Covid-19 Response

David Amess Excerpts

Monday 18th May 2020 Commons Chamber

[Matt Hancock]

The R rate has not doubled in Yorkshire or indeed anywhere else in the country. By contrast, as I said at the start of my statement, the good news is that things are progressing: the number of people in hospital is significantly down, and the number of people in critical care is down by two thirds. I think we should be thanking and supporting our NHS staff and others, and working together to get to the best possible outcome.

[Sir David Amess (Southend West) (Con)]

I acknowledge that no Health Secretary has faced the scale of challenges that my right hon. Friend has. Will he join me in thanking all the staff at Southend University Hospital, and those who provide associated healthcare, for their heroic efforts during this time of national crisis, and will he reassure them all that we do have plans to deliver this vaccine?

[Matt Hancock]

Yes, absolutely. To deliver the vaccine, if the science comes off—and we hope as much as we possibly can that it will—we will have the plans in place to ensure that it can safely be delivered to those who will benefit from it. We have the agreement with AstraZeneca for the production of 100 million doses—30 million right at the start of the programme. I join my hon. Friend in thanking the staff of Southend University Hospital, who have done so much in such difficult times to make sure that all the community can get access to the support they need if they have got coronavirus, and who I know are working now on the restoration of other services so that people with any health need can get the support they need.

Oral Answers to Questions

David Amess Excerpts

Tuesday 29th October 2019 Commons Chamber

[Mr Speaker]

I call Tommy Sheppard. Where is young Sheppard? [Interruption.] He has withdrawn. I was not advised of that. Never mind, he is a most active beaver in the Chamber in normal circumstances. It does not matter that he is not here, because Mr Andrew Rosindell is.

[Sir David Amess (Southend West) (Con)]

Speak for Romford!

[Mr Speaker]

Yes, speak for Romford. Well done.

--- Later in debate ---

[Mr Speaker]

I must say to the hon. Member for Southend West (Sir David Amess) that my kids think he is a great bloke because he made an effort to go and talk to them at my party last week. He will always be a hero in their eyes.

[Sir David Amess (Southend West) (Con)]

Does my right hon. Friend the Secretary of State share my concern that a highly paid health executive has been made redundant by Southend clinical commissioning group, given £200,000 and then employed somewhere else in the organisation? Disgraceful.

[Matt Hancock]

Today is the first time I have heard of this. National health service redundancy terms were capped at £160,000 in April 2015. We consulted on bringing that down to £95,000 and we have introduced powers in primary legislation to claw back contractual redundancy payments when someone returns to any public sector job within 12 months. I will raise the individual case with the NHS to ensure that taxpayers’ money is being used as well as possible.

Women’s Mental Health

David Amess Excerpts

Thursday 3rd October 2019 Commons Chamber

[Sir David Amess (Southend West) (Con)]

As a man, I make no apology for contributing to this debate, Madam Deputy Speaker, because I come from a household in which four of my five children are women. My late mother had a big role in my life and, of course, I do have a wife. I am prepared to say that I think women are the fairer sex but, by and large, they do have the tougher deal in life. I certainly would never fancy giving birth to a baby, and there are so many other things that women face that men do not.

I congratulate the hon. Member for Bath (Wera Hobhouse) on allowing us to debate this subject. I agree with all her points, and I just want to pick out a few other subjects that colleagues may not talk about later in the debate. With World Mental Health Day just one week away, I am pleased that the hon. Lady has secured this debate because, as she said, reports indicate that one in six people has experienced a common mental health problem in the past week—truly shocking. With a population of roughly 65 million in the UK, almost 11 million people need to access publicly funded support. The prevalence of mental health issues is similar for men and women in the UK but, as I have said already, women have to deal with different challenges. The House of Commons Library’s superb briefing on this topic makes it clear that the greater caring responsibilities and a high risk of domestic violence are contributing factors to the challenges that we are discussing today.

I was not in the Chamber yesterday for the Second Reading of the Domestic Abuse Bill—I was in my House of Commons office—but I was dumbfounded by the speeches. The hon. Member for Dewsbury (Paula Sherriff) may sit on the Opposition Benches, but she is a thoroughly wonderful colleague in every respect. She has had some terrible issues to deal with over the past few months and beyond, and I think of her struggle and hope that colleagues are rallying round to support her. We then heard the speech from the hon. Member for Canterbury (Rosie Duffield) the likes of which I have never heard before. It was so brave and truly shocking, but she was prepared to share that with colleagues. The hon. Member for Bradford West (Naz Shah) then told us about her life and I just could not believe it. It must have taken enormous guts and courage to speak publicly about it, knowing that all sorts of people on social media are going to pick up on the issue while not necessarily being sympathetic. It was a wonderful debate, and I absolutely agree with Mr Speaker that the tone used yesterday and today is far better than that used in recent months.

Women are more likely than men to experience anxiety, depression, post-traumatic stress disorder and eating disorders, as the hon. Member for Bath said. We need to recalibrate entirely how the media put ideas into young women’s minds about how they should look and how they live their lives. There is so much pressure on them to have the perfect figure or the perfect look, which is unreasonable and definitely adds to mental health issues. The suicide rate for young women has more than doubled in the past 10 years, which is shocking. Such facts are easy to speak about, but it is for the House of Commons to try to come together to think of some solutions.

I have two former Ministers behind me—my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for East Worthing and Shoreham (Tim Loughton)— who have more expertise in this subject than me and who did great work. I really am glad that this subject has at long last reached the top of the political agenda. I sat on the Select Committee on Health for 10 years and although we held inquiries into abuse in institutions in which people with mental health issues were detained, we never really tackled what lay behind those issues, so I am glad that we are highlighting them today. Since 2010, Back Benchers have come together to put pressure on Governments of different persuasions to set up the Women’s Mental Health Taskforce, which was a clear indication of the Conservative party’s commitment to understand and address problems with current women’s mental health support. It was also announced at the party conference in Manchester that funding will be made available for 1,000 extra staff in community mental health services.

I congratulate the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), on her appointment, and I wish her well. However, my hon. Friend and parliamentary neighbour, the hon. Member for Thurrock, spent two days at the Dispatch Box just before we—how can I put it delicately?—formed a new Government responding to points about mental health issues. She was a first-class Minister, and I thank her very much for her work highlighting the mental health challenges that women face. I am glad to see her here today, and I shall enjoy listening to her speech.

My hon. Friend used to be the Parliamentary Under-Secretary of State for Mental Health, Inequalities and Suicide Prevention and was kind enough to meet me together with my constituent Kelly Swain and her team at N.O.W Is The Time For Change. Kelly works tirelessly to provide alternative therapies and wellbeing classes to people of all ages. Before my hon. Friend left office, she seemed to have a magic wand, because I find that Kelly Swain is now pushing at open doors in trying to spread her message throughout Essex, so I thank my hon. Friend for that. The all-women leadership team led by Kelly Swain works so well together, and I am glad that local organisations, along with the clinical commissioning groups, are now considering how they can integrate and support the ideas that Kelly has promoted.

Another trailblazing constituent is Carla Cressy. I look to the hon. Member for Dewsbury at this point, because she was present at a meeting with Carla and my hon. Friend the Member for Thurrock. Again, it may seem strange to have a chap as the chairman of the all-party parliamentary group on endometriosis, but it was decided that I should chair it, and I am very proud of that. I now understand the damaging effect that the condition can have on women’s mental health, and I salute my constituents. Carla’s charity is called Women with Endometriosis, which seeks to provide comprehensive mental health support to any woman facing that uphill battle, and I will continue to support her work in any way that I can.

Something that both those charities have in common, other than the brilliance of the two founders, is a commitment to pulling down barriers and removing any stigma around mental health. As the hon. Member for Bath so rightly said, it is difficult to talk about these topics, and people can be branded very unfairly. We must do something to change people’s perception of women who have mental health issues, and there are still more barriers to be brought down. I have been in this place for 36 years—some people might say that that is too long, but I still have a bit more that I want to do—and there are still issues to tackle, and my two constituents have brought the challenges home for me in very different ways. Both their organisations provide tailored support to individuals, and they are always ready to listen without judgment. That is a basic requirement for mental healthcare at any level, and it would be a great asset to our nation if we could provide that service to every person who required it.

