Psychological Therapies

Angela Watkinson Excerpts

Wednesday 16th October 2013 Westminster Hall

[James Morris]

The hon. Gentleman makes an important point. The fundamental nature of my argument is that the current system, while it has made some progress, is not utilising the capacity that we should be able to develop in order to cope with the increasing problems that we face. IAPT needs to be tailored to older people and to be more flexible to meet their needs.

As I said, IAPT has made some progress, but we need to go further. Improving access is one thing; guaranteeing it is another. The NHS constitution provides a right to treatments recommended by NICE. The handbook to the constitution explains that that relates to any treatment that is

“recommended by a NICE technology appraisal.”

I am sorry to get a bit technical here, but I think the point is an important one. Technologies appraised by NICE include devices, medicines, diagnostic methodology, surgical procedures, health promotion activities and other therapeutic technologies. Regarding technologies, computerised CBT for depression and anxiety is the only NICE-approved psychological therapy, which, on the basis of the constitution, patients should have a right to. Psychological therapies have been excluded from the rights embedded in the NHS constitution, and we need to address that gap.

Also, there is no 28-week or any other waiting time target for psychological therapies. If I have a serious physical illness, for example cancer, I will be seen and treated within a particular time frame, and I will know my pathway of care, if that is the right way of describing it. However, if I have a mental illness, there is neither a guarantee nor a waiting time target.

[Dame Angela Watkinson (Hornchurch and Upminster) (Con)]

Does my hon. Friend agree that that is similar to what happens during the perinatal period? If a woman has a premature baby, thousands of pounds—if not hundreds of thousands—will be spent on neonatal intensive care; whereas if she has a full-term baby, but has a psychotic episode and requires in-patient mental health care, it is a complete postcode lottery as to whether she receives any help at all?

[James Morris]

I thank my hon. Friend for that intervention. She has done a tremendous amount of work in that area. I totally agree with her point; we need to shift our emphasis towards much more early intervention and ensure that the issue she identifies is addressed.

Tobacco Products (Plain Packaging)

Angela Watkinson Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Bob Blackman]

It was not a referendum or a vote; it was a consultation. It is the power of the arguments that matters in a consultation, rather than necessarily the volume, particularly when the arguments are organised by a lobby such as Philip Morris.

I declare my interest as secretary of the all-party parliamentary group on smoking and health. In common with my colleagues, I think that there is no good reason for delaying the implementation of standardised packaging, for child protection and health reasons.

[Dame Angela Watkinson (Hornchurch and Upminster) (Con)]

I draw Members’ attention to my entry in the Register of Members’ Financial Interests. Does my hon. Friend agree that the Government are already investing heavily in anti-smoking strategies through advertising in the print and broadcast media, hoardings in the street and smoking cessation classes? A packet of cigarettes says in bold letters, “Smoking can kill”. Any individual who makes a conscious decision to disregard all those warnings surely will not be influenced further by the removal of brand names from packets of cigarettes.

[Bob Blackman]

The key issue, to which I will come, is not discouraging current smokers but preventing children from smoking in the first place.

Oral Answers to Questions

Angela Watkinson Excerpts

Tuesday 16th April 2013 Commons Chamber

[Anna Soubry]

I find it most bizarre that the advice I am given by my officials—and I absolutely accept their advice—is that, as the hon. Gentleman will understand, because of judicial reviews of consultations, I am not allowed to have an opinion, so I do not give any opinion, notwithstanding the fact that many people would say that he advances a number of important arguments. I will say, however, that it is important to look at all the emerging evidence, including that coming out of Australia. As he will no doubt know, Australia continues to face a legal challenge that is yet to be resolved. It is also important to be aware of that.

[Dame Angela Watkinson (Hornchurch and Upminster) (Con)]

Does the Minister agree that adult smokers have already made a conscious decision to disregard all the health warnings that are so highly publicised, and are therefore unlikely to be influenced by the appearance of a packet of cigarettes? Is not the best way of deterring children from smoking the setting of a good example by responsible parents who know how much money their children are spending without supervision, and what they are spending it on?

[Anna Soubry]

If only it were as simple as that. Emerging evidence that I have seen suggests that it is the attractiveness of the packets that leads young people to decide to take up smoking. It also suggests—it is important for us to bear this in mind—that standardised packaging is not intended to persuade those who choose to smoke to continue to do so, and will make no difference to their choices. The aim is to protect children and young people.

Sudden Adult Death Syndrome

Angela Watkinson Excerpts

Monday 25th March 2013 Westminster Hall

[Steve Rotheram]

It is fantastic that the Minister has agreed to meet campaigners. Some are here, and if she has time at the end of today’s debate, I am sure that they would be happy to spend a few minutes trying to organise something more substantial in future. I am sure that people will welcome what she has said.

SADS is a term that is used to describe a group of medical conditions that lead to sudden, unexpected and life-threatening instability of the heart rhythm. It has also been commonly referred to, as it is in the motion, as sudden adult death syndrome, but given its propensity to strike in children, it is now often referred to simply as sudden arrhythmic death syndrome. In the majority of cases, the unstable heart rhythm—the arrhythmia—develops a rhythm called ventricular fibrillation, in which the ventricles, which are the main pumping chambers of the heart, lose all rhythm and regularity and start beating at rates in excess of 250 beats per minute. Ventricular fibrillation causes sudden collapse, seizure-like activity and cardiac arrest—in other words, the total loss of heart function—but if it is diagnosed quickly and if cardiac massage and shock from a defibrillator are applied, normal heart rhythm and signs of life can be restored.

