Community Pharmacies

Anna Soubry Excerpts

Monday 17th October 2016 Commons Chamber

[David Mowat]

That is speculation. We continue to look at the most recent communication that we have received from the negotiating body of the PSNC. I remind the House that 60% to 65% of these pharmacies are owned by public companies or private equity. The fact of the matter is that the Government have a responsibility to make sure that that money is spent effectively, and that is what we are going to do.

Finally, the hon. Gentleman said that GP access needs to remain good. I confirm and repeat the point that I made earlier: 1,500 additional pharmacists will be recruited into the GP sector by 2020. That is a massive investment, and it will make a big difference.

[Anna Soubry (Broxtowe) (Con)]

I should declare that Boots has its headquarters partly in my constituency and partly in Nottingham South. May I gently say to the Minister that there is great concern about the proposals? If there was ever a time to argue to increase the role of pharmacies, it is now. They perform a hugely powerful job in making sure that people do not, to be frank, bother their GPs and A&E with matters that are best dealt with by pharmacies because they are of a minor nature. The Minister makes a good point about clustering, but he has to get this right, because, if he damages pharmacies, there will be fewer of them, not just in poorer areas, but in remote rural areas. I urge the Government to take a hard good look at the issue, to make sure that this is the right approach as the pressures on the NHS increase.

[David Mowat]

I agree with my right hon. Friend. Boots makes a big contribution. It owns 1,724 pharmacies and is the biggest of the big four, which between them own 40% of all pharmacies. The Government’s position is that community pharmacists make a big contribution, but I repeat that the number of locations has increased by nearly 20% over the past decade, and each one gets £25,000 per annum just for being open and for being a pharmacy. One consequence is that we have seen a great deal of clustering, and 40% of pharmacies are within half a mile of three others. It is right that the Government look at that and make a judgment.

Baby Loss

Anna Soubry Excerpts

Thursday 13th October 2016 Commons Chamber

[Anna Soubry (Broxtowe) (Con)]

It is always with great care that one treads into some areas of one’s own life, but, like many hon. Members, I remember around that 21-week or 22-week point of pregnancy—obviously I am addressing the women Members in the Chamber—having that marvellous, magical moment of what the books describe as a fluttering. You suddenly realise then that the nightmare of morning sickness and the other afflictions that there often are in pregnancy are all about the new life there within you. I suspect that I am not alone in this but that many hon. Members of both sexes have had that moment of looking into the Moses basket and knowing that the next time you look into it that bundle of life that you bear will be in it. That is extremely exciting, and, the truth is, also really rather frightening, especially when it is your first child and so you have obviously never had a baby before. I absolutely cannot imagine what it must be like—something experienced by so many in this Chamber who have spoken today with such great courage—never to have that Moses basket filled with the joy of the child that you have borne for well over nine months.

I warmly congratulate my hon. Friends the Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince) not only on securing this debate but on the great work they have done. No one could been unaffected and unmoved by the incredibly sad stories of the hon. Members for Lewisham, Deptford (Vicky Foxcroft) and for North Ayrshire and Arran (Patricia Gibson). If I may say so—and I do so with no sense of lessening the terrible story we heard from the hon. Member for North Ayrshire and Arran—we were all particularly struck by what the hon. Member for Lewisham, Deptford experienced. I was not just struck with great sorrow, but, I have to say, I also felt anger rise within me. What happened to her was outrageous. I want to be made certain that what happened to her will never happen again to anyone in our society. Obviously, I extend that wish to the experiences related by everyone who brought to this place today either their own experiences or those of their constituents. We must learn the lessons from all of those experiences and do everything we can to make sure that babies do not die in the first place, so that we do not have the high rates of stillbirth that we have heard about or babies dying in the early months of their lives. But in addition, the treatment of both parents, as we have heard so eloquently expressed, must change.

I want to hold a spark of hope in my mind that what happened to the hon. Member for Lewisham, Deptford was a one-off, but sadly I have no doubt that it was not. But I would like to think that, given the passage of time, we can be confident that that kind of experience is now extremely rare. We must all work to make sure that no one ever again suffers what she did or what the hon. Member for North Ayrshire and Arran suffered.

I will make a short contribution about bereavement suites. My remarks are based entirely on the experience of two of my constituents. I first met Richard Daniels for reasons with which I need not trouble the House, and he and his wife have now become friends of mine. Members can imagine, as can anyone who hears their story, that there was much sympathy and real concern at the discovery that when their baby Emily was born in a stillborn birth at the Queen’s Medical Centre, in 2013, there was no bereavement suite. I had both my daughters there; I found that fact quite astonishing, as I know everyone else did who heard their story.

Hon. Members have already discussed this. There is no greater tragedy for any parent than the loss of a child, and, although there are no degrees of grief, I genuinely cannot imagine any greater tragedy and loss than to lose a baby in the circumstances that we are all now becoming more aware of. And then—and, let us be honest, this is almost cruel—while the rest of us are celebrating with balloons and relatives coming along, to be there with that terrible grief, which cannot really be described if it has not been suffered, and to have to sit with your loved one while all that jollity is going on around you because there is nowhere to go to grieve, and to have your private last moments with your baby before they are properly buried, is just appalling. I was horrified to learn from my hon. Friend the Member for Eddisbury that 25% of hospital trusts still do not have bereavement suites.

I am not one of those who says that it is just the role of the NHS to provide those suites. When a terrible tragedy happens, whatever it might be, human beings want to come together to make good of something that has been wholly horrible. I therefore have no difficulty in such circumstances with the idea of parents working hand-in-hand with hospital trusts that do not have a bereavement suite to create one.

