Rare Cancers Bill

Christopher Chope Excerpts

Report stage
Friday 11th July 2025 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move amendment 1, page 1, line 5, leave out “and”.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

With this it will be convenient to discuss the following:

Amendment 2, page 1, line 6, at end insert

“and

(c) set out a timetable for implementing any changes in the law recommended by the review.”

Amendment 3, page 1, line 7, leave out “in particular”.

Amendment 4, page 1, line 9, leave out “three” and insert “two”.

Amendment 5, page 2, line 3, leave out “in the opinion of the Secretary of State”.

Amendment 6, in clause 2, page 2, line 7, leave out from “are” to end of line 8 and insert “arrangements in place to”.

Amendment 7, page 2, line 12, after “appointed” insert

“within the period of 6 months beginning with the day on which this Act is passed”.

Amendment 8, in clause 3, page 2, line 33, leave out

“in the opinion of NHS England”.

Amendment 9, page 2, line 40, leave out subsection (4).

[Sir Christopher Chope]

This is certainly not a trivial Bill; it is a really important piece of legislation, which I congratulate the hon. Member for Edinburgh South West (Dr Arthur) on introducing and pioneering. It was not a Government handout; it was an idea that he thought needed to be the subject of legislation and he has pursued it. We had a fantastic Second Reading debate. There is tremendous interest in the Bill. May I therefore make it clear at the outset that my amendments are designed to try to strengthen the Bill rather than anything else?

I explained my position to the hon. Gentleman yesterday. He said, understandably, that to a large extent he was constrained, because he was trying to negotiate with the Government and with the Department of Health and Social Care, and unless he showed himself to be reasonably compliant, he would not have got the Bill to a state where it could be accepted by the Government.

I note the different positions on this, and I fully understand and respect the hon. Gentleman’s position. The hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) basically said that if she had introduced such a Bill, she would have got so steamed up about it that she would have included a lot more strength and safeguards, and as a consequence it probably would not have got anywhere near being considered on Report. Those are two different approaches. I am, relatively speaking, neutral on the matter—I am a sympathetic supporter of the Bill—but I have a lot of background experience of how Governments always try to give themselves wriggle room, in effect to maintain control over everything, and in my view the Bill could be improved by being amended, with the will of the House, on Report.

We could talk about taking some of my amendments to the other place, but the trouble is that the Government machine may say that there will not be any more sitting Fridays in this House, so if the Bill were to be amended in the other place it might fall completely, because it would need to be brought back here. That is why it is important that the House should consider these amendments now rather than leave them to the other place.

Amendment 1, which is to be read with amendment 2, is a prime example of the point I made earlier. We have a commitment from the Government that:

“The Secretary of State must…carry out a review of the law relating to marketing authorisations for orphan medicinal products that are for the diagnosis, prevention or treatment of cancer”—

great—

“and…prepare and publish a report setting out the conclusions of the review.”

But what is the timescale for that, and what will happen after those conclusions are produced? There is no obligation on the Government to do anything else. The review and its conclusions could be just left on one side. We in the House are in a position to tighten those provisions up and say, “This is not good enough. There should be a timetable for implementing the changes in the law recommended by the review.” That is the essence of the two amendments.

To look at another gap that could be exploited by the Government, the Bill says that the report must be

“published before the end of the period of three years beginning with the day on which the Act is passed”.

I have tabled amendment 4 to say that the period should be two years.

In respect of both those points, I have had a helpful email from Diana Jupp from Pancreatic Cancer UK, who writes on behalf of more than 30 charities representing patients affected by rare and less common cancers. She comments on my amendments. On amendment 2, she says,

“We are keen to push for this change with the Department once we reach implementation stage of the Bill.”

With the greatest of respect to Diana Jupp, we can do this now. Instead of leaving it to her and her colleagues to try to pressurise the Department later, we in this House have the power to change the legislation in the way that I have suggested, so that there would be a timetable set out for implementing the changes in the law recommended by the review.

In response to amendment 4, Diana Jupp says that

“this timeline has been agreed with the Department and in our opinion would tie into the timelines of other developing cancer policy implementation, including the cancer plan.”

Obviously, the most important part of her comment is that the timeline has been agreed with the Department, because if it had not been, the Department and the Minister would not have taken the Bill forward in this way and agreed to it.

On the timeline, I draw the House’s attention to the evidence base set out in the impact assessment. It says that the whole process will take one year. The Department reckons that it will cost £130,000 and sets out how many full-time equivalent civil servants will be involved in it. If it will only take one year, why are we saying that it needs to have three years? That is an example of why we need to tighten up the Bill, because if this is a review that needs to and will be carried out, why do we not get on with it? To suggest that it will take longer than a year is to go against the Department’s own evidence set out in the impact assessment.

The impact assessment says on page 6, under the heading “Mandating a Government review of the orphan drug regulations”:

“This will place a duty on the Government to publish a review which will be a comparison of orphan drug Regulations (specifically Part 5 of the Human Medicines Regulations 2012) and international regulatory approaches to supporting the research and development of orphan medicinal products that are for the diagnosis, prevention or treatment of cancers. Since the review is concerned with orphan drug regulations it is by default covering rare cancers. The findings should be published within 3 years.” On page 7, paragraph 19 on financial costs says,

“It is difficult to estimate the resourcing costs required for the orphan drug review, since the exact scope remains to be agreed. However, we estimate the cost to the Department of Health and Social Care to produce and publish a report on orphan drug Regulations to incur costs of approximately £0.14m in relation to staff resource. This reflects the cost of 0.3 x SCS staff, 1 x FTE Grade 6 or Grade 7 staff, 0.3 x Grade 7 staff and 0.5 x SEO staff for one year.”

That is what the Government say: only one year will be necessary.

In that case, why is my generous amendment, which would restrict the period from three years to two years, unacceptable to the Government? There is a history of dragging of feet at the Department of Health and Social Care, I am afraid; we certainly heard about that on Second Reading. I give the House that specific example of why, on the Government’s own evidence, they should accept the change from three years to two.

Amendment 3 would leave out “in particular” from line 7, which reads:

“In carrying out the review the Secretary of State must, in particular, consider regulatory approaches in other countries.”

The amendment is intended to probe rather than anything else. Why do the words “in particular” need to be incorporated? Surely it would be simpler to say that the Secretary of State “must consider regulatory approaches in other countries”—full stop, period. But that is not how it is at the moment.

Amendment 5 would leave out the reference to the Secretary of State. This is to do with the definition of a rare cancer. Currently, clause 2 would add this wording to the National Health Service Act 2006:

“The research that the Secretary must facilitate or otherwise promote under subsection (1)(a) includes research into cancers that in the opinion of the Secretary of State are rare cancers.”

Why cannot it not just say “that are rare cancers”? Indeed, clause 2 would also add this wording to the 2006 Act:

“In this section ‘rare cancer’ means a cancer that affects not more than 1 in 2000 people in the United Kingdom.”

That is an issue of fact. The Secretary of State should not be able to basically have a veto over the interpretation of what is or is not a rare cancer.

This is just another example of the control freakery within the Department. I am sorry that so far the Minister does not seem to have stood up to officials who have persuaded him, no doubt, that we need the expression

“in the opinion of the Secretary of State”.

Again, the argument is quite straightforward and the people from Pancreatic Cancer UK are on my side, but they are obviously very keen for the Bill to get on to the statute book. We all have to recognise that it is within the Government’s power to prevent it from making any further progress. That is why it will be quite difficult, I suppose, to persuade the Minister to accept amendment 5.

Amendment 6 would leave out from “are” to the end of the line and insert “arrangements in place to” in this statement in clause 2:

“In discharging the duty under subsection (1)(a) in relation to those cancers, the Secretary of State must, in particular, ensure that there are such arrangements in place as the Secretary of State considers appropriate to”.

Why can we not just say “arrangements in place to enable potential participants in clinical trials”, and so on? Why do we need to give the Secretary of State discretion —a veto, essentially—over whether he considers those arrangements to be appropriate? It seems to me completely redundant, unnecessary and, indeed, oppressive. It is counter to the expressed wishes of this House on Second Reading, when there was impatience over the delay, because of the need to get on with this, and suspicion over the failure of the Department of Health and Social Care—under not just this Government but previous Governments, which I would be the first to accept—to actually deal with the crisis involving people who are subject to rare cancers. That is amendment 6. I am trying to beetle through these amendments quite quickly, Madam Deputy Speaker, so that other people can participate in this important debate.

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[Dr Scott Arthur (Edinburgh South West) (Lab)]

I rise to oppose the amendments, but I thank the hon. Member for Christchurch (Sir Christopher Chope) for tabling them, for engaging with the Bill and for our conversation yesterday, which I really appreciated. I understand the stated intent of the proposals, although I am not minded to support them.

Over the last 10 months, I have held dozens of meetings with families, survivors, sufferers, charities, clinicians and legal experts, all with the aim of delivering meaningful change in this field. Those meetings were not so that I could tell people about the Bill, but so that those people could shape the Bill. I fear that if we were to pass these amendments, they would upset the delicate balance of hopes and aspirations that underpins the Bill. It is not just about the Minister, as the hon. Member suggested; there is a whole coalition of people who have different opinions about the Bill, and I do not think any one person has a right to change it in that way, including me. That would be hugely disrespectful and a disappointment to that coalition, but I understand the hon. Member’s points.

The Minister will go through the amendments in turn, so I will focus on three key ones. The review of orphan drugs was one of the hardest-fought things in the negotiations with the Department and charities, but we found a point that we could all agree on. I appreciate that the hon. Member wants it to go further, and perhaps we could speculate about the outcome and better prepare for it, but it is much awaited by the charities and they are grateful for it. I do not want to speak on their behalf, but that is what I have heard from them. That covers amendments 1 and 2.

Amendment 5 is about the definition of a rare cancer, which is an aspect of the Bill that I have not spoken about in any great detail, so it is worth touching on here. The Bill sets the definition of a rare cancer in statute and aligns it with the definition of a rare disease, which is a useful simplification. In future, let us hope that some conditions fall out of that “rare” specification and need less emphasis, and let us also hope that people in the Department look at the treatments that are being developed inside and outside the UK. It is right that there should be a bit of flexibility at the edges of what the Department considers a rare cancer.

The timeline of the review is three years. Again, we spent a great deal of time talking about that. For some while, it was going to be much longer than three years, and all of us want it to be much shorter, but that was the compromise we reached—it was like “Goldilocks and the Three Bears”. We reached that compromise together, so I urge the hon. Member to respect our negotiations on that issue.

