problems with the majority of funding coming from the voluntary sector through fundraising—I understand why that is important and we want it to continue, as it renews links with the communities—is that there is less of a connection with the statutory sector than there would be in other respects. ICBs need to work very closely with their local hospices, even if they are not based in the same geographical area, as is the case in my constituency. They jointly need to have a plan for how to go to the Government and persuade them that we need stable and ongoing funding, lasting more than one year and covering the impressive range of services that I have mentioned. Without that, a lot of services such as Pembridge will be in doubt.

A Member mentioned assisted dying, which we are debating next week. The two things are related but separate. We want the most compassionate and clearest services for people at the end of life. Part of that is ensuring properly funded hospice services, whether for adults or for children. I again thank the organisers of the debate, the hon. Members for Hastings and Rye and for Darlington, for bringing this matter to the House’s attention. I hope the Government are listening.

National HIV Testing Week

Andy Slaughter Excerpts

Thursday 8th February 2024 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to follow the Father of the House, and I thank my hon. Friend the Member for Warrington North (Charlotte Nichols) for so clearly setting out the issues. I do not need to repeat them, as I want to speak briefly.

I represent a constituency that has had a high incidence of HIV infection for many years. It has a young, mobile and diverse population, and a very busy sexual health clinic at 10 Hammersmith Broadway, which I visited last summer. I pay tribute to all the staff there and at the other clinics around the country. They offer a fantastic service and they are engineering testing and comprehensive treatment under very difficult circumstances and with very limited resources. I also pay tribute to the Terrence Higgins Trust and the National AIDS Trust, and all the other charitable organisations that have done so much over the past few decades.

We should pause in this debate to mark the successes and the transformation in both the prevention and the treatment of HIV and AIDS over the past few years. There has been great success. We know now that early diagnosis is important but, after diagnosis, those who are infected can live normal lives of normal duration. That would have been unthinkable even 20 years ago. There is very effective prevention through PrEP and other methods. To go from where the risk of infection was a few years ago to where we are now is extremely significant.

Given that testing and treatment are available—and prevention should be available—it is even more frustrating that we are in the situation that my hon. Friend outlined. First, the fact that 4,500 people are undiagnosed in the UK is entirely unnecessary. One of the solutions, which the Government are expanding, is opt-out testing in A&E and other locations. That needs to be embedded and extended. Until we get to the stage of preventing transmission altogether—for which there is an ambitious target—opt-out testing needs to be expanded and made more usual. In turn, that will help to eliminate the disparities in testing rates between different parts of the population—between men and women, and heterosexuals and men who have sex with men. This is not rocket science. This is about simply making sure that the proper remedies are available.

The other issue that has come up repeatedly over the past couple of years is the availability of PrEP and other preventive measures. That is partly down to the pressure on sexual health clinics, through an upsurge in other STIs such as gonorrhoea and syphilis, of which we have seen not quite epidemics but serious outbreaks. Last year we saw several episodes of monkeypox. Understandably, they have taken priority in sexual health clinics, but that means that less time is available for consultation, and there are fewer prescriptions of PrEP and other medications. The waiting times are still far too long, but at one stage they were being measured in months rather than weeks. It is clearly a missed opportunity if people are willing to be prescribed PrEP and understand its advantages, but are not receiving prescriptions because they simply cannot get an appointment at their local clinic, through no fault of the clinic or its staff.

These problems need to be tackled, and it would be relatively inexpensive to do so. The problems are relatively clear and straightforward. The drugs and products are safe and tried and tested, and the methods—whether postal testing or in A&E or outreach—are well known and proven to work. The only issue, which I hope the Minister will address, remains why it is not being done. Obviously, there were problems during covid, as there were in many health services, but that is no longer a good enough excuse. There is no reason why people should not be able to readily accept testing, medication and preventive measures.

I would like to hear a further commitment from the Minister today on opt-out testing, resources for sexual health clinics and the availability of PrEP. It has been suggested that, given the expansion in services now provided by pharmacies, PrEP could be added to them. I see no reason why that cannot be the case. It could be perfectly safe to prescribe it in that way. It would take the pressure off clinics and it would make the medication more accessible and easier for those who are not currently receiving prescriptions.

I ask the Minister and the Government to consider those points. They are not difficult and they will not take a long time, but they could have a significant effect on many hundreds and thousands of people who are unnecessarily at risk.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I congratulate my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) and the hon. Member for Warrington North (Charlotte Nichols) on securing this important debate. My right hon. Friend has been called away to his constituency today, but I am grateful to both him and the hon. Lady for their strong advocacy for National HIV Testing Week.

I pay tribute to all the other Members who have contributed today: my hon. Friend the Member for Worthing West (Sir Peter Bottomley), the hon. Members for Hammersmith (Andy Slaughter), for Strangford (Jim Shannon), and for East Dunbartonshire (Amy Callaghan), and the shadow Minister, the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill). It is clear that there is cross-party consensus on the need to challenge ourselves to meet our ambition of no new HIV transmissions by 2030, and I am sure that we can do that if we stick together on this subject. I listened carefully to all Members’ speeches, and I will try to answer all the questions that were asked.

Let me begin by saying how grateful I am to everyone who has taken part in in National HIV Testing Week, especially all those who have been tested in Portcullis House thanks to the work of the excellent Terrence Higgins Trust. I also commend the work of other charities, including the National AIDS Trust, Tackle HIV, LGBT Foundation, George House Trust and many others supporting families up and down the country—and I salute the work of the all-party parliamentary group on HIV and AIDS.

We should remember the way in which heroic NHS staff stepped up to care for people living and dying with HIV and AIDS in the 1980s, at a time when AIDS was a terrifying new disease that spared no one. It was to honour their legacy, and to complete the work that our NHS began 40 years ago, that this Government made a bold and ambitious commitment in 2019 to end new transmissions in England by 2030. To that end, we published the first, groundbreaking national HIV action plan just over two years ago. Testing is one of the plan’s central pillars, and I am proud to say that we have been making huge strides, setting an example to the rest of the world to follow. Last year the UK ranked first in the European combined sexual and reproductive health rights ranking atlas 2020 to 2023, in front of 43 other countries, and the UK Health Security Agency has confirmed that for the third time in a row, England achieved or exceeded the UN’s 95-95-95 targets. That means that 95% of people with HIV are being diagnosed, 98% of those diagnosed are being treated, and 98% of those receiving treatment are unable to pass on the condition.

However, while we have made excellent progress, we are not complacent, and we will not be satisfied until the number of transmissions is brought to zero. We have therefore put National HIV Testing Week at the heart of our efforts, year on year. We know that tailored and targeted campaigns are the most effective, so we have increased the number of tests and widened the scope of our campaign, ensuring that our messaging reflects and appeals to the different groups whom we are trying to reach. We are undertaking ever greater efforts to reach those who have been missed before and have become disengaged from the process. Last year we introduced the option of self-testing, with near-instant results at home, to give people more choice and more control over their testing, and this year we are partnering with local businesses to offer tests in places that regularly serve people from, for example, the black African community, who we know are less likely to want to go for a test.

These efforts have brought results. Since we launched the HIV action plan, we have sent out nearly 100,000 tests and received more than 300 reactive results, allowing us to immediately begin the process of getting vital treatment to those who need it. So far this year, the figures show that more than 4,000 self-sampling and self-testing kits have been ordered and nearly 500 results have been reported, nine of them reactive. Our campaign’s message is simple: “I test”—not “eye test”! I am pleased to tell the House that, like the hon. Member for East Dunbartonshire, I tested this week, so I can say from experience that testing is quick, easy, confidential and free. I engaged in a good bit of banter with my fellow Health Ministers as we undertook our testing together, so ours was not very confidential, but it was done through choice, and we were demonstrating how easy it is to do. Everyone should test. It takes two minutes, so I say: please do it.

