Oral Answers to Questions

Debate between Anne Milton and Mary Creagh

Monday 29th January 2018 Commons Chamber

[Anne Milton]

Yes, my right hon. Friend is absolutely right that further education colleges—seven out of 10 have been graded good or outstanding—are absolutely critical in drawing together businesses from the local area. Along with local authorities and local enterprise partnerships, they can have a significant impact on the education and training that young people get.

[Mary Creagh (Wakefield) (Lab)]

Wakefield College opened its advanced skills and innovation centre late last year. It is a brilliant new centre to help entrepreneurs start up their own businesses. The one cloud on the horizon is the excellent work done by the college through the national collaborative outreach programme, which is still up in the air following the fiasco of the Minister’s Department over the setting up of the Office for Students. When will she announce the funding for the years going forward and when will my excellent staff be able to continue that good work?

[Anne Milton]

The hon. Lady is right to praise the work of Wakefield College. Such colleges are real exemplars of what can be achieved. I appreciate the importance of outreach work, and that is particularly important when we consider social mobility. I am happy to discuss the matter further with the hon. Lady at any time.

Oral Answers to Questions

Debate between Anne Milton and Mary Creagh

Tuesday 29th June 2010 Commons Chamber

[Anne Milton]

Again, the hon. Gentleman raises the point that anything we do must have a strong evidence base. We are considering a number of schemes at the moment. What is important is that people have the information on the pack of food that they buy, so that they can make good choices about what they eat.

[Mary Creagh (Wakefield) (Lab)]

Last week’s Budget scrapped the health in pregnancy grant, which helps all pregnant women to eat healthily in the final 12 weeks of their pregnancy. The previous week, the Government scrapped the free school meals pilot for 500,000 children, thrusting 50,000 children back under the poverty line. They have also scrapped free swimming for under-16s and pensioners just as the long summer holidays begin. Is that not the most extraordinary start for a Government who promised to rename the Department of Health the “Department of Public Health”? With so many broken promises in their first seven weeks, how can we trust a word that they say about public health?

[Anne Milton]

The hon. Lady and I have exchanged niceties in a slightly calmer atmosphere in another setting. I find it staggering that Opposition Members cannot understand that what matters is not what we spend but how effective that spending is. They simply cannot understand it. In fact, Labour has said that it would cut the NHS, whereas we have said that we will not. The sick must not pay for Labour’s debt crisis. We did not get us into this mess, but I would point out to the hon. Lady that everything that we do must be based on evidence. It is not what you spend, but what you spend it on, that matters.

Human Tissue (Availability)

Debate between Anne Milton and Mary Creagh

Wednesday 23rd June 2010 Westminster Hall

[Anne Milton]

I thank the hon. Gentleman for his intervention. It is interesting that this is the first time that we have referred to the differences between ethnic groups, and that is an extremely important matter, but there is a resource out there that we do not necessarily use, which is the faith leaders in communities, who can perhaps raise the issue. That is why we need to send tentacles out, perhaps even from this debate, to ensure that we get the messages across in many different settings. We mentioned children; perhaps the issue should be talked about in school.

[Mary Creagh]

The Minister says that this is not a matter for the Department of Health, but is she not even a little curious about which hospitals do systematically collect and process the material, and about the 60% or so that do not? I am very curious about that. Her Department could easily map, with the resources that it has, where the hot spots and cold spots are. It could use the transparency that we have under the Freedom of Information Act almost to shame the hospitals that do not do it, or it could at least have a conversation with those that do not do it systematically, perhaps because they are not attached to a university or because they are not teaching hospitals. We could examine how we could encourage hospitals to do it and educate the staff about the wider benefits to the community.

[Anne Milton]

The hon. Lady is right. I think that in the end it is the differences that will spread good practice and drive up standards and professionalism in this area. She is right to say that we must examine why some places are so good on this. One example that I heard about recently is that of a trust that sends combined, personalised leaflets about consent to treatment to patients along with pre-operative medication. My colleague the hon. Member for East Dunbartonshire mentioned that. That trust is giving patients the time and chance to think about their treatments in advance. That is the type of innovative practice that we want. I do not believe that a standardised form is the answer.

