E-cigarettes

Bill Grant Excerpts

Thursday 31st October 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate my friend, the right hon. Member for North Norfolk (Norman Lamb), on securing this important debate.

E-cigarette use in the UK has followed a gently rising trend over the past few years, and last year, statistics from the Office for National Statistics showed that 6.3% of those over 16 were regular users—a rise of less than 1% over five years. In our August 2018 report, the Science and Technology Committee concluded that e-cigarettes should not be viewed in the same way as conventional cigarettes. They are an effective stop smoking aid and should be formally considered as such.

In its response to the letter sent on behalf of the Committee by the Chair, Public Health England confirmed that it believed, as the Committee did, that e-cigarettes are around 95% less harmful than conventional smoking. As our Committee found:

“A medically licensed e-cigarette could assist smoking cessation efforts by making it easier for medical professionals to discuss and recommend them as a stop smoking treatment with patients.”

Existing smokers should be encouraged to give up, but if that is not possible, they should switch to e-cigarettes as a considerably less harmful alternative.

We must acknowledge that there are uncertainties about the longer-term health effects of e-cigarettes. They have not been in circulation long enough for any scientific research to be certain. Concerns have been raised in the United States, as was mentioned, about an isolated outbreak of serious lung injury linked to illicit vaping products, but I suspect, as the right hon. Gentleman said, that there may have been other factors at play in that instance. In any event, we have not seen that replicated in the UK, largely because, as ASH confirms, we have a strong regulatory system in place, which is not yet the case in the US.

The Government mandate strict conditions, namely a minimum age of sale, a ban on advertising in broadcast media, print or the internet, and a stipulation that products containing over 20 milligrams per millilitre of nicotine need a medicinal licence. Products must also be child-resistant and tamper-evident, and packs must carry a health warning covering over 30% of the surface area.

Moreover, to be balanced, any judgement on the future of e-cigarettes must take account of human nature and the most likely alternative to vaping, namely returning to harmful conventional cigarettes, which have proven to be a serious health risk over time. While some groups would prefer the firmest possible line—Cancer Research UK, for instance, is pressing for a tobacco-free UK within the decade—most groups agree that e-cigarettes can provide a useful route towards quitting harmful conventional cigarettes.

We have seen clear evidence that e-cigarettes are an effective quitting aid for adult smokers and, crucially, the percentage of young smokers trying e-cigarettes in Britain is small, with continued use smaller still. They flirt with the e-cigarette, but do not continue with it. There is little evidence to suggest that such products act as a gateway to conventional smoking—they are not, as some would suggest, a stepping-stone to conventional smoking—and figures show that almost 3 million people in the UK today are using e-cigarettes as an aid to quitting harmful conventional cigarettes.

Unfortunately, the Committee found that some aspects of the regulatory system for e-cigarettes are holding back their use as a stop smoking measure. Restrictions on the strength of refills and maximum tank size have led some users to move away from e-cigarettes and return, sadly and regrettably, to conventional smoking. There seems to be little scientific basis for these limits, and I am pleased that the Government, in response to our report, intend to consider these anomalies and how to address them. It is good to see that the Government also agree with our conclusion:

“There should be a shift to a more risk-proportionate regulatory environment; where regulations, advertising rules and tax duties reflect the evidence of the relative harms of the various e-cigarette and tobacco products available.”

Such a move might well bring about the welcome improvements in health that we, as a society, desperately seek, particularly from lung cancers and other by-products and unintended consequences of smoking. It is proven beyond doubt that conventional smoking is harmful. I look forward to seeing those changes implemented.

I take this opportunity to speak directly to conventional smokers. Despite being a fire officer for 31 years, sadly I was a 50-a-day smoker for many years, although I have long since stopped. Believe me: being a smoker was a costly, smelly and unhealthy mistake in my life. I only realised that afterwards. Yes, I enjoyed my cigarettes then, as the smoker today does. Even in my time in the fire service, when I left a fire with my breathing apparatus on and pulled the face mask off, some kindly colleague would have a pre-lit cigarette for me. It was certainly madness at the time, and I indulged in it. It is not easy to stop, but anything that is good is not always easy. Believe me, it can be done. My plea to those who do smoke is: you can stop if you put your mind to it, and it is absolutely worthwhile.

[Norman Lamb]

The hon. Gentleman kept that information very quiet on the Select Committee.

[Bill Grant]

It is something to be neither proud nor ashamed of. It was part of the culture of the time. I was part of that culture. There are two things in life that I have never regretted: marrying my wife, Agnes, and giving up smoking. They are equally wonderful.

