Skin Conditions and Mental Health

Caroline Nokes Excerpts

Tuesday 25th January 2022 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to serve under your chairmanship, Mr Gray. I pay tribute to the APPG, and to my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) for securing this important debate. I will try to keep my comments brief, but the challenge is that there is so much to talk about.

I, like the hon. Member for Swansea East (Carolyn Harris), pay tribute to Changing Faces, which has done incredible work to promote the cause of those with visible difference, who too often in our lives face discrimination and bullying. We know that 55% of young people will be bullied about their appearance. With the skin the largest organ of the body, it is almost inevitable that those who have a visible difference, such as eczema, cystic acne, scars or burns, will face some horrendous bullying at school—the sort of bullying that means that they do not take part in the ordinary activities that other children do. When I say “ordinary activities”, I mean that they do not want to take part in PE or put their hand up in class in case attention is drawn to them. Is it any surprise that children who have conditions that require medical treatment also need psychological help to overcome all of that?

I pay particular tribute to the most amazing man in Southampton, Professor Keith Godfrey—a dermatologist at Southampton General Hospital who runs the paediatric dermatology service.

Nobody likes talking about acne. I have been in this Chamber when I have heard Members say to me, “Nobody died of a few spots.” But actually, we heard my right hon. Friend the Member for Gainsborough highlight acts of self-harm in young people who feel so bullied and pressured because of the state of their skin that they do not leave their bedrooms and do not want to take part in school activities. Tragically, some do take their lives; they lose their lives because of “a few spots”. That is why it is so important that they are given the psychological help they need to get through their conditions.

Sometimes this is terribly controversial and upsets people, but I want to pay particular attention to the drug Roaccutane, which in itself can cause low mood. It is therefore important that young people who are prescribed it get the support they need when under prescription. We are terribly good at ensuring that young girls who are taking that drug go on the pregnancy prevention programme, but terribly bad at ensuring that the young men who take it get the support they need to get through low mood swings and the depression that some—I am quick to emphasise, not all—feel.

The Women and Equalities Committee last year conducted our inquiry into body image and the pressures that young people face. Of the evidence that we took, particularly from witnesses put forward by Changing Faces, two stick out in my mind. Tatyana, who was a burns victim when she was a very small child—she was at primary school when she was disfigured—gave us the most incredible evidence, in which she spoke about the importance of being open and talking about her skin condition.

Tatyana also spoke about the importance of role models. Pretty much everybody we see on social media today—those influencers of young people—is seen through a filter, so they look perfect at all times, yet young people look in the mirror and do not see that same perfection. Tatyana drew attention to Katie Piper, who she said was the only person she saw in public with visible burns who she could hold up as a role model. She said that she talks about it because she wants that young boy or young girl in their bedroom to see somebody who looks like them who is prepared to speak up publicly and ensure that other people have the courage to take part in everyday life.

I conclude with a plea from Changing Faces, which provides a brilliant, charity-run service that includes its skin camouflage clinic and one-to-one counselling support. Changing Faces would love to work with the Government. My plea to the Minister is: please, go and talk to the people there, listen to the lessons that they have learnt and the support that they can give, and work out how we can bring them into the NHS and help clinical commissioning to ensure that the psychological support is available for those who need it.

Eye Health and Macular Disease

Caroline Nokes Excerpts

Tuesday 11th January 2022 Westminster Hall

[Caroline Nokes (in the Chair)]

Before we begin, I remind hon. Members that they are expected to wear face coverings when they are not speaking in the debate. This is in line with current Government guidance and that of the House of Commons Commission. I also remind you all that you should have a covid lateral flow test before coming on to the parliamentary estate, and give one another plenty of room when entering and leaving the Chamber. I call Jim Shannon to move the motion.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the matter of eye health and macular disease.

Thank you, Ms Nokes. This is a very important issue. I suppose all issues are important, but this one is very important, as I shall illustrate in my speech. I place on the record my thanks to the Backbench Business Committee, as always, for agreeing to schedule this debate, and to the Macular Society, which is working with Fight for Sight and Roche pharmaceuticals in the Eyes Have It campaign group—we say “The Ayes have it” in the House many times, and the eyes have it literally this time—for its support in securing the debate.

I thank all the hon. Members who are here for taking the time to discuss this important issue. I have spoken to some of them, and they will all bring their individual comments and contributions to the debate. I am very pleased, as always, to see the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), in his place, and it is a particular pleasure for me and for all of us to see the Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield) in her place. We look forward to her response as well.

As someone who had glasses from a young age—eight years old—and who has had diabetes for the last 15 years, I can say that eye health is a matter of great personal import, as well as a constituency issue that affects a huge swathe of my constituents. Every day, 250 people start to lose their sight. At least half of all sight loss is avoidable. That is the key issue in this debate, because if sight loss is avoidable, the question is what steps we take to ensure that people do not lose their sight. With that in mind, I look forward very much to the Minister’s response.

More than 2 million people have sight loss, and 350,000 people are registered blind or partially sighted. Age-related macular degeneration is the leading cause of blindness in adults, leading to 50% of blindness. The hon. Member for Great Grimsby (Lia Nici), when we spoke last night, told me that she herself has this. Therefore the contribution from the hon. Lady, out of everyone in the House, will be particularly poignant and relevant to the debate.

I was shocked to learn that more people in the UK are living with macular disease than with dementia. We hear lots of stories—I am not saying we should not, by the way—about dementia, but just to give an idea of the magnitude of the subject of this debate and its importance, there are more people with macular disease than there are with dementia. Macular disease is a particular risk for the nearly 4 million people in the UK who, like me, are living with diabetes. I have long been instructed that poor control of blood sugar and insulin levels can damage the blood vessels of the eye, causing fluid retention in a condition called diabetic macular oedema. About one in every 14 people with diabetes develops DMO, which will result in a noticeable loss of vision.

Why should this topic be flagged as urgent for every Member of the House? Well, the issue is not just the physical health problems but the financial costs. The cost of eye conditions to the UK economy has been estimated at £25.2 billion per year, and without action, that is forecast to rise to £33.5 billion per year by 2050, so there is clearly a financial equation to this issue. It is about prevention and about reducing the costs for the health service as well. But cost is not the only important factor. The fact is that it is an awful thing to lose one’s sight and—for many people—one’s independence. Members across the House will know—perhaps through their own experiences or those of a loved one, or perhaps through the stories shared by their constituents, which we see in our constituency offices each and every day—the impact that sight loss can have. Loss of vision can have an impact on quality of life by undermining patients’ ability to live and work independently. For example, I recently met a member of the Macular Society, Bryan, who was diagnosed with age-related macular degeneration in 2012 and told me that something as simple as catching a bus can become very challenging.

