Healthcare Services: Carshalton and Wallington

Elliot Colburn Excerpts
Tuesday 23rd May 2023

(9 months, 1 week ago)

Westminster Hall
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Caroline Dinenage Portrait Dame Caroline Dinenage (in the Chair)
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I will call Elliot Colburn to move the motion and then I will call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
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I beg to move,

That this House has considered healthcare services in Carshalton and Wallington constituency.

It is a pleasure to serve under your chairmanship, Dame Caroline. I am grateful to the Speaker’s Office for granting the debate to talk about the important issues facing the NHS and patients living in my constituency. This is an opportunity not only to raise the good work being done by our local NHS staff but to focus on three or four particular issues. I thank the Minister and the Department of Health and Social Care for their continued engagement with me over the course of the past few years. They must be getting sick of my name coming up on their phones, but they have been gracious with their time and I am grateful to them for that.

One of the most pressing issues facing our local healthcare in Carshalton and Wallington concerns our local hospital St Helier. I will not dwell too long on what it means to me, as I have said this before in other contributions, but it was the hospital that I and most of my family were born in. It saved a number of my family members’ lives and not too long ago it saved my life as well, so I have a great sense of personal loyalty to this hospital. The staff do an absolutely incredible job, and they are doing it under very difficult circumstances because the hospital is incredibly old. It is older than the NHS itself, and that is starting to show.

The hospital suffers from more than just outdated aesthetics; the state of disrepair is showing, and that is evident to anyone who has to visit St Helier. It has been the subject of numerous news articles and television exposés in recent months. The BBC, ITV and The Observer have all covered the state of disrepair at St Helier. There is a litany of problems including the sinking foundations, the faulty lifts—they are so old that the parts to repair them are no longer readily available—and the leaking roofs causing wards to be closed. My inbox regularly features emails from patients who have had to deal with the fallout and repercussions of these issues when visiting the hospital or waiting for treatment, alongside stories and reports from staff working at the hospital.

As I say, the staff are doing an incredibly good job in difficult circumstances, which is why I am pleased that the Government have recognised the good work that the Epsom and St Helier University Hospitals NHS Trust do, agreeing to a several hundred million pound investment to upgrade St Helier and build a new second hospital in the London Borough of Sutton. However, it is no secret that we have been waiting on the next stage for some time, so I would be grateful to hear from the Minister when we can expect an update on the next stages of the new hospital programme. I invite him and members of the Department of Health and Social Care team to come down to St Helier to see some of these issues for themselves.

To go into some more detail about what the new funding will provide, as well as improving St Helier and bringing it into the 21st century to provide modern medical care, it will provide a second hospital working in partnership with the Royal Marsden in Sutton to provide specialist emergency care for the sickest patients living in the borough. It will develop a partnership with the cancer hospital next door so that more cancer treatments can be provided in the London Borough of Sutton and patients do not have to be transferred to the Chelsea site, which can be difficult considering that the connectivity between my part of London and Chelsea is not fantastic.

So, this news is really exciting and the trust is raring to go; it really wants to get on with this work. I think that is why it has been so keen to highlight these issues in the press in the past couple of weeks. As I say, it is very keen to get going.

The pandemic has caused a delay to the timetable for this work; I completely understand that. However, we are still waiting for that all-important decision. I know I have secured assurances before that the plan is in development, but I hope today to relay the sense of anxiety felt by the staff and my constituents, who want to see progress made on the new hospital. It is the single biggest issue relating to local healthcare provision and it comes up time and time again locally. Having worked in the NHS locally myself, I know full well how much this development is needed, not just to ease demand on St Helier but to improve patient outcomes and to allow more specialist services and treatments to be carried out locally. That includes protecting services that were threatened under previous iterations of healthcare planning in our local area, which ranged from reducing services to closing St Helier all together.

This is the first time that the NHS has been able to come forward to the Government of the day and secure agreement to fully fund a plan that will not only protect services in the borough but improve them. And that includes making sure that accident and emergency services, critical care, acute medicine, emergency surgery, in-patient paediatrics and maternity services are all protected within the London Borough of Sutton and not transferred elsewhere. That is incredibly welcome news, but again we need to see progress.

What I like in particular about this plan is that it is not a Government reorganisation. This is not about bureaucrats sitting in the Department of Health and Social Care; this is about the Department agreeing to listen to what the NHS has said it needs to provide good-quality healthcare in the London Borough of Sutton. That is fantastic, but—again—we need to see the next steps.

In the time that I have left today, I will touch on a couple of other issues facing healthcare provision in Carshalton and Wallington, particularly access to local GPs and dentistry provision. We have some fantastic GP surgeries, made up of incredibly hard-working teams from the GPs themselves all the way through to the advisers, triage nurses, reception staff and administration staff. However, I am hearing from constituents that they are often struggling to get an in-person appointment. In particular, I hear from older constituents who struggle to navigate some of the new technology. I completely appreciate the need for that technology, but I would welcome anything that the Minister can say about encouraging GP surgeries to make it easier for those who find the digital world difficult to make an in-person appointment when they need one. I say that because many people have come to me and said that they had to take themselves off to the emergency department because they simply could not navigate the new online booking system that many GP surgeries now have.

I am sure that the Minister will agree that that is not what we want to see, because it puts an incredible strain on the healthcare system and especially emergency medicine, which is already under immense strain. Of course, primary care was one of the hardest hit sectors during the pandemic, and it is clear that there remains a backlog, both in terms of people with existing conditions and because people put off seeking help during the pandemic.

However, it was heartening, and the Government should be congratulated for this, to hear the recent announcement of £240 million specifically aimed at GP practices and getting patients appointments, so as to avoid the so-called “8 am scramble”. Nevertheless, the “8 am scramble” is still very much a thing for many of my constituents; it is still something that I hear about far too often. So, while I welcome the recent announcement, I would also welcome any update that the Minister can give me today about where he believes we are on recruiting new GPs and retaining those already in the sector and how we will deliver on the promises to our constituents that they can access a GP whenever they need to.

May I make a suggestion to help with that process? I was really pleased to hear the Prime Minister talking up the importance of community pharmacists and the role that they can play in the field by providing a range of services. It is incredibly welcome to see that recognition of pharmacies, as many think they went unthanked during the pandemic when their doors were left open while GPs were largely not seeing patients face to face. Pharmacists are doing an incredible job. I do not have time to go into all the issues now, but the Minister will know from our previous conversations about their immense struggles with how the reimbursement scheme for drugs is set up, and the fact that they cannot balance their treatment and advice for minor ailments with the time they have to dispense drugs, which is where the money is. I would welcome any update from the Minister, or a commitment to look in more depth at what role community pharmacies can play in supporting our local healthcare system.

Finally, I want to touch on dentistry. I spoke about it in a Westminster Hall debate not that long ago, but I want to reiterate a few key points. I am still getting horror stories from people who are turning to DIY solutions because they are struggling to access an NHS dentist. I have met local dentists in my consistency; they are clear that the way in which units of dental activity are set up in the dental contract, and the way in which they get reimbursed for their work, disincentivises them from doing more. Many say that it will be simply impossible to meet the targets this year to avoid money being clawed back, and they are worried about what effect that will have at the end of the financial year. I welcome the fact that £15 million has been put into dentistry to deal with the backlog, but there are long-standing, system-led issues. They span multiple decades and multiple Governments, but the pandemic has brought it all to a head. I would welcome any update from the Minister about what the Department is doing to reform the way in which the dental sector is set up, so that people can assess NHS dentists a lot more simply.

There is no magic wand that we can wave to solve everything overnight, but we can certainly do some things to get us there in the meantime. I hope that the Department will be able to let us know the next steps for the new hospital programme very soon, as that would be incredibly welcome. In addition, what assurances can the Minister give that existing maintenance problems will not be impacted by the new hospital programme, and that funding can be accessed to deal with some of those problems? Finally, what work is the Department doing to ensure access to GPs and NHS dentists? That will help us to improve on the most important thing that we all want to see—including the Government and the NHS—which is a better experience and outcomes for patients.

New Hospital Programme

Elliot Colburn Excerpts
Friday 24th February 2023

(1 year ago)

Commons Chamber
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Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
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I begin by thanking you, Mr Deputy Speaker, and the Speaker’s Office for granting me this Adjournment debate. I give particular thanks to the Minister for responding to today’s debate. I understand that his Department is incredibly busy at the moment and is in the grip of very tough negotiations, so I appreciate his taking the time to come to the Chamber today to talk about this topic, which affects so many, not only in my constituency, but around the country.

In the 2019 Conservative and Unionist party election manifesto, one of the key pillars of our plan for the nation was to deliver 40 new hospitals by 2030. That truly remarkable investment in buildings and equipment across the NHS would ensure that our world-class healthcare system and staff have the facilities they need for the future. Later, in October 2020, the then Prime Minister levelled up the pledge, with a further eight schemes invited to bid for future funding, taking the total number to 48—the biggest hospital building programme in a generation.

There are four set cohorts within the new hospital programme, each of which includes a wide variety of schemes: in flight, early small schemes, pathfinder and full adopter. The new hospital programme has now met some major milestones: the first of the full 48 hospitals, the Northern Centre for Cancer Care, has been completed, and six further hospitals are under construction.

Dean Russell Portrait Dean Russell (Watford) (Con)
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My hon. Friend will no doubt be speaking about his constituency, but I would like to thank the Minister for recently visiting Watford General Hospital and seeing the challenges we face and the fantastic staff we have there. Does my hon. Friend agree that making sure Watford General has the best world-class facilities is paramount, not just for the patients, who deserve it, but for the staff and the local community across the whole of west Hertfordshire?

