Surgical Mesh

Chris Elmore Excerpts

Thursday 19th April 2018 Commons Chamber

[Chris Elmore (Ogmore) (Lab)]

On the hon. Lady’s comments about justice being done, I have been approached by two constituents who have been greatly affected by vaginal mesh. One of them is unable to work. She has to be lifted up to walk as she cannot stand by herself, so she needs carers. Does the hon. Lady agree that in many cases it is not only justice that is needed, but compensation? As the Chair of the Health Committee said, we need to start looking at compensation for some women. My constituent is in her early 50s and can no longer work.

[Fiona Bruce]

That is something that I have said not only about this issue, but about the use of valproate. It is important that we pay close attention to the experiences and difficulties that patients have endured. We need to be more open to learning what we can from their experiences, making changes where necessary and—as the hon. Gentleman says—examining where compensation should be sought for them.

Baroness Cumberlege has been instructed to look comprehensively at the whole issue. The Government want to listen. We have all seen examples in which people have appeared to listen to concerns, nodded their heads and then gone away and done nothing. That is not what is happening here. I believe that the Secretary of State and Ministers not only want to listen carefully to concerns on this issue, but stand ready to act appropriately. For that reason, I think the proposal in the motion for a full public inquiry is inappropriate at this stage. We need to give time for Baroness Cumberlege to report. We need to urge that that be done urgently, and we need to ask Ministers questions.

I have some questions of my own for the Minister. What is the timescale for the review and what progress has been made already? Does the Minister agree that introducing an outright ban would be inappropriate before the review? Can she assure the House that the new NICE guidelines which recommend against first use of the surgical mesh to treat pelvic organ prolapse are being carefully followed throughout the NHS? Is it correct that in the vast majority of instances the use of surgical mesh has proven to be an effective intervention that has enabled many women to live happily and independently after surgery? I believe that some 1,500 women receive vaginal mesh implants each year and the majority respond well. If that is correct, it is important to balance that against the distressing individual cases that we have heard about today. I also understand that the high rate of success for the use of surgical mesh to treat hernias suggests that an outright ban would be rash at this stage, and certainly premature before the Cumberlege review reports.

What information can the Minister provide on the recent development of a new material for surgical mesh implants? What more information do we have about how that is expected to reduce discomfort because of its greater likeness to human tissue? Can the Minister update the House on what progress is being made to improve GPs’ awareness of SUI and POP and how best to treat those conditions, so that women are given the most appropriate treatment for their circumstances? Will the Cumberlege review take into account international research on this issue? We have heard some mention of it today, but I understand that no other jurisdiction has imposed an outright ban on the use of mesh.

In conclusion, the Secretary of State has made it clear that we are building on substantial work from over the past few years—the Cumberlege report comes on the back of a lot of other work, and I hope the Minister will confirm that that will all be taken into account. I ask Members to await that report before we make any final decision. Professor Keith Willett brought forward the 2017 Mesh Oversight Group report, which followed the Mesh Working Group interim report in 2015. He said that

“there has been significant progress since this work began. Information available to women and clinicians is now better and more consistent, data recording has been improved, including of complications, and women can now be referred to multi-disciplinary teams of health professionals with the experience necessary to advise women who are experiencing complications from mesh surgery on their treatment options.”

John Wilkinson, Director of Devices at the Medicines and Healthcare Products Regulatory Agency, stated:

“We continue to see that evidence supports the use of these devices in the UK for treatment of the distressing conditions of incontinence and organ prolapse in appropriate circumstances.”

We must ensure through this review that every circumstance in which these devices are used is appropriate, and that the women involved feel confident of that.

NHS Staff Pay

Chris Elmore Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

I certainly recognise my hon. Friend’s strong argument for an urgent care centre, and I commend the very hard work of the staff at the Alex. I know that the new leadership at the trust is making progress and turning things around, and I hope that what has happened at Harlow today will be an inspiration.

What we are doing today is significant. The extra doctors and nurses whom we are training, and a pay deal that is intended to boost recruitment in the NHS, demonstrate our recognition that we need a significant increase in capacity in the NHS and the social care system if we are to ensure that every older person gets the care that they really need, which is what the Government want.