Nottingham University Hospital Trust did much to make sure that when Richard and Michelle Daniels decided that they would raise money to fund such a suite, it was a relatively easy journey. It was not all easy—there were many bumps along the way—but they got through it. They started with a plan to raise £25,000 and within 18 months had raised more than £150,000. They did so by a variety of fundraising methods that we will all be familiar with. Emily died in 2013. They finally opened the Serenity suite at the Queen’s Medical Centre, with real joy and pleasure, in April this year. Such has been their dedication to Forever Stars, the charity that they founded, that even though they said that the fundraising would end, as they have been contacted by parents from other parts of the east Midlands—notably, from Derby, where there is no bereavement suite—they have decided to resurrect Forever Stars. They are embarking once more on a huge fundraising exercise to open a bereavement suite. I urge them to continue—I know they will. It is right that parents are involved. However, it is equally right that all those hospital trusts that do not have bereavement suites should now get on with getting them. They should not rely on a parent who has suffered such terrible loss to spark them into taking action to make sure that those suites exist and are fully equipped and their staff are fully trained.

I offer my absolute congratulations to all those who have spoken, and in particular to those who have laid bare the worst moments of their lives. They have put those experiences forward so that we can say to the Government—and I know that the Minister will be listening—that this is an area in which it is time for action, for all the reasons and in all the ways that have been described, as it is not just about bereavement suites. We must take that action so that we can be proud, as a nation, that we are reducing the number of babies who are born dead or who die in the first months of their infancy, and we are doing the right thing by their parents and families, for the sake of the future that they looked forward to but has been denied to them and their children.

NHS Sustainability and Transformation Plans

Anna Soubry Excerpts

Wednesday 14th September 2016 Commons Chamber

[Ms Abbott]

I need to make some progress.

The King’s Fund has said:

“There are some concerns that NHS leaders have focused their efforts on plans for reconfiguring a few hospital services, despite evidence that major acute reconfigurations rarely actually save money and sometimes fail to improve the quality of care.”

The BMA has said the same thing. The King’s Fund has also said:

“The cuts under the STPs are eye-watering”.

[Anna Soubry (Broxtowe) (Con)]

rose—

[Ms Abbott]

I am anxious to complete my remarks so that Conservative Members will all get a chance to intervene in the debate.

The Health Select Committee's recent report on the impact of the 2015 spending review stated:

“At present the Sustainability and Transformation Fund is being used largely to ‘sustain’ in the form of plugging provider deficits rather than in transforming the system at scale and pace. If the financial situation of trusts is not resolved or, worse, deteriorates further, it is likely that the overwhelming majority of the Fund will continue to be used to correct short-term problems rather than to support long-term solutions”.

[Sir Simon Burns]

rose—

[Anna Soubry]

rose—

[Ms Abbott]

Other aspects of the STPs that relate to cutting expenditure involve a combination of factors, including the use of new technology such as apps and Skype, patients taking more responsibility for their own health, “new pathways” for elderly care, increased reliance on volunteers and the downgrading of treatment by skills, responsibilities and pay bands. It seems to me that while some of these proposals might have some merit in themselves, it is delusional to imagine that they will deal with the financial black hole in the NHS. There is no evidence that among the patient population as a whole, increased use of apps, Skype and telemedicine can produce the efficiencies required while beds, units, departments and hospitals are being closed.

I remind Members, many of whom speak to their constituents in their advice surgeries on a weekly basis, that the truth about speaking to people face to face is that it is often towards the end of the conversation that people will come out with what really concerns them. My concern about the increased use of Skype is that many patients will not get the familiarity and comfortableness with their interlocutors to enable them to say at the end of the Skype session what it is that they are concerned about.

The STPs talk a great deal about increasing preventive medicine. That would indeed have the effect of lowering demand for acute NHS care, but it would also require a very substantial investment in public health programmes—and this Government have just cut public health funding. The elderly, the poor and patients for whom English is not their first language are the least likely to use these apps, telemedicine and Skype. It is inappropriate and unrealistic to assume that elderly patients who, I remind Members, are the biggest users of acute care and the fastest-growing demographic, will want to use Skype for any sensitive matter. “New pathways” for the elderly is sufficiently vague as an idea to raise alarm bells, given the projected rise in demand for geriatric services and continuing cuts in social care funding.

--- Later in debate ---

[Dr Murrison]

Will the hon. Lady give way?

[Anna Soubry]

Will the hon. Lady give way?

[Sir Simon Burns]

Will the hon. Lady give way, and if not, why not?

[Ms Abbott]

Let me now draw my speech to a close. It is absolutely right that health and social care stakeholders should come together to plan for the future. It is absolutely wrong that social transformation plans should be hatched in secret and used as a cover for cuts and hospital closures—and it is increasingly clear that STPs may be a stalking horse for more privatisation. Conservative Members may not take this issue seriously—[Interruption]—and Conservative Members’ response may be to shout, but I stress to the House that the consequences of these STPs will be very material for all our constituents.

[Anna Soubry]

Will the hon. Lady give way?

[Ms Abbott]

They will also be very material for those who work in the NHS. I take this issue seriously. [Interruption.] That is why we have called the debate, and I wait with interest to hear what Ministers have to say.

Public Health England (Porton Down)

Anna Soubry Excerpts

Wednesday 11th September 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I should like to congratulate my hon. Friend the Member for Salisbury (John Glen) on securing this debate. I also thank him for helpfully providing me and my officials with advance details of his speech. That has been of great assistance to us, because it enables us to provide answers to some of his questions and to address the many points that he has quite properly raised on behalf of the people who work at Porton and of his constituents and others who are interested in the future of the facility. I know that he is an active supporter of the work of Public Health England at Porton, and that he has worked tirelessly with Wiltshire county council and others to create a science park there. I will spend a few minutes outlining the work that Public Health England is doing on behalf of the Government to secure high-quality facilities for public health. I shall then try to respond to the points that my hon. Friend has quite properly raised.