[Sir Christopher Chope]

I hear what the hon. Member is saying, but why does the impact assessment say that the costs are for staff for only one year? If the review will take three years, why are the staff funded for only one?

[Dr Arthur]

I thank the hon. Member for that question. Of course, the review will not start on day one after passing the Bill. It will take time to get up and running. The existing workload of those staff members will have to be reallocated, and I hope and expect there to be some initial engagement with the sector—both charities and pharmaceutical companies—so a bit of flexibility is required. To be honest, I would love more money to be spent on that review so that we can get more depth and it can have a greater impact. I am sure other hon. Members present would agree.

I hope the hon. Member for Christchurch understands my position and recognises the strength of cross-party and sector-wide support that has brought the Bill this far. I regret not inviting him to take part in the Bill Committee—we would have benefited from some of these comments at that stage—but some of the points that have been raised were discussed in Committee. It was a reasonably long discussion; it did not last for hours, but it was not as short as some. I remain committed to working constructively with colleagues as the Bill progresses beyond today—let us hope it gets beyond today—but I respectfully ask, in the strongest possible terms, that these amendments are not pressed. If they are, I hope Members will oppose them.

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[Dr Luke Evans (Hinckley and Bosworth) (Con)]

I rise to speak on behalf of His Majesty’s official Opposition in support of the Rare Cancers Bill, and to welcome its thoughtful and necessary intervention on behalf of a group of patients who have been under-researched, under-represented, and under-acknowledged for too long. I commend the hon. Member for Edinburgh South West (Dr Arthur) on bringing this Bill forward, and on his ongoing dedication to the issue.

The case for the Bill is clear: rare cancers—defined, in line with the UK rare diseases framework, as conditions affecting fewer than one in 2,000 people—are individually uncommon but collectively account for more than 20% of all cancer diagnoses. However, as we know, patients with rare cancers routinely face delayed diagnosis, limited treatment options and far fewer opportunities to participate in clinical research.

The Bill does not claim to be a silver bullet, but it does mark a significant step forward in how we think about and legislate for research, regulation and data access in rare cancer care. It is focused, proportionate and strategically aligned with the existing NHS and National Institute for Health and Care Research frameworks.

Clause 1 places a duty on the Secretary of State to carry out a review of the law relating to marketing authorisations for orphan medicinal products that are for the diagnosis, prevention or treatment of cancer. It also rightly requires that the review includes comparisons with regulatory approaches in other countries. This is vital. The explanatory notes rightly observe that research into rare cancers is often commercially unattractive because of small patient populations and high developmental costs. If our regulatory environment creates further barriers to entry, patients suffer—not because the science does not exist but because the system does not support it.

The UK’s current approach to orphan designation lacks the pre-authorisation incentives found in systems such as the European Medicines Agency and the US Food and Drug Administration. The review required under the Bill is the opportunity to ask whether we are doing enough to attract the research and development that rare cancer patients deserve.

[Sir Christopher Chope]

I am not quite sure whether my hon. Friend is responding to the amendments or making a Third Reading speech. I hope he will address the amendments I have tabled, including those that relate to clause 1, about which he has just spoken.

[Dr Evans]

If my hon. Friend bears with me, I will turn directly to his amendments. It is important to first set out the context, because we must understand the clauses if we are to debate the amendments to them.

Clause 2 makes crucial changes to the Secretary of State’s duty under the National Health Service Act 2006 by stating explicitly that it must include research into cancers that, in the opinion of the Secretary of State, are rare. Although this matters, the research agenda is often driven by numbers and funding scales. By mandating that rare cancers be part of the agenda, the Bill begins to shift the culture towards inclusion, equity and long-term thinking.

I particularly welcome the creation of the national specialty lead for rare cancers, modelling the NIHR’s existing structure of research delivery leaders. This individual will be tasked with promoting and facilitating research, advising on trial design and convening collaboration. The success of this role will depend on it not just being symbolically supported but having a clear remit, adequate funding and a strategic alignment with the wider NIHR research delivery network.

Clause 3 amends section 261 of the Health and Social Care Act 2012 to allow NHS England to disclose information from cancer registries for the purpose of identifying and contacting potential clinical trial participants. This is a significant and necessary step. The Bill distinguishes between a disease registry, like the National Disease Registration Service, and a contact registry, such as Be Part of Research. Making sure that these systems can speak to each other will be of significant benefit when it comes to matching patients with opportunities. Importantly, the clause reaffirms that any such data sharing must remain compliant with the Data Protection Act 2018. As proposed new subsection 6A to the 2012 Act makes clear,

“A power conferred by this section to process information does not authorise the processing of information which would contravene the data protection legislation”.

This is a safeguard that we must preserve, not weaken, if we are to maintain public trust in the system.

At this point I turn to the amendments tabled by my hon. Friend the Member for Christchurch (Sir Christopher Chope). He approaches private Members’ Bills in the way that a jeweller examines diamonds—with a magnifying glass, a steady hand and absolutely no tolerance for flaws. We may grumble as the clock ticks on, but deep down we all sleep better knowing that he is reading the footnotes. This Bill is no different; he has approached it with rigour, and I thank him for his commitment to precision and improving clarity and accountability. As he pointed out, the Bill is not trivial. Therefore, it is not only right, but indeed the duty of this House, to scrutinise closely legislation and amendments laid before us.

To that end, several of the amendments aim to tighten the Bill’s drafting or introduce firmer deadlines. For example, amendment 4 would reduce the timeframe for the review under clause 1 from three years to two. Amendment 2 would require the Secretary of State to

“set out a timetable for implementing any changes in the law recommended by the review.”

I understand the concern that reviews can drift, but the three-year period reflects the complexity of the subject: a UK-wide review of the Human Medicines Regulations 2012, including benchmarking against other jurisdictions and engaging multiple agencies. Compressing the timeline might jeopardise the depth or quality of the analysis. Likewise, a statutory timetable for implementation could constrain the Government prematurely, before the review’s conclusions are even known.

[Sir Christopher Chope]

I am very grateful to my hon. Friend for his unprompted comments. He will know that the funding is sufficient to staff the review only for one year. If there is only funding for one year, why does it take three?

[Dr Luke Evans]

My hon. Friend knows, far better than I, not to look at legislation in isolation. The Government will at some point bring forward the cancer plan, which will have a direct crossover with the Bill, so it is right to give the Government the freedom and space to implement the legislation. If we rush it, we could get it wrong, which would be even more detrimental for those who suffer with rare cancers.

Other amendments address definitions and discretion. For example, amendment 5 would remove

“in the opinion of the Secretary of State”

from the definition of rare cancer, and amendment 8 would remove similar wording in relation to NHS England’s discretion. At first glance, the amendments may seem like matters of tidy drafting, but retaining discretion is important, especially as regards rare cancers. Prevalence data can be uncertain or lagging, and flexibility allows for expert judgments about edge cases in which rigid definitions may unintentionally exclude patients from trials or research that could benefit them.

On top of that, there are concerns even about simple definitions. We are still exploring the difference between, for example, pre-cancerous and cancerous cells. If someone goes for a smear, that is what they are told. This is a new area. Who knows what will come up in the future? Simply defining rare cancers on the basis of lagging prevalence data is a risk, and it is therefore right that the Government and the Secretary at State have discretion to direct in one way or another.

However, I would grateful if the Government would answer the question, which has been rightly posed, of who or what will fill the role when NHS England is abolished. It is not clear exactly what that will look like. I have asked the Minister this question several times, in relation to the Mental Health Bill and other areas, and it is a question that this House should rightly ask. Who will be responsible for what, when and why?

That said, amendment 7, which would ensure that the proposed national specialty lead is appointed within six months of Royal Assent, deserves serious consideration. Patients have waited long enough. If the Government are confident that the post can be established promptly and resourced effectively, I would welcome that ambition being stated at the Dispatch Box today.

Finally, I must express my concern about amendment 9, which proposes to remove the data protection safeguard in clause 3(4). Although the provision may be declaratory, in that it reaffirms existing legal obligations, it none the less offers clarity and reassurance. In an area as sensitive as health data, such clarity matters, and the subsection’s removal could cause unnecessary concern, even if the underlying law remains unchanged.

In conclusion, this Bill is not about grandstanding. It is modest in financial cost, careful in its drafting and realistic in its scope, but its impact could be significant. For patients living with rare cancers, and clinicians and researchers striving to support them, the Bill offers real hope—hope for faster access to innovation, hope for more inclusive research and hope for a regulatory system that works for the many, not just the minority. Every patient matters, whether they are one in two or one in 2,000. As we stated on Second Reading and in Committee, we support the Bill, and I thank the House for giving me the chance to explain why.

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[Madam Deputy Speaker (Ms Nusrat Ghani)]

Sir Christopher, is it your pleasure that amendment 1 be withdrawn?

[Sir Christopher Chope]

Is it possible to respond, Madam Deputy Speaker?

[Madam Deputy Speaker]

Very briefly. I was asking whether amendment 1 would be pushed to a vote or withdrawn, so if you could alert me to that it would be very useful.

[Sir Christopher Chope]

I will respond briefly to the debate. In so doing, I thank my hon. Friends the Members for Hinckley and Bosworth (Dr Evans) and for Farnham and Bordon (Gregory Stafford) for their contributions.

I listened for what the Minister would say in response to my point about NHS England, but I did not hear the expression “NHS England” come from between his lips, and I wonder whether that was an oversight or whether it was left out of his brief deliberately by officials from NHS England. Amendment 8 specifically deals with NHS England, and my hon. Friend the Member for Hinckley and Bosworth referred to it. Does the Minister’s reluctance to intervene at this stage show that he is in denial about the policy in relation to NHS England? I presume that he is in such denial.

We have had a classic example from the Minister of why the civil service is ruling okay, because it can come forward with a valid objection to every possible suggested alternative and amendment. I do not think that this attitude will be very helpful to the people we are trying to help through the Bill—namely, those who are suffering from rare cancers and who want us to make progress in this area. I will not press any of these amendments to a vote, but I hope that when the Bill gets to the other place there will be more persistent probing, particularly on the issues around NHS England and the definitions.

To give credit where it is due, I was pleased with what the Minister said about the specialty lead. As discussed, we do not need legislation for this anyway. He said he wants to have that dealt with promptly but is fearful of accepting an amendment that requires it to be done within six months because of the possibility of unforeseen delays. I take it from that that he is going to get on with that aspect, and let us hope that that goes faster rather than slower. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Third Reading

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[Sir Christopher Chope]

It is a pleasure to follow the hon. Member for Brent West (Barry Gardiner). I echo his tribute to the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh), who continues to be a pioneer in this campaign and is what I would describe as a no-nonsense lady. She has been in this place since 1997, and she has made and continues to make an enormous contribution.