I have had the pleasure to serve on the Science and Technology Committee since shortly after I was elected to this House, and it has been a fascinating and often inspiring journey. I am incredibly proud of the work we have undertaken as a Committee, ably assisted by a very fine secretariat, and I wish to put on record my thanks to them for their support. Indeed, as my friend the right hon. Member for North Norfolk and I both intend to retire at the forthcoming election, this will be our last debate together, and I wish to thank him for his fine stewardship over the two years.

Oral Answers to Questions

Bill Grant Excerpts

Tuesday 29th October 2019 Commons Chamber

[Matt Hancock]

The NHS is off the table in trade talks and pharmaceutical pricing is off the table. Transparency over pharmaceutical pricing would not benefit this country at all because we get the best deals in the world because we can keep them confidential, so it is a slight surprise to hear a Labour Member argue for what would effectively lead to higher prices for drugs in the NHS. Instead, we will protect the NHS.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

5. What recent assessment he has made of the merits of using genomics in healthcare.

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

We are world leading in genomics and should celebrate that. A recent trial at Addenbrooke’s Hospital in Cambridge provided whole genome sequencing, identifying underlying genetic conditions for babies and children in intensive care. As a result, three quarters of those young patients received changes to their care. The NHS genomic service is working to embed genomics in routine healthcare. Later this year, the national genomic healthcare strategy will set out the ambitious programme for the next 10 years.

[Bill Grant]

With increasing direct-to-consumer genomic testing by private companies, can my hon. Friend advise what assessment has been made of the potential impact of self-referrals on NHS services?

[Jo Churchill]

Patients who need a genomic test from the national genomic test directory will be referred to the NHS genomic medicine service. However, I recognise that some patients may contact their GP for advice after taking a commercial test. NHS England is working with partners to ensure that GPs receive training to help them respond correctly. Public Health England and the National Screening Committee have also published guidance on private screening.

The National Health Service

Bill Grant Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Dr Whitford]

Well, I am afraid that it was the Labour party that set up independent treatment centres. I am a surgeon, and one of the issues was that such centres were sucking away the routine elective work that contributes to training future surgeons, and leaving the NHS to deal with the complex, chronic, expensive cases. Before the Health and Social Care Act, the NHS usually managed to find enough money down the back of the sofa that, at the end of each year, it would have about £500 million left. After the changes, it was £100 million in debt, £800 million in debt, and then £2.5 billion in debt. That is because money is sucked out in all these different ways, leaving a lack of funding that leads to rationing, which is pushing people to have to pay for more of their own care. We are hearing about that with co-payments—paying for a second cataract operation or for a second hearing aid. My Choice, which the Health and Social Care Act also brought in, raised the cap from 2% to 49% of income that an NHS hospital could earn through private patients. The highest amount at the moment is over 27%.

The idea that that does not impact on NHS patients is nonsense, because surgeons have limited capacity in terms of who they can operate on during the day, so if someone is able to jump the queue within the NHS, they are taking someone else’s place. As we saw with Warrington and Halton Hospitals NHS Foundation Trust, price lists have been pinned up in clinics suggesting to people that they might want to pay £7,000 or £8,000 for a hip or knee replacement, and there were also a lot of cosmetic and minor operations. I would gently suggest, as a surgeon, that surgery is not a sport. Either the patient needs an operation clinically, in which case it should be provided by the NHS, or they do not, in which case they should not be able to buy it from the NHS. Under the principle of My Choice, hugely high thresholds are being set. In the case of some CCGs, a person has to have had two falls before they can have a cataract operation, or they have to be in pain, even in bed, to get their hip done. That is driving families to club together to address that. That is not right. If someone needs it, the NHS is meant to provide it free at the point of need, and if they do not, every single operation is a risk and should never be done to attract income for an NHS trust.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

I value the hon. Lady’s comments about how money is being sucked out of the NHS. In Scotland, we have a particular issue with a large showpiece hospital in Edinburgh that should have been opened in 2012, seven years ago, that is sucking money from the NHS—millions of pounds annually over the past six or seven years. She may wish to comment on that.

[Dr Whitford]

Well, it has not been sucking money for the past six or seven years because it was only declared open in February. I totally agree that it is a huge setback that, due to a failure within the health board’s tendering process for the build, it did not recognise the need for the level of ventilation in an intensive care unit. I would gently suggest to the hon. Gentleman that I do not think he would have wanted our Cabinet Secretary to simply go ahead putting babies and children in an intensive care unit where the ventilation was not considered safe.