As the hon. Member for Bath rightly pointed out, mental health issues are probably the most difficult healthcare issues to deal with. When I first became a Member of Parliament, I did not see many people with mental health issues at my surgeries, but now that is a regular occurrence. Of course, people with mental health issues need our time, but Members of Parliament are not necessarily equipped with the expertise to give advice and support; we try to signpost people in the right direction. I am sure all Members would say that, although they are very grateful for their local mental health services, we could all do better. That is where the real investment needs to be made.

[Wera Hobhouse]

I go to many schools. Mental health problems often start early, when people are teenagers, so does the hon. Gentleman agree that it is important that mental health services are also provided through schools? That is where we are falling very short.

--- Later in debate ---

[Sir David Amess]

I entirely agree. That is why I am so pleased with my constituents Carla and Kelly. That is exactly what they intend to do: we have written to schools, and they are going to go in to try to help and support not just sixth-formers but younger children. The hon. Lady is absolutely right about that.

I want the Government to ensure that people throughout the country who are not fully aware of the challenges women face are aware that there is help and support available. I know my hon. Friend the Minister will share with the House what support is available.

One group that needs particular attention is women who are serving time in prison. To express some sympathy for people who are in prison perhaps is not the cool thing for a Conservative to do, but we used to have a women’s prison local to me—Bullwood Hall, in the constituency of my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—and I remember visiting it for the first time and being shown around. Of course, so many of those women were convicted not as a result of violence but following domestic abuse, infanticide and all sorts of issues like that.

I am grateful for the briefing from the Howard League for Penal Reform, which states that a recent study found that more than 50% of women in prison report a history of violence and trauma, which contributed to 8,317 cases of self-injury in 2017 alone. We all understand that prison’s fundamental role is to deliver justice to people who have done wrong, but as the focus shifts towards rehabilitation, I very much want the Ministry of Justice to re-evaluate the practical support that is made available to female inmates.

I must say, Madam Deputy Speaker, that I am delighted that there are five Members from Essex in the Chamber. We have a real issue with mental health provision in our county, and I know that we all speak with one voice not only in expressing gratitude for the services we have but in hoping they will be developed and expanded. Of course, my hon. Friend the Member for Chelmsford (Vicky Ford) has the prison in her constituency.

As I said, a recent study found that more than 50% of women in prison report a history of violence and trauma, and the issues of self-injury are very distressing indeed, but I am glad that in 2018-19 the NHS in England spent £12.2 billion on general mental health. That is a huge amount of money, but I think we all want to ensure that it is well spent, and I would be very pleased if some of it found its way to Carla Cressy’s charity and Kelly Swain’s charity.

I am proud of my party’s continued effort to treat mental illness with the same seriousness as physical illness. In all the discussion of figures, it is essential that Ministers and officials remember that women’s lives are on the line. Every year, 1,604 women commit suicide. That is absolutely horrendous. Looking at these Benches, I am reminded that it was reported nationally only this week that a young member of my party committed suicide, which must be awful for those who loved that individual. Units are busier than ever before and, as a result, they are under increasing stress. If we do not take swift and effective action to address these challenges, there is a very real risk that the number of suicides and instances of self-harm will increase further.

I have received a number of briefings from various groups asking me to call on the Government to introduce various plans and schemes, and I am sure colleagues will be supportive of such programmes. My message, though, is plain and simple. As a group of politicians, whichever party we belong to, we should always remember that we are sent here to serve our constituents. That is why I am so pleased that my constituents Carla and Kelly have got off their backsides with real enthusiasm for sharing the message that we must support women with mental health issues. I pay tribute to Carla, Kelly and all those women throughout the United Kingdom who are doing everything they can to improve the care of women who suffer from mental health issues.

National Marriage and Mental Health Awareness Weeks

David Amess Excerpts

Thursday 16th May 2019 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to speak in this debate with you in the chair, Sir David. I congratulate the hon. Member for Congleton (Fiona Bruce) on securing the debate, and I thank hon. Members who have contributed to mark this unusual mix of Mental Health Awareness and National Marriage weeks.

Many points have been made on the value of marriage and family life, including in the excellent opening speech by the hon. Member for Congleton and by the hon. Member for Strangford (Jim Shannon)—I think I beat him by two years in how long I have been married. Happy anniversary for each of our relationships. The hon. Member for South West Bedfordshire (Andrew Selous) focused on family relationship issues and poverty, and the role of family breakdown.

In line with my brief, I want to bring this debate back to mental health, because it is Mental Health Awareness week and we could explore some issues there, too. I feel that, no matter how strong a family are, there will be times when they need support from outside—when they need the services that the state can provide to help them to cope. If those services are not there when they need them, it can cause immense strain for everyone involved. This is every bit as true for mental health as it is for physical health services.

We do not expect families to cope with a broken leg or a cardiac problem on their own, so we should not expect them to cope with depression or an eating disorder without professional support. I want to question whether we really are doing all we can for families where one child is living with a mental health condition and they need help. Whatever our best intentions, the fact is that we are not yet doing the best we can for children and families.

According to the British Medical Association, spending on mental health care equates to only 11% of our UK NHS budget, despite accounting for 23% of the burden of disease in the UK. As we know, there is increasing demand for mental health care, with patient numbers increasing across a range of conditions. It might be time to look at that number and decide whether it should be greater, particularly for children and young people. We know that one in eight five to 19-year-olds has at least one mental disorder, but that only 6% of the mental health budget is spent on services for children and young people. I believe it is time we questioned that, because such a gap has serious consequences for children and young people with mental health conditions.

Some 400,000 children and young people who have a mental health condition do not get to see a professional at all. Instead, they have to cope with informal support. More than one in four of the children and young people referred to specialist child and adolescent mental health services in 2016-17 did not have their referral accepted. As the Children’s Society analysis showed us last year—it is a very disturbing statistic—a quarter of 14-year-old girls and nearly one in 10 boys had self-harmed in a year.

I commend Sky News and their reporter Paul Kelso for a great piece of investigative work that sheds light on the experiences of children and young people in private mental health units, many of which take young people hundreds of miles from their homes and families. The report of this work was shown yesterday. One such young person is Natasha, who is now rebuilding her life after a lost decade spent in such units. Natasha has anorexia and escalating self-harm, and she hit crisis point when she was only 12. She then spent 10 years in private mental health units dotted around the country. She says she reached her lowest point in a mental health unit in a privately run hospital in Maidenhead. In that unit, she experienced brutal restraint, which she describes as follows:

“They would pin you up against the wall, smack your head against the wall, drag you across floors, wrap you round doorframes...People sat on your head and on your legs…this would be big men, not women.”

That was the unit where she said she did

“the worst amounts of self harm”

that she had ever done in her life. Despite Natasha’s history of self-harm, she was left unattended with razors and cut herself 26 times. She needed 200 stitches.

The constant threat of self-harm is a massive strain and worry for parents when their daughter is hundreds of miles away. A mother with a daughter in one of the units that was shown in the Sky News film described how when she wakes up she thinks, “Is she all right? Will she manage to achieve her self-harm aim today?” She added, “You are hundreds of miles away. If anything happened, you would not get there on time.” As the Sky News report showed, the toll of self-harm and suicide in these units is too high. Natasha explained how she lost 24 of her friends to suicide in such mental health units, including three or four in one unit alone.

Hon. Members here today will know how it feels when a desperate constituent tells us about their child’s mental health condition and the struggle they face being unable to get their child access to the services they need. This is intolerable. We have seen mental health services being underfunded—I know the Minister will tell me about the future funding that is coming in, but we have to think about where we are today—and we know that mental health budgets fell by nearly 8% between 2010 and 2015. Sadly, we are still seeing one in 10 commissioning groups unable to meet the investment standard expected of them by the Government, which means they are failing to give mental health services the funding priority they need. We must do better than that.

In 2017, Labour set out a clear plan for how we would do better than that. I want to touch on those points. Over the past decade, mental health spending has been a part of broader NHS budgets, but as budget pressures emerged, NHS trusts and commissioning groups raided their mental health budgets to prop up services elsewhere. To that end—I know the Government have not been keen on this—Labour would ring-fence mental health budgets, which is important to ensure that the money that those services need is not siphoned off to fill gaps elsewhere.