Sight loss can also have a profound impact on emotional wellbeing. Sight is considered by many people to be the most important sense. Patients with macular disease, who are at risk of losing their sight, report feelings of isolation, shock, anger, anxiety and hopelessness. Those feelings may grow as individual sight deteriorates, with patients increasingly cut off from the world as they had previously experienced it. Losing one’s eyesight makes one particularly lonely; those who lose their eyesight do not know what is happening around them. I often think that, of all the senses that one could lose, eyesight is—with no disrespect to those who have lost other senses—the most important.

At the same time, macular disease can put pressure on the family members, friends or neighbours who act as carers for people with macular disease. This means that, although macular disease is more common among older people, its effects can be felt across the working-age population as well. Such feelings are understandable.

Without treatment, sight loss can be rapid. For example, wet age-related macular degeneration—wet AMD, where blood or fluid from abnormal blood vessels leaks into the macula, causing scarring—can cause significant sight loss within a matter of weeks. That is why this is so urgent. It is vital that patients are diagnosed and treated as quickly as possible. Can the Minister tell us what has been done to achieve the early diagnosis of AMD? It is so important that sight loss is addressed urgently. Other hon. Members in the debate will reiterate what I am saying shortly.

--- Later in debate ---

[Lia Nici (Great Grimsby) (Con)]

I thank the hon. Member for Strangford (Jim Shannon) for securing the debate. As he alluded to earlier, I have macular disease, and I want to speak about what macular disease is and its effects.

When I was diagnosed 20 years ago, my eye specialist told me that I was going blind. Anybody who does not really understand about going blind might think that one day the lights will switch off, but that is not actually the case. The macula is a particular part of the retina that deals with detail. Over time, it becomes very difficult for people to see in the centre of their vision; there is difficulty reading, recognising faces and writing. It poses a number of challenges, but there is life after a macular disease diagnosis. Hon. Members will notice that I am using my iPad—technology performs a huge service to people with issues such as mine.

I would like to talk about some of the causes. We have talked about diabetes and age-related macular degeneration, but it also happens to younger people. It happened to me when I was young, as secondary to high myopia. Councillor Daniel Westcott, a colleague and constituent of mine, was diagnosed at the age of 17 with Stargardt disease, which is a loss in the macular area of the eye. Despite it ending his career as a plasterer—he could no longer see enough detail—he trained as a teacher and is now working as both a personal trainer and a councillor. Those people who experience the shock and concern of being diagnosed can certainly still have a very positive life that contributes to society.

I want to talk about the importance of going to the optician. We have talked about ophthalmology, but as the hon. Member for Strangford said, it is going to the optician regularly that spots these serious issues. With the retina in particular, speed is of the utmost importance. I went to my optician because when I was reading I noticed that the lines on the page of my book had a dip in them. I went to the optician not thinking anything of it, but it was actually the start of the back of my eye bleeding and causing a bubble. Imagine looking through a window through a raindrop—that is the effect that starts to happen. If anybody hears of someone having that kind of issue, they must go to their optician, who will give them an urgent referral to the hospital. If they cannot get to the optician, they should go to accident and emergency straight away and explain; they will then get straight in to the eye specialist. My constituency is Great Grimsby—that is where I live—and Diana, Princess of Wales Hospital has a fantastic ophthalmology team. Mr Kotta, Mrs Bagga and the whole team are fantastic; the nurse specialists really are specialists, and they are fantastic at care and treatment.

It is incredibly important that we support technology companies being able to continue helping with this. In my case, 20 years ago there was no treatment for my eye condition. However, when it went into my second eye, there had thankfully been a lot of development in technology. I had 11 injections directly into my right eye in order to save my sight. Companies such as Regeneron and Novartis have produced medicines that go directly into the eye. If they had not been available, I would now be registered blind. The effects of those 11 injections meant that my eyes improved five lines on the acuity test. That is quite amazing, and it allowed me to continue to drive. I obviously still have some issues, and colleagues will know that they have to prod me because I do not always recognise them—especially on a dark night. Stem cell research is the real pinnacle, and will hopefully mean that people’s eyes will work better for them in the future.

I want to highlight computer technology, and in particular Apple computers. Twenty years ago Apple had the foresight to ensure that accessibility was built into their operating systems. If it was not for Apple’s technology and foresight, I could not have continued in my previous job of teaching, video production and camera operating. When a camera operator is told that they are no longer going to be able to see, that can be a little bit of a problem. Computer technology allowed me to continue to be able to do what I do, and Members can see that I am working with large text today. It is absolutely vital, and I say to other producers of computer operating systems and programming systems that they should really think about simple things to allow people to zoom in and to magnify. All those things are now on the market and they really do make a difference to people’s independence.

If someone does not lose all of their sight, it is very difficult for people to understand. They do not walk into things, and their peripheral vision is fine. It is the detail that is the problem. For a lot of people, that affects their independence. They can no longer read a telephone bill or look at something on the internet. If they love reading, they can no longer do that either. Writing is also affected because they cannot see what they are doing. There is much hilarity in our household when people say that I should become a professional prescription writer because they cannot read anything that I write any more.

Most important, for me, is the role of employers. When I was first diagnosed, my public sector employer—whom I will not embarrass by naming—was appalling. They were not supportive; in fact, they went into panic mode. I would like to say to employers that when somebody comes to you to say that they are having eye problems, do not go into panic mode, because they can continue to be a positive, important part of the team. It just means that they will need slightly different ways of working. I continued to run a television station, keeping a close eye on my editors and camera operators, who always used to say that I may have eye problems, but I could still see their mistakes.

The Royal National Institute of Blind People in particular was fantastic. Its staff will come and do a free assessment in the workplace and offer advice to the employer. I also thank the people at ACAS because when my employer was being downright dirty, they were fantastic in advising me in what I was able to do. Rather than people with eye or macular disease having issues and becoming vulnerable, they can actually become a positive and important part of the team—even more so than before their eye problems. I send this message out to employers: embrace the team member who has these issues, because they will continue to be a fantastic part of the workplace.

[Caroline Nokes (in the Chair)]

I thank the Member for that contribution. We now come to the Front-Bench spokespeople.

Health and Care Bill

Caroline Nokes Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Dawn Butler]

My hon. Friend makes a valid and valuable point. One way we can show our appreciation for nurses’ work is to protect their title, but we should not do that instead of addressing any of the issues she mentioned, along with ensuring that they receive a pay rise.