Our most recent figures show that although new HIV diagnosis rates are steadily decreasing, they sadly remain disproportionately higher among gay men, bisexual men and other men who have sex with men, as well as heterosexual people from the black African community. Similarly, disparity can be found in testing: despite huge progress and record testing rates among gay men, lower levels of testing persist among black African and hetero- sexual groups.

NHS England has invested £20 million to deliver opt-out HIV testing in emergency departments in areas of extremely high HIV prevalence to ensure that people who need it receive the right treatment as early as possible. Anyone having blood taken in A&E in those centres has been automatically—with the potential to opt out—tested for blood-borne viruses, which means that people who would not have been reached via any other testing route have been diagnosed. This saves the NHS millions of pounds, relieves pressure on the service, and helps to address inequalities in testing. In under two years, the programme has already proved value for money by diagnosing more than 4,000 people with blood-borne viruses including HIV, hepatitis B and hepatitis C. The National Institute for Health and Care Research is investing an additional £20 million to find out how we might go further, faster, in tackling HIV rates in the additional 47 sites of high HIV prevalence across England.

[Andy Slaughter]

That may be a good initiative, but it is limited by time, geography, and the type of institution offering the test. Are the Government committed to going further, and spreading opt-out testing to other health facilities and other parts of the country?

--- Later in debate ---

[Dame Andrea Leadsom]

I completely agree. We would like to see this being done around the world. The UK is, I believe, the third biggest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which seeks to eradicate those diseases and to which we have donated £5.5 billion, so our interest is in eradicating those diseases throughout the world. Closer to home, the hon. Gentleman is absolutely right: that crucial part of the United Kingdom, Northern Ireland, should also be supported and helped to roll out this testing, and that will be possible now that the Northern Ireland Assembly has been re-established, which I am delighted about.

Of course, there is still much more to be done to smash the stigma attached to HIV testing and treatment. I pay particular tribute to Becky from Sheffield and Akhona from Leeds for coming forward recently and telling their stories to the BBC. They are setting an example for people up and down the country who should come forward for testing or treatment, and we are backing their efforts to spread awareness by funding HIV Prevention England’s HIV stigma symposium in March at the International Convention Centre in Birmingham. The event will bring together community experts, activists, healthcare professionals and affected people to discuss the impact of HIV stigma and look at effective stigma-reduction strategies. I am sure that it will generate promising stigma-reduction solutions, and I will listen carefully to its recommendations. I am pleased that HIV Prevention England is focusing its efforts on giving a platform to speakers from underserved areas.

Of course, HIV prevention goes beyond testing. The use of pre-exposure prophylaxis, commonly known as PrEP, is an important part of combination HIV prevention. It has been called a “miracle drug” that prevents HIV-negative people from acquiring the virus, and it is a vital tool in our battle to end new HIV transmissions by 2030. Oral PrEP has been routinely available in specialist sexual health services since 2020.

However, we recognise that certain groups have challenges in accessing the PrEP they need. That is why we have developed a PrEP road map with colleagues from Government, local authorities, professional bodies and the voluntary and community sectors, and it will be published on 15 February.

[Andy Slaughter]

At the moment, because it can be accessed only through sexual health clinics, the average wait to access PrEP is more than 12 weeks. Sexual health clinics have seen about a 30% real-terms funding cut over the last few years, so will the Minister either increase the resources available to clinics or increase the number of outlets, such as pharmacies, from which PrEP can be obtained? That is where the logjam is occurring.

[Dame Andrea Leadsom]

As I have just said, we have developed a PrEP road map precisely to increase access to PrEP, and its report will be published in a few days’ time. I encourage the hon. Gentleman to look at that report. I thank everyone who played their part in drafting the road map, working tirelessly towards our 2030 goal of zero new transmissions.

I also thank all our partners for supporting the promotion of HIV testing through National HIV Testing Week, our sexual health summer campaigns, the roll-out of PrEP throughout the country, the introduction of opt-out testing, the development of a PrEP access and equity road map; and so much else besides.

These results would not have been possible without Kevin Fenton, the Government’s chief adviser on HIV and chair of the HIV action plan implementation steering group. His bold leadership has brought together partners across the health landscape towards our shared goals, and I pay particular tribute to him.

So many of us have a part to play as we reach the endgame of ending new HIV transmissions in England by 2030. I reiterate my sincere thanks to all colleagues who have shared their stories, advice and experiences to support our efforts for so long. I hope that today’s debate will inspire thousands of people to do the right thing and take an HIV test.

HIV Action Plan Annual Update 2022-23

Andy Slaughter Excerpts

Tuesday 18th July 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

I pay tribute to my hon. Friend the Member for West Bromwich East (Nicola Richards) and to all other hon. Members present. A number of them have played leading roles in campaigning on this issue.

This afternoon, we have had an excellent debate, hearing important contributions about particular aspects of the challenge: my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) on the dimension for women; the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) on the opportunities for home testing; and the hon. Member for Vauxhall (Florence Eshalomi) on the importance to her constituency. We heard about the inspirational work of centres such as 56 Dean Street from my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) and about the searing personal experience of friends and families of people suffering and dying of this terrible disease from my hon. Friend the Member for Darlington (Peter Gibson).

[Andy Slaughter (Hammersmith) (Lab)]

I apologise, as I have not been present for the whole debate. May I mention one other clinic, 10 Hammersmith Broadway? I visited it recently and was hugely impressed by the staff and their partners in the community, such as the Terrence Higgins Trust. It is clear, however, that they are under increasing stress. The problem is that it only takes an emergency like the outbreak of mpox, or STIs going up, and routine services such as providing PrEP go on to the back foot. Will the Minister look at that, particularly in high-prevalence areas, because the limited cost is not worth the great risk involved?

[Neil O'Brien]

I am happy to look into that. We provided extra funding

in respect of mpox, but I will look into the issues the hon. Gentleman raised.

This debate is an opportunity to restate our joint commitment to tackling HIV and to reflect on the progress we have made since 2019, when the Government first announced our ambition to end new HIV transmissions, new AIDS diagnoses and new HIV-related deaths in England by 2030. As all Members know, 30 years ago AIDS was a fatal illness; today, when they are diagnosed early and have access to antiretrovirals, the majority of people with HIV in England can expect a near-normal life expectancy. People who are diagnosed with HIV can expect to receive HIV care that is world class, free and

open access.

We have come a long way. Despite the unprecedented and challenging backdrop of the covid pandemic, England has seen a 33% fall in new HIV diagnoses since 2019, and fewer than 4,500 people live with undiagnosed HIV. The vast majority of those diagnosed are on high-quality treatment and are now unable to pass on the virus—still not enough people know that. Our successes have been possible only through clear national leadership and strengthened partnership working.

I am incredibly grateful to Professor Kevin Fenton, the Government’s chief adviser on HIV, who chairs the HIV action plan implementation steering group, which has representation from the key partners involved in the delivery of the HIV action plan, including local government, the UK Health Security Agency, the NHS, professional bodies and our voluntary and community sector. The group has met quarterly throughout the year to monitor progress on our commitments and ensure that appropriate action is taken to help us to move forward on our objectives.

