Puberty-suppressing Hormones

Christine Jardine Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

Any young person in Great Britain and Northern Ireland who had a valid prescription for these medicines in the six months prior to 3 June and 27 August respectively can seek continuation of their prescription from a UK-registered clinician. Guidance has been issued to general practitioners setting out prescribing scenarios. It remains the case that continuation of puberty-supressing hormones can be considered where the GP feels competent to do so, and where confirmation in the form of documentary evidence that treatment had been under way is available. The guidance also makes clear that GPs should consider what further support should be offered, including assessing whether referral to the children and young people’s gender service or, indeed, for mental health support is required.

[Christine Jardine (Edinburgh West) (LD)]

I, too, thank the Secretary of State for the empathetic and reassuring approach he has taken today, because this has been a very toxic and, in many ways, very damaging debate for everyone involved. Further to the question about continued care, what reassurances can he give to people who have embarked on a course of treatment that they might now fear will be halted, and to the very many young people and their families in this country who are going through a very difficult time? Desperate situations make people do desperate things. What steps is the Secretary of State taking to ensure that the availability of these drugs is not driven underground—that they are not made available through means that none of us would like to see?

[Wes Streeting]

As I say, any young person in Great Britain and Northern Ireland who had a valid prescription for these medicines in the six months prior to 3 June and 27 August respectively can seek continuation of their prescription from a UK-registered clinician. More broadly, it is my intention to ensure we start bringing down those waiting lists, to make sure that children and young people and their families receive access to the wide range of support, information, advice and guidance that they need in order to navigate their pathway and to make sure they feel safe, respected and included in discussions about their own healthcare.

Income Tax (Charge)

Christine Jardine Excerpts

Tuesday 5th November 2024 Commons Chamber

[Kate Osamor (Edmonton and Winchmore Hill) (Lab/Co-op)]

Thank you, Madam Deputy Speaker, for calling me so early in the debate. I was not expecting that.

I very much welcome the investment in our NHS, and our renewed focus on public services. The Budget marks a break from the approach of the last Government, who presided over the decline of our health system. With this renewed investment, the biggest since 2010, there is now some hope that we can turn a dire situation around. We must improve patient outcomes, reduce waiting times and support the hard-working staff who form the backbone of our health system. However, I want to stress to the Secretary of State—my constituency neighbour —that investment must focus not only on delivering numbers, but on quality of care, with a human touch and equal access for all. That requires us to reject the creeping privatisation of our health service, which has proven costly, inefficient and bad for patients.

Before coming to this House, I worked in the NHS as a practice manager in the London borough of Enfield. I also worked in an out-of-hours GP co-operative, which covered north and east London. I know from first-hand experience that GP surgeries and core NHS services must remain publicly owned and accountable to their patients and staff, the public and stakeholders. Furthermore, I have deep reservations about the current plan to grant the NHS data platform contract to Palantir, which raises serious questions about privacy, security and the future of our NHS data infrastructure.

[Christine Jardine (Edinburgh West) (LD)]

I was listening very carefully to what the hon. Lady said about her experience as a practice manager. Over this past weekend and the last two days, I have been contacted by local practices in my constituency that are concerned about the impact of the national insurance changes on their ability to provide patient care and the vital first step towards getting people into the hospital and through the waiting lists. Does the hon. Lady agree that we have to address that as a fundamental problem that is potentially created by this Budget?

[Kate Osamor]

I thank the hon. Member for her intervention. I would add that it is important that patients, doctors and everyone else are listened to. I am assured that the Secretary of State will be listening to all voices.

NHS data is a public asset. Its management should be rooted firmly within the NHS, not placed in the hands of private interests, especially those controlled by an individual who is so hostile to the principles of public healthcare. Our NHS thrives due to the work of everyone in the system, from nurses to administrative staff and healthcare assistants, who each play a critical role in patient care. We must listen to all NHS staff, not just those in the highest-ranking medical roles, as everyone brings valuable frontline perspectives on improving efficiency, patient experience and accessibility.

I especially draw attention to the hard-working staff who provide out-of-hours services for our communities, often doing so on top of their normal hours. The Government must ensure that those professionals receive not only recognition, but the resources and support they need to continue serving our communities in this vital way. Staff in out-of-hours services often only work in such settings part time. However, they are often the last resort for people who are unable to get appointments with their GP or access the care they need.

We must also address the postcode lottery in healthcare. For various conditions, disparities persist in access to specialists, waiting times and outcomes in relation to area, ethnicity and gender.