I thank the people who have petitioned for the change in my new clause for a number of years, including the former Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), who is no longer in his place but supports my new clause; the Labour Front-Bench team; Ann Keen; the chief nursing officer for England, Ruth May; Professor Mark Radford, the chief nurse at Health Education England; the previous chief nursing officer for Northern Ireland, Charlotte McArdle; Andrea Sutcliffe, Matthew McClelland and the Nursing and Midwifery Council; Mr Paul Trevatt; Professor June Girvin; Dr Crystal Oldman; Ms Shamim Donatta Ayiecho; Ms Leanne Patrick; Mr Gerry Bolger; Ms Catherine Eden; and the Florence Nightingale Foundation leadership scholars. The Government know that there is a lot of support for new clause 12 and I hope it passes today.

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to contribute to this debate and specifically to speak to new clause 1, tabled in my name and the names of the right hon. Member for North Durham (Mr Jones) and many other Members throughout the House. First, though, I pay tribute to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for his incredibly important amendment on the workforce. I also pay tribute to my hon. Friend the Member for North West Durham (Mr Holden) for his crucial new clauses on virginity testing and hymenoplasty. As the Chair of the Women and Equalities Committee, I was pleased to be able to support those amendments and am delighted that the Government have introduced their own new clauses on those issues.

I wish to talk specifically about aesthetic non-surgical cosmetic procedures, which may seem quite trivial in comparison with the important matters I just referred to, but I vividly remember visiting a doctor in my constituency and talking to her about her experience when a patient came to her after she had had far too much lip filler placed into her lips by an unqualified and inexperience practitioner. The poor girl’s lips had, frankly, exploded, leaving her permanently scarred and with the prospect of many years of corrective surgery to try to rebuild her face. That is the stark reality.

The hon. Member for Brent Central (Dawn Butler) spoke about people being able to call themselves nurses when they are not nurses; aesthetic cosmetic practitioners can not only call themselves that but perform all sorts of procedures, some of which we would find it bizarre and disturbing to talk about and, indeed, at some of which we might look with absolute horror when they are reported on the internet and in the pages of national newspapers. I am talking about semi-permanent make-up and permanent tattooing, which can leave people permanently disfigured. The semi-permanent variety can fade to leave people with bizarre blue eyebrows that require many different procedures to be put back to normal. The list is long: we are talking about tattooing, botox and laser treatment—just imagine the damage that high-powered lasers can do to somebody’s skin when in unqualified, untrained hands.

[Dr Whitford]

Along with the damage to patients who trustingly go for such procedures, is it not also about the fact that when they go horrifically wrong, as sometimes they do, it is the NHS that ends up having to pick up the pieces?

[Caroline Nokes]

I thank the hon. Lady for using exactly that term because she is right: it is about the NHS picking up the pieces and spending taxpayers’ money trying to correct something that should not have been done in the first place. If it is to be done to somebody, it should be done only by the qualified, trained and, as my new clause argues, licensed. I call today for some form of licensing or regulation. I absolutely accept that the Minister may view my new clause as deficient and not doing what he would want it to do. I appreciate the fact that he took the time to meet me and other Members last week to discuss the issue, because there are concerns throughout the House.

I pay particular tribute to my hon. Friend the Member for Sevenoaks (Laura Trott), who has done so much work on injectables in respect of under-18s and deserves absolute credit for getting her private Member’s Bill on to the statute book. That is amazing work and I really appreciate the fact that she has done it. Nevertheless, we need to do more and to go further.

I pay tribute to a number of my constituents who, following the work I did last year on the beauty industry, approached me on this issue. In particular, I pay tribute to Dr Chris Rennie of Romsey Medical Aesthetics, and to Dr Mitra Najafi, who has developed an incredible process by which plasma-rich platelets are extracted from a patient’s blood and injected back into them. It is a highly medicalised procedure and her big worry is that if it falls into the hands of somebody who is unregulated and unlicensed, it could be extremely dangerous indeed. Those with medical qualifications absolutely understand how they have to treat blood products; the stark reality is that those without do not.

I pay tribute to aestheticians—I struggle to say that word—such as Naomi O’Hara who came to me, as someone who practises, to call for regulation and licensing.

I pay tribute to a lady who is not my constituent but travelled to Romsey to see me: Tania Gough, who publishes the Image Directory. Her concern was that it is perfectly possible for someone to set themselves up in practice with next to no training whatsoever. She spoke to me of some of the horror stories that she herself had seen and some of the training courses she had gone on that she said were quite simply not worth the money she paid for them or the waste of her time. She said that certificates were issued at the end of such courses that gave the impression that people were qualified and trained when in fact they had had no more than a couple of hours—in one case it was 90 minutes—of training.

I also pay tribute to the Chartered Institute of Environmental Health and the Joint Council for Cosmetic Practitioners; they have been incredibly supportive and helpful in the drafting of new clause 1. The Joint Council for Cosmetic Practitioners says:

“The creation of a national licensing scheme for practitioners of aesthetic non-surgical cosmetic procedures would ensure that all those who practise are competent and safe for members of the public.”

To my mind, that is the abiding word: safe. We want those who receive these sorts of treatments not to be putting themselves in harm’s way.

I look forward to the Minister’s response; I know he is listening on this issue. He can expect me not to push my new clause to a vote, but I very much hope he can show us a constructive way forward that may take us to the regime that we want to see.

[Tonia Antoniazzi (Gower) (Lab)]

I could speak about so many aspects of the Bill—such as the U-turn on the social care cap, the lack of action to include health inequalities, allowing private healthcare providers to access our NHS and, frankly, whether a reorganisation of the NHS at this time of crisis is what we need to support all our healthcare workers—but I am sure that colleagues will more eloquently cover a lot of those points in their contributions. As the chair of the all-party parliamentary group on cancer, I will restrict my comments to the amendment on the NHS workforce tabled by the right hon. Member for South West Surrey (Jeremy Hunt).

Staffing is the biggest challenge facing the NHS. The Prime Minister claims to be building 40 new hospitals; if that ever happens, they will be of no use to anyone if there are not the doctors, nurses, radiotherapists, pharmacists, porters, cleaners and other staff to look after patients. As we have already heard, the NHS had 100,000 vacancies before the pandemic started. That, coupled with the intense strain and burnout that staff have suffered over the past 18 months, is causing a crisis in staffing that needs bold action now.

The Budget was a missed opportunity to invest in the people who make the NHS great, but amendment 10 would go some way to rectifying that. According to research from Macmillan, it is estimated that we need an extra 3,371 cancer nurse specialists by 2030—that is a doubling of the number of cancer nurses in just over eight years if we are to have any chance of providing the care and support that patients deserve. Macmillan has worked out that it would cost £174 million to train and develop specialist cancer nurses to plug the gap. Any increase in funding would be passed on to devolved Governments through Barnett consequentials. In the grand scheme of things, £124 million in England, £31 million in Scotland, £12 million in Wales and £7 million in Northern Ireland is not too much to ask of the Government—it is probably in the region of the amount of money spent on security for the Prime Minister’s trip to Peppa Pig World at the weekend.