[Chris Elmore (Ogmore) (Lab)]

May I press the Secretary of State a little further on Barnett consequentials? Will he confirm that there will be consequentials for each of the three years of the pay rise? Will he also welcome the Welsh Government’s introduction of a living wage in the NHS in 2014, and does he recognise that NHS and social care spending is higher in Wales than it is in England? That is a matter of fact.

[Mr Hunt]

What is a matter of fact is that the NHS in Wales would have £1 billion more if the Welsh Government had matched the increases that have taken place in England and that Welsh patients waiting for both elective and emergency care are 40% more likely to wait too long.

NHS Winter Crisis

Chris Elmore Excerpts

Wednesday 10th January 2018 Commons Chamber

[Mr Hunt]

It absolutely does, and no one campaigns more vigorously for his local trust than my hon. Friend. Just before Christmas, I visited his trust’s Gloucester site and met the management and staff. The situation there is extraordinarily impressive and a great inspiration to many parts of the NHS.

I finish on the issue of funding. The shadow Health Secretary has been using very strong language, but he has conveniently overlooked the fact that in the past four years, real-terms funding for the NHS has increased by £9.3 billion, which is £5.5 billion more than his party promised in 2015.

[Chris Elmore (Ogmore) (Lab)]

Will the right hon. Gentleman give way?

[Mr Hunt]

I will conclude, because a lot of hon. Members want to speak.

The shadow Health Secretary is right that there are real pressures, so what are the facts? We spend 9.9% of our GDP on health, which is 1% above the EU average, and about the same as the EU15—the western European countries—but we want to spend more, so in England, from 2011, funding went up by 15.6%. In Wales, Labour chose to increase funding by only 8%. This motion is about money. When it comes to NHS funding, Labour gives the speeches, but Conservatives give the cash.

--- Later in debate ---

[Dr Whitford]

I completely agree that establishing accountable care organisations only through secondary legislation is utterly wrong. We have had multiple debates about STPs, and I have said that going back to place-based planning is the right way to integrate and develop a local service, but there should not be a private company at the top making the decisions. There needs to be a publicly accountable body. There is going to be yet another big reorganisation in NHS England, and the proposed structure needs to be debated in this place, not behind closed doors. Yes, money is tight, with the NHS seeing rises of just over 1% a year in the past seven years compared with almost 4% in the past, but it is estimated that between £5 billion and £10 billion is being wasted in the healthcare market itself, through bidding, tendering and profits, and now through this habit of companies suing if they do not win a contract.

It is crucial to move back to developing services for a community. It is also crucial that health and social care should be integrated, and I welcome the combination of both titles in the Secretary of State’s role, if that means that we are going to work towards meaningful integration, but it must be done in a structured, responsible and legalistic way.

[Chris Elmore]

The Government spend an awful lot of time attacking the Welsh NHS. In terms of the Secretary of State’s new cordial attitude in not attacking any NHS services, will the hon. Lady join me in condemning former Prime Minister David Cameron’s comment that Offa’s Dyke was the line between life and death, depending on which country one lived in? Wales has an integrated health and social care service, which is also integrated with local government, with a £60 million fund having been established over the past five years. She referred to the cross-party working that could happen, particularly if the Government were willing to engage properly in these services rather than attacking the Scottish and Welsh Governments on NHS care. Does she agree that we could use such working to learn good practice?

[Dr Whitford]

The four health services are very different. In essence, we have four laboratories. NHS England is by far the largest, but they all face different as well as similar challenges. I am sure that if there were more discussion of how things have been done, there could be more lesson-learning in different directions.

In 2010, we were promised that there would be no more reorganisation. The same promise was made in 2015, but NHS England is now facing another reorganisation, in the STP system and in accountable care. It is crucial that the focus should be not on bottom-line, budget-centred care but on patient-centred care. It is wrong that any such changes should be introduced through secondary legislation. They must be introduced in this place—either through debate, in Committee, through convention or in a royal commission—to enable us to come up with a structure that will function. Since 2013, the deficits have gone up, the waiting time failures have gone up and the stress on staff has gone up, making it even harder to keep hold of people. Let us put the patient in the middle, but let us also support the staff who look after the patient.

Hormone Pregnancy Tests

Chris Elmore Excerpts

Thursday 14th December 2017 Commons Chamber

[Sir Mike Penning]

I praise the Clerks who helped me to draft the motion. I was very angry when we started drafting it, after reading the report, but they helped me get it into some kind of parliamentary language.