The Government created Public Health England just a few months ago, in April 2013, with the aim of creating a national expert body charged with protecting and improving the public’s health and reducing health inequalities. The services provided at Porton are essential to the work of PHE in protecting the nation’s health and preventing disease. Porton provides some of the most specialist and high-technology microbiology facilities in the country. However, the main building at PHE Porton, as it is now known, was built 60 years ago, and the Government are committed to replacing those ageing facilities with modern state-of-the-art buildings through the submission of a revised business case some time next year.

I should add that the idea of consolidating health protection facilities on a single site to make best use of scarce skills from both Colindale and Porton is not new. What is new is the vision to develop a national centre with a much broader remit, reflecting the wider purpose of PHE to improve the public’s health and to reduce health inequalities. I understand that senior staff from PHE have met my hon. Friend about this work, as he described, and they have promised to meet him again and to engage with other interested bodies, including the county council

Let me address some of the points that my hon. Friend raised. The Government are committed to retaining some public health facilities at Porton as part of the planned science park. I know that the chief executive of Public Health England wrote a letter of support for the science park earlier this year at my hon. Friend’s request. I fully agree with my hon. Friend that it is vital to maximise the commercial potential of the services at Porton—unfortunately, that probably has not been done for some time, and the Government are absolutely committed to doing it. PHE is fully committed, too, as part of the programme on which my hon. Friend has also been briefed, and this opportunity can be grasped now. The other review is about the 15 to 20-year future for a wider range of services, currently not only at Porton, but at Colindale and elsewhere.

My hon. Friend mentions the distance between sites. The case for change that was submitted in 2011 focused on the additional benefits that can result from co-locating services on a single site. The position is not dangerous now, but there are significant opportunities for new scientific ventures and collaborations from a new national centre.

My hon. Friend asks why PHE does not simply share high-containment facilities with the Defence Science and Technology Laboratory. We need to be clear that although PHE and DSTL will continue to collaborate closely, PHE needs dedicated high-containment facilities to ensure that public health work can proceed in the event of the DSTL facilities being fully occupied. This will provide resilience if DSTL’s facilities are closed for any reason.

In conclusion, the Government have asked PHE to lead work on the creation of state-of-the-art facilities to protect the public’s health and to prevent disease. There is a well-established programme in place, overseen by the Department of Health and the Government’s Major Projects Authority.

It is really important to finish by stressing that Ministers have yet to make a final decision on how best to create future facilities for national public health science. PHE is on track to complete the business case for a ministerial decision by September 2014.

I hope that I have answered all the points so properly raised by my hon. Friend. If I have not answered any, he can be quite sure that I will respond in the normal manner by way of letter. My door is always open, and it would be a pleasure to meet him on any occasion to discuss this matter further and to provide any further assurances that I can to him and, perhaps most importantly, to the staff at Porton, who we would all agree do an outstanding job.

Question put and agreed to.

Tobacco Products (Plain Packaging)

Anna Soubry Excerpts

Tuesday 3rd September 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Hollobone. I echo the remarks of many speakers by congratulating my hon. Friend the Member for Harrow East (Bob Blackman)—a long-standing friend, if I may say so—on securing the debate and on his excellent speech. As he knows, I have been called many things, but I have never been called “very libertarian”, and I am still in a state of shock at that description.

I make it clear that I am no great fan or supporter of the nanny state. I do not have a particular problem with standardised packaging, because that does not relate to the nanny state. As we have heard in the many excellent speeches from Members of all parties, the issue is the protection of children, not preventing anybody from smoking or going out to buy cigarettes. It is about protecting young people from the attraction of taking up smoking.

It is important that I declare my interest. My father, a lifelong smoker, died at the age of 56 from lung cancer. I do not think that there was any doubt that that cancer was caused by his lifelong addition to tobacco—to smoking. I say with considerable shame, if I may put it that way, that until just over five years ago, I, too, was a smoker; both my brothers continue to smoke. I am not for one moment saying that if people are not or have not been smokers, they cannot engage in the debate, because that would obviously be complete nonsense, but they have to have been a smoker to understand the perverse psychology of smoking.

We know that 8 million people in this country continue to smoke and that the overwhelming majority of them want to stop. It is an admission of some weakness within us, which I think is the power of nicotine. It is often said that nicotine is more addictive even than heroin. Although I have never directly experienced heroin, when I was a criminal barrister I had enough clients to know how powerful heroin and cocaine are. Goodness me, even they would say that nicotine is a dreadful substance in its addiction. That accounts for why so many smokers, like me, found it so difficult to give up.

I want to make it clear that like so many smokers, I took up smoking before the age of 18. I accept that I sound very weak when I say—this is one of those moments where one almost wants to confess—that the power of the packet had an effect on this 17-year-old from Worksop who was working in a toy shop, which, bizarrely, sold cigarettes in those days. Younger people listening to this debate will be amazed to hear that a toy shop could sell cigarettes, but those were the days.

I have never forgotten the first time that I bought a packet of cigarettes. I deliberately chose a packet of St Moritz because they were green, gorgeous and a symbol of glamour. Do hon. Members remember the madness of those advertisements that talked of the cool fresh mountain air of menthol cigarettes? Those were the days that some of us remember because of our age. I distinctly remember the power of that package. It was the opening of the cellophane and the gold and the silver that was so powerfully important to many people who, as youngsters, took up smoking. I say that to my hon. Friend the Member for Bury North (Mr Nuttall) who says that he has never met anyone so drawn; well, he has now, because I am that person, and I am not alone by any means.