I would also have some misgivings about routinely seeking consent to use tissue for research unless we could be confident that there was a good chance of its being used. One of the key complaints from the families affected by organ retention scandals was that everyone tried to justify the practice of routinely retaining tissue in the name of research, when in fact most of the material had never been used. There is a test that is applied to children, called the Gillick competence. We do not often use the opportunities that we have to raise the issue with children, or to ask them what they want to do.

Let me clarify that there are no plans to revisit the question of an opt-out system. Certainly, on a personal level, I would not be happy with such a system. It would require an extensive information and education campaign, and there would be ethical and practical issues if people were able to opt out of some types of research but not others. No doubt some people would be happy to give tissue for some types of research but not others. Everyone feels so differently about the issue; it is a very difficult area.

My colleague the hon. Member for East Dunbartonshire also raised the prospect of a tissue database and mentioned the work undertaken by onCore. I understand that onCore was originally set up to collect and store tissue in a national bank for cancer research. It now focuses mainly on bio-banking activity, and that shift reflects the research community’s local initiatives.

I also understand that there have been excellent developments through the National Cancer Research Institute’s informatics initiative. For example, there is the oncology information exchange, a free-to-use computer portal for sharing information on resources for cancer research, including tissue collections.

At the heart of the debate is the issue of improving access to tissue for research. Some initiatives are under way, and there are some examples of good practice, but a common cause of concern is the complexity of the regulatory and governance regimes. A lack of confidence and misconceptions about requirements have meant that residual tissue from diagnostic procedures may be archived for purposes such as clinical audit, but not available for research. Perhaps the appropriate consent has not been secured or the licence to store tissue for research has not been obtained from the Human Tissue Authority. Either way, the effect has been to stifle research, which is not what we want. Researchers complain of local resistance to new research programmes because they are perceived as being too risky or beset with rules and regulations. Efforts are being made to help NHS organisations to overcome those perceptions.

The HTA, in collaboration with the National Research Ethics Service, has set out the licensing, ethical approval and consent requirements to enable diagnostic archives to operate as tissue banks. The HTA’s annual review tells the story of Guy’s and St Thomas’ NHS Foundation Trust, which was one of the first establishments to license its archive of diagnostic histopathology specimens as a research resource. A histopathologist from the trust said that

“support from the HTA was very helpful for us in approaching our Trust management with proposals to license our diagnostic archive for research and upgrade consent processes”.

That is precisely the type of collaborative and supportive approach that we want and it is typified by a joint enterprise between the HTA and the National Research Ethics Service, which has helped to open up access even further.

I look forward to the outcome of the consultation by the Nuffield Council on Bioethics. This is clearly a dynamic issue, and I personally would like to keep it as such. It is about raising awareness and about the role that we in this place can play in raising the issue in our constituencies and with a wider audience. That is not just down to the scientists or those with a scientific background in this place, although their expertise is very valuable. The media can play a role. The organ donation taskforce report raised the issue of awareness, and there have been a number of reasonably successful campaigns in the past year, but I cannot re-emphasise enough how important it is to have public trust and confidence in the systems in place. It is important that we do not have burdensome legislation. It is important to raise awareness among all types of clinicians in training and to raise awareness among members of the public. Possibly it is a question of just changing the culture, so that people think, “I can change what’s happening in the area in which I work.” Sometimes we perceive barriers when they do not exist.

We have raised the issue of the differences between men and women, so I suggest that the men go hence and give blood. It is true that there are gender differences. It is extremely difficult to get men to go to their doctor with symptoms, particularly concerning anything below the waist. It is an issue to get men to come forward and donate tissue and blood. It is important and perhaps incumbent on all of us at certain times in the year to seek an opportunity to demonstrate by example that we are prepared to do that.

I thank my colleague the hon. Member for East Dunbartonshire not only for her contribution, but for allowing us all to have quite a collaborative discussion about the issue. There is no single solution. The NHS, the research community, clinicians and Government agencies have a part to play. In particular, the Government have a role in facilitating, but at the end of the day, they cannot take action on the ground. I hope that I have been able to reassure my honourable colleague and other hon. Members that some progress has been made, and that the various initiatives allow us to be more optimistic about the future. I reiterate that my door is open, and officials in the Department would be pleased to hear from anyone with examples of attempts to make progress that have been frustrated by rules, regulations or bureaucracy that prevent research in this important area from going ahead.