NHS (Government Spending)

Chris Heaton-Harris Excerpts

Wednesday 28th January 2015 Commons Chamber

[Barbara Keeley]

I thank the Minister for giving way, particularly as he is a doctor. He never took into account my real-life experience in IT when we debated care.data, so he wants to be careful about saying that people do not have real-life experience—several of us have real-life experience in different industries, but he does not take that into account.

[Chris Heaton-Harris (Daventry) (Con)]

Point to them.

[Barbara Keeley]

I am pointing at myself.

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[Chris Heaton-Harris (Daventry) (Con)]

It is a pleasure to follow the hon. Member for Heywood and Middleton (Liz McInnes). I know that she cares passionately about our national health service, as well as having considerable experience of it. I want to start by mentioning some massive positives and some points of agreement with the Opposition. Everyone in this place knows that the NHS at all levels gives their constituents incredible care. Yes, some people occasionally complain when things go slightly wrong, but they are relatively small in number compared with the quantum of folk who come through the NHS’s doors every day.

Yes, I am going to make the points that every Conservative and coalition Member will make about the NHS budget going up by around £12.7 billion in cash terms over the course of this Parliament, about the fact that we have had 850,000 more operations being delivered each year compared with 2010 and about the fact that the number of MRSA bloodstream infections and incidences of clostridium difficile are at an all-time low. I am also going to make the point that more than 1.3 million more people have access to an NHS dentist. When we came into office, that was really difficult for people to do. We all remember the bad old days.

Given our excellent track record, I am surprised that the Opposition want to talk about the NHS quite so much, especially when their plans include extra spending that they simply cannot account for or that they have already spent several times over. I should not be surprised, however, because although I am sure that every individual Labour MP truly does love the NHS, they are complicit in their leader’s bizarre plan to weaponise it. They want to forget about the NHS caring for people and instead use it for political advantage.

Alas, I have seen such weaponisation locally in my county, where Labour has deliberately tried to scare vulnerable people by saying that hospitals or services are going to close. During the Corby by-election campaign—I informed the hon. Member for Corby (Andy Sawford) that I was going to mention him and his constituency—Labour ran a petition against the closure of Kettering general hospital. The hospital is not in the Corby constituency, and it was not going to close. During the campaign, I went to the Lakelands hospice in Corby, where I met a lovely elderly lady. She told me how afraid she was that the hospital that she was going to was closing. Just in case hon. Members think I am making this up, that exchange was witnessed by a local BBC television crew. I know that the hon. Member for Corby has learned from that experience and that he is now working with my hon. Friends the Members for Wellingborough (Mr Bone) and for Kettering (Mr Hollobone) to get better services from Kettering hospital.

The Opposition have even tried to scare people by using that disgusting tactic in my own constituency. Last week, I received an e-mail from a local Labour activist who told me that Danetre hospital would close if my party won the next election. That is a common theme among Labour party members when they talk to the public in my constituency. Danetre hospital is a fantastic NHS resource in the town of Daventry, but it remains under-used by the hospital trust that controls it. However, the trust is looking into using it better, and I have met its chief executive, Dr Sonia Swart, to talk about the plans for the hospital. It has two operating theatres and 28 beds. It also has free parking—a phenomenal thing in our NHS. I have been assured by everyone that Danetre hospital is here to stay, but I knew that anyway. How did I know? Because it has 22 years remaining on an amazingly expensive private finance initiative deal that costs about £3 million a year to fund.

Perhaps now is the time for those on the Opposition Front Bench to apologise for what they are allowing to happen in their name. But they will not, because they are weaponising the NHS, and they have a track record of doing that nationally. I seem to remember a national campaign in March 2012 about there being 24 hours to save the NHS. At 3 pm today, 25,047 hours will have passed since that campaign was launched, yet the NHS is still serving millions of people in our country.

The Opposition criticise the private elements involved in the NHS but they will not tell us how much private sector involvement is acceptable to them. It was introduced on scale by the Labour Government and went up to 4.4% on their watch. It is now nearly 6%. What percentage is acceptable to those on the Opposition Front Bench? Perhaps they would limit the areas in which the private sector could operate. Maybe there would be no more private cancer care—we heard that mentioned earlier. It would be interesting to tell that to someone suffering from cancer who might be getting better treatment at the moment. Perhaps the Opposition would put an end to hip replacements and MRI scans being performed outside the NHS. Which private sector involvement do they think is bad?

Yes, there are issues with NHS finances. Demand is massive; it is higher than ever before, and the NHS is treating more people than ever before. I sit on the Public Accounts Committee, and we have looked at many NHS projects and items. Perhaps an Opposition Member would like to stand up now and say how proud they are of the 2004 GP contracts, of the consultants’ contracts or of the NHS IT contract that cost the NHS and the country £10 billion in waste. Some salaries in the NHS seem very high. The chief clinical commissioning officer for the Vale of Glamorgan CCG is paid £185,000 a year, with pension and benefits, despite the fact that NHS England recommends a pay band of up to £100,000. NHS finances are safe only when our national economy is strong and growing. They are safe only under this party’s leadership.

Oral Answers to Questions

Chris Heaton-Harris Excerpts

Tuesday 21st October 2014 Commons Chamber

[George Freeman]

My hon. Friend makes an excellent point. As well as providing a £10 billion boost to the economy, which I am surprised to see that the left is not in favour of, and securing 13 million jobs in the EU, this treaty also helps our NHS pioneers and innovators and our UK life science companies generate revenue for this country from our innovations in health care in the world’s biggest health care market.

[Chris Heaton-Harris (Daventry) (Con)]

Is it not the case that free trade agreements have always grown the economies that have contracted within those agreements, and a growing economy can only benefit the NHS in the future?

[George Freeman]

My hon. Friend makes an important point. The truth is that we cannot have a strong economy without a strong NHS, and we cannot have a strong NHS without a strong economy. In a modern society, health and wealth go hand in hand, which is why this treaty, with the safeguards that we have secured, is good for Britain and good for NHS patients.