Within the steering group’s remit, we have established a community advisory group, comprising representatives from a wide range of community and voluntary groups, from which we have a lot to learn, and four task and finish groups to support PrEP access and equity, workforce, HIV control strategies in low-prevalence areas, and retention and engagement in HIV care. The groups provide vital, comprehensive and timely advice and help us to remain on track to meet our 2030 goal.

Many areas of the country have replicated the national action regionally by providing leadership and oversight of the work that is under way within local systems. For example, we have seen the development of regional HIV action plans in areas such as the south-west, multi-agency working groups in the midlands, and stocktakes of testing activity and action via sexual health networks in the south-east, the north-east and Yorkshire.

New Hospital Programme and Imperial College Healthcare NHS Trust

Andy Slaughter Excerpts

Tuesday 13th June 2023 Westminster Hall

[Andy Slaughter (Hammersmith) (Lab)]

I beg to move,

That this House has considered the New Hospital Programme and Imperial College Healthcare NHS Trust.

It is a pleasure to see you in the Chair this afternoon, Sir Mark. I understand that our proceedings may be interrupted for some time, but let us make a start. I am delighted to see my west London colleagues here—my hon. Friends the Members for Westminster North (Ms Buck), for Ealing Central and Acton (Dr Huq) and for Brentford and Isleworth (Ruth Cadbury)—and indeed the hon. Member for Cities of London and Westminster (Nickie Aiken), my hon. Friend the Member for Reading East (Matt Rodda), and, of course, the hon. Member for Strangford (Jim Shannon), without whom no debate would be complete, perhaps to remind us that although this is to some extent a local or regional issue, it has much wider implications.

To be clear, this debate is about one thing specifically: the defunding and removal from the 2030 new hospital programme of three major hospitals—Charing Cross, Hammersmith, and St Mary’s—all of which form part of the Imperial College Healthcare NHS Trust. They are teaching hospitals, major emergency and trauma hospitals, research hospitals, academic hospitals, tertiary hospitals—hospitals with a huge national and international reputation—but they are also local hospitals for my constituents and those of many other Members.

In the Secretary of State’s statement on the new hospital programme on 25 May, seven of the schemes that had previously been in the 40 hospitals scheme were removed from that programme with respect to completion by 2030—we must be careful in our words here. I need to deconstruct what has happened since that time, because there has been some misleading presentation of the facts. In order to clarify this, I sent some rather key questions to the Minister in advance of this debate.

Essentially, looking at the statement that was made, the Secretary of State said, in respect of those seven schemes:

“The work will start on those schemes over the next two years, but they will be part of a rolling programme where not all work will be completed by 2030.”—[Official Report, 25 May 2023; Vol. 733, c. 479.]

That is the key change, as far as we are concerned, in relation to that statement.

The questions that still sadly remain unanswered are these: what works will be done at each of the three hospitals before 2030? How much will the budget be for that, and will it come out of the £20 billion new hospitals by 2030 programme? What is the total budget for the rebuild schemes at each of the three hospitals? Is this secured funding, and when will it be allocated? By what date or dates will the works for each hospital be completed?

I have put together what I think are the answers—I have done my sleuthing—but I really need to hear it from the Minister’s own mouth, this afternoon if possible, or in a follow up if he needs to use that. I might also add a sort of meta-question to that: when will I receive a response to the email that I and my hon. Friend the Member for Westminster North sent to the Secretary of State on 28 May, which raised those same issues?

I understand that there is confusion associated with the new hospital programme—as would be true of any scheme that came in under the aegis of the former Member for Uxbridge and South Ruislip—about whether those were new hospitals or not. Almost a year ago, I asked the then Prime Minister about the new hospitals—the “new” hospital at Hammersmith that opened in 1902, and the “new” hospital at Charing Cross that opened in 1818—but I will not focus on that point today. This is about the funding and the timetabling of the scheme; frankly, the Minister can call them whatever he likes.

There have been a number of schemes moving in and out. At one stage there were going to be 48 new hospitals. I think 128 bids came in for the extra eight places and five were successful. We are told there is £20 billion, which sounds like a lot of money—it is a lot of money—but it is not the £32 billion to £35 billion that the Health Service Journal says would be needed to complete all the schemes that have at one time been put forward for the new hospital programme. Those are legitimate grievances, but I do not have time to deal with them all today. I have time only to deal with the one matter that I have already raised.

I need to give a little bit of background. As I have indicated, the hospitals have a long and illustrious history, going back more than two centuries in the case of Charing Cross. In 2012, an Orwellian programme called Shaping a Healthier Future, which had been the product of two years’ secret work by the consultants McKinsey, said that several A&Es should close, including the one at Hammersmith, and that Charing Cross should be demolished and replaced by primary care and treatment services on the site. It was the biggest closure programme in the history of the NHS.

Sadly, we did lose the A&E at Hammersmith in 2014, but after a herculean battle fought over seven years by community groups, such as Save Our Hospitals, and by Labour local authorities, particularly that in Hammersmith, that battle was won and Charing Cross had a reprieve and would go on being a major hospital. That happened in 2019.

It was rumoured that the money that would have been gained by selling most of the land at Charing Cross might have gone into the St Mary’s scheme, which, by common consent, is the hospital that most needs emergency work. But although the bill for essential repairs on the three hospitals is about £350 million—far and away the biggest repair bill of any hospitals in the country—if we want to make those hospitals fit for the 21st century, the actual cost, which I believe is accepted by Department of Health and Social Care officials, will be about 10 times that, between £3 billion and £4 billion. If that seems an unspecific figure—my hon. Friend the Member for Westminster North will say more about this—it is because it depends to some extent on what receipts can be received from land value and moneys at Charing Cross. It is a significant sum of money, but it is to make those essential and world-class hospitals fit for purpose for decades going forward, not just to patch them up.

It was always going to be difficult, and it was disappointing that the hospitals were in cohort 4 and would just squeak in by 2030—that is when the work would be completed. We would have a newly built hospital at St Mary’s and refurbished hospitals at Charing Cross and Hammersmith over that time. That is why it was so disappointing when they were moved out of that without any further future date being given.

What is at stake here? Because there has been so much information, I do not want to use my own words, but the words of the trust itself. In preparation for this debate today, it said:

“the main funding for our schemes has been pushed back beyond the original commitment of 2030 as other schemes have been added to the programme and prioritised. We had two schemes in the original list of 40 hospitals to be built by 2030: a complete rebuild of St Mary’s Hospital in Paddington; and extensive refurbishment and some new build at both Charing Cross Hospital and Hammersmith Hospital”—

confusingly, the Department of Health classifies the two hospitals of Hammersmith and Charing Cross as one scheme, but it certainly affects the two hospitals. The trust goes on:

“It is clearly very disappointing that we will not now be funded to complete these schemes before 2030.”

It also states that

“some funding to progress to final business case approval and to support enabling work”

should be provided, and

“we are awaiting a response in terms of a decision and a funding allocation.”

It then talks about the business plans that it is going to put forward. In rather more emotive but absolutely accurate language, it says:

“If we waited until 2030 to start building works at St Mary’s it would become impossible to patch up our oldest facilities, many of which house key clinical services. As the provider of London’s busiest major trauma centre and host of the NHS’s largest biomedical research centre, that would be hugely damaging for the health and healthcare of hundreds of thousands of people”.

