Health Infrastructure Plan

Emma Little Pengelly Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

My hon. Friend is absolutely right to highlight the huge contribution that that new medical school will make to delivering a highly trained, highly motivated local workforce. There is strong evidence that when people graduate from medical school their first post tends to be in the near vicinity of that school. I therefore think that he can look forward to, as I say, a highly motivated, highly trained workforce to continue delivering first-class healthcare to his constituents.

[Emma Little Pengelly (Belfast South) (DUP)]

I welcome today’s statement and the benefit it will bring to Northern Ireland by way of the Barnett consequentials. I also welcome the reference to NHS workforce investment. The Minister will no doubt be aware that Northern Ireland faces a very particular challenge with the recruitment and retention of consultants. Will he outline when and if the situation will be addressed that currently disincentivises consultants from doing any overtime while attempts are made to fill those vacancies, because that is having a knock-on impact on the waiting lists in Northern Ireland?

[Edward Argar]

I am grateful to the hon. Lady for her comments and for their tone. She is absolutely right to highlight the importance of the workforce. Investment in new, first-class buildings and in equipment is vital because they are the tools that the amazing workforce need to do their job. She highlights a specific point about pensions, particularly consultants’ pensions. As she will be aware, we have been looking at this, and the Secretary of State has recently launched a consultation more broadly on proposals to address the challenges on pensions taxation.

Infant First Aid Training for Parents

Emma Little Pengelly Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Sarah Newton]

Rowena’s story might not have ended so well without the wonderful work of Millie’s Trust and all the other organisations that ensure that people have the training to empower them to take the right action at the right time.

That brings me neatly to the statistics from the Royal College of Paediatrics and Child Health, which suggest that 21% of child deaths involve a modifiable factor—something that could have been done to prevent that death. That is quite a significant number of lives that could have been saved if the appropriate action had been taken.

[Emma Little Pengelly (Belfast South) (DUP)]

I congratulate the hon. Lady on securing this important debate. The statistics that she outlines demonstrate how important first aid training could be—it could genuinely save lives. Given the number of agencies and organisations that young parents engage with, from schools and nurseries to GP practices, is there not a good opportunity to signpost the availability of existing courses to parents and raise their awareness of them? In my area, they are available through St John Ambulance and the Red Cross. That would encourage take-up. If parents heard the statistics, very many more would take up the opportunity.

[Sarah Newton]

The hon. Lady makes a very good point. I hope that in our small way—as a result of this debate, the people watching it from outside the Chamber and the media coverage we secure—we will encourage people to take up that opportunity. That is a really good idea.

I have been listening very much to healthcare professionals in my constituency. Dr Simon Robertson, a consultant paediatrician at the Royal Cornwall Hospitals NHS Trust, told me:

“I have been a consultant general paediatrician for the last 12 years. I see children referred into hospital from their GPs, and the emergency department.

From the view of a general paediatrician a child illness and resuscitation course for all parents makes practical sense for the families and NHS services.

Parents are expected to make important decisions about their children’s health and about seeking medical advice. But we know they find it difficult to work out if their child just has a minor viral illness, or something more serious. Unfortunately not all parents are educationally equipped to read instructions from their red book, NHS Choices or health advice apps like the ‘HandiApp’. For them, we know they really need time and practice in a supportive environment to learn these decision making skills. We repeatedly see this in the families we teach resuscitation to on the wards.

What is needed in my opinion, is a course for all parents and those in child care on how to manage the common emergency problems like choking, diarrhoea and vomiting, a seizure, recognising sepsis, managing a head injury, or in preventing accidents, drowning or cot death. These learnt skills could help keep children safe and healthy, so should be the skills highly valued by families. Vitally, early action may help prevent some medical emergencies deteriorating to life threatening illness.

This can only be good for the health of children, and for children’s acute NHS services.”

I completely agree.