Chronic Obstructive Pulmonary Disease

Caroline Nokes Excerpts

Wednesday 17th November 2021 Westminster Hall

[Caroline Nokes (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings when not speaking in the debate, in line with current Government and House of Commons Commission guidance. I remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the estate, which can be done either at the testing centre or at home. Please also give each other room when you leave the Chamber.

[Mike Amesbury (Weaver Vale) (Lab)]

I beg to move,

That this House has considered support for people with chronic obstructive pulmonary disease.

It is a pleasure to serve under your chairmanship, Ms Nokes. I am grateful for the opportunity to lead the debate—and on World COPD Day itself, no less. Chronic obstructive pulmonary disease impacts many of our constituents, but it is simply not given the clinical priority in our health systems that it should have. I hope today, with the other parliamentarians present, to push the Government a step further and improve our fight against COPD on a few fronts: to push public health action to avoid our constituents contracting it; to improve diagnosis rates, so that it is caught at an earlier stage; to transform treatment to help patients manage their condition; and to invest in more research, so that we can develop groundbreaking diagnostics and treatments.

I am thankful for the hard work of the British Lung Foundation, which has campaigned tirelessly for better recognition and treatment of lung disease and which, ahead of World COPD Day, has highlighted the experiences of those living with COPD in their report “Failing on the fundamentals”, which I know some hon. Members in the room will have seen. I am also grateful to the all-party parliamentary group for respiratory health and those involved with the COPD national action plan for their work. I know that some Members present are involved in that APPG; I thank them sincerely. Many thanks also go to my constituent Sarah Jones, who has worked with the taskforce for lung health and pushed me to raise the fight against lung disease in Parliament after the sad loss of her father, John Jones, from idiopathic pulmonary fibrosis.

Chronic obstructive pulmonary disease is a group of lung conditions that cause breathing difficulties, including emphysema, which is a breakdown of lung tissue, and chronic bronchitis, the chronic inflammation of central airways. It is a disease chiefly caused by smoking, which causes nine out of 10 cases of COPD. Air pollution, childhood poverty and exposure to dust in workplaces are also contributing factors. I know that other Members in the Chamber will be very familiar with COPD and its constituent conditions. Many champion the cause of their constituents while others have direct experience.

In a case study provided by the British Lung Foundation, Chris highlights his desperation to breathe—something that many of us take for granted—the panic, the fear, the wheezing and in some cases the crushing sensation that he feels in depleted lungs. Those are just some of the facets of the debilitating disease known as COPD. Early signs are shortness of breath, a wheezing chest, tightness, chronic cough, lack of energy and weight loss. I encourage people with these signs to get an appointment with their GP.

According to the National Institute for Health and Care Excellence, 3 million people in the UK suffer from COPD. Shockingly, 2 million of are undiagnosed. As Sarah Woolnough, the chief executive of the British Lung Foundation stated:

“It is hard to imagine, for example, this proportion of cancer cases going undiagnosed”.

But that is the reality and it has to change. It is nothing short of a silent scandal.

To the Government’s credit, in response to campaigners and clinicians campaigning for respiratory disease, COPD is given priority in the NHS long-term plan. Yet, like all plans, the devil is in the detail and delivery on the ground is essential. It is vital to ensure that people with the disease are diagnosed early. Too often, diagnosis occurs only when the disease has considerably progressed, leading to greater risk of damaging flare-ups of COPD symptoms and greater risk of being one of the 30,000 people killed by the disease every year, making it Britain’s fifth biggest killer.

Of course, we encourage people to see GPs, but 9.8% of people in the north-west, for example, are struggling to get appointments. I am sure the Minister will refer to that in her reply. An important survey conducted by the British Lung Foundation—its largest ever of those suffering with COPD—found that 75% of those surveyed were missing out on the basic care recommended for the disease.

The theme of this year’s World COPD Day is “Healthy Lungs—Never More Important”. It aims to highlight the risk COPD poses against the backdrop of the pandemic, which has represented a higher risk for those suffering from lung disease and resulted in the additional demand on services created by the impact of covid-19. Even before the pandemic, it is clear that those with COPD experienced unacceptable delays in receiving a diagnosis—delays that can prove fatal.

Diagnosis rates, already far too low, plummeted further during the pandemic by 51%, meaning that nearly 50,000 of our constituents in England alone missed out on a diagnosis. Although the impact of covid-19 was widespread across our health service, this drop was more substantial than for comparable non-respiratory diseases, such as diabetes. Some GPs were advised during the pandemic to stop diagnosis breathing tests and they have yet to restart.

Does the Minister think that we should put in place a delivery plan with funding to get lung health strategies back on track and tackle the respiratory backlog so that another 50,000 people do not miss out on the diagnosis in the coming year? COPD already costs the health economy £1.9 billion. This could be an effective saving, not only of lives, but of essential financial resources.

Can the Minister confirm whether the new diagnostic hubs announced as part of the Budget will cover the tests needed to diagnose COPD and other pulmonary diseases? It would be useful to hear more detail on the part these hubs will play in the diagnosis of lung disease, and on an effective staffing and recruitment strategy.

The British Lung Foundation’s recent report on the experience of people with COPD also highlights shortcomings after diagnosis. It found that three quarters of people across the UK did not receive the five fundamentals of COPD care, as set out in the NICE guidelines. The problem is particularly severe in the north of England and in the devolved nations. Tackling this and ensuring that everyone is offered the five fundamentals of COPD care needs to be at the centre of the strategy. Those five fundamentals are a written management plan, access to pulmonary rehabilitation, help to stop smoking, management of co-existing medical conditions, and access to flu and pneumonia vaccinations.

As with many diseases, prevalence of COPD is linked with deprivation. Between 2019 and 2020 the life expectancy gap between the least and most deprived areas in England grew from 9.3 years to 10.3 years for men and 7.7 years to 8.3 years for women. Respiratory conditions are major contributors to widening health inequalities in the UK, with those living in the most socioeconomically deprived areas in England seven times more likely to die from respiratory disease compared with the least deprived areas.

In my constituency of Weaver Vale, 2.6% of residents are estimated to suffer from COPD, compared with 1.9% of people in England as a whole. Looking at the map of the prevalence in my constituency, we can clearly see that the most deprived areas have twice the proportion of COPD cases than the least deprived areas, and I know other hon. Members here will have the same experience. Eighteen of the 20 clinical commissioning groups in the worst areas for respiratory diseases and emergency responses are in the in the north of England.