That is the statement from the chief executive officer at Imperial, Professor Tim Orchard, and those words should resonate with the Minister.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I am aware that the Division bell will probably start ringing as soon as I stand up, but I am familiar with that quote from Tim Orchard. My hon. Friend is making a really powerful speech. I am familiar with all these hospitals, as are all my constituents. I was born at Queen Charlotte’s, my little sister was born at Hammersmith, and both my parents were under Charing Cross. I went to the Western Eye Hospital last year when I had shingles, and I have an auntie who has retired but was a consultant professor at St Mary’s.

Does my hon. Friend agree that it is really sad that, in the 75th year of the NHS, we are talking about crumbling estates and all these issues? The backlogs at these hospitals existed long before covid. The Government like to throw up that smokescreen and say, “It’s covid’s fault.” I have just written to Tim Orchard because a constituent told me that there is only one temporary scanner at Hammersmith at the moment. Is that not scandalous? Does my hon. Friend agree that, to paraphrase the Sex Pistols, who were formed on the Wormholt estate, which borders both our constituencies, this is the great NHS scandal?

[Andy Slaughter]

I thank my hon. Friend for that contribution, and I entirely endorse what she said.

I want to deal briefly with the misinformation—I accept that it was wholly unintentional—in the Secretary of State’s statement, or rather in his responses to questions following his statement, because it is important. A ministerial correction was made following a point of order that I made arising out of that. In response to my hon. Friend the Member for Westminster North, the Health Secretary said:

“We recognise the importance of the Imperial bid; that is why we are starting to build the temporary ward capacity at Charing Cross and the first phase of work is under way on the cardiac elective recovery hub, to bring cardiac work on to the Hammersmith site.”—[Official Report, 25 May 2023; Vol. 733, c. 485.]

There are 47 words in that statement, and four errors had to be corrected in the ministerial correction. That may be an all-time record; I do not know. Some are more important than others. There are bids, not one bid. We are not starting to build; we will start to build at some time in the unspecified future. There is no cardiac elective recovery hub; there is a cardiac catheter lab. The idea that we are just moving cardiac services to the Hammersmith Hospital site would be a surprise, given that St Mary’s is a world-leading cardiac hospital at the moment.

I accept that mistakes happen, but there were other errors in that statement. It implied that works are under way, whereas it is common consent now that they have not yet started. The cardiac work is nothing to do with the new hospital programme; it is part of the ordinary work, as is the refurbishment of wards. The temporary ward at Charing Cross will be necessary, but not until the main funding for the floor-by-floor hospital renewal refurbishment is ready to go. Some greater clarity would be helpful on those very contentious matters.

My first question is: what are the enabling works? What does that mean? We have heard several definitions. The trust says:

“We do not yet know when we will be able to start work.”

There has been mention of surveys. Of course there will have to be surveys before the works, which are estimated to cost several billion pounds, start. We are hoping to get a significant sum of money for the business case—perhaps as much as £200 million. This is about rebuilding the three main hospitals.

An energy centre is mentioned. There will need to be a new energy centre, partly because we have major supply issues in west London, and the existing energy supply would not supply modern, state-of-the-art hospitals. All that is true, but what is not true is that this is somehow the beginnings of the major works of the scheme. That is a fig leaf to cover the fact that the major works have been postponed beyond 2030. The fact is that they are not in the 2030 programme or the current spending review. I ask the Minister again: when will the work be done and what funds have been assigned? Yes, there has been preparatory enabling work, but does that come out of the £20 billion? What is the Government’s commitment to the major work of rebuilding those hospitals? There has been some work, with £20 million spent on preparing plans so far, but we are in limbo at the moment. We are suffering repeatedly from misinformation.

I understand that this is a highly contentious political area. The chairman of the Conservative party will, if the Boundary Commission proposals go through, be the MP who covers Charing Cross Hospital. That is no excuse for putting forward matters that are simply misleading to my constituents and many other people. That does us a great disservice. We all want to see these hospitals thrive, in the interests of patients, staff, management, the trust and the hospitals themselves.

Therefore, I will end my comments, because I want to give others an opportunity to contribute. What I need from the Minister today is clarity and honesty about what is happening. We will live with the consequences of that, and we will continue to campaign as we have done for our wonderful hospitals and local NHS. The Government do a disservice if they are not straightforward and clear in the message they send out.

[Several hon. Members rose—]

--- Later in debate ---

[Andy Slaughter]

I thank everybody who has contributed to the debate, and the Front Benchers for their contributions. I have a huge amount of respect for the Minister and genuinely wish him great success in his future career, wherever that may be, but he will not be surprised to hear that my constituents will not hear “early stage” and “fluidity” as comforting words. They had schemes for the completion of these major rebuilds of their hospitals by 2030 and assured funding. That is what we do not have, and however we dress it up, we are waiting in hospitals that are not fit for purpose. It is an insult not just to my constituents and patients but to the incredibly dedicated staff. Some of the best clinical staff in the world work in those hospitals, in frankly terrible conditions. That is why we need concrete answers. I will take up the offer of meeting the Lords Minister, but today’s Minister will not be surprised to hear that my hon. Friends and I will pursue this day by day and line by line until we have those assurances.

Question put and agreed to.

Resolved,

That this House has considered the New Hospital Programme and Imperial College Healthcare NHS Trust.

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 6th June 2023 Commons Chamber

[Steve Barclay]

My hon. Friend is right to highlight the series of investments that we have made in his local area. On the specific case he raises, he will know that the business case needs regional approval, and that is currently with NHS colleagues, but I am happy to commit to him that once that is received, we will look at it very keenly.

[Andy Slaughter (Hammersmith) (Lab)]

How much of the reduced £20 billion for the 2030 new hospital programme, if any, is secured for Imperial College Healthcare NHS Trust hospitals, and what are the new completion dates for building works to Charing Cross, Hammersmith and St Mary’s hospitals, now that they have been removed from the list of projects to be completed by 2030?

[Steve Barclay]

As I set out in my statement, there are three schemes within the trust proposal. That is part of the rolling new hospital programme. We are keen to get the enabling works started as soon as possible. That includes a decant at Charing Cross to enable floor-by-floor refurbishment to proceed. We also need to discuss with the trust potential sites for St Mary’s. There is a considerable amount of work to be done, but we are keen to get that enabling work done as soon as possible.

New Hospitals

Andy Slaughter Excerpts

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

Yes, we expect enabling works to start at Whipps Cross. I have been to the site with my right hon. Friend. We have seen the urgency of it. As he said, he has campaigned vigorously on this and championed it throughout. We are very keen, now that we have unblocked the issue around the RAAC hospitals, to start the enabling works on the cohort 3 sites as soon as possible. Obviously, we will, now that we have clarity, discuss with trusts the precise timetable, but the funding for the enabling works to progress will now be available, and we will work with the trust to take that forward.

[Andy Slaughter (Hammersmith) (Lab)]

In what way is delaying work on Charing Cross and Hammersmith Hospitals speeding things up? This is the most shameful, self-serving and nakedly political statement I think I have ever heard. We have heard that Imperial College Healthcare NHS Trust has the biggest backlog in the country. The Government tried for eight years to demolish Charing Cross Hospital, and now they are promising a portacabin there. The only thing that gives me comfort is that the Secretary of State and the whole rotten lot of them will be out of here in a year’s time, and we will have a Labour Government who will actually deliver for Imperial, for Charing Cross, for Hammersmith and for my constituents.