In 2013, the Department for Education undertook a confidential inquiry into maternal and child health in England. It conducted a meticulous audit of deaths of babies and children, and reported identifiable failures in children’s direct care in just over a quarter of deaths, and potentially avoidable factors in a further 43% of deaths. The University of Northampton’s 2017 report “Before Arrival at Hospital: Factors affecting timing of admission to hospital for children with serious infectious illness” stated that parents often find it difficult to access relevant health information or to interpret symptoms, and that it can even be difficult for GPs to determine how serious a case is in the early stages.

I have been working with Cornwall Resus, which was established in 2012 by two paediatric nurses to give parents and carers the necessary skills to empower them to recognise when their baby or child is unwell and to respond appropriately. It runs courses for parents in community centres around Cornwall. Those courses last two to two and a half hours and include practical training on choking and resuscitation using lifelike dummies, with lots of time for questions and discussion at the end. I know that I would not be happy to undertake those actions unless I had practised them on a dummy first; having just looked at instructions or a diagram, I would still be very nervous about the amount of pressure to apply, so using dummies and having practical sessions and reassurance is really important.

--- Later in debate ---

[Douglas Ross (Moray) (Con)]

Thank you, Mr Hollobone. It is a pleasure to serve under your chairmanship. I commend my hon. Friend the Member for Truro and Falmouth (Sarah Newton) for securing this important debate, and for the various points that she raised. The way she delivered her remarks shows that the care and compassion she displayed as a Minister continues on the Back Benches. We heard from the interventions of several hon. Members how important this issue is for many people.

I approach the debate as the father of a 22-day-old; young Alastair was born three weeks ago yesterday. That is where my interest in this issue comes from. I am now mentioning my son and my wife quite a lot in the Chamber; it seems my soft side is coming out. To compensate, I remind people that when I was first elected, a magazine did a profile of all the Scottish Conservatives who had been elected, in which I was described as “tough as teak”. I have a tough side and a soft side, which I hope to balance in the debate. I was keen to take part in it for personal reasons, but also to explain some of the issues that my constituents face. While I was shocked and disappointed by the Red Cross figures that showed that just 5% of adults had the skills and confidence to provide emergency first aid to infants, I had to accept and admit that I was among the 95% who do not have those skills and have not gone through that training. I probably should have. In the nine months ahead of Alastair’s birth, I thought we had prepared for everything. We bought nursery equipment and new clothes, and even went down to the detail of how we would introduce our child to our dog. Those are all things we thought about, and it was only when this debate appeared on the Order Paper that I thought we had done nothing about preparing ourselves for this new human being coming into our lives and how we would care for him and look after him if, in the unfortunate situation described by some hon. Members, he required emergency first aid.

One of the great benefits we got ahead of my wife giving birth was the care, understanding and education of our antenatal classes. They were excellent. At Dr Gray’s and throughout Moray we have excellent midwives. We went along to Moray College on two Thursdays to attend the classes, which really prepared us both, giving us all the knowledge and information we needed for the birth and the first few days. I now wonder why we do not introduce an element of first aid training into those antenatal classes. There is a captive audience of parents wanting to know more about the first stages in their child’s life and the birth process, and they could be told how to provide emergency treatment for an infant if they require it once they are home.

[Emma Little Pengelly]

I endorse what the hon. Gentleman and my hon. Friend the Member for Strangford (Jim Shannon) have said about using antenatal classes. The parents are there and they want to learn, so that is a good opportunity. Does he agree that there are alternative opportunities, such as through Sure Start, to target families to support them on looking after their child? There is that opportunity after the child’s birth to give parents those necessary skills to save lives.

[Douglas Ross]

I fully endorse what the hon. Lady said. If there is not time or there are other constraints that mean a first aid element cannot be included in an antenatal class, perhaps there should be a signpost saying, “This is something you can consider. Here are some of the organisations who could do this,” just to put it on people’s radar. They are very excited about the birth of their child and fascinated by the birth process, which they have gone along to learn about, so just mentioning that may be a trigger that would make some parents consider, “Actually it is important to go to that organisation, or another, to get that training.”

