Oral Answers to Questions

David Nuttall Excerpts

Tuesday 21st March 2017 Commons Chamber

[Nicola Blackwood]

The childhood obesity plan has already been published. I think the hon. Lady may be talking about the reformulation targets and the baseline data, which are coming out imminently. The experts in Public Health England are working feverishly to make sure that the data are exactly as they should be. One measure I think she will be particularly keen to see is the investment in schools committed to by the Chancellor in the Budget, including the voluntary healthy rating scheme, which will be published in June.

[Mr David Nuttall (Bury North) (Con)]

What measure is being used to ascertain the success or otherwise of the strategy and when will we know whether it has worked or not?

[Nicola Blackwood]

As I mentioned, we will be publishing the reformulation baselines against which all future success will be measured. They will include measurement across all industry targets. In addition, we will of course have the voluntary healthy rating scheme for primary schools to recognise and encourage their contribution to preventing obesity.

Health Committee

David Nuttall Excerpts

Thursday 16th March 2017 Commons Chamber

[Dr Wollaston]

I thank the hon. Gentleman for his contribution and join him in paying tribute to voluntary groups throughout the country that are doing extraordinary work to reach out to people in crisis. As he will know, the level of variation in support is a key issue, along with the financial challenge faced by people around the UK who are trying to provide proper support.

[Mr David Nuttall (Bury North) (Con)]

I thank my hon. Friend very much indeed for the work that she and her Committee have done on this issue. The suicide rate among men is three times that among women, and the gap has increased since 1981. As she mentioned, suicide is the leading cause of death for men under 50. A particular problem is contagion, whereby one suicide can often lead to a spate of others in the same area. During the inquiry, did the Committee identify how this aspect could be dealt with?

[Dr Wollaston]

I thank my hon. Friend for his important question. We absolutely looked at that issue and specifically mentioned it in our report. He will know that part of the problem is that irresponsible reporting can sometimes lead to contagion. We know that when local areas work together closely to identify suicides, particularly early clusters, measures can be taken—people can go into workplaces, schools and colleges—to provide support and stop it. It does, though, require that we notice it early, so the Committee urges coroners to work with local authorities and public health teams to ensure that they are aware of the high risk of suicides spreading.

NHS Shared Business Services

David Nuttall Excerpts

Monday 27th February 2017 Commons Chamber

[Mr Hunt]

The hon. Lady is always very good at telling the House things that Scotland does better than the NHS in England; there are, indeed, some. She is a little bit coyer about things that Scotland does less well than the NHS in England. If we put aside those issues, I think we can both agree that the sooner the NHS across the whole UK goes electronic, the better. That has been a big priority for this Government, and we have made big progress. More than two thirds of hospital A&E departments can now access a summary of people’s GP records, and we are going further every month.

[Mr David Nuttall (Bury North) (Con)]

As the affected patients could have moved anywhere in the country, will my right hon. Friend assure me or let me know, either today or by writing to me, whether any of my constituents in Bury North have been affected?

[Mr Hunt]

I do not have the information about Bury North patients immediately to hand, but I am happy to write to my hon. Friend to tell him whether we think any of his constituents have been affected.

Pennine Acute Hospitals NHS Trust

David Nuttall Excerpts

Tuesday 17th January 2017 Westminster Hall

[Mr David Nuttall (Bury North) (Con)]

It is a pleasure to have you take charge of our proceedings, Mr Streeter. It is also a pleasure to follow the hon. Member for Blackley and Broughton (Graham Stringer). He was right about our membership of the European Union and he has been proved right again about the Pennine Acute Hospitals NHS Trust. I particularly appreciate the very considered and proportionate way in which he has approached what is clearly a difficult subject.

Deciding on the best and most efficient way to organise our national health service is a problem that has long occupied the intellect of many able minds. I think it is fair to say that both the Conservative party and the Labour party have struggled over the years with how best to manage such an enormous organisation. That is not a political point; it is a matter of fact that there are different ways to organise huge bodies and everyone wants to do it in the best way possible to deliver the best possible service for all our constituents. I want the NHS to be organised in any way that delivers the best service for my constituents in Bury, Ramsbottom and Tottington. They rely on our NHS. They rely on Bury CCG and on the Pennine acute. Frankly, they are not too bothered about precisely where a management committee sits or meets, but they are bothered about whether they can get their appointments on time and, crucially, whether, when they have to use NHS services, they are safe.

