Health Infrastructure Plan

Bill Esterson Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

My right hon. Friend is right. In my previous role, I enjoyed a visit to her constituency to visit a prison with her and I am more than happy, although I am sure my officials will wince at the diary management involved, to take her up on her offer of a visit as well. She is exactly right: we are able to make this investment because, unlike the previous Labour Government, who left that note saying, “Sorry, there is no money”, we have stewarded the national finances well and we now have the money to invest.

[Bill Esterson (Sefton Central) (Lab)]

There was nothing in the announcement about Southport and Formby District General Hospital, which desperately needs a new walk-in centre to relieve the pressure on the accident and emergency department, and nothing about the much-needed health centres in Maghull and Formby, also in my constituency. Given the cancellation and delay in previous projects, and the growing repairs backlog, why should anyone think that these projects will go ahead in the way the Minister has announced any more than previous projects that have not?

[Edward Argar]

The hon. Gentleman is understandably and rightly fighting the corner for his local trust and local hospitals, but I am sure he would none the less welcome the huge investment by this Government in our NHS that this announcement amounts to. On delivering on these commitments, we are clear: we want to see these hospitals built as swiftly as possible. Unlike the Labour party, when we say we will do it, we get on with doing it.

Acquired Brain Injury

Bill Esterson Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Chris Bryant]

Yes, that is true. Because of the pattern of brain injuries across the country, it may be difficult for people to gather with people of a similar age and background. Lots of people with brain injuries arising from road traffic accidents are quite young—in their teens or early 20s. Sometimes they get put into support groups with people in their 60s or 70s. That is not an impossible combination, but sometimes it is not the most natural grouping for those with a much longer life expectancy.

The most difficult element for a lot of people is the significant impairment in their ability to speak and communicate. Speech therapists are an essential part of the mix in bringing people back to a degree of independent living after a significant event. One worry across the whole of the UK is the shortage of people working in this field, who sometimes do not feel as valued in the team as they might. We need to ensure that speech and language therapy is still available for some time after someone has had their immediate intervention.

One of the most common things that people tell me is that they are accused of being drunk, when in fact they have difficulty speaking properly because they have had a brain injury, not because they are a bad person. They feel the sense of stigma that attaches to not being able to speak as clearly as they might have been able to before their brain injury.

[Bill Esterson (Sefton Central) (Lab)]

My hon. Friend mentions that people can have the appearance of being drunk. My 15-year-old adopted son’s mum drank heavily while she was pregnant with him, which is where he acquired his brain injury. The most recent research suggests that every year tens of thousands of children are born in this country with foetal alcohol spectrum disorder; it is a spectrum, as the description implies. It is a massive problem, and it leads to the kind of emotional and behavioural difficulties that my hon. Friend will be familiar with from speaking to those who have had acquired brain injuries later in life. What are his thoughts on what is needed to address the numbers of people who have brain damage through their lives?

[Chris Bryant]

My mother was alcoholic. I do not know whether she drank during my pregnancy—[Laughter.] Was it my pregnancy? I mean before I was born. I am painfully conscious of how difficult it is for women who are alcoholic to stop drinking when they are pregnant. The message about the dangers of drinking during pregnancy has been out there for a long time, but we still have remarkably little in the toolkit for dealing with alcoholism in this country. Broadly speaking, it is still about the 12-step process, which has a very low success rate in comparison with other therapies and which relies on surrendering to a higher being, albeit not necessarily a religious one. It just does not work for an awful lot of people. The syndrome that my hon. Friend refers to is much more prevalent than we realised even 10 years ago. Further research is going on, and we need to ensure that it is fully understood across the whole educational spectrum, as well as the health spectrum.

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 7th May 2019 Commons Chamber

[Stephen Hammond]

My hon. Friend is absolutely right. That role has been introduced to help build the capacity of the nursing workforce and support nurses and wider multidisciplinary teams. As he will have heard me say earlier, I am delighted that Health Education England is leading the national nursing associate training programme, with a commitment to train 7,500 nursing associates this year.

[Bill Esterson (Sefton Central) (Lab)]

T8. Tens of thousands of children are born every year with brain damage as a result of pre-natal exposure to alcohol, yet most clinical commissioning groups are not providing support for those with foetal alcohol spectrum disorders, despite Government guidance telling them to do so. Will the Government take the action needed and provide support for those suffering with this life-limiting and lifelong condition?