The stark reality is that mental health services remain woefully inadequate. We face a mental health crisis, especially among young people, and this impacts on personal wellbeing and ruins life chances. We urgently need targeted investment in mental health services, and I look forward to supporting the Government in ensuring that the crisis in mental health support is treated with the seriousness it demands.

This Budget is a strong step in the right direction, but we must go further to ensure that the NHS remains public, that mental health is prioritised and that all NHS staff have a voice in shaping the future of our health system. I ask the Secretary of State to focus on all those areas, because I believe that if we have consistent investment throughout this Parliament, we can ensure that we make progress towards an NHS that works and in which everyone is able to access the quality and timely care that they justly deserve.

World Stroke Day

Christine Jardine Excerpts

Tuesday 29th October 2024 Commons Chamber

[Sarah Dyke]

The hon. Member makes a really important point. Although we often assume that it is older people who suffer with strokes, so many young people suffer in the same way.

Unless there are major improvements, Somerset’s poor ambulance response times and poor life-after-stroke care will mean that a disproportionate number of the 42,000 people who will die from stroke in 2035 will be from my constituency.

[Christine Jardine (Edinburgh West) (LD)]

Further to the point that the hon. Member for Strangford (Jim Shannon) made, although I fully accept that we have to do more in terms of stroke care, does my hon. Friend agree that the population of this country is generally unaware of the early warning signs of stroke to look for? When it actually happens, we recognise the symptoms, but we have no awareness of the long-term warning signs. We need to invest in teaching people what to look for and how to care for themselves to avoid a stroke.

[Sarah Dyke]

I thank my hon. Friend for making such an important point. I think we have progressed in our understanding of stroke awareness, but there is so much more yet to do.

Neither strokes nor the grim predictions I have made are inevitable. Stroke is preventable, it is treatable, and it is recoverable.

Access to Primary Healthcare

Christine Jardine Excerpts

Wednesday 16th October 2024 Commons Chamber

[Karin Smyth]

I thank the hon. Lady for her assiduous work in opposition. Looking at the capital estate is one of my favourite new responsibilities, and our commitment to a neighbourhood service means that we need to bring services together. We need to look at this across the piece, to make sure that primary care is provided where it is needed. We often hear about hard-to-reach groups, but I do not think they are that hard to reach. Frankly, services are sometimes located in the wrong area. One of our key commitments is to shift services into communities, and the neighbourhood service programme is part of that.

Just three in 10 NHS dentists are accepting new adult patients, and geographical inequalities are vast. More than 1,200 pharmacies have shut their doors for good since 2017. Again, the record speaks for itself: public satisfaction with general practice has fallen from 80% in 2009 to just 35% last year. If there is any reason why the Conservative Benches are empty, it is because dissatisfaction with access to primary care is so stark, as we learned in July’s general election.

It is absolutely clear that primary care is broken, but NHS staff working in primary care did not break it; the last Government did. They cut funding for the community pharmacy contract, they failed to incentivise enough dentists to perform NHS work, and they pursued a disastrous top-down reorganisation of the NHS, with which we are still living.

The last Government might have broken the NHS, but it is not beaten. NHS staff remain as passionate, dedicated and skilful as ever, and this Government will work in lockstep with them, their counterparts in social care and local partners across the country to fix the NHS.

[Christine Jardine (Edinburgh West) (LD)]

Will the Minister give way?

[Karin Smyth]

I am tempted, but I know that many of the hon. Lady’s colleagues want to speak, and I am sure she is on the list.

Fixing the NHS will take years of discipline and hard work, and we are in this for the long haul. However, we must first clean up the mess we inherited, and that work has begun in earnest. We have found the funding to recruit an extra 1,000 GPs this year as our first step towards fixing the NHS’s front door and making the system more flexible.

Cass Review

Christine Jardine Excerpts

Monday 15th April 2024 Commons Chamber

[Victoria Atkins]

As my hon. Friend was asking that question, there were people on the Opposition Benches tutting her. That shows that while some understand the need to keep the debate about the clinical needs of these children and compassion, there are still people on the Opposition Benches who do not get it. For example, in 2020 the deputy leader of the Labour party signed a charter describing bodies such as Woman’s Place UK, which, dare I say, campaigns for single-sex rape refuges—to which the House knows I have an enormous commitment—as “trans-exclusionist hate groups”. That sort of language needs to be apologised for, so that we can all move on. We expect clinicians and medical professionals to do the right thing by the Cass report, and by our children and young people. There needs to be some leadership from all of us in public life to ensure that we set the right example to those people.

[Christine Jardine (Edinburgh West) (LD)]

At its heart, the Cass report sadly highlights the low standard of care for our young people who were caught up in a toxic debate. There were long waiting lists, and the debate seeped into the staffing of the medical profession. Does the Secretary of State agree that we have to look at the wellbeing of our children holistically? How will she overcome the recruitment and staffing problems that have been created by this toxic debate?

