Oral Answers to Questions

Debate between Eddie Hughes and Steve Brine

Monday 7th March 2022 Commons Chamber

[Steve Brine (Winchester) (Con)]

4. What steps his Department is taking to help rough sleepers find accommodation.

[The Parliamentary Under-Secretary of State for Levelling Up, Housing and Communities (Eddie Hughes)]

We have committed more than £800 million to tackle homelessness and rough sleeping in this year alone. That includes the investment of £202 million through the rough sleeping initiative fund, which provides 14,500 bed spaces and approximately 2,700 staff throughout the country. We are also helping people to find longer-term accommodation, including through the £433 million rough sleeping accommodation programme, which we expect to provide 6,000 new homes before the end of this Parliament. So far, we seem to be having some success, because the rough sleeping snapshot taken in November and announced a couple of weeks ago shows that numbers have fallen for eight years in a row.

--- Later in debate ---

[Steve Brine]

He is giving me a thumbs up—excellent.

Does the Minister agree that we have to borrow what works—Winchester is happy to show what works in this regard—and then scale it up throughout the country? At the end of the day, it is wraparound care that is going to break the cycle.

[Eddie Hughes]

I guess that is the point: we need to legislate nationally and provide funding but trust local authorities, local areas and the excellent services of Trinity Winchester and others of that ilk to provide a bespoke service based on local demands. I am delighted that the Secretary of State is going to visit that scheme.

HIV and World AIDS Day

Debate between Eddie Hughes and Steve Brine

Thursday 29th November 2018 Commons Chamber

[Eddie Hughes (Walsall North) (Con)]

I just want to say briefly how fortunate I feel I am to have been walking past the Chamber, seen that there was this debate and taken the opportunity to come in. My first wife was a nurse, and I remember when she came home from work—I think 27 years ago—having just treated her first AIDS case, and we were both scared. Since then, the treatment of it and the understanding and appreciation of it in society have changed so dramatically. I realise now, having heard the speech of the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle), that there is still some way to go for those who are hesitant about telling new friends and acquaintances, but it felt like a genuine privilege to have been here to hear him speak, so I thank him very much.

[Steve Brine]

I thank my hon. Friend for his intervention.

As I was saying, much has changed since the late ’80s: health needs are different; we have better drugs and better diagnostic tools; and, as has been said, attitudes towards HIV and AIDS are totally different and totally transformed.

The hon. Member for Kensington mentioned Princess Diana—the original one, as opposed to the new one—and that incredible moment. I will repeat what I said the other night in Speaker’s House. I was in secondary school at that time, and I remember that powerful image being broadcast. I was only a teenager at the time, and little did I know that I would one day be the public health Minister talking about these issues. It was one of those images that is really seared into our national conscience. What a great loss that lady is to so many social causes, as well as of course to her family. It was an incredible image.

As the hon. Member for Brighton, Kemptown has said, today, it is not about dying of AIDS, but about living with HIV. I would go further, however, because it is about more than that, is it not? It is not really “living with”; it is just “living”. I am also very privileged to be the cancer Minister, and how many times cancer patients say to me—my shadow, the hon. Member for Washington and Sunderland West (Mrs Hodgson), knows this, because people very often used to say this to us when we ran the all-party group on breast cancer together—that, “I am not my cancer. It is just something that I do and something that I have as well.” Happily, HIV is now just part of the hon. Gentleman: I am sure he would rather it was not, but it is not just something he lives with; it is something that he lives.

A big public health display in the foyer of the Department of Health and Social Care currently shows all the different public health campaigns over the years. The terrifying tombstone image is obviously something that we have, rightly, moved on from, but it is still an incredible part of our public health campaign history. Back then, the Government made the bold move to run a major public information campaign on HIV—“Don’t die of ignorance”—and we piloted needle exchange schemes, introduced HIV testing and raised the prospect with the public. If we consider the HIV epidemic in this country, we can be proud of the record of Governments of all parties over many years.