[Jackie Doyle-Price]

The hon. Gentleman is right. Foetal alcohol spectrum disorders are not sufficiently widely understood across the NHS. We must ensure that we give support to those who are affected and also raise awareness, not least to encourage people to understand the risks they are taking when they drink alcohol during pregnancy.

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

Yes; my hon. Friend is dead right to bring up this subject. The rise in material promoting self-harm and suicide online is dangerous, and it needs to be stopped. I am delighted that, under pressure from this House, Instagram has now decided to take down that material, but there is much more to do. In this country, it is this House that makes the rules, not the global companies.

[Bill Esterson (Sefton Central) (Lab)]

The greatest damage from prenatal exposure to alcohol is often done in the first few weeks of pregnancy, yet three quarters of women in the recent Bristol University study said that they drank alcohol while pregnant. Will the Minister commit to ensuring that the chief medical officer’s advice is given loud and clear by all health professionals: do not drink alcohol if pregnant or trying to conceive?

[Jackie Doyle-Price]

I am pleased that the hon. Gentleman has raised this important point. We need to deliver this important public message because, as he rightly observes, the damage caused by alcohol can take place in the earliest part of pregnancy. Anyone seeking to get pregnant should be monitoring their alcohol intake, and in fact withdrawing altogether. It is important that we make the public aware of this, not least because of the rate of unplanned pregnancies, which continues to rise.

Foetal Alcohol Spectrum Disorder

Bill Esterson Excerpts

Thursday 17th January 2019 Commons Chamber

[Bill Esterson (Sefton Central) (Lab)]

It is a shame that the Children’s Minister, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), could not stay for the debate, because I think that it follows on very naturally from the last one.

“Babies being born brain-damaged by alcohol is a national emergency”. So ran the title of a piece in today’s edition of The Times about this debate. It is justified by a recent study conducted by Bristol University, which suggests that some 79% of women say that they drank alcohol while pregnant, and that between 6% and 17% of the 14,000 or so children covered by the study have foetal alcohol spectrum disorders. Scaled up—and this is why the term “national emergency” is not misplaced—that gives a figure of between 42,000 and 120,000 children a year.

So what is foetal alcohol spectrum disorder? It is an umbrella term for a range of effects that prenatal alcohol exposure can have on an individual. FASD is the commonest non-genetic cause of learning disability in the United Kingdom, yet it is entirely preventable. It lasts a lifetime: this is not just about babies. What does it look like? People often think that they understand the syndrome. They say to me, “Yeah, we know about that. It is a really bad problem when women have drunk heavily during pregnancy.” It is true that there are often facial and physical features characteristic of children with FASD, but, relatively speaking, that applies to a very small proportion of the wider spectrum.

The impact on the brain, although usually not immediately obvious from the outside, affects language, memory, attention, processing and understanding, and creates emotional, behavioural and learning difficulties. Children often struggle with complex concepts such as time, metaphor or consequences. Rewards and sanctions mean very little to children with this kind of brain damage, and consequences do not mean very much either.

A constituent of mine adopted two children. One of them, who is 16, had no idea of the consequences of his actions, and got into trouble. He has no idea that he has done anything wrong—the idea is meaningless to him—but because of a wider lack of understanding, including a lack of understanding in our criminal justice system, he very nearly went to prison. He was spared that, more by luck than by judgment. His victims did not understand—for good reason: why would they—and I think that there was very little understanding in the system.

A 17-year-old who gave evidence to the all-party parliamentary group on foetal alcohol spectrum disorders, which I chair, described the effect on her emotions. When she gets angry, she has no control whatsoever. I know that is true of many people, but controlling anger can be harder for those with this kind of brain damage. She described to our all-party group how she sees herself from the outside, as somebody else almost; it is a sort of out-of-body experience, and she has no control over it. I have heard that repeated by a number of children and young people affected by FASD, including my own adopted daughter; I have two adopted children, both of whom are affected by this, which is why I have become aware of it and taken so much interest in it.