If the Government are serious about tackling health inequalities and levelling up life chances, more work needs to be done to ensure that COPD is not overlooked as one of the major respiratory conditions driving health inequality in the UK. If this Government are really serious about levelling up, that should be a focus. Those living with COPD, as well as those living with other diseases, should have equal access to fast diagnosis, care and treatment, no matter who they are and where they live. I hope to hear from the Minister about how her Department plans to ensure that disparities in COPD prevalence, diagnosis and care are a major part of the national health inequalities strategy.

In most cases COPD is caused by smoking, so I would like the Minister to give an update on the new tobacco control plan, how it will focus on tackling health disparities and how she intends to plan and fund an effective, high-quality stop smoking service throughout the country. Over the past 11 years, many of those services have been cut, so I would be fascinated by her response.

Finally, I would like to raise the problem of awareness of COPD, lung disease more widely and the importance of lung health. Today’s debate has primarily focused on the lack of funding, the lack of real clinical and Government priority and the lack of awareness that extends beyond that. I would like the Minister to outline how, as part of getting lung disease the delivery prioritisation it desperately needs, her Department can promote greater public awareness of lung disease. Our shared interest must be to transform COPD care in the UK, while driving down the numbers who develop this condition in the first place. I look forward to this debate, and I certainly look forward to the Minister’s response.

Menopause (Support and Services) Bill

Caroline Nokes Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is always a privilege to be in this Chamber to support the work of the hon. Member for Swansea East (Carolyn Harris). It is just over a week since we last debated the menopause in the Chamber, and I always say that in Parliament we should pick not just our battles but our allies. It is a pleasure to campaign, to hold a revolution and to be a warrior alongside her.

The reality is that all women will go through the menopause, but not all women will suffer symptoms. Only about 80% suffer symptoms and HRT—a brilliant, wonderful solution to some of those symptoms—does not work for everyone, and the same type of HRT does not work for every woman. That is why it is often a case of trial and error, going through many prescriptions to find the form of HRT that works for each woman and resolves their symptoms. We have to address the costs because women will be bearing the burden of prescription after prescription until they find the solution for them.

We have heard a little this morning about education, but no one has yet paid tribute to the brilliant work of my right hon. Friend the Member for East Hampshire (Damian Hinds), who made sure that, as part of personal, social, health and economic education, girls are not just taught about periods, not getting pregnant and contraception but are taught about what might happen when those periods stop. Of course, it is not just a matter for girls. Their male classmates and colleagues, their fathers and brothers, also need to be part of this discussion.

As we have heard repeatedly, there is too little knowledge in schools and in the workplace. I regard this place as a workplace and, until very recently, it was heavily male- dominated, but we are clawing it back, sometimes just one seat at a time. I pay tribute to the work of one of the foremost menopause warriors, Anne Milton, the predecessor of my hon. Friend the Member for Guildford (Angela Richardson). As Deputy Chief Whip, Anne Milton played the crucial pastoral, human resources role of helping many of us with conversations on all sorts of weird and wonderful health issues. It helped that she was previously a nurse, but she was an evangelist for HRT. When I spoke to her about it yesterday, she said, “Just go and get yourself a prescription, because this will solve those hot flushes at night and the fact you wake up in a puddle of sweat.” I still tried to say, “No, I’m sure that’s just my insistence on sleeping under a 13.5 tog duvet.” Apparently not.

I vividly remember being brutally asked by GB News, “What are your menopause symptoms?” I recoiled a little from the question, which I thought was a bit rude. And then I thought, no, I have to talk about it. I regard it as my duty to talk about it so that younger women know, whether it is brain fog, anxiety, hot flushes or night sweats, this is all normal and it can be addressed.

[Angela Richardson (Guildford) (Con)]

I had that conversation with my predecessor, the right hon. Anne Milton, quite a few years ago, and she completely changed my mind about HRT. My mother and aunt had to go through this 30 years before me—I am now 47—and they had difficult reactions to HRT. My aunt died from cancer that, anecdotally, was blamed on HRT.

It was Anne Milton who said to me, in a frank conversation, “This is what women need to live good lives.” I pay tribute to her for having the courage to have that conversation with me, and I pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for the courage she shows in talking about it, too.

[Caroline Nokes]

My hon. Friend has made the point—lead good lives—and that is what we want to do, whether it is at home or at work.

Something in particular has struck me during Menopause Awareness Month. I have spoken to many employers about the menopause workplace pledge, and have talked to members of organisations in the City of London about what they can do to support women. According to a survey carried out by the Fawcett Society, 50% of women working in financial services were not taking on additional responsibilities because they were worried about their menopause symptoms, while 25% were considering leaving work. Women at the height of their careers are potentially losing them, and not providing those brilliant female role models to which we all need to aspire in order to progress in our careers.

I make no criticism of my right hon. Friend the Member for Pudsey (Stuart Andrew), the current Deputy Chief Whip, but I issue a plea to all those in the Whips Office: make sure you have good, strong women in there who can provide advice when it is needed. I pay tribute to Claire Hattrick, who lives in Hampshire and runs the clipboardclaire.com website, providing impartial, informed advice for women when they are going through the menopause. Many of us simply do not know what the symptoms are. We do not understand them, and we do not know where to turn. Claire and many like her across the country provide that advice, free of charge and independently, giving us all hope that the symptoms can be dealt with.

Bills such as this mean that we will debate the issue on the Floor of the House as well as in the wider country. It is about having the conversations, about making sure that we understand, and, most of all, about joining the hon. Member for Swansea East and ensuring that we are all warriors and allies, and that we are going to bring about change.

World Menopause Month

Caroline Nokes Excerpts

Thursday 21st October 2021 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to be able to contribute to this debate to mark World Menopause Day earlier this week, and the whole of October being Menopause Awareness Month. The hon. Member for Swansea East (Carolyn Harris) is absolutely bang on: this is not a political issue. I pay tribute to her tireless work, and it is a privilege to follow her excellent contribution. She and I have become something of a tag team on this issue, and it was notable that when we went to request that the Backbench Business Committee give time for the debate, we were quite definitely discussing when, not if.

In July, the Women and Equalities Committee launched our inquiry into menopause in the workplace, and since then we have collected evidence from a wide range of sources about the impact that menopause can have on women and work. However, before I highlight some of the issues that we have so far uncovered, I want to make a quick comment about the menopause and Westminster, or more specifically, the menopause and Whitehall.

