World ME Day

Carol Monaghan Excerpts

Wednesday 1st May 2024 Westminster Hall

[Carol Monaghan (Glasgow North West) (SNP)]

It is a pleasure to serve under your chairmanship, Dame Siobhain. I will start by declaring an interest as the chair of the all-party parliamentary group on myalgic encephalomyelitis. I thank the right hon. Member for Bromsgrove (Sir Sajid Javid) not just for bringing forward this debate, but for the work he has done. It is the second anniversary of the publication of a report produced by the APPG called “Rethinking ME”. As Health Secretary, the right hon. Gentleman came to its launch event here in Parliament, and that was very much appreciated by the ME community. More importantly, under his direction, the Department of Health and Social Care started engaging with the APPG in a way that had not happened previously, to learn about our findings and recommendations from the report.

Following that, the interim delivery plan for ME was announced and the consultation opened up for those with lived experience. The right hon. Gentleman’s hand was all over that work, which has really been transformational in getting the opinions of those who are actually living with ME on a day-to-day basis. The publication of the final plan, however, has been delayed several times, as we have heard already. I will press the Minister on this: we need to know when the final delivery plan will be produced. We do not want it to be after a general election, because another Government might mean different priorities. We need that plan now.

Another step that has taken the situation forward for those with ME was the publication of the new NICE guidelines in 2021. That replaced the previous guidelines, which had recommended graded exercise therapy as a treatment for ME—a treatment that many had undertaken, and many had had their symptoms made far worse as a result. It was good to see the publication of those guidelines, but there is still much more to be done. We heard from the hon. Member for Putney (Fleur Anderson) and the right hon. Member for Romsey and Southampton North (Caroline Nokes) how this condition impacts women far more than men, so there has to be a focus on women in research, treatment and diagnosis.

People with ME experience a lot of issues, such as a lack of understanding from healthcare professionals, as was highlighted by the right hon. Member for Hayes and Harlington (John McDonnell). That leads to delays in diagnosis and to inappropriate treatments. We are still hearing of people who have been forced through graded exercise—that is, the old NICE guidelines, not the new ones. Parents of children with ME find themselves subject to child protection investigations; that has to stop. Of course, many people face difficulties negotiating the welfare system, as was highlighted by the hon. Member for Strangford (Jim Shannon). According to Ann Innes, a welfare rights adviser with the ME Association,

“Repeated assessments are a huge drain on people with ME. They put them back considerably, in terms of their health”.

One of the areas of greatest concern is the treatment of those with severe ME. It is estimated that one in four people with ME has it severely, which means they are house-bound or bed-bound and need 24-hour care. Between 2017 and 2021, 62 deaths have been attributed to ME, and the tragic death of Maeve Boothby-O’Neill highlights the need for urgent action. Maeve was repeatedly hospitalised and discharged due to a lack of specialist services for ME patients. The absence of known treatments meant that her diagnosis sadly came too late. I pay tribute to her dad Sean O’Neill, who joins us this afternoon, for the work he has done.

Over the next couple of months, the APPG will be taking evidence from those affected by severe ME. I encourage Members present to join us for those sessions, where we will hear what we can do as parliamentarians and what we should be doing. If outcomes are to improve, increased funding for biomedical research is vital. I ask the Minister how much funding there will be, how it will be delivered and where we will see that. I know that I am out of time, but I will pay tribute quickly to a couple of people: the Countess of Mar from the other place, who has sadly had to retire, but she has done decades of work; Sonya Chowdhury from Action for ME, who joins us; Forward ME; the ME Association; and all those affected by ME and their families, who have done so much work to bring the issue to the attention of Members in this place.

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[Andrew Stephenson]

I am happy to provide an update to Members. I hope that when we provide the summary of the 3,000-plus responses, it will shine a real clear light on that, but I am more than happy to write to everyone who has engaged in today’s debate to provide an update, and perhaps to address any points that I am not able to in the time allowed.

Patients can receive the care they deserve only with timely and accurate diagnosis. Sadly, there is no specific test for ME, which can be challenging to diagnose as it shares some symptoms with other conditions, as set out by the shadow Minister. That is why in 2021 the National Institute for Health and Care Excellence published the new guidelines on the management of ME that several Members mentioned. That was a step forward in helping medical professionals understand the condition so that people could be diagnosed as soon as possible. It also set out best practice for healthcare professionals in the management of ME, and the care and support they should offer patients.

[Carol Monaghan]

Given that we have heard that many health trusts are not implementing the new guidelines, can the Minister or his Department undertake to write to health boards to remind them that they are in place?