[Steve Barclay]

At pretty much every election the hon. Gentleman has stood for, he has said that all the local hospitals will be closed by a Conservative Government, so it is good to have him championing the redesign and refurbishment of those hospitals. What really undermined his question was the question from his colleague, the hon. Member for Westminster North (Ms Buck). The whole point is that we need to look at the interaction between Charing Cross, Hammersmith and St Mary’s Hospitals—the design of services needs to be looked at across the Imperial trust as a collective. Vis-à-vis a potential new site at St Mary’s, there are questions relating to Transport for London and Network Rail. On Charing Cross, we need to create temporary ward capacity in order then to unblock the refurbishments, which we will do floor by floor. It is a very tightly constrained site and it needs a bespoke approach. That is what we are setting out. Where schemes can follow a standardised design, we will have a modular 2.0 approach, but some schemes that need refurbishment have particular site issues, and we will work through them in a more bespoke way.

Food Labelling and Allergies

Andy Slaughter Excerpts

Monday 15th May 2023 Westminster Hall

[Jon Cruddas (Dagenham and Rainham) (Lab)]

What we are talking about today matters a great deal to a great many people. Millions across the country suffer from some allergic condition: it is estimated that 44% of adults and 50% of children in the UK have one or more allergic disorders. While the prevalence, severity and complexity of allergies have increased on a global scale over the past 60 years, UK rates are among the highest in the world. There is a modern-day epidemic in allergy. I therefore very much welcome both petitions: one to appoint an allergy tsar as a champion for people living with allergies and the other in support of Owen’s law, a change in the law around allergy labelling in UK restaurants. I congratulate the organisers. Literally tens of thousands of people are mobilising and demanding a change both in public health and in corporate responsibility for labelling policy.

Why do we need an allergy tsar? No single person has overall responsibility for the wellbeing of allergy sufferers in the Department of Health and Social Care, NHS England or anywhere else in Government. There are no clear lines of accountability in relation to the overall NHS provision of allergy care. An allergy tsar would act as a champion for people living with allergies. As the national lead, the tsar would ensure that adults and children with allergies received appropriate support to prevent avoidable death and ill health. The lack of a national lead has been raised time and again by coroners at the inquests of those who have tragically died following severe allergic reactions. The need for an allergy tsar is supported by the National Allergy Strategy Group and across the allergy community.

[Andy Slaughter (Hammersmith) (Lab)]

I pose this question because my hon. Friend is an expert in the subject. There have been calls for a national allergy tsar for a long time. Does he understand why the Government are resistant to them?

[Jon Cruddas]

I will come on to that point. There have been 20 years of reports that agree about a common platform for policy change, and there is a unanimity across the community. It is bewildering that over the past 20 years, Governments have not responded in a proactive way, although over the past 18 months there have been a few changes, which I will come to later.

The need for an allergy tsar is supported by the National Allergy Strategy Group. In addition, the Natasha Allergy Research Foundation and the NASG are asking the Government to better support people with allergies through, first, an expert advisory group for allergy, which would actively support the growth and delivery of high-quality, comprehensive and geographically diverse allergy provision, and secondly a national allergy action plan.

--- Later in debate ---

[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Graham, in such an important debate. I will echo the Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), and others. Through relatively small changes to how the NHS is organised and to legislation, this dramatic change would both improve and save the lives of millions, so I hope we will hear something positive from the Minister.

I also thank the hon. Member for Don Valley (Nick Fletcher), who opened the debate, for his comments about Natasha Ednan-Laperouse and her family, and for the sensitive and compassionate way in which he dealt with that tragic death. Natasha’s family are my constituents, and we have heard that Natasha died at the age of just 15 from eating an inadequately labelled Pret a Manger sandwich.

The afternoon I spent with Nadim, Natasha’s father, will stay with me for the rest of my life. He described his experience of how she went from enjoying a happy holiday—getting ready to go out, the excitement of getting ready to fly, taking the precautions she normally did as someone who knew about her allergies, in this case to sesame—to end in her awful death. I do not want to draw that out today, though.

I am very pleased to see Natasha’s mother Tanya here today. I feel huge sympathy and compassion for the family, but also huge admiration for them and everything they have done to commemorate Natasha’s life, going far beyond what many people have done to ensure that the lives of others are improved. Not only have they set up the Natasha Allergy Research Foundation, which we have heard about, but they pioneered Natasha’s law, which came into effect in 2021. It requires food businesses to include full ingredient labelling on foods that are pre-packed for direct sale. Natasha’s law filled an important gap in food legislation and food safety, and Owen’s law would do exactly the same in another respect. His family are here today, and I praise them for having courage and pursuing this matter. I hope that because of the efforts made by these families, we will see a positive response.

Although we have taken those important steps forward, there is still a lot of work to do, hence the petitions and the debates today and last week in this Chamber. The petitions received a very high number of signatures, and some of the highest numbers were among my constituents. That shows how a case such as Natasha’s can have a profound impact on not just a family, but a whole community.

I am grateful to my hon. Friend the Member for Dagenham and Rainham (Jon Cruddas) for securing last week’s debate marking Allergy Awareness Week and for his speech today. I looked carefully at the Minister’s reply, which I will come back to in more detail in a moment, from the debate last Thursday. I read nothing about steps towards appointing an allergy tsar in that response, which is unfortunate because that is something that the allergy community tell us is needed to keep people safe and to keep research moving forward.

As we heard in both debates, allergies in the UK are on the rise. About one in three people have an allergy-related disorder, and over the past 20 years there has been a more than 600% increase in hospital admissions due to allergic diseases. It is not just the numbers of allergy sufferers that are escalating, but the severity of the symptoms. Over 200,000 people in the UK require emergency adrenalin on prescription to manage their allergy.

The very real and ever-present risk of death from an allergic reaction is an ongoing trauma for families and parents of young children who have an allergy condition. As we have heard, about 50% of our child population now live with an allergic condition. Many of our schools have rightly become nut-free zones, due to the numbers of children who would be at risk if someone brought in a nut-based food in their lunchbox. Children go to school with medication bags including EpiPens and adrenaline, in case the worst happens. We should not underestimate the distress and anxiety that that can cause a child, who must learn from a very early age the consequences that can come from eating the wrong thing.

The weight of that on a child is really quite unfathomable, yet we have nobody in the Department of Health and Social Care or NHS England who is responsible for a strategy to tackle allergies. We know that this is a growing problem and research is desperately needed, but to ensure that allergic conditions get the focus they need, someone must be appointed to champion the issue. Given the current state of the NHS, we all understand that resources are stretched, but if the Government committed to an allergy lead, along with funding, they would allow someone to take ownership of the matter and drive forward a strategy to improve the lives of those with allergies.

If I may, I will give a brief, or at least recent, history and timeline of the lack of progress made towards appointing an allergy tsar. Back in January 2020, an inquest was held into the death of another young person who tragically died as a consequence of an allergy: Shante Turay-Thomas. Following the inquest, Emma Turay, Shante’s mother, said:

“Nothing will ever bring our beautiful Shante back to us but what has kept me going throughout this process is knowing that she would want me to get answers and make sure the same thing doesn’t happen to anyone else…The coroner highlighted the fact that no one person in NHS England or the Department of Health is responsible for allergies, and it is quite clear we need an allergy tsar to co-ordinate and implement steps to prevent others from suffering avoidable deaths like Shante’s.”

It is interesting that we still do not have access to a compendium of prevention of future deaths reports. We rely on individual reports, which are very important, but if coroners’ reports were better organised, this issue would have much greater public attention. In Shante’s case, the coroner’s report said:

“there is no person with named accountability for allergy services and allergy provision at NHS England or the Department of Health as a whole”.

The response from the then Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), was:

“Although there is no single, named individual with oversight for all aspects of allergy policy, individuals and teams work closely together in the Department on all aspects of policy relating to allergies.”