As we think about children, young people and their families, it is important that we question why only 6% of mental health spending goes to services targeted at children and young people, despite them making up some 22% of the population. Labour would dramatically increase the proportion of the mental health budget spent on children and young people.

Following on from what I said about yesterday’s Sky News programme, we would end the disgraceful practice of sending people hundreds of miles for mental health treatment when there is no good reason to do so. In the past year, sadly we have seen the number of inappropriate out-of-area placements rise from 640 to 720, despite a Government pledge to reduce their use. I see these out-of-area placements as a tragedy for families. They jeopardise the recovery of people receiving treatment and force parents and other family members to travel long distances to support the young person. With Mental Health Awareness Week, let us not persist in treating mental health as the Cinderella service of the NHS, and children and young people’s services as the Cinderella service inside that Cinderella service.

My plea is this. Let us help children and young people in need at the time of their need, rather than making them wait 18 months to get specialist support or letting them end up in very long-term placements in locked mental health units far from home. Let us do something about the fact that the number of autistic people detained in inappropriate in-patient facilities on dubious mental health grounds remains stubbornly high, and includes a rise in the number of children in what have been seen as modern-day asylums. Let us do better. We can do better than this for our children and young people and their families.

[Sir David Amess (in the Chair)]

Just before the Minister responds, I should have announced at the start that, because the second debate was cancelled, this debate could actually continue until 4.30 pm. I will leave it with hon. Members.

Appropriate ME Treatment

David Amess Excerpts

Thursday 24th January 2019 Commons Chamber

[Sir David Amess (Southend West) (Con)]

I congratulate the hon. Member for Glasgow North West (Carol Monaghan), along with the hon. Member for Ceredigion (Ben Lake) and my right hon. Friend the Member for Loughborough (Nicky Morgan), on initiating this debate. I first heard ME being mentioned in the Chamber in the 1980s by, I think, the late Richard Holt on these Benches and Jimmy Hood on the Labour Benches. I could not pronounce the long title of the condition, but they could. As the hon. Member for Glasgow North West has said, it is disappointing that not much progress has been made, all these years later.

Like so many other Members, I am here today to speak on behalf of constituents with ME who want their voices to be heard. I am thinking of last week’s Westminster Hall debate on fibromyalgia, which is another of those problems that is not spoken about much. ME is also an invisible illness, and many people suffer in silence, so I will be using this opportunity to speak on behalf of my 500 constituents in Southend West who suffer from the illness. I would like to share with the House the words of one of them, Isabel Butler, whose moving story tells of the devastating impact of the condition, and the desperate need for the Government to take action. She says:

“I was a trainee teacher and raising my young son, having just graduated with a first class honours degree when I was struck down suddenly with this horrific illness in 2003. I battled on in pain, and despite repeated visits to my GP was simply fobbed off with antidepressants. I was not depressed, I wanted to do things but for every exertion I was overcome with pain that left me bedbound for days. Despite my best efforts and determination, I was too unwell to continue my job and pursue the career I had also dreamt of. The worst of it is, I went undiagnosed for seven long years. People don’t believe you when you tell them that you are ill, so you keep quiet, even when I had been admitted to hospital, as medics can often turn on you in contempt at the mention of ME.”

[Justine Greening (Putney) (Con)]

My hon. Friend is setting out a shocking case, and I am sure that we will hear many others like it today. The key to this has to be research, so that we can start to understand this terrible disease and then be able to build proper treatments that actually have a chance of working.

[Sir David Amess]

I am taken by the fact that we have two former Secretaries of State sitting together—my right hon. Friend the Member for Putney (Justine Greening) and my right hon. Friend the Member for Loughborough —and I certainly listen well to their advice. I absolutely agree with what my right hon. Friend says.

My constituent goes on to say:

“I do not understand why we are not being believed. I had a promising life, two beautiful boys and a career I loved. I didn’t choose to be this ill with no hope of any treatment, compassion or cure.”

The overwhelming experience of sufferers is a struggle to be believed. There is a lack of understanding among the public, policy makers and, most worrying of all, the medical profession.

[Dr Julian Lewis (New Forest East) (Con)]

My constituent Rachael King told me that one area in which there has been understanding is in schools, saying that Noadswood School and Brockenhurst College in my constituency are very understanding indeed. However, she says that her 15-year-old daughter Larissa is one of the luckier ones in that respect, because so many people are not believed, as we have heard today. If they were not depressed by the condition, they will be depressed as a consequence. However, ME is not depression; it is a serious illness in its own right.

--- Later in debate ---

[Sir David Amess]

I hope that the good practice in the schools in my right hon. Friend’s constituency will be shared throughout the country.

Sufferers are too often left in agony for years, undiagnosed and untreated. GPs are failing to recognise or even believe the severity of symptoms that can devastate patients’ lives. I urge the Government, as the hon. Member for Glasgow North West did, to work with the medical profession to ensure that all GPs have the understanding to diagnose, treat and manage ME with compassion.

However, a lack of awareness among GPs is a symptom of how little we understand the condition medically. There is no known cause, reason or cure, and there is a worrying lack of investment in biomedical research for ME in this country. Without that research, we simply will not be able to improve diagnosis or treatment for patients. I join Members across this House in calling on the Minister to consider properly funding the biomedical research that ME desperately needs.

Finally, as the National Institute for Health and Care Excellence guidelines are under review—I was on the Health Committee for 10 years and remember the arguments—we should now take this opportunity to start listening to patients. The controversy of the PACE trial arose from a failure to listen to sufferers and to believe their experiences. For the NICE guidelines to be successful and transform sufferers’ lives, we need to listen to patients. I sincerely hope that this debate will not just be mere words and that it will lead to some well overdue action. In signing off her letter, my constituent Isabel said:

“After 20 years of pain, thank you for listening.”

Now that this House has listened, I hope that we can have some action.

Hepatitis C

David Amess Excerpts

Tuesday 12th June 2018 Westminster Hall

[Sir David Amess (Southend West) (Con)]

I beg to move,

That this House has considered elimination of hepatitis C.

I should tell the House at the outset that I am not really the instigator of this opportunity to debate hepatitis. The colleague who had succeeded in securing the motion is not able to be here, but I am delighted to share my thoughts with the House.

I was a member of the Health Committee from 1998 to 2007, and during that time we certainly spent a lot of time considering hepatitis. I am also the co-chairman of the all-party parliamentary group on liver health. I have been the chairman now for some 13 years—simply because I do not think anyone else wants to take on the mantle, to be frank. When we set up our all-party parliamentary group, we looked for a celebrity to head it all, as one does, and we chose George Best. The House might feel that George Best was an unlikely person to head up the charity, but at that time he was a reformed character, and he did a lot of good in those early years. Unfortunately, as we all know, a great toll was taken on his health and, sadly, he died.

We then looked for another celebrity, and—what a joy—Anita Roddick of The Body Shop, who was a wonderful and remarkable lady, became our patron. She died in 2007. The House may know that she contracted hepatitis C from a blood transfusion in 1971 and was unaware that she was living with the disease until 2004. A routine blood test revealed the diagnosis. She was a tireless campaigner, and we owe her a great debt of gratitude, but since 2007 we have struggled to find a patron to head up the organisation as president. If colleagues have any ideas, I know our APPG would be glad to hear from them.

The APPG recently conducted an inquiry into the elimination of hepatitis, and in March it launched a report entitled “Eliminating Hepatitis C in England”. It is my intention to refer to the report’s recommendations throughout my speech. We have an excellent Minister here, and I hope that both he and the shadow spokesperson have had sight of the report. If not, we will ensure that they get it in full; perhaps they could come back with their suggestions on how we might take the recommendations forward.

In our report, we suggest raising awareness, prevention, testing and diagnosis, care and treatment, funding and monitoring progress, so we have covered every single aspect. I take this opportunity to pay tribute to Charles Gore, the former head of the World Hepatitis Alliance, and to the secretariat of the APPG, the Hepatitis C Trust, for all their assistance. They have been wonderful in all the work they do for us, ensuring that our group is effective.

On 14 December, I visited Her Majesty’s Prison Wandsworth—not because I had been sent to prison but, ironically, to accompany the Minister who has resigned from the Government today, my hon. Friend the Member for Bracknell (Dr Lee), although I do not think his resignation was the result of our visit. It was a very good visit indeed, and of course it is in the constituency of the hon. Member for Tooting (Dr Allin-Khan).