[Andrew Stephenson]

I completely understand the frustration that was raised by the hon. Member for North Shropshire and others about the lack of implementation. At the moment, we and NHS England are working hard to understand the barriers to the full implementation of the guidelines. They should have been fully implemented but we acknowledge that they have not. It is so important that we get this plan over the line because the final delivery plan will, without doubt, underline the need to follow NICE guidelines. That will be underpinned by e-learning from the Department on the development of new medical professionals and other initiatives that have been taken as part of the plan. I am keen for that to be looked at. I will now turn to medical training, but I will finally say that the NICE guidelines should be followed, and we are trying to understand why that has sadly not been the case in all too many trusts.

The new guidelines, while important by themselves, must come with a broader cultural shift across the NHS. That is why we have been working with NHS England to develop an e-learning course for health professionals, which they themselves have helped to develop, alongside charities and people living with ME. The Medical Schools Council will promote the course to every medical school in the country, while encouraging schools to take students to meet patients who suffer from ME face to face to help bust some of the myths around the condition.

I want to end by saying a few words about the future. I strongly agree with my right hon. Friend the Member for Bromsgrove on the importance of research. As he knows, the Government are funding research into ME through the National Institute for Health and Care Research and the Medical Research Council. As he kindly mentioned, those institutions came together to fund DecodeME, the world’s largest genome-wide association study of the condition, which was also mentioned by the hon. Member for Putney. We are backing the study with over £3 million to analyse the samples from 25,000 people in the search for genetic differences that may indicate an underlying cause for the increased risk of developing the condition.

The study is already generating key insights. For example, while it has long been known that women are more susceptible to the condition, the DecodeME study has shown for the first time how their experience differs from that of men. I am happy to provide my right hon. Friend the Member for Romsey and Southampton North with the assurance that not only will we do everything to get the plan over the line as quickly as possible, but I will work with people such as the chief scientific adviser, Professor Lucy Chappell, to eradicate the gender bias in research.

Genomics is already revolutionising the way we diagnose and treat a range of conditions, solving riddles for diseases that were mysteries just 10 years ago. By improving understanding, investing in research and implementing our delivery plan, we will go further and faster in the years ahead. I know there is much to do. I will end by paying tribute to my right hon. Friend the Member for Bromsgrove for everything he has done on the matter. I will continue to work with him and other hon. and right hon. Members to ensure we get this right.

Question put and agreed to.

Resolved,

That this House has considered World ME Day.

Ultra-processed Food

Carol Monaghan Excerpts

Wednesday 21st June 2023 Westminster Hall

[Carol Monaghan (Glasgow North West) (SNP)]

I congratulate the hon. Member on securing this important debate. We have a lot of these debates, and one issue with ultra-processed food is that it is ultra-addictive—people want more of it, and we cannot help ourselves—but we do not treat it as we treat other ultra-addictive things like cigarettes and alcohol, although the health implications could be just as serious.

[Suzanne Webb]

I thank the hon. Member for her intervention. Again, we are having the same conversation and I hope to answer her question later in the debate.

Ultra-processed food makes up half of the total purchased dietary energy in the UK. In fact, when it comes to UK children, more than 60% of the calories consumed comes from ultra-processed foods such as frozen pizza or fizzy drinks. All that food is linked to obesity, which causes me great concern. In England, 64% of adults and 40% of 10 to 11-year-olds are either obese or overweight. Those figures are taken from the Dimbleby report. They are staggering.

Figures from 2019-20 show that 1.5 million years of healthy life are lost to diet-related illnesses every year. Tackling obesity costs the NHS about £6.5 billion a year and is the second biggest cause of cancer. To put it starkly, it is a ticking timebomb. Some might say that the ticking has stopped and the bomb has already exploded.

Some 100,000 people have a stroke each year. There are 1.3 million stroke survivors in the UK, thanks to the advances of medicine and medical interventions such as blood pressure tablets, statins and so forth. Children who have high levels of ultra-processed food consumption have been shown to have high levels of cholesterol, increased weight and tooth decay. Obesity has been brought to the fore due to covid. Living with excess weight puts people at greater risk of serious illness or death, with risks growing substantially as body mass index increases.

The cost of all that to the NHS is significant, from prescription drugs and GP and out-patient appointments to the orthopaedic impacts on limbs of weight bearing. Of course, the greatest impact is on NHS hospital admissions. Tackling obesity is one of the greatest long-term health challenges that this country faces. Ultra-processed food is one of the main routes to all obesity issues, because the food is mainly high in fat, salt and sugar. It is marketed aggressively, to the detriment of our health, feeding a growing obesity crisis and feeding our arteries full of fat.

The food supply chain endorses and promotes products that are linked to serious health outcomes, marketing products for which the motivation is profit over health. Certainly at the cheaper end of the market, ultra-processed food does not provide a fully nutritious meal. The marketing and branding of ultra-processed food is relentless. Have we ever seen a high-profile marketing campaign for anything that falls off a tree or comes out of the ground? The answer is no. Instead, we see highly aggressive campaigns selling us the dream of so-called delicious meals. In reality they are highly addictive foods and, without moderating consumption, contribute significantly to poor health outcomes.

