Oral Answers to Questions

Annette Brooke Excerpts

Tuesday 24th February 2015 Commons Chamber

[Mr Jeremy Hunt]

I will tell the hon. Gentleman what the public think about the NHS: last year, under this Government, dissatisfaction was at its lowest ever level and satisfaction jumped the highest among Labour voters. And where did satisfaction go down? In Wales.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T5. I have previously made Ministers aware that there are no beds for females in Dorset who need intensive psychiatric care. Our local newspaper, the Daily Echo, reports that such places will not be provided in Dorset for another three years. Meanwhile, patients are being sent as far away as Bradford. Do Ministers regard that as satisfactory? Are there enough resources coming to Dorset, or is it a local organisational issue?

[The Minister of State, Department of Health (Norman Lamb)]

No, I do not regard that as satisfactory and I am happy to talk to the local commissioners. We have ensured that there will be real-terms increases in mental health funding for 2015-16, and that should be regarded locally as a matter of urgency.

GP Services

Annette Brooke Excerpts

Thursday 5th February 2015 Commons Chamber

[Paul Burstow]

Absolutely, and certainly in its local planning my local authority does exactly that—it looks at what the community facility needs are. In the southern part of my constituency, in south Sutton, there has been some controversy over plans for a new GP centre. It is planned on a piece of land that was NHS land but which does not sit within easy reach of public transport and is perceived to be in the wrong place. It is also less than a mile from a soon-to-be-unused hospital site that many of my constituents feel would be a more sensible location. It will be the basis of a new housing development in the coming years and so will be the perfect place for a consolidation of existing substandard GP surgeries currently based in houses.

In its briefing, the Royal College of General Practitioners has set out some of the pressures on GPs, including increased levels of stress and depression. In a ComRes poll it conducted, eight out of 10 GPs expressed concern that those pressures were leading to an increased risk of misdiagnosis. Yesterday was world cancer day but there are still serious issues with the number of people who do not get a cancer diagnosis until they are in an accident and emergency department, by which point it is far too late, and consequently their lives are cut short.

GPs are at the heart of delivering health care: nine out of 10 NHS consultations take place in a GP surgery, while the number of consultations has increased by 40 million since 2008 to 340 million. Interestingly, according to the 2012 GP patient survey, 1.2% of patients went to a walk-in centre or A and E department because they could not get a GP appointment at a time that worked for them, but that figure has now risen to 1.7%. I am sure the Minister will tell us that those are very low percentages and therefore not a cause for concern, but given the number of consultations—340 million—it does not take a very high percentage to have a significant impact on our A and E departments. Given that there are nearly 14.6 million A and E attendances, we can see that the gearing is such that ensuring sustainable and easily accessible GP and primary care services is critical to getting the balance in the system right.

I hope the Minister will say something about the piloting of 24/7 access to GPs and ensuring we have the right data to better understand which areas are under-doctored so that we do not have to rely on anecdotal evidence. There is clearly a concern about deprived and rural areas not having sufficient doctor cover, but at the moment we cannot map that accurately. I hope he can tell us what is being done to target resources to support areas crying out for better GP coverage. In addition, I hope he can say what will be done to address the fact that, despite the Government’s having identified the need to train more GPs and despite the number of places having increased significantly under this Administration, not enough places are being filled. What is being done to get up to the right number?

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I have visited a number of GP practices and I agree that while they are desperately trying to meet the increased demands, the frustration at not being able to recruit is adding seriously to their stresses and strains.

[Paul Burstow]

It is said that we need about half of all trainees to go into general practice and, at the moment, only 2,700 of the more than 3,250 places that are available are being filled. That is an issue, but it sits in the context of a global workforce pressure when it comes to medical staff. The opportunity to fill this gap by recruitment overseas will be difficult as well.

I am conscious that others wish to speak so I shall end by asking the Minister to address the issues of access, of how we make sure that more deprived areas do not suffer a double disadvantage by not having access to good quality primary care and of what will be done to ensure that we cease to have this distortion of funding priorities caused by a payment-for-activity system in our acute sector and a contracting model for primary care that has disadvantaged primary care for too long and led to this reduction in funding that other hon. Members have talked about. I look forward to the rest of the debate and the Minister’s response.