Oral Answers to Questions

Chris Heaton-Harris Excerpts

Tuesday 1st April 2014 Commons Chamber

[Mr Jeremy Hunt]

It is financially challenging for the NHS, but we will not lose control of NHS finances, as happened under Patricia Hewitt. I remind the hon. Lady that for nine of Labour’s 13 years in office the NHS trusts sector as a whole was in deficit. We are getting a grip of those problems. We will publish the figures she wants, but the reason it has been particularly challenging this year is that hospitals have responded to the Francis report and hired 3,500 additional nurses to ensure that we have proper care on our wards.

[Chris Heaton-Harris (Daventry) (Con)]

T5. What progress is being made on ensuring that selective dorsal rhizotomy is available to children with cerebral palsy who need that life-changing operation?

[Norman Lamb]

I remember well the meeting I had with my hon. Friend, other hon. Members and some families, and indeed I remember the testimonies those families gave. I will write to NHS England about his question and report back to him on the progress it is making.

Oral Answers to Questions

Chris Heaton-Harris Excerpts

Tuesday 11th June 2013 Commons Chamber

[Norman Lamb]

I understand that all clinical commissioning groups have a lead on diabetes care, but we can do an awful lot more to improve prevention work. We know that if we guide people in self-care, we can achieve massive improvements in their own health and well-being, and reduce the number of crises that occur. I am happy to work with the right hon. Gentleman to ensure we do everything we can to improve diabetes care.

[Chris Heaton-Harris (Daventry) (Con)]

13. What recent representations he has received expressing concern about the service provided by the East Midlands Ambulance Service.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Over the past year we have received more than 40 letters from MPs in the east midlands, including my hon. Friend the Member for Daventry (Chris Heaton-Harris), local authorities and members of the public, about the service provided by the East Midlands Ambulance Service NHS Trust and its being the best programme. My hon. Friend will also be aware that there was an Adjournment on the matter earlier this year.

[Chris Heaton-Harris]

The Minister will recall that I have raised a number of constituency cases with his Department and the Care Quality Commission about the standard of services provided by EMAS to my constituents, and how it treats its staff. Will he assure me that the Department will continue to monitor EMAS’s performance in the coming months?

[Dr Poulter]

My hon. Friend can be reassured that the trust development authority and the local chief commissioner for Erewash CCGs are closely monitoring the situation. Today, the Marsh review into the east of England ambulance service has been published, and lessons from that review about how management processes can improve front-line care for patients can be learned and applied across other ambulance services.

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[Anna Soubry]

I pay tribute to the hon. Lady, who campaigns hard for her hospital, and quite rightly so. I have met my right hon. Friends the Members for Sutton and Cheam (Paul Burstow) and for Carshalton and Wallington (Tom Brake) and am more than happy to meet her to discuss all the important matters she raises.

[Chris Heaton-Harris (Daventry) (Con)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

There have been two important developments since the previous Health questions. First, in response to pressure on A and E departments, my Department, together with NHS England, has started work on a vulnerable older people’s plan that will act quickly to address the underlying causes of the issues, including services that are not integrated, poor IT systems, confused emergency care offered to the public and poor primary care alternatives.

Secondly, following the tragedy at Mid Staffs, I am delighted to announced that Professor Sir Mike Richards has been appointed as England’s first ever chief inspector of hospitals. He is an inspirational leader who has personally championed huge improvements in cancer survival rates. He will lead the vital work of driving up standards of safety and care throughout NHS hospitals.

[Chris Heaton-Harris]

I thank the Secretary of State for that statement. Will he give the House an assurance that he will look at GP contracts, with a view to amending them to ensure that better care is given to older patients?

[Mr Hunt]

My hon. Friend makes an important point. Talk to any A and E department in the country, and they will say that poor alternatives in the primary care sector are one of the things that are driving the pressures on them. It is important that we look at the structures put in place by the 2004 GP contract to see whether they are the right way to provide the care we need to give to older people.

Mid Staffordshire NHS Foundation Trust

Chris Heaton-Harris Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

I agree with what my hon. Friend says.

[Chris Heaton-Harris (Daventry) (Con)]

I congratulate my right hon. Friend on his statement, particularly the parts about where perverse effects of the old target culture kick into the NHS. When the dust has settled on the Francis report and its conclusions, will he look at targets that affect the ambulance service and how they directly affect rural communities across the country?

[Mr Hunt]

We will absolutely do that, but I should also reassure my hon. Friend that the inspection regime will apply to the ambulance service as well as hospital trusts.

Neonatal Care

Chris Heaton-Harris Excerpts

Wednesday 6th February 2013 Westminster Hall

[Chris Heaton-Harris (Daventry) (Con)]

It is a pleasure to serve under your chairmanship once again, Mr Streeter. I thank my hon. Friend the Minister, who could have been, but was not, slightly late, which is ironic in a way because the debate is about babies who turn up very early. He was due to be in the Chamber as we speak, but kindly rearranged a whole host of things to be here this afternoon to answer the debate. I thank him very much indeed. He and I have often spoken about neonatal care, and indeed stillbirth, so I know that he will do all he can to answer the debate with deeds as well as words.

Neonatal care is an absolutely vital service that no parent or prospective parent ever wants to have to rely on, but lots do. One in every nine babies in the UK is born either premature or sick—more than 80,000 every year. We therefore need a service that is fit for purpose and provides the best possible care to all premature or sick babies and their families in facilities that can give the best care—sometimes very specialised care—at a harrowing time for the parents concerned.

One of my constituents, a fantastic mum called Catherine Allcott, alas, had to rely on neonatal care a few years ago. Catherine’s twins, Luke and Grace, were born unexpectedly at 26-weeks gestation. At six weeks old, they were separated and sent to neonatal units 40 miles apart due to Luke’s critical condition. Catherine and her husband, Nigel, spent the next three months visiting two hospitals every day until Luke sadly died and Grace was discharged. Grace is now a delightful, happy, healthy six-year-old and Catherine’s experiences during that time have shaped her fundraising and campaigning work for Bliss—a fantastic charity that campaigns for continual improvements to neonatal care and is a strong advocate of care for babies.