[Victoria Atkins]

I thank the hon. Lady, who has an exemplary record of campaigning on this issue. This comes down to the very careful review by Dr Cass. We have to get away from the idea that if a child presents with gender distress, that is the only part of their health that we should care about and look into. We have to look across the board to ensure that we look after every single part of them and do not assume that medical pathways are the only and inevitable pathways for them. One of the concerns raised in the report is that the terrible mental health issues that many children and young people were suffering from were not being looked after. People were just put on drugs and expected to get on with it. That is wrong, and we are determined to change it.

Oral Answers to Questions

Christine Jardine Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

I would be very happy to meet my right hon. Friends to discuss those concerns.

[Christine Jardine (Edinburgh West) (LD)]

I thank the Secretary of State for her offer to help cut waiting lists in Scotland. I listened to the frankly delusional statements from the SNP Benches about the state of the NHS in Scotland. We are in dire straits and suffer the same problems, particularly about GPs and appointments disappearing. When are we going to see an improvement in appointment availability?

[Dame Andrea Leadsom]

The hon. Lady will no doubt be extremely envious of the fact that in England there are 50 million more GP appointments now every year, which is a fantastic achievement by this Government. She will want to look at what is happening in Scotland, which has some of the worst health outcomes in western Europe, and challenge SNP Ministers over drug and alcohol death rates and falls in life expectancy.

NHS Dentistry: Recovery and Reform

Christine Jardine Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

I thank my right hon. Friend for all the work she did on dentistry in the Department. I am conscious that many people have contributed to this plan; I am grateful to her and others. Again, I hear the observations on the General Dental Council, and will ensure that the GDC hears them as well. That is a fair challenge to the NHS. Colleagues will see that the plan is co-signed by NHS England, which shares our ambition to deliver those 2.5 million more appointments and set up the future of NHS dentistry for our country.

[Christine Jardine (Edinburgh West) (LD)]

Today’s statement by the Health Secretary will have been listened to with great interest by my constituents in Edinburgh West, who share a lot of the same concerns, face the same difficulty getting NHS dental treatment and will be looking for the same sort of solution as constituents in England. Could the Secretary of State clarify for me, and for all those who come to me, whether there will be Barnett consequentials? If there are, will she impress upon the Scottish Government the need to ringfence the money and actually invest it in dental services? If not, would she be willing to share with the Scottish Government how she is approaching the problem in the hope that they might actually respond and do something?

[Victoria Atkins]

I hear the frustration in the hon. Lady’s question. This is a devolved area—as it is in Wales—and is therefore a matter for the Scottish National party. I assume the hon. Lady will continue her usual advocacy on behalf of her constituents to ensure that the SNP looks at what is happening in England and tries to do better for Scotland.

Type 2 Diabetes: Availability of Drugs

Christine Jardine Excerpts

Tuesday 30th January 2024 Westminster Hall

[Christine Jardine (Edinburgh West) (LD)]

I beg to move,

That this House has considered the availability of drugs to treat type 2 diabetes.

It is a pleasure to serve under your chairmanship, Mr Pritchard.

I am grateful for the opportunity to speak about what is a vital and, I think, under-recognised issue. I wish I did not have to, and that all the necessary medicines were available for all of the serious, life-changing conditions we face, but the reality at the moment is that they are not. Specifically, I would like to talk about type 2 diabetes, which is more common than type 1 and can go undiagnosed for years.

To be clear about what we are talking about, if someone’s body does not make enough insulin or what it makes does not work properly, the result is high blood sugar levels—type 2 diabetes. If untreated, that increases the risks of serious problems with their eyes, feet, heart and nervous system. High blood sugar levels can cause serious complications, potentially at great cost to individuals, but also to the national health service. The reality is that any of us can develop type 2 diabetes, but it mostly affects people over 25, and often those who have a family history of it.

What about treatment and medication? We know there is currently no cure, but we also know that type 2 diabetes can be put into remission by losing weight. We all know that eating well and exercising are the key to a healthy lifestyle, and that is never truer than with preventing and reversing the onset of type 2 diabetes.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing the debate forward. I am a type 2 diabetic—I declare an interest as such—and when I was diagnosed some 13 or 14 years ago, I went on a weight loss course right away. The doctor told me, “You lose weight!” I lost about 4 stone, and I have kept it off, but that did not stop the diabetes in its entirety. I still have it, and I still have to be very careful about what I eat.