This Bill will hopefully be an exemplar for Members who are successful in the private Members’ Bills ballot. So often, those who are successful in the ballot are told, “Here’s a handout Bill—we need to fill a little niche here in a bit of legislation.” The hon. Member for Edinburgh South West (Dr Arthur) has used his good fortune in having success in the ballot to bring forward something that he wanted to do and that meant a lot to him, but he did not do it selfishly; he did it after listening to a whole lot of other people and realising that this is a subject on which there is deep-seated consensus, unrest and concern among parliamentarians. Full marks to him for doing this.

I was only once successful in the private Members’ Bills ballot, and it was just after the rules were changed, so even though I came third out of the hat, I was No. 17, because it was done in reverse order so that it looked better on television. I think the previous Deputy Chairman of Ways and Means was responsible for that change. I have never had the good fortune of having a Bill that has been able to make progress; it is something I still look forward to and yearn for.

This is a really important subject. When we look at the Second Reading debate, in which I was briefly able to participate by way of an intervention, we can see the strength of feeling.

I go back to the Minister’s response to my amendments on Report. I hope he will be a bit more helpful on Third Reading about the role of NHS England and what will happen. I have paid tribute to him for agreeing that priority should be given to getting on with setting up these research bodies and looking into these issues. It is asking too much for the Government to agree to put those things on the face of the Bill, but I think it is clear from the pressure that is already on the Minister that his Department—however much it may have dragged its feet in the past—is now intent on rectifying that.

Most important of all, we will get the Government’s cancer plan. Let us hope that it will not be on the slow burner—we are promised it before the end of the year, and I hope it will be nearer this end of the year than next year. That could be very important, and as my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) said, it links in with a lot of what we have discussed today.

Cancer needs to be taken more seriously in this country. We need to invest more. We need to get back to the top of the international league table, where we should be, as a leading nation with a very strong economy. I see in today’s news that the economy is shrinking, but that should not be a reason not to campaign to get these cancers shrunk.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

GP Services: Christchurch

Christopher Chope Excerpts

Tuesday 20th May 2025 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Sir Christopher Chope to move the motion and I will then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and from the Minister. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move,

That this House has considered access to GP services in Christchurch.

It is a pleasure to serve under your chairmanship, Mr Dowd. This short debate was triggered by the perverse decision, announced last week, of the Dorset integrated care board to refuse permission for Burton surgery to reopen. The surgery is a premises in Burton village in Christchurch constituency, which has had a GP surgery for more than 30 years. The surgery was converted from a guest house. It has good car parking nearby and a pharmacy adjoining it, and is a well-loved community facility.

In 2007, the GP practice in Burton was amalgamated with Christchurch medical practice and became a branch of that practice. Then, in December 2023, patients were told that the Burton premises would be closed and all patients transferred to Christchurch medical practice in Purewell. I wrote to the integrated care board to express my concern at the impact that would have on the people of Burton. Although the ICB said that it was powerless to intervene because the surgery was only a branch, local residents were confident that another GP practice would acquire the premises and continue to provide GP services, because the building is in really good order: it has 11 consulting rooms and is a very attractive proposition for another GP practice. It was expected that it would be put on the open market for sale.

Much to everybody’s frustration, that did not happen. The owners of the practice decided instead to do a closed deal with a veterinary hospital based in Christchurch, which agreed to acquire the site, thereby excluding the possibility of another GP practice taking it over. However, one thing they had not thought about was that they needed to get planning permission for a change of use. The planning application was strongly opposed by local residents, backed by me, and it became a major issue in the general election campaign. Eventually, Bournemouth, Christchurch and Poole council refused the application on a series of grounds, the principal one being that

“insufficient evidence has been submitted to demonstrate that the loss of a community facility at this site would not result in a substantial decline in the range and quality of facilities and services available for local people.”

In essence, the local planners said that it was necessary to keep the surgery in Burton because removing it would take away an important community facility. If nobody else was willing to open such a community facility, I would not have been able to put forward this argument, but another practice has now purchased the premises and is willing and ready to open a branch in them. However, in order so to do, it had to apply to the integrated care board for permission. It did just that last November. Extraordinarily, it took months before a decision was reached—so long that I raised the issue in an oral question. The Secretary of State himself took it on board and, as a result, the ICB was pushed into having to make a decision on 23 April. As I understand it, the decision was made on 23 April, but was not communicated until some time afterwards.

In the meantime, and in anticipation that the application to reopen the branch was essentially a formality, South Coast Medical completed the purchase of the building and started the refurbishment. The plan was that it would reopen this summer. The ICB’s decision to refuse permission for the branch surgery to reopen is, in my view and that of my constituents and local residents, beyond belief. I appeal to the Minister to intervene on behalf of the 4,500 patients whom the ICB accepts would choose to re-register at Burton were the surgery to reopen.

Ironically, it is said that the cost of re-registering those 4,500 patients would be a significant burden on the health service. That is because people who are in their first year with a GP are thought to be more burdensome, so the GP gets paid a slightly larger amount for each of them. To describe the exercise of patient choice in that way—as a burden on the NHS—seems to me to be pretty wide of the mark.

After I heard the outcome of the application, I tabled a series of questions, one of which sought to establish how many people have been transferring from one practice to another in Christchurch each year, because I wanted to get a feel for that. The answer, from the Minister for Care, stated that the information is not available.

Some of the arguments made in favour of not allowing the surgery to be reopened, in answer to another of my questions, were based on the number of appointments already taking place in Christchurch. That prompted me to table a named day question on that subject. At about 9.30 am this morning I received a holding response, saying that the information relating to the number of appointments at surgeries in Christchurch over the past couple of years is not available, yet the ICB says that it used that very information to help it reach its conclusion. I hope the Minister will explain why the ICB, which I think is basically the custodian of all this information, so far has not decided to share that information with Ministers. Either it has the information or it has not been wholly open in suggesting that the information helped in its decision.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will not just at the moment, but I may do later.

This whole issue is a test case for the credibility of the new Labour Government’s promises about increasing access to GP services. In August 2024, after the general election, no one in government or in the NHS, including Dorset ICB, was suggesting that a GP surgery in Burton was not needed. Now that a serious plan to reopen the surgery is in place, without any capital cost to the NHS because South Coast Medical has acquired the premises using its own resources and does not need a grant, it is surely perverse that the ICB is arguing that such a branch surgery can no longer be afforded and that reopening it would adversely affect the financial viability of other practices in Christchurch.

I tabled questions on that issue as well. There is no evidence that other practices in Christchurch would be adversely affected, and I challenge the Minister to share with me, the House and my constituents the evidence that has been used to reach this decision. Will she also explain what can be done to appeal against the decision? It has been handed down by an unelected and unaccountable quango, or arm’s length body, which, among other things, has said to me in a letter that there have been no complaints about the quality of service being provided by the other main practice in Christchurch, which was operating the Burton branch and chose to give it up. However, there have been many complaints; I have fistful of them here, some of which I may refer to. Either the ICB does not open its post, or it is closing its eyes and ears to representations about issues relating to the availability of doctors, the importance of patient choice and the inconvenience of having to travel so far in a community that is not well served by public transport and where taxis are very expensive. If somebody is dissatisfied with the quality of service being provided by their general practitioner, they may wish to exercise their choice, and it is good to have some healthy competition, but all that seems to be being squeezed out by the integrated care board.

I will quote from a letter from Helen Yonwin, who writes: “Since the surgery closed last year in Burton and patients were transferred elsewhere, trying to get an appointment has been a nightmare. They seem to be unable to cope with the extra patients. The telephones are not always answered and it can take over 30 minutes to eventually get a response, only to discover that you are number 20-something in the queue. After a long wait to be told there are no available appointments, so ring again the next day, there are still no appointments, ‘But you can receive a telephone consultation from a GP’—but the next available slot is in four weeks’ time.”

That is not improving access to GP services, which is what the Government pledged. It is a levelling down and reduction in service. I hope the Minister will say that it is intolerable and unacceptable, and that for it to be condoned, if not supported, by the ICB is appalling.

[Jim Shannon]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will just finish quoting from this letter: “If you are lucky enough to get an appointment, the next problem is getting there. Many people don’t drive or have a car, public transport is not easy for those with mobility issues, and taxis are expensive. If you do drive, another problem arises because parking is very limited.” It continues: “I cannot understand how it was stated that no complaints have been made. I and many others, in emails sent to the ICB, mentioned several issues, but I doubt any were noted.” That is a letter from one constituent; there are lots of others.

A new housing development has been approved in the locality of Burton; with some 700 new houses, there will inevitably be increased demand for GP services. Indeed, the developer, or the owner of the land, has already approached a surgery to see whether it would open a branch on the new estate. That will not be necessary if the branch to which I have referred is reopened.

I will quote from another letter. I will not give the person’s name because it refers to their condition, but she has multiple sclerosis. She says: “It’s so hard for me to get to the Purewell surgery even if you can get an appointment…I fell nearly two years ago, and I still haven’t had a proper appointment to see a doctor to see what’s causing my pain.” She says that she wants to have a choice.

Another person wrote: “I previously lived in Stour surgery’s catchment”—that is another surgery within the Christchurch constituency—“and they were amazing. I couldn’t fault them one bit. I then moved to Burton and was forced into this alternative provision.” She says that it is a nightmare to get hold of and that we should have a right to choose who we want as our GP. She also says, “Every time I’ve had an appointment, it’s been running 30 to 45 minutes late.” Reopening the local branch surgery would resolve those problems.

I hope that I have given a flavour of the strength of local feeling on this fraught issue. Somebody else wrote to me that not everybody wishes to complain publicly about the lack of service available from providers in the Christchurch medical practice, because they are worried about the consequences for them. I think that such concerns are irrational, but they are understandable.

[Jim Shannon]

I commend the hon. Gentleman for his campaign on this issue. It is what we expect from him, because he is very assiduous and very committed to his constituents. He has clearly laid out the issue. Does he feel that the main reason for the ICB’s not pursuing the case is finance? If it is, even with the proposed new housing, perhaps the Minister needs to look at the case personally to ensure that it is not being held back by anything that the Government are doing at this moment in time.

[Sir Christopher Chope]

The hon. Gentleman mentions the issue of finances. I tabled a written question about how much the health service has been spending on general practice in the Christchurch constituency. Again, rather surprisingly, the information is available only for the year ending 2023, so we do not have any information for 2023–24. Although I would not expect the figures for 2024–25 to be available, I certainly would have expected the total costs for 2023–24 to be available by now. The answer says that in 2022–23, some £17.5 million was spent on providing GP services in Christchurch.

