Oral Answers to Questions

Fabian Hamilton Excerpts

Tuesday 11th July 2023 Commons Chamber

[Will Quince]

I thank the hon. Member for that question and join him in paying tribute to the hon. Member for Mitcham and Morden (Siobhain McDonagh), especially after the tragic loss of her sister, for all the work that she has done in campaigning on this issue. I have spent significant time on the issue and I have met her, the hon. Member for Leicester West (Liz Kendall), campaigners, charities and other hon. Members from across the House. Funding for research is available and, having spoken with the Secretary of State, I know that he is as keen as I am to work with colleagues from across the House. There are issues that transcend party politics and this is certainly one of them. I would be very happy to meet the shadow Secretary of State, the National Institute for Health and Care Research, NHS England, the Tessa Jowell Brain Cancer Mission and clinical specialists to find a way forward.

[Fabian Hamilton (Leeds North East) (Lab)]

9. What assessment he has made of the adequacy of treatments for complex mental health illnesses in West Yorkshire.

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

NHS West Yorkshire integrated care boards have increased their investment in mental health services in line with their overall allocation increase. They have spent more than £591 million in the past financial year on their mental health services.

[Fabian Hamilton]

I thank the Minister for that answer. My constituent, Joanne Allotey, has custody of her young granddaughter, who has complex mental health problems, but local mental health services in Leeds are still chronically underfunded after 13 years of Conservative Government cuts. Will the Minister join me in commending Roundhay high school for the support that it has given the family—this is the same school that the former Prime Minister claimed “let down” children—and commit today to delivering truly effective children’s education, health and care plans?

[Maria Caulfield]

I absolutely pay tribute to the school in the hon. Gentleman’s constituency. I also point out that Red Kite View is a new unit specifically for young people in his constituency. That 22-bed mental health unit opened last year and aims to eliminate out-of-area placements for young children with mental ill health. I am sure that he would welcome that investment in his constituency.

Mental Health Services: Leeds

Fabian Hamilton Excerpts

Tuesday 23rd April 2019 Westminster Hall

[Fabian Hamilton (Leeds North East) (Lab)]

I beg to move,

That this House has considered mental health services in Leeds.

It is a pleasure to serve under your chairmanship, Mr Hosie.

I requested this debate with some reluctance, because I did not want to believe that mental health services in my city—a city that I have lived in for 40 years and which I have been privileged to represent for the past 22 years—were so appalling, especially when compared with other cities and regions in this country. Sadly, however, when I met my constituent Charley Downey two months ago at a routine advice surgery, the evidence that she presented to me on behalf of her husband was so damning and shocking that I felt that there was no other option than to bring their concerns to the attention of this House and hopefully to the attention of the Government, so that appropriate action could be taken to put right a gross injustice being done to so many of my constituents, as well as those of my seven fellow Leeds MPs from across the House, and those of MPs in the broader area, such as York MPs.

The Government have acknowledged on many occasions over the past few years that mental health services across the country are under-resourced and they have promised remedial action, but one of the biggest problems is the uneven distribution of funding, as I have mentioned. The waiting list for treatment in Leeds is approximately 48 to 52 weeks, once a patient is actually put on the waiting list. However, that requires a prior diagnosis by a qualified nurse, or a “formulation”—because nurses are not permitted to make diagnoses. If a patient is suicidal, then even a few hours on a waiting list may be too much, or in the worst cases possibly fatal, but to wait for a year is simply appalling. Compare that waiting-list time with, say, that of East Lancashire, which is 12 weeks, or that of the London Borough of Hillingdon, which is six weeks, or that of Cheshire, which is nine weeks, and I am sure that the Minister will understand my concern and the deep anxiety of my constituents.

Andy Downey first attended his GP’s surgery on 8 November 2016 with serious concerns about his depression. He was given a leaflet about a service called “Improving Access to Psychological Therapies”, or IAPT, and he had a blood test, which subsequently showed that he had a folate deficiency, for which vitamin D supplements were supplied.

