Whitsun Recess

Claire Perry Excerpts

Thursday 24th May 2012 Commons Chamber

[Ann Clwyd (Cynon Valley) (Lab)]

It was a great temptation to go off down the M4 about an hour ago, but I wanted the opportunity to speak today since we are going to be away for two weeks. Many changes will take place in the middle east in that period, so I could not go without voicing my concern. If I take more than 10 minutes, perhaps you will signal vigorously in my direction, Mr Deputy Speaker. I also hope the Hammersmith flyover will soon be back to normal—it is ridiculous that it has taken so many months to repair. Those who use that artery to the M4 have to allow an extra hour in our journey just to get over it.

I have spoken about Bahrain a number of times. The Select Committee on Foreign Affairs is currently preparing a report on the Arab spring. For some countries, spring came earlier, but things have been more difficult in others. In countries where the spring is in its early stages, such as Bahrain, there are concerns about the lack of progress. Many of the recommendations made by the commission set up by the King are yet to be implemented. Human Rights Watch said in a new report released earlier this month that Bahrain’s human rights situation remains critical in the wake of the brutal crackdown on pro-democracy demonstrators in 2011, with clashes between police and protesters continuing. There are also reports of deaths from beatings and the excessive use of teargas.

The King established that so-called independent inquiry—I have high regard for some on the inquiry, such as Sir Nigel Rodley—but unfortunately, very few of its recommendations have been implemented, such as holding senior officials accountable for crimes. Recommendations on torture have also not been implemented, and there has been a failure to free protesters who were jailed for exercising their right to free expression and peaceful assembly. Bahraini police continue to beat and torture detainees, including minors, despite the report’s recommendations and public commitments by the heads of Bahrain to end torture and police impunity.

Nabeel Rajab, a Bahraini human rights activist and head of the Bahrain Centre for Human Rights, a non-governmental organisation, who led protests against authorities in the gulf kingdom by calling for democratic change, was arrested on his return from a trip abroad on charges of

“participating in illegal assembly and calling others to join”

and “insulting a statutory body” via Twitter. He has been granted bail but is still being held in anticipation of other charges being made against him.

The court of cassation, the highest judicial body in that gulf Arab state, shifted the case of 21 men who were convicted in a military court to a civilian court and freed one lesser known prisoner. Seven of the 21 are abroad or in hiding, but the court ruled that the other men would remain in jail, including Abdulhadi al-Khawaja, who is being fed intravenously in a military hospital after nearly three months on hunger strike. We assume that that is still the case, because we have heard nothing further about him recently.

More than a year after the men were arrested, the Bahraini authorities have produced no evidence that the jailed leaders were doing anything but exercising their basic human rights. The Bahrain Government have made it clear that they still view the case as serious. One of the al-Khalifa family—the chief Government spokesman —alleged that the 21 men

“called for the overthrow of the monarchy using violent means”.

He said:

“In due course new evidence will be presented in a civilian court to prove that point.”

A similar retrial process is under way in a civilian court for 20 medical professionals—doctors, nurses and dentists—who were convicted of anti-state activities by a military-led tribunal.

After signalling that Saudi women might be allowed to compete in the Olympics for the first time at the London games, Saudi officials appear to have retreated. The only possibility remaining is that a few Saudi women might gain entry as “unofficial participants”. Saudi women must walk behind men at home, but they cannot walk behind the Saudi flag in London.

A few months ago, Human Rights Watch reported discrimination against female athletes in that Islamic kingdom. Even physical education classes and sports club memberships for women are prohibited. The report referred to a religious scholar who said that

“the health of a virgin girl will be affected by too much movement and jumping in sports such as soccer and basketball.”

How ridiculous is that? The report concluded:

“It is impossible to square Saudi discrimination against women with the noble values of the Olympic Charter”,

which forbids intolerance.

Under the kafala system of sponsorship, by which foreigners can work in the country only if they have a sponsor who organises contracts, salaries, visas and repatriation, sponsors use their control to exploit workers by taking away their passports or residence permits, or by failing to pay wages on time.

