Oral Answers to Questions

Debate between Dan Poulter and Glyn Davies

Tuesday 24th February 2015 Commons Chamber

[Glyn Davies (Montgomeryshire) (Con)]

T3. Not enough GPs want to practise in rural Wales. I am told that one of the reasons is that GPs registered in England have to go through a bureaucratic process to be able to work in Wales. Will my hon. Friend the Minister work with the Welsh Government to ensure that we have a common registration process so that GPs can move between England and Wales without having lengthy, time-wasting new bureaucracy?

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

I am very happy to look into that issue and to do what we can to support our NHS work force to move as freely as possible between England, Scotland, Wales and Northern Ireland. GP numbers in England have increased because we have protected the NHS budget, unlike in Wales, where it has been cut by the Labour Administration.

Atrial Fibrillation

Debate between Dan Poulter and Glyn Davies

Wednesday 12th March 2014 Westminster Hall

[Dr Poulter]

The statistics that I am aware of are slightly less positive than those that the hon. Gentleman has cited. It is not for us in this place to micromanage medical professionals or to do their jobs for them. However, it is our job to raise legitimate concerns about care for AF or any other health conditions. We must do our best, as stewards of the health system, to push for good local commissioning that is mindful of best practice. I have undertaken to write to NHS England about that, and I will be happy to share the reply that I receive with the hon. Member for Huddersfield and other hon. Members and hon. Friends.

The exact causes of AF are unclear, but it is important to get the diagnosis right and to diagnose the condition as quickly as possible. We believe that some 18% of cases of AF are undetected, so there is more work to be done. NHS England has recognised that, and has suggested that CCGs should work with local practices to target people who are at risk from AF. The issue is already on NHS England’s radar, but I will write to obtain further assurances that it is being taken as seriously as it should be; I am sure that that is the case.

Research is under way into the condition. The National Institute for Health Research is funding a study into automatic diagnosis of AF in primary care using a hand-held device, which may help identify more patients who have AF and reduce the number of related strokes. If someone does not know that they have the condition, they do not know that they need to see a GP to get help. We must do as much as we can to support people to recognise that they have a medical condition and that help and treatment are available. I hope that the research into that technology provides better early detection of AF, and that that comes forward in a rapid and timely manner.

[Glyn Davies]

I thank the Minister for giving way and allowing me to correct an omission in my contribution. Does he agree that the excellent work of the Atrial Fibrillation Association in promoting knowledge of the disease has had a hugely positive impact, which we should all appreciate?

[Dr Poulter]

My hon. Friend is absolutely right to highlight that work. When NICE draws up guidelines, it consults best practice and tries to engage with key stakeholders. In addition, the Royal College of Physicians has developed some national clinical guidelines for stroke with the objective of encouraging higher levels of anti-coagulation. That is directly linked to some of the things we have debated today.

It is a testament to the work of groups such as the Atrial Fibrillation Association that we are helping to raise the profile of the condition and to get early support and help for people. There is clearly more to do, and NICE must continue to develop strong guidelines to support understanding of the best care and pathways for people who have AF. NICE is updating guidelines at the moment and developing a quality standard on AF, which will set out what a high-quality AF service should look like and drive improvement locally by helping local commissioners and CCGs understand what good looks like in AF care.

Adult Social Care

Debate between Dan Poulter and Glyn Davies

Monday 16th July 2012 Commons Chamber

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

It is a great pleasure to follow the hon. Member for Luton North (Kelvin Hopkins). I commend him for his ability to get Europe into almost every debate we have in this House. I am not sure whether his sums quite added up at the end of his speech, but it is commendable that we have seen a commitment across the House this evening to improving the dignity and quality of elderly care, which is something I am sure we would all like to see.

All previous Governments have taken steps in that direction, but I believe that the White Paper and the draft Bill that this Government have brought forward represent the most significant steps towards improving dignity in elderly care for a generation. The “in-principle” support for Dilnot and the Dilnot proposals is a good recommendation, and it needs to be considered in the context of whole-government spending at the next spending review. However, for the first time there has been an in-principle agreement by a Government that social care is one of the most important issues and challenges facing our country. How we are going to provide dignity in elderly care—high-quality care in the community—is a clear priority for this Government, and that should be commended.

I want to outline some of the real challenges that face people who are in receipt of social care, particularly the frail elderly. The hon. Member for Blaydon (Mr Anderson) pointed out that it can be difficult to distinguish between NHS care and social care, because they often involve exactly the same things. They include supporting the activities of daily life that we all take for granted, such as washing, dressing, getting in and out of bed or the bath and going up and down stairs. Those are the kinds of things that we mean when we talk about providing high-quality social care, and this Government have put forward strong measures that will make it much easier to provide such care for the people who most need it.

The White Paper and the draft Bill provide for support for carers, and for improving the personalisation of care, which is particularly important for younger people in receipt of social care, as the hon. Member for Scunthorpe (Nic Dakin) said. Respite care is also recognised as an important means of better supporting carers, giving them a break from the hard work of looking after people and ensuring that the role of carers is properly supported. The proposals also include a commitment to portability of care, and to a universal care assessment.

