Trade Bill

Debate between Bill Esterson and Steve Brine

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Monday 20th July 2020 Commons Chamber

[Bill Esterson]

I am grateful to the hon. Gentleman for raising that point about Northern Ireland. When the Bill was published, the Government were sticking to the mantra that there would be no border. How the new arrangements will operate in Northern Ireland and the impact on the UK is exactly why there needs to be proper scrutiny of the agreements and their impacts.

The Trade and Agriculture Commission is advisory, not regulatory. It has no teeth. It is not representative. It does not report to Parliament. It cannot enforce import standards and it will be gone again in six months’ time anyway. It cannot stop changes to food standards if the Government agree them in a trade deal with the US because it does not have any teeth. The hon. Member for Tiverton and Honiton (Neil Parish) said that he had been led up the garden path by the Government on the Agriculture Bill. The Government should lead him and his colleagues back down again, accept his new clause 4 and our new clause 11, and guarantee them in primary legislation. Mega-farms in the United States and Australia stand to benefit from any lowering of animal welfare and production standards. When we banned sow stalls in the UK, we had to admit pork from countries that had not caught up with our standards. What happened? Half our pig farmers went bust. If we were to accept chemical-washed chicken, our poultry industry would go bust, too. It must not happen again.

Public health, animal welfare and food production are inextricably connected. Hormones in animal feed may cause cancer in people. Industrial farming techniques affect the environment and global warming. In the middle of a global pandemic, minds should be concentrated. The use of antibiotics in farming is linked to the ability of diseases to jump between species. A coalition of businesses, unions, consumers, environmentalists and civil society is warning of a democratic deficit. The coalition is headed by the International Chamber of Commerce, which states:

“We no longer live in a world where trade can be treated separately from our international commitments on issues such as climate action, digitisation or building a more resilient health system. The public need to feel confident that trade decisions and processes are working for them and the Bill is a good opportunity to embed a more transparent, consensus based, democratic approach that clearly demonstrates a net benefit to all. It’s an opportunity to set a new gold standard.”

[Steve Brine]

Will the hon. Gentleman give way?

[Bill Esterson]

I am not going to take any more interventions because I am about to finish.

I said at the start that the Bill is really about social responsibility, environmental protection and democracy. The lack of scrutiny threatens to leave the NHS wide open to pharmaceutical giants and to undermine farmers and consumers. Chemical washes of chicken, hormones in beef, ractopamine in pork and GM crops are banned in the UK. What is wrong with keeping it that way? If the Government are saying, “We are going to do it anyway”, what is the objection to putting it all in primary legislation? The trouble is that we all know what is really going on here: they do not want to put protections for our NHS farmers and consumers in law or take the action needed on the climate crisis, because they have no intention of keeping their promises.

Foetal Alcohol Spectrum Disorder

Debate between Bill Esterson and Steve Brine

Thursday 17th January 2019 Commons Chamber

[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.

--- Later in debate ---

[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.

Oral Answers to Questions

Debate between Bill Esterson and Steve Brine

Tuesday 23rd October 2018 Commons Chamber

[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.

Oral Answers to Questions

Debate between Bill Esterson and Steve Brine

Tuesday 20th March 2018 Commons Chamber

[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.