When the results of the 2010 general election were announced, Catherine was one of the first people to find my advice centre. Before I knew it, I was being whisked around the Gosset neonatal ward of Northampton general hospital, looking at their facilities and talking to staff and parents. Since then, I have had the pleasure of visiting many other maternity and neonatal wards across the midlands and the south-east.

Catherine is concerned, as Bliss is, about the national shortage of neonatal nurses, particularly those qualified in that specialty. Half of all units do not have enough nurses to meet national standards and one in 10 units is so busy or understaffed that they cannot release nurses for specialist training. According to Bliss’s report on saving our specialist nurses—by specialist, I mean nurses who have a recognised qualification in specialist neonatal care—that figure is pretty solid.

As was shown by a Bliss report in 2010, that boils down to the need for 1,150 extra qualified specialist neonatal nurses—the figure has changed since that date, but that is the latest I have—if we are adequately to provide the service that this country so desperately needs and that babies and their families deserve. Not all nurses working in neonatal care have the specialist qualification, but the “Toolkit for high quality neonatal services” states that 70% of a unit’s nursing work force should hold one.

According to an Oxford university study, an increase in the ratio of qualified and specialist nurses to babies in intensive and high-dependency care might reduce infant mortality rates by 48%, something that is surely worth every penny and for which it is definitely worth fighting. I am told that that works out at about £1,400 of additional investment per baby, which, as the Government have themselves highlighted, would benefit society in the longer term to the tune of approximately £1.4 billion.

As I have said, I have seen my local neonatal care unit in action and know the pressures that Gosset ward is under. The staff at Northampton general hospital do an excellent job, but they face significant pressures, even after an increase in staff equivalent to 4.3 full-time nurses. Despite that increase, the unit has had to close its doors to new admissions more than 20 times in the past year for non-medical reasons, a statistic that is surely not good enough. We should not and cannot restrict access to health care to some of the most vulnerable and innocent in our society—the next generation—on the basis of those lax numbers. Frankly, we must do better and we must do more.

The shortfall nationally shows the extent of the issues that we face. More than half of all units do not have enough specialist nurses to meet the national standard—that 70% of the nursing work force should hold a specialist neonatal care qualification—and the importance of such specialist care is so clearly shown in an area where such tiny and fragile babies can have such complex and often multiple conditions. It is not a hole that can just be plugged in the short term to meet a budget, but something that needs long-term planning and investment in a skilled work force.

If we are to achieve such a national standard and address the recruitment of specialist nurses that neonatal units require, continued investment in education is of paramount importance. I therefore welcome the national changes to the commissioning of specialised services. They promise to ensure that we do not face a postcode lottery, thus improving the consistency of services across the country and spreading best practice.

Locally, my constituents in Daventry and I have other concerns and opportunities. The Minister will know of the “Healthier Together” programme in the south-east midlands, which is looking at the services provided at the five main hospitals in Bedford, Kettering, Luton and Dunstable, Milton Keynes and Northampton. There are options or plans to reduce the number of maternity units that are consultant-led from five to three, an action that would have a clear impact on neonatal services, because it is most likely to result in the closure of neonatal units at the hospitals that have midwife-led units.

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing this important debate. I have a very successful midwife-led maternity unit at Hexham general hospital. Does he agree that such units can provide a fantastic ongoing service, but that it is very important that parent and larger hospitals in the region provide them with neonatal transfers and ongoing support?

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[Chris Heaton-Harris]

I am happy to agree with my hon. Friend, and I will speak about that in more detail later.

I am not particularly against the mooted changes in the south-east midlands if they provide a higher quality of specialist care at nearby centres of excellence. However, the changes raise several important questions that I hope the Minister will answer either now or later by letter. Will he ensure that the “Healthier Together” proposals and similar ones up and down the country are driven by a genuine programme to improve outcomes and quality, and not just to save costs or money?

As my hon. Friend the Member for Hexham (Guy Opperman) said, it is absolutely vital that the needs of families of premature and sick babies are factored into any changes and are not inadvertently overlooked when mainstream maternity and children’s services are redesigned. Will the Minister say something about transport to neonatal centres, both now and in the future? Many parents find themselves quickly transported from knowing what is happening and where they expect a birth to take place, to not knowing what is going on and intense worry.

When parents have to travel further afield to centres of excellence, they have plenty of increased costs in the travel, parking charges and time considerations that come from such changes. Those responsible for planning services must take that into account. I hope that the Minister will respond on that point, and assure me that those planning services take costs into account so that not only do babies receive the highest quality care, but services and support are in place to meet families’ needs.

The parent is intrinsic to the care of the child, which I believe sets neonatal care apart from almost every other branch of medicine. We must therefore consider the needs of the parent alongside those of the child. It makes good economic sense: babies whose parents are included in their care grow faster, have less illness, go home sooner and do not come back; and their parents have less stress and fewer mental problems later. There is a huge benefit from getting neonatal care right, and if we can get it right at an early stage of planning service changes, that is all to the good.

Has the Minister heard of the children’s air ambulance service that is currently being set up by the East Midlands air ambulance, which will help to cut transfer times? It will go operational on 13 March, but has already done the odd transfer here and there. On Monday 10 December, a baby who was a few days old was flown from Glenfield hospital to Sheffield children’s hospital for potentially life-saving treatment. The total transfer time was only 34 minutes, but it would have taken one hour and 23 minutes for the team to have gone by road, which is a huge time saving for a baby suffering from a serious illness. Obviously, being operated by the air ambulance service, such transfers are at little, if any, cost to the taxpayer.