[Glyn Davies (Montgomeryshire) (Con)]

I raised the issue of portability with the Secretary of State last week. It is crucial that a debate should take place about what we are doing here and what is happening in Wales, as this is a devolved matter. There must be close liaison between us. I understand that the initiative must come from the Welsh Government but, without that liaison, people will fall between the two countries.

[Dr Poulter]

My hon. Friend makes an important point. Social care and NHS care do not recognise county borders, which is why portability is so important. They certainly do not recognise the boundaries between England and Wales or between any other parts of the United Kingdom. We have devolved responsibility for the NHS, and the fact that there are different funding priorities in the different parts of the UK, with the Government in England supporting investment in the NHS and the Labour Administration in Wales cutting NHS spending, highlights the importance of my hon. Friend’s point. I am sure that the Minister will be able to reassure us that the coalition Government are taking steps to ensure that portability can take place across those borders wherever possible.

The White Paper also contains a commendable commitment to improving integrated care and ensuring that more joined-up working takes place between the NHS and social care.

Assisted Suicide

Debate between Dan Poulter and Glyn Davies

Tuesday 27th March 2012 Commons Chamber

[Glyn Davies (Montgomeryshire) (Con)]

Thank you, Mr Speaker, for calling me to speak in this very important debate. It is a pleasure to follow the right hon. Member for Cardiff South and Penarth (Alun Michael). We do not always agree, but I agreed with every word that he said on this occasion. I also congratulate my hon. Friend the Member for Croydon South (Richard Ottaway) on the tone that he adopted: I thought it just right for the introduction of such an important debate.

I should declare an interest. I am a member of the board of Living and Dying Well, an organisation that commissions evidence-based research into end-of-life care. I have regular conversations with Lord Carlile, who chairs it, and with Baroness Finlay, who has already been mentioned today.

I too have received several letters from members of Dignity in Dying. I write back disagreeing, but I always do so with a great deal of respect, because—like other Members who have spoken—I think that opinions on both sides of the debate are motivated by compassion, and I do not think it right to be critical of those who take a different view if compassion is what motivates them.

I am rather concerned about some of the media coverage that appeared before today’s debate, which seemed to suggest that we were contemplating, and perhaps moving towards, a change in the law. That is not the case. All that we are discussing today is a reaffirmation of the current position in law, which is why I am happy to support the motion.

I am probably unusual here in having had an interest in assisted suicide for as long as it has been an offence. I was 17 in 1961, and an active member of my young farmers club. As young farmers clubs do, we discussed the issues of the day in debating competitions, and I supported the decriminalisation of suicide. A key point, however, is that that simply would not have happened without the inclusion in the Suicide Act 1961 of section 2, which introduced the offence of assisting a suicide and was seen as an absolute protection allowing the offence of suicide itself to be abolished.

My view remains exactly the same today. Over the last few days I have received many representations and briefings, as have many other Members, and over the months during which I have been a member of Living and Dying Well, we have commissioned several research papers. There so much information that it is almost impossible to engage one’s mind clearly with all of it, and because the time limit on speeches today is so tight, I shall make just one fundamental point.

In 1961, I just knew that assisted suicide was wrong. I thought that it was extremely dangerous, and I still think that. If the DPP’s guidance became statutory we would be legalising assisted suicide, and I believe that that would have a very negative impact on the frail elderly, the terminally ill, the incapacitated and the seriously depressed.

I have never believed that the malicious assister is the biggest problem, although that is probably an issue. What has always concerned me is the likelihood that the normalisation of assisted suicide would lead to uncertainty about their own worth among the groups whom I have listed. It would cause them to ask questions about their own value. They would see themselves as becoming a burden on society. When we talk to elderly people who are nearing the end of their lives, we often find that they are concerned about not being able to leave assets to their grandchildren, and I believe that that concern would be expanded greatly if assisted suicide were legalised and normalised. My view is that it was and is wrong, and that only in very special circumstances should it not be prosecuted.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I think that there is a clear distinction between allowing discretion for a prosecution that says “It is wrong to assist someone in committing suicide,” and potentially widening the number of people who may be put under pressure by codifying assisted suicide in any form in law.

[Glyn Davies]

I firmly believe that assisting in suicide is wrong and should be a criminal offence, but, as with all criminal offences, the DPP or the prosecution service must always have the discretion to apply a degree of common sense and make judgments about what motivated the person concerned to commit that criminal offence. Since the guidelines were issued two years ago, the DPP has made a sensible judgment in every case. Where he has been satisfied that the crime was motivated by compassion, no prosecution has taken place.

The system is working well. It is delivering exactly what we want in law; it supports what this Parliament has judged we should have in law. If we were to put things on a statutory basis, we would damage the current law, which is working so well, and it would result in pressure being put on some of the most vulnerable people in society, which would be plain wrong.

Finally, I want to say something about palliative care. For decades, all Governments have spent a huge amount of money on extending life and curing disease. We have not spent nearly enough time ensuring that that extended life is a life of quality.