Breast Cancer

Annette Brooke Excerpts

Tuesday 25th November 2014 Commons Chamber

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I am very pleased to have secured this debate, as it permits further discussion on some of the work that my hon. Friend the Member for Winchester (Steve Brine), the hon. Member for Washington and Sunderland West (Mrs Hodgson) and I, as co-chairs of the all-party parliamentary group on breast cancer, have been engaged in over the past four years. We work with all the major breast cancer charities, including Breakthrough Breast Cancer, which provides the secretariat for our group, Breast Cancer Campaign, which is merging with Breakthrough next year, and Breast Cancer Care. We thank them all for their work and support.

Breast cancer is a disease that many of us will know about and have experience of. With nearly 55,000 people diagnosed with the disease in the United Kingdom every year, everyone will know of somebody—a loved one, a friend or even themselves—who has experienced this disease. It is still the most common cancer in the UK, and around a third of all new cancers diagnosed in women are breast cancer.

Over the past few decades, great strides have been made in treatment and care, leading to much improved outcomes. Since the 1980s, breast cancer deaths have fallen by more than a third, and today more people survive breast cancer than ever before. More than eight out of 10 people are living five years or more following their diagnosis. The all-party parliamentary group recently carried out an inquiry into breast cancer in older women. The resulting report is entitled “Age is just a Number”. We discovered that there were many improvements that could be made to ensure earlier diagnosis, better communication, and better treatment and support. We are pleased that many of our recommendations will be implemented and hence overall life chances will be improved further.

[Steve Brine (Winchester) (Con)]

I congratulate my right hon. Friend, at the end of her time in the House, on bringing the topic of breast cancer to the Floor of the House of Commons in the way that she has. She conducted the inquiry with me and, as she knows, one of the things that I was so struck by is the belief out there that the risks of contracting breast cancer go down as one gets older and passes the screening age, whereas we know and the evidence shows that, on the contrary, they go up.

[Annette Brooke]

I thank my hon. Friend for the great leadership that he gave in the inquiry. I believe we brought out a great number of myths, which will much improve the approach to primary breast cancer. However, fewer people know about secondary breast cancer.

In October 2010, the United Kingdom had its first secondary breast cancer awareness day. In secondary breast cancer, sometimes known as metastatic, advanced or stage 4 breast cancer, the breast cancer cells have spread to other parts of the body, most commonly the bones, brain, liver or lungs. Secondary breast cancer is incurable and, sadly, 11,600 people die every year as a result of secondary breast cancer—the equivalent of 32 people every day. Many people diagnosed with secondary breast cancer live with the disease for a number of years. In such cases, the care and support that they receive can make a real difference to their quality of life.

I was able to raise the issue of data collection directly with the Prime Minister during Prime Minister’s questions in 2010. At that time there was no reliable data collection on how many people were living with the disease in the UK, meaning that care and support services could not be accurately costed or developed. Subsequently the main breast cancer charities and the three co-chairs of the all-party parliamentary group met the Prime Minister to discuss what was needed. We were very pleased to welcome in 2011 the publication of the Department of Health cancer strategy, “Improving Outcomes: A Strategy for Cancer.” The strategy included the aim of beginning a full collection of statistics on secondary breast cancer from April 2012, yet there still seem to be considerable gaps, as I shall outline later in my speech.

The purpose of data collection is to make sure that the quality of services offered is improved. Although we can undoubtedly find examples of best practice, there are still many concerns about the overall level of service provision in this area.

[Steve Brine]

I am sorry to interrupt my right hon. Friend’s flow again. One of the things that came out of our time with the Prime Minister on collecting the data on secondary breast cancer was the importance of secondary breast cancer care nurses. I pay tribute to the work of Breast Cancer Care in this respect. Does my right hon. Friend agree that those nurses can make a transformative difference to women and their families who are going through secondary breast cancer, by linking them up to other services in the NHS and providing knowledgeable support to them?

[Annette Brooke]

Again, I thank my hon. Friend. Over the years we found that the provision of a specialist nurse makes a crucial difference. When someone has a symptom that they are not quite sure about and they think, “I don’t want to bother to go to my GP”, being able to pick up the phone and get expert advice deals with the problem quickly, takes away the worry, and if it is necessary to see a doctor, they can go, confident in the knowledge that they are not just imagining the symptom and that it is important for them to follow it through.