I welcome the free and—it appears—fair and peaceful elections in Egypt, but there are still problems in the country. I was there with the Foreign Affairs Committee a few months ago. Human rights violations continue to take place, in some cases to a worse extent than under Mubarak. Military trials continue; reports of the use of torture are frequent; freedom of expression is curtailed; and peaceful demonstrations have often been met with violence and repression. Additionally, civil society and NGOs continue to be repressed and restricted. The trial of foreign NGO workers who were arrested for allegedly breaching Egypt’s law on association, which took place during the Committee’s visit, is due to continue on 5 June. The law on association has criticised repeatedly by UN treaty bodies and human rights experts and is likely to be replaced with a new law by the new Parliament.

Women’s rights are under threat in Egypt, and there are only eight women in Egypt’s 500-seat Parliament. We met many parliamentarians and raised that point with them. They have removed their quota system, which ensured proper representation for women in the Parliament. Activists in Egypt have serious concerns that the personal status code, which currently provides some equality for women in divorce and custody law, could be repealed, resulting in women’s rights being curtailed.

Women human rights defenders and activists are being targeted with virginity testing, with those responsible being acquitted, and attacks and beatings. I have raised that in the Chamber several times.

In Afghanistan, women should not be abandoned by the pull-out of western troops or traded in favour of reconciliation with the Taliban and other insurgent groups. Afghanistan remains a key foreign policy priority of the UK Government, and as a major international partner and donor they can exert significant diplomatic influence on the Afghan Government and the transitional process. Only a couple of months ago, Afghanistan’s ulema council—the country’s leading group of religious clerics—published a statement in which it referred to women as secondary to men and implied that violence against women was appropriate in some cases. Worryingly, President Karzai expressed support for the statement, in a move seen as widely conciliatory to the Taliban and other groups that would curtail the rights of women.

Women’s security continues to be extremely fragile in areas of Afghanistan under Taliban control. Women who contribute politically or in the public and civic sectors face considerable pressure and intimidation.

[Claire Perry (Devizes) (Con)]

I am delighted that the right hon. Lady has brought this incredibly important topic to the Floor of the House. This morning, I met ActionAid, which has campaigned heavily in this area, and it told me that for an Afghan woman to approach a police officer was considered an immoral act. Does she agree that we must do more to ensure the security of Afghan women and that without it there will be no lasting peace in that country?

--- Later in debate ---

[Lyn Brown (West Ham) (Lab)]

I hope that hon. Members will be gentle, because my voice is not as strong as it usually is. I also hope that I can be heard today. It is an honour to follow the hon. Member for Argyll and Bute (Mr Reid), who made an excellent speech about VAT on static caravans. Those of us on the Opposition Benches support much of what he said. I hope that his Government were listening to that speech, which really was rather excellent.

I want to take this opportunity to speak about an issue of increasing concern—breast cancer. I want to focus on three areas: diagnosis, treatment and mortality in my constituency; worrying comparisons with other countries, which raise issues about the effectiveness of cancer services in the UK; and a specific concern about radiotherapy, on which we perform rather badly, compared with other countries.

Let me first set the scene with some facts about breast cancer. As many colleagues will know, it is the most common cancer in the UK, with some 48,000 new cases diagnosed every year. Around 12,000 women and 90 men will die from breast cancer this year. The good news—relatively speaking—is that a generation ago, only half the people with breast cancer survived for five years after diagnosis. Today, eight out of 10 people are still alive after five years or more. That improvement is due to the unprecedented investment made in the NHS, with a shift in emphasis—the right shift—towards prevention and early detection, and the establishment of cancer networks, bringing together specialists to improve the quality of care.

Advances in research, new treatments, earlier diagnosis, breast screening and greater public awareness have all played a part, but it is essential that we keep up the momentum if we are to avoid slipping back. I have spoken in the House before about the inequality in health outcomes that is characteristic of my constituency and other areas with high poverty, poor housing, a poor environment and low educational achievement. Things are improving and health outcomes are getting better, but the gap remains. Although I have a huge hope that the legacy of the Olympic and the Paralympic games will bring an even greater health improvement to my area, as well as economic regeneration, we have to do more, rather than just sitting back and waiting to see whether that happens.

[Claire Perry]

Let me give the hon. Lady a chance to rest her voice. I am grateful to her for bringing this incredibly important subject to the Floor of the House. Would she like to join me in the Race for Life at the beginning of June? We can put on our pink T-shirts, and although I am afraid that I will be walking, she can walk with me and we can raise some money for a worthy cause.

[Lyn Brown]

That is possibly an offer that I cannot refuse. I think that sounds like an excellent thing to do together.