The visit allowed us to tour the secondary screening and healthcare facilities in the prison and to participate in a roundtable on the subject of the hep C virus and the importance of testing and of attending appointments. It was a wonderful visit; I pay tribute to the governor, and I know the Government are focused on the excellent work that is being done there. We talked to inmates and the governor, and the Ministry of Justice, NHS England, the Department of Health and Social Care and Public Health England were represented.

Perhaps the Minister and I should have compared notes, but I will say a little bit about what hepatitis C is. As I am sure that most hon. Members are aware, it is a blood-borne disease that affects the liver. It can subsequently lead to liver cirrhosis and cancer, and it has been linked to cardiovascular disease, musculoskeletal pain, kidney issues and mental health problems. I see we have two practitioners present in the Chamber; they might want to contradict me if they think I have got the cause of hepatitis C wrong.

The virus is said to chronically infect some 71 million people globally. Sadly, 214,000 of them reside in the United Kingdom. That is why I welcome the United Kingdom’s decision to join 193 other states in signing the World Health Organisation’s global health sector strategy on viral hepatitis in 2016. It has the principal aim of eliminating hepatitis C as a major public health threat by 2030—and I believe that if we are serious about that, we can do it. At least one Member of the House of Lords, who regularly attends our APPGs, has the illness himself. He speaks with great passion in the other House about the challenges he faces.

I say to my hon. Friend the Minister that I also welcome the target announced by NHS England in January of eliminating hepatitis C by 2025, five years ahead of the WHO. However, many problems surround the virus and its elimination, and confusion persists over how the virus is spread. Many people do not appreciate that it is spread by blood-to-blood contact. Instead, some still believe it can be spread by sneezing, coughing, spitting or other forms of physical contact. I am advised that that is not the case and it is only blood-to-blood.

Furthermore, it is estimated that between 40% and 50% of the approximate number of people chronically infected with the virus in England do not know they have it. At the start of the debate, I pointed out that Anita Roddick did not know she had it until she was tested in 2004. Between 64,000 and 80,000 people are living in England without the knowledge that they have the virus. Even more worrying is the Polaris Observatory’s prediction that the UK is set to miss the WHO target of eliminating hepatitis C by 2030.

[Mr Jim Cunningham (Coventry South) (Lab)]

I welcome the efforts the Government are making to tackle this problem. I do not want to digress too much, but there is still the outstanding problem of contaminated blood. The hon. Gentleman knows that as well as I do, because we have had many debates on this in the House of Commons. Even the previous Prime Minister said he was going to do something, but nothing has really happened yet, and there have also been allegations that some of the records—for want of a better term—have disappeared somewhere. We asked for an inquiry into that in the last Parliament.

--- Later in debate ---

[Sir David Amess]

The hon. Gentleman makes an excellent point. The hon. Member for Kingston upon Hull North (Diana Johnson) has done a fantastic job in bringing this issue to the attention of the whole House, but we must not take our eye off the ball. The hon. Gentleman is certainly right to remind me how important that issue is.

This country unfortunately lags behind Australia, Brazil, Georgia, Egypt, Germany, Iceland, Japan, the Netherlands and Qatar, which are all predicted to eliminate the virus within the proposed timeframe. I have said to my hon. Friend the Minister that we cannot really compare those countries with the UK, but it would be good if we could perhaps make even more progress on eliminating hepatitis C in this country. In the words of Polaris Observatory, the UK is “working towards elimination” of hepatitis C.

The APPG’s report highlighted awareness. First of all, it noted that awareness of hepatitis C has gradually improved in recent years, which we celebrate. However, awareness is still relatively low, and the stigma of having the virus remains a hurdle to people actually getting tested, diagnosed and treated in the first place. The report also found that there is low awareness of transmission risks among at-risk groups, with many people underestimating the seriousness of the condition and the urgency of accessing treatment. Even so, there are still misgivings among those with greater knowledge of the condition. Within that group, there is still a lack of awareness of new treatments that are available, and many still have worries regarding the side effects of former treatments.

The same is true of the stigma attached to the virus. Although it has decreased over time, the report found that progress still needs to be made in this area, as that stigma often acts as a barrier to people presenting themselves for testing or seeking treatment. The APPG therefore recommended initiating local and national publicity campaigns in an attempt to increase awareness. That is why I mentioned celebrities. Although I am not big on celebrities, I suppose that people do not listen so easily to us politicians—they tend to switch off. However, a so-called celebrity who is prepared to speak out publicly attracts more attention.

The report suggests two ways to increase awareness. One is among primary care professionals, through targeted testing initiatives in primary care, together with additional resources—it is always about securing more money—and support for primary care workers. The second is to raise awareness among at-risk groups through peer-to-peer messaging programmes. During my visit to HMP Wandsworth, I witnessed a peer-led group operated within the prison by inmates. It was wonderful what they had achieved.

However, it should be said that raising awareness of hepatitis C is in fact a short-term goal. Our long-term goal of eradicating the infection should see a switch to the offensive—to preventing the disease in the first place. That is what we are really aiming for.

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

I congratulate my hon. Friend on securing the debate and more generally on all his work on this issue and on promoting effective liver health during the many years he has been an MP.

On prevention, given that intravenous drug use is one of the primary causes of the transmission of hepatitis C, does he agree that at the moment a lot of drugs policy is seen far too much through the prism of the criminal justice system? We need to bring that much more into the health domain. Effective working with prisons and with the Ministry of Justice is vital if we are to get on top of this issue, reduce infection rates and provide proper treatment for people who are infected.

[Sir David Amess]

My hon. Friend was a Health Minister and has real expertise in this area. I shall use the expression “joined-up government”. He is absolutely right that we need Departments to work together. That is why it was so good that we visited the prison.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I may be able to help my hon. Friend here. As he knows, the drug strategy board is a cross-government committee. It met yesterday, chaired by the Home Secretary, and its members include the Justice Secretary, Health Ministers, Home Office Ministers, Housing, Communities and Local Government Ministers and representatives from the Department for Work and Pensions, as well as senior police officers, representatives from the National Crime Agency and a representative of the police and crime commissioners. That board takes that cross-government look, and hepatitis C is certainly an issue I would like to see it look at.

[Sir David Amess]

That is excellent news. I thank my hon. Friend for that positive response to looking at this issue.

The testing and treatments initiatives in place will lead to a decline in the prevalence of the disease. However, prevention will come from identifying and educating at-risk groups. To do that, we need the help of substance misuse services, sexual health clinics and peer programmes that can educate those most vulnerable sections of society on the transmission of the virus. I am advised that these services are at risk of closure without sufficient increases in their funding. Perhaps the Minister will have some news on that when he replies.

Harm reduction is another paramount mode of prevention. If we can reduce the harm to at-risk groups, we can combat one way in which the disease is transmitted. That can be achieved by providing clean and sterilised injecting equipment. Our report also emphasises the treatment-as-prevention approach towards tackling newer infections. That approach has been successful in treating drug users and other users engaging in riskier behaviours to prevent the spread of hepatitis C.

As I said earlier, between 40% and 50% of people living with hepatitis C in England are undiagnosed, which is shocking. It is therefore vital that we continue to increase testing and diagnosis levels. It is generally believed that the vast majority of those who have been diagnosed and put in touch with support services have now been treated, which I welcome. The challenge is therefore to locate those people who remain undiagnosed. That is a tricky one; it will be a real challenge.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The hon. Gentleman talks about all of those people who have hepatitis C who have been diagnosed being treated, but my understanding is that these new antivirals are given to those with the most severe disease and have cirrhosis, rather than to everyone who is diagnosed with hepatitis C on a preventive basis. Can he clarify that?

[Sir David Amess]

I am concerned by what the hon. Lady says. No doubt the Minister will eventually be passed a note from his officials and will advise us on the situation. That does not seem right if it is what is happening, and I hope that the Minister will correct me if that information is wrong. It is also vital to re-engage those who have been diagnosed and have slipped through the net to the point where they are no longer in touch with those services.

The APPG thinks that the way to combat these issues is to change how we test for the virus. We recommend routine testing in substance misuse services, sexual health clinics and prisons. We also advocate increasing testing in primary care and in settings such as hostels, day centres and police custody. I know that that will not be cheap, but if it could be done it would be wonderful. Another solution is to test for hepatitis C on occasions when people are already having blood tests, which seems like common sense to me. For example, should we not consider testing people for hepatitis C while they are being tested for HIV, or when taking blood in accident and emergency centres?