As I said, when I visited neonatal wards—especially at my local hospital, Northampton general, and the John Radcliffe in Oxford—I was really taken by the kind and understanding manner with which the staff dealt with parents. From stories related to me from across the country, I am absolutely sure that best practice can be better spread. I hope that the Minister might comment on how he will continue to ensure that the needs of such families are taken into account and that best practice is spread.

In any Westminster Hall debate on health, we get to talk about money. Although cost should not act as a disincentive to provide quality and specialised care, it is obviously a factor that cannot be overlooked. Payment by results, which has been introduced in this area, works for many other areas of policy where there is a national currency but a local tariff. However, payment by results takes into account only the current levels of service provision, rather than the services required to meet national standards; currently, those standards are not quite being met. Thus, the current shortfalls that I have outlined will only be reinforced, rather than addressed, by the payment system. A set national price would ensure that commissioners can focus on quality and outcomes of service. However, neonatal care faces a local tariff, where price invariably is a larger factor, and that equates to variable outcomes across the country.

In other types of care, significant service levels remain available under the system, but the statistics show that the disparity between one unit and another is growing in neonatal care, which suggests that the system is not working in this particular case. What steps is the Department taking to ensure that the current shortfalls are addressed and how can we ensure that this Government’s legacy sets a precedent for future neonatal care?

On a day when a disaster in Staffordshire will dominate the news on the national health service, I want to acknowledge that, all across the country, there are some amazingly wonderful NHS staff delivering the best care that they can and helping mums, such as my constituent, Catherine, and their premature babies get through some of the toughest times any of us can possibly imagine. However, with the help and advice of charities such as Bliss, the spreading of best practice and the sensible allocation of resources, I believe that neonatal care—this fantastic service that we already offer—could, and should, be delivered in a better and more consistent way.

East Midlands Ambulance Service

Chris Heaton-Harris Excerpts

Monday 21st January 2013 Commons Chamber

[Anna Soubry]

I have to say that, for the first time, I am almost speechless. It is not for me to say what is my preferred option. That decision has to be made at a local level. As the hon. Gentleman might imagine, however, I may have a point of view on the preferred option, and I am entitled to make my view known to EMAS, as indeed I will. I take the hon. Gentleman’s important point about the former coal-mining communities —they are similar to my own, although mine is not on the same scale as Bolsover. I make the point again, however, to be fair to EMAS, that the reason it has gone through this process—which has been painful for many people—is precisely because it wants to improve its service. It recognises that rural areas do not receive the kind of service that urban areas do.

[Chris Heaton-Harris (Daventry) (Con)]

In the last couple of minutes, will the Minister address the concept of regionalisation of a service such as this? We have previously seen money being wasted on the regionalisation of the fire service, and many of us with constituencies on the periphery of the East Midlands ambulance service really worry about this. The hon. Member for Bassetlaw (John Mann) talked about the hospitals outside the region that his constituents go to. My constituents go to hospitals in Oxford, Coventry and elsewhere. Does this mean that those of us in the rural outreaches of the east midlands are the ones who have to pay for this centralisation?

[Anna Soubry]

My hon. Friend’s intervention raises a point that I hope I can help him with. There is absolutely nothing to prevent an ambulance in Daventry from going to whichever hospital offers the best treatment for that particular patient. Exactly the same applies in Bassetlaw. Under the new rule, there will be nothing to prevent a patient from going to Doncaster royal infirmary, or up to Sheffield, or indeed down to the Queen’s medical centre in Nottingham. The changes will not affect the ultimate decision of which is the best hospital for that particular patient—[Interruption.] The hon. Member for Bassetlaw is chuntering at me. Does he wish to intervene on me?

Stillbirth Certification

Chris Heaton-Harris Excerpts

Wednesday 31st October 2012 Westminster Hall

[Chris Heaton-Harris (Daventry) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Owen. I hope that you will be as gentle with me as are the other Chairmen whom I have served under in Westminster Hall. I thank the House for giving me the opportunity to talk about stillbirth certification.

On 18 May 2011, I led a Westminster Hall debate on the sensitive and emotive subject of stillbirth. I explained back then that I had wanted to raise the subject ever since a couple of my best friends had a stillborn child. The way in which they and other parents of stillborn children are treated is simply not good enough for a modern developed country.

Seventeen babies are stillborn or die shortly after birth every single day in the United Kingdom, and the stillbirth rate has not changed in a decade. That number is way too high. I have been told that approximately 30% of stillbirths remain completely unexplained and that lots of different factors play into the deaths of the remaining 70%. I know that the Minister who will reply to the debate is concerned that the UK is slipping down the league table of developed nations in this regard. According to a study published last year in The Lancet, the UK has one of the worst records for stillbirths, ranking 33rd out of 35 high-income nations. Although it is important to acknowledge that all women are vulnerable, we need to work out why women in our nation may be at a higher risk of stillbirth and what we can do to change that fact.

There are some troubling regional differences in the percentage rates of stillbirth across the United Kingdom. How can we explain the 33% difference between the incidence of stillbirth in the south-west, which has the lowest rates, and the east midlands, of which my constituency is a part, which has the highest?

I have had discussions with people who point out that in recent years, Britain has become one of the unhealthiest nations in Europe. We are the most obese nation in Europe and we have the heaviest drinkers. As life expectancy has increased, more British women are also waiting until later in life to become first-time mothers. All those could be contributing factors to the horrid statistic that I read out earlier.

I could not let this occasion go by without asking the Minister what research is being done into the reasons behind our high stillbirth rate. Why is there so much regional variation? More than anything, I want the Minister to assure me and those in the Chamber that the Government have an ongoing commitment to reduce the number of stillborn children throughout the United Kingdom, to talk about this subject more and to spread best practice. What will the Minister do to ensure the spread of best practice? There are many hospitals across the United Kingdom that have fantastic practice in this area, but, equally, there are those where best practice is desperately needed. Eventually, I hope that fewer parents will suffer this terrible fate. I was personally delighted by the announcement by the Department of Health, on 16 May, of the Government’s maternity pledges, which include the pledge to provide more NHS support to women who have suffered a stillbirth.