Newham has a lower incidence of cancer than many other areas, but sadly our mortality rate is higher. The London-wide cancer mortality rate is about 112 deaths per 100,000 cases. In Newham it is 123 deaths per 100,000 cases, which is a significantly higher rate than we ought to find. That is clearly unacceptable. The five-year survival rate for women in Newham who have had breast cancer is 75%, which is significantly lower than the UK average of 83.4%. The reason is illustrated, in part, by the take-up rate of breast-screening services. In 2009-10, the take-up rate across England was 73%. Across London it was 62%, but in Newham it was 50%.

Early detection enables treatment in early stages, when the cancer is easier to treat and when women’s chances of survival are higher. In my area, the combination of late presentation and late diagnosis leads to treatment that is, of necessity, more complex and less successful. That is causing the unnecessary deaths of too many women. Those deaths are, frankly, preventable. I will be seeking to ensure that a consequence of the Health and Social Care Act 2012 is not a visible deterioration in health screening services in my constituency. In fact, I will be hoping to see the 50% uptake of screening in Newham increase in the years to come.

I want to turn to international comparisons. I have before me some statistics, which were helpfully provided by the House of Commons Library. These data are drawn from a cancer epidemiology research project on the survival of cancer patients in 24 European countries. The figures need to be treated with some care, given that the most recent are for survival rates for those diagnosed between 1995 and 1999, but they provide a useful snapshot of the five-year survival rate. For England, the survival rate for all cancers at five years was 47.3%, ranking us 17th out of the 24 countries. The survival rate at five years for breast cancer was somewhat better, at 79.7%, but this still ranks us just 13th out of the 24 countries. That international comparison raises some disturbing questions about the effectiveness of our screening, diagnosis and treatment services, and I intend to return to that matter in the future.

One issue that I want to explore further today is the use in treatment of radiotherapy and, specifically, of new and advanced forms of radiotherapy such as intensity-modulated radiation therapy—IMRT. Radiotherapy treatment is more effective in treating all forms of cancer, including breast cancer, especially when the cancer is diagnosed early. It can be targeted on the cancer much more effectively, thus limiting the damage caused to non-cancerous tissue. It is far less invasive than other treatments, it leads to better outcomes and it is a much better experience for the patient.

The use of radiotherapy is more advanced in Scotland and Wales. London is marginally better provided for than the rest of England, but that does not alter the fact that the UK as a whole is woefully behind the best-performing countries in the rest of Europe and the US in using advanced radiotherapy as an effective tool against cancer. Access rates to existing radiotherapy services are already lower than the 50% of cancer patients who it is generally agreed should receive the treatment. We do not even know how many breast cancer patients are able to access the more advanced IMRT.

What assessment have the Government made of the impact of the Health and Social Care Act on the commissioning of radiotherapy, and on the supply of suitably trained radiotherapists? From my perspective, it is entirely unclear where responsibility for the commissioning of radiotherapy will sit in the future arrangements of the NHS. The clinical commissioning groups are far too small effectively to manage it, and the position of the NHS Commissioning Board is obscure.

For radiotherapy, there is no is no equivalent of the big campaigns that we see in our newspapers. It has no equivalent of a big pharmaceutical company to promote it and lobby for new treatments, because there is no profit to be made from it. Radiotherapy is an effective treatment that is widely used in other countries, but it is patchily under-utilised here, to the detriment of cancer patients, and that is likely to be contributing to our relatively poor survival rates. In the absence of an external lobby promoting radiotherapy, I humbly suggest to the House that that responsibility lies here with us.

The issues that I have outlined today go to the heart of the quality of cancer care in this country. They need to be explored in more detail and subjected to more scrutiny so that the service offered across the country can be improved to the level of the very best, and not just the very best in this country, but the very best by international standards.

[Claire Perry (Devizes) (Con)]

It is a pleasure to follow the hon. Member for West Ham (Lyn Brown), who spoke eloquently on an important topic. I look forward to our “walk for life” together.

As I am sure everyone knows by now, I represent a military constituency. with 10,500 soldiers and at least the same number of family members, but because I have a tiny job helping the Secretary of State for Defence, I can never speak on military matters, so there is no point in hon. Members lobbying me about cap badges. I meet many members of the armed forces in my surgeries, however, and I want to speak today about a story that I heard during one such meeting.