As figures released today show, the UK has met the UNAIDS 90-90-90 target—yes!—and it is one of the first countries in the world to do so. Members from across the House are proud of that, and the latest report from Public Health England showed that in 2017 an estimated 92% of people living with HIV in the UK were diagnosed, 98% of those were on treatment and 97% of those on treatment were unable to pass on their infection. That is a major achievement that we should be proud of. More importantly, those who work in our health service and have done so for years—like the partner of my hon. Friend the Member for Walsall North (Eddie Hughes)—should be even more proud.

Prevention is one of my passions, and one of the Secretary of State’s priorities. We do not yet have a cure for HIV, which is why prevention is so important. Our efforts to prevent HIV and AIDS have been highly successful, and much has been said about the international dimension, which I will touch on. The UK is a world leader in efforts to end the AIDS epidemic, including through our major investment in the global fund. Our largest investments are through multilateral organisations such as the Global Fund to Fight AIDS, UNAIDS and Unitaid, given their greater reach and scale. I met Lelio from Unitaid at the G20 in Argentina last month, and it is doing such good things with the investment that we announced in Amsterdam, to which the hon. Member for Cardiff South and Penarth (Stephen Doughty) referred. I work closely with my hon. Friends in the Department for International Development and the Foreign Office, and these three Departments are very tight and work closely together on this issue.

Excellent initiatives such as the MenStar Coalition aim to get more young men tested and on to life-saving HIV treatment to protect them and their partners. There is the Elton John AIDS Foundation and other partners, and MenStar is rolling out a self-testing campaign in east Africa. The UK is the second largest donor to Unitaid—a charity that does so much work against stigma—and provides an annual contribution of around €60 million as part of our 20-year funding commitment.

There has been much talk about the domestic situation, and NHS England launched the world’s largest pre-exposure prophylaxis—PrEP—trial last year. To be honest, I had never heard of that until I became a health Minister—why would I have?—but once officials had explained it to me, it did not take me long to think that it sounded like a real no-brainer. I know that many people are eagerly awaiting the results of the trial. I am one of them, and my officials know of my impatience, which is legendary in our Department. It is crucial to have the right information to address the major questions and effectively implement the PrEP trial on a larger scale.

The point about savings was well made and not lost on me. I am not in a position to make a policy promise at the Dispatch Box today, but on the point about places made by the hon. Members for Brighton, Kemptown and for Cardiff South and Penarth, I say only that I am listening closely and they should continue those discussions with me—I know they will. The Department met members of the all-party group on HIV and AIDS to discuss these issues, and they should continue those discussions with me. We are listening. Many of the public health challenges we face today require different approaches and fresh thinking if we are to make progress. Indeed, in the past few years many innovative ways to tackle HIV have emerged, including HIV testing options such as self-sampling and home testing services, which I know are very popular.

I would like to mention the HIV prevention innovation fund, which I am very proud of. Innovative community-led interventions have had a significant role to play in limiting the HIV epidemic in England, so we set up the HIV prevention innovation fund in 2015 to support voluntary sector organisations. The fund has supported many projects since it started. I announced them at an event here in the House last year—the hon. Member for Cardiff South and Penarth, who chairs the all-party group, was present. In 2017, we awarded just under £600,000 to 12 projects. I am very pleased to say that we are running the fund again this year. The principle of the fund is something we are carrying over into other areas of policy, because it has been so successful. I want to see us do more of that.

This year we celebrated the 70th birthday of the NHS. I have already mentioned the incredible staff who work across the service. England has an outstanding record of achievements in HIV treatment and care. I want to take this opportunity to recognise and thank everyone for doing that. Care for people with HIV is now highly effective, and increasing numbers of people are living with HIV into older age with normal life expectancy. Antiretroviral therapy has transformed the outlook for people living with HIV, from what used to be a tragic death sentence to a very manageable long-term condition, as we heard so eloquently this afternoon.