I do not intend to go over much of the territory that we covered in the debate last year, but wish instead to concentrate on one particular area—the certification of stillborn children. Without a doubt the passing of the Still-Birth (Definition) Act 1992 was a breakthrough and had huge significance for parents. From the passing of that Act, a baby who was born dead at or after 24 completed weeks of pregnancy was recognised in law as an individual. It required that the baby’s death be registered in person by one or both parents at a register office within six weeks of the baby’s birth and it stated that a stillbirth certificate be issued.

Since I raised this subject in May 2011, I have been contacted by hundreds of families who have suffered the terrible anguish of stillbirth. Many of them have shared their stories with me, and I am in awe of how some of those parents have dealt with the worst of all possible situations.

A number of themes have started to fall together around the whole subject of stillbirth. Indeed, many parents had issues that were individual in their nature. If they had complaints about their treatment, they tended to sort them out for themselves. However, there was one very distinguishable theme that came out of my many conversations and e-mails—how to help parents grieve and eventually to move on. I believe that something simple can and should be done in that regard.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this matter to Westminster Hall. It is something that affects many people across all the constituencies in the United Kingdom. Does he agree that as things stand, the parents are not able to get the closure that they so desperately need? Although nothing can ease the pain, even to acknowledge that there was life in the first place would give a sense of closure to the family. It is a small thing but it could be of great comfort to a grieving family.

[Chris Heaton-Harris]

Yes, I do agree, and I shall come on to that point in the next couple of minutes. Certainly, that applies to a number of the parents to whom I have been speaking. Although no one will ever be able to give them back their baby, they almost feel as though the state is cheating them. It is as if their baby was never in existence. Having a birth and death certificate might help them get over that point in their grief so that they can move on.

[Jim Shannon]

The issue for parents is coming to terms with the emotional trauma that they have been through. Having a certificate will mean a terrible lot to those people, and that is what we are trying to achieve.

[Chris Heaton-Harris]

That is my intention in raising this debate today. However, this is about not just the certification element, which I hope the Minister will answer, but the need for more awareness of all the issues around stillbirth and neo-natal care.

Having the flexibility for parents to be able to choose to have a birth and death certificate for babies born after 24 completed weeks of pregnancy but showing no signs of life, would massively help a large number of parents in their grief and show that the state recognises that they had a wonderful child. As some parents would be distressed at the possibility of having to go down that route, I wonder whether we could have a more flexible system whereby parents have the choice of a formal birth certificate, a stillbirth certificate issued by the hospital or—if they so choose—nothing. In modern society, we have the ability and sensibility to deal with the matter of certification, which is important to most of the parents to whom I have spoken because it is a simple process of formally naming their deceased baby.

Over the course of my time in this place, I have raised the matter of stillbirth certification a number of times. However, on each occasion I have received a similar reply from the Department of Health. One reply said:

“The registration of stillbirths and live births serve different purposes.”

It helps Departments collect statistical data and

“enables us to monitor the causes of stillbirth.”

Another reply said:

“Different state benefits are available to parents depending on whether a child was live-born or stillborn, so it is important to be able to distinguish one certificate from another.”

I completely understand the need for the state and the Department to be able to collect these important data for use in research. In fact, I am keen to encourage the Department to do more. However, I simply cannot understand why in 2012, with all the modern technology that we have at our disposal, we cannot, in a sophisticated way, collect all the data that are required and issue birth and death certificates when they are requested by parents.

[Jonathan Lord (Woking) (Con)]

I am grateful to my hon. Friend for giving way and I commend him for pursuing this issue in Westminster Hall when I know that there is another debate very close to his heart going on in the main Chamber. Does he have any information that he could share with us about how other countries do things, which might help to nudge the Department of Health in the right direction on this matter?

[Chris Heaton-Harris]

There is actually quite a lot of information out there. There is a very good charity called Sands, which has brought me lots of examples of best practice from across Europe, and indeed from different states in the USA. I am not saying that those methods would all work if they were brought into the NHS. However, by looking at the research that has been going on in Denmark and in Australia, and at the best practice in France and in some states in the US, we might be able to form much better practice in the UK to spread throughout the NHS. There are examples of good practice out there, and although I cannot cite them “fact for fact” off the top of my head right now, the charity Sands has all that information on its website. Sands is a very good resource for information.

I want to go back to the issue of what the state can do when it comes to stillbirth certification. I am quite sure that a sensible and easy solution can be found that allows these certificates to be issued and at the same time enables the state to have all the right information that it might require about any situation around each stillbirth.

Knowing that this debate was coming up, I asked some parents to try to help me to express why this new flexibility—if we are able to have it—would help them. A mum in my local area called Michelle told me this:

“My son was 9 days past his due date when he died at the end of my labour in May 2011; he weighed 7 pounds and 7 ounces, had wavy fair hair and was perfect. I can still feel the weight of him in my arms and how soft his skin felt. To be told your child has died is the worst pain a parent can feel but to be told they will not be recognised as a person in their own right but a statistic is heart-breaking. My son looked like any other baby, I went through a labour like any other mother but I didn’t have the happy ending. Going to the registry office to register his death was made harder knowing that the parents waiting with us would be registering their baby’s birth yet we would only be allowed to register our son’s death, not given the dignity of having a birth certificate. I feel I am being punished for not having a child that was lucky enough to take a first breath or to hear his first cry. A birth certificate is incredibly important to me and unless you have lost a child who has had the misfortune of being labelled as stillborn it is difficult to understand the need for this recognition. I have been lucky enough to go on to have a daughter, I love both my son and daughter equally yet they are not treated equally in the eyes of the law.”

She went on to say:

“This cruel law needs to be changed, what sense does it make to only register the death when the baby has to be born first regardless if he will take a first breath.”