Cervical Cancer Smear Tests

Emma Little Pengelly Excerpts

Monday 28th January 2019 Westminster Hall

[Helen Jones]

The hon. Gentleman is right. Women need to be assured that they will be treated sympathetically, whatever their age. All of us who have been to screening know that sometimes it is fine, but sometimes someone is a bit ham-fisted and it is not fine. It is better than getting cancer.

Another issue needs tackling: when women under 25 present with abnormal symptoms such as abnormal vaginal bleeding, they are not always treated according to the guidelines. In fact, they are frequently not treated according to guidelines. There are plenty of examples of younger women going to their GP with symptoms and being told they are too young for cervical screening, and plenty of examples of women going time and again and, as one lady told me earlier, being fobbed off. The problem is that GPs do not see a lot of cases and cervical cancer is therefore not the first thing they think of. The Government must do more to alert GPs to the possibility of cancer to get early diagnosis and ensure that people are referred to consultants where necessary.

[Emma Little Pengelly (Belfast South) (DUP)]

I absolutely agree with the hon. Lady that GPs and others must take the concerns of young people under 25 seriously. I recently attended a pensioners’ parliament in Northern Ireland and many women over 64 spoke of the difficulty of being taken seriously when they go to the doctor. The vast majority of deaths from cervical cancer happen to those over 50 and many of those over 64. Is that not also an issue that needs to be addressed? Those women feel that they are being left behind.

[Helen Jones]

The hon. Lady makes a good point. We need people to realise that women know their own bodies and know if something is wrong, so people must listen to what they say. There are too many examples of women having to pay for a private test before finding out they have cervical cancer. If it is not diagnosed early, there is a chance it will become terminal. If it is diagnosed early, the chances of survival are much greater, so we need to ensure that people are diagnosed early.

On the question of whether the age for screening should be reduced, I am not convinced at the moment. The scientific evidence does not support it, but I hope that the Government will keep it under review. If the evidence changes, we need to change what we do. Sir Mike Richards is undertaking a review of cancer screening and is due to report by Easter. I hope he looks at the issue. Ministers must ensure that they get the best advice and they have to proceed on that advice. We have to remember that, rare as it is, in 2016, 15% of women diagnosed with cervical cancer were under 30, and last year, 12 of those who died were under 30. We can and should do much more to prevent such deaths by ensuring that women are screened where necessary, even if they are under 25. If they have indications that require them to be screened, they should be. We must ensure that we promote the HPV vaccination programme, which is one of the best things that has been done in recent years. I say to parents who worry about it, “Don’t put your daughters at risk. Get them vaccinated.” We have to do much more to convince them that vaccination is the right thing. We have to do much more to make screening accessible and easily available to women, and it must be done in a supportive environment. Let us be honest: it is a bit like a sausage machine when we go to the GP, precisely because health workers are screening all the time. To them it is not at all unusual, but it is to the people who attend; that is the difference.

Surgical Mesh

Emma Little Pengelly Excerpts

Thursday 19th April 2018 Commons Chamber

[Emma Little Pengelly (Belfast South) (DUP)]

Let me begin by adding my voice to those of other Members in congratulating the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing and introducing a debate on this important issue.

I agree with much of what has been said by Members on both sides of the House. It is good to hear such similar views expressed about the need to think about what action should be taken to help women who are suffering some horrendous conditions as a result of this procedure. Unfortunately I did not have an opportunity to take part in the Westminster Hall debate, so I have found the many speeches that I have heard today very informative. Some, indeed, have been very technical. Questions have been asked, and the answers will be useful to us because we shall be able to convey them to our constituents. I also welcome the specific recommendations that have been made, particularly by the hon. Member for Kingston upon Hull West and Hessle. There seems to be a difference of opinion on whether mesh operations should be suspended while the audit and other matters are being resolved. I think that many of us are somewhat confused about why the risk should have been considered acceptable.

Like, I suspect, many other Members, I first heard of the issue when I was contacted by a number of constituents via social media. I subsequently met some of them face to face. The right hon. Member for New Forest East (Dr Lewis) described the specific circumstances of some of his constituents, and my experience has been very similar. I have sat and listened to many women describe what they have suffered. Theirs is a strong, powerful story of pain, and of the incredible impact on their lives, their families, their marriages and their relationships. Hearing such stories, we must ask ourselves how such pain, risk and suffering can be justified by the cases in which the procedure does work. I know that many of us are appalled when we hear of the experiences of the numerous women whose lives have been blighted by these procedures.