A recent survey by Breast Cancer Care, which was released to mark this year’s secondary breast cancer awareness day on 13 October, reported that 90% of people with a secondary breast cancer diagnosis have experienced pain as a result of the disease in the past month. Half of those described their pain as moderate or severe. For 78% of people, their pain meant that they were unable to undertake normal everyday activities, such as household chores, work, child care, hobbies or socialising. Pain is one of the most common symptoms of secondary breast cancer, but much of it can be controlled and managed through access to palliative care. In fact, guidelines from the National Institute for Health and Care Excellence state that referrals to palliative care should be offered soon after a secondary breast cancer diagnosis. However, the same survey by Breast Cancer Care found that only 41% had been offered a referral to a palliative care team. That means that thousands of people are experiencing pain that could be controlled and managed. I am sure that we can all agree that it is unacceptable that anyone should be expected to live with unnecessary pain.

Another indicator of where the care and treatment for secondary breast cancer is not good enough is the lack of secondary breast cancer clinical nurse specialists. The NICE quality standard for breast cancer highlights that everyone with secondary breast cancer should have access to a clinical nurse specialist. The most recent results of the national cancer patient experience survey also found that access to a named clinical nurse specialist was often associated with having a more positive experience in care. For primary breast cancer—I am pleased that progress has been made in this area—it is much more routine for patients to have a clinical nurse specialist to help to co-ordinate their care and provide the support they need.

[Mr Mark Spencer (Sherwood) (Con)]

I congratulate my right hon. Friend on not only securing the debate but the work she has done in the House on this topic together with my hon. Friend the Member for Winchester (Steve Brine). Will she recognise that as well as the physical pain, the psychological aspect of this disease is quite dramatic? One way of fighting the psychological impact is to give hope to those victims that their life can be extended for as long as possible. The data that she seeks to collate and collect can give medical advancement and hope to those victims at the same time.

[Annette Brooke]

I thank my hon. Friend, and yes, it is so important. We have the good news that life expectancy is increasing under these circumstances, but that makes it all the more important to think about the quality of those extra years.

There are far fewer clinical nurse specialists for secondary breast cancer. There is no definitive figure, but estimates from Breast Cancer Care suggest that there may be no more than 20 clinical nurse specialists who have expertise or experience of working with secondary breast cancer. This is despite there being approximately 36,000 people living with a secondary breast cancer diagnosis. Given the results of the cancer patient experience survey, and anecdotal evidence from those living with secondary breast cancer, we can assume that many secondary breast cancer patients are not having as positive an experience in their care as those with a primary diagnosis. Unfortunately, we do not know for certain as the cancer patient experience survey does not include a specific stand-alone question on secondary breast cancer. It is essential that the survey continues, so could it not include a question on secondary breast cancer?

Breast Cancer Care ran a taskforce on secondary breast cancer in 2006. Its final report, published in 2008, highlighted a number of issues, other than those already mentioned, that patients with secondary breast cancer face. Those include multi-disciplinary teams not discussing secondary breast cancer routinely, the information needs of patients not being met, and patients not being assessed for their psychological or social needs following a diagnosis—the point that my hon. Friend has just made. Unfortunately, it seems that little progress has been made in the six years since that report was released.

Underpinning the problems with care and treatment for secondary breast cancer—and key to much of this debate—is the lack of data and information about patients diagnosed and living with the disease. As I have already mentioned, we still do not have an accurate figure for the number of people who have been diagnosed with secondary breast cancer, only an estimate. We do not have enough quantitative evidence about the experiences of secondary breast cancer patients.