I know from previous conversations that I have had with the Minister that he completely understands all the issues that I have raised here today, and I very much look forward to hearing his comments. All I ask is that he returns to his Department, reflects on today’s debate and considers whether it is actually not too difficult to build into the system the flexibility that I and a large number of parents from across the country would like to see. It would mean a great deal to a lot of people, Michelle included.

EU Working Time Directive (NHS)

Chris Heaton-Harris Excerpts

Thursday 26th April 2012 Westminster Hall

[Chris Heaton-Harris (Daventry) (Con)]

My hon. Friend is doing a fantastic job of articulating the problems that the working time directive has brought to the NHS. On the question of the Jaeger ruling at the European Court of Justice, is my hon. Friend aware that the Republic of Ireland has had problems, and has tried to exempt training from its definition of work, so that trainee doctors fall outside the scope of the directive? In the Netherlands, trainee doctors are apparently classed as autonomous workers: the Netherlands, too, tries to sideline the directive. Across Europe, it is causing problems in health services.

[Charlotte Leslie]

I know that my hon. Friend has done a tremendous amount of work in this area. The ways in which other countries get round the directive will be the conclusion to my speech. The Minister has a choice whether to prioritise political process in Europe or patients. Will we put everything into finding a way to give patients the care, and the professions the flexibility and respect, that they deserve? I thank my hon. Friend the Member for Daventry (Chris Heaton-Harris) for anticipating that point.

--- Later in debate ---

[Ian Paisley]

The hon. Gentleman pre-empts me. He is a mind reader. He seems to be able to find something that perhaps we are all agreed on. If the directive is a complete disaster; if it is starving our patients of good care and our junior doctors and senior physicians of being able to deliver what they are brilliant at delivering, we should address the problem at its root. The root cause is that we have a poison in the body politic of this kingdom. We are being regulated by people who do not live in this kingdom, do not care about this kingdom, are not part of this kingdom or do not have the needs of this kingdom at their heart, and we should stand up and recognise that. The over-regulatory practice that is being put upon us by Brussels is destroying this country. The sooner that we realise that, the better, and the sooner that the Government realise that and recognise that they should address the root cause of the problem, the better for us all.

[Chris Heaton-Harris]

The hon. Gentleman should just come off the fence. I have to declare that I was a member of the European Parliament for 10 years and served alongside his father. On two occasions, I attended an employment committee meeting in Brussels and saw Labour Ministers pleading with representatives to not allow the various connotations of the directive to flow through. Back in 2004, when the Commission opened up its first rethinking of this process, Labour Ministers came to the Parliament to plead with their MEPs not to vote to insist that this went ahead and to plead with the rest of the Parliament to allow Britain to do the right thing for its own people.

[Ian Paisley]

The hon. Gentleman gives us a valuable insight, or an inside track, into what the horse trading is really like in Brussels. This is not about the needs of the constituency or of the people, but about horse trading. It is about what we can achieve here to solve something in Brussels, Lithuania or Greece that is completely unrelated to the health needs of this nation. That horse-trading mentality is failing this nation. The insight that the hon. Gentleman provides is useful, and I am glad that he has come out from the shadows of Europe and, like me, is standing here in this Parliament. I know the happy times that he spent with my father when he was in Europe.

Other nations do not gild the lily as we do. We are pretty special at gilding the lily. We can really implement regulations like no one else. Why do the Government do it? Every other European nation seems to interpret the European working time directive in whatever way they want and get away with it. I am amazed that Ireland—the other bit—has been able to interpret the directive its way and get away with it. Surely, if it can say that training is not part of being a doctor, we too can find the flexibility—a word used by the hon. Member for Bristol North West (Charlotte Leslie)—necessary to make this work for us. Let us use the F-word; let us be flexible and get this right for our patients, our hospitals and our services.

In Lithuania, there is poor EWTD compliance because of the recession, so it can get away with it. Greece, too, has got away with not implementing the European working time directive because of its poor economic financial state. Surely, we can get away with implementing the European directive our way, and in a way that is flexible for our people and for our country. Apparently, Portugal is fully EWTD-compliant. However, many doctors and surgeons there now work more than their contracts say that they should. Surely, if the rest of Europe can find a way to be flexible to suit the needs of their people, it is not beyond the kith of men or beyond our wonderful Health Minister who is here today and our wonderful Department of Health to come up with a way to make the directive flexible for our people, for our nation, for our kingdom and—most importantly—for the needs of our patients, and to allow our doctors to deliver the service that they need to deliver?

I believe that we have a complete erosion of fundamental realities when we look at how the EWTD is being implemented to the destruction of the delivery of service and patient care. I hope that the Minister and the Department are listening to a voice that is coming across from all this kingdom, which says that the directive needs to be changed and changed fast.

Selective Dorsal Rhizotomy

Chris Heaton-Harris Excerpts

Wednesday 18th April 2012 Commons Chamber

[Chris Heaton-Harris (Daventry) (Con)]

A couple of years ago, like every other candidate in the general election I was eagerly watching my local press—for me, mainly the Daventry Express—to see what stories were making local headlines. In the run-up to the election, the Daventry Express and its sister paper the Northampton Chronicle and Echo both rather brilliantly covered the story of Holly Davies, a young girl from Daventry who was suffering from cerebral palsy and whose family were raising £40,000 so that she could go to America for a life-changing operation that would enable her to walk freely for the first time in her life. A few months later Holly, who could barely walk before the operation, returned from the St Louis children’s hospital a completely different girl. The procedure she had is called selective dorsal rhizotomy, or SDR, and Holly was operated on by the world’s leading expert surgeon in this field—Dr Tae Sung Park.