[Mark Field]

There is little doubt that if alcohol were synthesised for the first time today, or if we discovered sugar for the first time, it would be banned. The Minister has made the case about nicotine. Ideally, does she want the product banned? She talked about protecting young people. What age is she talking about? In America, for example, alcohol is banned for anyone under the age of 21. Is that the age she is considering, especially as we could outlaw both tobacco and alcohol at university when people are at an impressionable age?

[Anna Soubry]

My hon. Friend is most naughty. He asks me in a short period of time, when I have other matters to address, to answer about three or four questions all at once, most of which are completely irrelevant. We cannot say that there is a correlation between alcohol and tobacco; of course there is not. One can enjoy a glass of wine on an occasional basis. Indeed there is evidence that it can help certain people with their health. I am talking about the gentle consumption of alcohol or sugar. Indeed there is nothing wrong with eating sweets for goodness sake or even chips and other fatty substances. It is all a question of how much one eats; it should be part of a sensible and well-balanced diet. There is nothing in support of cigarettes or tobacco. It is about as barmy as saying, “If you want to help yourself after a stressful day, have a fag.” Cigarettes—tobacco—kill people and harm people’s health. Get it!

[Alex Cunningham]

The Minister is making a tremendous case—a better one than most of us—for standard packaging. Will she therefore persuade the Health Secretary that he does not have to wait for Back Benchers or others to take the matter to the Backbench Business Committee to get a vote on the Floor of the House of Commons? He can actually crack on now with tremendous support from across the House.

[Anna Soubry]

I suppose that I am sort of grateful for that intervention. It was not the most helpful, but it was a fair one and it is a good point that needs addressing. I have no difficulty in waiting for the evidence to emerge from Australia. It is on that point that I agree with the hon. Member for North Antrim (Ian Paisley). However, it is the only point on which we agree on this matter. It is important that we consider the evidence. Of course we know that the Irish Government have also said that they want to introduce this measure. Again, we will wait and see. It is no simple matter to introduce standardised packaging. There will be many challenges that the Irish will face in their attempts. It is right and fair that we wait to see all of that as it develops.

[Barbara Keeley]

rose—

[Anna Soubry]

May I make some progress, because it is really important that I make the matter clear? The coalition Government have made no final decision. As I have said, we wait to see the evidence as it emerges from both Ireland and Australia. It is important to say that standardised packaging is no silver bullet. There is no simple solution to the problem of persuading both the remaining 20% of the population to give up smoking and our youngsters not to smoke.

I want to deal if I may with some of the excellent points that have been made. I, like many other Members, have talked about the power of the package. The hon. Member for Vale of Clwyd (Chris Ruane) helpfully brought in some packets. He mentioned the cigarettes that are deliberately targeted at young women. My hon. Friend the Member for Banbury (Sir Tony Baldry) asks why children, in the face of the overwhelming evidence and the health messages, take up smoking. He is right to say that we need to do more research. We know many things.

We know, for instance, the power of parents. If a child is brought up by parents who smoke, they are likely to smoke because they will see it as the norm. One of the great benefits of the legislation that was introduced by the previous Administration—I pay full credit to them for introducing that ban on smoking in open places—was that it made smoking less socially acceptable. Effectively, it turned many of us into modern-day lepers. If we wanted to smoke, we were reduced to standing outside, ostracised from our workmates, and that was a powerful reason why so many of us gave up smoking. Many of us remember with shame, as I do, sitting in restaurants thinking that we had some God-given right to smoke next to people who rightly found it deeply offensive, and who were trying to enjoy their meals. It is astonishing to look back at films and television programmes of only a few years ago to see how acceptable smoking was and how the previous Parliament changed that.

I absolutely agree with all those who are trying to nail the falsehood in two important parts of this argument about standardised packaging. The first is whether it is plain. I concede that one of the great failings of this debate is to explain what we mean by “standardised”. That goes back to the point that was inaccurately made by my hon. Friend the Member for Bury North. I never said that packaging would be glamorous or glitzy, but that, as I think my hon. Friend the Member for Harrow East also tried to say, under the regulation and legislation holograms can be put on standardised packaging—not to be attractive but as part of the argument against the claim that anybody will be able to counterfeit it.

Far from being a counterfeiter’s charter and dream, standardised packaging is a counterfeiter’s nightmare. I wish that I had with me some of the packets that have been produced by Australia. If we had them, Members would see that they are far from plain. On the contrary, they have colour in them, but they have the standardisation, which takes away this incredibly powerful marketing tool and the attraction for young people.

[Barbara Keeley]

On the point about waiting for the evidence, it is not 20% of people who smoke in Salford but 25%, and much more in some areas, and it is 1,000 children. As we wait, 1,000 children every year will start smoking in Salford. Why are we waiting?

[Anna Soubry]

I think I have explained why we have waited. My understanding of the statistics is that it is 20%, but it differs in different parts of the country. I also want to make the point that the Government have not stepped away from taking action against the harmful effects of tobacco. We have a tobacco control plan for England that sets out our national ambitions and our comprehensive evidence-based strategy of national and local actions to achieve them, including high-profile marketing campaigns. Our Stoptober campaign, which was hugely successful last year and which we will be running again this year, provided help and assistance to smokers, the majority of whom want to quit.

I also want to pay tribute to local authorities, which now have responsibility for public health. I have met members and representatives from councils in the north-east who are doing some terrific work persuading people to stop smoking or not to take it up, and that shows good local action.