I had the opportunity to meet some women at a recent Breast Cancer Care event to mark secondary breast cancer awareness day last month, and they told me that the care they received was often inadequate, and certainly not at the same standard as the care that followed their primary breast cancer diagnosis. Some typical comments from patients with secondary breast cancer include:

“A diagnosis of secondary breast cancer changes your life completely—nothing is ever the same again”;

“When you’re diagnosed with secondary breast cancer you can have no idea of just how far and in how many different ways it’s going to change your life. So many people don’t understand what a secondary diagnosis means”;

“So many people tell me how great I look, or tell me that I can beat it with chemo and surgery. They don’t understand that I am in pain and I can’t be cured”;

“The pain I had, from when I was diagnosed, basically it was excruciating. But the pain had started slowly and I’d always had aching pains in my chest area. To the point that it was so bad that I couldn’t hold a glass in my hand or put a handbag on my shoulder. I couldn’t touch my head, I couldn’t dress myself. I couldn’t sleep. I couldn’t turn on my side. And also I couldn’t breathe properly”;

“One thing that does distress me is the lack of continuity in my care and I think that if I had one person who was with me through it all that would help a lot”;

and

“The strange thing about this whole disease is that they don’t really prepare you at all. It’s almost finding out as you go along”.

I think that those comments highlight how much progress we have made on primary breast cancer, with all the advice and support that is given to patients very early on. I want to use this debate to highlight not only that progress, but the need to address those issues for secondary breast cancer, some of which have been faced with primary breast cancer.

Although the comments I have just read out highlight the human story, they are not enough to help us find the solutions. Without firm data and evidence, it is impossible to understand fully the impact of secondary breast cancer. We do not really know enough about the types of treatment that patients are receiving or how the quality of a patient’s life changes over time. That lack of information makes it virtually impossible for commissioners to be able to plan and commission services properly that meet local needs. That, in turn, makes it much harder for clinical nurse specialists with the right knowledge and skills to be recruited, particularly when NHS budgets are under pressure. The result is that patients continue to miss out on the vital support and care they need.

As I mentioned earlier, the Government have committed to improving the collection of data on secondary breast cancer, making it mandatory for the NHS in England. When my colleagues and I met the Prime Minister, he agreed that adequate data collection was required. Following that meeting, in January 2011, the Department of Health published its national cancer strategy, “Improving Outcomes”, which committed to collecting data on secondary breast cancer for the first time, stating:

“During 2011/12 we will pilot the collection of data on recurrence/metastasis on patients with breast cancer with the aim of undertaking full collection from April 2012.”

[Jim Shannon (Strangford) (DUP)]

I thank the right hon. Lady for giving way and apologise for not being here for the beginning of her speech; I was at a do down below and could not get here in time. She has just outlined the importance of collecting and then using data to respond to those who have breast cancer. She will also be aware that Breast Cancer Care has campaigned strongly to ensure that data are collected in England. I understand that it hopes to have a similar initiative in Scotland, Wales and, hopefully, Northern Ireland. She refers to the NHS in England. Does she share my opinion that the data should be collected for the whole of the UK so that we can agree a strategy that all four regions of the United Kingdom of Great Britain and Northern Ireland can benefit from?

[Annette Brooke]

I thank the hon. Gentleman for his intervention. I hope that the Minister has taken that point on board, because it is really important. Although data are being collected, they are not being received by various groups, and the purpose of this debate is to address that.

The pilot was run by the National Cancer Intelligence Network in collaboration with Breast Cancer Care, and it involved 15 breast cancer units across England. The pilot report, published in March 2012, identified 598 patients with recurrent or metastatic breast cancer. Of those, only 53% were recorded as being referred to a clinical nurse specialist, palliative care nurse specialist or other key worker at the time of diagnosis. That is despite the NICE quality standards and the evidence in the cancer patient experience survey of the benefit to patients of a named nurse.

[Steve Brine]

The pathway—the person who can help to pilot the patient through services—is not only found in the public sector; there are also services in the third sector. Is my right hon. Friend aware of the amazing work of Breast Cancer Haven, which has two centres—and, I hope, a third on the way in our Wessex area next year? It provides a complementary service that helps women to feel human again after they have had surgery and a devastating secondary diagnosis. This is not just about connecting them to services in the NHS; it is also sometimes about the charitable sector.

[Annette Brooke]

I thank my hon. Friend for reminding us of those very important services. I very much hope that I can visit one of Breast Cancer Haven’s units in due course, because I have not yet done so.

The pilot recommended that all breast cancer units in England submit data on patients with recurrent and metastatic breast cancer using existing data collection mechanisms. However, since the pilot no such data have been published. Since January 2013, it has been mandatory for all new recurrent and metastatic diagnoses to be recorded in England. The third annual report on the strategy confirms that this collection is taking place, but the problem is that the data do not seem to be publicly available.