Jan and Barry Burns came to see me in my surgery in Ludgershall, in the south of my constituency. Barry is a serving Army officer. I felt incredibly moved and educated by what I heard, and I was glad that I had boxes of tissues handy. They came to tell me about their son Charlie, who died unexpectedly last year at the age of 10. I have a boy who will be 10 this summer, and it was very moving to be presented with that tragedy.

Charlie Burns was a completely fit, well and happy 10-year-old who had an epileptic seizure, completely out of the blue, on Friday 7 October. The paramedics arrived well within the target time, but they made a diagnosis that many people think was incorrect. They diagnosed a febrile convulsion, even though there was no associated temperature. Over the weekend, Charlie was fine, but subsequently his parents took him to their GP, as he was a little unwell. The GP correctly suggested that Charlie had suffered an epileptic seizure and that he should see a neurologist.

On Tuesday 11 October, Charlie went to school in Larkhill as usual and was absolutely fine. He was able to see his sister, Isabella, that evening—she goes to boarding school, so it was lucky that they saw each other that day. He went to bed at 8.45 that evening, and when his parents went to check on him later, they found that he had died in his sleep. They were of course horrified. Their little boy had, until the previous week, been incredibly healthy. The coroner diagnosed the cause of death as sudden unexplained death from epilepsy—SUDEP—involving a massive cerebral haemorrhage.

The reason that Mr and Mrs Burns came to see me was that they had never heard of SUDEP before that awful tragedy struck their family. In fact, SUDEP kills more people in the UK than AIDS and cot death—conditions we have all heard of—combined. We have been educated recently to understand certain other conditions, including strokes—there has been a very good national education campaign to help us to understand the signs of strokes and what happens when someone suffers a stroke.

It is fitting that this week is national epilepsy week, running from 26 May. Charlie’s parents really made me aware of this condition—sudden unexplained death from epilepsy. It is a silent killer. As a result of conversations with the parents, I believe that it is almost unknown, which means that parents are not looking out for the signs, and in many cases nor are paramedics and medical professionals. In my comments today, I intend no criticism of the local paramedic or hospital services; a separate inquiry is ongoing. It was the depths of the personal tragedy and the suddenness of the bereavement suffered by the Burns family that particularly resonated with me.

I ask three things of colleagues today. The first is for them to help me raise the profile of a fantastic national charity, Epilepsy Bereaved, which works with parents and anyone who has suffered a bereavement through epilepsy. We should remember that more than 1,000 people a year are so affected. I was pleased to learn that my hon. Friend the Member for Kenilworth and Southam (Jeremy Wright) had met the charity and done some publicity work last year, for which the family and the charity are extremely grateful. Secondly, there is no national standard register of epilepsy deaths, and one of the charity’s proposals is that the chief coroner should maintain such a record and have a standard diagnosis, so that we can understand the scale of the problem. I would heartily support such a measure.

Finally, we call for a review of the guidance issued to medical professionals, particularly first responders, to help them to look out for signs of that type of seizure in otherwise healthy children. Charlie’s parents told me that children can come back very quickly from such episodes. Charlie came back after his attack and was conscious when the paramedics got there, although he was droopy, drowsy and not himself. If he had been taken to hospital at that point and a brain scan had been done, he just might have been saved.

[Sajid Javid (Bromsgrove) (Con)]

I want to express my support for everything my hon. Friend has said about SUDEP. A few months ago, some parents in my constituency came to see me, having sadly lost their teenage daughter to SUDEP. When their daughter was diagnosed with epilepsy, the parents were not really made aware of SUDEP—the “sudden death” aspect. If they had been told about it at the time, they might have acted differently. They highlighted the need for more publicity so that more people—parents and children—are made aware of it. I congratulate my hon. Friend on raising this very important issue.

[Claire Perry]

I thank my hon. Friend for that intervention. He is absolutely right; it is estimated that more than 40% of these deaths could be avoided with better recognition, better diagnosis and speedier action. Epilepsy is a condition that affects many thousands of people and it is a manageable condition, but Charlie’s parents were subsequently told that he was among the most susceptible to a nocturnal epileptic episode out of the blue, and that such children were at greater risk of dying unexpectedly from this killer.

There is nothing I can say today to bring Charlie Burns back, or give his parents any comfort. I simply want to make as many people as possible aware of this condition, so that we can all help to make sure that similar tragedies do not happen in the future. Thank you, Madam Deputy Speaker.