In Scotland, so far our funding for the NHS has doubled in the past 10 years and will actually increase further next year. But it is not just about funding; it is about structure. What is happening in NHS England is fragmentation. It is not just that NHS hospitals are competing with private companies; they are competing with each other, and that undermines collaboration. We need to have collaboration, with the patient at the centre. Anything that fragments or undermines that collaboration is weakening the quality and safety of care.

Living with Dementia

Bill Grant Excerpts

Tuesday 25th June 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship, Mr Paisley. I thank the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this important debate, in conjunction with the hon. Member for Cambridge (Daniel Zeichner) and the Backbench Business Committee.

Hon. Members should be dismayed to learn that, according to a recent survey, 98% of the 2,521 respondents felt that those with dementia were treated differently from people with other health conditions or disabilities. Some even found that employers would not make reasonable adjustments to the workplace. Those respondents believed that they were discriminated against, facing unnecessary stigma and often negative attitudes. It is a worrying statistic given that, apparently, 850,000 people in the UK live with dementia. Indeed, 70% of care home patients live with the condition.

Media coverage of the condition tends to occur only when it befalls a prominent person in public life, when relatives have the courage to publish their experiences, as the TV presenter Sally Magnusson in Scotland did in relation to her mother, or when a member of the public sadly goes missing and the police issue an urgent appeal for help in locating them. It is important that we raise wider and more regular awareness of a condition that appears to be on the increase throughout the United Kingdom.

[David Simpson (Upper Bann) (DUP)]

I apologise for being late to this debate. Last November, my father passed away. He was a sufferer from dementia and, while he got fantastic care, we found as a family that there was a lack of staff with the experience to diagnose dementia, because there are different stages and diagnoses. Does the hon. Gentleman agree that one area that is forgotten about is young carers, who have to dedicate a lot of their time to looking after their parents while still keeping up their studies? We seem to forget about them.

[Bill Grant]

The hon. Gentleman is right that we often seem to overlook the young carers. In my family, we have experience of hosting my mother-in-law. I was very fond of her, but we had two or three months of hosting her, and despite having two daughters who are nurses, what a challenge that was in my life and that of my wife. We thought we knew about dementia, but we knew nothing about it until we walked for several months with my mother-in-law, who I was very fond of.

When I served as a councillor in South Ayrshire, one of my colleagues, Councillor Hugh Hunter, and others were active in ensuring that the needs of dementia sufferers and their carers were to the fore. In his council area, in 2016, a dementia-friendly project was launched, with the laudable aim of building a community that supports people with dementia, enabling sufferers to remain in their community for as long as practicable and reducing the stigma. Indeed, in the constituency of the hon. Member for Central Ayrshire (Dr Whitford), which borders mine, is the Carlton Hotel, one of the first in Scotland to provide a dementia-friendly bedroom. I think she and I would both agree that that is delightful, and I give credit to that hotel and others that do the same.

In 2015, the UK Government launched the Dementia 2020 challenge, a vision for dementia care, support, awareness and research, which includes awareness training for NHS and care staff. I understand research spending is around £60 million a year to 2020, but not beyond. Four years on, I wonder whether the Minister might provide us with an update and an outline of what the future might hold for those with dementia and—equally importantly, as was said earlier—their carers.

In particular, I am sure sufferers and carers would be grateful for more detail on the proposed Green Paper on a new social care policy, especially the Alzheimer’s Society’s desire for a dementia fund to afford financial support for the very real additional costs associated with dementia treatment and care. An update on the Accelerated Access Collaborative introduced last year, which enables patients to benefit from rapid uptake products, breakthrough medicines and technologies with the greatest potential to change lives, would also be welcome. I know an update would be gratefully received by many of my constituents and others elsewhere in the United Kingdom.

I very much welcome the fact that mental capacity legislation should enhance safeguards against deprivation of liberty and ensure that those living with dementia have a person to advocate on their behalf. However, the Government could further assist by making form filling easier and considering whether there is truly a constant need for reassessment, given that dementia is sadly a progressive condition for which there is currently no effective cure.

All our Governments and other organisations must ensure that those living with dementia are able to do so with dignity, respect and, most importantly, compassionate care, to remain safely independent for as long as is reasonably practicable. The Alzheimer’s Society’s mantra that everyone affected by dementia should feel part of—not apart from—society sums the situation up. It is to be commended for encouraging more than 2 million people to sign up as Dementia Friends, and its informative website is truly well worth a visit.