A recent parliamentary question by the hon. Member for Ealing, Southall (Mr Sharma) about diagnosis of metastatic breast cancer in his constituency was responded to by the Office of National Statistics, which said:

“Detailed information about secondary cancer diagnoses is not routinely recorded on individual cancer registrations sent to ONS for processing and publishing as National Statistics. For these reasons it is not possible to provide figures on secondary breast cancer.”

This information needs to be made publicly available to allow scrutiny of the data and to help highlight areas that require action. It would be helpful if the Minister outlined what plans are in place to start publishing these data and whether the data include routes of referral. If there are no such plans, what is the reason for not making the data publicly available?

Not only have we seen no data published on secondary breast cancer, but there is also evidence to suggest that the data collection is not happening consistently across England. Breast Cancer Care is concerned that this will impact on the quality of the data that could be made available. Whether we will have a clearer picture on the needs of secondary breast cancer patients remains to be seen. Once consistently collected, it is also imperative that data can be accessed by research organisations, including charities, to drive improvements in care. Obviously, it is crucial that there are strong safeguards on privacy, but for numerous other reasons, including uncertainty following the restructuring of the NHS, there is great concern that routinely collected pseudonymised data sets are not consistently being made available for health research.

Breast Cancer Campaign has drawn my attention to some detailed points about data collection. The first relates to the current review of the national cancer peer review programme, which routinely monitors the quality and safety of NHS cancer services. I understand that it collects data on a number of key measures related to secondary breast cancer. There are concerns that it may not continue next year in its current form, or at all. I hope the Minister will comment on that. How will patients be provided with information on the safety and quality of their local cancer services, should the national cancer peer review programme be discontinued?

Secondly, if we are to achieve the Health Secretary’s goal of being among the best in Europe for cancer survival, measures to hold clinical commissioning groups to account for the cancer services they provide are vital. What consideration has the Minister given to the inclusion of indicators on cancer patient access to a clinical nurse specialist and multidisciplinary teams in the CCG outcomes indicator set, and what steps can she take to ensure that CCGs are held to account on their performance against that set? What further discussions is the Minister actually having?

In conclusion, the Government should be congratulated on the important progress they have made on cancer over the past four years. Initiatives such as the cancer drugs fund have made a big difference to patients in improving access to clinically effective drugs and treatments. However, in order to achieve the Government’s stated ambition of being the best place in Europe to survive cancer, more needs to be done. For that to happen, evidence is needed to provide the intelligence and insight required to enable local commissioners and health care professionals to plan effectively to meet their patients’ needs. I hope the Minister will join me in agreeing that it is no longer acceptable that the collection of data on secondary breast cancer does not consistently take place.

This is an important public issue. A petition by Breast Cancer Care calling for secondary breast cancer to be a priority for this Government has to date secured almost 12,000 signatures—a fitting milestone, given that almost the same number are dying from secondary breast cancer every year. Will the Minister commit to making secondary breast cancer a priority for her Department and, once more evidence is highlighted from the data, to working with Breast Cancer Care and other charities to improve the support and care that patients receive?

Only once everyone has the opportunity to access a clinical nurse specialist to support their care, to be referred to palliative care so they are not in unnecessary pain, and to receive the best possible care and treatment to live as good a quality of life as possible with the disease can we truly consider the United Kingdom to be one of the best in Europe for cancer care.

Oral Answers to Questions

Annette Brooke Excerpts

Tuesday 21st October 2014 Commons Chamber

[Dr Poulter]

The hon. Lady raises an important issue, which is that the NHS Litigation Authority often picks up on things when they do not go well and when the communication between patients and trusts has broken down. That is one of the things that need to be put right. I will look into the matter and write to her, because it is important that when things go wrong patients are supported in the right way and the lessons are learned.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T9. Currently, there are no psychiatric intensive care unit beds for women in Dorset. One of my constituents was recently sent to a unit in Bradford. Will additional funding be available to address this appalling situation?

[Norman Lamb]

I am very happy to meet my right hon. Friend to discuss the concerns in her area. I heard similar concerns when I was in Devon last week and clearly the objective must be to have facilities close to where people live, rather than their having to travel long distances.