Diagnosis is one thing, but accessing care is another. It is therefore essential that people who are diagnosed are referred for treatment as soon as possible, without delay. There should be a direct link between diagnosis and care. The time between diagnosis and the commencement of treatment should be minimised, to prevent patients from dropping out of the care pathway altogether. One way to achieve that would be to make treatment available immediately following diagnosis. That may be ambitious, but it is, ideally, what our APPG wants. Another way would be to streamline the referrals process. As it stands, some secondary care services will only accept referrals for treatments from general practitioners. Allowing referrals from any service at which someone might be tested and diagnosed, as the APPG recommends, would go some way to solving the problem.

[Dr Poulter]

I agree entirely with my hon. Friend. One challenge that we face is the fragmentation of the commissioning of substance misuse services and sexual health services. Those are commissioned by local authorities under the Health and Social Care Act 2012, which I think we have to reflect on as a mistake in this context, as opposed to many secondary care services, which are commissioned by the NHS through clinical commissioning groups. Until we sort out that fundamental issue of commissioning, we will not be able to put in place the improvements that he suggests.

[Sir David Amess]

Oh dear! I say to my hon. Friend—I and, indeed, you, Mr Streeter, were in this place when we were dealing with all these issues—that the fragmentation is very worrying. My hon. Friend is right to point out that more work needs to be done on the issue.

[Dr Whitford]

I am not sure whether the hon. Gentleman is aware that there is a cap on the number of patients who are allowed to receive drugs such as sofosbuvir; certainly, hepatologists I have met in recent years report having to ration it to the most severe cases. The limit was set at about 10,000 patients a year. This year, it has been increased to 15,000, but that is not a target; it is a cap. It means that despite it having been stated that 160,000 patients in England suffer from hepatitis C, it would literally take 10 to 16 years to treat them all, so this is a matter not of referral but of access to the drugs.

[Sir David Amess]

I said at the start that I was totally the wrong person to lead this debate. I put my hands up: I was not aware of the cap. It, too, is a little worrying, but perhaps the Minister will have an answer. I am the first to admit that money is not always available for these things, but it is worrying that we are talking about another 16 years. That is not what our all-party group wants.

If services share data more effectively, the number of patients lost to follow-up will certainly be reduced. That will minimise cases such as prisoners who have been diagnosed being released before being referred to a service that provides the treatment that they so desperately need. Another example is where general practitioners have records of people who have been diagnosed but never received treatment.

On the subject of treatment, pioneering treatments have been in place since 2014. I am advised that they are shorter in duration and have higher cure rates and fewer side effects. They have thus been instrumental in making progress in the way we treat hepatitis C, and many people have been cured thanks to the drugs available since 2014. Notwithstanding that, we should continue to maintain targets for the number of people treated and to maintain universal access to treatment for those who have been reinfected. Those targets should be local, regional and national.

There is even an argument for making the targets more aspirational. Currently, there is a target to treat 12,500 people in England per year, and the all-party group would like that to increase to 20,000 new treatment initiations. If the target is not raised, there is little chance of achieving NHS England’s target of eradicating hepatitis C by 2025. It might be more pragmatic to have initially an even greater target, which would progressively be lowered in the future. That approach would reflect the assumption that, as overall prevalence falls and approaches minimal levels, those still living with the virus will be harder to locate within the population.

Treatment should be focused in the community. That will ensure that access is not hindered for those who have difficulty accessing secondary care services. The all-party group recommends making treatment more readily available in GP clinics and pharmacies, homeless shelters, substance misuse centres, sexual health clinics and prisons.

Funding is where the crunch comes, and we have quite a bit to say on it in our report. Although new curative treatments have considerably decreased in cost, pioneering new treatments for hepatitis C are not immune to concerns. The way in which the new treatments were initially rolled out by NHS England drew criticism at the time. For example, restrictions were placed on the number of patients able to access them each year in England. Of course, the hon. Member for Central Ayrshire (Dr Whitford) has reminded the House of that. I am sure that the Minister is aware of recent negotiations between NHS England and the industry to develop a new funding model in this area and one that does not restrict access for patients. Without such dialogue, elimination in England would be severely compromised.

The all-party group has gone further, however. We recommend that any future deal should prioritise equitable availability throughout the country—I suppose we are thinking here of the postcode lottery—that does not discriminate against patient populations. On the subject of the all-party group’s recommendations, we believe that we should continue to monitor elimination progress with reference to progressive targets. The report calls for more diverse data on the virus to be collected and shared. It is the group’s belief that that would additionally allow for improved allocation of testing and treatment resources.

As the all-party group’s report makes clear, we believe that the eradication of hepatitis C in the foreseeable future is an extremely achievable goal—we really think we can do this. It is a goal to which our international partners are committed, which is very good. Some of them are making greater progress towards achieving it than we are, for whatever reason. For the target to be met, we must change our approach to hepatitis. It is my belief that the recommendations that I have summarised today must be implemented, and as soon as possible. Failure to do so will only prolong the existence of hepatitis C in this country. We have at our disposal the means to eliminate it. Let us do that.

--- Later in debate ---

[Sir David Amess]

I am really happy with what my hon. Friend the Minister has said about all-party parliamentary groups because, sadly, the recommendations of the all-party parliamentary group on fire safety and rescue were not listened to over a number of years, and of course we had the Grenfell disaster. However, I get the distinct impression from my hon. Friend that he is listening to the recommendations of this report by the all-party parliamentary group on liver health.

It has been a great privilege to learn one or two things from other colleagues with more expertise in this field than I have. In every sense, this debate has been time well spent, and I am very, very optimistic about the future progress towards eliminating hepatitis C. I thank all colleagues for the time that they have spent here in Westminster Hall, participating in this debate, and I very much look forward to celebrating with my hon. Friend the Minister within a few years the elimination of hepatitis C.

Question put and agreed to.

Resolved,

That this House has considered elimination of hepatitis C.

Oral Answers to Questions

David Amess Excerpts

Tuesday 19th December 2017 Commons Chamber

[David Morris (Morecambe and Lunesdale) (Con)]

6. What his priorities are for the additional funding allocated to the NHS in autumn Budget 2017.

[Sir David Amess (Southend West) (Con)]

14. What his priorities are for the additional funding allocated to the NHS in autumn Budget 2017.

[The Minister of State, Department of Health (Mr Philip Dunne)]

The autumn Budget committed to backing the NHS, so that by 2019-20, it will have received an additional £2.8 billion of revenue funding for frontline services, including £337 million for winter allocated last Friday and £3.5 billion of new capital investment by 2022-23 to transform the estate.

[Mr Dunne]

My hon. Friend needs to be congratulated in this House on being a champion of the University Hospitals of Morecambe Bay NHS Foundation Trust. The trust has been through some difficulty, and he has stuck with it and supported it. I can confirm that the trust was allocated up to £2 million of funding last Friday; I congratulate it on that. I am sure that he would also join me in congratulating the trust on recently being awarded the title of the eighth most inclusive employer in the UK.

[Sir David Amess]

Does my hon. Friend share my delight at the £41 million capital allocation that was announced in the recent Budget? Does he agree that that huge sum will enable us not only to maintain the present excellent services at Southend hospital, but to enhance and develop them further for the benefit of all local residents?

Stroke Services

David Amess Excerpts

Tuesday 5th December 2017 Commons Chamber

[Sir David Amess (Southend West) (Con)]

I am grateful to you, Mr Speaker, for allowing me the opportunity to raise the crucial subject of the provision of stroke services throughout the United Kingdom. Every Member of Parliament will have a relative or friend who at some stage has suffered from stroke, so we all appreciate at first hand what the outcome of stroke can be. It can sometimes be halted and a recovery can be made, but that is not always the outcome for people who are not so fortunate. We can all recall the former Member for the Isle of Wight, Andrew Turner, who suffered a stroke recently, and there have been many others.

On Thursday 26 October, I chaired a roundtable on stroke solutions and the revolutionary potential of mechanical thrombectomy for stroke patients. The facts about stroke are as follows: more than 100,000 strokes occur in the UK each year; there are more than 1.2 million stroke survivors in the UK; and almost two thirds of stroke survivors leave hospital with some sort of disability.