During Dementia Action Week last month, I belatedly became aware that some stores in Ayr—a town in my constituency—such as Specsavers, have several Dementia Friends on their teams. Hopefully this small step will be a growing trend in retail, hospitality and, equally importantly, transport throughout the UK, to extend that hand to those living with dementia who need that wee bit of extra help.

Acquired Brain Injury

Bill Grant Excerpts

Thursday 9th May 2019 Commons Chamber

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to follow the hon. Member for Swansea East (Carolyn Harris).

I note and welcome the valuable work of the all-party parliamentary group on acquired brain injury, including its most recent report. I agree that Governments together need to lend their support and implement, where reasonably practicable and borne out by evidence, the measures that will bring about improved neuro-rehabilitation for those with acquired brain injury. About 1.4 million people in the UK are living with a brain injury. According to Headway Ayrshire and as has been mentioned, every 90 seconds someone in the UK is admitted to hospital with an acquired brain injury, and in 2016-17 some 1,816 people with a diagnosis related to acquired brain injury were admitted to hospital from the Ayrshire and Arran area within which my constituency lies. These are large figures and very worrying statistics.

It has been acknowledged that more persons are surviving trauma to the brain, which may occur after birth or because of disease, an accident, sport, military service or a criminal act. Let me stop for a moment on the question of accidents. Having spent 31 years in the fire service and attended numerous needless road accidents, I commend those who created, invented and install airbags—we have no measure of the number of brain injuries that they have prevented—and the Governments who introduced the compulsory wearing of seatbelts and of crash helmets. The number of people saved from accidents by that is wonderful. I will leave this hanging for a moment, but would it be possible and worth considering the compulsory wearing of safety helmets for cyclists? I am sure that that would reduce brain trauma injuries in the future.

Those people’s survival is to be welcomed, although regrettably some could have a degree of disability and might have a different persona, which can prove difficult for all to cope with. The individual and their families undoubtedly need an informed and readily available bespoke support package. The onus is on us to enable these individuals to regain their dignity, which they so richly deserve, and to have an active role in our society, which is their society as well.

To date, rehabilitation provision for in-patients and those returning to the community appears to have been sadly lacking, or, when it is provided, of varying standards and not always in line with those narrated by the National Institute for Health and Care Excellence, NHS England’s best practice tariff and the all-important person-centred rehabilitation prescriptions. Those prescriptions are so important to that individual, their family and their carers.

I support the desire for a specialist acquired brain injury rehabilitation consultant who would guide, oversee and co-ordinate matters. Oversight and co-ordination appear not to be as good as they could be. That is not to detract from the excellent work of charities mentioned in the Chamber this afternoon, such as Headway Ayrshire, which is part of Headway, the brain injury association, raising public awareness and working to improve life after brain injury by providing simple things like information on where people go for help. When someone puts their hand out for help, someone has to grasp it, and in many ways Headway does that, providing advice and support to the person, their family and their carers. Having previously sat on that charity’s local board, I have seen for myself how it is able to benefit my constituents and many throughout the UK in other branches of Headway. I thank Headway—its staff, volunteers and those who raise money for it—and welcome the contribution and support it gives individuals.

In 2017, the Scottish Government’s community justice funding enabled Supporting Offenders with Learning Difficulties, also known as SOLD. SOLD was able to assist those with alcohol-related and acquired brain injuries out of the dreadful cycle of reoffending. The prison community often does not understand these issues.

[Sir John Hayes]

The hon. Member for Swansea East (Carolyn Harris) made an incredibly important contribution—as my hon. Friend is doing—highlighting that many people become involved in alcohol, gambling or some other pursuit, which would never have happened had they not had their brain injury. The Government need to look at that aspect of the issue, because the consequences of brain injury can be as unpredictable as that.

[Bill Grant]

I thank my right hon. Friend for that welcome intervention. It is easy to identify someone with a physical injury—the leg in plaster or the arm in a sling—but an injury to the brain is not visible, and we need to be aware of that.

Scotland has seen the development of a brain injury e-learning resource, created under the umbrella of the Scottish Acquired Brain Injury Network, with funding and technical support provided by the national services division of the NHS. Glasgow University’s excellent Centre for Rehabilitation Engineering also undertakes work on the neuro-rehabilitation of hand and arm functions, neuropathic pain and the possibilities of retraining the central nervous system after spinal cord injury or a stroke. I should also mention a facility from which I benefited: the Douglas Grant rehabilitation centre, which is operated by NHS Ayrshire and Arran. The centre gives confidence back to people who have been subjected to brain injury or nervous system injury. It also gives them back their ability to find their own way in life, and great credit is due to the staff there.