[Dame Angela Watkinson (Hornchurch and Upminster) (Con)]

I am most grateful to the hon. Gentleman for allowing me to intervene. He has just touched on the importance of speed in an emergency, and I wonder what level of knowledge, understanding and expertise would be required of a member of the public to be effective in an emergency and to use the defibrillator to the best effect?

[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.

--- Later in debate ---

[Steve Rotheram]

It is an excellent point, which I will mention later in my contribution. The hon. Lady is absolutely right. If we persuaded the Government, Government bodies, large organisations or a combination of people to purchase AEDs, the price would plummet because they would order in bulk. I think they are £1,200 to £1,500 per unit at the moment, but empirical evidence from other countries shows that, when they are purchased in large volumes, their price comes down to almost 40% of the original cost.

Finally, I shall address directly what the Government can do to help, and it is simple: legislation. It can be done in a controlled and progressive manner and, in the current economic conditions, it need not cost the earth. Legislate first in education: enshrine mandatory emergency life skills training in the curriculum; ensure that every child who walks out of school at 16 or 18 possesses life-saving skills, and ensure that this Parliament, here and now, commits to having a new generation of life savers. We have the support to do it. Will we need to come back with another 100,000 signatures to get the Government to act? According to a British Heart Foundation survey in 2011, 86% of school teachers agree that such skills should be part of the curriculum, 78% of children said that they wanted to be taught how to save someone’s life in an emergency, and 70% of parents thought that children should be taught emergency life skills in school. When we place emergency life skills education in the context of my earlier point about the relationship between CPR and defibrillators, we begin to see just how many lives we could save daily, monthly and yearly.

The Government, though the Department for Business, Innovation and Skills, should introduce legislation such as the Canadian province of Manitoba’s Defibrillator Public Access Act. In Canada, public consultation and medical expertise identified the most likely places for a person to suffer a cardiac arrest—apart from in hospital, of course—and legislated to ensure that all those buildings, such as gyms, football stadiums, golf courses, schools and airports, had to have an AED fitted by January 2014.

There is also a financial argument: fitting AEDs could save the NHS millions of pounds, because survivors would not need the same degree of critical care or, potentially, aftercare. To discredit further the myth that it would be too expensive, let us once again put it into context: a defibrillator costs about the same as a PC and if we put AEDs in public buildings, that cost will come down, as the hon. Lady identified, as it does for other equipment ordered in bulk.

[Dame Angela Watkinson]

I thank the hon. Gentleman for allowing me to intervene again. It occurs to me that he said earlier that there are defibrillators in this building, but I am ashamed to say that I do not know where they are. I do not know if I am alone in that. It is important therefore not only to have them in buildings and for people to know how to use them, but for people to know where they can be found. There is no time in an emergency to wonder where one is—everybody needs to know.

[Steve Rotheram]

The hon. Lady is right, but there are people who know where the defibrillators are. On behalf of the OK Foundation, I asked a few police officers. We are very cosseted here. People such as police officers and other security staff know where the defibrillators are. She is right in that, just as there has to be a chart that says where the fire extinguishers or first aiders are—where someone can get treatment should they cut themselves—the same process should apply to identifying where the nearest AED is. It is not beyond the realms of Parliament for us to pull together legislation to cover the good point she raises.

I know about the costs associated with AEDs. The Association of Primary Schools and the OK Foundation said that every primary school in Liverpool should have one, which would be a considerable benefit. They have now got an AED, which they purchased together, fitted in each school. Pinehurst primary school in my constituency was the first to benefit, but now all 122 primary schools in the city have AEDs. As I said earlier, where Liverpool leads, the rest of the country needs to follow, because AEDs will save young people’s lives. We need to make that happen across the whole country and encourage our devolved partners to follow suit.

I conclude by reiterating why today’s debate matters. We cannot put a price on a life. If something practical can be done that has the ability to save a life and falls within what we politicians might call the envelope of affordability, we in Parliament have a duty to act. In times of austerity, when we look for ways of saving money and reducing the burden on the NHS, investing in screening research and equipping an entire future generation with emergency life-saving skills that will keep people alive, increase survival rates and reduce the demand on hospital care is a step we should all support. Every minute that goes by after a person has suffered a cardiac arrest reduces their survival chances by 10%. Although CPR can keep the heart going, it is not enough in itself. Britain should aspire to achieve survival rates such as those in Seattle, where more than 50% of sudden cardiac arrests lead to a full recovery. Our survival rate is currently somewhere between 2% and 12%.

Now is the time to act and for Parliament to say, “Enough is enough.” Now is the time for levels of screening of young people to increase, for teaching CPR to be mandatory in schools, and for the Government to initiate a new legal requirement for a defibrillator to be installed in all schools and prominent public places. We need a cohesive national strategy to improve heart safety in the UK. I hope that Government Front Benchers are listening. They have the political authority to address the issue. Let us hope that they have the moral fibre that is needed to act.