I am slightly disappointed that the Government are not proceeding with the plan to ban two-for-one junk food deals. That plan, which has been delayed, would have prevented shops from selling food and drink high in fat, salt and sugar through multi-buy deals. However, at a time when household budgets are under continuing pressure from the global rise in food prices, it would not be right to restrict those options. The principal issue for health outcomes is not so much two-for-one deals anyway; it is the food itself, and we should not lose sight of that. Buying multi-deals does not matter; it is the product itself that matters. That is what we should focus on: trying to eliminate addictive products that are creating poor outcomes for our children.

A good step forward would be an advertising watershed—a 9 pm watershed has been mooted—that would restrict the TV advertising of foods that are high in fat, sugar and salt, not forgetting those online. Current advertising regulations do not go far enough in protecting children from a significant number of unhealthy food adverts. I think that we have all seen the continual adverts for pizzas when we watch family programmes, certainly at the weekend. Those should not be allowed. Half the time, I am moments away from going online to order a couple of those pizzas, but I don’t do that any more.

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[Carol Monaghan]

I thank the hon. Member for being so generous with her time. She says she is not a fan of the nanny state, but we would not market cigarettes and alcohol to children, because we know the harm they do to them. Children are not allowed to buy vaping products, because of the harm they do to them. Yet we have this ticking time bomb. I think she said that 40% of children are overweight. Surely that is a group of people we need to take care of. Maybe adults can make their own choices, but we are talking about children here.

[Suzanne Webb]

I thank the hon. Member for that powerful intervention. I believe that before we get into nanny statedom, those manufacturers need to step up and wake up to what they are selling. They are peddling a false dream. This is not about wrestling with one’s conscience; they need to think about the impact of what they are selling to people. That is what they have to face up to first. I believe I am coming on to that further on in my speech.

We have talked about misleading health claims. Children are regularly exposed to products that extol their own virtues but are in fact the opposite: rich in saturated fats, trans fatty acids, added sugar and salt. If a manufacturer were to put labelling telling us that that was what was in their product, I do not think any of us would go out and buy it. We are being sold something completely different from what is actually in the product.

We should not forget emulsifiers, which hold ultra-processed foods together and improve appearance and texture. In other words, emulsifiers make a product taste and look like the food we want it to be. There is growing evidence of their impact on an increased risk of cancer—notably breast cancer—and cardiovascular diseases. Meanwhile, aspartame—I do not know how to pronounce it—is the most controversial ultra-processed food; a sweetener 200 times sweeter than sugar. When I gave up smoking, I used fizzy drinks to help me through that process. Hon. Members will guess that I am now near enough addicted to those fizzy drinks.

[Carol Monaghan]

It is a horrible sweetener.

[Suzanne Webb]

It is, hence my sparkling water, which I was rushing out for. In May 2023, the World Health Organisation said it was concerned about the long-term use of aspartame as it increased the risk of type 2 diabetes, heart diseases and mortality, although the UK’s Food Standards Agency has accepted that it is safe.

Much of this food is our everyday pleasure, so I am not advocating that we tell people what to eat and not to eat. I am hugely conscious of the cost of living pressures and the ways that people are trying to make changes and save money. Consumed in isolation and moderation, this food is fine. The problem is when it takes over our lives—and it has.

The key challenge is to get supermarkets to put healthy products on multi-buys, encourage a promotional spend shift to healthier food products and focus on making food more affordable. Promotional deals are easy ways to make profit for the supermarkets, peddling products that, to them, are low cost but high margin, and have no nutritional value. There is no doubt that modern living and work patterns mean that we find it difficult to find time to cook unprocessed foods instead of purchasing ultra-processed foods, as they are quicker to cook, ready to eat and cheaper. I do not think that there is anyone here who has not left Westminster on a Wednesday night and probably just picked up a ready meal because it is the quicker and easiest thing to do.

I am pleased to have read that the Scientific Advisory Committee on Nutrition, which provides recommendations on dietary guidelines, is carrying out a scoping review of the evidence on processed foods and health. It aims to publish its initial assessment in the summer of 2023. TV medic Dr Chris van Tulleken has also been vociferous on ultra-processed foods, and long may that continue. The facts are there. It is a serious crisis when one in three children are obese by the time they leave primary school.

I want to see the private sector lead by example, with manufacturers stepping up, taking responsibility and stopping packaging and promotional techniques that lure customers towards ultra-processed food with no nutritional value. We need to address the potential loopholes and displacement from marketing regulation of food that is higher in fat, sugar and salt when selling the dream of a 100% beef burger when, in fact, it is not. Regulators need to focus more on how the processing of food impacts our health outcomes. Will the Minister consider introducing the important advertising watershed sooner rather than later? We cannot afford to delay. The obesity figures speak for themselves; the cost to the NHS speaks for itself. Also on my wish list is considering introducing a reduction target to keep focused on ensuring that ultra-processed food consumption levels in the UK are at a healthier level.