A number of issues have been raised, and I do not want to reiterate what has already been said. Instead, I shall focus on two elements that I do not think have been dealt with in any detail. First, we need to ensure that all the women affected are identified and fully supported, and benefit from the highest-quality care and intervention that can be provided at this stage. That, for me, is a priority, which involves two important considerations. One is the question of where we are right now—what these women are suffering right now, and what we can do to help them to try to find resolution. That journey will require the highest levels of expertise and support.

As we have heard, many of the medical interventions involved are complicated, and, given their previous experience of medical procedures, many women are understandably deeply apprehensive and worried about undergoing further necessary procedures. The right experience and qualifications, and a wrap-around support service, are critical not only to securing the best medical outcomes but to building confidence among the many women who have been let down by interventions in the past. I empathise with women who know that they will have to undergo even more medical procedures, even after having such horrific experiences and suffering the consequences of the previous interventions.

There is also the question of the suspension of mesh operations. I have written to the authorities in Northern Ireland and to the Secretary of State requesting a suspension pending the outcome of the audit and the review. In circumstances such as this, I am always very aware that many of us here are not doctors. We are not members of the medical profession. We are told—this has featured in the responses to my correspondence—that even Departments and their civil servants must and do listen to the medical professionals. It is important for NICE to move more quickly, though, because its recommendations will be crucial for frontline care, advice and the pathways that are followed for women who present with the issues that have led to this procedure.

Secondly—this has been discussed at some length today—there are the critical questions of why this happened and why it was not picked up earlier. I welcomed the Secretary of State’s announcement of a review, because it will cover some of those issues, but we need to understand how we have reached this position. I have spoken to constituents, and to members of the lobby from across Northern Ireland, and their common experience is that they were not taken seriously enough at all stages. Complaints made to medical professionals about complications were often dismissed, even when the women were in extreme and chronic pain. The database has been referred to. There should have been a database at an earlier stage so that the information could be located. I fully support a UK-wide database, because, as has been said, it would be the best way of gaining a wider sense of what is happening.

It is worrying that hundreds and thousands of women across the United Kingdom were individually presenting with complications from these procedures, yet nobody joined up the dots until a very late stage. I am glad that that is now happening—I am glad there is a review—but many women have had to suffer for too many years without the dots being joined and action being taken.

It is not acceptable that women presenting with problems were told by some GPs or other medical practitioners that perhaps it was just women’s problems—that these were the types of complications that generally arise in issues associated with the menopause. The problems were dismissed, and women felt dismissed and that their issues were not being taken seriously. That is wrong and unacceptable.

We hear a lot at the moment in Northern Ireland—I am sure it is the same across the United Kingdom—about patient-focused care and the patient-focused experience in the health service. Yet in all the stories I have heard about this issue, there is the common experience of people not being taken seriously and not having a patient-focused experience. That must be addressed urgently.

I look forward to the outcome of the review, and to some of the actions being discussed such as the audit and the setting up of the database, but it is important that we identify not only what went wrong, but clear actions to take to stop it happening again. We must learn from the mistakes of the past and make sure that actions are identified and that we progress.

Finally, I thank the advocates who have done a huge amount of work to raise awareness of this issue across the United Kingdom, including in Northern Ireland.

Medicines and Medical Devices Safety Review

Emma Little Pengelly Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

I can confirm that, although it is also important to say that if we discover changes in procedures that will improve the safety of medicine use or medical device use, the people who put those new drugs on the market would want to benefit from any changes in regulatory processes, but what we would not want to do is reduce the speed.