As was mentioned earlier, the effect of sports injuries involving concussion is not quite fully understood, but it is better recognised, particularly in rugby, but such injuries can also happen in football. There has been great success in football of late. Dare I mention Tottenham Hotspur and Liverpool? Perhaps clubs should invest some of their money protecting their valuable players—not for today or tomorrow, but for later in their life—from the consequences they may suffer. Football still has some way to go on that front.

We may still need to educate the educators to understand the hidden disabilities and lifelong consequences for young people with acquired brain injury. Medical science is leading to a better understanding of ways to address rehabilitation, and organisations are seeking to communicate what is available. However, it is vital that this work is co-ordinated, and that a holistic treatment plan and the functioning needs of acquired brain injury patients are considered and acted on promptly. This should not be delayed, waited for or pushed down the line; we have to respond timeously.

Some patients may reach a plateau, but for others sadly the condition may be progressive, so there is no one-size-fits-all approach for victims of acquired brain injury. We need to continue to build on the Government’s good work in achieving and maintaining specialist centres of excellence and enhanced community support services for persons with acquired brain injury, their families, and—let us not forget—their carers.

I ask the Minister to look favourably on further measures to support those with acquired brain injury, their families and carers, and to ensure that the Departments of all Governments communicate with one another to make contact for these service users easier. Communication and form-filling may be extremely difficult for people with acquired brain injury, as their concentration levels are often depleted. Ease of application—a simple thing—would be a great step forward, with Departments sharing information, instead of individuals repeatedly filling in forms and going back to repeat the process several times. It is, indeed, time for change.

Hormone Pregnancy Tests

Bill Grant Excerpts

Tuesday 23rd April 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful to the hon. Member for Bolton South East (Yasmin Qureshi) for securing this vital debate on what, for many people, has been a long journey.

Sir William Osler, an eminent Canadian physician, once said:

“Medicine is the science of uncertainty and the art of probability.”

My constituents who took the hormone pregnancy tests of the ’60s and ’70s, including Primodos—which was removed from the market in 1977—have to date been met with uncertainty. They placed their trust in those involved in manufacturing, testing, prescribing and dispensing—trust that in their view, and in mine, was betrayed. With dogged but dignified determination, they still seek to confirm the probability of a possible connection between those drugs and birth defects and/or fatalities.

I understand that Professor Carl Heneghan carried out a meta-analysis that backs up the findings of Professor Vargesson’s zebrafish study. While I appreciate that meta-analysis is a complex and comprehensive tool, my layman’s understanding is that it may be undertaken to review and reconcile multiple research studies on the same topic with different results. In doing so, it may uncover a study that has different results due to systematic error or bias in the research process. In response to a recent question posed by the hon. Member for Bolton South East, the individual answering on behalf of the Secretary of State for Health and Social Care stated that the Commission on Human Medicines expert working group did not undertake a meta-analysis as part of its review, citing different designs, lack of robustness and the extensive limitations of studies as the reasons therefor.

Dan Mayer’s text, “Essential Evidence-Based Medicine” advises the reader:

“Some common problems with meta-analyses are that they may be comparing diverse studies with different designs or over different time periods.”

However, importantly, the author does not appear to suggest that such circumstances should automatically rule out proceeding with meta-analysis. Rather, he states that such apparent divergence may be addressed by incorporating various checks and balances as part of that analysis. It appears that professors at the University of Oxford who have had sight of data recently recovered through a freedom of information request are yet again persuaded that there is an association between hormone pregnancy tests and birth defects, thereby casting doubt on the robustness of the EWG’s work and the material that it has published to date.

I note that the Government’s response referred to the European Medicines Agency’s ongoing independent review of the publication by Professor Heneghan and others, and I await the EMA’s conclusions with interest. Hopefully, those conclusions will finally bring some comfort to my constituents and many others. I ask the Minister to provide greater clarity as to why meta-analysis was ruled out by the EWG, and to confirm whether the EMA’s conclusions will be published next month. Finally, I make a passionate plea—which I am sure many others share—on behalf of the victims of hormone pregnancy tests in the ’60s and ’70s. Let us introduce honesty, openness and, above all, humanity into the long-standing journey that those individuals have been on.

Eating Disorders Awareness Week

Bill Grant Excerpts

Wednesday 27th February 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship this morning, Mr Bailey, and I thank my hon. Friend the Member for Angus (Kirstene Hair) for securing this important debate in Eating Disorders Awareness Week.