[Mr Ivan Lewis]

Will the hon. Gentleman give way?

[Mr Nuttall]

I will give certainly way to my neighbour, the hon. Member for Bury South.

[Mr Lewis]

The hon. Gentleman and I have always sought to work together in the interests of Bury and to put party political differences to one side. Does he agree that the decision being pressed ahead with, to close the walk-in centres in Prestwich and Bury, is perverse—or bonkers, depending on how one wants to look at it? Will he join me in ensuring that, when the formal consultation begins, we fight that decision? Given the pressures on the existing accident and emergency departments at North Manchester and Fairfield general hospitals, that decision would make the situation far worse.

[Mr Nuttall]

I am grateful to the hon. Gentleman for raising walk-in centres. I was going to mention them later, but I will deal with the issue now. I met with representatives from the Bury CCG some months ago, before all this was announced, and they took me through what they were planning. They convinced me that it was in the best interests of my constituents. It would be easy for me to say the popular thing, which is, “I think we should oppose it.” I entirely appreciate why the good folk of Prestwich do not want their walk-in centre to be closed. I can see that there is a likelihood that it would increase pressure on the A&E. That highlights the point I was making, which is that there are good arguments to be made on both sides of the debate as to whether to have walk-in centres or a more community-based approach to delivering services. That is where Bury CCG was coming from.

Following the devolution of healthcare in Greater Manchester, since last April, we have been in an entirely new situation. We have an opportunity to make a reality of the joining up of health and social care, which has long been argued for.

I want to make three points this morning. First, I do not accept that the problems that have been identified at Pennine acute are all down to a lack of funding. To be fair, I think the hon. Member for Blackley and Broughton accepted that the questions went much wider than funding. It is an easy get-out to simply blame a lack of funding.

[Debbie Abrahams]

Does the hon. Gentleman accept that the NHS estimates a shortfall of £1 billion for the Greater Manchester health economy by 2020 under the devolution deal? Does he also accept the differences between the consolidation of different sites into specialist units and the huge shortfall that has meant that Pennine acute has not been able to recruit staff?

[Mr Nuttall]

There are two separate points there. On the first, I have been involved in politics for getting on for the best part of 40 years, and I have never come across a time when it has been claimed that the NHS is not short of money. I cannot remember a time when the parties have all agreed that the NHS was getting all the money it needed. In every general election that I have ever been involved in, there has always been this claim that the Conservative party is about to privatise the NHS and the NHS is short of money. We are not very good at it—if we had been, we would have privatised it years ago, were that the Conservative party’s intention. The fact of the matter is that Pennine acute alone is a huge organisation, with a budget of more than half a billion pounds. Even with our small part of the NHS, such sums of money are difficult to comprehend, never mind the totality of it.

We can all argue that our particular part of the NHS should be given more funding, but in reality the NHS will always be competing with all the other calls on the public purse. If we are to stick with the current funding model, we will only ever be able to increase spending on the NHS significantly if we have a strong and growing economy. I do not want to get bogged down in the broader questions about our NHS, however, because the specific issue this morning is the future of Pennine Acute Hospitals NHS Trust.

The CQC report identified major problems with the leadership of the organisation. Like the hon. Member for Blackley and Broughton, I have every confidence that Sir David Dalton and his new team will bring a fresh approach and outlook to the trust. The one worry I have is that we are perhaps expecting too much of that gentleman. He is clearly a very talented man, but we are all limited by the fact, no matter what our particular talents may be, that there are only 24 hours in the day. I have heard anecdotal stories that he is pulled from pillar to post because he has so many demands on his time. That is understandable; it is not in any way a criticism. It is just a fact of life that he is being asked to do an awful lot. I wish him every success in the world. I hope he can deliver, and I am confident that he will but, if I have one concern, it is that he is perhaps being asked to do too much. I understand that he is focusing on trying to have a more decentralised approach to management to bring management closer to those the trust seeks to manage, and I hope that that will improve matters.

