The National Health Service

Ann Clwyd Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Ann Clwyd (Cynon Valley) (Lab)]

Madam Deputy Speaker, you were in the Chair when I was granted an Adjournment debate by Mr Speaker on a subject which I will discuss again today. I was a patient at the time and I came out of hospital to speak.

I have a very long involvement with the health service. I sat on a royal commission on the NHS, having been appointed by Barbara Castle 40 years ago. For me, it is incredible, 40 years on, to still hear the same arguments over and over again. I wish the Health Secretary was in his place. I enjoyed writing a report on hospital complaints in England for the Department of Health when David Cameron was Prime Minister. I was very much hoping to get assurances today that the recommendations we made then have all been acted on. I do not believe that they have been.

I was also on the Welsh hospital board many years ago with Aneurin Bevan’s sister. It is quite useful to have people in this place who are a bit older, who have long memories and who can remember what has been said and done and promised. I remember going to the United States, talking to health professionals there and realising that two thirds of all personal bankruptcies in the US were because of inadequate health insurance. I think that that was still the case when I last checked. I very much hope that that does not become the norm in this country.

As a recent patient, I would like to thank everybody in the English health service and the Welsh health service for their care, because I would not be here today were it not for them.

[Gerald Jones (Merthyr Tydfil and Rhymney) (Lab)]

Would my right hon. Friend like to pay tribute to the NHS in Wales? As my constituency neighbour, I am sure she appreciates all the good work done in Wales.

[Ann Clwyd]

I have been a critic of the health service in Wales, as my colleagues know, but I am also an admirer of much of the good work it carries out, particularly in my hon. Friend’s constituency at the Prince Charles hospital in Merthyr Tydfil and at University Hospital Llandough in Cardiff, where I apparently almost died in August. I am grateful to be alive, and I thank all the doctors and nurses involved.

Over 200,000 people in Britain suffer from venous leg ulcers, a form of chronic wound. It is highly painful, I can tell you, and socially isolating. For most, treatment involves managing the symptom—the ulcer—rather than addressing the underlying cause, yet proven surgical interventions are available to treat this underlying condition. Clinical guidance is comprehensive, but the evidence shows that local-level implementation is extremely patchy.

The UK spends between £940 million and £1.3 billion every year managing venous leg ulcers. Most of that comes from the need for community nurse visits to support patients in managing their conditions. Seventy-five per cent. of costs alone can be attributed to community nursing, placing a huge strain on community care, yet evidence shows that where clinically appropriate, a surgical intervention approach is cost-neutral in year one, and that is what I would like to hear about from the Secretary of State.

While early intervention incurs high initial costs, these are quickly offset by lower one-year community nursing costs. The issue is that most cases are simply never referred to a specialist vascular service. Seventy-five per cent. of venous leg ulcers do not receive a comprehensive vascular assessment, as enshrined in National Institute for Health and Care Excellence guidance. Sixty-four per cent. of clinical commissioning groups’ commissioning policies were found to be non-compliant with NICE guidelines for the treatment of the problems responsible for venous leg ulcers.

The opportunity to provide cost-neutral treatment, proven to heal ulcers faster and help to prevent recurrence, is missed, causing unnecessary pain and suffering for thousands. I can tell the House that it is the most painful thing that has ever happened to me. I know many, many people who are living in this pain now. How can we ensure that primary and secondary care providers, commissioners and local authorities are brought together, made aware of the benefits and able to deliver early intervention in venous leg ulcers? Quite simply, it will save NHS funds and save the suffering of so many people.