Adult Autism Strategy

Annette Brooke Excerpts

Wednesday 5th March 2014 Westminster Hall

[Mrs Gillan]

That is a point to be taken on board. There is variation across the country that we are all aware of. The Minister will have noted the hon. Lady’s remarks, and it is important that we try to get more standardisation across the country.

The Act guaranteed the introduction of the first-ever adult autism strategy, setting out how adults with autism should be better supported. It was underpinned by guidance and placed duties on local authorities and the national health service to take action. The strategy has been well supported by the National Autistic Society; I think everyone in the Chamber and beyond would pay tribute to the NAS, which does the most amazing work right across the board. Its “Push for Action” campaign has captured people’s imagination. It calls for urgent action to end the wait for the everyday support that people with autism need.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I was delighted to support my right hon. Friend’s Autism Act, which was an enormous step forward, and I congratulate her on securing this debate, because it is exactly a push for action on what we have achieved so far.

I want to draw my right hon. Friend’s attention to a point raised by a constituent of mine who said:

“I have a bright son who is now 21 and spends every day isolated at home as there is no support or help available for him. I would like him to find a job and make friends but he will need help”.

When we get down to those individual cases and almost the waste of lives compared with what could be done, I certainly hope that we can secure something for this next push.

[Mrs Gillan]

I am grateful for that intervention. This place is about making legislation, both primary and secondary, but for each and every one of us as MPs, it is those individual cases that strike home to our hearts. It is a valuable role for an MP to bring individual cases to the attention of the House, as the hon. Lady has done, because it makes both our laws and their implementation better. I think that we will all have stories of families and individuals in our constituencies who need more help, and there is nothing more moving than a parent coming to plead for help for their child.

Oral Answers to Questions

Annette Brooke Excerpts

Tuesday 25th February 2014 Commons Chamber

[Norman Lamb]

I think it was a big mistake to leave out mental health when the 18-week maximum waiting time limit was introduced for physical health services. To me, that is inexplicable, so I am determined to correct it: from next year, there will be waiting times standards for mental health. Indeed, when the Care Quality Commission inspects and regulates providers, it will ensure that those access standards are met, in the same way as applies for physical health.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

11. What reports he has received on the possible reclassification of ME/CFS by the World Health Organisation.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

The World Health Organisation is currently developing the 11th version of the international classification of diseases, which it aims to publish in 2017. No discussions have taken place between the Department and the WHO on the reclassification of ME/CFS, but the WHO has publicly stated that there is no proposal to reclassify ME/CFS in ICD-11.

[Annette Brooke]

I thank the Minister for her answer. Many people will be greatly relieved about that. As chair of the all-party group on myalgic encephalomyelitis, I receive many representations about GPs in this country still not necessarily recognising the condition. Will she look into that, and will she work with her counterparts in the DWP on the benefits side as well?

[Jane Ellison]

I am aware that this is a very difficult, complex and emotive area. I have heard before the point that the hon. Lady makes about GPs. I am very happy to take up her points and discuss them with her.

Oral Answers to Questions

Annette Brooke Excerpts

Tuesday 14th January 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

On the hon. Lady’s substantive point, the reports for the British Medical Journal investigation, which I read in full, did not say that at all and in fact confirm that that was not asked, so what she says is not quite right.

On the wider point, over the past two weeks we have heard a succession of attacks from the hon. Lady and the Opposition about dealings with industry and business. This Government have set out to work in partnership across business and industry, with public health experts and local authorities, to tackle some of these really big public health issues. It is simply incredible that the Labour party believes that these big issues can be taken seriously without engaging with business. Instead of demonising businesses, let us hear some praise for those such as Lidl, which yesterday announced that sweets would be removed from all its checkouts across the country, in response to its customers—a voice that is too little heard by the Labour party.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T2. Will the Secretary of State join me in congratulating the UK Chronic Fatigue Syndrome/Myalgic Encephalopathy Research Collaborative for providing a mechanism for ME charities, researchers and clinicians to work together in a co-ordinated way? What support will his Department give research into the causes of and treatment for ME?