My second point is the issue of maternity services. The removal of children’s services and the closure of the maternity department and the special care baby unit at Fairfield occupied much of my time for years when I first moved to the Bury North constituency. Almost everyone thought that the services at Fairfield were excellent. At the time, my constituents and I were told that things would be even better—even safer—if services were closed at Fairfield and moved to North Manchester and Bolton hospitals. I made it clear that I had doubts about that, as did my constituents. I do not want to quote again from the CQC report, but I want to put on the record this particular quote from it:

“We found poor leadership and oversight in a number of services, notably maternity services, urgent care (particularly at North Manchester Hospital) the HDU at Royal Oldham hospital and in services for children and young people.

In all of these services leaders had not led and managed required service improvements robustly or effectively.”

My constituents could be forgiven for saying, “We told you so.” They can understandably feel vindicated on the stance they took. Incidentally, I understand from a councillor who serves on the Pennine acute scrutiny committee that it was told that the trust was liaising with Newcastle hospitals to learn best practice for maternity services. However, some little time later, when the scrutiny committee asked how that was going and followed up on that idea, it was told, “Sorry, it never went ahead. We are not proceeding with that now.” That little anecdote perhaps gives some idea as to why the CQC discovered problems.

In conclusion, I will make a quick third point. I believe that what Pennine acute would benefit from most in the months and years ahead is a period of stability. It seems to me that part of the problem at Pennine is the constant chopping and changing of leadership. No sooner does one team settle in than they move on and someone else takes over. The difficulty is the resultant lack of accountability. When things go wrong, it can always be blamed on someone else, whether that is to do with a lack of funding or decisions made by a previous management. My constituents and I need to see an end to the changes; we need to see some continuity. My constituents want Pennine acute to be a success. Other NHS trusts are successful, so there is no reason why, with the right leadership in place, Pennine acute cannot be as successful.

Children’s Wellbeing and Mental Health: Schools

David Nuttall Excerpts

Tuesday 10th January 2017 Westminster Hall

[Norman Lamb]

I thank the hon. Lady for that intervention. Given that I was responsible for that report, I feel very strongly about its absolute importance. I chaired a commission for the Education Policy Institute that reported last November, and we were pleased that the Secretary of State for Health came to speak at the launch, which I thought was important in itself. We looked at what has happened since “Future in mind” and in some parts of the country they are doing great work, but in others very little is happening. Very little has changed, with the bulk of the money still going to the acute end of the spectrum and not being reinvested in preventive care.

Critically, in many areas of the country, as the YoungMinds survey showed, 50% of clinical commissioning groups are not spending all the money—the additional investment secured in the coalition Government’s last Budget. They are not spending the full allocation on children’s mental health. I think that is scandalous. It amounts to theft of money solemnly pledged by the Government for children’s mental health, yet in many areas it is being diverted to prop up local acute hospitals. We cannot tolerate that. The Government have to find ways of ensuring that all that money is spent as intended. I know that the Government plan to have greater transparency, with Ofsted-style ratings for CCGs, but frankly there needs to be more than that. When a CCG is under financial stress, it is just too easy to shave a bit off children’s mental health to spend it where the public are clamouring for action, because ambulances are stacked up outside the A&E department.

In the first year after “Future in mind”, the system that we designed meant that local areas would get the money only if they produced a transformation plan to show how the money would be spent on changing the system to focus more on prevention. My proposition to the Government—the EPI commission report said this—is that every year the money should be tied to a commitment from the CCG that every penny of it is spent on children’s mental health. The CCG must also demonstrate that it has stuck with the plan from the previous year and that it has a plan to continue the change in the subsequent year. Unless we use the money to drive change in local areas, it will not happen because the system is under so much strain.

The other point argued for by the Education Policy Institute commission was that the Prime Minister should launch her own Prime Minister’s challenge on children’s mental health, as the former Prime Minister did on dementia, because that sort of prime ministerial stamp of importance for this subject would be incredibly valuable. Yesterday was a start, but I challenge the Prime Minister to go further and launch a formal challenge of that sort.

My final point—I am conscious that other Members wish to contribute to the debate—relates to the importance of ensuring that when a child needs specialist treatment, they get it on time. This goes to what I regard as a discrimination within the NHS, because anyone who has a physical health problem benefits from a maximum waiting time. Whatever their issue is, they know that a standard maximum waiting time applies nationally. It is accepted that those standards are under strain, but at least they exist, and I know that they drive the system, from the Secretary of State’s office downwards, in looking at every individual hospital’s performance across the country.