Elliot Colburn Portrait Elliot Colburn
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I am grateful to my hon. Friend for that intervention. He is a fantastic champion for Watford—indeed, I see him here far too often talking about issues to do with Watford—and he has once again demonstrated why his community are lucky to have him as their local Member of Parliament.

Healthcare improvement in Carshalton and Wallington was a key pillar of my personal pledge to constituents at the last general election, which was to protect our local hospital, St Helier, and build a brand-new, state-of-the-art hospital in the borough. I am incredibly grateful and proud that as part of the new hospital programme, the Government have committed the funding to do just that: to create a purpose-built major specialist emergency care hospital in the London Borough of Sutton and to transform Epsom and St Helier hospitals, ensuring that local people can access the care that they need, from life-saving emergency care to out-patient appointments. Despite the scaremongering by Labour and the Liberal Democrats over many years, it is a Conservative Government who are delivering the biggest investment in healthcare in south-west London and the Surrey region in a generation.

When I delivered my maiden speech in this House, I made it clear that healthcare was the single greatest issue affecting my constituents and the single greatest opportunity to improve Carshalton and Wallington. It remains the greatest issue today, along with tackling the cost of living, and St Helier is one of the many recurring topics under my name in Hansard. I am grateful to the Minister and his Department for working so closely with me on the issue in recent years. I assure him that the sooner the new hospital is built and upgrades are made to St Helier, the sooner I will stop banging on about it; I give the Speaker’s Office the same assurance.

Let me set out the background. St Helier Hospital predates the NHS. It was first commissioned in 1934 and became operational in the early 1940s, during the second world war. At the time, it was considered a state-of-the-art, modern design; I believe it was the largest hospital of its type anywhere in the country. It was damaged by a bomb in an air raid less than a month after its completion, and by two flying bombs later in the war, but it remained open and operational. It showed the same resilience throughout the pandemic.

Like many people in Carshalton and Wallington, I and many members of my family were born in St Helier. I owe the hospital so much, not just for bringing me, my family and my constituents into the world, but for saving my constituents’ lives, my loved ones’ lives and, not that long ago, my own life. St Helier has served our community for generations, but we are now in desperate need of an upgrade to provide healthcare fit for the 21st century. That is why the announcement of the new hospital and the improvements at St Helier was so welcome.

There has been a lot of scaremongering about St Helier in the past, as I am sure the Minister is aware, so I want to do some fact checking. The new hospital in the London Borough of Sutton will provide major services, including accident and emergency, critical care, acute medicine, emergency surgery, in-patient paediatrics and maternity services, particularly births. The plans will also involve at least—I stress “at least”—£80 million being spent across Epsom and St Helier hospitals to deliver essential repairs and refurbishments and to enable them to focus on delivering excellent elective care. That will enable the sickest patients to get a fast diagnosis and start treatment more quickly to speed up recovery, with bigger teams of expert staff at the specialist emergency care hospital. Some 85% of patients will continue to be treated at Epsom and St Helier, and there will be urgent treatment centres across all three sites. Under the plan, the refurbished St Helier Hospital will be here to stay, providing the majority of local health services, and the sickest patients will get state-of-the-art treatment in the brand-new specialist emergency hospital in our borough.

It is important to stress that unlike previous reorganisations, including the reorganisation planned by the last Labour Government, this is not a Government-led scheme. The NHS has come up with a plan and has told the Government what is needed to improve the delivery of healthcare in south-west London and Surrey. I am pleased to say that the Government have listened and have allowed the NHS to get on with it.

The initial plan was that the new hospital would open in 2025, but for multiple reasons—the covid-19 pandemic was obviously the biggest reason, but another was the attempt by some Opposition parties to block the investment from reaching my constituency in the first place—the opening has inevitably been delayed. Although the headline news is still very positive for our area, with the Government spending hundreds of millions to improve local healthcare, the delays are causing a number of complications that need to be addressed.

As I am sure the Minister is aware—I am sure this is the case across many hospitals in the UK—Epsom and St Helier have had a particularly challenging winter, made even more difficult by the old, tired estate. Patients are being cared for in near-impossible conditions: wards are flooding, roofs are leaking and heating failures are causing cold temperatures. Epsom and St Helier University Hospitals NHS Trust has already spent vast amounts of money trying to maintain its old buildings, and its backlog of maintenance costs is awful—well over £100 million. There is also the expense of duplicating services across the two hospitals.

We are now in the position that 98% of the St Helier estate is considered to be in a poor or bad condition, so we desperately need more up-front funding so that the trust can submit a planning application and start building work on the new hospital and the renovation works at St Helier much quicker. I would appreciate the Government’s comment on that. Every day that the decision is delayed makes the maintenance bill more expensive, and that money has to come from somewhere. I know the Minister is aware of the shocking report by ITV News, which aired on Monday night, that showed the appalling state of some parts of St Helier Hospital. I walked around the estate recently with the chief executive to see that for myself.

These issues are not new—they are exactly the reason that the Government are funding the new hospital programme—but their impact only grows with each day that the new hospital project cannot get off the ground. I will not go into explicit detail, but I do not think it is too melodramatic to say that the hospital is nearing its breaking point. The trust has had to move one ward out of a 20-year-old temporary building because the foundations were sinking. Earlier in the winter, it had to vacate parts of the hospital due to flooding, and there are regularly buckets in the corridor. Last summer, to cope with the stifling weather and temperatures stubbornly above 35°C, the trust did everything it could with portable fans, but those are not sustainable conditions, and patients and staff should not have to tolerate them.

The trust does not have enough bed space to meet infection, prevention and control standards, and that was further compounded by the pandemic. Even before the pandemic, it was not uncommon for patients to be transported across the site by ambulance because the lifts are so old that they do not fit modern medical beds—they are also more likely than not to be out of order. Only a quarter of in-patient beds are in single rooms, only half of which have en suite bathrooms, and only a third of which meet the current bed spacing standards. Patients deserve a better standard of care. The trust’s new model of care, with modern healthcare facilities as part of the new hospital programme, will reduce length of stay, increase the quality of care and improve outcomes.

Duplicate services are currently being run across two sites, which means that the workforce is over-stretched. Continuing to run duplicate services for longer is making nurse and medical rotas hard to fill and clinical guidance on nursing and consultant levels hard to achieve. For example, the trust struggles to meet the consultant workforce standards to have 24/7 consultant cover on both sites. It has vacant consultant posts and gaps in the staff rota, which reduce the quality of care and create financial pressures. It has a shortage of doctors and nurses, so it must train or employ temporary staff to fill the gaps in the rota. Running duplicate services is also very expensive due to the higher cost of using temporary clinical staff to cover vacancies and gaps in staff rotas. It increases the cost of maintaining hospital buildings and reduces the opportunity to make savings.

Everyone who works at Epsom and St Helier hospitals does an absolutely fabulous job. They contribute every single day to delivering safe and effective care, despite the huge challenges with the estate. As a former NHS worker in south-west London, I want to thank them for all the amazing work they do. I know from working in the NHS previously that there was not such a thing as a quiet day in the NHS even before the pandemic, and I know the pressures they are up against at the moment. The new hospital programme and the new model of healthcare that goes along with it need to be delivered, because they will address the staffing issues. A new hospital is so much more than just new buildings.

Building the new hospital in Sutton and improving St Helier is more important than ever because of the learning from covid-19. It will allow us to increase infection prevention and control with more patient bathrooms, single rooms with en suite facilities, and beds spaced further apart; to provide more flexibility to increase critical care capability; and to continue to deliver non-emergency services and treatments at the refurbished sites.

Unfortunately, the best case scenario under the delayed timeline is that the new hospital will open in 2027 or 2028. I appreciate that that still falls within the Government’s pledge of 40 new hospitals by 2030 and, again, the overall headline message is still positive: the Government are delivering the greatest transformation of our local healthcare in almost a century. I have lived in Carshalton and Wallington for my whole life and I cannot count the number of years that we have had campaigns to save St Helier, because the future of our local hospital has been in question. Thanks to the investment that the Government have committed, we know that the hospital is here to stay, which is welcome news. We now need movement to address the issues at St Helier and to get on and build the second hospital.

I have been working closely with people in our NHS trust since I was elected in 2019. I know that they are wholly committed to delivering on the upgrades to St Helier and to building a new hospital, and I appreciate all the work that they have done on it. I know that they would love to invite the Minister and the Secretary of State to come to St Helier Hospital to see the current situation first hand.

I will briefly outline where the business case is at the moment, because that is where there is delay. We need to get the business case for the new hospital and the upgrades signed off as a priority to ensure that the necessary funding is allocated to get the ball rolling on the planning application and to start work on some of the vital issues at St Helier. I appreciate that other projects across the country, as part of the new hospital programme, are also in need of expediting—not to mention the trusts that are having to work around old concrete structures, the severe state of which I do not believe the Department of Health and Social Care could have imagined prior to the programme’s launch.

I understand that more than £20 million has already been spent in Sutton alone, but I say again that with every day that goes by, the costs will only rise. It is in the Treasury’s best interest to ensure that we expedite this project and allow the trust to get on with doing what it knows it wants to do—refurbishing St Helier and building a new hospital in Sutton.