The inadequacy of that response led to the petitions being launched and to the call by tens of thousands of people for the Government to appoint an allergy tsar to act as a champion for people with allergies and ensure they receive appropriate support and joined-up healthcare, and so prevent avoidable death and ill health.

In June 2022, following those events, the Natasha Allergy Research Foundation met a new Health Minister, who showed an interest and assured the foundation that meetings were ongoing with the National Allergy Strategy Group and my hon. Friend the Member for Dagenham and Rainham. Three months later, because of the carousel of Prime Ministers turning, the Health Minister was demoted to a different Department and the momentum was lost, notwithstanding the fact that my hon. Friend the Member for Nottingham North (Alex Norris), who was then the shadow Health Minister, tabled an amendment to the Health and Care Bill to create an allergy tsar. Although the Government refused to accept the amendment, the then Health Minister promised to raise the issue with NHS England.

There is a constant expectation that something is going to be done, and then it is dashed, either because of inaction by a particular Minister or because the Minister has simply moved on. Time and again, progress has stalled because of the musical chairs—the many Prime Ministers and the sacking, promotion and demotion of Ministers—and the allergy community has been left waiting patiently for the matter of an allergy tsar to be taken seriously once more.

This reminds me of the long battles we fought to have inquiries into Hillsborough and the contaminated blood scandal. Ministers constantly promise things, or at least say they will look into things, and then they move on and we are suddenly back to square one. I hope the Minister will give us positive news today, not just warm words, and that he will tell us about tangible steps he will take to appoint a lead person for allergies as soon as practicable.

I have not heard anybody coherently argue against the merits of having an allergy tsar, which is why I posed the question I did to my hon. Friend the Member for Dagenham and Rainham. An allergy tsar would be dedicated to and focused on the development of research into cures for allergies, and tasked with ensuring specialist allergy clinics and services up and down the UK. They would be a dedicated lead who works with the Government to implement mandatory reporting on all anaphylaxis events presented to hospital to support comprehensive investigations of fatal and near-fatal anaphylaxis events, and a champion and advocate for those who live with allergic conditions and need more specialist practitioners in their corner.

There is a lot more that I could say, but I will concentrate on two questions that I would like the Minister to answer. First, in relation to the appointment of an allergy tsar, may I remind the Minister what his colleague the Minister for Social Care said in responding to the debate last Thursday? She said:

“There have been calls over recent years—I have heard them echoed today—for stronger leadership on allergy. I am pleased to take this opportunity to outline the allergy leadership that we already have in place. In October 2022, Dr Claire Bethune was appointed national speciality adviser for specialised immunology and allergy. Dr Bethune chairs the NHS England clinical reference group that provides clinical advice and leadership on the specialised immunology services, and advises on how specialised services can best be delivered.”—[Official Report, 11 May 2023; Vol. 732, c. 264WH.]

That is not good enough. That is somebody who has a partial role—a part-time role—who may well do a good job in their own field, but who is not an allergy tsar. It is not a single person who is taking overriding responsibility for allergy.

Let me briefly give a few reasons why an allergy tsar is essential. The debate and the concern about the lack of a national lead on allergy has been going on for 20 years. During that time, clinical outcomes have barely improved, but the number of hospitalisations has tripled. An adviser who specialises in immunology and who simply chairs the existing clinical reference group does not meet the requirements for a national allergy lead. Allergy is currently managed by too many different professional groups. The immunologists do not see it as a priority and are more pathology-focused or laboratory-focused rather than clinically focused. That means that different specialties manage allergy disorders differently.

There is not a strong appreciation that allergy leads to severe symptoms that sometimes lead to death, for example through anaphylaxis or asthma. Allergy is too often trivialised and passed down to primary care practitioners, who are inadequately trained and over-committed in other areas. Allergy is equated with mild disease, but even hay fever has a much greater impact on those affected by it than is appreciated. It would be far better to have a national lead who could also be a clinical lead and who is an expert in managing allergic disease. Training in clinical allergy is minimal, whether for specialist clinicians or for primary care practitioners. We need special efforts to build this specialty. Finally, deaths from anaphylaxis are appreciably lower in those countries with a joined-up clinical allergy service, and in such countries population knowledge about allergy is more highly developed. The case for why we should have an allergy tsar is overwhelming and I would like a clear answer from the Minister today. I do not want a restatement of the current position, because the current position is clearly inadequate.

The second question for the Minister is whether he or one of his colleagues, ideally the Secretary of State, would meet the Natasha Allergy Research Foundation and other interested and expert parties. I ask for that meeting for three reasons. The first is that people at the foundation have personal experience, which to their great pain they have shared publicly, and they have a great deal to offer to the Government and to the NHS in explaining the needs of people with allergy.

The second reason is that the foundation and these other organisations have expertise. I have already indicated that the work done by the foundation since her death really puts the Government to shame. It is not just about the passage of Natasha’s law. The foundation also launched a £2.5 million Natasha clinical trial across six British university hospital sites, seeking to prove that everyday food products could be used in NHS settings as a cheap alternative to expensive pharmaceuticals, to provide oral immunotherapy treatment for children and young people. It has also funded bursaries over four years for students and healthcare professionals at the University of Southampton on the internationally recognised allergy master’s degree and PhD courses at this world-leading allergy research centre. The foundation also organised the global allergy symposium in September last year, which was hosted by the then Prince of Wales, now King Charles, at Dumfries House in Scotland, home of the Prince’s Foundation, to discuss allergy and the environment, which was attended by 16 of the world’s leading allergy scientists. That is the work of one family—one foundation. What have the Government done during that time to compare to it?

The third reason why a meeting is necessary is that we have waited too long. I have talked about the musical chairs of Ministers coming and going. The time is long overdue for a Minister to sit down and talk seriously to the Natasha Allergy Research Foundation and other interested parties, and to confront the issue. I would love to hear the Minister say that the Government are going forward with an allergy tsar. If he will not say that, I ask him to say that he will sit down and seriously listen in detail—he can do so far better than others in this room can—to the reasons why an allergy tsar is needed. Lives have been lost, and lives are at stake. As I said at the beginning of my remarks, the Minister’s response today can make a huge difference to how we go forward on the issue.

Sudden Unexplained Death in Childhood

Andy Slaughter Excerpts

Tuesday 17th January 2023 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is a pleasure to serve under your chairmanship, Mr Twigg, and a pleasure to follow the right hon. Member for Spelthorne (Kwasi Kwarteng), who made a very moving and thoughtful speech. I especially congratulate him on securing this really important debate.

SUDC is an unimaginable tragedy to strike any family. We are here because people in our communities have reached out to us to share their experiences with us. I know we all feel that it is a huge responsibility and an honour to share their experiences.

I spoke last night and previously to my constituent Charlotte and her husband Andy regarding their little son Wilfred, who was two years and 10 months old when he died a little over a year ago. Charlotte and Andy refer to Wilfred as a

“vibrant, energetic little boy who had a vivacious and fearless lust for life.”

She goes on to say:

“The shock that reverberates into every aspect of your life when your child dies unexpectedly and suddenly is unimaginable”.

Unimaginable it is to those of us who have not personally experienced that tragedy. As I seek to honour Wilfred, perhaps the best thing that I can do is speak briefly about actions that could spare other families from experiencing the grief and tragedy with which Wilfred’s family continue to live.