The point I want to make is that there are recent indications that certain diabetes treatments can also be successful for weight loss, but weight loss is really important at least for the first stage of diabetes, and priority for such treatments must be given to those with type 2 diabetes before, with respect, those who are finding success with them for weight loss. How can the Minister and our Government encourage such guidelines to be firmly set in place?

[Christine Jardine]

I thank the hon. Member for that intervention, because that point is at the heart of the matter. We have to ensure that the supply of drugs, which is short at the moment, is prioritised for those who need them for important health reasons.

A healthy weight, as the hon. Member said, and keeping active make it easier for someone’s body to manage their blood sugar levels and help prevent insulin resistance, which can lead to type 2 diabetes. Research has shown that, for some people, a combination of lifestyle changes can reduce the risk of type 2 diabetes by about 50%, but sufferers may also need to take diabetes medication such as metformin and insulin, as well as making changes to their lifestyle.

In the UK, 4.6 million people have type 2 diabetes and around 13.6 million are at risk of developing it. People often need help, such as intervention and medicines. Last year, I called on the UK Government to take action on the shortage of medicines for type 2 diabetes patients, after a constituent came to me concerned that her treatment and her health would be impacted by a shortage of the diabetes drugs she needed. They are known as GLP-1 RAs—glucagon-like peptide-1 receptor agonists—and include one of the most common drugs, semaglutide.

As for many other manufactured drugs, there is currently a supply problem with semaglutide. In this case, the problem has been made worse, as the hon. Member for Strangford (Jim Shannon) said, by the fact that the same drugs are effective for weight loss. The very thing that semaglutide does to help diabetes patients is making it difficult for them to access it.

I wrote to the Scottish Government, who told me they did not expect the supply to return to normal until mid-way through this year. I appreciate that that is not the most helpful response, but in some ways it is understandable, because medicine supply and licensing is a reserved matter. That is why I am raising it with the UK Government. We have seen issues with drug shortages beyond diabetes, and that is why I am so concerned at the slow response to the lack of medication.

Patients find themselves stuck between the proverbial rock and a hard place. In Scotland, they have the Scottish Government unable to act, and they perceive the UK Government to be very slow to act. It seems that neither Government have realised how potentially serious this situation could be for patients who use these drugs daily. For a patient to be in a position where they do not know whether they can get what they need to help them get well and keep them healthy is simply not acceptable. I have heard from people in my constituency and beyond about the impact that the situation is having on their lives.

[Ian Lavery (Wansbeck) (Lab)]

Does the hon. Lady recognise that this is not just about access to drugs for type 2 diabetics, but about access to medical equipment, such as the LibreView glucose monitoring sensors that have changed people’s lives? Does she agree that, because the incidence of type 2 diabetes is closely related to areas of social deprivation, where the finance is not available, the NHS should look to give those sensors to as many people living with type 2 diabetes as possible? That would save a fortune in the future, and it would reduce harm to lots of people who are currently suffering greatly because of diabetes.

[Christine Jardine]

The hon. Gentleman makes an excellent point, and I completely agree.

Type 2 diabetes is a problem in itself, with the lack of medication, but it is also an illustration of a major problem that our health services are facing with growing costs. We should be looking at how we prevent the problem in the first place, both in areas of social deprivation and in society generally. We should be looking at how we help people to avoid the problems that come with conditions such as type 2 diabetes. If we fail in that, people will fall into the situation where they are living with diabetes—a condition that requires 24/7 self-management to stay healthy. I invite Members to imagine living with a condition that they have to manage every day—a condition that has the power to affect them at any moment, disrupting what they are doing and altering their day to day life—when they have done all they can to stop that happening. Now consider how the lack of a medication that we have organisations and administrations responsible for providing makes that situation worse.

A couple of years ago, as part of a campaign by Diabetes UK, I tried to live life as if I had diabetes, and I have to say that I failed dismally. I realised just how difficult it is, and I realised that people living with diabetes —type 1 or type 2—deserve much better than they are getting at the moment. To be turned away at the GP surgery or pharmacy through no fault of the practitioner and to be told, “You might have to wait 18 months for what has been helping you get on top of the condition”, is simply unacceptable.

I know some people who have been left waiting since 2023. Shortages have been linked to those without diabetes using the drugs, as the hon. Member for Strangford mentioned, simply for weight-loss purposes. Drugs such as Ozempic are being sold online for nearly £200—a 1,765% increase on the cost of what they would be on an NHS prescription.

The Association of Independent Multiple Pharmacies has talked of the shortage of medication to treat the likes of epilepsy and attention deficit hyperactivity disorder as well as diabetes, all of them potentially life-changing and life-ending conditions. That is true also of some cancer drugs and hormone replacement therapy. The consequences do not lie just at the door of patients but, as we have heard, at that of the NHS and community pharmacy teams, which are under increased strain.