Ten months later, in October 2017, with his symptoms worsening and the supplements failing to help, Mr Downey attended his GP’s surgery again. A week later, after suffering a full panic attack and breathing difficulties, he was referred back to his GP, who suggested that Mr Downey refer himself to the IAPT through a website called Mindwell. The problem was that Mindwell has no mental health content or referral option to the IAPT, apart from a phone number. Andy rang that number, which went straight through to voicemail. His GP had told him that Mindwell was the only way to get a referral to the IAPT, but when Mrs Downey phoned the mental health trust—the Leeds and York Partnership NHS Foundation Trust—she was told that the GP had given her husband the wrong advice, and the trust accepted Mrs Downey’s request for treatment as a referral. Therefore, Andy’s initial assessment meeting finally took place on 5 February 2018. Charley Downey has provided me with almost four pages of information about dates, times, meetings, appointments and lack of outcomes, all of which I can make available to the Minister, if she so wishes, or to the trust, which should already have this information.

When I first met Charley on 16 February, I was appalled not only at the way in which her husband had been treated but by the state of mental health services in Leeds, which this case seemed to typify. On 19 February, I wrote to Dr Sara Munro, chief executive of the Leeds and York Partnership NHS Foundation Trust, to express my concerns about the case of Andy Downey and to raise the issues of underfunding for mental health provision in general across the region.

I asked Dr Munro what her perspective was on the difficulty of accessing mental health care through the NHS at present and why the trust had decided to use online tools rather than face-to-face therapy, when it seemed to me—purely a layman—that mental illness is one area in which human interaction and sensitive expert clinical judgement might be essential.

[Andrea Jenkyns (Morley and Outwood) (Con)]

First, I congratulate the hon. Gentleman and my fellow Leeds MP for bringing this important issue to the House; we all have constituents who have suffered in a similar way to his constituent.

Recently, I visited Morley Newlands Academy in my constituency during mental health week. I, for one, think we need to tackle mental health issues at a young age. Representatives of Place2Be, a charity, were there, having come into the school to offer a variety of services. I saw the value of raising the awareness of mental health at such a young age. Does the hon. Gentleman agree that we need to ensure that children in schools, even primary schools, receive the support they need, and that we also support the charities involved, to ensure that they get the funding to continue their good work?

[Fabian Hamilton]

I thank my hon. Friend—if I may call her that—and my colleague from Leeds for her intervention, because she makes a very important point, namely that we need to begin at the earliest possible age. It is tragic to me, and I am sure to every Member of this House, that an increasing number of young people are showing signs of depression and other mental health problems, and that is evident in our schools. The role of charities is very important, but so is the role of the national health service. Although we need to support those charities, as she rightly says, we also need to ensure that we have the resources within our NHS too.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am really grateful to my hon. Friend for securing this debate, because the Leeds and York Partnership NHS Foundation Trust lost the main contract with our clinical commissioning group as the result of a litany of failures in my constituency, including ignoring three Care Quality Commission reports, which put mental health patients in my constituency at serious risk. My question today is this: will the Minister review the licence of that trust to operate, or not, in light of the consequences of its actions and the harm it has caused?

--- Later in debate ---

[Fabian Hamilton]

I thank my hon. Friend for her intervention. York is a city that I know well, and of course York and Leeds are united together through the partnership trust. I will now go on to detail my own experience with the Leeds and York Partnership NHS Foundation Trust, because my experience is similar to the experience that many of her constituents have discussed. The points she makes are very valid and I would be very interested to hear what the Minister has to say in response, not only to her intervention but to what I am about to say.

The reply to my letter to Dr Sara Munro, the chief executive of the Leeds and York Partnership NHS Foundation Trust, was dated 1 March, and it was written by Samantha Marshall of the complaints team, who said she was

“sorry that you have reason to make a complaint and, as a trust, we have failed to meet your expectations.”