There are implications for society as well as individuals, because this disorder does not go away when children become adults. In Canada, they have estimated that half of their prison population has FASD; I wonder whether the situation is very different here. FASD affects people’s ability to get qualifications, and I wonder how many of those who are sleeping rough or are otherwise homeless have FASD. Returning to the point I made about not understanding time or consequences, I wonder how many people who are sanctioned for not attending appointments with the Department for Work and Pensions have FASD. There is likely also to be a strong link between FASD and having difficulties with holding down a job or maintaining a stable relationship.

In the United States, a study last year estimated an annual personal cost of $24,000, before considering the cost to the criminal justice system. That is a relatively small element of the cost for some of the people with FASD in the United States. For years in the United States they have described people with FASD as million-dollar babies, often multi-million dollar babies, because of the long-term societal costs as well as that to the individual.

We have just had a very good debate on children’s social care, and I wish I had been able to take part instead of just listening to it. Population evidence to the all-party group suggested—this is a relatively low estimate —that at least a quarter of the children in the care system are affected by FASD. I have heard other adopters and people who run adoption agencies describing adoption as a family-finding service for children with FASD, because it is so common among the adopted children population. May I add to the tribute paid in the last debate to adopters, foster carers and all professionals who do what they can to support the children, young people and, indeed, adults who continue to face the challenges of FASD?

What am I asking for? I am asking for action on prevention and diagnosis, and action to cut the numbers, and for a sea change in our approach and our building of awareness among the population, including and especially among health professionals.

[Lyn Brown (West Ham) (Lab)]

My hon. Friend and I have talked about this issue a number of times, and I commend him for taking it forward. I was interested to read that twins who are exposed to exactly the same amount of alcohol in the womb can have very different outcomes. It is a very complicated situation. Genetic factors are involved and we have no way of predicting in advance what the risks are. Does my hon. Friend agree that we need to understand this better, we are learning all the time, and we cannot identify anything that would make drinking safe during pregnancy?

[Bill Esterson]

I thank my hon. Friend for her intervention which prompts me to cite a recent study from the Washington State University. Its foetal alcohol syndrome diagnostic and prevention network has identified that foetuses can experience vastly different FASD outcomes despite being exposed to identical amounts of alcohol—which is what happens with twins. There is no way of predicting what will happen, and its conclusion, which I am glad to see the chief medical officer now accepts, is that the only safe amount to drink is “none at all”.

I am asking that the chief medical officer’s advice and guidance, which has now been accepted by the National Institute for Health and Care Excellence as well, be given much greater prominence and that we build awareness so that everyone understands it, especially, but not exclusively, health professionals. I am asking that we have a proper study of incidence so that we need not rely on the limited evidence of the Bristol University study. It was only able to make rough estimates, given the nature of its research, but if it is between 6% and 17%, it really does need that intervention and prevalence study.

We have to build greater understanding among health professionals and professionals right across the public sector. I have mentioned support as well. There needs to be greater support for those living with FASD—both those suffering from it and those caring for them— and those in education and elsewhere who are looking after them.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I commend the hon. Gentleman for all the work he has done raising the profile of this condition. He knows I support him through the all-party group, and he knows of the experiences I have had with children’s homes in Denmark, which very much pioneered the work here, because of the alcohol problems among residents of Greenland and others. He is absolutely right that many of our children in the care system are directly affected by this. Does he agree that we have to get much better at giving clear advice, as we now do on smoking and its impact on lungs? We need a similar campaign to make absolutely clear to women exactly what the risks are to their unborn children if they continue to drink, as many of them will do.

[Bill Esterson]

The hon. Gentleman is absolutely right to draw the comparison with smoking. There is no way anybody does not understand that you do not smoke when you are pregnant. We need the same cultural understanding of the effect of alcohol.

I am very pleased that the chief medical officer listened to the all-party group’s advice in the inquiry that we held when we published our report at the end of 2015 and that the guidance is now right and advises women not to drink at all if they are pregnant or planning to conceive. NICE caught up last year, but many people, including some health professionals, still regard the previous guidance as relevant. There is a question mark for many. They think, “If the advice previously was one or two drinks, maybe it’s still okay”. It is not, and we need to make that clear.

The country has a history in this respect going back many years. A glass of Guinness used to be thought a good idea for pregnant women because of the iron.

[Lyn Brown]

And red wine.

[Bill Esterson]

My hon. Friend says red wine too.