On mental health, however, apart from the two maximum waiting time standards that we introduced in the last two years, there are no other maximum waiting time standards. There is no standard for children. Families across the country can be left waiting, sometimes for months, to get any treatment at all, and when they get referred too often they have to clear high thresholds. In other words, someone has to prove that they are really sick before they get any help at all. That dysfunctional and irrational approach completely contradicts the principle of early intervention.

When you have a child aged 15—as I did, a girl—who had an eating disorder and was turned away from treatment because her body mass index was not low enough, and who then got admitted as a crisis case two months later because the problem had been neglected, you are left in a state of despair. We need to ensure that children with mental health problems have the same right to timely, evidence-based treatment as anyone with a physical health problem does, and that they should be treated close to home rather than being shunted sometimes hundreds of miles away.

These are the burning injustices that exist for many families across the country who cannot pay to opt out of the system. We have a duty and a responsibility—the Government, in particular, have a duty—to ensure that those children get the treatment they need on a timely basis.

[Mr David Nuttall (in the Chair)]

Five Members wish to speak in the debate and I intend to call the Front-Bench spokesmen at 10.30 am, so if Members could keep their remarks, including interventions, to about seven minutes each, I calculate that we should get everyone in and share the time equally.

--- Later in debate ---

[David Rutley (Macclesfield) (Con)]

It is a pleasure to serve under your chairmanship, Mr Nuttall; it is the first time I have done so. I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing the debate. During his time in office he really helped to highlight the challenges in mental health and he continues, quite rightly, to put the spotlight on mental health now. We are all grateful to him for the work that he has done in this area.

It is clear—obviously partly because of the Prime Minister’s speech—to all of us who have tried to make some efforts on young people’s mental health over the last year that it has become a major issue. For me, it became absolutely clear that it was a critical issue around 18 months ago, when I had a group of about 10 young people come to Parliament for an induction day. In a gap in the Q and A session, I decided to ask them what they thought was the most pressing challenge that their generation faced. In unison, those 10 young people, who were studying for their A-levels and had great prospects ahead of them, did not talk about tuition fees or debt; they talked about mental health. They said that mental health is the challenge we need to deal with.

As I started to explore this area in more detail, I went to an event at a school—it was a Christmas party, I think—and spoke to one of the parents who happened to be involved in dealing with pupils with pastoral issues in another neighbourhood. She talked about the increased incidence of self-harm, particularly among young women, which the hon. Member for Bridgend (Mrs Moon) mentioned. I then had the chance to speak to a number of children who were not actually dealing with mental health challenges in their own life but who were really worried about how they could help their friends who were. They were coming home and asking, “How do you deal with a friend who is involved with self-harm, or who is considering it?” Trying to come up with those solutions is a heavy burden for a 12 or 13-year-old, so these issues need to be tackled urgently.

I am grateful to YoungMinds for the work it is doing. As I have spoken with its chief executive, Sarah Brennan, and her team, it has become clear that mental health is now not just a challenge for the one in 10 children who we have heard about, or the one in 12 to one in 15 children who are dealing with self-harm; the latter figure could even be higher, according to the hon. Member for Bridgend. It is clear that young people’s mental health is a growing challenge. It is not just static; it is growing. Therefore, because of the increase in the number of referrals and because of the challenges that exist—from talking to my local mental health service provider, Cheshire and Wirral Partnership, I know that they exist—we must tackle the issue. As I have said in previous debates, the issue is amplified by social media. Feelings of low self-esteem and low self-worth need to be tackled and we need to help build resilience.

Although, obviously, not everything has been done yet, the Government took an important step forward with the “Future in mind” report, and credit needs to be given to the Prime Minister for her efforts and for the initiatives she put forward yesterday: mental health first aid training for teachers and staff; a thematic review by the Care Quality Commission, with Ofsted support; a new Green Paper on children and young people’s mental health; and the absolutely key aim—it has not been mentioned in this debate but we must ensure that it is delivered—that by 2021 no child will be sent away from their local area to be treated for general mental health disorders. My hon. Friend the Member for Bury St Edmunds (Jo Churchill) highlighted that concern. The Prime Minister was honest enough to highlight that treatment is only part of the answer. What we need to do now is prevent mental health challenges and build resilience.

Something else that has not been mentioned today is the important investment of nearly £68 million in digital mental health services to provide online therapies. It is absolutely critical that we can multiply the expertise out to as many people as possible, making it easily accessible through digital technology.