Back in 2018, I had the privilege to be a member of the employment taskforce, and I have never forgotten the introduction given by one of the most senior civil servants in Whitehall to one of those meetings, where he spoke of the economy being “menopausal”—like it is some sort of insult, as if it is something to be ashamed of or ridiculed. I challenged him then in the same way that we must all challenge it now, because we have to beat down that stigma, that taboo, and make sure that the menopause is something that we can actually celebrate. I am talking about those brilliant menopausal women who have contributed so much during the course of their careers up to that point; the ones who are approaching the peak of their careers; the ones who have learned the ropes, gained the experience, given confidence to those following behind them and been role models to younger colleagues; the ones who have demonstrated that you can do it. If we allow menopause to be an insult, we are saying that the women who have achieved are suddenly of no use any more, and that is not the case.

But the workplace can be phenomenally difficult when experiencing menopausal symptoms. Goodness, anywhere can be difficult, but a recent survey carried out by the Fawcett Society on behalf of Standard Chartered and the Financial Services Skills Commission, specifically about women in finance who are experiencing the menopause, highlighted some really stark findings. Over 50% of women are worried about taking on additional responsibilities because of the menopause—that is the promotion gone. Twenty-five per cent. of women considered leaving their career altogether because of the menopause—that is the job gone; that is the income gone.

We talk about 1 million women being lost to the workforce. Let that sink in: a million women. Those are experienced, talented, confident, knowledgeable women no longer playing a role in the boardroom and lost to the management tier—decades of experience and advice to younger colleagues simply gone. In stark economic terms, we cannot afford to let that happen. No business, no school, no fire service, no organisation, no Parliament can afford to lose its best and its most experienced.

The really scary thing about the evidence that my Committee has so far received is the number of requests for anonymity from women who want their evidence kept confidential because they are worried about its impact on their careers. That is not acceptable.

Yes, of course the menopause can be difficult. We will all have different symptoms at different times; some will be phenomenally lucky and have no symptoms at all, but some will have symptoms so severe that they cannot carry on at work. We have to break down the stigma and start the conversations so that I never again get an email like the one that I received from a company’s HR director because she did not want her name attached to evidence to the Committee; she wanted it kept private because she was scared about what would happen to her career if anybody in her organisation even thought that she was menopausal.

I cannot predict where the evidence will take the Committee or what recommendations we might make to the Government. We have not even started taking oral evidence, so we are some way off my beating a path to the Minister’s door, or to the door of Ministers in the Department for Business, Energy and Industrial Strategy, to ask for change.

I do not wish to make out that everything is negative. Far from it: the hon. Member for Swansea East gave some fabulous examples of companies that are real trailblazers. In our evidence-taking, I have been completely candid with employers and said, “I want to hear the good as well as the bad—I want to be able to celebrate you and hold you up as a role model to other companies and organisations.”

We have already heard some of the names: Timpson, John Lewis, Tesco, PwC and all the companies that have signed the menopause workplace pledge organised by Wellbeing of Women and supported by Bupa. To all the companies and organisations such as the NAO, which invited me in to talk about the menopause as if I were some sort of expert—it should have had the hon. Lady, who is a far greater expert—I say thank you, because they are starting the conversations. They are just talking about it, and that is the first step.

Nowadays, I am pretty happy to talk to anybody about my menopause or perimenopause symptoms, whatever they are. My induction to that came from GB News, which bluntly came straight out with “What are your symptoms?” I had to give the answer, “I don’t know”—I do not know whether the sweats at night are the start of the menopause or a result of my absolute addiction to a 13.5-tog duvet, which could explain it. Even I baulked at the prospect of using the term “vaginal dryness” in the presence of the Countess of Wessex; others were not quite so reticent.

I am conscious of time, but I want to mention briefly an individual champion. She is not quite my constituent—she is just over the border in North West Hampshire—but Claire Hattrick in Andover runs clipboardclaire.com, a blog dedicated to giving help and advice to other women. In the past week, she has published a whole book on the subject; she is coming to Parliament next week to support the hon. Member for Swansea East, give me a copy of her booklet and make sure that together we champion the brilliant advice out there for menopausal and perimenopausal women and spread the word.

We women born in the late 1960s and early 1970s are the ones most likely to be going through the perimenopause or menopause now. We are determined to speak up, speak out and find paths through the menopause that work for us. We will not be hiding away, because although we might be a pretty unlikely bunch of revolutionaries, it is a revolution that we need.

--- Later in debate ---

[Suzanne Webb (Stourbridge) (Con)]

Periods, labour, childbirth, breast feeding and the menopause—oh, mother nature, please give us a break. Today, we are talking specifically about the menopause. Here we go again: migraines, insomnia, anxiety, aching joints, confidence dips, brain fog, tiredness, flushes, irritation, tears and AC-130—Members may ask what that is. It is fair to say that they will get the picture when I say that my ex-ex-boyfriend described me at one point as being similar to an AC-130, the world’s biggest flying artillery gunship nicknamed “Hell in the Sky”, with three side firing weapons, a 25 mm Gatling gun, a 40mm Bofors cannon, and a 105 mm howitzer firing on all sides. We are talking about the joys of menopausal rage. Members will be pleased to know that the AC-130, so described, was only temporarily in action and was retired some time ago, as was the ex-ex-boyfriend.

Seriously, I do not want to be here talking about this today. I do not like baring my soul about something so deeply personal, let alone here in this great place. This is the only time, Mr Deputy Speaker, that I wish there was a time limit. The taboo around the subject is evident when we consider who is, or who is not, sitting in this Chamber. It is a shame that there are not more people of all ages in here contributing to the debate. Clearly, speaking in this debate is what I needed to do to give women hope that, while this is a club that no one wants to join, ultimately we all do—as a woman. But you know what? Once in, it is a lovely club with some amazing and awesome women.

I thank the hon. Member for Swansea East (Carolyn Harris) and my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for ensuring that we actually had this debate and that I actually came here and spoke out. I came through all of this very early and unscathed. However, I do wish to raise the issue of bone density, which the hon. Member for Bradford South (Judith Cummins) mentioned. Unbelievably, I did not realise what was happening at first—it was some years ago now—but I do now in hindsight. The horror was to do with my bone density. I did not have HRT at the time, so there was a sudden rush to put me on it once we realised that I had practically gone through the menopause. I had a bone density scan and everything was tickety-boo in that area—thank the Lord for that.

Talking about the menopause is a big deal for women. It is for me. I feel that we often have to defend ourselves. We are very much judged on it and women are embarrassed about it, as am I. It is often not talked about, even between women. We just do not want to talk about it. Men are embarrassed about it, too. As I was leaving for this debate, I was speaking to one of the guys in the flat. I told him that I was just about to go and talk in a menopause debate. He said, “Oh, all right. We can’t talk about that, so good luck.” Young women just see something that they think is unique to their mothers and that will not ever happen to them, but, trust me, it actually will and they will certainly know about it when it does happen. Look we must talk about it. We have to educate those who sadly believe that a women’s identity is built only on biological fertility and educate those who think that being menopausal indicates that a woman’s sell-by date has well and truly expired. Well, to whoever said any of the above or thinks it: just look at the amazing number of women sitting on these Benches who entered politics at their supposed sell-by date. We must talk about this so that it is no longer a taboo. And please—so I do not have to stand here talking about it ever again—can we just get it out there? Of course, also for the partners, colleagues and employers of menopausal women, we must share and understand the physical and mental impacts that the menopause can have on women.