[James Duddridge (Rochford and Southend East) (Con)]

I understand that this debate is very much about the UK and stroke units, but is my hon. Friend and parliamentary neighbour aware that today I met the Stroke Association, which is prepared to come to Southend to discuss changes in the stroke unit with the public? It will also have discussions with the wellbeing board, specifically to talk about the experience of reorganising acute and hyper-acute stroke units to give better outcomes, fewer deaths and fewer disabilities. This is good news for Southend, and the Stroke Association is happy to come to speak to us in Southend.

[Sir David Amess]

I very much welcome that news. I think that the two of us will look forward to meeting the Stroke Association and working with it to enhance the already excellent facilities at Southend Hospital.

The costs of stroke to the NHS and social care are about £1.7 billion a year, which is a huge amount. If I may be biased for a moment, let me say to the Minister that since 2013, the Government whom I support have contributed to significant advances in the treatment of stroke victims all over the country. The percentage of patients scanned within one hour of arrival in hospital has risen from 42% in 2013 to 51% last year, and the figure for those scanned within 12 hours has increased from 85% to 94%. I think the whole House will welcome that improvement, and I am grateful to Members on both sides of the House who are in the Chamber to listen to this Adjournment debate. I hope that their constituents will recognise the fact that they have stayed here.

[Jim Shannon (Strangford) (DUP)]

I sought the hon. Gentleman’s permission to intervene before this debate, Madam Deputy Speaker.

Right across the UK there are many problems in relation to stroke services. Some 4,000 people in Northern Ireland have had a stroke in the past year, and 36,000 people in Northern Ireland are living with the effects of a stroke. What consideration has the hon. Gentleman given to people having a normal life after stroke through the provision of rehabilitation, and of occupational and cognitive therapies, and through the way in which the NHS handles aftercare, especially for the growing number of younger people who have strokes? This is not just about people in their 70s; it is sometimes about those in their 30s, 40s and 50s.

[Sir David Amess]

If I did not know better, I would have assumed that the hon. Gentleman had read my speech, because I was just about to say that in the past three years there has been a rise in compliance with standards for physiotherapy from 53% to 79%, and from 24% to 47% for speech and language therapy. I know that similar progress has been made in Scotland. With all that in mind, it is essential that the NHS continues to lead from the front. We must utilise some of the newest technologies to improve the effectiveness of stroke treatment, to allow patients to live fuller lives, and to decrease the burden of ill health after someone has suffered a stroke.

Two out of three stroke survivors currently leave hospital with a long-term disability at a cost of £1.7 billion, as I said. The provision of healthcare to people who have had a stroke accounts for approximately 3% to 5% of all healthcare expenditure, which is a vast amount. The cost of stroke treatment will rise to £43 billion in 2025 and £75 billion in 2035. If I remember rightly, I think the husband of the hon. Member for North Down (Lady Hermon) suffered strokes during his illness.

[Lady Hermon (North Down) (Ind)]

It is very kind of the hon. Gentleman to mention my late husband. He did not actually suffer from a stroke; he suffered from Alzheimer’s, which was unfortunately the cause of his death. While I am on my feet, however, may I encourage the hon. Gentleman to put on record his appreciation for all the wonderful charities that work with stroke victims, and that support them and their families after what is a devastating health incident?

[Sir David Amess]

I absolutely join the hon. Lady in celebrating the work of all those charities.

The European Stroke Journal found that improving access to thrombolysis and early supported discharge services alone can contribute to reducing the financial burden of stroke on health and social care services. When the benefits of treatments such as mechanical thrombectomy are included, the costs can be lowered significantly. What measures are the Government taking to address the rising costs associated with strokes in England? I very much hope the Government are considering the widespread use of mechanical thrombectomy, which is a new and effective way of treating some of the most serious strokes caused by a blood clot.

[Maggie Throup (Erewash) (Con)]

I have heard first-hand stories about the impact of mechanical thrombectomy and just how fantastic a treatment it is. It can enable people who might have had lifelong disabilities to lead normal lives. I gather it is being rolled out throughout the NHS through specialised commissioning, but does my hon. Friend agree that the roll-out needs to be speeded up, and that we need more people in place to carry out the treatment so that more individuals can benefit from it?

--- Later in debate ---

[Sir David Amess]

Even though money is tight, I absolutely agree with my hon. Friend. I have seen a video of the operation, and it is just extraordinary that a catheter can be inserted into a patient’s artery to access the clot, which is then mechanically removed. The technology is extraordinary.

Mechanical thrombectomy significantly reduces disability rates after strokes. It removes clots that are too big to be broken down by drugs alone. For each six-minute delay in the delivery of mechanical thrombectomy, there is a 1% increase in the proportion of people who become disabled. Royal College of Physicians guidelines for stroke care label it as the best recommended practice. It is an effective procedure with very low complication rates. It is highly cost-effective, too. The Stroke Association has calculated that over a 10-year period, the net monetary benefit of 9,000 eligible patients receiving the treatment would be between £530 million and £975 million.

Mechanical thrombectomy enables more stroke survivors to live independently in their own homes, which is crucial, and then to return to work and take control of their lives again, thereby saving the NHS money. It really is a game-changing treatment that could revolutionise stroke victims’ experiences, yet despite NHS England’s agreeing to fund it, it is delivered for only 0.008% of the 85,122 acute stroke admissions, versus the EU benchmark of 3%, so we are really some way behind.

Let me blow the trumpet for Southend, following on from what my hon. Friend the Member for Rochford and Southend East (James Duddridge) said earlier. Southend has been developing an interventional neuroradiology service alongside a hyper-acute stroke service providing thrombectomy. Our service is led and delivered by an interventional neuroradiologist. It has been developed with the local trust board since 2013, but due to a current recommendation that only interventional neuroradiologists can perform the procedure, she is the only person who can perform thrombectomy at the moment, so the service is provided on a “best endeavours” basis and is not, unfortunately, a regular service. The service is currently available only at Southend and nowhere else in Essex. We need to expand it to provide a 24-hour service. The only other place where it is provided is at St George’s Hospital in London.

Mr Paul Guyler, who is a lead consultant in stroke medicine at Southend University Hospital, tells me that less than 1% of ischaemic stroke patients receive endovascular treatment and that, despite around 9,000 patients being eligible for mechanical thrombectomy, only 400 patients received the treatment last year. He has argued that the barriers to this treatment revolve around skills and education, resources and attitudes.

This is not a criticism of my hon. Friend the Minister, because he cannot wave a magic wand and solve all these problems, but Mr Guyler has advised me that there are not enough trained specialists to be able to provide a 24/7 service in all areas. Unfortunately, we also have a postcode lottery, with not enough neuro- radiologists and only 80 interventional neuroradiology operators in the United Kingdom.

[Maggie Throup]

My hon. Friend is being very generous with his time. He has hit the nail on the head: the treatment is very specialist and is carried out by surgeons and neurologists who are not normally there to treat stroke victims. The change in the way in which stroke centres work has been fantastic. Stroke services have been centralised, but we need to go a step further and to make sure that we get the right training for these neurologists so that we can continue to save lives.

[Sir David Amess]

My hon. Friend is spot on in her analysis. I know that the Minister will take the points that she has made to heart and consider how we can improve the present situation.

Consensus forecasts predict that 150 trained people are required to run a fully functioning 24/7 national service. Mr Guyler says that training in stroke intervention is not readily available, that not enough hospitals can afford 24/7 availability and that there are not enough expert neuroradiologists to interpret CT scans. He says that there are turf wars between neurologists, cardiologists, neurosurgeons, radiologists, vascular surgeons and neuro- radiologists on who can and will perform interventional stroke treatment in the future. I do not think it is for politicians to get involved in those turf wars. The medical staff need to sort out between themselves who will lead in these matters. Apparently, there are also turf wars between university and district general hospitals on who should perform the procedure.

Mr Guyler also highlighted the fact that we have the expertise to develop this treatment significantly. The UK has one of only five training simulators in Europe—we should be proud of that—which is based at Anglia Ruskin University.