As ever, the clock is against me, but I hope that I have made the Government’s position absolutely clear. I congratulate again everybody who has spoken in this debate. My own views are clear, but it is right to wait to see the evidence. I assure Members that the wise words from so many different parties today will be taken back to the Government and will be listened to. It is to be hoped that in due time, standardised packaging will be introduced.

Brain Tumours in Children

Anna Soubry Excerpts

Tuesday 3rd September 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Sheridan. I have been called some bizarre things today. I was called “very libertarian” in a debate in this Chamber this morning, and I have been called something else this afternoon. I think it is a compliment, but in any event I will take it as such.

I begin by congratulating my hon. Friend the Member for Esher and Walton (Mr Raab) on securing this important debate. As I have said on many occasions, the clock is always against us. I look around and I see the faces of Members who have been engaged not just in similar debates but, most importantly, in some of the meetings and in the all-party group on brain tumours, with which we have all been involved for some time.

I pay tribute to my hon. Friend the Member for Brentford and Isleworth (Mary Macleod). She and I had a very good meeting with some of her constituents on brain tumours in adults, and many of the problems of diagnosis are also experienced by adults who suffer from this unpleasant, horrible and often fatal disease. I also pay tribute to my hon. Friend the Member for Cannock Chase (Mr Burley) and Trudy’s Trust. Some of us were at the launch of Trudy’s Trust with Mr Speaker.

I also pay tribute to my hon. Friend the Member for Castle Point (Rebecca Harris) and the Danny Green Fund. We hear today of yet another tragedy that has occurred, but some good comes out of every evil. One of the good things that comes out, especially when a child dies from a brain tumour, is the great power of a family to leave a legacy and make a great tribute to that child. There is nothing worse than the loss of a child—it is every parent’s nightmare—but to be able to turn that awful situation into something good, and to use that power to great effect, is something that we see in many instances. Today we have heard about just some of them, and there are others.

[Sir Gerald Howarth (Aldershot) (Con)]

I, too, congratulate my hon. Friend the Member for Esher and Walton (Mr Raab) on securing this debate, because HeadSmart is based in my constituency. Will my hon. Friend, the Minister pay tribute to Neil and Angela Dickson? Their daughter Samantha died of a brain tumour and they have done fantastic work, not only to produce the kind of initiatives that have been mentioned by several hon. Members today, but to raise funds that have contributed to research that has produced results that have enabled the causes of brain tumours to be identified in part. Neil and Angela Dickson deserve many congratulations on what they have achieved.

[Anna Soubry]

I am more than happy to add my grateful thanks for the work of Neil and Angela Dickson, and the work of all those who support them. There are many such examples, and funds are often raised for research and to support families or other bits of work.

As my hon. Friend the Member for South West Bedfordshire (Andrew Selous) said, money that goes into research often has the most powerful results. I pay tribute to Headcase cancer trust in my constituency, as I am very much aware of the great work that continues to be needed on brain cancer, which is a pernicious and horrible disease that affects people of all ages, but it seems somehow to be particularly cruel and wicked when it is inflicted on children.

There are a few things that I want to mention before moving on to some of the substantive points raised by my hon. Friend the Member for Esher and Walton. We recognise that we need to do more to bring cancer survival rates up to the level of the best in the world—survival rates have been languishing in the wrong place for too long—so we have an outcome strategy that sets out our ambition to halve the gap between England’s survival rates and those of the best in Europe through saving an additional 5,000 lives every year by 2014-15. We know that the earlier a cancer is diagnosed, the greater the scope for curative treatment, and our strategy therefore prioritises addressing late diagnosis. To support that, we have £450 million over four years going into early diagnosis, which is part of the £750 million of additional funding from the Government for addressing cancer over the spending period. That funding will do much great work that I am happy to identify in a letter to my hon. Friend.

On direct GP access to diagnostic tests, my hon. Friend the Member for Hexham (Guy Opperman) made a good point about having someone within each clinical commissioning group who knows about not only brain cancers and brain tumours but other similar afflictions. As he rightly identifies, when a child has a headache, or when an adult has some other complaint and they are not sure what it is, there could be a more specialist GP who can say, “Maybe this is the sort of case that we need to scan swiftly,” or, “Maybe it needs some other treatment.” That is a very good point, but we need GPs to recognise symptoms that could be indicative of cancer and, where appropriate, to refer patients to more specialist care.

The National Institute for Health and Clinical Excellence has published referral guidelines for suspected cancers, including a section on children, to help GPs and primary care professionals identify children with suspected cancer. The Department of Health published guidance in April 2012 on the best practice for what we call “referral pathways” for GPs.

When GPs suspect a brain tumour, they are able urgently to refer patients for special care using the two-week urgent referral pathway, and I have been helpfully supplied with some figures that I hope will give comfort and encouragement. Some 95.5% of patients were seen by a specialist within two weeks of an urgent GP referral for suspected cancer—that is for all cancers—in the first quarter of 2013-14, and 96.4% of patients urgently referred by their GP for suspected brain or central nervous system tumours were seen by a specialist within the two-week period. In the first quarter of 2013-14, 96.4% of patients in England urgently referred by their GP for a suspected children’s cancer were seen by a specialist within the two-week period. I think those are good figures, but of course we can always do better.

[James Duddridge]

Will the Minister give way?

[Anna Soubry]

Briefly, yes.

[James Duddridge]

Those are the figures for being seen by a consultant, but are there figures for when surgery actually takes place? Will the Minister provide us with those figures after the debate?