An inquiry has to be independent and judge-led, and it has be able to subpoena people to give evidence before it on oath, so that we can get to the absolute truth. It also has to look at the regulatory system that was in place at the time. I am afraid that the Department of Health cannot hide behind this report. To me, that is vital.

Let us look again at the point about the inquiry being fair and independent. One of the ways we thought it could be independent and fair was to have an expert witness who was not part of the campaign, but whom everybody massively respected. For those of us who have been involved in the thalidomide campaign over the years, it was a really positive thing when we heard that Nick Dobrik’s name would be put forward.

Interestingly enough, although Nick was there as an expert witness, he was not asked to play a part in drawing up the conclusions in any shape or form. In fact, he was asked to leave the room. Nick was very surprised—actually, he was gobsmacked—when, in good faith, the Minister and then the Prime Minister said that Nick Dobrik had fully endorsed the conclusions of the report. I know now that the Minister and the Prime Minister know—I have met the Prime Minister, and Nick has done an interview with Sky today—that he categorically does not endorse the conclusions of the report. It was fundamentally wrong for anyone to advise the Prime Minister or the Minister that he did. He does not blame the Prime Minister; I do not think I blame the Prime Minister. As a former Minister—I know that there are former Ministers on the Opposition Benches—I know that we take advice from our officials and they tell us what the situation is. In good faith, the Minister at the urgent question, and the Prime Minister at Prime Minister’s questions, said that Nick endorsed the conclusions.

On behalf of Nick, who cannot defend himself in this Chamber, I would like whoever gave that advice to the Minister and the Prime Minister to formally apologise to Nick Dobrik. He is a fantastic campaigner not only for the Thalidomide Trust, but for all injustices, especially within the pharmaceutical area. The victims do not feel that the inquiry was fair and independent at all. They should have trust and confidence.

The most important thing is that the inquiry was asked to find a “possible” association—not “causal”, but “possible”. I and other members of the all-party group asked the experts from the panel why, after taking the word “inquiry” out, the remit was changed again, because “causal” is very difficult to prove. They said that they followed the science, but they were supposed to follow their remit and do what they were told. If they felt that they could not do that based on the evidence in front of them, fine. They could have gone back to the Minister and the victims and explained that. Instead, we had the farcical situation of the group looking for something when they knew full well—it is clearly in the documents—that they could not reach the conclusion that there was a causal link.

Interestingly enough, the group also could not come to the conclusion that there was not a causal link, because the evidence was not there for either conclusion. As I said during the exchanges on the urgent question, an injustice has taken place. Natural justice is the reason we are sent here. We defend our constituents when the system has come down against them and caused such horrific, horrible things to happen to them, so we need to address that injustice.

[Chris Elmore (Ogmore) (Lab)]

Will the right hon. Gentleman give way?

[Sir Mike Penning]

I will give way once more and then I will conclude to give other colleagues time to speak.

[Chris Elmore]

I am exceptionally grateful to the right hon. Gentleman. He says that everyone has constituents who have been affected. Two of my constituents have told me that they believe that they lost their children as a result of the drug. It is even more severe than losing a baby; one of them lost several children by taking the advice of their GP. This is a fundamental issue of trust—trusting the GP, trusting the NHS and trusting the inquiry. All those things have failed. Both my constituents told me over and over, “We no longer have any faith in the system.” They believe that the report is a whitewash, which is why I wholeheartedly agree that there should be a full and frank inquiry.

[Sir Mike Penning]

I thank the hon. Gentleman for his support for the victims.

As I said earlier, there is no constituency in this country that does not have someone who lost their baby due to stillbirth or dying shortly after birth, or whose life was transformed—for those who survived. However, many people were advised to have an abortion, and the figures on that are not available to us. Reports that the inquiry was not allowed to have are starting to come through.

I fully endorse the fact that we need some money so that we can ensure that we have modern reports, because the methodologies used back then would never be allowed today. We also need to see the missing reports. We need to find the stuff that has gone missing in Germany, where the drug company knew there were issues. We need to know why the drug company settled in America—it was using a slightly different name for the product, but it was the same company. What evidence was put before the legal system in America, where the company settled as fast as possible, and then gagged everybody and kept everything quiet?