[The Minister of State, Department of Health (Norman Lamb)]

I am not the Secretary of State, but I would be very happy to join my hon. Friend in congratulating the collaborative, which is doing excellent work to generate more CFS/ME research. Spend by the National Institute for Health Research has already doubled in two years, and more funding applications are welcome. The NIHR has awarded nearly £0.9 million to the collaborative’s deputy chair for a senior fellowship studying paediatric CFS/ME.

Hospices (Children and Young People)

Annette Brooke Excerpts

Wednesday 18th December 2013 Westminster Hall

[Annette Brooke (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mrs Osborne. I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on securing the debate. I certainly like the description of him as the smiling MP. He has much experience to bring to this whole debate.

I should declare that I am a long-standing supporter and patron of Julia’s House, a children’s hospice in my constituency. I am pleased we have this opportunity to recognise the plight of families with a seriously ill child, as well as the role of children’s hospices and other palliative care providers in supporting them. I endorse many of the comments that have been made.

I would like to use this opportunity to highlight a vital type of support that is lacking in many parts of the country for these children and their families, but which Julia’s House has helped to pioneer. Most children’s palliative care focuses on end-of-life care, emergency care and some respite, but Julia’s House, in response to parental demand, mainly provides all-year-round, frequent respite care at homes throughout Dorset and south Wiltshire, as well as in the hospice in Poole, in Dorset.

For families with a child with a life-limiting or life-threatening illness, sleep deprivation, exhaustion and anxiety about the child’s health can take a heavy toll on family relationships. Parental break-up rates in families with a long-term seriously ill child vary, but they are known to be higher than the national average. People commonly report isolation, lack of time as a couple or as a family, and physical and mental exhaustion among their worries. Knowing that a specialist service will take the pressure off them for a few hours at a time of their choosing each week can be the difference between coping and not coping. It is even better if the service comes to their own home, as many families cannot easily transport their fragile child.

In the more than 10 years since Julia’s House began to provide this care, evidence has emerged that many parents see frequent respite as a factor in helping them to stay together as they try to cope with their child’s complex round-the-clock care needs. The impact of the frequent respite service and the flexibility afforded by offering much of it in families’ own homes earned Julia’s House the accolade of health care charity of the year at the 2012 national charity awards.

Julia’s House and Bournemouth university are now researching the extent to which frequent respite care helps couples with a seriously ill child to stay together. Their three-year study will conclude in autumn 2015, with interim results available in autumn 2014. Reliable data from the research could point the way towards a change in policy. It is in nobody’s interests, including the welfare state’s, for the parents of seriously ill children to separate. If frequent respite can play a preventive role, and if successful models of support are emerging, health and wellbeing boards should be asked to make frequent respite for families a strategic priority. As well as involving Julia’s House the research project will widen early next year to include client families from a selection of children’s palliative respite providers in England.

When the research started, the Julia’s House chief executive Martin Edwards met officials at the Department for Work and Pensions and the family policy unit to explain the research aims. The officials were naturally interested in tracking the results. I hope that the Department of Health and the Department for Communities and Local Government will take a similarly close interest, along with policy makers in all the main political parties. We all like to talk about reducing family break-up, but we struggle to find levers for that, and the project could provide one. Julia’s House will share the research results with the children’s palliative care sector and representatives of the three main political parties.

Emergency and end-of-life care, whether provided by the state or the voluntary sector, is very important, but it may come after a process of several years. Many children diagnosed with a life-limiting or life-threatening condition will live into their teenage years or beyond, and it is important to make that time as happy as possible. The cumulative effect on parents of sleep deprivation, exhaustion, isolation and anxiety is enormous. Which of us can say that we could survive such pressure?

[Jason McCartney (Colne Valley) (Con)]

I want to praise my hon. Friend the Member for Pudsey (Stuart Andrew) for initiating this emotional and important debate. I hope that he will keep smiling; I know that his constituents smile a lot because of the hard work he does in his constituency.

The hon. Lady makes a great point about respite care. The Forget Me Not children’s hospice in Huddersfield opened its doors formally this year, but for a couple of years its nursing teams have been going into the community, helping 50 families. I volunteered with them last summer and remember vividly a single mum with a very ill child, whom they would help two mornings a week. She has not had more than two hours of unbroken sleep in the past six years, and those two mornings a week are the only times when she gets a little time to herself, whether to have her hair done or meet a friend. The contribution of those teams to her life make her a better mum, and help her to care for her child better. It is an excellent point.