I am deeply concerned about the impact that such food is having on health outcomes and the impact on the NHS. We need to continue the debate, as the simple fact is that 64% of adults in England and 40% of 10 to 11-year-olds are either obese or overweight. That is staggering. To me, we are not far off from the time for urgent intervention like we had in the cigarette industry. An article was written on Monday, independent of my securing this debate, in which I read someone saying very similar things. The obesity crisis is truly shocking and cannot be ignored. The role of ultra-processed foods in that is significant, as is the role of the food supply chain. The food supply chain needs to step up and play its part in the fight against obesity before the Government need to intervene and start to tackle the ultra-processed foods like they did with tobacco— to basically get in there. The Government will have to intervene at some point if the industry do not get a grip.

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[Jo Gideon (Stoke-on-Trent Central) (Con)]

I thank my hon. Friend the Member for Stourbridge (Suzanne Webb) for securing this important debate on a subject that is really close to my heart.

Most people are now aware of the health impacts of HFSS diets, yet it is increasingly clear that the primary cause of diet-related disease is not a diet that is high in fat, salt and sugar, but rather one that is high in UPF. However, as has been said, I wonder how many people know what UPF is and what it stands for, even though it represents 60% of the average UK diet.

To put it simply, if a food is wrapped in plastic, has at least one ingredient that we would not usually find in a standard home kitchen, or has a health claim on the packet, it is likely to be UPF. Much of it will be familiar as junk food, but there are also plenty of organic, free-range and “ethical” ultra-processed foods that might be sold as healthy, nutritious, or useful for weight loss.

Home-made chips, lasagne and cake are not the same as their UPF equivalents. The processing is what is important—so we do not have to all give up cake, as long as we make it ourselves. When we think about food processing, most of us think about the physical and chemical things done to food, but the definition of ultra-processing includes its purpose: to create profitable, convenient, hyper-palatable products. Those indirect processes—marketing, legal challenges and lobbying—all make the issue of how to tackle the health impacts of ultra-processed foods more complicated.

The evidence on ultra-processed food is robust. It is not just a couple of trials; hundreds of papers and high-quality data show the wide-ranging health impacts. Many people are unaware of how artificial the designs of ultra-processed foods are. They typically contain little, if any, whole food. The food’s structure is destroyed by industrial processing, meaning that UPFs are usually soft. They are therefore easy to eat quickly, which means that people eat far more calories per minute and do not feel full until long after they have finished eating. UPFs contain drastically reduced levels of phytochemicals, which are essential for dietary health and cannot be replaced through supplementation. There are also extensive environmental effects. The monocultural food system necessary for the production of UPFs is a leading cause of declining biodiversity and the second-largest contributor to global emissions.

If they are so bad for us, why do we eat them? Highly processed foods are on average three times cheaper per calorie than healthier foods. People from households with lower financial security or food security report consuming fewer fruit and vegetables, less fish and more sugar-sweetened soft drinks than those who are more financially secure.

The rise of UPFs is an emergent property of today’s commercialised and commodified food systems. Many people feel food systems have become more profit driven, with natural and fresh food less accessible. For example, buy-one-get-one-free offers in supermarkets often tempt us to buy more but, in 2015, supermarket promotions in Britain were the highest in Europe, with around 40% of our food expenditure going on promoted products.

Lord Hague recently wrote a fabulous article that argued that it now seems extraordinary to us that tens of millions of people used to smoke cigarettes without realising the serious harm they could cause. I suspect that when people look back a few decades from now, they will have a similar sense of incredulity about the food we eat.

One in 20 UK cancer cases is down to excess weight, which is the second largest preventable cause of cancer after smoking. Diet-related disease is the leading cause of early mortality, with the primary cause being high-UPF diets. Two in five children in England face ill health as a result of the food they eat. Those children are five times more likely to develop serious and life-limiting diet-related conditions in adulthood.

We must re-design our food system to put health first. That our diets should be made up mainly of real food seems simple. Individual responsibility is important but, to facilitate it, we must ensure that as many children as possible finish school with the knowledge and ability to cook healthy and nutritious food for themselves. I am arguing for a proactive approach to public health that equips people with the tools and information they need to make informed, healthier choices. We must also increase the powers of local authorities to empower their communities to address their unique health challenges by, for example, tackling the flood of unhealthy food and drink advertising in outdoor areas, especially near areas where children congregate.