We have a duty in this House to call things into question when they go wrong. These things started going wrong many years ago—before I was born. I have been a Minister, so I know that Ministers have to support their Department, but one role of a Minister is to question the advice that they get. I know that that is what the Prime Minister is going to do now, and I hope the House will support the victims so that they can have some confidence in the system and the NHS once again.

Health Committee

Chris Elmore Excerpts

Thursday 16th March 2017 Commons Chamber

[Chris Elmore (Ogmore) (Lab/Co-op)]

I congratulate the hon. Lady and her Select Committee on their work. She might be aware that in the mid-2000s there was a series of tragic suicides across the Bridgend County Borough Council area, of which my constituency forms part. I obviously was not a Member of this House when those suicides took place, but they are a major part of people’s memories of what happened across those communities.

On media attention, the hon. Lady may be aware that a film was made about those suicides that was not welcomed by the various communities; I am glad she is pursuing the part of the report on tackling the media impact regarding the glorification of suicide, if I can put it like that. Suicide prevention and health policy more widely are devolved to the Welsh Government, but will she consider sharing the Select Committee’s report with the Welsh Assembly’s Health, Social Care and Sport Committee? I passionately believe that if we can learn best practice on tackling suicides from Select Committees in the Scottish Parliament, the Northern Ireland Assembly or, indeed, the Welsh Assembly, we should share that throughout the UK.

[Dr Wollaston]

I would be delighted to meet the hon. Gentleman and share the report, as he suggests, because I agree that we should be sharing best practice throughout the devolved nations and England. On the specific point about the role of the media, the Samaritans has produced really clear guidelines, which I hope all media organisations will look at closely. We should also go beyond broadcast and print media and look at the role of social media and the internet.

Social Media and Young People's Mental Health

Chris Elmore Excerpts

Wednesday 2nd November 2016 Westminster Hall

[Chris Elmore (Ogmore) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Sir Alan. The development of social media and the role they play in each of our lives is significant, yet there is limited focus on their impact, so I sincerely thank the hon. Member for Cheltenham (Alex Chalk) for securing this debate. Social media are neither inherently good nor inherently bad, but there is no doubt that they can have a negative impact on the mental health of young people. I take this opportunity to draw attention to a few adverse effects of social media and how they can affect the mental health of children, teenagers and young people.

One of the most notable consequences of social media use is that it can create an unhealthy need for constant approval. When a young person uploads a new photo of themselves, the number of likes can act as a barometer of their perceived popularity that they can instantly compare with their peers. In the past, being at the receiving end of a compliment or even a smile may have been enough for a teenager to feel good, but now they will often need dozens of likes on their profile picture or dozens of retweets to feel the same sense of acceptance. It can be incredibly important for a young person to feel as if they fit in, but with social media creating such an obvious scale of approval it can be painfully difficult for a teenager to think they are popular.

Aside from that, social media can be damaging because they can create unrealistic expectations. Young people naturally compare their appearance with that of their peers, but when the photos they see of their friends have had filters and effects applied, they are comparing themselves to unrealistic standards. When people use social media to post about their lives and how they spend their weekends and holidays, teenagers will compare their lives, too. Inevitably some will see themselves as having less interesting or less exciting lives than their peers, which can be damaging to their self-esteem. Of course it is not only friends and family with whom young people compare themselves. Social media give opportunities to follow celebrities, which gives way to even more distant and unrealistic standards to which to aspire.

We should be cautious not to overplay the dangers of social media. It is important to recognise that all technological developments of this scale can have positives. History should serve as a reminder that we often get ahead of ourselves when a new technology plays a role in our lives. Social media are having an adverse effect on the mental health of young people, but they are not inherently bad. Indeed, in moderation, social media can help young people to have a more positive adolescence. If platforms such as Facebook are used to organise face-to-face interactions, rather than replace them, young people can create relationships with far more ease than previous generations.

Social media can also be a great alternative education tool and a way for young people to express themselves, but we should be cautious of them and recognise the negative effect they often have on the mental health of young people. It is vital that social media companies do more not only to manage the content of their pages and sites but to take responsibility for their impact on young people and their mental health.

It is great to see attention and parliamentary time given to debate mental health issues again, and I am particularly pleased that we are debating the roots they can have in social media. I hope we can all learn from this discussion and that concerns raised today will be taken on board by the Minister and eventually translated into Government policy.