In the couple of minutes I have remaining, I want to highlight what else we need to do next. We need to learn from best practice. Peer-to-peer support does not cost a huge amount and we need to ensure that we do it. The Emotionally Healthy Schools programme in Cheshire East has been particularly helpful. We must also ensure that there is counselling support and space available at school.

I know that you are keen for me to wind up, Mr Nuttall, but let me just say one thing in conclusion. We need to ensure that the digital funding that is available pushes forward recognition for greater support from social media themselves. Often social media are a cause or an amplifier of mental health challenges. We must ensure that easily accessible apps are in place to support these young children.

Finally, given what the Prime Minister has said, it is time for our various third sector charities to come together with a clear set of asks for the Government and a clear plan of action that they would like to see us take forward; YoungMinds, the National Society for the Prevention of Cruelty to Children, Barnardo’s and all organisations that have clear expertise bringing to bear a clear plan of action that will deliver for those young people who are suffering and those we do not want to see suffer in the years ahead.

[Mr David Nuttall (in the Chair)]

I ask the Front-Bench spokespersons to restrict their comments to nine minutes, so that we can leave a couple of minutes for the mover of the motion to wind up at the end.

Community Pharmacies

David Nuttall Excerpts

Monday 17th October 2016 Commons Chamber

[David Mowat]

Yes, I can assure the hon. Lady that we fully understand the issues in places such as Cumbria. To an extent, the access scheme is designed to make sure that large rural communities are properly protected. I can only repeat that we value the services that pharmacies provide and that we do not believe that there will be a substantial detriment to them as a result of a bit less clustering.

[Mr David Nuttall (Bury North) (Con)]

Given that as part of the Greater Manchester devolution deal, the Greater Manchester health and social care partnership has taken control of the £6 billion a year health budget, will Greater Manchester be treated differently? If not, is there not a case for the area to be allowed to determine for itself how best to make use of community pharmacies?

Dietary Advice and Childhood Obesity Strategy

David Nuttall Excerpts

Monday 23rd May 2016 Commons Chamber

[Alistair Burt]

I thank the right hon. Gentleman for taking the opportunity of the report’s publication to give the Government the chance to respond and, hopefully, to put in the public realm a degree of concern about the report to back up the comments that he has made. I can do no better at this stage than quote what the chief knowledge officer of Public Health England, Professor John Newton, said today:

“Suggesting people should eat more fat, cut out carbs and ignore calories conflicts with the broad evidence base and internationally agreed interpretations of it.”

He continued:

“This opinion paper from the National Obesity Forum and Public Health Collaboration is not a systematic review of all the relevant evidence. It does not include an assessment of the methodological quality of the studies and should not be confused with the comprehensive reviews of the evidence that are produced by our process. For example, this paper highlights one trial suggesting high dairy intake reduced the risk of obesity, while ignoring a systematic review and meta-analysis of 29 trials which concluded that increasing dairy did not reduce the risk of weight gain.”

I am pleased that the right hon. Gentleman has given us the opportunity to agree with him and others who have said the report is irresponsible.

To respond to the right hon. Gentleman’s questions for the Government, it is clear that the childhood obesity strategy will be much welcomed, but it has to be soundly based. Much though I would like to give a date, I have to say that its launch will indeed be “in the summer”, and the summer is in parliamentary terms a flexible period. In saying that, I do not in any way minimise its importance.

The presence of my hon. Friend the Minister for Children and Families demonstrates that this is a cross-Government strategy. We know it will be scrutinised by many different parties, so it has to be right to give the guidance the right hon. Gentleman talks about. One can look at any national newspaper—one in particular—any day of the week and read conflicting advice on what is good and what is bad. Whereas that might be a source of amusement to the news programmes, for parents looking for what is right for their children, it is vital that they have advice they can trust. That is why the childhood obesity strategy, much commented on in this place, is so important.

The right hon. Gentleman is an important voice in dealing with diabetes. “Healthier You”, the national diabetes prevention programme based on international evidence, will start this year in 27 areas covering approximately 45% of the population and making up to 10,000 places available to people at high risk of developing diabetes, and will roll out to the whole country by 2020. The right hon. Gentleman is right to emphasise the importance of diabetes. I hope he acknowledges that that is recognised by the Government.