The levy on sugar and soft drinks has been an enormous success. The sugar removed from the national diet as a result is estimated to be equivalent to the weight of 4,000 double-decker buses, without leading to a fall in sales. Fiscal measures can incentivise—

[Carol Monaghan]

I am sorry to interrupt the hon. Lady’s flow. Sugar may have been removed from soft drinks, but other things have gone in. We have already heard about aspartame, which is a particularly horrible sweetener. We know that the levy has taken a huge amount of sugar out, but it has not had any impact on obesity, particularly childhood obesity, so maybe we need to look at other things too.

[Jo Gideon]

I entirely agree with the hon. Lady. If I had my way, fizzy drinks would be banned from all schools and would be hugely discouraged wherever they are sold, but at least the money raised from that tax helps to educate people that we need to look at what we are drinking and eating.

I will not take up more time, but I want to make the case that we have good reason to look closely at the food that finds its way on to the nation’s plates, and we should take ways to tackle the health impacts of ultra-processed foods seriously, renew our commitment to halving childhood obesity by 2030, reduce diet-related inequality and create a long-term shift in our food culture.

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[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship today, Dr Huq. As many Members know, the subject of food and nutrition is close to my heart, and not just because I enjoy eating good food. I chair the all-party parliamentary food and health forum, which is discussing holding a joint meeting with the all-party parliamentary group on obesity on this very subject. I am therefore really grateful to the hon. Member for Stourbridge (Suzanne Webb) for securing the debate. I know that the Minister’s closing remarks will be of interest to the Members here, to people throughout the nations, and to both all-party groups.

There can be no doubt that ultra-processed foods have created a looming health crisis that has cost implications for the future of our public services, particularly our NHS. With more than half the calories consumed by the average person in the UK coming from ultra-processed foods, and with research from The BMJ linking these foods to early death and poor health, we really cannot afford to be complacent.

As we have heard, ultra-processed foods usually contain ingredients that people would not add when cooking food themselves. Many would not recognise the names of these ingredients, many of which are chemicals, colourings, sweeteners and preservatives. Research suggests that these additives could be responsible for other negative health effects, with several studies showing links between larger amounts of ultra-processed foods and cardiovascular disease and death, and the more of them a person eats, the greater the risk. The words of Professor Tim Spector, professor of epidemiology at King’s College London, are alarming. He said:

“In the last decade, the evidence has been slowly growing that ultra-processed food is harmful for us in ways we hadn’t thought. We’re talking about a whole variety of cancers, heart disease, strokes, dementia”.

Let that sink in. Quite frightening.

Buying processed foods can lead to people eating excess amounts of sugar, salt and fat, often unaware of how much has been added to the foods they are buying and eating. Scotland, as I mentioned a couple of weeks ago, has the highest obesity levels in the OECD countries, so we have a bit of work to do. Public Health Scotland found that children from the most deprived backgrounds were almost three times as likely to be at risk of obesity as those from the least deprived. According to the Scottish health survey, in 2021 two thirds of adults were overweight, similar to or marginally higher than the rates recorded every year since 2008. We are not making much progress in tackling the issue. Men have consistently shown higher prevalence of being overweight than women each year since 2008. One third of children are overweight, and I have no doubt that diet, and overprocessed foods in particular, is a major factor.

I want the UK Government to implement a sustainable food strategy that targets products that are high in sugar and ultra-processed foods. Our colleagues in Holyrood published the Good Food Nation Bill and passed it unanimously, enshrining in law the Scottish Government’s commitment to Scotland being a good food nation, where people in every walk of life take pride and pleasure in and benefit from the food they produce, buy, cook, serve and eat each day.

Education and consumer knowledge are important tools in the fight against ultra-processed foods, but accessibility and price are also key. A few weeks ago, in another debate, I pointed out that for many living in poverty, eating healthy food is a secondary consideration to eating at all. Access to healthy food should be a right, not a privilege.

[Carol Monaghan]

We have talked a lot about children, and there are a few issues there. Children who are obese are less able to exercise, which continues the cycle, and of course this is made more difficult in areas of deprivation. Some Members know that I coach gymnastics locally. We see children, some of them very young, who struggle to exercise because they are overweight. We need serious action.

[Martyn Day]

I thank my hon. Friend for making that point. I agree entirely; the only thing I would add is that not only is it important for children to exercise, but when they do they develop habits that stay with them for their lifetime. We have to crack the children issue at an early age.

On a positive footnote—I will get hell for this when I get home—I am pleased to say that our household contains a 19-year-old who has much healthier eating habits than I had as a 19-year-old male, all those decades ago. If I ask him before going to the shops what he would like, I am invariably told, “Raspberries, strawberries and grapes,” whereas I would have asked for chocolate bars and cans of fizzy juice.

[Carol Monaghan]

They are expensive.