Dr Park is without doubt one of the world’s leading paediatric neurosurgeons, has received a host of honours for his surgical innovations and clinical research, and has literally been the pioneer in this field. St Louis school of medicine in Washington university, where Dr Park is the Shi Hui Huang Professor of Neurological Surgery, is ranked third in the US, while the St Louis children’s hospital is ranked fifth in the US for overall performance in medicine. Those world-leading institutions would not allow the SDR operation to be practised if it did not work or if it had significant complications. They know that it works. Indeed, SDR is so successful that every single medical insurance policy that can be bought in the States covers the procedure because it is realised that spending money up-front on these individuals saves a great deal more expense in the future—a point I wish to heavily underline in this debate.

Dr Park has operated on people from 48 different countries and a number of those countries have trained or are training surgeons to offer this procedure. Indeed, SDR is currently performed in Germany, Sweden, the Netherlands, Italy, Poland, Korea, Japan, Hong Kong, Canada and Mexico. As of 30 March 2012, 145 people from the United Kingdom have been operated on in St Louis—120 from England, 18 from Scotland and 7 from Wales.

So what is this miracle operation, selective dorsal rhizotomy? Of all the surgical procedures currently performed on patients with cerebral palsy, SDR has probably undergone more thorough scientific scrutiny than any other, including the various types of orthopaedic surgery. Accumulated evidence and my constituent’s experience indicate that SDR is an excellent option for selected patients with spastic cerebral palsy.

SDR involves the sectioning, or cutting, of some of the sensory nerve fibres that come from the leg muscles. There are two groups of nerve roots that leave the spinal cord and lie in the spinal canal. The ventral spinal roots send information to the muscles and the dorsal spinal roots transmit sensation back from the muscles to the spinal cord. In the operation, the neurosurgeon divides each of the dorsal roots into between three and five rootlets and stimulates each electronically. By examining the electromyographic responses from muscles in the lower extremities, the surgical team can identify the rootlets that have caused the spasticity. The abnormal rootlets are selectively cut, leaving the normal rootlets intact, which reduces the number of mixed messages from the muscles, resulting in a better balance of activity in the nerve cells in the spinal cord and thus reducing spasticity.

Let me tell the House what that means in human terms. Last year, I was fortunate enough to meet for the first time Holly’s mum, Jo Davies, who wanted to talk to me about Holly’s new post-operation life. I shall read a few lines from “Holly’s Diary” a few years after her operation:

“September 2011—and Holly is starting school. She has her school shoes, bought from Clarks, not from Northampton General Hospital—and she loves them! It is such a small thing, but something I really never thought she would be able to do. I used to worry about school shoes—I know this sounds silly but the NHS would only give you one pair of boots at a time and this was either going to mean her having pink boots for school or black boots for home. Not very fair on a little girl—but now we don’t have to worry. She is wearing normal school shoes, has flashing trainers for the weekend and now even has a pair of ‘Ugg’ boots!

We recently posted a video of Holly on her Facebook page as people were asking how she was doing. It isn’t until you watch the before and then after videos that you see the amazing progress she is making. Dr Park even commented on her video and was really pleased with what he saw and has assured us that more improvements will be seen in the next 3 months.”

[Tom Brake (Carshalton and Wallington) (LD)]

May I draw to my hon. Friend’s attention the success of the operation for my constituent Dana Johnston, and encourage him to commend the work that she and her family have done with Support4SDR to campaign on the issue?

[Chris Heaton-Harris]

I happily commend their work. I have met Dana and her mother—a very powerful lady who has fought hard for her daughter’s rights and saved a lot of money so that she could have the procedure.

To return to the diary:

“Just these last couple of days she has started to learn to run. Prior to SDR her running technique was no faster than my normal walking pace and she had a swing to her hips that made it look like she would trip at any moment. I now need to walk very fast and sometimes even jog to keep up with her run and she has less swinging of the hips. She is still a long way off the speed and ability of her friends when it comes to running but she is definitely getting better at it.”

The next point is very important:

“Holly has also grown in confidence. She speaks out at school, joins in with activities more and is a nightmare at the park. She climbs up climbing frames that even her 7 year old sister would be wary over. It really is hard to believe that without the operation she would not be able to do these things.”

[Jim Shannon (Strangford) (DUP)]

I am very pleased about the successful outcomes for the hon. Gentleman’s constituent and for the constituent of the right hon. Member for Carshalton and Wallington (Tom Brake). Billy Douglas is three years old and lives in the village of Ballygowan in my constituency. Unfortunately, he has not yet had the operation but is trying to get it. Does the hon. Gentleman agree that it is not just a question of the operation, but the physiotherapy as well? It is a nine-month process and it is very important. Does he think that the NHS ought to make provision not only for the operation but for the physiotherapy? Families are asked to provide £50,000 for the operation and the physiotherapy, but that is beyond the budget of many people. Even with fundraising events it is almost impossible to reach that amount unless the Government or the NHS are prepared to help. Does he agree that we need compassion and financial help for many families across the whole United Kingdom?

[Chris Heaton-Harris]

I absolutely concur. Indeed the final paragraph I wanted to read from “Holly’s Diary” states:

“Finally—we are continuing with Holly’s strict physio programme. She has 1 hour a week from the NHS and we pay privately for a further 2 hours a week from different therapists.”

As we have just heard, for the best results from SDR the operation must be followed by intensive physiotherapy. As an aside, one thing that all the parents who have raised the money for their child’s operation have in common is the basic lack of interest in the patient from the NHS when they return home from abroad, especially when they try to get regular physiotherapy to ensure that their children benefit from the operation to the maximum extent possible. Essentially, the more physio a patient receives in the first years after the operation, the greater the level of ongoing success and the level of manoeuvrability in the patient. Can the Minister help to remedy the situation?

[Jesse Norman (Hereford and South Herefordshire) (Con)]

I congratulate my hon. Friend on securing this debate. Is he familiar with the case of young Ellis Jones in my constituency, who has just returned to the UK after his family raised an extraordinary £45,000 to fund what appears to be highly successful SDR surgery with Dr Park in St Louis? I pay tribute to Ellis and his family, to the generosity of the communities around them, and to the Hereford Times, which led the way in gathering local publicity and support. Ellis is just two years old. Does my hon. Friend think there may be a case for extending the current treatment under NICE guidelines to include suitable children as young as two years old?