The menopause is an entirely natural biological process. I thank the Government for putting it on the agenda. If I remember rightly, it was my hon. Friend the Member for Redditch (Rachel Maclean) who started to do so. The Government are in the process of developing a women’s health strategy, which will look to tackle menopause education. I have long thought that we needed to do more in schools to normalise hormones. From September 2020, relationships and sex education and health education have been compulsory in all state-funded schools. As part of this, pupils are taught about menstrual health and the menopause. A positive attitude to hormones is crucial and much needed, with more education in schools to break the myth that women are only defined by and are relevant through their biological fertility.

Society needs to reframe its attitude. It is okay to be grumpy. Tears are okay. Hot flushes are okay. Hot necks are okay. Layering clothes is the new “en vogue” for any perimenopausal woman, who can go from ambient temperature to extreme heat in the blink of an eye. The coldness in this Chamber is actually so welcome for anyone who is perimenopausal—so I thank the House! Some women fly through the menopause, some deny it and others suffer symptoms that affect their family and professional lives, and they deserve empathy, support and practical solutions.

Let me touch on HRT. As I said, I did end up having some HRT towards the end of that time, but it did not work for me. I think it is important to say that it does not always work for everybody, and it is important for people to have the right conversations with their doctor and to share that experience. If people start to feel other symptoms, as I did, they must go back to their doctor to have that conversation.

[Caroline Nokes]

My hon. Friend makes an important point about HRT not working for everyone. What is also true is that different types of HRT work differently. Of course, the issue of prescription costs comes in for people who have to try several versions.

[Suzanne Webb]

My right hon. Friend makes an important point. That is exactly what happened with me. We went through the process and tried the various options, although I ultimately ended up coming off HRT because it just did not suit me.

Talking about menopause is so important, especially when we often do not realise that we are starting to go through the process. We are not tapped on the shoulder one day and told, “This is it.” It is a slow and confusing process that can create anxiety and depression. Some say that it can be akin to a grieving process. The menopause brings on deep and profound changes, which should not be underestimated, but somewhat embraced, and perimenopausal women should not be confined to the out-of-date shelf. It is for all of us to think about this issue and do something about it; we all need to do something about this.

Black Maternal Health Week

Caroline Nokes Excerpts

Tuesday 14th September 2021 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

I put on record my appreciation to the hon. Member for Streatham (Bell Ribeiro-Addy) for having led the debate today and for her incredible work on this important and sensitive issue.

Alongside me, she is a member of the Women and Equalities Committee. We have been privileged to listen to the evidence of black and mixed-race mothers about the experiences that they have had in giving birth and in supporting their family members in giving birth. We have heard some real horror stories of lost sisters and lost daughters, because their maternal health outcomes have been worse than the outcomes that my hon. Friends the Minister and the Member for Cities of London and Westminster (Nickie Aiken) and I would have had.

It is wrong that in 21st century Britain we can still expect black and mixed-race women and women from ethnic minorities to have such a massive disparity of experience. The Five X More campaign has done some incredible work. In the Select Committee, we have been lucky enough to do roundtables with them, and to listen to their experiences, their recommendations and the changes that they believe would make a real difference.

Those stories have been difficult but important to listen to. The thing I took away was how fed up those women were about having to repeatedly tell the story. They feel that they are not being listened to, that there is no change and that they are not seeing action, when actually, as the hon. Member for Streatham has pointed out, the statistics are so stark that this should be driving immediate and rapid change.

In November last year, the Joint Committee on Human Rights discussed targets. I can sometimes be a bit sceptical about targets and think they do not necessarily always drive the right outcomes and behaviours, but this is a clear case where I think that they would and where I want to see the Government have real ambition to set a target and a timeframe, so that we can see that four times more disparity driven down and ended. It is crucial that we try to do that in a very rapid timescale.

There have also been clear recommendations from the Health and Social Care Committee. Indeed, the Government should be responding to them imminently. Can the Minister update us on that in her response and give us an indication about whether the Government will embrace those recommendations?

I am conscious that my hon. Friend the Minister has done good work on the subject and last year set up a forum designed to bring together experts in the field to meet key stakeholders, to consider and to address the inequalities for women and babies from different ethnic backgrounds and socioeconomic groups. We cannot shy away from that. We also have to look at some of the intersectional challenges, and ensure we are looking not just at race but at the socioeconomic situation.

Can the Minister outline how that forum is assisting policy making? It is crucial and we want to understand what role those experts are playing in feeding into Government to drive policy change. Can she indicate how often the forum has met and what the key recommendations have been? How quickly will those recommendations be acted upon, if indeed they will be acted upon?

One challenge that we heard at the Women and Equalities Committee roundtables was about research. Many experts felt that there was already a great depth of research that had been done, that the knowledge was there and that perhaps further research was not needed. In April this year, we heard that the Government had commissioned the policy research unit in maternal and neonatal health and care at the University of Oxford to develop an English maternal morbidity outcome indicator, which is not easy to say. That is crucially important. We want to see how that indicator is working and when we expect it to be rolled out. I would like to hear the Minister today update us on that work and give us some indication as to whether she is any closer to committing to a target for reducing the deaths of black women in childbirth.

Towards the end of her contribution, the hon. Member for Streatham spoke about continuity of care, which is crucial. We know very well that if there is continuity of care during pregnancy then the birth outcomes would be better for both mother and child. The NHS long-term plan included targeted support around continuity of care, with an aim that by March this year most women would receive the sort of crucial continuity that we are calling for. That was a target that was set, so I would very much welcome the Minister’s updating us on how that is going. We heard from the Health and Social Care Committee that the targets for continuity of care were inadequate and in need of improvement, so perhaps we can have an indication of how the Government will achieve that.

The hon. Member for Streatham finished her speech with a commentary on institutional racism in the national health service. I was really struck—I was going to say this time last year, but perhaps it was a bit earlier—when we took evidence in the Women and Equalities Committee on how much worse the outcomes of covid were for people from black, Asian and minority ethnic communities. One of the messages that we heard from healthcare professionals from black and Asian backgrounds who were working in the NHS was that they were scared to speak up. They were scared to tell their stories to line managers about the pressures that they faced when working in our NHS. In many instances, they felt exposed to racism if they asked for perfectly reasonable adaptations or changes, or for greater levels of personal protective equipment. It is absolutely wrong in the 21st century that we have people working in our health service who are frightened to speak up.