Elective Care Recovery in England

Carol Monaghan Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend for his shout-out for his local hospital. He is absolutely right: we need to utilise the resources and the capacity of the whole system, and this is the approach we are adopting. Often, the debate can focus on the large, acute district general hospitals, but he is absolutely right that smaller hospitals, community hospitals and indeed community facilities all have a part to play in helping to tackle this waiting list.

[Carol Monaghan (Glasgow North West) (SNP)]

Long delays in diagnosis and inappropriate and sometimes outdated treatment are typical for those living with the condition ME. As chair of the all-party parliamentary group on ME, I was pleased to see the new National Institute for Health and Care Excellence guidelines on treatment of the condition. Can the Minister detail what steps are being taken to implement those and to ensure speedy diagnosis and appropriate treatment?

[Edward Argar]

The hon. Lady raises an important point. I know that the House is grateful for her work on this important issue. She highlights the NICE guidelines, which are an important step forward. We continue to work with NHS England on how to most effectively ensure that patients with ME get the early diagnosis and treatment that they need. I or the relevant policy Minister will be happy to meet her to discuss progress and her and the APPG’s thoughts and ideas in that space.

Oral Answers to Questions

Carol Monaghan Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Matt Hancock]

Of course we assess this, but it is challenging to get to a statistical answer to the question that my right hon. Friend raises. When we have taken action to restrict access to areas where there is evidence of significant transmission, such as the hospitality industry, that confounds the statistical analysis because people cannot go into that environment and therefore the passing on of infection there reduces. This is a matter of evidence and judgment. It is a significant challenge, but the road map is based on our best assessment of the situation, which is based on clinical advice, including the focus on the fact that we know that outdoors is safer than indoors. Hence the early steps, after schools, are focused on opening things up outdoors.

[Carol Monaghan (Glasgow North West) (SNP) [V]]

Opening up by date and not data, as described by the Prime Minister yesterday, will allow prevalence in the general population to continue, unfortunately increasing the number of people affected by long covid. What discussions has the Secretary of State had with the Secretary of State for Work and Pensions to ensure that proper financial support is available for those afflicted by long covid, including a continued £20 a week uplift of universal credit?

[Matt Hancock]

Of course long covid is an incredibly serious condition for some and is part of our considerations and deliberations, but I want to correct something the hon. Member said. The road map sets out indicative dates before which we will not move, but we will be guided by the data, hence the five-week gaps between each step to make sure we have four weeks to see the impact of the step and one week of advance notice for the go/no-go decision. That is based on clinical advice, which I know is shared across the UK.

Long Covid

Carol Monaghan Excerpts

Thursday 14th January 2021 Commons Chamber

[Carol Monaghan (Glasgow North West) (SNP) [V]]

I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this afternoon’s debate. For the past three years, I have been involved with individuals living with myalgic encephalomyelitis, a post-viral condition triggered by a virus such as flu or, in some cases, severe acute respiratory syndrome. Knowledge of post-viral conditions, particularly with regards to activity management, is essential for the many people now living with long covid. As early as January last year, some people expressed concerns that this mysterious new coronavirus could produce similar post-viral effects. However, the sheer numbers affected by long covid is a serious health challenge.

In addition to listening to and—crucially—believing and supporting people with long covid, health professionals should be providing guidance on symptom management. I am pleased to see that the National Institute for Health and Care Excellence moved quickly to provide guidelines for long covid, and thankfully it has cautioned against the use of graded exercise therapy. It is surprising to find a guideline recommending exercise testing. Exercise testing in people who may have an undetected cardiac pathology clearly carries a risk. In addition, the NICE guideline contains no specific guidance on the management of any of the common symptoms of long covid. That is a serious omission that requires urgent attention.

Advice on symptom management cannot be left to charities and support groups. Instead, we should be looking at how that can be delivered in primary care, with the help of, for example, properly trained community physiotherapists. There is a need for health professionals, employers and wider society to recognise that recovery from a virus takes time. Employers must identify tasks that individuals can continue to carry out, and that might be in a different setting from what they are used to doing. The Government must ensure that there is proper financial support for those affected. It may be that these people take months or even years until they start seeing improvements in their health, and we must make sure that the support system can be just that during these times.

Today, we had a study by Public Health England that shows that those who have had covid will have immunity for about five months post-infection. Those who are living with post-viral conditions such as long covid or, indeed, ME, should therefore be considered vulnerable beyond the five months and prioritised for vaccine. Finally, it has taken decades of campaigning, largely due to the lack of belief—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I am afraid I have to thank the hon. Lady for her speech. We need to move on, because not everybody will be able to get into this debate.