Ultimately, however, the priority must be patient safety and patient outcomes. For NHS trusts such as Epsom and St Helier where we are seeing unexpected delays to new hospitals, there needs to be greater consideration of how we can mitigate the impact on patients. I would appreciate it if the Minister elaborated on what steps the Department is taking to ensure that St Helier and other older hospitals being improved as part of the programme are receiving the support that they need to operate safely until the new hospitals are open—and, indeed, beyond.

I appreciate and agree that the new hospital programme is an extraordinary initiative and undertaking by the Government to improve the healthcare that we receive. It is absolutely right that the programme exists and I am incredibly proud of it. I am also incredibly proud that Carshalton and Wallington patients will be some of the first to benefit from having a new state-of-the-art hospital working inside our much-loved local St Helier Hospital, which is now safe for the future. It will provide all the services that the trust currently provides and more, and it will work in partnership with other hospitals such as the Royal Marsden Hospital so that, for example, cancer patients in Carshalton and Wallington no longer have to travel to the Chelsea site but can access cancer surgery in my constituency.

The fact that we are falling short with timelines, however, is causing unexpected problems and is having an impact on patient safety. I hope that the Minister can reassure residents in Carshalton and Wallington that the new hospital is on the way, that steps are being taken to tackle the maintenance issues at St Helier, and that patients can expect to continue to have world-class healthcare on their doorstep for many years to come.

Oral Answers to Questions

Elliot Colburn Excerpts
Tuesday 6th December 2022

(1 year, 2 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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This is an important issue which I know is of concern to many families throughout the country, so I am pleased to be able to reassure the House about our response. While GPs are important in this regard, so are directors of public health, who are leading the response in respect of, for example, liaison with schools. We are seeing a peak in cases earlier than usual, which we believe is due to lower exposure during the pandemic, which in turn has led to lower immunity. There is no new strain, and that is one of the key points of reassurance, but the UK Health Security Agency has declared a national standard to improve the co-ordination of our response, including what is being done in schools.

Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
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7. What steps he is taking to upgrade existing hospitals and build new hospitals.

Steve Barclay Portrait The Secretary of State for Health and Social Care (Steve Barclay)
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As we heard earlier, the Government are committed to a programme to create 40 new hospitals by 2030. We have committed £3.7 billion—[Interruption.] The hon. Member for Ilford North (Wes Streeting) will get a go in a moment, and I look forward to hearing him welcome the increase in the Government’s capital spending, not just on our new hospitals programme but on, for instance, elective surgery. We are putting £5.6 billion into more surgical hubs and community diagnostic centres, and £1.7 billion has gone to more than 70 hospitals to enable them to deliver significant upgrades.

Elliot Colburn Portrait Elliot Colburn
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Patients in Carshalton and Wallington will benefit massively from the building of a new hospital in Sutton and the improvement of St Helier Hospital under NHS plans approved by the Government. Will my right hon. Friend agree to meet me, and the NHS trusts? They are raring to go and to get spades in the ground next year.

Steve Barclay Portrait Steve Barclay
- Hansard - - - Excerpts

I know they are raring to go because I personally have spoken to the chief exec about this scheme, but I can offer my hon. Friend something better: the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince), will personally be visiting shortly to discuss this further. But I also need to be transparent with the House: we are fundamentally changing how we are going to be building hospitals in the NHS estate—[Laughter.] I am not sure why something as important as new hospitals—learning from the Department for Education and the Ministry of Justice through a more standardised model that allows us to deliver more at a cheaper unit price and get them built quicker—is a source of mirth to Opposition Members. It is important that we standardise those designs, and that is what my colleague the Minister of State will be discussing with my hon. Friend.

Pancreatic Cancer Awareness Month

Elliot Colburn Excerpts
Tuesday 8th November 2022

(1 year, 3 months ago)

Westminster Hall
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.

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This information is provided by Parallel Parliament and does not comprise part of the offical record

Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
- Hansard - -

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate, and I thank my hon. Friend the Member for Stroud (Siobhan Baillie) and the hon. Member for East Dunbartonshire (Amy Callaghan) for their contributions. I am delighted to be taking part in this debate, not just because I am the new chair of the all-party parliamentary group on cancer, but because my borough is home to the excellent Royal Marsden Hospital, the Institute of Cancer Research and the London Cancer Hub.

Colleagues have set out the key issues very well indeed, but they are worth repeating. Out of all the common forms of cancer, pancreatic cancer remains the deadliest. More than half of all patients die within just three months, and only 7% live beyond five years. It is always difficult for an individual to go through a cancer diagnosis, but the statistics make a pancreatic cancer diagnosis particularly hard on the individual, their friends and family, so it is right that Government redouble their efforts to work with the NHS and the third sector, particularly with Pancreatic Cancer UK, in order to improve survival rates.

I join colleagues who have reiterated key calls made by Pancreatic Cancer UK. They include providing a clear and urgent national-level focus on pancreatic cancer and other less survivable cancers, investment in targeted innovative pancreatic cancer research, producing more and better data, publishing the 10-year cancer plan and improving access to PERT. However, I would like to focus on an additional call in my speech today.

I acknowledge the good work the Government have done in this space already, including trying to raise awareness of PERT, conducting better data audits, looking to see how we can improve diagnosis and providing a commitment to look at that in the 10-year cancer plan. I hope the Minister can provide us with some assurances about the publication of that plan. We know that health disparities exist across the country and between people with different protected characteristics, but I hope we can learn from an example of best practice in my own constituency.

In Carshalton and Wallington, we are lucky to have the Royal Marsden on our doorstep, along with the Institute of Cancer Research, where world class research is happening, and the London Cancer Hub, which I would be delighted to invite the Minister to come and visit whenever she is free. That site is truly a world leader in cancer research, second only to those in the United States. The Royal Marsden is currently being refurbished, and it is looking to increase its capacity and work with partners to deliver new and innovative treatments.

One of the most exciting projects coming down the line is the partnership with the Epsom and St Helier University Hospitals NHS Trust. That project plans to invest in the existing two hospitals and build a third acute hospital, which will be a specialist emergency care hospital, on the old Sutton hospital site, next to the Royal Marsden. As well as providing state-of-the-art acute services, that will also help the Royal Marsden with capacity to provide cancer surgery on the Sutton site, rather than sending people covered by that catchment area up to Chelsea, which can sometimes be difficult. That means local cancer patients, and cancer patients from across south London, Surrey and parts of Sussex, will be able to conduct most, if not all, their cancer journey right on their doorsteps.

I welcome the work the Government have done to increase investment in the NHS and develop strategies in this area, but a major barrier that prevents optimal care, not just for pancreatic cancer but across the NHS and social care sector, is workforce. I know the Minister knows that already. Yesterday, I had the honour of chairing a roundtable event with the Westminster Health Forum to discuss how we tackle cancer backlogs and how we optimise cancer care in the UK. Again and again, workforce was brought up as the major barrier to improvement. We can invest as much money as we like, develop new strategies and, of course, find efficiencies and better ways to do things, for example by investing in digital and information technology, but without the workforce on the ground to deliver it, much of what we do will not create an impact, at least from a patient perspective, for a long time.

It must be stressed that workforce does not just mean doctors. Of course we need more doctors, and I am glad to see the progress the Government are making on our manifesto commitment to recruit more doctors, but it must also include nurses and allied health professionals, such as oncologists, pathologists, data scientists and all the specialists involved in the cancer pathway. I appreciate that creates a massive challenge, because we cannot magic a skilled workforce out of nowhere: it takes years to train the staff required. There are a few things the Government can do in the short term to encourage recruitment and retention—I reiterate calls to look again at NHS pensions, which are incentivising early retirement—but workforce options are few and far between, without training the next generation of the NHS workforce.

As the Minister may have guessed, my fifth call to Government is that a specific NHS and social care workforce plan is developed, alongside the cancer plan, in order to take advantage of the measures available in the short term and to increase the number of people in that highly trained workforce. That will help to fill the vacancies that it is necessary to fill and deliver first class, nationwide cancer care, including for pancreatic cancer patients.

I look forward to hearing the Minister’s response to the calls from colleagues and from Pancreatic Cancer UK, because as has been set out so well, a diagnosis of pancreatic cancer can be truly devastating for people. I hope the Government can offer some assurance and some hope to patients today, and to future cancer patients, about the work they are undertaking to improve patient experiences.

Oral Answers to Questions

Elliot Colburn Excerpts
Tuesday 1st November 2022

(1 year, 3 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
- Hansard - - - Excerpts

Across the clinical workforce—whether we are talking about dentistry, nursing, social care or doctors—we are seeking to boost recruitment, including international recruitment, and to remove red tape. Within the GP population, however, we are looking at retention, recruitment and boosting the number of trainees.

Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
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T7. The Government have given Epsom and St Helier University Hospitals NHS Trust the green light to get on with improving St Helier and building a new hospital in Sutton. We know that the pandemic has had an effect on timetables, so will my hon. Friend facilitate a meeting between his Department, the Treasury and the trust to ensure that we can get a planning application in by the end of the year?

Will Quince Portrait The Minister of State, Department of Health and Social Care (Will Quince)
- Hansard - - - Excerpts

We are fully committed to delivering a new hospital in Sutton, one of the 40 new hospitals to be built by 2030. Officials from the Department and the NHS are working closely with the trust at every step in the process, and I look forward to working with my hon. Friend to deliver this much-needed hospital improvement.

Covid-19 Vaccines: Safety

Elliot Colburn Excerpts
Monday 24th October 2022

(1 year, 4 months ago)

Westminster Hall
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Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
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I beg to move,

That this House has considered e-petition 602171, relating to the safety of covid-19 vaccines.