I described some of the symptoms to a constituent of mine in his 60s, and he said, “That’s me”. That will have been a result of the culture and the advice about it being okay to drink. We need a sea change in that culture, which is so deep seated, in order to end the misapprehension. A baby’s liver matures later in pregnancy than other parts of the body and so cannot process alcohol. When mum drinks, so does the baby. People have to understand this. The problem is that much of the damage is likely to be done early in pregnancy. There is a video on the internet of an embryo that is introduced to a drop of alcohol. It stops moving for two hours. Goodness knows what damage is done in that time by one small drop of alcohol. People do not understand the risks they are taking. In that regard, the intervention from the hon. Member for East Worthing and Shoreham (Tim Loughton) was very welcome.

Nicola Blackwood, in a Westminster Hall debate on 2 February 2017, talked about improvements to industry labelling, and guidelines were issued in March 2017, but I am afraid it simply has not changed. It is not good enough. The labelling is not clear. It is still small. People do not understand it. We need to improve on that. That was a subject of my ten-minute rule Bill in 2015. Please can we have improvements there.

Nicola Blackwood also said in that debate:

“Health professionals are supposed to discuss it with pregnant women”.

We need to ensure that health professionals put much more emphasis on the issue and to consider the impact across the wider population. There should be greater understanding and awareness in the drinks industry. The industry makes great progress some of the time, but where are the notices in our pubs and restaurants telling people about the dangers of FASD? I want to know what happened to what the then Minister said in that debate, because we have not seen much progress. I think it was the Minister present, the Under-Secretary of State for Health and Social Care, the hon. Member for Winchester (Steve Brine), who responded to my hon. Friend the Member for Swansea East (Carolyn Harris) just a few weeks ago about the duties of midwives and other professionals. It is great that we have the duties, but what are the outcomes? That is something that needs to change.

I want to hear the Minister’s response, but I have one or two more comments. Sadly, women sometimes consume alcohol before they know that they are pregnant, and damage may be done during that early period, but others are unwilling or unable to stop drinking alcohol while pregnant. The damage to babies, the impact on families, the long-term effect, the direct costs to the public purse, and the lost productivity from FASD sufferers and carers are real problems for this country. It is a hidden epidemic, and it is time that it was out in the open. It is time that we had the full information. I said that I want prevention and greater support, so let us get the advice out there. I am sure that the Minister can make a lot of progress in that regard.

This is too big just for good intentions. Those suffering from FASD need firm commitments and action. This country has the fourth-highest prevalence of FASD in the world. Canada has invested 1.1 million Canadian dollars just for indigenous children who suffer from FASD. We have money going into dealing with alcohol-related problems, but not directly into FASD, so perhaps the Minister will take that away and consider it. FASD is an entirely preventable problem, and it is the biggest cause of disability in the UK. Minister, your move.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

Nobody has ever handed over to me that way before, but I like it. I was just saying to the Whip on duty that I should congratulate the hon. Member for Sefton Central (Bill Esterson) not just on getting this debate, but on his consistent record of campaigning in this area over many years. I am sorry that that came about due to bad personal experience, but I hope that his two adoptive daughters are okay and are proudly watching him do his work in the House tonight.

I thank the hon. Gentleman for all his work to raise awareness of the condition through the all-party parliamentary group on foetal alcohol spectrum disorders. I chaired many APPGs when I was on the Back Benches, and I always say—I make no apologies for repeating it—that so much good work in this House goes on in APPGs. There is so much expertise, and they do not get enough awareness in the public or in this House, but they should. The hon. Gentleman has certainly helped with that tonight.

It is true that we do not know enough about the extent of FASD. The recent Bristol screening tool study suggests that between 6% and 17% of people in the general population could be suffering from FASD, but I suspect that that is an underestimation. The study is an important contribution but, even as its authors acknowledge, there are limitations to the data, and its prevalence estimates should be treated with caution. There is no question that the hon. Gentleman is right that more needs to be done to clarify the true prevalence of FASD, and the Department will consider future research in this area—I take the hon. Gentleman’s challenge. We do know that the impact of FASD can be severe, with the lifelong physical, behavioural and/or cognitive disabilities that he mentioned. Unfortunately, there is no cure, but we know that early intervention can help improve a child’s development and help them to lead an improved life. The hon. Gentleman made well the point that FASD does not just affect babies.