The idea that the cost of transferring patients from one practice to another should be a decisive factor against the reopening of a branch seems extraordinary. It makes a nonsense of the argument that we must rein in our expenditure. While we are talking about the ICB’s expenditure, for the last several years I have been complaining that, at any given time in Dorset, under the ICB’s supervision, there are some 250 patients in Dorset hospitals who have no need to “reside”, as it is called. In other words, those people are in hospital but do not need to be there. Every day, that is 250 patients at a cost of between £500 and £1,000 each.

The same body is presiding over that scandal. It said last year that it was going to halve the number, but it has failed to do so—indeed, the number is just the same as a year ago. Instead of taking it out on the people of Christchurch and saying, “You can’t have access to a reopened branch surgery,” it should be looking at its own poor performance. As I have said to the Minister informally, the idea that Dorset ICB will somehow be amalgamated with other ICBs—creating even more bureaucracy, and making it even more remote from the people—is, again, farcical.

My final point—I want to give the Minister time to respond—is that, in answer to a written question, the Minister for Care said that as a result of what has happened in the last year, the number of patients in Highcliffe has increased by about 150. In Christchurch medical practice, the total number of patients has actually fallen; in the Stour surgery, it has increased; and in the Grove, it is about the same. To suggest, on those figures, that the financial viability of other practices in Christchurch will be threatened if this branch surgery is reopened seems to be without any justification. I hope that the Minister will be able to give a positive response, although I note that the Minister for Care is not responding to the debate.

[Clive Jones (Wokingham) (LD)]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will not, because I want to ensure that the Minister has time to respond to those points.

--- Later in debate ---

[Karin Smyth]

I will not, because the hon. Member for Christchurch wants me to answer his questions.

We are working closely with the Secretary of State for Housing, Communities and Local Government to address the issue of additional demand in national planning guidance and ensure that all new and existing developments have an adequate level of healthcare infrastructure for the community. The NHS has a statutory duty to ensure that there are sufficient medical services, including general practice, in each local area, with funding and commission reflecting population growth and demographic changes. The hon. Gentleman highlights an important point that we will continue to pursue.

Those are the facts about the decision made by the ICB, which was its decision to make. I am not going to stand here and tell the hon. Gentleman that he is not right to do what he is doing; he is absolutely right to fight for the best possible service provision for the people of Christchurch, and I would do the same for my constituents—all hon. Members do that. These decisions are best made locally, however, and it is for Dorset ICB to use its autonomy to make them, not Ministers in Whitehall.

[Sir Christopher Chope]

The ICB is not elected or accountable. We have an elected and accountable council—BCP council—which decided that the surgery in Burton, a community facility that had been there for more than 30 years, should remain and that permission should not be granted to change its use, because of its value as a community asset. Why should the ICB be able to second-guess the elected representatives of the community? Is that not intolerable?

[Karin Smyth]

I could talk for a long time about the accountability of health services, but we do not have time for that. The legislation, as set up by the previous Government and others, is clear that ICBs have responsibility for commissioning services on behalf of the local population within the resources that they have available. They need to do that under particular guidelines, which I have outlined, and it is important that they keep up communications with Ministers and local people.

I am not au fait with the day-to-day running of Dorset ICB—that is not for Ministers—but at a strategic level, I recognise that Dorset currently has the fifth-highest ratio of GP clinicians to patients in the country. I know that everyone wants to be in first place, but I am sympathetic to the ICB’s arguments that other practices may suffer if the surgery were reopened. Closing the former site has made the services at Christchurch medical practice and other neighbouring practices slightly larger, which has given them greater resilience in the long term.

The hon. Member for Christchurch mentioned the new Labour Government and what we are trying to address. I do not have the figures in front of me, but every hon. Member present will know there have been hundreds of GP service closures—not just branches but practices—over the past 14 years. The trend has been for primary care to receive a smaller share of the NHS budget, and as a result, secondary care has had much more activity. We all know about the 8 am scramble, and some GPs have been forced to work in appalling conditions with leaky roofs and buckets catching rainwater.

That is why our priority is to stem the flow of resources away from primary care, shift the focus of the NHS from hospital to community, and begin building a much better neighbourhood health service. Our objectives are to hire more GPs, reach an agreement on a new contract, rebuild surgeries through increased capital spend, and bust the bloated bureaucracy that has built up. In the summer, we committed to bringing in an extra 1,000 GPs through the additional roles reimbursement scheme, which we backed with an extra £82 million of funding after changing a technicality that prevented primary care from hiring more new doctors. We have surpassed our initial target and 1,500 more GPs are now serving patients on the frontline. Since we took office, I am happy to confirm that 11 have been recruited by Dorset ICB, including, as I understand, three in the hon. Member’s constituency.

In conclusion, we are committed to shifting the NHS from hospital to community and to building a neighbourhood health service. We are bringing back the family doctor.

[Sir Christopher Chope]

One of the issues is that since the branch surgery was closed, Christchurch medical practice has reduced its number of full-time equivalent GP doctors. There used to be 10.7 and now there are only 10.2, which may be part of the problem. Surely it must be in the interests of the Government, the taxpayer and everybody else to allow a branch surgery to reopen, at minimal additional cost, to the benefit of 4,500 people in the Christchurch area.

[Karin Smyth]

As I said, decisions about how the additional costs are borne and the resilience of the rest of primary care in the area are for the ICB. It has been very clear that that is not the case, so the hon. Member may want to take it up with the ICB.

Since we came into office, we have been doing the hard yards of restoring the role of general practice at the heart of our health service, including in the hon. Member’s constituency, by investing in people, places and programmes that cut bureaucracy. We are laying the foundations for an NHS that is fit for the future, particularly based around primary care and neighbourhood health centres.

Question put and agreed to.

Oral Answers to Questions

Christopher Chope Excerpts

Tuesday 25th March 2025 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

Waiting times for patients living in the village of Burton outside Christchurch could be drastically cut if the local integrated care board were to approve the creation of a new branch surgery. That application has been outstanding for more than four months. Will the Secretary of State put a bomb under Dorset ICB and get it to approve it straight away?

[Wes Streeting]

That sounds like an invitation to commit a criminal offence, and I think I will resist the temptation. I am sure that the ICB has heard the hon. Gentleman’s forceful representations, and we will make inquiries to get him an update.

Rare Cancers Bill

Christopher Chope Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Dr Arthur]

I thank my hon. Friend and office neighbour for making that point, which was also made by Eve Appeal. I cannot remember the statistics, but there is a stark difference. I talked about this issue when I met the Minister yesterday and she gently pointed out to me that it is not just in healthcare where women are dismissed as hormonal, premenstrual and so on. I thanked her for reminding me of that in the gentlest possible way.

It is a cruel irony that rare cancers such as Gabrielle’s tumour are typically less survivable, making early diagnosis even more important. Rare cancer patients require early, not later, diagnosis. I have spoken about poor outcomes, lack of progress in developing treatments and late diagnosis. My Bill focuses on the first two points, but I want to acknowledge the need to improve diagnosis, because of comments that have already been made. I am sure that will feature in the cancer plan.

I am the first to admit that, when I was successful in the private Member’s Bill ballot, I found it daunting as a new MP. I thought I had some really good ideas for a Bill, but as soon as my ping-pong ball was picked from the goldfish bowl, I was inundated with calls from constituents, charities and lobbyists, each telling me that their cause was better than any I could think of. I considered many worthwhile causes over the following days, but while having a coffee in Colinton Mains Tesco in Edinburgh South West, I received emails from members of the public who support the campaign of my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh). Just last week I met Oriana, one of the people who emailed me. It was incredibly moving to meet her; it took me right back to the start of this journey. I posted on my Facebook page about meeting her, and straight away somebody said that they knew her and that she had helped them when their family had been faced with glioblastoma. That is a reminder that so many people affected by these conditions turn their loss into something really positive and help other people.

My hon. Friend’s campaign relates to glioblastoma, a type of tumour that took my father-in-law. I felt that the stars had aligned for me. I really do mean that; I really did get that feeling. I want to pay tribute to my hon. Friend. [Hon. Members: “Hear, hear.”] More, more! I know her to be a formidable woman who in this context is driven by glioblastoma taking her sister, Margaret. I did not know her sister at all, which is my loss, but I do know that she shaped my party and she helped change our country for the better, and I know above all that she was loved by her sister.

Glioblastoma is typical of so many rare cancers, and it started me on this journey so I want to talk about it further. My father-in-law, Ivor Hutchison, was a dignified man but glioblastoma did not respect that. He was a technical teacher at Bell Baxter high school in Fife. He was married to Sylvia and they have four daughters, Denise, Iona, my lovely wife Audrey who is in the Gallery —I have just embarrassed her—and Sarah. In time, Ivor and Sylvia had grandchildren: Andrew, our daughter Ruth, Hannah, Matthew, our son Ben, Rory and Sophie. Ivor was not a passive grandfather; he worked hard to ensure his grandchildren flourished.

In September 2017, Ivor began having problems with his speech. My wife Audrey, an NHS nurse, was concerned that it might be a sign of dementia. We all hoped that that was not the case. Following an MRI scan in the November, we received the devastating news that Ivor had glioblastoma. At Christmas he was still very much himself and enjoyed the festivities. Ivor never had a pound of fat on him, but when it came to Christmas time he really did hoover up the food and enjoyed the Christmas meal. It was great to see him that Christmas, but we did feel that it would be his last. Once we entered the new year, he began to lose his mobility, and eventually he was admitted to Adamson hospital in Cupar. In 2018, surrounded by his wife and daughters, Ivor died peacefully, eight months after his first symptoms. He had a good life and his daughters are a fantastic legacy to him, as well as all the pupils he taught at school.

However, as a physically fit man, Ivor should have lived longer: he should have lived to see his birthday last weekend, and if he had done so, he would not have missed two of his grandchildren getting married and his first great-grandchild, Fraya, being born in December last year. I assumed that he had been unlucky with glioblastoma. It was not until I met my hon. Friend the Member for Mitcham and Morden that I learned that only 25% of glioblastoma patients live beyond 12 months after diagnosis, and only one in 20 survive beyond five years. Despite that awful prognosis, as for other rare cancers, the drugs to treat glioblastoma have not changed in decades. That is why I knew in my heart that I needed to introduce a Bill that would help equip those working hard to fight against glioblastoma, and all rare cancers, with the tools they need to further their efforts and, ultimately, save lives.