It is a pleasure to serve under your chairmanship, Sir Roger. On behalf of the Petitions Committee, I will read out the prayer of the petition, which states:

“There has been a significant increase in heart attacks and related health issues since the rollout of the Covid-19 vaccines…This needs immediate and full scientific investigation to establish if there is any possible link with the Covid-19 vaccination rollout.

It is the duty of the Government to ensure that the prescribed medical interventions of its response to Coronavirus are safe. We believe that the recent and increasing volume of data relating to cardiovascular problems since the Covid-19 vaccine rollout began is…enough…to warrant a full Public Inquiry.”

The petition has amassed over 107,000 signatures, including signatories from my own Carshalton and Wallington constituency. I put on record my gratitude to the Petitions Committee Clerks and the team behind the scenes for organising today’s debate, and particularly to the Medicines and Healthcare products Regulatory Agency—the MHRA —which recently briefed me on its vaccine safety surveillance strategy. Throughout my speech, I will point out why I do not think that the Government should launch a public inquiry into vaccine safety; it would be a waste of taxpayers’ money, and is not necessary for reasons that I will discuss.

The covid-19 vaccine has been the subject of four previous e-petitions debates in Westminster Hall, and of many other parliamentary debates, many questions and much Committee work since the pandemic hit. It is worth remembering that, for the first 26 months of the pandemic, over 178,000 people across the UK died within 28 days of a positive covid-19 test. It remains my position that vaccination is the single most effective way to reduce deaths and severe illness from covid-19.

More than 53 million people in the UK have received at least their first covid-19 vaccine, and I put on record my thanks to the amazing staff and volunteers who contributed to that gargantuan operation, which was a shining example of effective national collaboration. I would go so far as to say that, in the public inquiry into covid, the Government should look at how the vaccine roll-out was such a success, how we can learn from that success and how we can apply those lessons in future circumstances.

Christopher Chope Portrait Sir Christopher Chope (Christchurch) (Con)
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My hon. Friend has obviously done a lot of preparation for the debate. Did part of that preparation include looking at Oracle Films’ “Safe and Effective: A Second Opinion”, which was produced about a month ago and has already had more than 1 million views online? Most people think it highly persuasive.

--- Later in debate ---
Elliot Colburn Portrait Elliot Colburn
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I have not seen that publication, although I have read a lot of the significant amounts of material that have been shoved through my constituency office door by a large number of anti-vax protesters, who have flyposted my office on no less than a dozen occasions, and intimidated my 18-year-old apprentice and the people who live above my constituency office. Given that the content of that literature includes climate change denial, moon landing denial and so on, I am inclined to ignore it completely.

It is impossible to vaccinate every person in the country, nor should vaccines be thrust upon people without their consent. People have a right to know what is put in their bodies, and have the autonomy to decide whether to have a vaccination. It is therefore the job of the state to ensure not only that vaccines are safe for use and continually reviewed, but that knowledge of why they are safe and effective is communicated well to our constituents.

With that in mind, I will briefly outline the steps taken to review the safety of covid-19 vaccines before the roll-out, and the continuous monitoring of vaccine safety. All vaccines must be tested through a series of clinical trials to establish their efficacy and safety, and must have a product licence before they can be made available for widespread use in humans.

The MHRA is responsible for regulating all medicines and medical devices in the UK by ensuring they work and are acceptably safe. Starting in 2020, a dedicated team of MHRA scientists and clinicians carried out a rigorous, detailed scientific review of all the available data in the development of covid-19 vaccines, including from laboratory pre-clinical studies, clinical trials, manufacturing and quality controls, product sampling and testing of the final vaccine, and it considered the conditions for the vaccine’s safe supply and distribution.

In early June 2020, the MHRA set up an independent expert working group to begin some of the most important safety work. In August 2020, a second working group was formed with different expertise, this time to advise the MHRA on the benefits and risks of the vaccines in development. The groups were formed of 48 experts from outside the MHRA, including virologists, epidemiologists, immunologists and toxicologists.

In September 2020, the MHRA started preparing laboratories for independent batch testing of the vaccine. Although the vaccine manufacturers carried out their own comprehensive testing regimes on the batches of products they produced, it is vital that tests focusing on safety and quality are conducted independently too. In the UK, the independent testing is performed by the National Institute for Biological Standards and Control, which is part of the MHRA. Before any batch testing can reach the public, the NIBSC must conduct a rigorous assessment to check that it is consistent with characteristics derived from results from batches previously shown to be safe, and from effective clinical trials or routine clinical use. That work began in November 2020.

The covid-19 vaccines were developed in a co-ordinated way that allowed some stages of the assessment processes to happen in parallel, which enabled the producers and regulators to condense the time normally needed. That rolling review allowed the MHRA to review data as it became available from ongoing studies, rather than waiting.

Danny Kruger Portrait Danny Kruger (Devizes) (Con)
- Hansard - - - Excerpts

My hon. Friend talks about the independence of the MHRA, and I very much hope he is right about that. Is he aware that it is overwhelmingly funded by the pharmaceutical companies that it regulates? Does he have any concerns about the objectivity of its work?

Elliot Colburn Portrait Elliot Colburn
- Hansard - -

No, I see nothing to concern me about the independence of the MHRA. Indeed, I saw a group of anti-vax protesters outside the House today, holding up signs saying, “Vaccines kill,” and, “Would you not believe that pharmaceutical companies kill?” It seems a bit of a strange business model for a pharmaceutical company to kill off everyone it is trying to administer a vaccine to. I have seen absolutely nothing to concern me that the MHRA has any problems with independence.

For previous vaccines, we have had to wait for a full package and for each stage to be finished before moving on to the next stage. That is one of the reasons that the covid-19 vaccine was developed at such speed; corners were not cut, but the model was changed.

Pfizer and BioNTech fed the MHRA data to be assessed even before the final clinical submission in November 2020. Once it was submitted, scientific and clinical experts robustly and thoroughly reviewed it with scientific rigour, looking at all aspects, including the laboratory studies, the clinical trials and more. That included assessing the level of protection the product provides and how long that protection is provided for, as well as its safety, stability and how it needs to be stored.

On top of that, the MHRA has a range of experts inspecting the sites used across the whole lifecycle of the vaccine, from its initial development in a lab to its manufacture and distribution once approved. The inspectors work to legislation that incorporates internationally recognised clinical standards. The MHRA seeks advice from the Commission on Human Medicines, the Government’s independent advisory body, which critically assesses the data before advising the UK Government on the safety, quality and effectiveness of any potential vaccine.

I wish I could delve deeper into the specifics of how and why vaccines work, but we would be here all night and I do not want to duplicate the work that has been done in other debates. Nevertheless, I hope I have managed to demonstrate succinctly the rigorous scientific testing that occurs prior to a vaccine being distributed in the UK. However, the main premise of much of the literature that has been distributed about the impact of the covid-19 vaccine and the nationwide roll-out needs to be looked into. As part of its statutory functions, the MHRA continually monitors the use of vaccines to ensure that their benefits continue to outweigh any risks. This monitoring strategy is continuous, proactive and based on a wide range of information sources, with a dedicated team of scientists reviewing information daily to look for safety issues or unexpected events.

Richard Holden Portrait Mr Richard Holden (North West Durham) (Con)
- Hansard - - - Excerpts

My hon. Friend is making a good speech. My constituent Gareth Eve lost his wife Lisa Shaw when she was only 44, as a result of the AstraZeneca vaccine. He is not an anti-vaxxer. Although the debate is on the broad issue, does my hon. Friend agree that matters such as how families get compensation could be dealt with much better, even if he does not agree with a full public inquiry into the entire body of the issue? So many families, including that of my constituent, have been left waiting for that support for a very long time.

Roger Gale Portrait Sir Roger Gale (in the Chair)
- Hansard - - - Excerpts

Order. I appreciate that hon. Members wish to represent their constituents, but interventions must be interventions and not speeches.

Elliot Colburn Portrait Elliot Colburn
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I am very sorry to hear of the case of my hon. Friend’s constituent, and I agree that we need to look at compensation and measures when things go wrong. No vaccine is without risk. No medicine is without risk, but that is the balance that we must weigh up when making decisions about our own health.

Let me return to the safety and efficacy of the vaccine, and how that is monitored. The core of this work is individuals self-reporting any adverse effects post vaccination, and active surveillance of particular groups of adverse events. That is well known as the yellow card scheme. I recently met representatives of the MHRA to be briefed on its vaccine safety surveillance strategy, which has four main pillars, the first of which is enhanced passive surveillance through observed versus expected analysis. The MHRA performs enhanced statistical analysis on data generated through the yellow card scheme to evaluate observed versus expected event reports in order to determine whether more events are occurring after vaccination than might be expected ordinarily. That assists the MHRA to identify when and where vaccine-related side effects are signalled.

Secondly, the MHRA conducts rapid cycle analysis and ecological analysis to supplement the yellow card scheme, which relies on direct reporting. The MHRA also analyses anonymised electronic healthcare records, particularly by way of the clinical practice research datalink Aurum dataset, which captures data from 13 million registered GP patients in the UK. It will track a range of theoretical side effects in order to detect safety signals. The MHRA also performs ecological analysis to monitor trends in high priority vaccination population cohorts—for example, increased trends among the elderly.

Thirdly, the agency performs targeted active monitoring; it has developed a new, voluntary follow-up platform for a randomly selected group of those vaccinated through the NHS. The group is contacted at set intervals to determine the frequency and severity of any vaccine side effects. Finally, there are formal epidemiological studies. The above methods detect signals and patterns but do not necessarily confirm vaccine causation. As such, where necessary, formal epidemiological studies are undertaken to solidify causal links.