[Mr David Nuttall (Bury North) (Con)]

Does my right hon. Friend not agree that instead of all this complex and conflicting nanny state advice, it would be far better simply to advise children to move about more and eat less?

[Alistair Burt]

I am delighted to welcome the question from my hon. Friend the Member for Bury North—may God bless all who live there. I had a small bet with the Secretary of State on how long it would be before the words “nanny state” were uttered, and I was not disappointed.

My hon. Friend is right to ask the question, and we still want to encourage children to move more and eat less—there is nothing contradictory about that. However, a Government who take children’s health seriously, whether in relation to dentistry, deprivation and the environment, or indeed their physical health, weight and wellbeing, are as entitled to comment on this issue as anyone else. The childhood obesity strategy will not contradict efforts to encourage physical activity, but it will, I hope, have elements that my hon. Friend and everyone in his constituency welcomes.

Oral Answers to Questions

David Nuttall Excerpts

Tuesday 10th May 2016 Commons Chamber

[Mr Hunt]

I recognise that we have a difficult situation in Chorley and that people in that trust are working very closely together. The chief executive of the trust pointed out that the reason for the closure was that neighbouring trusts were not respecting the caps on agency staff that she was respecting. It is incredibly important that, across the NHS, we have a concerted effort to bring down the prices paid for agency staff, which I think is the root problem here. However, we are monitoring the situation closely.

[Mr David Nuttall (Bury North) (Con)]

But how will my right hon. Friend’s powers to ensure good quality accident and emergency provision in hospitals across Greater Manchester be affected by the devolution of health and social care responsibilities to Greater Manchester councils?

[Mr Hunt]

I can reassure my hon. Friend that, although we are happy to put the local authorities in Greater Manchester in the driving seat for some major changes, including what I hope will be the first full-scale integration of health and social care across the NHS, we are monitoring the performance against national standards. We will be able to see exactly how well they do on patient safety, waiting times and so on, and whether they live up to the big promises that have been made.

Meningitis B Vaccine

David Nuttall Excerpts

Monday 25th April 2016 Westminster Hall

[Mr David Nuttall (Bury North) (Con)]

As always, it is a pleasure to serve under your chairmanship this afternoon, Mr Pritchard.

I want to share the story of Charlie. Charlie Edmondson is a lively, boisterous four-year-old. I know him because he attends the Sunday school at St Anne’s church in Tottington in my constituency where, for the past seven years, I have been one of the church wardens.

Last year, at midnight on 15 December, just two days after Charlie took part in the Sunday school’s annual Christingle and nativity play, he woke up and complained to his mum, Rose, that he was not feeling very well. He had a high temperature, but his twin sister had been ill the previous week and his parents had not felt 100%, so his mum understandably thought Charlie was probably going down with a similar bug.

Rose tried to get Charlie’s temperature down with Calpol and some Nurofen, but the next morning he woke at 6 am looking extremely pale, with dark rings under his eyes, and his breathing seemed quite fast. His mother put the symptoms down to a viral infection and assumed he would start to feel better after he had been sick. Never in a million years did she think it could be meningitis.

Charlie went downstairs and, after some more Calpol and ibuprofen, he seemed to perk up and managed to eat some breakfast. At about 10 am, as he and his mum settled down to watch Tim Peake go up in a space rocket, something that would normally excite the imagination of any young boy, he started to chat less and became quieter. At that point, his mum became concerned about a pinprick rash that had appeared. It did not look like a typical viral rash, and doubts started to form in her mind.

After they had watched Tim Peake go into space, Rose noticed Charlie was staring vacantly at the television, but she put that down to him perhaps being a little sleepy. Shortly after that, Charlie was sick, and he fell asleep next to his mum on the couch. As his mum said:

“I don’t know what prevented me from putting him in his bed and to keep him on the couch—it would have been so easy to do that and he may not have been so lucky.”

While Charlie was napping, his mum noticed what she thought was a bruise on his upper leg, with one on his arm and another small one near his neck. Rose knew that was a potential sign of blood poisoning, and she started to piece together the other symptoms. She looked at the Meningitis Now website for the checklist of symptoms. She called her husband, who told her to call their GP. Unfortunately, the GP closed at lunchtime, but she was put through to an out-of-hours doctor, who told her to call 999 immediately. She decided to check the rash, to see if it disappeared with a glass— it did not.