[Chris Heaton-Harris]

I thank my hon. Friend for that intervention. I will come to that, but I entirely concur. The earlier the problem can be tackled, the better, in general terms.

As I mentioned previously, the global medical community gradually became aware of Dr Park’s superb work in St Louis. Here in the UK, on 3 May last year, the very first UK micro-neurosurgical SDR was performed in Frenchay hospital in Bristol. Kristian Aquilina, the consultant neurosurgeon, and his team carried out this operation. Towards the end of last year, I took Mr Aquilina and some parents whose children have benefited from SDR, including my constituent Jo Davies into the Department of Health for a very helpful meeting with a couple of the Minister’s officials, in a bid to encourage the NHS to offer SDR here in the UK. The hope is that there would be three or four centres of excellence that could offer the operation to those patients who had been evaluated as able to benefit massively from the procedure.

From speaking to Mr Aquilina, I know that he has now set up a multidisciplinary team at Frenchay hospital to evaluate and select children for SDR. This team consists of a number of people—a paediatric physiotherapist with special expertise in cerebral palsy, a paediatric neurosurgeon, a paediatric orthopaedic surgeon and a paediatric neurologist. Mr Aquilina tells me:

“Children over four years of age, with a diagnosis of spastic diplegia following premature birth, should be considered for SDR. Children with typical spastic diplegia, whether born prematurely or at term, should also be considered. These children tend to have delayed motor development and spasticity interferes with their progress.”

I am also aware that another surgeon, Mr John Godden, from Leeds has been out to St Louis to learn about the procedure and is ready to undertake his first operation.

One of the common causes of cerebral palsy is premature birth and there is now extensive evidence, recognised by NICE, that demonstrates the value of SDR for these children. The NICE guidelines for SDR were issued in December 2010 and concluded:

“The evidence on efficacy is adequate. Therefore this procedure may be used provided that normal arrangements are in place for clinical governance and audit.”

But a more recent guideline focused on the lack of long-term studies of outcome and changed the first NICE guidelines, recommending that SDR be done in the context of clinical research. The problem with that is that a long-term study for, say, 10 or 20 years after surgery, costs an awful lot of money, and because no long-term study has been done on any of the non-surgical and surgical treatments currently employed here in the UK, following that rationale to its logical conclusion would mean that this successful proven treatment for cerebral palsy cannot be covered by the NHS for years.

[Jackie Doyle-Price (Thurrock) (Con)]

I commend my hon. Friend for the eloquent way he is making the case for the procedure. I have two cases in my constituency where the local community has come together to raise £40,000 each time to fund the treatment. On the point that my hon. Friend is making about the need for long-term trials, surely all NICE needs to do is to look at those children and how their lives have been transformed by that procedure.

[Chris Heaton-Harris]

I absolutely agree. In the United States, SDR has been practised since late 1986. Dr Park has been performing the operation since May 1987. SDR is currently performed in many medical centres across the US and has undergone unprecedented scientific and clinical scrutiny by orthopaedic surgeons, neurologists, rehabilitation medicine practitioners, therapists—the lot. At this time, medical evidence shows that SDR is more robust than any other treatment for cerebral palsy. It is the only treatment that can reduce spasticity permanently and that enables patients to move better and thus allows them to exercise as they grow, which anyone with spasticity cannot do. SDR at an early age reduces the rate of orthopaedic surgery and there are many other proven benefits.

SDR is safe. Of Dr Park’s 2,300-plus patients, only two have developed spine problems and three have had spinal fluid leaks that needed surgical repair. None has developed neurological complications such as paralysis or loss of bladder control. Some of Dr Park’s patients who had SDR 20 or 25 years ago are now in their mid-40s and not one patient has returned to him with late complications.

The purpose of the debate is to ask the Minister, his Department, NICE and the commissioners of procedures in the future to look at the success of SDR elsewhere in the world and help those practising it in the UK to overcome any of the remaining hurdles so that it can be performed on the NHS without problems or charge.

Children suffering from cerebral palsy in the UK are invariably given a frame for the first four or five years of their life and are then given a wheelchair when it becomes too difficult for them to walk with the frame. SDR can enable many of those wheelchair-bound children to walk independently, sometimes for the first time. An excellent example of this is a constituent of my right hon. Friend the Member for Carshalton and Wallington (Tom Brake), Dana Johnston, whom I had the pleasure of meeting very recently and who used a wheelchair 90% of the time before she had the SDR operation. Now, eight months after that operation, Dana does not use her wheelchair at all and is looking forward to a future of walking everywhere and living as close to a normal life as possible.

SDR would not be a very common operation, but it would change those who undergo the procedure from being recipients of taxpayers’ money via the NHS over a protracted period—in fact, for their lifetimes—to being active, tax-paying members of society in the future.

In Chichester, a friend of a friend is trying to raise £24,000 so that his grandchild, Finlay Fair, can be operated on by Mr Aquilina in Bristol. Indeed, Finlay’s financial target has nearly been reached and if all is well he will be operated on later this month. As I mentioned earlier, in the past three years or so 145 parents have raised the £40,000 and more required to get their children SDR in St Louis. I completely understand that the NHS, the Department of Health, NICE and any future commissioning body will all have procedures and processes that need to be followed, but surely it is now time for us to say that this life-changing, well-researched operation should be funded across the country by the NHS. We have surgeons with the expertise, an operation with a long-track record of success and children who could be walking and running independently, rather than being consigned to a life in a wheelchair.

I ask the Minister for whatever support he can give to ensure that SDR is offered by our excellent national health service so that in the future the parents of remarkable children such as Holly Davies, Dana Johnston and Finlay Fair as well as those given as examples by my colleagues do not have the burden of having to raise large sums of money to pay for their children to have this amazing, life-changing operation.