Social Distancing: 2 Metre Rule

Carol Monaghan Excerpts

Monday 15th June 2020 Commons Chamber

[Edward Argar]

I am grateful to my hon. and gallant Friend for that question. The WHO says that the distance should be at least 1 metre, so it is not prescriptive in that respect. We should make sure that we note that. He makes a very powerful case for getting our economy, and particularly our small businesses and hospitality businesses, moving again. We are making good progress in tackling this disease, and we do not want to put that at risk. The review will give us the scientific evidence to make an important decision on the way forward.

[Carol Monaghan (Glasgow North West) (SNP) [V]]

Anybody who has seen the crowds waiting for shops to open today, the people at recent demonstrations, and, indeed, MPs queuing at Parliament will know that it is human nature to push the limits. A distance of 2 metres gives a margin for error. If it is reduced to 1 metre, surely people will push that limit as well and stand even closer. I ask the Government to keep the rule in place for as long as it is required, knowing what human nature will do.

[Edward Argar]

I am grateful to the hon. Lady, but the 2 metre social distancing rule has both a health and an economic impact. Therefore, we must look at this in the round, on the basis of both sets of evidence, which is exactly what this review will do.

Oral Answers to Questions

Carol Monaghan Excerpts

Tuesday 5th May 2020 Commons Chamber

[Michelle Donelan]

We should not underestimate the impact of the package that we announced yesterday, which builds on the Treasury announcement that universities are eligible for Government financial support worth at least £700 million. This package also brought forward £100 million of research funding. We have also brought forward £2.6 billion in tuition fees to help with cash flow. Most fundamentally, this is a package that is designed to stabilise the higher education sector and safeguard it as a whole.

[Carol Monaghan (Glasgow North West) (SNP) [V]]

May I take this opportunity to welcome the new Labour Front-Bench team to their positions and also to pay tribute to all those working in the education sector to support our young people through this pandemic?

The £100 million of quality-related research funding that the Minister has just referred to is research for England. Can the Minister confirm that this is indeed new funding and that these increases to the English QR grants will deliver Barnett consequentials for universities in Scotland?

[Michelle Donelan]

I can confirm that this is QR funding that has been brought forward for English universities, but the hon. Member will have noted in the announcement yesterday that it also included a research taskforce designed to prioritise safeguarding our research base. That is a cross-governmental taskforce on which the devolved Administration Ministers will have a seat.

Electromagnetic Fields: Health Effects

Carol Monaghan Excerpts

Tuesday 25th June 2019 Westminster Hall

[Seema Kennedy]

I think the hon. Lady talked about accurate information, and about honesty concerning the information put out by Public Health England. Public Health England conducts extremely rigorous research, all based on the best available international evidence and on monitoring assessments of expert reviews. Some of those things will, of course, be in the public domain, and others will not. I will happily write to the hon. Lady with all the evidence that is available in the public domain.

The Committee on Medical Aspects of Radiation in the Environment has a watching brief on non-ionising radiation. It assesses all the available data to give health advice. Many scientific studies have been done over several decades, and a wide range of health topics have been investigated, including cancer, reproduction, cognitive effects and electrical hypersensitivity.

[Carol Monaghan (Glasgow North West) (SNP)]

The Minister referred to the frequency range. It is true that we are talking about lower frequencies than the ionising radiation that would be beyond the visible spectrum. However, it is not true to say that all low frequencies are not harmful. Looking at microwave radiation, for example, if we get a high enough intensity of non-ionising radiation we can still cause harm. I would not want to be in a microwave oven and I am sure the Minister would not either. So it is not just about frequency; it is about the intensity of the radiation.

[Seema Kennedy]

The hon. Lady is talking about risks and hazards. [Interruption.] Yes, we are talking about two different sorts of radio wave, but she said that I would not want to go in a microwave oven. I am not suggesting that I would put myself or anyone else in a microwave oven, so we are talking about hazards and risks. The best scientific evidence given to Government is that the radiation is safe, and I was going to go on to talk about the evidence that Government have used before addressing some of the points that the hon. Member for Gower raised. I apologise if I have not quite understood the point made by the hon. Member for Glasgow North West (Carol Monaghan); I will happily discuss it with her later.

Expert groups in the UK and around the world have examined the evidence and published many comprehensive reports. In the UK, the Advisory Group on Non-ionising Radiation produced reports in 2003 and 2012. The Government have played their role in the international effort to learn more about the health effects of radio- wave exposure. They supported the dedicated mobile telecommunications and health research programme that ran from 2001 to 2012 and they continue to fund research.

A challenge in understanding the evidence is that some studies report effects, while others do not. Sophisticated analyses are needed to draw studies together, considering their strengths and weaknesses and working out what they mean collectively, which is the role of expert groups. Simply counting or listing studies that have found effects is not an adequate way of assessing where the overall evidence lies.