According to YoungMinds, one in 12 teenagers in the United Kingdom suffer from eating disorders, and about 25% of those with eating disorders are noted as being male. Statistics for 2017-18 recorded that 536 Scots were treated for eating disorders. Eating disorders are complex illnesses that take many forms, such as anorexia nervosa, which was mentioned earlier, whereby people erroneously believe that they are overweight.

The root causes of these disorders are unclear, but they may include things such as career choices. The biographies of many jockeys speak of crash dieting and sometimes dehydrating themselves with the aid of saunas, to reach a low weight prior to a race. The image of the ballerina is of a slight and fragile figure floating through the air. What must it take to maintain such a body image? In show-business, there are child stars of stage and screen for whom the limelight proves too much, or perhaps they fear losing popularity during the transition to adulthood. How will growing up affect their future career?

It is important not to stereotype and to be alert to the fact that eating disorders befall people regardless of their age, gender, race, or socioeconomic circumstances. What is clear are the dangers associated with the resulting malnutrition and the serious complications, such as osteoporosis, low blood pressure, heart failure, oedema and anaemia. Anorexia can be life-threatening; it is one of the leading causes of deaths related to mental health problems. Every single such loss is a tragedy for the individual themselves and their family—indeed, the unnecessary loss of a life is also a tragedy for the nation.

Binge eating is characterised by an uncontrolled addiction to food, involving over-eating and exceedingly fast eating in secret, whether the person is hungry or not. And bulimia is a combination of the worst elements of both anorexia and binge eating.

Encouragement to seek treatment at the earliest opportunity will no doubt enhance the chances of recovery, which very often is a long-term process, requiring an immense amount of support from professionals and family members. However, as with any addiction, the person must acknowledge their problem—in this case, unhealthy eating—and they themselves must want to seek assistance. Anxiety and depression are common threads, whether as a cause or a result of an eating disorder.

I acknowledge the good work of the child and adolescent mental health staff of NHS Ayrshire & Arran, but from the complaints I have heard at surgeries from my constituents about waiting times for appointments, it is clear that the numbers of those much-welcomed professional staff do not match society’s demand for their time and support. When individuals with eating disorders reach out for help, we as a society must grasp that hand and be there for them. I welcome the new guidelines for Scotland announced at the beginning of this week, which it is stated will assist in providing a range of approaches to mental health issues, ensuring that help is available when and where it is needed.

In closing, I ask both Governments to continue providing vital funding for much-needed support services for persons afflicted with eating disorders and their heartbroken families—heartbroken does not sum it up; it does not describe the agony and the pain that those families go through. I also ask them to consider whether there needs to be enhanced control of slimming and dietary products, especially the marketing of those products to young and vulnerable individuals. I understand from the news that only this week, concerns were expressed by Food Standards Scotland that DNP—dinitrophenol, an industrial chemical—is being illegally marketed as a slimming pill, which FSS considers to be potentially lethal. It is still available to purchase on the internet, and we as a Government need to rein in social media platforms that permit, condone, or have a policy of turning a blind eye for the pursuit of profit, regardless of the health and wellbeing of our young people. As a Government, as has been said earlier, we must seriously bring those people to book for the damage and harm that they are causing to families throughout the United Kingdom.

Sunbed Use: Health Implications

Bill Grant Excerpts

Wednesday 13th February 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship this morning, Mr Hosie. I thank my hon. Friend the Member for Mid Derbyshire (Mrs Latham) for securing this important and emotive debate.

Good health is a precious gift, which most of us will hopefully be able to maintain throughout our life by ensuring that we have a balanced diet, take regular exercise and make appropriate lifestyle choices. However, one lifestyle choice that appears not to be beneficial is the frequent use of sunbeds, which give out potentially harmful ultraviolet, or UV, rays.

According to Cancer Research UK,

“sunbeds are no safer than exposure to the sun itself”.

The damage to the DNA in our skin cells builds up over time, possibly resulting in skin cancer, of which melanoma is the deadliest form. NHS research illustrates that people

“who are frequently exposed to UV rays before the age of 25 are at greater risk of developing skin cancer later in life.”

Over the last decade, the number of people diagnosed with melanoma in the United Kingdom has increased by almost half, and it is the fifth most common cancer in the United Kingdom. However, not only have UV rays been linked to the increased risk of developing melanoma, but they may result in premature ageing of the skin, and eye damage may occur if proper and effective eye protection is not applied.

Sadly, some people continue to put body image before their personal health, perhaps inspired by the media coverage of celebrities and models they seek to emulate. That is despite the fact that the risk of cancer is constantly being highlighted by the NHS throughout the UK, with various charities giving the same advice; indeed, the issue was the subject of a debate in the main Chamber only nine days ago.