The challenges are what to do with the evidence and what to do about the lack of evidence. Those are the two things that it would be good to consider. Let me first turn to what to do about the evidence. Wilfred passed away at two years and 10 months. At 10 months old, he suffered his first febrile seizure. He was never referred for further investigations to ascertain the cause or to ascertain whether a febrile seizure could lead to anything more dangerous. Wilfred had his sixth febrile seizure, which led to a cardiac arrest, and he passed away just a few days later.

Research by the US branch of the charity Sudden Unexplained Deaths in Childhood shows that roughly a third of sudden unexplained child deaths happen to children with a history of febrile seizures. So they are not totally unexplained, are they? At least some of them are not. However, febrile seizures are mostly not treated as serious or potentially serious. Most NHS trusts do not have a pathway to deal with children who have suffered a febrile seizure, and that surely must be addressed urgently. Febrile seizures must be seen as a red flag that all NHS providers should be aware of, and they should be equipped to act accordingly.

I want also to refer to something that tends to affect not very young children, but young people who are still minors: deaths caused by undiagnosed heart conditions. In particular, I want to refer to the work of CRY—Cardiac Risk in the Young—which does tremendous work in screening young people, particularly those who have any kind of family history but even those who do not, to see whether there is a potential risk. Thousands of people have been assessed by Cardiac Risk in the Young, which is a wonderful charity that works across the north-west and further—indeed, it has done sessions in Kendal. I encourage the Minister to look into how we can screen young people, particularly if there is any family history, to ensure that we do not lose them to undiagnosed heart conditions.

That is what to do with the evidence. What do we do about the lack of evidence? Simply, for the children we lose to sudden unexplained death, it is indeed totally unexplained: there are no clues. We ask collectively today that the Government prioritise scientific research into sudden unexplained deaths among children, potential causes and modifiable risk factors. We also ask that the Government and the NHS prioritise medical education to increase awareness.

[Andy Slaughter (Hammersmith) (Lab)]

I agree with what the hon. Gentleman said. I am here because a constituent told me about the tragic death of her two-year-old nephew in 2021. I am educating myself, with the help of SUDC UK, but it is difficult because there is so little debate, publicity and awareness. I hope that this well-attended debate will mean that research and education is forthcoming. It is a very rare but absolutely devastating condition.

[Tim Farron]

I agree with the hon. Gentleman.

In memory of Wilfred, in honouring his family, and as we remember all those who have tragically died and we seek to support their loved ones, we ask that the Government take practical steps to help us to tackle the horror of sudden unexplained deaths among children.

I spoke to another family—I will not name them—who talked about the loss of their child not so long ago. The mother said to me:

“It clouds everything you do, feel and breathe. I hate that it happened to him and not me. I will never not be able to see him in A&E, thinking this can’t be happening, he is healthy, and I left him a couple of hours ago absolutely fine.”

There is a reason why it is such an uncomfortable issue, but it is important to grasp uncomfortable issues, not only in honour of the memory of Wilfred and everybody else who has passed away and to honour their families, but to prevent any other families from going through the same thing in future.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

I am grateful to my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for securing the debate on this incredibly important issue. It is the first debate of its kind in this House and he made a number of important points, which I will address.

The first point was about raising awareness, which is something that the debate itself does. We recognise the devastation to families caused by the sudden and unexpected death of a child. Each death is a tragedy and that we are unable to offer the families an explanation for the child’s death after what will have been a long and potentially invasive process, including a coroner’s investigation, must compound the family’s confusion. For the death to be unexplained just adds to the trauma.

I thank hon. Members for some powerful speeches and interventions, including those from my hon. Friends the Members for Warrington South, for Runnymede and Weybridge (Dr Spencer), for South West Hertfordshire (Mr Mohindra), for Witney (Robert Courts) and for Keighley (Robbie Moore), and the hon. Members for Westmorland and Lonsdale (Tim Farron), for Oldham East and Saddleworth (Debbie Abrahams), for Hammersmith (Andy Slaughter) and for Lancaster and Fleetwood (Cat Smith), as well as hon. Members who have listened but not been able to speak today.

I acknowledge the advocacy work of the organisation SUDC UK, which is raising the profile of the issue and providing valuable support for families. We all share the same end goal, which is to reduce the risks of sudden unexplained death in childhood, and I welcome the contributions that have been made to today’s debate.

As has been mentioned, there has been a reduction of around 70% in the number of unexplained deaths in infancy since the early 1990s. The risk factors are well recognised and the steps that parents can take—safer sleeping practices or stopping smoking—have formed clear messages for years. We are still sponsoring more research on infancy to help reduce those risks further.

[Andy Slaughter]

The Minister mentioned sudden infant death syndrome. One of the asks that has come from both sides of the House has been whether the Department and the NHS can give the same priority to SUDC as it gives to SIDS in terms of education, research and provision of information to the public.

[Neil O'Brien]

That is exactly what we want to do. We are committed to the health service learning from child deaths. In 2019, the Government published the “Child Death Review Statutory and Operational Guidance (England)”, advising NHS trusts on how they should support, communicate with and engage with families following the death of someone in their care. Listening to bereaved families and ensuring clear communication is integral to the process, and putting clear support in place is a top priority. That guidance sets out the full process that follows the death of a child in England. It builds on the statutory requirements set out in “Working Together To Safeguard Children” and clarifies how individual professionals and organisations across all sectors involved in the child death review should contribute to reviews.

It is important that when a child dies, bereaved parents should be supported to understand the child death review process and how they are able to contribute to it. The family should be assigned a key worker to act as a single point of contact for the bereaved family, who they can turn to for information and who can signpost them to sources of support. The hon. Member for Lancaster and Fleetwood mentioned one particular, excellent way to do that.

Each local authority area has a child death overview panel that is responsible for reviewing information on all child deaths, looking for possible patterns and potential improvements in services, with the aim of preventing future deaths. This process enables us to act quickly to address local failings within the system.

The first step towards understanding the problem is to get the data. In 2018, NHS England supported the establishment of the national child mortality database to reduce preventable child mortality in England. The NCMD records comprehensive data on the circumstances of children’s deaths and is the first of its kind anywhere in the world. The child death review process aims to ensure that information regarding every child death is systematically captured and submitted to the NCMD to enable learning to prevent future deaths.

In December, the NCMD published its report into sudden and unexpected deaths in infancy and childhood. The Government are grateful to the NCMD for its important research, which is a significant step forward. Of the 204 unexpected and sudden deaths of children reviewed by child death overview panels in 2022, 32 were classified as unexplained. The report highlighted that both explained and unexplained deaths in this age group were associated with a history of convulsions, but that association still needs further research, which I will come back to later.

The NCMD provides evidence for investigation, responding to deprivation, housing and other potential risk factors, which the hon. Member for Denton and Reddish (Andrew Gwynne) asked about. Housing Ministers are already strengthening the powers of the regulator of social housing to tackle unsafe homes, and introducing a decent home standard for the private rented sector for the first time ever, which will make sure that privately rented homes are safe and decent.

My right hon. Friend the Member for Spelthorne asked how we will improve medical education, and the report recommends consistent national training on the child death review statutory process and on sudden unexplained death in childhood. Sudden deaths of children over 12 months of age are not well understood, especially where those deaths remain unexplained. As I have outlined, child death overview panels will continue to develop their processes following the publication of the child death review statutory and operational guidance, and they will be supported by the NCMD and work with relevant professional bodies where appropriate.