[Anna Soubry]

I do not believe I have those figures in front of me, but I am more than happy to provide them to everyone who has taken part in the debate. My official is indicating that we have the figures, and it is not a problem for me to give them to my hon. Friend.

NHS England now monitors the use of key diagnostic tests through the diagnostic imaging dataset, and the latest available provisional data for the period from April 2012 to March 2013 show that 28,995 tests—which is about a quarter of all tests—that may have been used to diagnose or discount cancer were requested by GPs under direct access arrangements.

I pay huge tribute to HeadSmart, and of course I welcome its “Be brain tumour aware” campaign and the collaboration between the Brain Tumour Charity, the children’s brain tumour research centre at the university of Nottingham—to which I admit I have a bias, being a Nottinghamshire MP—and the Royal College of Paediatrics and Child Health. I have written to HeadSmart offering encouragement and advising that it could apply to the voluntary sector investment programme for funds to raise awareness of HeadSmart cards in schools. I will continue to work with those great and wonderful charities, and I look forward to seeing them inform the development of our nationally led campaigns.

My hon. Friend the Member for Esher and Walton directly challenges me to take action, and I shall tell him what I will do. I might not completely agree with all that he proposes, but I am more than happy to speak to my colleagues at Public Health England—cancer screening is an obvious priority for Public Health England—about how we can best advance HeadSmart cards in schools. As he knows, of course, public health is now devolved to local authority level. And as he also knows, we are a Government who believe in localism, and therefore it is not for Ministers to tell people what to do, however much we might want to at times.

The idea advanced by my hon. Friend the Member for Brentford and Isleworth is very good. A great deal of work can be done by local MPs. Of course, hon. Members might not know about this, but we can talk afterwards about how we can alert our colleagues throughout the House to what can be done. A letter from a local Member of Parliament to their director of public health, or to the chair of their health and wellbeing board, will frankly have more weight than any letter from me.

[Andrew Selous]

As my hon. Friend the Member for Esher and Walton (Mr Raab) has said, local authorities are already writing to schools and putting stuff in the post. If MPs do that too, it will cost the public purse. It strikes me that that already happens, and cheaply.

[Anna Soubry]

I do not agree. I do not know about my hon. Friend, but I write to all my schools. In truth, I do not have that many schools, so there are not that many letters. A letter from a Member of Parliament to all their schools and to their health and wellbeing board could be very powerful. I am more than happy to talk to my colleagues in the Department for Education, but I am not sure that a letter to cabinet members will have any weight.

[Mr Raab]

Will the Minister give way?

[Anna Soubry]

I am going to run out of time. Unless my hon. Friend is very quick, I do not see how I can respond.

[Mr Raab]

I thank the Minister for giving way. The whole point of this debate is to try to get central Government to co-ordinate with local government. We are not talking about forcing local government, but we are talking about urging local government to do something through its internal mail system. Will she give that further consideration and perhaps meet me and the HeadSmart campaign?

[Anna Soubry]

Yes. That is a brilliant idea, and I am more than happy to do it, especially as I have only six seconds left. Seriously, though, between us all we can find a way to ensure that we all get what we want.

Question put and agreed to.

Public Health (Local Authorities)

Anna Soubry Excerpts

Thursday 18th July 2013 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

We have today laid before Parliament “Government Response to the House of Commons Communities and Local Government Committee Eighth Report of Session 2012-13: The Role of Local Authorities in Health Issues” (Cm 8638).

The Government are grateful to the Committee for its constructive and positive report, and for the opportunity it provides to set out our position and expectations on some key issues in greater depth.

I am grateful to the Department for Communities and Local Government and the Department for Work and Pensions for their contribution to this report, and commend to the House the increasingly broad base for thinking and action on public health across Government.

Copies of the Government response are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.

Managing Risk in the NHS

Anna Soubry Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

This is debate is about the NHS in England, and if the hon. Gentleman has concerns about the NHS in Wales, why does he not have a word with his right hon. Friend the Chancellor of the Exchequer and get a better deal for the Welsh Assembly so that a bit more money could be put back into the Welsh national health service?

As I was saying, the Government have put staff morale at rock bottom, and where are the promised benefits of this reorganisation? Clinical commissioning groups are not, as we were promised, the powerhouse of the new NHS; they are embryonic at best and anonymous at worst. Members of all parties, I am sure, write letters to CCGs that get passed to NHS England, which then either does not provide a proper answer or passes them on again. [Interruption.] I hear the public health Minister saying it is dreadful that Members do not get proper answers. When my hon. Friend the Member for Easington (Grahame M. Morris) wrote to her about cancer services in his constituency, she also brushed it off to NHS England. Is this proper accountability? No.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

rose—

[Andy Burnham]

I hope the Minister is going to deliver some accountability now.

--- Later in debate ---

[Anna Soubry]

Will the right hon. Gentleman please agree and accept that I have not only answered his letters, but met him on at least one occasion? It is right under the new system for such letters to go to NHS England, but that does not stop me making representations. We have introduced a much better system than we used to have under his Administration.

[Andy Burnham]

We have just heard it; this is what the NHS has been reduced to. The Minister has to make representations to NHS England about cancer services of all things. My goodness, if Ministers are not responsible for cancer services, what are they responsible for? Who is making the decisions and who is responsible for what? Even now, confusion reigns.

What precisely is the role of the Secretary of State in this new world? He has cast himself in a new role as a detached commentator on the sidelines, magnifying all of the NHS’s failings and accepting none of the responsibility to fix them. I assume that that is all for NHS England, too. With the NHS already laid low by cuts and reorganisation, the Secretary of State has opened up a new front on staff: nurses repeatedly blamed for not caring enough; hospitals blamed for coasting, as I have said; GPs blamed for causing the A and E crisis. Everything is someone else’s fault.