Bear in mind that I had written on behalf of my constituent and that I had raised other issues. Ms Marshall went on to say that the trust has had no contact with Mr Downey since he was referred to the IAPT, which is provided by Leeds Community Healthcare, and that she would forward my letter to LCH if I wished. However, no reference was made to any of the other more general questions that I had asked Dr Munro, questions that I believe are highly pertinent to the treatment that my constituent received, and to the treatment that many of my fellow Leeds MPs’ constituents have received as a result of the severe underfunding of mental health services in our area.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend from Leeds North East is making an excellent speech. I had a similar case with one of my constituents, who visited her GP on 31 December 2018 to say that she felt suicidal. She was asked to go home and told that the crisis team would contact her. The crisis team did not contact her. Four hours later, she returned to her GP and then had to go by ambulance to Jimmy’s—St. James's University Hospital. She waited in accident and emergency for 20 hours. Eventually, the acute liaison team gave her a leaflet. That was the level of intervention that she experienced. It was not until my office intervened with the IAPT that she got a referral, and by then she had already made another suicide attempt. That is how the services in Leeds were delivered in the case of my constituent.

[Fabian Hamilton]

I thank my hon. Friend, whose constituency is next door to mine. As I suspected when I requested this debate, there are cases all over the city of Leeds—probably all over the country, but certainly in the Leeds and York area —that highlight the inadequacy of mental health services and the maze that people have to navigate if they need them. That is a source of huge concern.

[Andrea Jenkyns]

A couple of years ago, I had a memorable case of a gentleman who was suffering from horrific mental issues and had attempted suicide several times. On one occasion, after he had slit his wrists, he went to A&E. There was no joint communication; his GP, who was supporting him, did not even know about the incident. Does the hon. Gentleman think we need to ensure that the NHS systems talk to each other a lot better and that there is a much more joined-up approach?

--- Later in debate ---

[Fabian Hamilton]

Yes. I thank the hon. Lady for her point. That is one of the problems: it is a maze. If people are told to refer themselves through a website, which can then refer them to another organisation that is supposed to allow them to make an appointment, and they then leave a message on voicemail and it is never responded to, that is shocking in itself. The example my hon. Friend the Member for Leeds North West (Alex Sobel) gave of the ambulance and the waiting in A&E, and then the lack of credible resources and assistance from the mental health services, highlights the scale of the problem.

After the date for this debate was published, I was contacted by Healthwatch England, which told me that Healthwatch Leeds was about to publish a report on mental health in Leeds and that it would be happy for me to use some of the report’s data and conclusions in the debate. Unfortunately, owing to unforeseen circumstances, the publication of the report has been delayed, but to show that Andy Downey’s is not an isolated case, here is a quote from one of the 697 people in Leeds—I do not know his or her name—who gave evidence for the report during the first three months of 2019:

“I do not know what is wrong with the entire Trust. I had waited since February for a referral to the CMHT”—

the community mental health team—

“I was seen in August. I was discharged, told to talk to IAPT. IAPT has its own waiting lists. As a result of not being able to prove I accepted, I lost everything. I DID NOT REFUSE TREATMENT!! NONE WAS OFFERED!! Today I phoned the crisis team in tears, and they said ‘contact your GP in the morning’. I have no job, I have no money, I went through over 6 months waiting for a simple appointment. I am struggling, and the best the crisis team can do is say ‘contact your GP’. My GP referred me to the CMHT because I was suicidal. Can’t believe the crisis team said ‘tell your GP’. I have been telling my GP, who couldn’t handle it, so he sought help. Today I found out I lost my job, and I will soon be homeless, because my home is provided by my employer. I was suicidal and depressed before today... can’t the crisis team show some empathy and realise some things are a tipping point?”

[John Howell (Henley) (Con)]

I am not a Leeds Member, but what the hon. Gentleman has highlighted in that moving passage is the need for GP training in this area, right across the country. Is it not time that we got that training right?

[Fabian Hamilton]

I thank the hon. Gentleman for that important intervention. He is absolutely right. It is clear from what I, and all of us, have seen that all GPs need far better training in how to deal with mental health issues.

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

It seems extraordinary that it is not compulsory for GPs to be trained in mental health. That is something that the Royal College of General Practitioners would like to change and something I hope the Minister will be able to pick up and work on. On the capacity in Yorkshire and the Humber, general and adult psychiatry at ST4 in 2017 had 20 places for trainee psychiatrists, only six of which were filled, and for dual general adult and older adult there were two places, none of which were filled. How much does the hon. Gentleman believe that a lack of staff resources contributes towards the poor care available to his constituent?