[Annette Brooke]

That was an excellent intervention. How could any of us maintain a good family life under such unrelenting stress? What a difference that respite makes.

A family in my constituency likened the pressure to slowly drowning, in exhaustion. In their words, “The only name on the life raft reads ‘Julia’s House’.” For families elsewhere in the country, in the numerous places where there is no genuinely year-round respite, there is no life raft. I commend the initiative to the Minister and look forward to her response. The research is likely to show the great benefits to commissioners of spending more money on respite care.

Oral Answers to Questions

Annette Brooke Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

No one campaigns harder than my hon. Friend on the issue of putting patients first in his constituency and throughout the NHS. CCGs have a legal obligation to involve patients in decisions about services and about them personally. The ideas in the paper he mentions are interesting, and I respect them, but given that we have brand-new commissioners and inspectors going out this year, I think we should see how the current reforms work first.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Today we published a report demonstrating that the NHS could recover as much as £500 million from better systems to monitor and track those who should be paying for the NHS treatment and introducing new charges to certain categories of people currently exempt. This is a significant sum of money that could fund 4,000 doctors, and far from being xenophobic, as some in the Opposition have alleged, the Government believe it is right that overseas visitors who do not pay for the NHS through the tax system should make a fair contribution through charges.

[Annette Brooke]

Poole hospital, which is much loved locally and has excellent care ratings, has a financial problem relating to tariffs that must be addressed. The £5 million spent on putting a failed case for a merger between Bournemouth and Poole hospitals to the Competition Commission raises questions about processes and openness with the public. I hope the Secretary of State can make some comments today, but will he meet me and other local MPs to discuss all these issues in greater detail?

Tobacco Products (Plain Packaging)

Annette Brooke Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Paul Burstow (Sutton and Cheam) (LD)]

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing the debate at this early stage, so that we can put the case for Parliament making the decision and getting the solution, getting on with it in a way that the Government have been reluctant to do.

I want to pick up on the phraseology: standardised packaging versus plain packaging. Standardised packaging is what we are talking about. It is clear, and enables public health messages to be delivered powerfully. The way in which the packages are designed has a clear psychological impact in reducing the likelihood of people taking up smoking and increasing the likelihood of their quitting. It is important that we talk about standardised packaging, because it really makes a difference.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

The case has been well made that clever packaging seduces children into smoking, but how will standardised packaging impact on the rational adult person’s choice to smoke?

[Paul Burstow]

I would use the phrase “insidious packaging”. That is what we are talking about. We have seen today examples of the sort of packaging that has been used, and in the evidence submitted as part of the preparations for the debate we have seen how those who lead tobacco companies talk about the value they place on packaging as a tool to solicit more custom and get more people to take up smoking in the first place. Big tobacco needs to recruit more smokers because it has to replace those who quit and, more chillingly, those who die as a consequence of taking up smoking. That is why we must have a bias towards action to protect the health of children and young people from the harm that smoking does.

In its systematic review of evidence, published as part of its consultation, the Department of Health gathered absolutely clear and strong evidence of the impact of standardised packaging on reducing smoking. The evidence is there; what is lacking is the political will. The Minister has that will, but the Government as yet do not. Parliament should take a leaf out of the book of the previous Parliament, when it came to smoking in enclosed public places. It was not the then Government who led on that; they hid behind many of the same arguments that are being used now. Yet again, it took the leadership of the Health Committee—having an inquiry, producing a report and publishing the evidence—to make the case for the ban, and the Government being prepared to allow a free vote.

We should have a debate and a free vote in this House to give effect to the policy change, because it will save lives. It is no longer satisfactory or acceptable to be kicking this can down the road. We should not have been doing that with the ban on smoking in enclosed public spaces and we should not be doing it now with standardised packaging.

I hope that people will be moved by this debate and that the Minister can move her colleagues. I know that both she and the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), are committed to this change, which is an essential public health goal. As one speaker said, controlling tobacco and saving lives requires us over time systematically to improve and strengthen regulation. This is another step on the journey of changing public attitudes and saving lives.