As of 28 September 2022, in the UK, 173,381 yellow cards had been reported for Pfizer-BioNTech; 246,393 for AstraZeneca; 42,437 for Moderna; 14 for Novavax; and 1,848 for vaccines where the brand was not specified. For Pfizer, AstraZeneca and Moderna, the reporting rate is about two to five yellow cards per 1,000 doses administered.

The use of the yellow card scheme has been used as an example of why vaccines do not work, but it is important to note that the scheme is a self-reporting system. It cannot be used to prove a causal link between reported symptoms and potential damage caused. The reported reaction could have occurred regardless of the vaccine, or the person reporting could have no knowledge of the relationship between that symptom and the vaccine; it may have occurred even if the person had not been vaccinated altogether. I could get on the phone to the yellow card scheme right now and say that I have a side effect from a vaccine—I could completely make it up. The scheme has no verification process.

Danny Kruger Portrait Danny Kruger
- Hansard - - - Excerpts

I think my hon. Friend is suggesting that the yellow card scheme numbers exaggerate the potential negative effect of the vaccines. Is he aware that the independent MHRA suggests that vaccine injuries have been under-reported by one in 10, meaning that there may be 10 times more vaccine-related injuries than the yellow card scheme reports? Surely, if there is an exaggeration, it is in the opposition direction from the one that he is suggesting.

Elliot Colburn Portrait Elliot Colburn
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I am aware of that, but the point I am making is that the yellow card scheme is not a determining factor of damage done by the vaccine; there is no way to prove a causal link, as the reported reaction could have happened anyway. The worldwide awareness of covid, its blanket media coverage over multiple years, and the impact it has had on all our lives, are bound to have led to an increase in reports from previous vaccine roll-outs. Most reports relate to injection site reactions, including a sore arm and generalised symptoms, such as flu-like symptoms, illness, headache, chills, fatigue, nausea, fever, dizziness, weakness, aching muscles or rapid heartbeat. Generally, those reactions are not associated with more serious illness and likely reflect an expected, normal immune response to vaccines.

There have been some occurrences of inflammatory heart conditions following a covid-19 vaccination, but fortunately they are incredibly rare. For Pfizer, the suspected myocarditis reporting rate is 12 reports per 1 million doses. For suspected pericarditis, including viral pericarditis and infective pericarditis, the overall reporting rate is eight reports per 1 million doses. For Moderna, that is 42 per million, and for AstraZeneca four per million.

The events reported are typically mild, with individuals usually recovering within a short time, following standard treatment and rest. The benefits of the vaccines in protecting against covid-19 and the serious complications associated with it far outweigh any currently known side effects. I understand that one of the biggest concerns about vaccine safety is the potential influence on excess deaths. Of course, the excess mortality rates have increased. However, there is no evidence to prove a causal relationship between a spike in excess deaths and covid-19. I am not clinically trained, so I do not wish to preach in this debate, but multiple drivers could have caused the spike, including the impact of missed and delayed diagnoses earlier in the pandemic, and the long-term impact of covid-19 on people who contracted it; and that has been confirmed to me by the MHRA.

In one study this year, researchers estimated how often covid-19 leads to cardiovascular problems. They found that people who had the disease faced a substantially increased risk for 20 cardiovascular conditions in the year after infection with coronavirus. Researchers say that such complications can happen even in people who seem to have completely recovered from a mild infection. With millions—perhaps even billions—of people having been infected with the virus, clinicians are wondering whether the pandemic will be followed by a cardiovascular aftershock. Again, I am not clinically trained, but I wanted to touch on that point to provide some food for thought, because I understand that the issues around excess mortality rates are of extreme importance.

Easily the biggest elephant in the room while discussing the safety of the covid-19 vaccine and a potential inquiry into its safety is that the Government have already announced a public inquiry into their handling of the covid-19 pandemic as a whole. Since the Government responded to the petition, the terms of reference for the UK covid-19 public inquiry have been published by the Cabinet Office. One of the inquiry’s aims is to examine

“The response of the health and care sector across the UK…including the development, delivery and impact of therapeutics and vaccines”.

The first preliminary hearing of module 1 of the inquiry took place just a few weeks ago, with the second due to take place next Monday. The inquiry will further announce modules in 2023 that are expected to cover both system and impact issues, including vaccines, therapeutics and antiviral treatment. I would be grateful if the Minister could shed a bit more light on the aim of the content of the modules that will be investigating the vaccines, and if she could provide more details on how others can contribute towards the process, including those who signed the petition.

I will bring my comments to a close because other Members wish to contribute. I appreciate that for some people the question of whether the covid-19 vaccine is safe is still up in the air, and I understand that my comments may not easily persuade them otherwise. However, we know that vaccines are the best way to protect against covid-19 and they have already saved tens of thousands of lives. I hope that I can offer some reassurance to those who are unsure about this matter that the right steps were taken to ensure that vaccines were safe prior to roll-out, and that vaccines continue to be monitored for their safety and effectiveness. I hope that they can also be reassured by the Minister’s remarks that the Government are including an extensive investigation into the vaccine as part of their covid-19 public inquiry, and that separate investigation is not necessary.

None Portrait Several hon. Members rose—
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--- Later in debate ---
Elliot Colburn Portrait Elliot Colburn
- Hansard - -

It is unusual to be in this place and be lambasted by colleagues, but I make no apology for looking out for the health and wellbeing of my constituents. I completely agree with the sentiments raised throughout the course of the debate. We have to do more, and I urge the Minister to look into what more we can do for those who are adversely affected. I will not apologise for not allowing that to be a gateway that allows vaccine misinformation to come into the mainstream.

Some people have said that the debate is overdue. I hastened to remind colleagues in my opening remarks that there have been four of these Petitions Committee debates, let alone the Backbench Business debates and private colleagues who have come forward to ask for debates. This is not overdue; it has happened plenty of times. We have given a lot of parliamentary time to this. Yes, there is more that we can and must do for those who suffer harm, but it is worth reiterating that the system for approving and monitoring vaccines is robust, the inquiry exists already and vaccines are a great British success story. It was a Brit who discovered vaccines in the way that we know them today, and they have been effective in tackling a range of illnesses that would previously have been life-threatening or very dangerous indeed. The proof is that they work, they are saving lives and they protect us and others. I join the Minister in urging people to come forward for their vaccines this winter, to help to protect themselves and others and ensure the strain on our NHS is as minimal as possible.

Question put and agreed to.

Resolved,

That this House has considered e-petition 602171, relating to the safety of covid-19 vaccines.

NHS Dentistry Services: Carshalton and Wallington

Elliot Colburn Excerpts
Wednesday 7th September 2022

(1 year, 5 months ago)

Westminster Hall
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Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
- Hansard - -

I beg to move,

That this House has considered NHS dentistry services in Carshalton and Wallington.

It is a pleasure to serve under your chairmanship, Mr Twigg. I start by paying tribute to the incredibly hard-working dentistry professionals in Carshalton and Wallington, and around the UK, many of whom dealt with extremely difficult circumstances over the pandemic. They were some of the, I think, unfairly less applauded heroes of the NHS and our healthcare system during those dark days. I want to make it clear from the outset that the concerns I will raise during this debate are not aimed at the professionals, but rather at the system at large. They are concerns that have been shared with me by local NHS dental professionals in Carshalton and Wallington.

It is a well-known saying from the 19th century that a quarter of all human misery is toothache. The modern equivalent for many residents in Carshalton and Wallington is trying to get an appointment to treat said toothache. Dozens of my constituents have been in contact with me recently to raise concerns about accessing an NHS dentist.

Those concerns broadly fit into four main categories. The first is access to NHS dental services as a whole, from all patients—including those who are registered with a practice. The second is the often huge waiting list to register with an NHS dentist. The third is the removal of some patients from the NHS register due to their understandable lack of using services as much since the first covid-19 restrictions were brought into place in spring 2020. The fourth is the cost of purchasing private dental healthcare in order to gain access to treatment when trying to go through an NHS dentist has failed.

NHS figures released this year have found that a quarter of all people who attempted to get an NHS appointment did not succeed. Of those who were new patients, or at least had not had an appointment in over two years, the figure shoots up to almost 75%— almost three in four new patients are unable to get an appointment. A HealthWatch report published in December 2021 showed that seven of the NHS’s 42 integrated care systems were reporting that they had no practices at all taking on new NHS patients. Of course, visits to the dentist did drop over the pandemic, and that was understandable. However, the percentage of the population recently seen by a dentist has been slowly falling for several years. The Care Quality Commission has stated that the core of this problem originated before the pandemic hit.

The long-term impact of decreasing access to NHS dentists should not be underestimated. Without regular and easily accessible dental treatment, smaller issues can grow into greater ones. That puts a greater strain on the healthcare service as a whole—not just on dentistry—including an increase in patients turning to A&E for urgent oral health problems that were not treated by NHS dental services earlier in the process. Many patients who have been treated for mouth cancer or diabetes, for example, were first diagnosed, or at least had symptoms highlighted, by dental professionals. These patients have much higher survival rates if these issues are caught earlier on.

As we continue to try and help our constituents through the storm of the cost of living crisis and of building back a better national health service, we are heading into a winter of huge energy price rises and inflation as a consequence of Putin’s war in Ukraine and of the pandemic. It is even more important to ensure that dental care can be received on the NHS.