Rose called 999 and was told that an ambulance would be sent straight away. When the fast-response car arrived, Charlie was lying on his side on the couch. He immediately had antibiotics administered to him. The ambulance arrived about five minutes later and took him to the Royal Bolton hospital, which, as his mum said, did “an absolutely amazing job”. The hospital staff explained everything they were doing, including when they decided to induce Charlie into a coma and he was transferred to the intensive care unit at Alder Hey children’s hospital. At that point, they told his mother that they were treating him for meningitis B.

Charlie stayed in Alder Hey until Christmas day, including eight days in intensive care. He received fantastic care and treatment, but his family were disappointed that they were not given more information about meningitis and its after-effects. At this point, however, I will place on the record the enormous help that the charity Meningitis Now gave to Charlie and his family. I know that they are all extremely grateful. The charity sent them lots of information and they found that reading others’ stories helped them to understand the impact that the disease can have. It helped them to cope.

Unfortunately, three days after Charlie’s initial discharge, he was readmitted to the Royal Bolton and then Alder Hey, as he was struggling to stand and walk. The doctors suspected he might have a bone infection. That meant another week in hospital, including over new year, but he was finally discharged, with much more mobility, as the doctors discovered that the problem was inflammation around his ankle and hip joints. As an MMR scan confirmed, the meningitis had scarred his bones. It was two months before Charlie could walk and stand properly.

Charlie will continue to be monitored by Alder Hey for the next few years, to keep an eye on his growth plates. As Charlie’s mum said:

“I will be forever grateful that Charlie can say he has survived meningitis and I want him to remember how lucky he is and we are that he is still here despite being hit with such an awful, awful disease.

The speed at which this disease acts is frightening and the symptoms can be so easily confused with other things. This is why it’s so very important to recognise the signs and symptoms quickly.”

I hope that one benefit of this afternoon’s debate will be that more people learn the signs and symptoms, and know what to do. Understandably, Charlie’s parents want to see the roll-out of an improved meningitis B vaccination programme, so that others will never have to go through what they had to go through. Mr and Mrs Edmondson did not know that they could have vaccinated their children privately until the consultant told them that he had vaccinated his children because he knew how important it was.

I appreciate that even with the increased resources being made available to our NHS, the advances in medical science, new treatments, new drugs and a growing and ageing population inevitably mean that difficult decisions have to be made. Of course it will be costly to vaccinate even up to only the five-year-old age group, but when one considers the loss of life, the cost of treating cases such as Charlie’s—which one healthcare professional put at £30,000 to £40,000—and the suffering of children such as Charlie, along with the heartache, anxiety and distress of the parents, the cost of the vaccination suddenly starts to look very cheap indeed.

As you know, Mr Pritchard, I am not one to present problems without trying to find a solution for Government, so let me suggest another source of funding: the millions of pounds spent on trying to persuade adults who, despite years and years of warnings about the dangers of smoking, nevertheless continue to do so. If they have not stopped by now, when will they? Those adults have a choice and they choose to continue to smoke. Some of the millions spent on increasingly ineffective stop-smoking campaigns could be spent on children, who have no choice.

Oral Answers to Questions

David Nuttall Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Alistair Burt]

I will happily look at anything that might assist us. As the hon. Lady knows, we are caught in the process of trying to deal with a court judgment and the issues surrounding mental capacity in relation to deprivation of liberty safeguards, which are genuinely serious and cannot be easily changed at the stroke of a pen, as well as the extra costs that the problem has raised. We are now close to hearing the Law Commission’s post-consultation proposals. I understand that it will publish its latest analysis in mid-May and will have drafted detailed legislation by the end of December. I will look at any suggestion of hers that might ease the situation practically.

[Mr David Nuttall (Bury North) (Con)]

Will the Minister confirm that when the new legislation is finally introduced, it will be simpler to understand and result in fewer bereaved relatives facing distressing delays when a loved one dies in care?

[Alistair Burt]

My hon. Friend is absolutely right. What has caused the confusion has been a definition of loss of liberty and dying in state detention that bears no relation to anyone’s common-sense understanding of the situation. Whatever new legislation is proposed by the Law Commission, it must meet the test of being much simpler, but it must also meet the legislative test of meaning what it says so that it does not get disrupted in the courts again.