Touching on prevention, the hon. Gentleman will know that it is one of the key priorities of the new Secretary of State for Health and Social Care, which is music to my ears as the Minister for Public Health, Primary Care and Prevention. The hon. Gentleman is right that FASD is an entirely preventable condition, so that makes my ears prick. Prevention is vital, and the all-party parliamentary group has made it the fulcrum of its work to raise awareness of the dangers of drinking in pregnancy in order to protect future generations from an entirely preventable condition.

First and foremost, we need to be absolutely clear to women about the facts on alcohol so that they can make well-informed decisions. That applies both before they become pregnant and when they come into contact with the health system—in primary care we call it making every contact count. The UK chief medical officer, Professor Dame Sally Davies, with whom I work closely, published low-risk drinking guidelines in 2016, which provide very clear advice to women not to drink alcohol if they are planning for pregnancy or if they are pregnant. Public Health England, for which I have ministerial responsibility, reinforces that advice through its public health messaging, both global and targeted.

We have been very clear with the alcohol industry that we expect the guidelines to be reflected on the labelling of all alcoholic products, and we have given the industry until September 2019 to ensure that its labelling reflects the updated guidelines. The industry knows that I will be watching it like a hawk.

There is also central advice through NHS.uk and other media platforms such as our Start4Life branding to inform women of the dangers of drinking during pregnancy. Of course, all upper-tier local authorities in England are now public health authorities. As part of their local public health duties, they rightly continue to educate the public about the dangers of alcohol during pregnancy, and it is encouraging to hear about initiatives such as “Be your baby’s hero, keep alcohol to zero,” which is one of my particular favourites. In Blackpool, of all places, areas of high alcohol use in pregnancy are being targeted to stop future cases of FASD. Be your baby’s hero, keep alcohol to zero—I just like saying it.

Once women are pregnant, they generally come into contact with health services frequently, which gives many opportunities for healthcare professionals to give advice on alcohol. As I mentioned at Health and Social Care questions this week, there are many campaigns on diet and nutrition, and health professionals are very aware of the dangers of drinking. Cancer Research UK has been helpful on this issue, and it is very aware of the dangers of drinking alcohol during pregnancy. The key thing is that pregnant women are given consistent messages, delivered in a supportive, non-judgmental way. The same goes for obesity, another area for which I am responsible. Messages about being overweight should be delivered in a supportive way and alongside a call to action, and many primary care professionals find that difficult, which I understand. It is easy for us to say, “Well, they should just mention it,” but it is not quite so easy.

Midwives and health visitors have a central role in providing clear, consistent advice and early identification and support, and they are well equipped to do it supportively. We are reinforcing that role through a number of strategies. Through the maternity transformation programme, the Department is working with NHS England, Public Health England, the Royal Colleges and a range of charities such as Sands, the stillbirth and neonatal death charity. The House will be well aware of Sands, which does such good work to promote safer maternity services. This programme covers a range of initiatives, which include raising awareness of the known risk factors among pregnant women and health professionals, as the hon. Gentleman has asked for. This will ensure that women receive consistent, supportive advice on how to minimise the risk of stillbirth, including the importance of healthy eating and of not smoking—I am responsible for the tobacco control plan—or drinking alcohol during pregnancy.

The National Institute for Health and Care Excellence has updated its guidelines to reflect the CMO’s advice not to drink during pregnancy. The Department will continue to work with the Royal Colleges—I was with the head of the Academy of Medical Royal Colleges last night—and various other regulatory bodies to raise the profile of the CMO’s guidelines and to recommend that they include those guidelines within their training, which the hon. Gentleman has consistently asked for.

[Bill Esterson]

I appreciate the tone and content of the Minister’s response so far. I neglected to ask him about the alcohol strategy. Will he say a few words about his intentions to include action on FASD in that strategy? That would be an extremely important and welcome step for those interested in this subject.

[Steve Brine]

I do not directly own the alcohol strategy, but obviously I am involved in it. I take the hon. Gentleman’s challenge on board, and maybe we can discuss it further. I know he has stuff he wants to feed into the strategy—he has produced it through the all-party parliamentary group—so perhaps we can discuss it further. I can then discuss it with my ministerial colleagues in the Home Office. It would make absolute sense to do so as part of the strategy, and I suggest linking it to our Green Paper on prevention, which we will be bringing out this year. His question is spot on.