The cost of NHS dental treatment to the patient starts at around £23.80, with the most expensive band of treatment capped at £282.80. However, if a patient takes a private route, they can expect this pricing to significantly multiply. I am not just talking about a few extra quid here or there; for complex treatment such as extractions, we are looking at hundreds of pounds when done privately. There are no set limits on what practices can charge for private dental treatment, and prices will of course vary from practice to practice. Such extra financial burdens on people during the current economic crisis is unrealistic.

Unfortunately, difficulty in accessing NHS dental treatment has led to some worrying reports of dental DIY, with people turning to extracting teeth at home using household items and tools. In fact, reports of DIY dentistry in England and Wales have not just been reported by the media here in the UK, but have made it worldwide. Such practices are not only bad for those committing the DIY dentistry, but put greater strain on the whole public healthcare system when they inevitably go wrong.

However, financial issues are not just limited to patients. According to local dentists, many concerns about access to NHS dental care are a result of the financial implications of the system in which dental practitioners operate. Dental practices are essentially small business, but they operate in a strict top-down system.

Since 2006, dental contracts have required dentists to complete a set number of units of dental activity, or UDAs. Treatments are assigned to a band based on complexity and urgency, and each band is given a UDA value. A course of treatment is assigned to one UDA value based on the most complex element rather than the number of different treatments involved. That means that treatment to fit one crown is assigned the same number of UDAs as the treatment to fit eight crowns. That makes it impossible for many practices to make ends meet from NHS contracts, particularly during the current economic climate.

Furthermore, dental contracts in England and Wales are based on NHS dentistry providers performing an agreed number of UDAs a year. This means that if the target number of UDAs is not met, the contracts provide for a clawback, also known as a fine. If the target is reached, patients must be sent elsewhere or else wait for a new quota. The system is almost universally criticised by dental practitioners. A 2022 survey by the British Dental Association found that 82% of practices have reported unfilled vacancies and cited the current contract as the key barrier to filling posts. The Government are of course aware of this and have described the current dental contract as the nub of the problem. I welcome the new Health Secretary’s ABCD approach—ambulances, backlogs, care, doctors and dentists—and was pleased that it specifically mentions dentists, because they sometimes feel like they have been forgotten.

The Government have also described the contract as “a perverse disincentive” for dentists to carry out NHS work, but despite attempts to review and reform the dental contract since its introduction in 2006, it remained largely unchanged until the reforms announced in July. Those problems have obviously only intensified since the covid-19 pandemic, and the BDA estimates that over 38 million dental appointments were missed as a result. That has had a huge knock-on effect, which the industry is still trying to deal with. I am pleased that the Government announced an additional £50 million in funding for dentistry in January to help with the backlog. However, the impact of the pandemic has only mixed with the pre-existing contractual problems to create a perfect storm in dental care, which will take greater work to correct.

The Government do seem to be taking steps in the right direction, and I welcome that progress. The Government’s announcement in July of proposed changes to the system is very welcome—the Minister will tell me if I am wrong, but as I understand it, they will mean NHS dentists being paid more for treating more complex cases, such as those who need multiple fillings. Dentists will now receive five UDAs for treating three or more teeth, an increase on the current level of three UDAs, which was applied to any number of teeth. Higher-performing dental practices will also have the opportunity to increase their activity by a further 10% to see as many patients as possible. That will help to address some of the concerns with the current UDA inconsistencies and their financial impact.

However, there are fears in the industry that the reforms will not go far enough to address—if you will pardon the pun, Mr Twigg—the root cause of the problem in dental care. The BDA has suggested that the UDA system is fundamentally flawed and needs a complete overhaul rather than slight improvements, which, although helpful, will have little impact on practices and patients in the majority of cases.

For many of my constituents, accessing NHS dental care can be like pulling teeth. I am incredibly proud of the Government’s record on healthcare and the NHS, and I look forward to working with the new ministerial team at the Department of Health and Social Care not just to deliver for NHS dentists, but to deliver the new £500 million hospital in my borough and improvements to St Helier.

When it comes to dental care, there needs to be greater consideration of the fundamentals of the system that need reform, in order to improve NHS dental care. There are long-standing system-led issues that span multiple Governments and multiple parties. The recent improvements are greatly welcomed, but I hope that the Minister will outline what further steps the Government can take to address the crux of the matter, which is affecting many residents in Carshalton and Wallington.

Healthcare: Carshalton and Wallington

Elliot Colburn Excerpts
Wednesday 30th March 2022

(1 year, 11 months ago)

Westminster Hall
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Christina Rees Portrait Christina Rees (in the Chair)
- Hansard - - - Excerpts

I will call Elliot Colburn to move the motion, and then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
- Hansard - -

I beg to move,

That this House has considered healthcare outcomes in Carshalton and Wallington.

It is a pleasure to serve under your chairmanship, Ms Rees. It is also a pleasure to be here, because it is just over two years since I made my maiden speech in the Commons Chamber, when the House was debating the health and social care element of the Queen’s Speech, and I made it abundantly clear that afternoon that health and social care outcomes in Carshalton and Wallington would be a top priority for me, as they were for my constituents.

I want to read out some statistics that demonstrate why the issue is so important. I am particularly concerned about four areas of health, beginning with cancer. One in two, or 50%, of us will receive a cancer diagnosis in our lifetime. The London Borough of Sutton is very lucky to be home to the Surrey branch of the Royal Marsden and the Institute of Cancer Research. The plans for the London cancer hub will be truly groundbreaking in the UK and will deliver better cancer outcomes for all patients.

Dementia is another issue I am concerned about, after having my own family experience with it. There will be a predicted 25% increase in the number of people diagnosed with dementia in Carshalton and Wallington by 2030, which presents a huge challenge for health and social care services.

My third concern is obesity, which has got progressively worse—I have had my own struggles with obesity, having once been as heavy as 21 stone—so we need a decent obesity strategy to tackle the problem from a young age. My fourth concern is mental health. Throughout lockdown we saw how the rates of mental health cases spiked as people struggled to cope with isolation.

I am sure the House will be aware of my many contributions on health and social care issues, and one of the topics I raise most—unashamedly—is my local hospital, St Helier. I offer no apology for doing that, and it should come as no surprise that St Helier will feature as a major part of my speech today.

I was born at St Helier, as were most of my family. The hospital and the staff have supported my family and me through some of our darkest days and have saved the lives of people I know. They also saved my life at Christmas. It is difficult to articulate just how grateful I am, and the residents of Carshalton and Wallington are, for that local hospital and all the amazing work it does.

St Helier opened its doors in 1941, during the second world war. Despite a few bombings—and the birth of a former Prime Minister—the building has barely changed. At the time of construction it was considered a modern 1930s design, but almost a century later the way that we practise medicine has developed and improved, and the buildings are now anything but modern. Over recent years, particularly throughout the last two years of the pandemic, the limitations of that old building have become glaringly obvious. For example—this is one of the worst examples—some of the lifts are too small to fit a modern-day hospital bed, so money has to be spent on transferring patients from the back of the building to the front via ambulances.

When I made my maiden speech in the Chamber and spoke about St Helier, I never imagined that I would be serving as an MP during a global health pandemic. St Helier was hit hard by covid-19, as were all our hospitals across the country. I thank the staff for their tireless efforts and their uphill battle with the limitations of older facilities in trying to tackle the pandemic. There was a very worrying moment in the winter of 2020 when oxygen supplies nearly ran out, but thanks to the innovation and enthusiasm of the team there the situation was quickly resolved.

Over the 20th century, St Helier helped to raise our local care and health services to a much higher plane, but it is now time to take that care even higher. That is why I am incredibly grateful that the Government are using the nation’s resources to do just that by investing £500 million—half a billion pounds—in the NHS in Carshalton and Wallington. That does two things: it protects St Helier and Epsom hospitals, allowing them to make the improvements needed to become more modern medical facilities, and it allows us to have a third brand-new, state-of-the-art and built-from-scratch acute care hospital in Sutton. That record level of investment will do wonders to improve healthcare outcomes for local residents, so I am incredibly grateful to the NHS and colleagues at the Department of Health and Social Care who developed the plan and allowed the funding for it to come forward.

I want to make it clear that, for the first time, the plan was developed by our local NHS services. We have heard so many times in this place about reorganisations of the NHS or plans for the NHS coming from politicians and bureaucrats, but this was an NHS-led initiative. The NHS came to the Government and asked for the funding, and I am so pleased that the Government listened.

It is therefore disappointing that my Lib Dem opposition in Carshalton and Wallington have turned their backs on St Helier and refused to support the £500 million investment. I would like to read out a statement I received only yesterday from a Lib Dem councillor, who does not want to be named but who is retiring and not re-contesting their seat at the elections in May:

“Hi Elliot, I wanted to pass this onto you as I think you’ve actually done a great job since taking over as the MP, but please don’t tell anyone I sent you this.

As you may know, I am standing down as a Lib Dem councillor. I was promised a lot by the party when I agreed to stand. I was told it would be easy and I’d be well paid, but it’s been hell frankly and the party’s been no help at all. I can’t keep asking my family to go through this.

I also cannot support my party’s u-turn on St Helier. We were all so excited when we heard the £500m was being announced for St Helier, but we were told we had to campaign against it as St Helier is one of the only reasons people used to vote Lib Dem.

This experience has not been what I was led to believe. I feel betrayed, let down and hurt.

Again, please don’t pass this onto anyone—they can be very angry and vindictive, anyone who raises any issue get shouted down, but keep up the good work, you have my support!”