Our policy is to make sure that HIV testing is as accessible as possible, in particular to those at increased risk. It is therefore very important that testing is available in a range of clinical and community settings—hence why the innovation fund and its programmes are important. Over the years, local authorities, which are now public health authorities up and down the land, have introduced innovations and improvements of their own, in particular on testing. We know it is working. Testing activity at sexual health services, which we know are under great pressure—we do not deny that for one moment—continues to increase and HIV diagnoses have fallen. HIV testing in sexual health services has increased 15%, from 1.07 million tests in 2013 to 1.24 million in 2017. Most significantly, we have seen a 28% drop in new HIV diagnoses between 2015 and 2017. That is encouraging and good, but we must not be complacent. I assure the House that we are not complacent and we want to continue to maintain this progress.

The hon. Gentleman mentioned the prevention strategy. That was a very top line document. I had a meeting this afternoon to discuss the prevention Green Paper, which will follow next year. I can assure him that the long-term plan, which will follow before that, will absolutely have sexual health and HIV in it. I am being very ambitious with officials on that. I know that he will rightly hold us to account and I thank him for giving me a chance to say that.

I want to touch on education and awareness. Education around HIV and how it is transmitted remains absolutely critical, as the hon. Member for Brighton, Kemptown said in his opening remarks. I am pleased to say that schools will be required to teach relationship and sex education from September 2020. The Government announced that relatively recently. I have been very involved in that in relation to the cancer brief, because I am very keen for schools to responsibly teach cancer awareness to young people. At secondary schools, there will be clear and accurate teaching about sexual matters, including factual knowledge around sex, sexual health—including HIV—and sexuality. The schools Minister was sitting next to me throughout his speech. He wanted me to pass on his congratulations to the hon. Gentleman on his speech.

Testing is the only way to be certain of HIV status. Last week was National HIV Testing Week and the Secretary of State took part. This flagship campaign promotes regular testing among the most at-risk population groups and aims to reduce the rates of late diagnosis or of those remaining undiagnosed. Sadly, stigma remains a significant factor in why people do not test for HIV. I understand that. This can mean that HIV goes untreated and can then be transmitted. It is vital that we continue to break down the stigma, normalise testing and support those most at risk of infection.

I want to mention the “Can’t Pass It On” campaign. Whoever is doing the marketing for the Terrence Higgins Trust is doing a very good job—I know it works with a very good agency. As I said at the reception the other night, I was on the tube the other day with my daughter, who spotted some advertising or branding for testing week. She asked me what it was, because it caught her eye, and I was able to explain it to her. She is only 11. If more parents did that for their children and relatives, it would help to break down that stigma. The trust’s website has a very good page on the “Can’t Pass It On” campaign that includes different people’s stories, and I have a funny feeling that before we leave the Chamber, “Lloyd’s story” will be on it, with a clip from today in Parliament. I will certainly be clipping it off the Parliament TV website and tweeting it out through the Department of Health’s social media account.

In conclusion, I congratulate the hon. Gentleman again on introducing this timely and vital debate, and I wish him and everybody well for Saturday who will be marking World AIDS Day, whether they be remembering and celebrating private, not yet able to do so publicly, and those who, like him, are able to do so publicly. They are all part of the story, and our best wishes and love go to them all. We look forward to brighter futures in this policy area, as we work towards what I am determined will be zero stigma and zero transmissions.

Acquired Brain Injury

Debate between Eddie Hughes and Steve Brine

Monday 18th June 2018 Commons Chamber

[Steve Brine]

I thank the hon. Gentleman for his intervention. I hope to get to his part of the world at some point while doing this job and it may be that I could visit it while I am up there.