We are modernising healthy child programme resources to improve available evidence for health and other professionals who work with children. This will include stronger evidence on safer sleep and sleep hygiene for older children, and NHS England is also making commitments to improve knowledge. The children and young people programme is reviewing the patient information made available, so that it is relevant and appropriate. This will involve a review of all NHS-commissioned information, including on febrile seizures. NHS England is also conducting a review of the leaflet that is handed out when a child dies, which will provide further information on sudden unexpected death in childhood.

The hon. Member for Lancaster and Fleetwood asked specifically about the NHS website. The team are reviewing the information with patient groups, so that it is appropriate.

A number of Members have quite rightly called for more research, and the report calls for further research into SUDC to better identify modifiable factors. My officials have contacted their counterparts at the University of Bristol to discuss potential research priorities, and I am happy to continue that dialogue with Members of this House and others, to scope further research priorities. Such research will help us better understand what can be prevented. The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including sudden unexplained death in childhood, and NHS England will be working with the NCMD to track trends in modifiable factors further. Their work will help to raise awareness across professions and identify key areas for research. My officials are also in contact with the chief nursing officer in England about any opportunities linked to the CNO’s research strategy. I look forward to hearing experts and parents’ suggestions on research, so that we all have better data on prevalence and a shared understanding of risks around gender, ethnicity and other characteristics.

Someone would have to have a heart of stone to not be moved by the contributions to today’s debate. By raising awareness and developing the understanding of modifiable factors, we can provide better information to parents and professionals, and help to reduce the risks, so that more families will not have to suffer in the same way.

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 14th June 2022 Commons Chamber

[Sajid Javid]

I do of course agree with my hon. Friend. There are huge challenges for the NHS here in England, but as she has highlighted, the challenges are much greater in Wales because of how the Labour Government there neglected the NHS, way before the pandemic as well as during it. When it comes to leadership, although the Messenger review was commissioned for England, I think they would do well to learn some lessons from it.

[Andy Slaughter (Hammersmith) (Lab)]

Operose Health is one of the biggest employers in the primary care sector. When it bought up 70 surgeries across England, including in Hammersmith and Fulham, the Government were warned that this would put patient care at risk in pursuit of profit. That is what Operose’s US parent company, Centene, is notorious for. Now that the Secretary of State has evidence of Operose employing half the average number of GPs per patient, and of not reading clinical correspondence for six months, what is he going to do about it?

[Sajid Javid]

The hon. Gentleman might know that in 2007 the then Labour Government changed the law to allow takeovers such as that to happen. He might want to reflect on that. In terms of local management, there are consistent high standards that need to be met locally, and local commissioners should be made aware of what he has just said.

Irish Diaspora in Britain

Andy Slaughter Excerpts

Thursday 17th March 2022 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

I thank my hon. Friend the Member for Rochdale (Tony Lloyd) for initiating the debate and I look forward to the closing speech from my hon. Friend the Member for St Helens North (Conor McGinn), who has so often represented the diaspora in this country and done so very well indeed. I am proud to represent one of the largest and longest-settled Irish communities in Britain. The Irish presence in Shepherds Bush, Hammersmith and Fulham goes back many years before the 60 years that I have lived there, so it is not only first and second generation, but third and fourth generation Irish people who continue to make their home in that part of west London.

It goes without saying that despite the difficult times rightly mentioned by the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) and my hon. Friend the Member for Bristol South (Karin Smyth), this has overall been an enriching and successful coming together of the British and Irish communities, and not just those communities but many other migrant communities. I often feel that the Irish presence in Britain was a pioneer and acted as somewhat of a glue and an enabler of integration across many different cultures. That is certainly true where I am.

I want briefly to highlight two organisations that have not featured much in the debate so far, but they are key to the success of the diaspora. One is the network of community, cultural and social centres across the country and the other is the Government of Ireland and the embassy here. In Hammersmith Broadway, I have the Irish Cultural Centre, which is

“the premier centre in the UK dedicated to the promotion and welfare of Irish art and culture abroad”

and

“the home of its best cultural events and Irish performances, films, music and theatre”,

and I know that is true because I read it on the front of its website only a few moments ago—those are the centre’s words, before Members start intervening on me.

Getting a building as prestigious and beautiful as that was a long struggle for the Irish community and their supporters. It goes back to the mid-1990s—we celebrated the 25th anniversary recently—and the foresight of my predecessor as MP and leader of the council, Iain Coleman, and Councillor Sean Reddin, who put together the funding. They built it, we enjoyed it for 10 years and then we did it all over again because a different council wanted to knock it down and sell off the land for profit. It was only through the intervention of the Shepherds Bush Housing Association, which put up the money for a housing development, that the centre was rebuilt bigger and better than it was before. It has been a huge success as a result of an alliance between the wider community, the council, others and the embassy, with the Government of Ireland putting in money at a time when money was extremely short during the financial crisis.

Above all, it has all been about the local Irish community. I am tempting fate by naming individuals, as inevitably one forgets someone, but there have been many heroes in establishing and keeping that centre and bringing it to life. I must mention Jim O’Hara, who chaired the trustees through many difficult years, and his successor, Peter Power-Hynes, the vice-chair Michael Kingston, Seamus McGarry, Ivan Gibbons and the wonderful centre managers we have had, the cultural director Ros Scanlon, and David O’Keefe who sadly died too young and was replaced by William Foote, who stepped into the breach as the manager. I should also mention—I am namedropping in a big way—that among the patrons of the Irish Cultural Centre are Adrian Dunbar, Fergal Keane, Edna O’Brien, Dara Ó Briain, the noble Lord Dubs and the former President of Ireland, Mary McAleese. That is not a bad list for a local centre, but indeed it is not just a local centre.

Of course, built on the beauty and success of the centre and what it has to offer, we have had a whole procession of Taoisigh and Tánaistí and Government Ministers from both sides as visitors over the years, but something a bit special happened this week when His Royal Highness Prince Charles and the Duchess of Cornwall came to visit. I do not often recommend the Daily Mail website, but if Members go to the website they will see the heir to the throne trying out his hand at Irish dancing, drum playing and drinking a pint of Guinness. That is well worth going to see.

The centre is a great success, but let us pay tribute to all those who have made it a success over many years. I have mentioned the Irish Government, and of course one of the visitors we had for Their Royal Highnesses was Adrian O’Neill, the current ambassador, who is sadly ending his five-year posting quite soon. He and his predecessors, Daniel Mulhall and Bobby McDonagh, have been huge supporters, not just in their presence—Irish diplomats are in a different league, which is one reason why Ireland punches so much above its weight; it has the most brilliant representatives abroad who really engage in that way—but in practical and financial support and encouragement, which has been fantastic over that time.

The hon. Member for West Dunbartonshire (Martin Docherty-Hughes) quite rightly mentioned the Irish Traveller community, and he does a very good job chairing the all-party parliamentary group for Gypsies, Travellers and Roma. Unfortunately, we have seen in recent legislation, such as the Police, Crime, Sentencing and Courts Bill, that the Government wish to make things more difficult for Gypsies and Travellers in this country, which is shameful.

By contrast, the Irish embassy supports the Traveller community, by inviting them to the embassy and visiting them around the country. Some years ago, I went on a visit to the Dale Farm site with a secretary from the Irish embassy. I cannot imagine many other countries doing that and extending their hand in that way. The Irish embassy is making sure that the entire Irish population in this country, whatever its roots, is dealt with in that way.

I thank everybody who has come together to make the Irish community in Hammersmith such a success, most of all the community members themselves. Let us not forget those who have enabled and supported them in doing so, including people outside the community, the Irish Government and the Irish embassy. We are grateful for all that they continue to do.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call SNP spokesperson, Patricia Gibson.