I will now touch on services for affected families. We know that FASD can have a huge impact on the early years development of children and on their life chances, and the hon. Gentleman gave a number of good examples. We also know that early intervention services in this area, as in every area, can help to reduce some of the effects and, therefore, the secondary disabilities that come as a result. The responsibility for commissioning services in this space lies with the clinical commissioning groups in England, working together across all different sectors of the local health economy. We have heard of cases of long waiting times for a diagnosis. My Department will consider how we can improve access to these services and a diagnostic pathway, but we also need to learn from best practice. The Tameside and Glossop Integrated Care NHS Foundation Trust has developed the maternity alcohol management algorithm pathway—why can people not come up with something snappier, like that first one? It has introduced screening and awareness of FASD, enabling what we think is effective early intervention. Just as the long-term plan gives different examples on smoking, with the Canada example on challenging smoking rates among pregnant women, I am interested in the best practice ideas and that trust has a lot to bring in this space. The Surrey and Borders Partnership NHS Foundation Trust has a specialist centre, although sadly it is the only one in England. The trust provides a comprehensive and rapid diagnostic pathway for those with FASD and it has a lot to share from its journey and with its ideas for service delivery, and on the success it has had.

[Bill Esterson]

The Minister mentions Surrey and Borders, and I have had significant interaction with Dr Raja Mukherjee, the specialist who runs that centre. I am glad the Minister acknowledged that it is the only one in the country. May I encourage him to intervene to make sure we have such centres right across the country, as that would make a massive difference?

[Steve Brine]

The hon. Gentleman can certainly encourage me in that regard, and I will look at that in terms of the prevention paper. We would have to be guided by the clinicians and the CCGs on where they would see the greatest need for that provision to be. That is very much the spirit of the long-term plan, but it is not ideal that that centre is the only one. Surrey is near my constituency, but a long way from Sefton.

Finally, I wish to touch on the wider departmental policy engagement in this area. Our deputy chief medical officer, Gina Radford, has held roundtable meetings on the subject, which considered the future development of policy to improve prevention and support. I do not know whether the hon. Gentleman has been involved in that. These meetings were attended by experts in the field and, crucially, FASD service users. I thank NOFAS UK—the National Organisation for Foetal Alcohol Syndrome-UK—which has been helpful in supporting and contributing to these meetings, along with other charities working in this field. We are also providing wider support to children and families affected by alcohol misuse, through the children of alcoholic dependant parents programme, which I am proud of. It was one of the first thing I got to announce in this job. The previous Secretary of State working as one with the current shadow Secretary of State had managed to do this, which shows that cross-party working can happen in this Parliament between the two main parties—and there were no preconditions to it.

Hospice Funding and the NHS Pay Award

Bill Esterson Excerpts

Wednesday 31st October 2018 Westminster Hall

[Liz McInnes]

St Christopher’s Hospice got in touch with me about this debate, so I have had some communication with it about the problems it is experiencing. Sadly, those problems are replicated in hospices up and down the country, and it is important that we find a pot of funding to finance the NHS pay award.

[Bill Esterson (Sefton Central) (Lab)]

Queenscourt Hospice serves my constituents and their families and carers. Like all hospices, it plays an incredibly important part in delivering NHS services, but it can only play a full part if it is fully funded. It faces a £250,000 increase in its wage bill in order to do just that. Is it not the point of this debate, which the Government have so far refused to engage with, that unless that money comes from central Government, those hospices, including Queenscourt, will not be able to continue to provide the vital services they provide now?

[Liz McInnes]

My hon. Friend makes an important point: hospices seem to be facing a choice of asking the community to give them extra money, or reducing the service they provide.

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Matt Hancock]

My right hon. Friend identifies a critical factor in improving the future of the NHS, which is to have stronger leadership at all levels, to be able to support innovation and to find out the best that is happening elsewhere and bring it to trusts. I know he has a particular interest in that, and I look forward to working with him on it.

[Bill Esterson (Sefton Central) (Lab)]

Foetal alcohol spectrum disorders mean permanent brain damage. In the United States, studies show that one in 20 children are affected. So when will this Government carry out their own prevalence study, so that we can confirm the extent of this entirely preventable disability in the UK?