Then we get to this weekend. The Keogh report rightly exposed poor care standards, which should never be tolerated; we support action to tackle to them. The report, however, exposed something else, too—a Government who are now actively spinning against the NHS for which they are responsible, generating misleading or, in Sir Bruce’s words, “reckless” headlines about 14 already troubled hospitals. What chance do they have of improving when the man supposedly in charge is actively doing them down?

Organ Transplants

Anna Soubry Excerpts

Wednesday 17th July 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Let me begin by congratulating the hon. Member for Stretford and Urmston (Kate Green) on securing this debate, raising this important issue, and enabling us to discuss it for this very short period. It is not really a debate but a number of questions quite properly asked, no doubt many of which I will not answer, through no unwillingness on my part but because, as I always say, the usual rules apply. However, all questions will be answered, if not by me tonight then certainly by way of a letter. I thank the hon. Member for Strangford (Jim Shannon) for his helpful and interesting contribution. He has been good enough to provide me with a clipping. I believe that it is about kidney transplants and kidney donations, and I will make further inquiries.

As you will know and understand, Mr Deputy Speaker, this matter has come up by way of the fact that hon. Lady, as she explained, has a constituent, Natalie McCusker, who has had a lung transplant. We are all delighted that she was able to have that lung transplant.

As we know, the donation of organs is sometimes from a living source, to put it in crude terms. There are many examples of people who have made the most amazing sacrifices, often within families, to supply a kidney to a loved one so that they can live. There is, of course, the whole additional subject of what happens on death and the wishes of somebody in relation to their organs, and the absolutely amazing difference that that generosity after life can make to people. No doubt Natalie is a very fine example of that, and no doubt she and her family are profoundly grateful to the person who had the good sense to indicate that they were willing that on their death their organs would be donated. Then there is the great and often very emotional matter of the family deciding that they are all content for this to happen. There is nothing worse than when someone is taken from us when they die. It is very difficult for anyone in the medical profession—we have nurses who are specially trained in this—to approach the family in those profoundly difficult times and discuss the possibility of organ donation. The work of those nurses and other medical professionals is one of the reasons we have seen an increase in organ donation.

We all know the benefits of transplants and know that we need to do more to increase the number of organs donated. That would give many more people the opportunity to benefit from a transplant that could save their life or significantly improve the quality of their life. About 8,000 people are listed on the national transplant list waiting for a transplant. Many more could be listed if more donated organs were available for transplant. Many people wait months and years for a phone call telling them that a suitable organ has been donated and calling them in for a transplant. I am aware through my work as a Minister of some of those families and their anguish as they literally sit around waiting for that phone call, especially when it is a child who so desperately needs the transplant to, in effect, save or improve the quality of their life. For some, that phone call never comes and about three people—adults and children—die every day waiting for a transplant that could have saved their lives.

Given that the number of people needing organ transplants in the United Kingdom is greater than the number of donor organs available, there has to be a system to ensure that patients are treated equitably and that donated organs are allocated in a fair and unbiased way. Allocation is based on the patient’s need and the importance of achieving the closest possible match between donor and recipient, which is often very difficult.

All patients waiting for transplants are registered on the national transplant database. Rules for allocating organs are determined by the medical profession in consultation with other health professionals in health departments and specialist solid organ advisory groups. The blood group, age and size of both the donor and the recipient are all taken into account to ensure the best possible match for each patient, and the cardiothoracic advisory group is currently looking at improving the allocation of donated lungs to help to ensure equity and better outcomes for patients.

At present, lungs are allocated to the transplant centre based on the location of the donor, as the hon. Member for Stretford and Urmston said. The transplant centre will decide whether or not to accept the lungs and will select the most appropriate recipient. NHS Blood and Transplant is working with transplant centres to consider whether the current allocation system can be improved. It is considering whether it would be worth while implementing a national allocation scheme offering lungs and other organs nationally, rather than by centre. Other models are also being considered. NHS Blood and Transplant monitors the current allocation system closely to ensure that there is equity of access across the UK, and a recent analysis showed no statistical differences in outcomes across the UK in relation to lung transplant centres.

[Kate Green]

I appreciate that the Minister may not immediately know the answer to this, but does the equity of outcome apply not just to survival rates, but to waiting times?

[Anna Soubry]

As the hon. Lady has anticipated, I do not have the answer to that question in my brief, but I will make sure that she receives a proper answer.

Over the past five years, we have been strengthening the donation infrastructure by implementing the 14 recommendations of the organ donation taskforce, which were published in 2008. Is it not nice that in this sort of debate we can pay tribute to another Government of a different political persuasion? We are all united on this issue; it is not a party political issue and it is always a pleasure to take part in these sorts of debates.

The number of donor co-ordinators across the United Kingdom has nearly doubled. They are working closely with intensive care clinicians and families to identify potential donors and obtain consent. As I have said, it is difficult work but, goodness me, what a difference it can make when it is successful.

We have appointed clinical leads and established donation committees and chairmen in all trusts. This has driven improvement in hospitals, optimising the potential for organ donation. I am delighted that we have achieved an increase of 50% in organ donor rates and of 30% in transplant rates over the past five years, helping many more people to have the transplant that they so desperately need. We need to do more, however, to enable many more people like Natalie to receive the organ transplant that in many circumstances will save or enhance their life.