An expert group reporting to the European Commission delivered a review in 2015, and the World Health Organisation is currently carrying out a major review on radio waves and health, which will include studies performed over the past 25 years. Overall, those expert groups have not found any clear evidence of adverse health effects occurring if the International Commission on Non-Ionizing Radiation Protection exposure guidelines are followed. The ICNIRP exposure restrictions have been incorporated into a 1999 European Council recommendation on limiting public exposures to electromagnetic fields. The United Kingdom and Public Health England support that recommendation.

Since 1996, the World Health Organisation has been running an international electromagnetic field project that provides a forum for countries to gather together, discuss and share knowledge on this topic. The WHO’s main conclusion is that electromagnetic field exposures below the limits recommended in the International Commission on Non-Ionizing Radiation Protection guidelines do not appear to have any known consequence for health. However, as the hon. Member for Gower and other Members have mentioned, that does not mean that people who have electrical hypersensitivity do not have symptoms. Those symptoms are real and can be very debilitating, and the Department’s guidance is that those people should seek medical advice, so that their personal situation can be taken into account and the best possible treatments found.

I will also address the points raised by many hon. Members about the effects of screen time on the mental health of children; as any parent can attest, there are some effects. The shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), referred to SCAMP, and the Government conduct research that looks at the effects of technologies on schoolchildren.

Exposure levels reduce very rapidly with increasing distance from transmitting antennae, which means that being in immediate proximity to the transmitting antenna of a mobile phone handset held next to the head is different from living near a base station. There is long-standing precautionary advice from Public Health England and the NHS for mobile phone users, and research is continuing. We are continually looking at the evidence and updating our advice.

Social Media and Health

Carol Monaghan Excerpts

Tuesday 30th April 2019 Commons Chamber

[Matt Hancock]

Artificial intelligence clearly has a role in identifying material that needs to be removed in the same way that it is now being used to remove terrorist content. We are talking to companies that may be able to do this, but we also need to identify what material should be taken down and what should be left up. Defining that boundary is critical to training artificial intelligence to do its job, hence the importance of the decision to ask the Samaritans to do the work of identifying the boundary so that we can train artificial intelligence to identify what needs to be taken down.

[Carol Monaghan (Glasgow North West) (SNP)]

rose—

[Alison Thewliss (Glasgow Central) (SNP)]

rose—

--- Later in debate ---

[Matt Hancock]

My hon. Friend puts it exactly right. That is what the duty of care is all about. The argument—we hear it less and less, to be honest—that these are international companies and so will abide by somebody else’s laws, thanks very much, is wrong and out of date, as the online harms White Paper makes clear. We must establish a proper enforcement mechanism to ensure that it is the rules that this House sets—occasionally amended by the other place—that define the law of the land and that we do not have a wild west. This action to protect people’s health is just one part of the response needed to make the internet safe, especially for children.

[Carol Monaghan]

Thank you for calling me so early, Mr Speaker. [Interruption.] It couldn’t be any worse.

My son contracted measles one month before he was due to receive his MMR vaccine because of a dip in numbers being vaccinated, so I very much welcome the Secretary of State’s statement about tackling anti-vaccination posts on social media. Last year, the Select Committee on Science and Technology carried out an inquiry into the impact of social media on young people’s health, and one of the statistics presented to us was quite disturbing: 50% of young people between the ages of 11 and 16 had seen pornographic images, and many of them had stumbled across them. When I spoke to my 11-year-old daughter, she confirmed that she had seen images that upset her but had been too scared to speak to me about it. What is the Secretary of State doing to alert parents to the dangers of social media and to give them guidance on how to speak to their children and identify when they might have seen things online that have upset them?

[Matt Hancock]

Mr Speaker, that question was so good it is only a pity it was not asked earlier in our exchanges.

I want to address two important points. First, the hon. Lady’s son is a case in point of how, if parents do not vaccinate, they endanger not only their own children but other people’s. It is because of a failure to vaccinate that these diseases still exist, and it is children who are too young to be vaccinated who are at risk. She has made the case more powerfully than anybody for the importance of vaccinating and keeping vaccination rates up, and I am grateful to her for sharing that personal experience. On the second point, she is quite right that we all have a responsibility to act, and act we will.

Oral Answers to Questions

Carol Monaghan Excerpts

Tuesday 26th March 2019 Commons Chamber

[Stephen Hammond]

I was delighted to visit Kettering and to meet the chief executive and the chairman of the trust again. They made very strong representations. The representations by my hon. Friend and the trust have been heard, and he knows that they are at the forefront of my mind.

[Carol Monaghan (Glasgow North West) (SNP)]

Changes to the pensions allowance are particularly impacting consultants in their willingness to do additional shifts, or indeed stay in their roles, so what discussions has the Minister had with the Chancellor about the effect of the changes to pension allowances on the retention of consultants in the NHS?

[Stephen Hammond]

My right hon. Friend the Secretary of State and I have both had conversations with the Treasury and the Chancellor, and there are ongoing discussions.