Over the past 15 years, thanks to the dedicated work of charities, survivors and researchers, we have seen a 10% rise in survival rates for those diagnosed with cancer. Globally, new treatments are being developed and rolled out to patients, improving outcomes and saving lives in our NHS every single day. However, rare cancer patients are being left behind, and I need to explain why. It is not due to a lack of effort by charities or those affected by the disease. In fact, in the Gallery today are members of some incredible charities who are fighting against rare cancers in what is often an uphill battle. I thank them for their hard work in helping me to develop the Bill—they really have helped me—which aims to address the injustices faced by rare cancer patients and their families. For all the people I have met from the charities, their work is much more than a job for them; it is about making a difference to people’s lives, improving survivability and supporting families.

The reason for the uphill battle is that research into rare cancer is much less appealing to pharmaceutical companies when compared with more common conditions. With smaller patient populations, there is an increased logistical challenge in bringing patients together. Currently, we are lacking a sufficient development strategy and there is no single source of patient data, meaning companies must undertake the costly endeavour of finding patients and verifying eligibility. Even if they succeed in running a clinical trial and a drug proves to be an effective treatment, companies face the challenge of selling a drug developed at great expense to a small market. Ultimately, these companies exist to return a profit for their shareholders. Given a choice between investment in potential treatment for a rare cancer or a more a common one, too often rare cancer patients lose out.

Having set out the challenges faced by those diagnosed with rare cancers, let me now address what the Bill aims to accomplish. I will list four key measures and explain their impact: appointing a named responsible lead for the delivery of rare cancer research; creating a single registry of rare cancer trials; creating a single registry of rare cancer patients available for trials; and defining an evidence base for repurposing new cancer treatments. Let me explain in turn why these are important.

First, the Bill would place a duty on the Secretary of State to facilitate and promote research related to rare cancer patients. The appointment of a national specialty lead for rare cancers in the National Institute of Health and Care Research would provide the Secretary of State with advice on the design and planning of research to facilitate collaboration between relevant parties. That will ensure co-ordination and accountability for the delivery of new cancer research in the UK.

Secondly, the Bill would increase access to clinical trials via a service tailored to rare cancer patients. Through the Secretary of State’s new duties, that would be accomplished as part of the existing “Be Part of Research” registry, ensuring that all trials are registered in a single place.

Thirdly, charities and clinicians tell me that more trials would be attracted to the UK if we had easier access to patient cohorts. Establishing a single database of willing patients would remove a significant burden on researchers in finding and verifying eligible people for clinical trials.

[Sir Christopher Chope (Christchurch) (Con)]

I congratulate the hon. Gentleman on introducing a Bill on this important subject. He mentions research. Can he explain why the extent of clauses 2 and 3 is limited to England and Wales? What is happening in Scotland in relation to the research issues?

[Dr Arthur]

The challenge is devolution. I am a huge fan of devolution, but often the UK is at its best when it works together, particularly on healthcare. I hope that in time we will see progress and the nations will work together. I do not want to overstate this, but there have been discussions across the UK about how we could work together on the issue, so perhaps the answer is, “Watch this space.”

The Bill’s fourth measure is to trigger a review by the Government of the orphan drug regulations, to examine how they can be reformed to better incentivise pharmaceutical companies to invest in clinical trials for rare cancers. Specifically, it will consider how incentives could be provided to pharmaceutical companies to trial the repurposing of new cancer treatments. We often hear about how drug development for one cancer can be used to defeat another; that is what Kira relies on right now. My Bill aims to build a foundation for industrialising that approach via incentives. The EU has a similar system for incentivising the testing of drugs for paediatric use that have already been approved for adult use, so the approach has been tried and tested.

Together, these measures will ensure that we have leadership in Government and will remove the barriers to running new clinical trials that researchers and pharmaceutical companies face.

Maternity Services

Christopher Chope Excerpts

Tuesday 25th February 2025 Westminster Hall

[Chris Bloore]

I thank the hon. Gentleman for his intervention and I am sorry to hear about the level of problems that mothers face his constituency. The hon. Member for Chichester started the debate saying that this is about services for women at their most vulnerable, when they are giving birth. It is clear from the experiences of the hon. Gentleman’s constituents and mine that services are not meeting the needs of those women when they need them the most. That is the challenge that we should now take up.

I conclude by saying that, in the past, the reconfiguration of services has been based on a financial envelope and the challenges of staff shortages, and that has dictated many decisions, but now is the time, with the Darzi report and the eloquent speeches we have heard today, to build that service for the future. We should all strive to meet that challenge, even if that means making difficult financial decisions to invest in the long term, so that we can give women and families the support that they deserve.

[Sir Christopher Chope (in the Chair)]

There are three speakers, and we have five minutes to go.

Medicines and Healthcare Products Regulatory Agency

Christopher Chope Excerpts

Thursday 16th January 2025 Commons Chamber

[Esther McVey (Tatton) (Con)]

I beg to move,

That this House notes that the Medicines and Healthcare products Regulatory Agency (MHRA) continues to need substantial reform, as recognised by the Independent Medicines and Medical Devices Safety Review (IMMDS), with patient safety concerns persisting and exacerbating since the review’s publication in 2020; believes that the MHRA’s 2017 expert working group report on Primodos was deeply flawed, with IMMDS later concluding the drug had caused avoidable harm; further notes that the yellow card system for reporting suspected adverse drug reactions is failing, with no process for following up on serious or fatal reactions and conflicts of interest, with 75% of the MHRA’s funding being derived from industry fees, a concern raised in the Fourth Report of Session 2004-05 of the Health Committee, The Influence of the Pharmaceutical Industry, HC 42-I, published on 5 April 2005; also notes the MHRA’s delayed response to reports of myocarditis, pericarditis and vaccine-induced thrombotic thrombocytopaenia following covid-19 vaccination, despite action from regulators in other countries; and calls on the Government to fully implement the recommendations in the IMMDS review and to acknowledge the harm done to patients and the financial burden on the healthcare system as a result of the MHRA’s widespread regulatory failures.

I thank the Backbench Business Committee for granting this debate and the many colleagues from across the House who supported my application for it, especially the hon. Member for Blackley and Middleton South (Graham Stringer), and also the hon. Members for Bolton South and Walkden (Yasmin Qureshi) and for Great Yarmouth (Rupert Lowe).

The Medicines and Healthcare products Regulatory Agency is the body responsible for ensuring the safety and efficacy of medicines used in the UK. Its job is to oversee medical products, medicines, medical devices and blood components for transfusion. The responsibility it has is extremely important, as it comes with the potential not only to change people’s lives for the better, but to cause serious harm—even death—if poor decisions are made or safety signals are missed.

The MHRA is required to scrutinise applications from the pharmaceutical companies for new products and devices and to remain ever vigilant over existing drugs should safety problems arise post-authorisation. It has to weigh up the arguments for and against these products and devices. After all, the companies trying to get these products on to the market—and to keep them there—are driven, as all industries are, by commercial success. It is up to the MHRA to balance that with the health and safety of the UK and the public.

Alarm bells rang for many of us when, in March 2022, Dame June Raine, the chief executive of the MHRA, boasted of the agency’s transition from watchdog to enabler. Twenty years ago, the Health Committee report, “The Influence of the Pharmaceutical Industry”, found that the MHRA was unusual in being one of the few European agencies

“funded entirely by fees derived from services to industry”.

Not much has changed since, with the MHRA continuing to get 75% of its funding from the pharmaceutical industry. In this context, the agency’s transition from watchdog to enabler does little to quell suspicions of conflicts and the implications that has for patient safety.

One of the most worrying issues is the MHRA’s mismanagement of the yellow card system. Established in 1964, the system is a way for patients, relatives and healthcare professionals to report suspected adverse reactions to drugs or medical devices. The reporting scheme should be a valuable source of information about possible harms, and act as an early warning system, but there is gross under-reporting to it. As the IMMDS’s 2020 review put it, the system is

“too complex and too diffuse to allow early signal detection.”

Under-reporting is a big problem because it makes it difficult to spot safety signals and assign causation. That then translates into unnecessary harm or death, with devastating side effects from treatment going unnoticed for years, months or even decades. That was recognised by the IMMDS review led by Baroness Cumberlege in the case of Primodos, sodium valproate and surgical mess—I meant to say mesh, though perhaps the word should have been “mess.”

According to research from Bangor University in 2019, potentially avoidable adverse drug reactions cost the NHS £2.2 billion a year in hospital admissions. In 2018, the MHRA estimated that only 10% of serious reactions and between 2% and 4% of non-serious reactions are reported. More recently, it has claimed that reporting rates for covid vaccines are better due to higher public awareness, but it has not been able to point to published evidence to back up that claim. The yellow card is currently a voluntary scheme that doctors and members of the public can report to, but I echo calls from the Sling the Mesh campaign and others for the UK to follow the example of Denmark and Sweden by making it mandatory for all healthcare professionals to report suspected adverse reactions.

Let me turn to the MHRA’s failure to act promptly on evidence of adverse reactions. We have seen that historically. For example, sodium valproate was known to cause harm to unborn babies in the 1980s, yet the MHRA did not establish a valproate pregnancy prevention plan until 2018. The known harms to unborn babies were allowed to persist for over 30 years. More recently, in 2021, the MHRA reacted slowly to strong signals that there was a serious problem with the AstraZeneca vaccine causing an autoimmune condition called vaccine-induced thrombotic thrombocytopenia. Denmark and other European countries suspended the vaccine for all age groups on 11 March 2021. The MHRA, by contrast, only started to restrict the vaccine in some age groups nearly two months later, on 7 May—yet there was a signal in the yellow card reports as early as 8 February. How many people were needlessly exposed to a risk?

[Sir Christopher Chope (Christchurch) (Con)]

My right hon. Friend hits on an important point. What action did the MHRA take to apologise for or explain its failure to give adequate and timely warnings to potential patients?

[Esther McVey]

I do not believe that the MHRA has taken such action. We are probably still waiting for it. Hopefully, that will come out. People are also either not getting compensation quickly enough or not receiving compensation that is commensurate with the illness and damage caused to them.

It is worth noting what happened when The Daily Telegraph reported on the potential causal link between the AstraZeneca vaccine and blood clots in March 2021. The journalist who wrote the story received a threatening call from the MHRA warning that The Telegraph would be banned from future briefings and press notices if it did not soften the news—an extremely defensive approach for an agency whose No. 1 strategic objective is to maintain public trust through transparency and proactive communication. Does that sound like an agency that is doing its best to maintain public trust, let alone patient safety?