[Emma Little Pengelly (Belfast South) (DUP)]

I welcome the Secretary of State’s statement. I have met and been contacted by many women in my constituency who continue to suffer excruciating pain and serious detrimental outcomes as a result of surgical mesh implants. I welcome these initiatives, but I suggest that there would be huge value in some of them, such as the database, being established at a UK-wide level. What discussions have he and his Department had, or do they intend to have, with the devolved regions to ensure that this could take place at a UK-wide level?

[Mr Hunt]

Our approach on safety issues is that we are happy to do anything on a UK-wide basis if that is what the devolved Administrations want, because we do not see any benefit in not sharing data. If the willingness is there among the other Administrations, we would be happy to play ball.

Baby Loss Awareness Week

Emma Little Pengelly Excerpts

Tuesday 10th October 2017 Commons Chamber

[Emma Little Pengelly (Belfast South) (DUP)]

I am grateful for the opportunity to take part in this important debate, which allows us to play our part in Baby Loss Awareness Week.

In terms of how we talk about it day to day, pregnancy and childbirth are for many people times of joy and celebration: a new addition to the family, a celebration of new life, the hopes and dreams—and laughter and tears—that a new baby can bring to a family. It is all the more difficult, therefore, when a family suffers the loss of a baby. These issues— miscarriage, stillbirth, death in infancy—are less commonly spoken about for a range of reasons. I note that the hon. Member for Central Ayrshire (Dr Whitford) referenced miscarriage. I know from speaking to family and friends that the loss is felt acutely, but too often, perhaps, society trivialises it. To the mother and family, it is the loss of a baby—an unborn baby—and the hopes and dreams that go with it. When that is taken away, privately it can be very difficult. Some do not tell their family and friends straightway, so the grief takes place in a very private and unspoken way. Others break the news, and it is heart-breaking to have to so shortly after sharing the good news of the pregnancy. I know that that can be particularly difficult for families and women.

The pain and loss that follow from the loss of a child can be acute. I know that families admire the many improvements made and I recognise that much work has been done, but I also know that more must be done to enhance services, including bereavement services, and the support for perinatal and post-natal mental health. I know from speaking to many women that the support services are simply not there at this very difficult time. It is not right, for example, that many women continue to be placed in and around maternity wards, surrounded by new mothers, parents and joy, at a time when they are grieving. Having to listen to the conversations, hearing the cries of new-born babies, while suffering their own personal loss, makes it all the more difficult for them and their families. It is not right that a woman who has suffered miscarriage after miscarriage, often when a child is much longed for, is required to sit in an out-patients maternity ward with heavily pregnant and joyful mothers-to-be. Very often women are left there for half an hour or an hour watching those families and feeling the pain of their loss—sometimes loss after loss—very acutely. It is not right either that families are left without adequate bereavement care.

I want to raise a number of short points. First, our perinatal and support services must improve, not just following baby loss or miscarriage, but in relation to women’s mental health. The way in which we understand the human mind, mental health and trauma has changed and advanced year on year, but I think that, for too many of the people who go through this experience, those services are not advancing at the same pace and they need to catch up.

Secondly, we need to look at statutory and support services for bereaved parents as a matter of urgency. Like many people, before I started to speak to parents, I had assumed that these issues would be dealt with compassionately by employers, schools and statutory agencies, but it became clear that that was not always the case. There is a good basis for the introduction of enhanced statutory protections for bereaved families, to ensure that they are given the time that they need to try to heal and move forward with their lives.

Thirdly, I think it would be remiss of us not to refer to the health of mothers, infant mortality and miscarriage rates all over the world. There is no doubt that improvements can be made, and that they can be made throughout the United Kingdom as well. I welcome the commitment that has been made in that regard, but in too many countries, there are still appalling rates of infant mortality and appalling statistics about the health of mothers and what happens during childbirth. I know that most of those who campaign on the issue here will have the same interest in trying to improve services for women throughout the world. Those in the poorest areas often suffer incredibly during childbirth, and there are still very high levels of infant and mother mortality in such places.

Lastly, I want to take a moment to recognise all the parents and families who have suffered loss in this way. I think that it will be an incredible tribute to those families, and to the loss that they have suffered, if we go on striving to create world-leading services in both bereavement and childcare.