--- Later in debate ---

[Fabian Hamilton]

I thank the hon. Gentleman for that important point. I know that staff—competent and qualified staff—are needed to fulfil the expectations and the demands, but I do not know why that is. Is it under-funding or under-resourcing, or simply that there are not enough trained personnel available to fill the posts? Or is it that the level of training, competence and experience is not sufficient for the demands of the posts? That is something we will have to explore and I hope the Minister will also make it one of her priorities.

The quote I read out is a truly damning condemnation of the trust, not in my words, but in the words of someone crying out for help and cruelly being denied it, through, I believe, a mixture of incompetence, complacency, under-funding and—I am reluctant to say this—a bit of callousness too. Lives are being put at risk by the crisis and the question I would ask above every other is: why is Leeds so inadequate and so poorly funded compared with many other parts of England?

Let me come back to my constituent, Andy Downey. Andy was placed on the waiting list for mental health treatment in April 2018, with an estimated date for his first appointment in November or December of that year. That was subsequently extended to March 2019. However, in the meantime he experienced an unrelated physical health issue, in November 2018, and was sent to a private hospital—Spire Leeds Hospital in Roundhay —to see a surgeon, as they were contracting NHS services. That appointment was in December last year. He was told that he needed exploratory surgery to resolve the issue, which would be scheduled “after Christmas”. When no update had been received by January 2019, Charley chased the matter, only to be told that the hospital had tried to call but “hadn’t got through”. However, no calls or messages had been received by the Downeys. The surgery was subsequently scheduled for May 2019—next month. Because Andy will apparently not be able to attend mental health treatment while waiting for surgery—I am not sure why—his mental health treatment has been cancelled and he has been placed back on the bottom of the waiting list to start the whole process again. The current waiting list is 10 months.

Let me summarise Andy Downey’s case, for the Minister’s benefit—I am sorry, I am eating into her time: it took longer than a year, and multiple GP appointments, just to get a mental health referral, and then only after an ambulance attended. Referral for assessment took four months. From assessment to recommending prescription for antidepressants to receiving a prescription took an additional two months. The waiting list from decision on treatment to first treatment session took 49 weeks. It took 18 months from first contact to get an antidepressant prescription. It took 29 months from first contact to initial treatment appointment. It then took another 10 to 11 months to restart treatment because of the failure of a private company to schedule unrelated surgery. I am sure that the Minister will agree that that is totally unacceptable. Mental health services are often as urgent and necessary as physical health treatment, yet they are treated almost as a Cinderella service. The fragmentation and under-resourcing of mental health services, especially in Leeds, means that lives are often at risk.

We have had several debates in the House over the past few years about depression and the effect that it can have on the individual and everyone who cares about that person, with a few brave MPs telling the House and the public what they have suffered, but unless we make our mental health a priority, we will have more and more cases like that of Andy Downey and his wife Charley —who is present here today, and has had to carry the burden of incompetent and inadequate public services on her shoulders. Although we live in one of the richest societies in the world, we cannot, it seems, organise and fund the very services that will help to bring so many people afflicted with mental illness and depression back into mainstream society. It is a condemnation of us all that couples such as the Downeys have had to bring their shocking experience into the public domain through their Member of Parliament. I salute their courage, but feel angry on their behalf.

Finally, will the Minister answer these questions or, if she is unable to do so, will she write to me after the debate? First, what mechanism do the Government have to ensure that mental health services are delivered equally across the country? Secondly, does the Minister really believe that the private sector has a beneficial role in delivering mental health services? Thirdly, will she intervene by raising with the Leeds and York Partnership NHS Foundation Trust the issues that I have drawn to her attention in this debate? I hope, for the benefit of the Downeys and on behalf of the many thousands like them across our city, that mental health services can be given the priority and the resources they need in order to ensure a healthier and better society for us all.

Anti-TNF Drugs

Fabian Hamilton Excerpts

Wednesday 9th December 2015 Westminster Hall

[Fabian Hamilton (Leeds North East) (Lab)]

I beg to move,

That this House has considered prescription of anti-TNF drugs.