It is clear that the system does not work. We have good evidence that suspected adverse reactions are under-reported, but what about the ones that are reported? We know from freedom of information requests that the MHRA does not have a process for investigating and following up individual yellow card reports. We know that the retrieval of follow-up information from the yellow card database still requires manual extraction and that only 54% of deaths reported as possibly linked to exposure to one of the covid-19 vaccines were followed up by the MHRA. That is extremely worrying or, as Matt Hancock infamously described it in a 2021 WhatsApp message, “shonky”. The chief medical officer, Chris Whitty, replied to that message by saying that the system “needs to get better”.

Another long-standing problem with the MHRA is its lack of transparency. Take FOIs to the agency as an example. Between 2008 and 2017, only 41% of requests were successful. In 2021, 76% were answered outside the 20-working-day statutory response time. A culture of delay and secrecy has emerged, and MHRA’s behaviour around the Commission on Human Medicines meetings for the covid-19 vaccine benefit risk expert working group show that beyond any doubt. Minutes of the meetings were published just last month, four years after they took place—why the delay? They are stuffed full of redactions that leave us with many more questions than answers, particularly as to why the new vaccines were continually described as safe and effective.

In the meeting on 18 November 2020, the expert working group asks if Pfizer was “required to respond to the 36 questions asked by MHRA”. In response, the MHRA confirmed that “there is no formal obligation to reply”. Why is there no formal obligation to reply? Surely it is essential, when making such an important decision as to whether to allow a new vaccine to be rolled out to the nation, to have those replies. The minutes do not specify the 36 questions. Indeed, they do not appear to have been mentioned again.

I asked a written question last week to see whether, in the spirit of openness and transparency, the MHRA would publish those questions and any answers received from Pfizer. The response was that the MHRA does not intend to publish those questions or any subsequent responses. Why not? Is this not a matter of public interest? Those issues were not resolved before the MHRA gave the green light to start the vaccination of the nation.

Particularly worrying is the issue of lymphopenia, where blood does not have enough white blood cells, which was reported in phase 1 of the trials and then went away—not because they fixed the problem, but because testing for the condition was not conducted in phases 2 or 3.

In summary, the failure to act on the weaknesses of the MHRA will lead only to more harm and further damage to the public’s trust in the pharmaceuticals agency and those tasked with regulating it. My hope is that the debate will help bring those wide-ranging issues further to light and focus the Minister’s mind on finding solutions. I will end on the words of Dr Tom Jefferson of the University of Oxford:

“You cannot support both secrecy and vaccination. Requesting data is not a sign of being against drugs or vaccines; it shows that you favour transparency. Those who try to keep data confidential and criticise those who ask for evidence are anti an evidence-based approach. How can you have informed consent if you do not know precisely what is happening?”

[Sir Christopher Chope]

On that point, does my right hon. Friend accept that one of the consequences of the lack of transparency has been a public distrust of vaccines, which is spreading rapidly? As a consequence, for example, there is less take-up of MMR vaccines than there should be and used to be, and that is because of a lack of trust in the system.

[Esther McVey]

My hon. Friend makes a good point. If people lose trust in vaccines, the pharmaceutical industry and the regulatory agency, that is precisely what happens. We know that these vaccines are essential to many people, so we do not want that happen. We want to ensure that new vaccines and medicines coming into use are thoroughly tested and that, along the way, we keep an overall watch on whether they are working correctly.

--- Later in debate ---

[Sir Christopher Chope (Christchurch) (Con)]

I shall try to be brief, Madam Deputy Speaker. I follow the hon. Member for Blackley and Middleton South (Graham Stringer) by referring to a quote from Hayek’s book, “The Road to Serfdom”. I do not claim credit for identifying it myself; it was quoted in the other place by Lord Hannan of Kingsclere on 15 January in the context of the Football Governance Bill. He was talking about the growth of the administrative state, about which the hon. Gentleman was speaking at the beginning of his speech. Hayek said:

“The delegation of particular tasks to separate bodies, while a regular feature, is yet only the first step in the process by which a democracy…relinquishes its powers”.

That is in chapter 5 of “The Road to Serfdom” from 1944, so not much has changed. The MHRA is an example of what happens if we in this House transfer responsibility to unelected and unaccountable organisations.

It so happens that on the Order Paper for tomorrow is my Covid-19 Vaccine Damage Bill, which is sponsored by a former Attorney General. That Bill calls for an independent review of covid-19 vaccine damage. It calls on the Secretary of State to

“appoint a current or former High Court judge to lead an independent review of disablement caused by Covid-19 vaccinations administered in the United Kingdom and the adequacy of the compensation offered to persons so disabled.”

We know that more than 600 people have already been told by the agency responsible at the Department of Health and Social Care that they have suffered disabilities as a result of covid-19 vaccines. A large number of them, where the disability is in excess of 60%, have been awarded wholly derisory payments of £120,000 each.

My Bill goes on:

“The review must consider…the rates and extent of disablement caused by each type of Covid-19 vaccination offered in the United Kingdom”.

Relevant to this debate, the review must also consider

“the effectiveness of Medicines and Healthcare products Regulatory Agency monitoring of such side effects, and National Health Service and Government responses to such monitoring”,

as well as

“the adequacy of compensation offered to persons so disabled”.

There has always been an agreement, basically, that if something goes wrong for people who undertake vaccination voluntarily or are in receipt of other medical products—if they are doing the right thing by the country at large—and they have an adverse reaction, they will be able to look to the Government or the taxpayer to pay them some recompense under the scheme to which I have referred, if causation is established. The trust built by that scheme has been undermined by the long denial of the previous Government—and, to an extent, the current one—that any adverse reactions had been caused by the covid-19 vaccines, other than the most minor disablement. It has also been undermined by the fact that so many people have applied for a review of their cases. Some people—I think more than a thousand—have been waiting more than 18 months for a decision. That shows that this is a low priority for the Government.

I hope that when the Minister responds to the debate, she will be able to explain why the Government will block my Bill again tomorrow. If they were taking this issue seriously, as they should be, they would be open to and supportive of the establishment of an independent review of disablement.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I am setting a five-minute time limit.

Tobacco and Vapes Bill

Christopher Chope Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

I will certainly come on to the action that we are taking on vaping, and the case for it. I welcome the contribution that my hon. Friend has made in his first few months as a Member of this House. He brings enormous expertise and experience, particularly on health, which we very much value here in the Chamber.

One choice would be to continue paying an ever heavier price for failure. That is the road that we were heading down, under the previous Government. Our NHS already takes £4 for every £10 spent by the Government day to day. We are on course to go from being a nation with a national health service to a health service with a nation attached to it. It is projected that by the end of this Parliament, 4.3 million people will be on sickness benefit if we fail to act. Smoking could cause 300,000 patients to be diagnosed with cancer over the next five years, including 3,000 for whom that is the result of exposure to second-hand smoke. That is what happens if we only ever treat the symptoms of ill health. We end up spending more on the NHS than ever before, but with worse care for patients, a ballooning welfare bill due to more and more people being out of work, stagnant economic growth, and the heaviest tax burden in 70 years. In short, we will be paying more, but getting less.

Britain is like a ship with a hole. We are constantly battling to chuck enough water overboard to keep us afloat, as more and more floods in. We must break out of this cycle. Britain can break out of this cycle, but only if we are serious about tackling the causes of ill health, and shift our focus from treating the symptoms to preventing them. Plugging the hole in the ship is how we get back to growth, how we reduce the burden of taxation, and how we ensure that this Government can intrude more lightly on people’s lives.

[Sir Christopher Chope (Christchurch) (Con)]

The argument that the Secretary of State puts forward is essentially one for banning smoking altogether. What he said earlier was misleading; he suggested that people of a particular age group will not be able to smoke. They will not be able to buy cigarettes, but they can still smoke. They can cadge cigarettes off other people. Is this not a half-baked measure?

[Wes Streeting]

I am sure that the hon. Gentleman was not accusing me of misleading the House. The argument that he puts forward is used against all sorts of laws and prohibitions. Most people in this country are law-abiding citizens who follow the law. In my constituency today, there will be people dumping fridges and mattresses on street corners—fly-tipping—because they are irresponsible and not law-abiding citizens. We will not always catch them, either through closed-circuit television or local authority enforcement, but that does not mean that we should not tackle them when they do those things.

By phasing in a generational smoking ban, we are taking a measured and reasonable way of creating a smokefree country. That is the right way to proceed, and it is sensible. I know that he does not agree, but he must accept the trade-off—the choices that he is making for the Opposition. First, he is accepting that people will pay a higher price for their healthcare, either through taxes, if he still believes in the national health service, or through the cost to the individual of their healthcare. Secondly, he must concede that, through the harm caused by smoking, he is fuelling welfare dependency. My right hon. Friend the Secretary of State for Work and Pensions had a point when she said earlier that Labour is the party of work, and the Conservatives are the party of welfare. That is the logical conclusion of the hon. Gentleman’s opposition.

Maternity Services: Gloucestershire

Christopher Chope Excerpts

Wednesday 9th October 2024 Westminster Hall

[Clive Jones (Wokingham) (LD)]

My local hospital, the Royal Berkshire hospital, is where my two children were born and many of our friends’ children were born. It has recently received an upgraded rating of good from the Care Quality Commission, and it is one of only nine organisations, out of 131, that got an upgrade to good over the last year, so I commend the Royal Berkshire leadership and staff for their diligence and dedication, and congratulate them on that result. Does my hon. Friend agree—

[Sir Christopher Chope (in the Chair)]

Order. Interventions should be short. If the hon. Gentleman wishes to make a speech, he can do so later. Let us hear the response to the intervention.

[Max Wilkinson]

I am sure that I would agree with whatever my hon. Friend was about to say. He was making the point, I think, that it is easy to be down on our NHS and its staff. That is not the purpose of this debate at all; its purpose is to ensure that we give the support that is needed to our midwives, other NHS staff and, indeed, NHS managers, who are often maligned but, like other NHS staff, work long hours and are in it for the betterment of health services.

On a personal note, I offer my wholehearted thanks to the staff at Gloucestershire hospitals, who were there for my wife and me when our daughter was born in Gloucestershire Royal hospital in 2022. It was an important day for my family and for the country when we went into the operating theatre for the C-section: this country had no Prime Minister, and when we came out we had my daughter, Elodie, and we had Liz Truss. That is a memory that will live long for me. I particularly thank Fiona Liddle, the midwife who gave us the most care during my wife’s pregnancy, as well as all the doctors, nurses and healthcare workers who helped to make the experience so joyful for us.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Sir Christopher.