I was struck when we took evidence during the roundtable discussions with black and minority ethnic mothers, and indeed with experts—we heard from Christine Ekechi, who is the most incredible woman, and from the doula Mars Lord, to whom the hon. Member for Streatham referred. They made a really important, shocking and, in many ways, depressing point: too many black women and their partners were not being listened to during childbirth. They were trying to convey how they felt and the worries they had when they felt that things were going wrong. Mothers going through childbirth were scared and instinctively felt that something was going wrong, and they told us repeatedly that they were not listened to. In a 21st-century health service in the sixth largest economy in the world, that is simply not acceptable.

--- Later in debate ---

[Ms Dorries]

Absolutely—across black, Asian and mixed ethnic minority groups as well. The point has been made today that black women do not feel listened to. We hear stories of complaints about pain, prolonged labour and other issues, and black women just do not feel as though they are being listened to in that environment. The core finding of the Cumberlege report, which addressed mesh, sodium valproate and Primodos, was that women are not being listened to, and black women probably even more so in the maternity setting. That issue for women, black women, Asian women and women from mixed ethnic backgrounds needs to be addressed. Women have to be listened to.

Turning to covid-19 and vaccinations, covid-19 has further exposed some of the health and wider inequalities that persist within our society. While considering disparities in the context of the pandemic, initial data suggests that vaccine uptake among ethnic minorities is lower than for other groups. Covid-19 vaccines are recommended in pregnancy. Vaccination is the best way to protect against the known risks of covid-19 for women and babies, including admission of the woman to intensive care and premature birth of the baby.

New findings from a National Perinatal Epidemiology Unit-led study showed that of the 742 women admitted to hospital since vaccination data has been collected, only four had received a single dose of the vaccine and none had received both doses. That means more than 99% of pregnant women admitted to hospital with symptomatic covid-19 are unvaccinated. That is quite stark.

[Caroline Nokes]

On that point, will my hon. Friend reassure me and all Members that the Government will keep pushing the crucial message that the vaccine does not affect fertility or pregnancy, and that it is important for pregnant women and women of childbearing age to get the vaccine?

[Ms Dorries]

Absolutely. My right hon. Friend has done it for me, but I absolutely encourage women to get the vaccine because 99% is a huge figure. There is a basis of mistrust. The reason why many black women do not access some of the health services they should do before pregnancy is because they do not feel listened to and they do not feel they can trust their practitioner. The message of “Take the vaccine” must be pushed.

I will finish by taking the opportunity to urge women to continue to access maternity care and to stress that pregnant women should never hesitate to contact their midwife, maternity team or GP, or to call NHS 111 if they have any concerns. That also applies if parents are worried about their health or the health of their newborn baby. I urge expectant mothers to have their covid-19 vaccination as soon as possible. I do not think we can give out that message often enough.

Covid-19 Update

Caroline Nokes Excerpts

Monday 19th July 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Gentleman attends the Friday briefings that I offer colleagues. He is absolutely right. Last week, Public Health England published some encouraging real-world data that showed that two doses of the vaccines offer around 74% protection for those who are immunosuppressed or immunocompromised. That comes with a caveat that that group of people is not homogenous and we need to unpack some of the data. The JCVI has already recommended in its interim advice on the booster campaign in September that that group goes top of the list for the third dose as a boost. Of course, we have a large clinical trial, which will report imminently on the immunosuppressed and the immunocompromised. We will look at that data with the JCVI. The chief medical officer continues to ask the JCVI to look at what else we can do to protect that group, including through the therapeutics taskforce, which is doing some tremendous work.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

There is some real concern among my constituents that they might in some way have the wrong batch of AstraZeneca vaccine. My hon. Friend provided a useful update on Friday, but can he give any further reassurance that no British traveller will be turned away at the border because they have been given the wrong vaccine?

[Nadhim Zahawi]

My right hon. Friend is right that there is no such thing as a wrong batch of Oxford-AstraZeneca vaccine in the United Kingdom. Our independent regulator regulates all manufacturing sites for AstraZeneca, Pfizer and the other vaccines. The AstraZeneca vaccine produced in the Serum Institute is the same vaccine—the Vaxzevria vaccine brand that is approved by the MHRA and the European Medicines Agency. There was some confusion in parts of world such as Malta last week, which the MHRA, the EMA and the Commission helped to clear up. I reassure my right hon. Friend that anyone who has had an Oxford-AstraZeneca vaccine and has the UK app or the letter to demonstrate their vaccination can travel. I think that 33 countries now recognise our vaccine certification.

Covid-19 Update

Caroline Nokes Excerpts

Monday 5th July 2021 Commons Chamber

[Sajid Javid]

I think the hon. Gentleman is suggesting that people should have the freedom to wear a mask if they wish, but it should not be mandatory—it should not be mandated by law. There are countries—I lived in Singapore for three years—where people would wear masks if they were feeling unwell, out of respect for others. If people choose to do that here, that will be a good thing, but it will not be a requirement from the Government. As I said, in certain settings—crowded places such the tube in London—many people would choose to wear masks, despite its not being a legal requirement.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

The immunosuppressed want to know what the plan is for them. Will they be allowed tests for spike antibody levels on the NHS? Will they be able to get a booster before September if their antibody tests show that they have no protection, despite being vaccinated?

[Sajid Javid]

My right hon. Friend asks an important question and we are still considering what more we can do to give more confidence to the immunosuppressed, and we will be saying more on this shortly.

Covid-19 Update

Caroline Nokes Excerpts

Monday 14th June 2021 Commons Chamber

[Matt Hancock]

We published the data for the number of imported cases of B1617 and other variants at the time the decision was taken. That data was the data—including up to 7 April—on which we took the decision, which was announced on 19 April, but it does take that time to see the sequencing, because it operationally takes time. Since we have published that data, I have heard endless calls from those on the Opposition Benches, including from the right hon. Lady, that I should have acted on data that we could not see and that had not been gathered, and that is only a way to make a point if you do not care about the truth of what actually happened.

[Caroline Nokes (Romsey and Southampton North) (Con) [V]]

As the evictions ban comes to an end and rate relief ends, what reassurance can my right hon. Friend give businesses such as Fitskool in my constituency, which is still operating under restrictions, that this delay to full step 4 really is the last delay?

[Matt Hancock]

I understand entirely the point that my right hon. Friend is making in terms of these restrictions and the impact on businesses and, in particular, the link to those in rent arrears. That is something I have been discussing with the Communities Secretary, and I am very happy to meet her to discuss how in the short term we can ensure that businesses, such as the one in her constituency that she mentions, get the support they need.