That is a very striking and brave statement for someone to make, particularly to a member of an opposing party, and it demonstrates why it is so important to invest in St Helier Hospital.

I want to talk about the positives of the investment and why it is such good news. The new specialist emergency care hospital will treat the sickest 15% of patients in my constituency—those normally arriving by ambulance—and the specialist team will be available 24 hours a day to diagnose patients more rapidly, start the best treatment faster and help patients recover more quickly. St Helier and Epsom will also remain open 24/7, with updated and improved facilities. This will be absolutely ground-breaking for health and social care outcomes in Carshalton and Wallington. I cannot say how long we have waited for investment to come into St Helier. Time and again I have seen the threat of closure and loss of services, such as A&E and maternity going to St George’s, Tooting or Croydon, but they are now staying in the London borough of Sutton and can treat local patients, which is absolutely incredible news.

To reiterate, the purpose of the plans is to improve local health outcomes, which all my local residents want to see. Our priority has always been the outcomes for people’s health. Since the covid-19 pandemic hit, the NHS has slightly amended its plans for the project. It has learned from the pandemic to future-proof health and social care against future shocks. The new hospital ward designs will increase ventilation, and single room occupancy rates have gone up, which will help to reduce the risk of disease transmission.

In terms of timelines for the new project, a planning application is due to be submitted later this year. Over the next three years, some of the planned improvements will begin to be implemented at St Helier, including the building of a new pathology centre and a nursery. From 2025 onwards, the plan is to build a new main entrance to St Helier, to improve accessibility, and a new multi-storey car park, as well as to make major internal changes to A and D blocks and other improvements. As things stand, the new specialist hospital is due to open in 2026.

I have a number of quotes from local NHS professionals on why these changes are so important. When the independent reconfiguration panel last year backed the proposals for a new hospital and upgrades to Epsom and St Helier, it emphasised the need to expedite the project, stating:

“The problems facing the Epsom and St Helier University Hospitals NHS Trust are real and require urgent attention…The Panel understands the heightened sense of uncertainty created by Covid-19 but does not believe the interests of local health services will be served by pausing—rather work should proceed on the basis that there may well be benefits should another pandemic arise in the future.”

Commenting on the confirmation of the investment, Arlene Wellman, the chief nurse at Epsom and St Helier said:

“What covid-19 has shown the NHS is that for all our communities survival rates are higher if specialist hospital staff work together in one team, in one place to care for the sickest patients around the clock”.

Dr Andrew Murray, a GP and clinical chair of NHS South West London clinical commissioning group commented:

“Covid-19 has shown that there’s no time like the present to invest in our hospitals. Now more than ever we need to ensure the right healthcare services for local people”.

Finally, Surrey Downs integrated care partnership clinical chair and GP, Russell Hills, said:

“This pandemic shows we cannot afford to delay improving and modernising our local health services for the benefit of both patients and staff—and the independent analysis of feedback shows there is clear support for this vital investment.”

It is clear that the £500 million investment in our local healthcare system is much needed and very much welcomed by the NHS.

I hope the Minister will be able to provide an update on work on the project, which should be expedited and delivered as soon as possible. As always, I am more than happy to meet her and her departmental colleagues to discuss the issue, alongside my hon. Friends the Members for Wimbledon (Stephen Hammond), for Sutton and Cheam (Paul Scully) and for Reigate (Crispin Blunt), who have been fighting for this project longer than I have been in the House.

Unfortunately, attempts to frustrate the delivery of this record investment will no doubt continue for reasons of political point scoring. Nevertheless, I am not deterred, and I hope the Government will not be deterred. I am proud of what we are trying to achieve—prioritising health outcomes above everything else—so let us get on with the job and raise the plane of health and social care delivery, which has been almost a century in the making.

Covid-19: NHS Support for Prostate Cancer Patients

Elliot Colburn Excerpts
Thursday 10th March 2022

(1 year, 11 months ago)

Westminster Hall
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Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
- Hansard - -

I beg to move,

That this House has considered NHS support for prostate cancer patients after the covid-19 pandemic.

Ms McDonagh, as your constituency neighbour, it is a pleasure to serve under your chairmanship for the first time in Westminster Hall. I extend my thanks to the Backbench Business Committee for granting time for such an important debate. I also thank the many Carshalton and Wallington residents who came forward to share their experiences of prostate cancer, either having had it themselves or having supported a loved one or friend through it.

Many people in this room and many of those watching will know a male relative or have a friend in their life who has had prostate cancer. I hope this important debate will raise awareness of the need to get yourself checked. There will be many striking statistics mentioned in the debate that will concern Members present, but I am keen to begin with a positive. Cancer survival rates in the United Kingdom have never been higher. Survival rates have improved each year since 2010. Prostate cancer survival has tripled in the past 40 years, with 85% of men surviving for five years or longer. However, the covid-19 pandemic threatens to derail this progress through a decrease in diagnostics, especially for men over the age of 50.

There are over 47,000 new prostate cancer cases every single year, with a man dying every 45 minutes from the condition. Early diagnosis is the key to fighting this disease. The pandemic has resulted in fewer men coming to their GP to get tested for prostate cancer, with the “stay at home” messaging particularly deterring older men, who are most at risk from prostate cancer, from coming forward. While the referral rate for prostate cancer has recovered to 80% of pre-pandemic levels, it still lags behind those for other forms of cancer, such as breast cancer, which is operating at 120% of pre-pandemic levels.

Stark figures from the charity Prostate Cancer UK reveal that there have been 50,000 fewer referrals for suspected prostate cancer patients than the usual trends would predict. The impact of that is incredibly worrying. Some 14,000 fewer men in the UK started treatment for prostate cancer between April 2020 and December 2021 compared with the equivalent months prior to the pandemic. That means that 14,000 men are living without the knowledge that they have the condition, and it means that 14,000 men have not yet started that all-important treatment plan.

Prostate Cancer UK has warned that, because of that, 3,500 men risk being diagnosed with late-stage prostate cancer. I cannot stress enough the importance of people getting themselves checked if they have symptoms or if they fall into the high-risk categories. Those include men over the age of 50, black African and black Caribbean men, and men with a father or brother who have had prostate cancer.

Sadly, the statistics and anecdotes that many of us will have heard point to the fact that men are far less willing to get themselves checked. Whether that is out of embarrassment or fear, getting diagnosed early can make an enormous difference to survival rates; five-year survival rates for men who are diagnosed with prostate cancer between stages 1 and 3 are over 95%. There are fantastic NHS campaigns, such as the “Help Us Help You” campaign, which has urged people with potential cancer symptoms to come forward for life-saving checks. The second stage of that campaign addresses the fear that often comes with booking the first appointment. Despite the fantastic work that is already being carried out, I hope that the Minister will be able to enlighten us about what more the Government are doing to destigmatise men coming forward to check their symptoms.

While being checked for prostate cancer is important for all men, it is especially important for men of black African or black Caribbean origin. I was taken aback to learn that, while one in eight of all men will get the disease, one in four black men will be diagnosed with prostate cancer in their lifetime; black men are also far more likely to be diagnosed with a more aggressive type. People from black and ethnic minority groups are also 4% less likely to receive radical treatment than people from white ethnic groups.

Through covid-19, we have seen what we can achieve when we work together. Last year, I was proud to host a roundtable in Carshalton and Wallington in collaboration with the NHS, the third sector and community groups to encourage ethnic minority communities to come forward and get the jab. The roundtable was well attended and demonstrated what we could achieve in prostate cancer diagnostics if the Government worked closely with the third sector and community groups to spread awareness.

However, improving awareness requires a corresponding increase in imaging capacity. Imaging services such as multiparametric MRI are critical to achieving earlier diagnoses, which, as I stated earlier, is key to survival. MpMRI scans can confirm or rule out prostate cancer in an accurate and timely manner, reducing the stressful wait for patients and their families. From speaking with cancer charities, I know that the significant variation in access to mpMRI provision is concerning. If we are to bring prostate cancer diagnoses back to pre-pandemic levels—and, indeed, increase them—we must address that postcode lottery. MpMRI provision must, as a minimum, be expanded in line with growth rates prior to the pandemic if we are to get diagnoses back to pre-pandemic levels. The 10-year cancer plan provides a golden opportunity to address this issue.

I have already mentioned the negative impact the pandemic has had on the prostate cancer community, but I am keen to highlight some positives that could be considered in a post-pandemic setting. Prostate Cancer UK has noted that the policy change during the pandemic to grant special access to certain covid-friendly novel hormone therapies for patients was very warmly welcomed by the community. This policy change has been wanted for some time, and it not only kept patients safe at home during the pandemic but improved their care experience, as they spent less time in hospital. Along with the increased interaction between patients and clinicians using technology, the change has made for higher levels of patient satisfaction and experience.

I look forward to seeing greater access to diagnosis and treatment and increased use of technology in my constituency at the London cancer hub, an exceptionally exciting project in the London Borough of Sutton. As a former employee, the Minister will know the Royal Marsden Hospital very well. I will not go over ground that she already knows, as cancer nurse who, I believe, is still practising.

Elliot Colburn Portrait Elliot Colburn
- Hansard - -

The Minister is nodding. The Royal Marsden and the Institute of Cancer Research already form one of the leading cancer research and treatment centres in the world. The development plans for the London cancer hub will double the capacity for cancer research on the site, making the United Kingdom second only to the United States. It will be a game changer and will take our cancer research to the next level. It is a prime opportunity to ensure that the reduction in prostate cancer diagnoses remains a temporary blip in the overall effort to achieve early diagnosis for everyone with the condition.