What are the Government doing to encourage more areas to reconfigure acute stroke services? We do need a new national stroke plan. I was at the launch of the original plan at St James’s Palace many years ago, but it is now time for a new one.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

The hon. Gentleman is making an excellent speech on stroke services, which are invaluable right across the United Kingdom. I refer the House to my entry in the Register of Members’ Financial Interests. Does the hon. Gentleman agree that it is important that people who suffer strokes also have access to psychological services? Many people experience depression when adjusting post stroke, and it is important that counselling is available to support them through that.

[Sir David Amess]

The hon. Lady, with her considerable expertise in this area, is right to bring that particular matter to the attention of the House. We certainly need more provision of the women and men who give that sort of support.

A significant part of a new national stroke plan should be the development of 24/7 access to mechanical thrombectomy for all United Kingdom citizens, no matter where they live. Southend has already shown itself to be both safe and effective. It exceeds the recommended audit standards, its improvement in patient outcome is similar to international trials and, despite a severely ill patient collective, its results exceed the British Association of Stroke Physicians’ quality benchmarks. I want all my constituents to have 24/7 access to the best possible stroke treatment, so I urge the Government to find a way of effectively introducing mechanical thrombectomy to all parts of the United Kingdom. What is the Government’s assessment of the national stroke strategy, and will the Minister update the House on progress with its replacement?

I am not criticising the Government’s provision in any sense but, as with all these things, we could and should do more. We could do better. It is frustrating that a wonderful technique is available but is not available to everyone. Perhaps we can find a few more resources now because that should result in a saving in the long run. Finally, does the Minister agree that this wonderful facility at Southend Hospital is a further good reason for Southend to be declared a city?

Southend Hospital

David Amess Excerpts

Thursday 6th July 2017 Commons Chamber

[Sir David Amess (Southend West) (Con)]

I am grateful to Mr Speaker for giving me the opportunity to raise on the Adjournment the future of Southend hospital. In so doing, I congratulate my hon. Friend the Member for Winchester (Steve Brine) on his promotion to Under-Secretary of State for Health. I know he will do a splendid job. I must warn the House that I will not take any interventions, because I have a lot to say, and I am sure my hon. Friend the Minister will not take offence if we do not split the half-hour available exactly.

I am absolutely furious that it is necessary for me to raise in the House the future of Southend hospital. We are all gathered here after what in my case was the 10th time I have been a parliamentary candidate in a general election, and I certainly did not enjoy this particular experience. I am a conviction politician. I am not in the school of, “Oh, it’s a choice between the red and the blue team. I support the blue team, and if the going gets tough I might slide over to the red team.” I support things, and one of the things I support is an enterprise culture. I hope that businesses can make a bit of profit, the country can do well and we can spend money on our wonderful health service.

As I look at the Dispatch Box, I recall 34 years ago standing just behind the now Leader of the Opposition—we both had rather long hair in those days. All I would say is that I think he and I hold the same views today as we did 34 years ago. Let me say this and get it off my chest immediately. I do know a bit about the health service. Colleagues stand up and say that they are expert in this and expert in that. It does not matter what age they are, but I think there should be a little bit of respect for how long we have been here and for experience. I go back to the time when I was a junior Parliamentary Private Secretary to Michael Portillo and Edwina Currie and we had our departmental office in Elephant and Castle, and I was there when we first moved into 79 Whitehall, so I do know a little bit about the health service, and a little bit about sustainability and transformation exercises, which I will come to in a moment.

Not only that—I know a little bit about politics. Unlike all my colleagues, I held a challenging seat not once, not twice but three times between 1983 and 1997—just like my hon. Friend the Member for Thurrock (Jackie Doyle-Price) has now. I have moved on to a slightly more comfortable seat in terms of support for the Conservative party, but I never ever forget how tough it was.

My inspiration in politics is the late Baroness Thatcher. Unlike many colleagues in the House, I was a colleague of hers and knew her when she was at the top of her game; not only later in her life when perhaps she was not firing on all cylinders and romanticising about things. She is my inspiration, frankly. Of course, she never went along the populist line; she always did what she thought was in the best interests of the country. I say to my hon. Friend the Minister that during Mrs Thatcher’s time as Prime Minister, when we had a huge Conservative majority, I was able to stop Basildon A&E closing within two days. In Basildon, our garden backed on to the grounds of the hospital, and I now live five minutes from Southend hospital. As I look at our situation today, there is no way that I, the Member of Parliament for Southend West, am going to allow the hospital in the heart of my constituency to have its A&E downgraded. There is no way that I am going to allow it not to have 24/7 access. There is no way that I am going to allow ambulances with blue lights flashing not to stop at Southend hospital.

Getting back to the campaign, colleagues up and down the country think they had a tough campaign because of the manifesto and the style of the campaign, but the rudeness I encountered in this campaign disgusts me. The things that people—young, middle aged and old—now say to us, the politicians who take the blame for decisions made by bureaucrats and others who are paid twice as much as we are, and the way they use the F-word and C-word, disgust me. On social media, the mickey is taken about of me because of “cake”. Shame! Shame on any youngster who thinks it is a laughing matter, when my constituent Leah Betts died of an ecstasy overdose. Shame on Channel 4, which got people into the building when the then Minister Tony Newton was checking with his civil servants and thought there was a drug called cake. It is an absolute disgrace. Those people who think it is funny now were not even born when my constituent died. The general tone of this election campaign was jolly disappointing.

For me in Southend, at the heart of it all was a campaign called Save Southend A&E. I am furious that those who were behind the proposals did not get the politics. Behind the scenes, I had been organising health summits, where we got decision makers in SEPT—South Essex Partnership Trust—dealing with mental health services, representatives of the clinical commissioning groups of GPs, and the hospitals to talk to one another. I was not at all happy with senior management, who are paid large salaries—it is all in Hansard over the years.

I get frustrated that the longer one is an MP, the more one is ignored. I think of the chairmanship I am privileged to hold of the all-party fire safety rescue group. It was not just Conservative Ministers or Liberal Ministers; it was Labour Ministers who accepted the wrong advice. We all know the dire consequences of our advice being ignored.

To get back to the health service, with 15 minutes to go, one individual was going to stand against me in the general election on the issue of the A&E. There was all the online abuse. We had rallies. We had mass demonstrations. It was a nightmare, but I can look after myself. I have not survived for 34 years in Parliament because people have been looking after me. I am arrogant enough to say that I know what I am doing. I know a bit about people, because before I became an MP I owned an employment agency, so I have interviewed hundreds of people. It annoys me that others think they know better than I do on this issue. I say to my hon. Friend the Minister that in future, when anything that involves Southend hospital is being done—including by bureaucrats and officials—pay the hon. Member for Southend West the courtesy of telling me what is going on. I should be told first.

On the proposal to dumb down Southend A&E, the argument is lost—completely lost. In the election manifesto on which we fought the recent campaign, we see on page 67 the heading “Holding NHS leaders to account”, followed by a part of the manifesto that I shall repeat over and over again if I am not listened to:

“We will also back the implementation of the plan at a local level, through the Sustainability and Transformation Plans, providing they are clinically led and locally supported.”

For goodness’ sake! A politician does not ask a question speculating what the answer might be. Unknown to me, we had clinicians employed by the people suggesting these proposals openly speaking out against any changes. It beggars belief that just two weeks ago the person running Southend A&E—I will not name them—went to Rochford Council for a meeting and tore the proposals apart line by line, word by word. How on earth could the arrangements for A&E be changed if the very person running the scheme speaks against it? I have any number of examples of clinicians, GPs and others who are openly speaking against the proposals. It is certainly not clinically led.

Hospitals are not perfect—not by a long run—but I wish to pay tribute to everyone who works in the national health service. I do so not in a patronising way—I know that there are all these arguments about the public sector pay review and all of that—but because they do a fantastic job. Although it is sometimes forgotten, all Members of Parliament are human beings, so we all get unwell and we all have family members who get unwell. We are grateful to GPs and hospital consultants for the wonderful work they do for us time after time. Of course MPs are the ones who hear the complaints when someone is not looked after well, but we must never allow that to cloud the overall fact that we have a wonderful health service.

I was a member of the Health Committee for 10 years, which is not a short time. I went all over the country, and all around the world—you name it; I have been there and seen it—and I returned to the UK with the view that we have the best health service in the world. However, because people have the highest possible expectations, no amount of money will deal with all the issues. There is the situation with this baby, and the President of the United States reckons he is going to sort it out. But there is no limit to the amount of money that could be spent on the health service. The women and men who work in our health service are absolutely marvellous.