[Steve Brine]

Public Health England collects some data on foetal alcohol syndrome, but we recognise that the data do not reflect the range of FASD. These disorders are difficult to diagnose, which is why we are engaging experts and those affected to explore what more could be done to improve our understanding.

GP Recruitment and Retention

Bill Esterson Excerpts

Wednesday 28th March 2018 Westminster Hall

[Bridget Phillipson]

The hon. Gentleman raises a fair point about patchiness, and I hope the Minister will be able to respond to it in his summing-up. There are big regional variations, and differences even within cities and towns, and we need to try to even out access to general practice. He raises an important point about routes into the profession and the barriers that they sometimes place in the way of those seeking to work in general practice, and I hope the Minister will say a bit more about what the Department will seek to do to take away some of those barriers.

[Bill Esterson (Sefton Central) (Lab)]

In my constituency, just yesterday, a practice in Hightown that had been earmarked for closure was saved at the eleventh hour thanks to a vigorous campaign by residents, the local authority and the parish council. Does the experience of Hightown, which is no doubt repeated elsewhere, not show that the damage done by the reorganisation of the NHS from 2010 onwards has caused real problems in GP services up and down the country, and that the Government need to get their act together and address the shortage of GPs for communities in all our constituencies?

[Bridget Phillipson]

I am happy to hear that my hon. Friend was successful in his campaign, but we are seeing closures and mergers of practices across the country, and we need a much broader solution. It should not fall only to local campaign groups or local NHS managers to try to put right some of the broader systemic problems in our health service.

Oral Answers to Questions

Bill Esterson Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Speaker]

Well, if there are to be more GPs, they will have to be paid.

[Bill Esterson (Sefton Central) (Lab)]

Patients at Hightown GP surgery were promised that their surgery would stay open, but, out of the blue, they were written to and told that the surgery would close on 8 June. The Government are belatedly taking action on the shortage of GPs, but will the Minister intervene to make sure that Hightown surgery is kept open and that a promise is kept to patients?

[Steve Brine]

I will look at Hightown surgery, and if the hon. Gentleman wants to talk to me about it, he is welcome to do so. Of course it is the responsibility of his clinical commissioning group and NHS England in his area to provide primary care services for the patients who are his constituents, but if wants to talk to me further, I am very happy to do so.

Woodlands Hospice, Aintree

Bill Esterson Excerpts

Wednesday 7th February 2018 Commons Chamber

[Dan Carden]

I am delighted to agree. This is a great opportunity to thank all those staff and volunteers, wherever they are across the UK.

[Bill Esterson (Sefton Central) (Lab)]

My hon. Friend was describing the excellent work that goes on at Woodlands Hospice, and my constituents benefit from that as well. In addition, the hospice provides “Hospice At Home”, helping people out in the community. The combination of services is vital to supporting the national health service. Does he agree that failing to support hospices, including Woodlands, is very damaging and undermines the national health service?

[Dan Carden]

Absolutely, and I am coming to how the hospice sector is such a key part of our national health service.

It was a privilege to learn about the work of the wonderful staff and, importantly, the volunteers. More than 125,000 people give their time to volunteer for hospices each year. They are the lifeblood of the hospice sector. The Woodlands’ volunteer workforce of over 200 people from all walks of life and all ages add value to the patient experience, while the volunteers themselves get opportunities to develop their skills, avoid isolation and build a sense of community.

Woodlands Hospice must raise £1.3 million, which it tries to achieve with the help and support of communities in my constituency and beyond, but against the backdrop of financial uncertainty and squeezed living standards, that is no easy feat, particularly in more deprived communities such as mine, which have been hardest hit by austerity. I will return to the issue of funding later, but there are a number of ways our community supports Woodlands that do not involve straightforward cash donations: volunteering, undertaking challenge events for sponsorship, holding coffee mornings and—this year, I hope—becoming a friend of Woodlands via the new membership group scheme, which I will be taking up myself as soon as it is operational.

The support for Woodlands shown by my constituents illustrates how dearly we hold the care it provides. All Members here know how much their constituents value the care provided by hospices in their own local areas. That is what inspired me to call this debate tonight—to highlight the value of hospices as an essential part of the healthcare economy and to look at sustainable funding for hospices around the UK, particularly in the more deprived areas. It is right that those in more deprived areas, who will struggle to raise funds, receive more statutory funding.