The World Health Organisation states that rehabilitation intervention should be aimed at achieving the following five broad objectives: preventing the loss of function; slowing the rate of loss of function; improving or restoring function; compensating for lost function; and maintaining current function. NHS England’s Improving Rehabilitation programme applies those principles, rightly, in a holistic way to encompass both mental and physical health. In 2015, the programme published the “Principles and expectations for good adult rehabilitation” to support commissioners on delivering rehabilitation care locally in our constituencies. This document describes what good rehabilitation looks like and offers a national consensus on the services that we think people should expect.

[Eddie Hughes (Walsall North) (Con)]

It is important that we consider that it is not just trauma with regard to ABI. One of the other causes might be excessive exposure to carbon monoxide, so I was grateful to the support that Headway gave to my private Member’s Bill, which seeks to introduce mandatory carbon monoxide detectors in new-build and social rented houses.

[Steve Brine]

My hon. Friend makes an excellent point. As I said at the start, obviously there are non-traumatic injuries—so, through conditions, and meningitis and stroke were two examples that I gave—but he is absolutely right to point out that issue. I congratulate him on his success with his Bill.

The rehabilitation programme includes 10 principles and expectations that were designed by people who use rehabilitation services—the carers, healthcare professionals, commissioners, strategic clinical networks and national clinical directors. Building on this, in 2016, NHS England published further rehabilitation guidance covering both adults and children. This provides local service planners with a commissioning model, a range of case studies and crucially, an evidence base for the economic benefits of delivering high-quality rehabilitation services.

While the vast majority of rehabilitation care is locally provided, NHS England commissions specialised rehab services for those patients with the most complex levels of need. Teams within trauma units assess and develop a rehabilitation prescription for patients with ABI. Through this, patients can access specialists in rehabilitation medicine, whose expert assessment helps to inform the prescription. The teams manage ongoing patient care, including a key worker to support patients through the pathway and into rehabilitation at a level appropriate to their clinical need, in accordance with their clinician’s advice—be that highly specialised rehabilitation or through a local provider in the local network.

I want to mention the Rehab Matters campaign. As I said, rehabilitation is a key part of the patient’s recovery. I saw at first hand the impact that this can have in helping people to recover from illness or injury when I visited the Hobbs rehabilitation centre in my Winchester constituency earlier this year. The Chartered Society of Physiotherapy launched its Rehab Matters campaign here in the House at the end of October last year. It makes a very powerful case for community rehabilitation, and I think that all commissioners should ensure that levels of provision are meeting local needs and look to places such as the Hobbs centre as a good example of what can be achieved through rehabilitation care. The society produced a film that was made by the Oscar-shortlisted UK director, Chris Jones, called “Rehab Matters”, and I highly recommend it to Members interested in this area.

I am just going to skip over to research, and then close, because we have only an hour and I know that a lot of people want to speak. Let me just highlight the research being undertaken in this important area. We are investing over £1 billion a year in health research through the National Institute for Health Research. The NIHR is funding ABI research from basic science to translational research in civilians, military and sport. For example, we are investing over £100 million, over five years up to 2022, in a biomedical research centre in Cambridge that is developing new approaches to reduce the impact on patients’ health and wellbeing of neurological disorders, stroke and brain injury. We are investing £5 million to co-fund the surgical reconstruction and microbiology centre in partnership with the Ministry of Defence—that has been going since 2011. The centre specialises in research, taking discoveries from the military frontline to improve outcomes for all. We have invested about £16 million in brain injury research since 2014 through the NIHR health technology assessment programme, and we are investing just over £2 million over three years through NIHR’s global health research group on neurotrauma, which aims to advance global neurotrauma care and research to help to save lives, reduce disability from the trauma and improve the quality of life for patients with brain injury.

I fully recognise the devastating impact that acquired brain injuries can have on individuals and their families. The evidence shows that neglecting rehabilitation is a false economy. Rehabilitation equips people to live their lives, fulfil their potential and optimise their contribution to their family, their community and society as a whole. I am honoured to have introduced this debate and, as always in such debates, I look forward to hearing the views and insights from across the House on what further work or support is needed to reduce risk and improve the care available.