I also want to point out that the people who came up with these suggestions have presumably not yet started talking about the ambulance service. I have any number of people telling me that the idea that we can transfer people to Basildon A&E is just not on, for all sorts of reasons. I have heard many reasons why that cannot happen.

I really want to praise Southend hospital and the wonderful things the people there achieve. Only last Thursday the Countess of Wessex, who has a particular interest in babies, opened the Kypros Nicolaides foetal medicine unit, which helps around 45 women each month with specialist foetal medicine care. It is absolutely tip-top. The latest Care Quality Commission report gave the A&E department good ratings. It had been underperforming for a while, but we have now got it up to a good level of performance. The simulation suite has recently celebrated its first anniversary. This state-of-the-art suite has been used to deliver a wide range of training opportunities designed to look and feel like a real patient bay, and it can replicate any medical scenario. Last November the brand new £3 million state-of-the-art endovascular hybrid theatre was opened. This new cutting-edge suite combines all the features of a fully equipped operating theatre, with an interventional radiology suite, and it includes ultra-modern imaging and operating equipment for complex endovascular work.

Our hospital has always had a wonderful reputation for treating people with cancer. It has also always been first class at treating people who suffer strokes. Basildon has really been the centre of excellence for people with heart problems. Southend hospital has the Red2Green system. The initiative has seen positive results across all the wards, ensuring that every day is valuable for patients in the hospital’s care through early daily review by senior clinical staff expediting investigations, treatments and early safe discharge home. The last thing we want is elderly people spending too long in hospital and catching infections.

There is funding for GP streaming. The Department of Health announced allocation of A&E capital funding to ease pressure on emergency departments in time for winter 2017, and we are absolutely delighted with that. We are also delighted with the £180,000 that we have received to help with cancer. A patient-led assessment of the care environment was undertaken in May. Although the formal outcomes will not be available until later this year, the informal comments from the volunteer inspectors were very positive. Thrombectomy training is a cath lab-based technique where a blood clot is directly removed from the brain’s arteries. This is fantastic technology, and Southend will be not only top of the country but top of the world in this discipline, which is wonderful news.

A team at Southend University hospital are using innovative 3D presentation technology with radiotherapy to allow patients greater insight into the machines used for cancer treatment. Everybody is obviously very frightened when cancer is diagnosed, but this therapy will help with the treatment, and it helps the patient to feel more positive and confident that they will beat the disease. A maternity training simulator has been introduced, which enhances patient care, and a new paediatric insulin pump service improves diabetes care for children. Southend University hospital’s team were recently highly commended in the Health Service Journal value in healthcare awards, and a dementia day room funded by Southend Hospital Charity’s appeal was recently opened.

Anyone who works in the health service—whatever they do—has a gift. I am not terribly good at looking after other people when they feel unwell. Frankly, it makes me feel unwell. How a surgeon cuts someone open, I do not know. Someone has to do it—brain surgery and all that. These women and men are absolutely blessed and splendid. I speak from the Conservative Benches, and we used to be seen as the enemies of the national health service. The situation is quite the reverse; we totally support and value the health service. As long as I am the Member of Parliament for Southend West, I will ensure that Southend University hospital has not only a bright future, but a glorious one.

--- Later in debate ---

[Steve Brine]

I will, Madam Deputy Speaker. I could feel you bristling at the length of the intervention. I can assure my hon. Friend that none of the options being considered includes the closure of any of the three A&Es, and all will continue to provide emergency care 24 hours a day, seven days a week.

I was mentioning the work of the Mid and South Essex STP, which was published in November 2016 as part of the work to ensure that there are sustainable services in mid and south Essex. There is now a major workstream looking at service configuration across the three hospital sites. Work led by clinicians in 2016 arrived at five possible future configurations for consolidated specialist services across the three hospitals. As well as providing the majority of routine hospital care for its local population, each hospital site would provide some centralised specialist services.

Let me briefly outline the current thinking as it has been set out to me. Southend hospital will continue, as I have said, to provide substantial emergency services 24 hours a day, seven days a week. In addition, it will be a centre of excellence, as my hon. Friend the Member for Southend West rightly said, for planned care, alongside its already well-established cancer centre and radiotherapy services. Basildon hospital will provide enhanced specialist emergency care—for example, specialising in the total management of major life-threatening illness. Broomfield Hospital in Chelmsford will provide a combination of specialist emergency and planned care, with the potential to provide a specialist centre for children. I have to emphasise that these ideas are being further developed by the clinical groups as we speak. No single preferred option for consultation has been arrived at.

Let me now turn to the proposals for emergency care. It is important to note, and I wish to reiterate, that in all potential options for hospital reconfiguration currently being discussed, Southend hospital would continue to provide emergency services 24/7. An options appraisal process was held earlier this year involving clinicians, stakeholders and local people. The higher-scoring options listed one hospital as the provider of specialist emergency care. Basildon was identified as the better location for that. Southend and Chelmsford would continue to provide emergency services, but they would be less specialised than Basildon. Southend would instead specialise in planned care, cancer and radiotherapy, building on the excellent work already being done at the hospital. There would be separate units specially designed to give fast access to assessment and care for older and frail people, children and people who may need emergency surgery. In some cases, that could include an overnight stay, if necessary. Those units would involve both health and social care so that patients could return home as quickly as possible with any continuing support and treatment that they may need.

The potential services in the A&E and assessment units at Southend would be able to respond to a range of emergency needs, some of which could be initiated by a 999 call and may involve an ambulance. The possibility of Basildon hospital being the provider of specialist and complex emergency care has benefits for local patients. It would have several teams of specialists ready to provide immediate access to state-of-the art scans and treatments around the clock, which is not always possible in the current three general hospital A&Es.

I also understand that the practice of taking patients by ambulance from Southend to a specialist centre is already established. For example, people who suffer an acute heart attack in Southend are currently taken by ambulance to the Essex cardiothoracic centre—that was easy for me to say—in Basildon. I have been advised that that arrangement has been in place for many years. Separating some of the major emergency work in that way releases capacity and resources for planned surgery and other treatments.

For the local NHS, new centres of excellence across the hospital group in both planned and emergency care have the potential to compete with the best in the country to attract high-calibre staff and bring the best of modern and world healthcare to mid and south Essex. I emphasise that in all options currently under discussion, about 95% of hospital visits would remain local at each hospital.

As I have stated previously, the programme is currently under discussion and I am advised that the aim is to launch a full public consultation at the end of the year at the earliest, centring on a single preferred option. The public consultation will explore in detail the benefits and implications of the proposals and will inform plans for implementation. Engagement with staff and local people will continue to influence and refine plans at every stage. That is a key principle, as I have said, in local reconfiguration of services, and it has to be right that the process is guided by those who know and understand the local area best.

In conclusion, as a constituency MP I completely appreciate the concerns of my hon. Friend the Member for Southend West, whom I again commend for his work.

[Sir David Amess]

I should have said in my speech that all my literature had headlines such as, “David pledges support for 24/7 A&E service”. I felt that I was not believed, so it is good that my hon. Friend has repeated that we will have 24/7 care. Finally, given that morale at the hospital has been ruined over the past few weeks, it would be great if we could have a ministerial visit at some stage, perhaps even from the Secretary of State.

[Steve Brine]

I thank my hon. Friend for that offer and will pass it on to the Secretary of State, although I am not entirely sure whether he or any of his Ministers can compete with royalty.

In the 30 seconds I have left, I commend my hon. Friend for his work on those issues affecting his constituents. He is a doughty champion for them. I think they do believe him, because they re-elected him admirably just a few weeks ago. I encourage both him and his constituents to maintain an open dialogue with the local NHS, as I know they will, especially during the pre-consultation and consultation phase, and reassure him that Southend A&E will continue to provide substantial A&E services.

Question put and agreed to.

Stillbirth

David Amess Excerpts

Thursday 9th June 2016 Westminster Hall

[Several hon. Members rose—]

[Sir David Amess (in the Chair)]

I have been advised that there are five colleagues who wish to speak. The concluding speeches will start at 2.30 pm. Perhaps the other colleagues who have taken the time to be here may be minded to make interventions.