With your leave, I will start with a few words to mark Baby Loss Awareness Week. Many mums and dads across the country have suffered the heartbreak of losing a baby. Everyone deals with grief in a different way, but it has been moving to hear from parents how baby loss certificates have allowed them to process what they have gone through and have helped give them closure.

That is why this week we launched an extension to the baby loss certificate service, which is a voluntary scheme to enable parents who have experienced a pregnancy loss to record and receive a certificate to provide recognition of their loss, should they wish. Until now the service was only open to parents who had experienced a loss since 1 September 2018, but today we are removing that restriction, making the certificates available for every parent who has lost a child. We will update the House with a formal written statement shortly. The Government are committed to delivering compassionate care for women and support for parents who have suffered a baby loss. It is the right thing to do.

I think this has been a genuinely good debate. We have heard from experts—I commend the Opposition spokesperson the hon. Member for Sleaford and North Hykeham (Dr Johnson) and my hon. Friend the Member for Stroud (Dr Opher) for the work they do—and others have shared experiences. I knew that the hon. Member for Cheltenham (Max Wilkinson) would bring forward good points too, so I contacted the trust myself so that I could give the hon. Gentleman and hon. Members present my frank assessment of what is happening on the ground.

To reiterate, as of August 2024 the midwifery vacancy rate in the Gloucestershire hospitals NHS foundation trust stood at 13%—the equivalent of 32 full-time midwives. That level is high for the south-west, though roughly in line with the national average. In April 2022, the Care Quality Commission gave the trust a warning notice for the maternity service, and rated it “inadequate” a year later. In May this year, the CQC issued the section 31 notice—a severe warning that requires at minimum an immediate action and improvement plan, which, as colleagues will know, in some other settings could result in a closure. It issued that after seeing postpartum haemorrhage rates, poor foetal monitoring and high levels of agency staffing.

The hon. Member for Cheltenham and others from the area are right to be concerned. We can all agree that it is unacceptable when new mothers do not receive the highest possible standard of care. As my right hon. Friend the Secretary of State has said, we should be honest about the problems in our NHS and serious about fixing them. Maternity services are very far from where we want them to be. Childbirth should not be something that women fear or look back on with trauma. Safety is obviously paramount. As the hon. Member for Cheltenham said, it should be a special moment.

I thank the hon. Member for Thornbury and Yate (Claire Young) for sharing her experiences. I was in hospital for two weeks after having my first child, and it is a traumatic time, so the length of time she mentioned must have been very difficult. My second came out so quickly that I was in and out of hospital before we knew it. My third child, as has been mentioned, was almost delivered at home by my husband after we had chosen a home birth. He is not medically qualified, so I can tell you that the sound of the doorbell ringing for the midwives’ arrival was the best sound I have heard in my life.

To the second question asked by the hon. Member for Cheltenham, I will outline the steps the trust is taking to improve the situation. They include a new director of midwifery, an education and training midwife and a perinatal quality and governance lead. To improve retention, the new leadership has introduced a retire and return scheme and is holding monthly events for senior leadership to listen to staff and address their concerns. The trust has recruited 33 new midwifery starters since 2023, including from overseas. Ten midwives are due to start this month, with a further 10 expected in January. But there is still a gap. That is why the Aveta birthing unit and the postnatal beds at Stroud maternity will remain temporarily closed until they reach safe levels of staffing. The trust clearly felt that it could not continue those services without putting new mothers at risk, which is an impossible situation to be in.

I am pleased that the birthing unit at Stroud remains open, but the other closures have had an impact on women, their families and the local community, as has been eloquently expressed by my hon. Friend the Member for Gloucester and mentioned by my hon. Friend the Member for Thornbury and Yate. The impact goes further afield to my own city of Bristol. In addition to those measures, the trust is developing new apprenticeship schemes; building partnerships with universities, including Worcester and Oxford Brookes; and launching a midwifery attraction campaign in the autumn.

Although the trust has had positive feedback from last year’s new starters, I am pleased that it is carrying out regular assessments, as per the recommendations in the Ockenden review, to ensure that midwives have the right skills to serve the people of Gloucestershire. The turnover rate is now settling, and I know the hon. Member for Cheltenham and other colleagues will do everything they can to help convince midwives that his county is a great place to live and work. The passion for those units is very evident here today, which I am sure will be welcome to those trusts.

I know from my career in the NHS that such changes take a long time. It is too soon to make an assessment until all the new midwives have started. However, we are not waiting for the CQC to do the rounds to ensure that the picture is improving. The local maternity and neonatal systems team and the regional NHS England team are meeting with the trust on a fortnightly basis to review progress. The trust’s monthly board reports will report on progress; I know hon. Members will be watching carefully.

It is important to give the new team space to prove themselves. I am hopeful that we will see improvements in time. At a national level, whenever trusts and maternity units do not perform on our watch, we will steer them back to safer ground. That is why we are supporting Gloucestershire maternity services through the national maternity safety support programme. That means that the trust is supported by a maternity improvement adviser for midwifery and obstetrics, who helps the trust to embed the maternity improvement plan.

I know that the hon. Member for Cheltenham and others will continue to hold the trust to account, until it is delivering for women in their constituencies. I am grateful to him for obtaining this debate and giving me the chance to put the Government’s position on the record. With regard to his third question, like many trusts in this position, the trust does have the budget for establishment; it is the recruitment and retention of midwives that is the issue. Some trusts do different things with incentives; I do not know whether this trust is particularly doing that. That might be something he would wish to pick up with the trust at another time.

On more general maternity improvements, in September the CQC published a report that demonstrated how much the previous Government let down new mothers in this country. Lord Darzi’s report has shown that, despite some improvements, there is still a disgraceful inequality of outcomes for black and minority ethnic women, as we have heard again today. We will look at every recommendation in the CQC report, and if officials object to any of them, I expect to hear a very good reason why.

There is ongoing work to improve maternity and neonatal services across England. The NHS put in place a three-year delivery plan to make maternity and neonatal care safer, fairer and more tailored to every new mother’s needs.

I shall now discuss the Government’s wider ambition. Choice—which was mentioned today by my hon. Friend the Member for Stroud and the hon. Member for Thornbury and Yate—is for us absolutely a key part of maternity care. As the hon. Member for Winchester said, our NHS must listen to and work with women and families on how their care is planned and received, based on what matters to them.

To get maternity care back on its feet, we need to train thousands more midwives as part of the NHS workforce plan, while encouraging experienced midwives to stay in the NHS. Many hon. Members, including the hon. Member for Cheltenham, spoke of recruiting midwives, with regard to morale and workload. That was also mentioned by the hon. Members for Tewkesbury (Cameron Thomas) and for Carshalton and Wallington (Bobby Dean). The NHS will deliver the people plan, giving a stronger focus to a modern, compassionate, inclusive culture, which absolutely has to be part of our forward look in the 10-year plan.

We will ensure that trusts failing on maternity care are robustly supported into rapid improvement. We are setting an explicit target to close the black and Asian maternity mortality gap. NHS England is on the right track, boosting the workforce through training, apprenticeships, postgraduate conversion, return to midwifery programmes and international recruitment. I have been clear that the Government will build on those programmes, not replace them.

Finally, I want to end by restating our unwavering commitment to maternity services across the nation, including in Gloucestershire. We are actively working to improve staffing levels and are planning for the future needs of Gloucestershire’s maternity services. I say to the constituents of the hon. Member for Cheltenham that I hear his concerns and completely understand them, and I will work with him to set this right.

The Opposition spokesperson is an assiduous writer, and I have answered a number of her letters, but if I have not responded to particular points from the previous debate before recess, I apologise, and will ensure that that happens after this debate. She has raised important questions.

In the constituency of the hon. Member for Cheltenham and in mine, women have had to bear the brunt of inaction for the past 14 years, but this Government will deliver for women, not just in the south-west but in the country as a whole.

[Sir Christopher Chope (in the Chair)]

I call Max Wilkinson to respond to this very well-informed debate.

Sepsis Awareness

Christopher Chope Excerpts

Wednesday 9th October 2024 Westminster Hall

[James McMurdock (South Basildon and East Thurrock) (Reform)]

I thank my hon. Friend the Member for Ashfield (Lee Anderson) for this debate. It is hard to think of a more appropriate topic. I also thank Abbi—who has shared with us the warmest smile that I have seen in a long time—and her husband for being here; it is a privilege to meet them.

I want to take a moment to share a personal story, to show why drawing attention to this subject is one of the most appropriate things we can do as Members of Parliament. I have four young children at home. After the birth of the most recent one, my wife began to suffer some of the symptoms we have discussed today, but—very much like the hon. Member for Kingswinford and South Staffordshire (Mike Wood)—tough Brits do not easily give in to the hospital. As fate would have it, though, we had a meeting that morning with a carer who was checking on women who had recently had children. She popped round to check on the welfare of baby and mother, and although my wife and I were adamant that everything would be fine, this skilled professional spotted the symptoms immediately and demanded that we were rushed to hospital. We were there within half an hour and, within another 20 minutes, there were around a dozen doctors, nurses and support staff rushing around like maniacs. Although I cannot remember the specific number of signs, they were tenfold, fifteenfold, twentyfold what they should be in a healthy person. The staff may have saved my wife’s life in very real terms.

That is why I wanted to take this moment to recognise why this issue is extremely appropriate. The consequences of catching sepsis are minor, but the consequences of not catching it are extraordinarily severe. The difference is cheap: it is education; it is information that we can all carry with us for free, but which can potentially benefit someone’s life.

I want to take one last moment to again thank Abbi for sharing her story and my hon. Friend the Member for Ashfield for allowing us to hold this debate, and to thank the extraordinary staff at Basildon University Hospital.

[Sir Christopher Chope (in the Chair)]

There are two more speakers and six minutes to go, so that is three minutes each.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Ashfield (Lee Anderson) on securing a debate on this very important topic. I should also declare an interest as an NHS consultant paediatrician. I have cared for and continue in my work to care for people with this condition.

I would like to thank Abbi for coming today. It was an honour to meet earlier today and to hear her story from her MP, which highlighted both the difficulties she faced in getting good immediate care for sepsis and the consequences of that. I commend her for the bravery she has shown in coming today and for raising this issue for the benefit of other people. This debate will increase awareness, which is a very positive thing.