This effort must include the cancer workforce. The Government have already invested money to address the cancer backlog, but the workforce issue must also be addressed. Patients with prostate cancer and their families go through one of the most difficult things in life to navigate. They are desperate for more clinical nurse specialists, who provide holistic, patient-centred care, with the empathy needed in these very dark times. Having access to clinical nurse specialists means that prostate cancer patients are far more likely to be positive about their care and treatment and to receive more individualised treatment plans.

One suggestion to be considered for the post-pandemic NHS is non-medical practitioner-led prostate cancer clinics. Such clinics would not only enhance the clinical pathways in prostate cancer, but relieve time burdens on oncologists and help to reduce costs that can be cycled back into the system. With one in four consultant clinical oncologists reporting risk of burnout, and with covid-19 exacerbating those issues over the past two years, investing in non-medical practitioners or increasing the number of clinical nurse specialists—or both—could be solutions to workforce concerns. I urge the Government to work with NHS England, Health Education England and the devolved Administrations to ensure that professional working groups in the prostate cancer workforce are addressing the workforce backlogs, including with clear training routes for healthcare professionals wishing to upskill.

I appreciate that there is strong interest in the debate, so I am keen to conclude my remarks. If the Minister takes anything away, I hope it is the need to find those 14,000 men missing from the prostate cancer treatment pathway, and to ensure that workforce issues are looked at by the Government. The pandemic has provided the NHS with a unique opportunity to rethink how we provide care not just to prostate cancer patients but to all cancer patients, with greater use of technology and the benefits of covid-friendly treatments that patients have had access to throughout the pandemic.

Finally, the one message that I hope those watching the debate—especially those in high-risk categories—will take away from it is: “Please get yourself checked”. The support available for patients and their families is fantastic, and it is out there. I say to people watching: “You are never alone”. I urge them to book that vital first appointment. I look forward to hearing the contributions from other hon. Members on this incredibly important issue.

--- Later in debate ---
Elliot Colburn Portrait Elliot Colburn
- Hansard - -

I thank all hon. Members for their contributions throughout this debate. I think that the hon. Member for Strangford (Jim Shannon) highlighted very well the danger in men often downplaying their symptoms. I was struck by the statistic, given by my hon. Friend the Member for Don Valley (Nick Fletcher), that one in five men will die before retirement. That is not a statistic that I had heard before; it is shocking, and shows the importance of taking these issues seriously.

I thank the shadow Minister, the hon. Member for Enfield North (Feryal Clark), and the SNP spokesperson, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), for their contributions and, indeed, the Minister for her reply. I know, as someone who has worked in the NHS, as she has, that she obviously brings a great deal of expertise to the role. I know how seriously she takes it, as she was a cancer nurse in my borough.

We are lucky in the London Borough of Sutton; we have the Royal Marsden base, the Institute of Cancer Research and the Epsom and St Helier University Hospitals NHS Trust, all of which are working together to really drive improvements in cancer patient outcomes. Indeed, the £500 million investment that the Department has given to the two hospitals will do just that, so I really welcome it.

However, if there is one message for us all to take away from this debate, it is to encourage men to check their level of risk and to get themselves tested. If we have learned anything from the pandemic, it is the importance of getting tested, so I say to people, please, get out there and encourage people to, “Check your symptoms” and, “Get yourself tested”.

Question put and agreed to. 

Resolved, 

That this House has considered NHS support for prostate cancer patients after the covid-19 pandemic.

Covid-19: Deteriorating Long-Term Health Conditions

Elliot Colburn Excerpts
Thursday 10th March 2022

(1 year, 11 months ago)

Westminster Hall
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Elliot Colburn Portrait Elliot Colburn (Carshalton and Wallington) (Con)
- Hansard - -

It is a pleasure to serve with you in the Chair, Mrs Cummins. I congratulate my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) on securing the debate and thank the Backbench Business Committee for granting it. I join colleagues in thanking a coalition of charities and organisations that have come forward to support us with research and briefings in advance of the debate, particularly the “Moving forward stronger” policy paper.

Prior to being elected in 2019, I also had a background working in the national health service. Never in my wildest nightmares could I have imagined so early on in the job, after leaving the NHS, that we would be dealing with a global health pandemic on the scale of covid-19. It has permanently changed the way we look at and plan health and care services in the UK. In the London Borough of Sutton, where my constituency of Carshalton and Wallington is situated, 600 lives were tragically cut short due to covid-19. I am sure that that number would have been higher had it not been for the dedication, bravery and care of our local health and social care services.

I know that hon. Members across the House have the deepest gratitude and thanks for the unsung heroes. They were not just our doctors and nurses, but associated health professionals, pharmacists, volunteers and all those who stepped up to do their part. Part of the reason why I launched the Carshalton and Wallington unsung heroes scheme was to recognise their dedication. Unsurprisingly, our local health and care volunteers and staff featured heavily among the hundreds of nominations that I received. I cannot possibly name them all, but I would like to thank the St Helier Hospital eye treatment team; Reena, Sanja, Ravi and other local pharmacists; the head of occupational health at Epsom and St Helier University Hospitals NHS Trust; and of course the staff at vaccination centres across Carshalton and Wallington.

At the time of the outbreak of the pandemic, there was very little public discourse—understandably, as we were grappling with something that was unprecedented—about the long-term indirect impacts of the pandemic on our health and social care system. I know that I am not alone in receiving thousands and thousands of cases from constituents during the opening weeks of the pandemic and at its peak, when there were way too many incidences of people with long-term and pre-existing conditions experiencing disruption to their care. Many of them experienced much faster deterioration than would be usual or expected, and I hasten to add that it was through no fault of health and social care staff; it was simply because of the situation that we faced.

Some of the constituency cases that I heard of involved people with long-term cardiovascular problems who were unable to get treatment, spinal cord patients who were not able to be housed appropriately, and people with dementia and Alzheimer’s who were cut off from the social interactions that were crucial to keeping their cognitive and communication skills alive. As an officer of the all-party parliamentary group on dementia and someone who has had personal experience of dementia in my family, I would like to focus on this area.

In the London Borough of Sutton there are over 2,400 people living with dementia. Based on recent trends, it is estimated that well over 3,000 residents over the age of 65 will be living with dementia by 2030—an increase of approximately 25% in a very short space of time. There are almost 1 million cases of dementia nationwide. People with dementia were badly hit by the pandemic, as indeed were many people with long-term conditions. Dementia was the most common pre-existing condition for people who died from covid-19: people with dementia accounted for more than a quarter of all covid-19 deaths in England and Wales during the first wave of the pandemic.

However, the effect of the pandemic on people living with dementia goes far beyond the statistics. Tragically, they have also seen accelerated progression of their conditions, for a number of reasons. We know that social contact is very important for people living with dementia, but it was of course restricted—again, for a very understandable reason. That has exacerbated the issues for people living with dementia. For people living in care homes, where more than 70% of residents have a form of dementia, the restrictions were particularly serious, given that the Office for National Statistics estimates that 97% of care homes were closed to visitors at one point.

People with many long-term conditions, including dementia, rely on rehabilitation services to maintain their skills and abilities. When provided with the right support, rehabilitation services can help people living with dementia to maintain their cognitive, social and emotional skills, as well as meeting their physical needs and any other related conditions. As mentioned by my hon. Friend the Member for Bromley and Chislehurst and the hon. Member for York Central (Rachael Maskell), those services were not able to meet everyone’s needs at the height of the pandemic. That was particularly true for people living with dementia, whose condition often makes it difficult for them to engage digitally, even if the service could be provided that way, which means that many people living with dementia have not been able to preserve their skills in the way that they could have done. That is exactly what happened to my constituent’s mother who is living with dementia and saw a dramatic deterioration during the first wave of the pandemic, suffering severe memory loss by the time she could meet her family again.

For those living with dementia, interaction with family is not just a nicety. It actually forms an integral and formal part of their care and treatment plan, as there is a causal link between lack of social interaction and the worsening of the condition. As we now emerge from restrictions and come out the other end of the pandemic, the long-term impact on the NHS, the care sector and people living with dementia will continue. I welcome the determination shown by the Department of Health and Social Care in dealing with the elective backlog. It is a mammoth task.

I also want to congratulate my own local NHS trust—Epsom and St Helier University Hospitals NHS Trust— for the work it has done. Previously, I welcomed the announcement of £500 million both to upgrade Epsom and St Helier hospitals and build another hospital in the London Borough of Sutton. I particularly want to applaud the trust’s ingenuity. As soon as it realised the scale of the pandemic, it had the foresight to amend its plans for the development of the new hospital to ensure that it can future-proof itself against future pandemics.

I believe we need to see determination from the Department to deal with the backlog of deterioration that we have seen among those with long-term conditions. I join colleagues and the coalition of charities and organisations in support of that national rehabilitation strategy for everyone who has seen their long-term condition progress throughout the pandemic. If planned properly, the rehabilitation strategy is an opportunity to reduce pressure on other services in our health and social care system.

Colleagues will have heard plenty of examples of people in their constituencies ending up in hospital needing round-the-clock care for entirely avoidable reasons, such as a fall. If we help people maintain the skills they have, they will be less likely to require support from acute care. The Alzheimer’s Society estimates that up to 65% of emergency admissions for people living with dementia could be avoided. Both rehabilitative and memory services are under significant pressure, and the waiting lists are still getting longer. That means that we need strategies to deal with the backlogs. With the right planning, we can not only overcome these issues but deliver better, more personalised support, because people living with dementia deserve nothing less.