In recognition of the potential dangers, it is illegal for people under 18 years to use sunbeds at commercial premises, including beauty salons, leisure centres, gyms and hotels. Use is controlled in England and Wales by the Sunbeds (Regulation) Act 2010, and Northern Ireland has passed delegated legislation in the form of regulations, providing a health warning with information that must be imparted to sunbed users. That information explains that those who use sunbeds for the first time before the age of 35 increase their risk of developing malignant melanoma by around a staggering 75%. Scotland has similar but less specific information in the Public Health etc. (Scotland) Act 2008 (Sunbed) Regulations 2009.

In 2009, the Health and Safety Executive was so concerned that it issued revised guidance on sunbed use in the UK. It is clear about the health risks associated with using UV tanning equipment such as sunbeds, sunlamps and tanning booths. However, any legislation is only as good as the enforcement, and that needs to be extremely robust. I would welcome any measures from the Minister that further protect the public from what is in effect a form of self-harm, emanating from the unnecessary pursuit of that perfect appearance. One measure he may wish to consider is raising the age limit from 18 years or consulting on a ban. Equally importantly, however, I ask those using or considering using sunbeds to weigh up the risk that it might present, not immediately but in later life. I said at the start that good health is a precious gift: why, oh why, would we as individuals put that gift at risk?

In closing, it is worthy of note that, properly utilised by experts in the field, and particularly medical staff in the NHS, light rays and phototherapy have a place in the treatment of skin conditions such as psoriasis and eczema, but they are not the same as tanning sunbeds.

World Cancer Day

Bill Grant Excerpts

Wednesday 30th January 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this important debate.

It is staggering that about 4,600 women and more than 20 men in Scotland are diagnosed with breast cancer each year. Sadly, few people, particularly males, realise that men can also be affected. My researcher was diagnosed with breast cancer nearly 16 years ago and remains eternally grateful for the care and support she received from the national health service. Her paternal grandmother and great-aunt were of a different, less fortunate generation and lost their lives to breast cancer shortly after diagnosis, although a delay in seeking assistance was undoubtedly a factor in their demise.

Regrettably, previous generations were often reticent to seek assistance, perhaps due to a lack of knowledge or embarrassment. Encouraging openness and interaction, as World Cancer Day does, and media campaigns from the national health service and various cancer charities are vital if we are to empower people through education and advocacy, including peer support, to improve their quality of life and life expectancy following a cancer diagnosis.

[Dr Whitford]

I welcome the mention of embarrassment. Does the hon. Gentleman not think that we have a particular job to do with men to get beyond the embarrassment of talking about bowels, bowel motions and other bodily functions? If people cannot talk about it with their families, they will struggle to talk about it with a GP.

[Bill Grant]

I totally agree; I am of the embarrassed generation. It is challenging for males—I concede that it is men in particular—to go to the general practitioner, but we need to educate them about making that first contact and being conscious of the risk. It is particularly my generation; the generation following are a bit less self-conscious and more eager to go to the GP, where they will find that help.

As a member of the Select Committee on Science and Technology, I have become acutely aware of the importance and benefits of research. In 2014, the city of Glasgow, not far from my constituency, hosted the European breast cancer conference. Such conferences bring together experts in their respective fields to share knowledge and experience for the benefit of patients and to consider preventive measures for the future, such as developments in immunotherapy that harness the body’s immune system to target cancer cells. As I understand it, such developments may be able to complement, if not replace, radiotherapy and chemotherapy, the side effects of which many breast cancer patients find more challenging than the cancer itself.

Treatment has very much improved, recognising the importance of body image in an era when the media often seek to portray the perfect person. The charity Breast Cancer Care stages regular fashion shows in which those who take to the catwalk have themselves been cancer patients. The male and female models, resplendent in their latest outfits, send a very clear message that they have beaten or are robustly fighting cancer.

Tamoxifen, a common medication for breast cancer treatment, is now just one of a range of drugs available to patients. It was heartening to learn of the Scottish Medicines Consortium’s decision to approve the life-extending drug Perjeta for routine use in treating secondary breast cancer on Scotland’s national health service. Compared with existing treatments, the drug apparently has the potential to offer valuable time to those with incurable HER2-positive secondary breast cancer.