On 11 July, NHS Blood and Transplant published the new UK strategy for organ donation and transplantation. “Taking Organ Transplantation to 2020” sets the agenda for increasing organ donation and transplant rates to world-class standards over the next seven years by aiming to improve consent rates to organ donation to more than 80%—they are currently 57%—and transplant more organs and increase the number of people receiving an organ. The strategy calls for a revolution in public attitudes and behaviours, and emphasises the importance of individuals and families agreeing to donation. That important work needs to take place irrespective of someone’s background, ethnicity, religion, faith or whatever else. We need to ensure that more people in all parts of society sign up to donate their organs and that we are able to persuade people’s families to allow their organs to be donated upon death.

[Jim Shannon]

The Welsh Assembly has recently taken a decision on organ donation, which is a positive step. Is it the intention to consider having that system in England, because that might help the hon. Member for Stretford and Urmston (Kate Green) in her quest?

[Anna Soubry]

The Welsh Government have introduced legislation under which people will have to opt out. We need to work with the Welsh Government to ensure that that system works, because there are concerns about the effect it will have across the United Kingdom when one country has people opting out as opposed to opting in, as in the rest of the United Kingdom.

The independent organ donation taskforce examined the case for moving to an opt-out system in 2008 and its recommendation was against such a system. Spain had an opt-out system, but I think that it has now rejected it. In any event, it no longer has an opt-out system. I know that because I had a conversation with Spain’s Health Minister at a recent EU conference, as one does at such events, where people learn from each other, which is extremely useful. Spain has one of the highest uptake levels for organ donation and there is an awful lot that we can learn from it.

When people apply for a driving licence, they can now tick a box to sign up for organ donation. That has its value. I think we should take every opportunity to encourage people to donate. However, if people are applying for a driving licence, there will be a tendency to skip that box because they want to get on with filling in the form.

I will be quite frank. When I got this job, ITV ran an excellent campaign for about a week in which it encouraged its viewers to sign up to be donors. I suddenly realised that I did not have a donor card. I was informed by my brilliant officials that I did not need a donor card and that all I needed to do was go online. I went online and signed up extremely easily and quickly. I was highly impressed by that system. I would not have known about it if ITV had not run that campaign. There are many opportunities to encourage and positively enable people to sign up and donate.

I will keep an open mind on the opt-out system. We will look at what happens in Wales. We may well have a great deal to learn from it. It may be that that system, which the Welsh Government have great hopes for, will be successful and that, in looking at it, we will form a different view. It is important to keep all one’s options open.

As I was saying, NHS Blood and Transplant announced its new strategy on 11 July. It has a new chair who is full of vigour and who I am sure will do an extremely good job.

In conclusion, transplantation offers many people the opportunity of life and enhances the lives of many others. I am delighted that Natalie has had that opportunity and we all wish her a long, happy and healthy life. We have made significant progress over the past five years and we must thank all the families of donors for agreeing to or supporting donation and giving the gift of life at such a terrible time in their own lives. We want to build on that progress and increase our donation and transplantation rates up to 2020 to match the world-class performance in many other countries. There is no reason why we cannot do as well as the Spanish or even better. We will continue to monitor the procedures in the United Kingdom for the selection and allocation of organs, and to consider whether changes to the allocation of organs need to be made to ensure equity of access for all people on the national waiting list.

I hope that the hon. Member for Stretford and Urmston, whom I congratulate again on securing this debate, has been heartened by the points that I have made. If there are any questions that I have not answered, I will of course write to her, unless she wants to make a quick intervention before I finish. She seems content and I am grateful for that.

Question put and agreed to.

HFEA and HTA (Government Response)

Anna Soubry Excerpts

Wednesday 17th July 2013 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Department of Health is today publishing Government response to the independent report, “Review of the Human Fertilisation & Embryology Authority and the Human Tissue Authority” by Justin McCracken.

On 25 January 2013 I announced to the House that, following a consultation carried out in 2012 on proposals to transfer functions from the Human Fertilisation and Embryology Authority (HFEA) and the Human Tissue Authority (HTA), I had commissioned an independent review of both bodies which would also give serious consideration to their merger. This review was conducted by Justin McCracken, the then chief executive of the Health Protection Agency, between January and April 2013 following which he reported to me and the Minister for the Cabinet Office.

We have now considered Mr McCracken’s report in detail and have taken careful note of his conclusion that the current arrangements deliver generally effective regulation and achieve high levels of public and professional confidence. We have also closely examined his finding that there is little overlap in the activities of the two bodies and his conclusion that greater efficiency is to be gained from reducing the burden of regulation than from structural reform. The review recognises that there is scope for improvement in the ways the bodies operate, and that efficiencies can be achieved by way of a review of human tissue legislation. There are 18 recommendations in total to help achieve a reduction in the burden of regulation. Most of the recommendations are aimed at the HFEA and HTA and we will work with them to ensure they are implemented.

The report recommends that the Government review human tissue legislation. We recognise the importance of that and understand that there will be particular sensitivities around such an undertaking but believe that the evidence presented in the McCracken report is persuasive. We are committed to safeguarding the principles of the Human Tissue Act (and the requirements of EU legislation) but believe that after nearly a decade in force, a review of this legislation is timely. We aim to produce a consultation document in this financial year.

The Department, therefore, accepts Mr McCracken’s recommendations in total, and will work closely with the HFEA and HTA as they implement those recommendations for them.

In conclusion, we believe that implementation will bring about increased efficiency and effectiveness of the regulators while maintaining public and professional confidence in these sensitive and complex areas.

A copy of the Government response to the report of the independent review of the Human Fertilisation and Embryology Authority and the Human Tissue Authority by Justin McCracken along with a copy of the independent report, “Review of the Human Fertilisation & Embryology Authority and the Human Tissue Authority” have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.