I remember sitting in the Chamber earlier this year when the former hon. Member for South Thanet re-entered Parliament to a standing ovation—an exceptionally rare occurrence in the House of Commons. It is truly humbling to reflect on the journey that he has been through in such a short space of time. Little over a year ago, he had no outward signs of sepsis at all. He has now become one of the most well-known advocates for people with it. His case brought renewed attention to this disease, which kills nearly 50,000 people in the UK every year. As the hon. Member for Ashfield said, that is around the same number of people who die from bowel, breast and prostate cancer combined.

The case of our former colleague speaks to not only a remarkable recovery but the suddenness with which sepsis can utterly change someone’s life. As many people have said today, early identification is vital. Under the previous Government, awareness of sepsis improved significantly, as did the clinical recognition of symptoms, screening rates and the administration of antibiotic treatment, but there is much more to do.

I want to commend the UK Sepsis Trust and other public campaigners who played a significant role in improving awareness among the general public. A recent YouGov survey showed that the UK has high levels of public awareness compared with other countries. Will the Minister say what steps the Government will take to work with NHS England and patient groups such as the UK Sepsis Trust to raise public awareness, so that people can more easily identify the signs of sepsis? I have also asked this of another Minister, but have not yet received an answer. The Chancellor said that she was cutting the communications budget—can the Minister confirm that those cuts will not affect the important public health messaging for campaigns like this? It is important that we do not cut budgets that will save people’s lives and, indeed, save the NHS money. It is also important to raise awareness not just across the general public, but among health professionals, including medical staff in both hospitals and communities.

The national early warning score has been introduced and is being rolled out, along with the sepsis six, which was developed with the UK Sepsis Trust. The six—oxygen, cultures, antibiotics, fluids, lactate management and urinary output monitoring—must all be carried out within the first hour. Has the Minister established how well those measures are being rolled out across the UK, and what is he doing to ensure that is being done effectively? The National Institute for Health and Care Excellence updated its guidance earlier this year. Will the Minister update the House on how effectively that guidance has been implemented across the UK? Martha’s rule was introduced before the election; the rule relates to the ability for people to get a second opinion from another health professional if they remain concerned about their loved one or themselves. Will the Minister update the House on the work the NHS is doing to roll that out, too?

Research is the cornerstone of transforming sepsis care, and the last Government invested more than £1 billion through the National Institute for Health and Care Research. It is important that we research the causes of and treatment for sepsis, but we must also research new antibiotics, because we are starting to see antibiotic resistance to infections. If we do not invest in antibiotic research, new antibiotics will not be developed—we are essentially asking people to develop a drug to be kept on the shelf for when we need it, and there is no money in that, so it will not get commercial take-up. It is therefore important that the Government invest in that.

The UK Sepsis Trust is calling on the Government to publish data on the sepsis care pathway so that we can see where it is performing well and where it is performing less well. I urge the Government to do that. It would be helpful if the Minister could confirm today that they will do so.

As we close the debate, let us remember what we are fighting for. Sepsis takes the lives of 50,000 people every year. It strikes suddenly and often without warning, as Lord Mackinlay’s case reminds us so powerfully. Early identification and rapid treatment are the keys to saving lives; we have made strides, and awareness is growing, but we must do more. We must continue to improve recognition, strengthen control and push forward with life-saving initiatives. I urge the Government today not just to maintain their commitment but to strengthen it by partnering with NHS England, publishing more data, researching the causes of sepsis and ensuring we can fight this disease together.

[Sir Christopher Chope (in the Chair)]

I thank the Front Benchers for sticking to their five minutes, which means the Minister now has 10 minutes; there will hopefully also be a couple of minutes for the proposer to reply.

Healthcare Provision: East of England

Christopher Chope Excerpts

Tuesday 3rd September 2024 Westminster Hall

[Clive Lewis]

I thank the hon. Gentleman for his interesting question. I am not happy with the removal of the winter fuel payment—of course I am not—and I do not think anyone on this side of the House will be happy with it, but I also understand that there are two points in the year when you support your Government: the King’s Speech and the Budget. I am not looking to break that, but like many of my colleagues I have severe concerns about the impact this proposal will have on people’s health and wellbeing and on their pockets. I have every confidence that my Government will put in place the best possible response to the £22-billion hole left by Conservative Members. I just do not think that the removal of the winter fuel allowance is necessarily the right way forward, but we shall see what happens in the days and weeks ahead. My question to the Minister is this: does she believe—this almost pre-empts the question asked by the hon. Member for Broadland and Fakenham (Jerome Mayhew)—that the cut to winter fuel payments will improve the situation in terms of fuel poverty and its impact on health?

Another example is financial insecurity. Age UK Norwich told us that 35% of Norwich wards fall within the top 10% of the most deprived areas in England. There has been a 35% rise in food bank use in the city, fuel poverty is at nearly 16%, and 68% of Age UK Norwich inquiries are about money, debt or bills.

Another example is poor housing and malnutrition. We have quite extreme malnutrition in Norwich. Norfolk has the highest malnutrition rate in England; malnutrition affects one in five people in Norfolk and Waveney. Jade Hunter, the headteacher of West Earlham infant and nursery school, told The Guardian:

“We do get a lot of bad chests because they’re in damp homes that are maybe mouldy, and we get a lot of sickness and diarrhoea because the quality of the food they’re eating isn’t great”.

She told me that one way teachers know children are hungry is that they chew their pens and chew sand. That shows that they are not being given what they need to thrive at school.

Before I conclude to allow others to contribute, I would like to ask the Minister some more questions. We know there will be a Government review of NHS England structures. There is an incomprehensible patchwork of bodies covering different geographical areas, including the Norfolk and Suffolk NHS foundation trust, the East of England ambulance service, the NHS Norfolk and Waveney integrated care board—the list goes on. Are there plans to simplify those structures and make those bodies more accountable? I understand that NHS reorganisations and reforms are not always popular, particularly with staff, but I wanted to ask that question.

Secondly, before the general election, all Norfolk MPs called for an undergraduate dental school to be established at the University of East Anglia. With my hon. Friend the Member for Norwich North (Alice Macdonald) and many others across the region, I have been working on that proposal, so will the Minister tell us whether there has been any news or developments? Such a school will be critical to beginning to end the dental desert in Norfolk and Waveney—dentist provision in Suffolk is in almost as bad a state.

Finally, I campaigned for mental health before I was an MP, I and continue to do so to this day, despite the difficulties. Despite the past 15 years of so-called change and reform in our local mental health service, it is still arguably the worst in the country. Will there be a statutory public inquiry into the systemic failure of mental health services in Norfolk and Suffolk? This scandal—this slow-motion disaster—has gone on too long, disrupted and ruined too many lives, led to people dying unnecessarily, and caused much grief. People need answers, and if we are to learn lessons from what has happened in the past 15 years, we need an independent public inquiry to get to the bottom of these issues.

[Sir Christopher Chope (in the Chair)]

Before I call the next speaker, let me say that about 10 people have indicated that they wish to speak. The winding-up speeches will start just before 10.40 am. I believe in self-regulation, so I hope people will contain themselves so that their speeches meet the overall need.

--- Later in debate ---

[Adrian Ramsay]

I totally agree with the hon. Member’s point. I have had family experiences in recent months that have shown me, starkly and at first hand, just how much we need to address the crisis in social care and the lack of integration with the health service.

I want to highlight that on the Norfolk-Suffolk border, in towns such as Eye and Diss, people are 20 miles from the nearest big hospital in Norwich, Bury St Edmunds or Ipswich—and in towns such as Halesworth, which does not have a local community hospital at all, people are even further away. I ask the Minister to consider what support can be given to rural hospitals to provide more services, and particularly to encourage cross-county border working in the health services that will enable us to look at how services can be provided in a way that benefits communities straddling the county border, as they do around Diss and Eye in my constituency.

Secondly, is no surprise that we have heard about dentistry from nearly every hon. Member who has spoken in this debate. We have the Sahara of dental deserts in the east. In the winter, I conducted a survey of residents in Waveney Valley to which more than 800 people responded. A quarter had given up on dentistry treatment altogether because of lack of NHS provision, others were driving long distances to access a dentist and some had even pulled out their own teeth. That is just not tolerable in the 21st century.

I welcome the Government’s commitment to reforming the dental contract. From my discussions with dentists and dental organisations such as the British Dental Association, it is clear that reform of the dental contracts is the root cause of the big exodus of dentists from the NHS. Dentists are not being paid appropriately for the work they do. Can the Minister set out the timescale for reviewing that contract? Health organisations have told me that for every effort they put in to getting new dentists into the NHS, dentists are leaving at a greater rate. We must address the root cause of the problem.

Thirdly, I want to highlight optometry. I received correspondence from an optometrist in Norfolk concerned about the lack of post-operative aftercare, particularly for operations such as cataract surgeries. They highlight that private companies are operating services of that kind and then discharging members to the community without aftercare, which is having a knock-on effect on A&E. Can the Minister ensure that, where private companies provide such services, the proper aftercare is also provided? Will she commit to looking at whether that highlights the problem of relying on private companies, which might seek to cut corners in the name of profit, to provide services?

To conclude, our rural services, particularly in market towns and villages, are severely affected by the decline in health services. Whether it is dentistry or a lack of local hospital services, we need urgent action and I would welcome the Minister’s addressing my specific points.

[Sir Christopher Chope (in the Chair)]

Mohammad Yasin, you have one minute.

[Mohammad Yasin (Bedford) (Lab)]

Thank you, Sir Christopher. You said you would surprise me, and you really did. It is a pleasure to serve under your chairmanship.

Like those in many other areas, Bedford’s residents are suffering when it comes to GP and dentist appointments. One of the reasons my constituents are struggling is that we have shortages of GPs. We are trying to recruit from other countries, but we need local GPs. I am pleased that the Government have pledged to train more GPs locally.

Data from the 2021 census showed that the populations in each of the local authority areas covered by the Bedfordshire, Luton and Milton Keynes integrated care board grew much faster than average, ranging from a 10.9% increase in Luton to 17.7% in Bedford. The population in England only grew by 6.6% in that period—

[Sir Christopher Chope (in the Chair)]

Order. I am afraid I have to call the hon. Gentleman to order because we have run out of time. I am sorry that a lot of people will not be able to give their speeches.

I try to promote self-regulation, but it is worth reminding ourselves that paragraph 7 of the “Rules of behaviour and courtesies in the House of Commons” says that even if time limits are not imposed, Members

“should speak with reasonable brevity and be mindful of others. Brevity in debate will give other Members a greater opportunity to speak and increase…chances of being called early”,

on the next occasion on which a Member seeks to speak. I read that out as this is the first Westminster Hall debate of this Parliamentary Session. It is important that Members take into account that although I would prefer not to have to impose time limits, people then have to regulate themselves.