Nowadays, cancer is treated by multi-disciplinary teams that include GPs, surgeons, oncologists, radiographers, radiologists and clinical nurse specialists. It is crucial that we have appropriate succession planning so that we can replace those vital experts as they reach retirement age or change career for whatever reason. It is quite concerning that 20% of breast radiologists in Scotland are predicted to retire before 2025, according to the charity Breast Cancer Now. We need to get the wheels in motion to replace those very important individuals.

Cancer is a challenge to our society. It changes people’s lives in different ways, and sadly some go on to develop lymphoedema. However, collectively we can meet that challenge. Some countries have a lesser incidence, so it may be prudent, as an aspect of self-help, to reflect on diet and lifestyle choices in the UK that may have a bearing on development or outcomes. The potential effects of obesity, cigarettes and alcohol need to be seriously addressed. That apart, we need to focus on the future needs of the researchers and medical professionals to protect the population who are at risk of cancer.

Finally, my constituents and I thank the national health service professionals, the volunteer drivers, the penguins of Dundee, the marathon runners from the borders and the charities. They all make the challenge of living and dealing with cancer that wee bit easier.

Acquired Brain Injury

Bill Grant Excerpts

Monday 18th June 2018 Commons Chamber

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

As a local councillor, I had the privilege of sitting on the board of Headway Ayrshire, which is affiliated with Headway UK, the brain injury association, a registered charity. Headway Ayrshire is based in the town of Ayr in my constituency of Ayr, Carrick and Cumnock, and it provides services to the population of Ayrshire and Arran. Its invaluable work includes the provision of information, advice and support services to people with brain injuries, their families and carers.

Up to December 2017, approximately 420 clients and 320 carers and family members were receiving support from Headway Ayrshire, with, on average, 60 referrals per annum. We have heard in this debate that acquired brain injuries may result from sports injuries, violent crimes, road traffic accidents or industrial accidents. As my right hon. Friend the Member for South Holland and The Deepings (Mr Hayes) mentioned, a simple slip, trip or fall can change the life of a person and their family for years to come.

During my 30 years in the fire and rescue service, attending road traffic collisions and cutting the occupants free from crashed vehicles, I saw the trauma at first hand. However, I acknowledge that vehicle manufacturers are constantly evolving, changing and improving in-built safety measures such as simple seatbelts, side-impact bars and not least, and more recently, airbags, which all assist in a good recovery from road traffic accidents and road traffic collisions.

I call on the Government to consider or, indeed, to address a few specific issues. First, I call on them to ensure that those assessing claimants on behalf of the DWP understand that, given the nature of their injury, the sufferer may lack personal awareness and may be under misconceptions as to their own capabilities. The sufferer may believe they will return to normality, for when they look in the mirror they still see their former self. To the onlooker, the sufferer may not present with overt symptoms, and often their life challenges are covert in nature. A sufferer may be asked whether they are able to learn a new task, and their answer might be yes. However, given an inability in some cases to retain and recall information, the fact is that the next time they are asked to undertake such a task, they may have genuinely forgotten how to do it. Appropriate questioning on forms and at assessments and hearings is crucial. For cases where the maximum recovery point has been reached, according to medical opinion, will the Government consider making long-term awards, as completing application forms is challenging for persons who lack concentration skills and who fatigue easily?

Secondly, I call on the Government to ensure that the NHS is able to offer the crucial multi-disciplinary support from an NHS team that is required in many of these cases, to provide ongoing rehabilitation and to recognise that a person’s treatment plan may need to be bespoke as, with acquired brain injuries, it is not a case of one size fits all. The symptoms and challenges faced by a sufferer have changing dynamics throughout their life. Professor Diane Playford, president of the British Society of Rehabilitation Medicine, has stated that there are not enough specialist rehabilitation facilities for those with brain injuries. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) mentioned the four additional centres in Scotland, and I congratulate and thank the staff at the Douglas Grant centre in Irvine, operated by NHS Ayrshire and Arran, on the good work they undertake every single day.

Thirdly, we should recognise the dedication of family members who do not necessarily see themselves as carers but who undoubtedly, through their own personal efforts, lighten the burden on our social care services and the NHS. This dedication on their part can lead to their own social isolation because brain injuries tend to have cognitive, physical, behavioural and emotional consequences that have an impact not just directly on the sufferer, but indirectly on the carer or the family members.

We also need to reach out to employers to ask them to consider engaging with the Government’s Disability Confident Scheme, to think about the potential to retain and, if necessary, retrain employees who have sustained acquired brain injuries and to think about these people when considering new employees. Fortunately, many make a good recovery from acquired brain injuries, but for others life becomes a constant challenge—for them and their family. As a Government and as a society, let us do all we can to assist those who have sustained an acquired brain injury.