A national patient safety alert has been issued by NHS England and the Department of Health and Social Care to address supply, but I ask those with the power to consider standing in the shoes of those going through this. People who should have been started on GLP-1s are facing delay or are being put on to less effective options. Let us imagine being told that we had to take less effective medicine for a life-changing condition. If the supply is interrupted, a person potentially has to go through the side effects again and again when being restarted. People have been contacting Diabetes UK regularly since the start of the shortage in early 2023. This is not just about equality or ease of access. For all those affected, it is about quality of life.

Oral Answers

Christine Jardine Excerpts

Tuesday 25th April 2023 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

10. What recent assessment he has made of the adequacy of the availability of NHS dental services.

[Christine Jardine (Edinburgh West) (LD)]

22. What progress his Department has made on improving access to NHS dentist appointments.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

There are 6% more dentists doing NHS work than in 2010, and activity levels are going up. In March the number of patients seen over the past year was up by nearly a fifth on the year before. The initials reforms we have made to make NHS work more attractive are having positive effects but there is much more to do and we will be publishing a plan to improve access to dentistry.

[Neil O’Brien]

We will look at all those things. We have introduced additional flexibilities, as the hon. Lady knows, and we are allowing dentists to do more to deliver 110% of their UDAs and bringing in minimum UDA values, but we are also interested in prevention and I would be happy to look particularly at what we can do for younger people.

[Christine Jardine]

Tooth care, like any other form of healthcare, should be universally accessible, but we know that we are facing a crisis across the UK, with one in five adults who could not get an appointment in the past 12 months carrying out dental work on themselves, or getting someone else to do it, which is quite horrifying. The problem is not confined to one part of the UK. In Scotland, 80% of dentists are no longer accepting new adult or child patients. We have a crisis across the UK, so will the Minister commit to introducing a national programme and to speaking to the Scottish and Welsh Governments to address the shortage of NHS dentists for all of us?

[Neil O’Brien]

I am happy to work with the Scottish and Welsh Governments. We are, as I said, driving up levels of delivery, and we will be publishing a plan to take that further.

Government PPE Contracts

Christine Jardine Excerpts

Tuesday 6th December 2022 Commons Chamber

[Christine Jardine (Edinburgh West) (LD)]

I rise to support this motion, but the sentiment that I feel most strongly is, “What a mess—what an unnecessary, unmitigated mess.” We have heard a lot from Conservative Members about how difficult it was at the time. We all know that, as we all experienced it. We have heard a lot about having to be quick and decisive and the pressure that people were working under, with lives at stake. I wonder whether the Minister appreciates that that is exactly why people are so angry about this. We all went through it and experienced it.

The thing that we remarked on most at the time was the spirit in the country and how everybody got behind the Government, even those of us whose job it is to scrutinise them. We got behind the Government, and people had faith in, believed in and supported them, but three years down the line, we wake up every morning to yet another news story, another scandal and more suggestions about what might have gone wrong. People feel let down and betrayed.

The numbers are frightening. At one point, it was £2 billion of taxpayers’ money that was wasted on PPE contracts, but we are now told that almost £10 billion was wasted on PPE in total. We hear about PPE being stored and burned. That is not really the issue for the people in my constituency and elsewhere in the country who are struggling this winter to make ends meet, who have massive energy bills, who wonder whether they will be able to feed their children, who are worried about what their mortgages will cost. What is bothering them is that when they were putting their faith in the Government, when they believed the Government that we were in all in this together, maybe we were not. The suggestion now is that some people were profiting from other people’s pain. That is why, in supporting this motion, I make a plea to the Government to listen to what we are saying. We are not saying that civil servants were wrong. We are saying that people need to know what actually went on. They need transparency.

When the latest Prime Minister first took office he promised us a Government who would be ethical and would have doing the right thing at their heart. We need him to be as good as his word now. We need him to make it clear that he will leave no stone unturned and that his Government will leave no possibility of anything sleazy, of any cronyism or of anyone having profited at a cost to and at the expense of the British public at a time of extreme—and it was extreme—national crisis.

That is why this debate is important, and we need that from the Government now. We need something of the spirit that we had back then when things looked so dark and we were all worried for ourselves, our families, our health and our futures. We need the Government to stick by what the Prime Minister said and to give us transparency. Let us see the papers; put everything out in the open. And please ban VIP lanes, because the very notion that there was such a thing as a VIP lane when the country was in the midst of a pandemic and people were dying is offensive.