[Stuart Blair Donaldson]

rose—

Land Registry

Chris Elmore Excerpts

Thursday 30th June 2016 Commons Chamber

[Carolyn Harris]

I am aware of that and I will come to it later in my speech.

The consultation on moving Land Registry operations to the private sector was launched on 24 March 2016. Ludicrously, it closed two days later. I would argue that it was deliberately timed so that MPs would not notice the announcement, because we were all heading home for the Easter recess—I was actually on a train to Swansea, and I read of the plan on a Twitter post. Like many colleagues, I was furious at the way the announcement was made.

Currently, the Land Registry is entirely self-funding and no drain whatever on the Government purse. Furthermore, the service makes a surplus year on year. That is passed on to the public by way of reduced costs for using the service. It also provides the Treasury with a significant income.

A report from the New Economics Foundation shows that selling off the Land Registry would harm Government finances in the long term. It suggests that the Land Registry and other assets under threat of privatisation or part-privatisation are clearly able to innovate and deliver a profit without needing to be in the private sector.

The sale of the Land Registry will hardly put a dent in the national deficit finger—[Laughter.] We can all point the finger at the Government. At the same time, we will be giving up valuable assets and forgoing long-term revenue streams. Land Registry jobs are also well paid and, more importantly, well respected. It is important that we retain them as part of a well-mixed economy to give job opportunities and a way forward to people from all sorts of backgrounds.

Only an in-house Land Registry can continue to deliver a quality, trusted and impartial public service.

[Chris Elmore (Ogmore) (Lab/Co-op)]

My hon. Friend is making a key point, and I completely agree with her. The public outcry about the privatisation of the Land Registry is unprecedented. People trust the service, and they want it to remain. Fundamentally, it is also profitable. Why the Government are considering privatising it is beyond most Opposition Members and several Government Members as well.

[Carolyn Harris]

I entirely agree, but, unfortunately, public demands do not always fall on receptive ears, to quote the Women Against State Pension Inequality Campaign.

If privatised, the Land Registry would no longer be subject to the Freedom of Information Act, so it would be easier to conceal who owns land and to prevent the publication of datasets such as those that identified the properties in London owned by the non-domiciles in the Panama papers.

I am distressed to see jobs disappear in my constituency. Swansea East is already suffering enough job losses—Royal Mail, HSBC, Virgin Media and Tata Steel. We cannot afford to lose any more jobs. In the last Parliament I tabled an early-day motion calling for the Government to abandon plans for privatisation, and I am glad to say that it received a lot of support. It has been retabled this month, and it is again gathering support.

Many feel that this proposal is just another get-cash-quick scheme from the Government, but in reality it jeopardises jobs, brings economic uncertainty and threatens to remove the transparency that allows us to have confidence in the fight against corruption and illegal accounting.

I implore the Minister to realise that this plan is ill-thought-out and that it will be challenged by the unions, legal and property professionals, the public and Opposition Members. The Land Registry is value for money, and it is an efficient and trusted service.

NHS Commissioning (Pre-Exposure Prophylaxis)

Chris Elmore Excerpts

Tuesday 7th June 2016 Commons Chamber

[Jane Ellison]

The first point is a red herring, because I understand that the matter has been resolved. I do not accept the hon. Gentleman’s criticism. It is slightly disappointing, although I understand the reason for it in the context of this urgent question, that Members are forgetting that the UK has a world-leading position on HIV treatment in all the ways that I laid out in my response to the urgent question. Our movement towards the UNAIDS goals is very significant, so to say that the UK is somehow not a leader in HIV treatment and prevention is not right. We have clearly acknowledged that PrEP has a role to play, but we need to understand more about what that is.

[Chris Elmore (Ogmore) (Lab/Co-op)]

Will the Minister clarify her previous answer in which she said that she is putting aside the clinical significance of this? I find it quite confusing that she can do that. Does she agree that although the UK has been a leader in HIV prevention for decades, our progress is under threat because of her decision? Will she now think again?

[Jane Ellison]

Not for the first time, may I clarify that no decision has been made about the commissioning of PrEP? I am therefore not sure why the hon. Gentleman would say that. I have been very clear about the clinical effectiveness. What I am saying is that there is more work to do to understand the wider cost-effectiveness of this in the context of the commissioning of HIV prevention more broadly.