It is a pleasure to serve under your chairmanship, Mrs Main. I am grateful for the opportunity to speak about NHS prescription of anti-tumour necrosis factor drugs, a subject on which I have become somewhat familiar since I was contacted more than two months ago by my constituent, Samara Ullmann.

Before I move on to why I requested the debate and to define what anti-TNF drugs are and their uses, it may be helpful to give you, Mrs Main, the Minister and other Members present the background as to why this specialist medication will make such a difference to my constituent and so many others.

Samara Ullmann, who is now 29 years old, was born in my constituency in 1986. At the early age of just two, her parents noticed that she was walking with a limp. Worried about her clear inability to walk without pain, her parents took her to her local GP, who referred her to Leeds general infirmary where she was diagnosed with a condition known as juvenile idiopathic arthritis. The terrible condition affected both of little Samara’s legs, her wrists, her ankles and her knees. Her parents were told by the hospital that it was likely that she would have to be in a wheelchair by the time she reached the age of 10. From the age of two and until she was six, she had to wear splints on both her legs.

Professor Anne Chamberlain supervised Samara’s treatment over the next few years. During Samara’s visits to Leeds general infirmary every three to four weeks she was given hydrotherapy, physiotherapy and a cocktail of drugs. Her parents were told that little else could be done for her, which was confirmed by some of the country’s top rheumatologists.

From the age of six, Samara started having problems with both her eyes, which developed uveitis, a common effect of JIA. By the time she was seven, a cataract had developed in her left eye and was removed, but it was left considerably weakened so that, by the time she reached the age of 11, she had completely lost the sight in that eye. Fortunately, her right eye continued to function normally, although when she reached the age of 14 she needed laser treatment on that good eye and was understandably frightened that she would be left completely blind.

The JIA improved considerably by the time Samara reached 17, but sadly her left eye had to be removed because it was both blind and painful. After three months, she was fitted with a prosthetic glass eye, which fortunately is able to move to a limited extent with her functioning eye. The Minister may be able to imagine the terrible effect that all of that had on a teenage girl growing up in the early part of this century. Her self-confidence was badly damaged, too.

As the arthritis gradually abated, Samara was left with a common consequence of the condition, refractory uveitis, which often causes blindness even with the best treatments currently available. Her right eye—her only eye—is now severely affected. So far, despite a paralysed iris, a stuck-down pupil and a developing cataract in her remaining eye, her sight has been partially protected by the use of a drug called mycophenolate, which together with methotrexate is commonly used to treat uveitis.

Those drugs impair the white blood cells that promote the inflammation that causes uveitis. However, despite treatment with those drugs over the past eight years, the vision in Samara’s only eye continues to deteriorate. That is why her eye specialist at Calderdale Royal hospital in Halifax, Mr Teifi James, believes that in order to save her sight, she needs to be prescribed an anti-TNF drug such as Humira—adalimumab.

An anti-TNF drug is a monoclonal antibody that specifically targets tumour necrosis factor alpha. Because of the way in which it is manufactured, it is called a biologic. TNF is involved in causing inflammation in a number of autoimmune and immune-mediated disorders. Those diseases probably cause too much TNF to be produced, modifying the body’s immune response and causing inflammation. Anti-TNF drugs reduce the amount of TNF in the body. They are expensive and may have side effects that could be severe, but, with appropriate monitoring and care, such effects are rare. In fact, they are much less common than the many problematic side effects of corticosteroids.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this issue to Westminster Hall. The Minister will be seeking to improve the success rate of anti-TNF drugs. Many universities across the United Kingdom are looking at how to improve medication for those with eye ailments. We have two in Northern Ireland, which are Queen’s University Belfast and, in particular, Ulster University—

[Jim Shannon]

Does the hon. Gentleman agree that that is a good idea?

[Fabian Hamilton]

I thank the hon. Gentleman for that intervention. He is right. The more studies carried out across the country at university level, the better it will be for patients suffering from refractory uveitis.

The anti-TNF drugs switch off the molecule that creates the inflammation in the first place and are therefore far more effective than corticosteroids in cases such as Samara’s. I am sure that Queen’s University Belfast and many others can confirm that.

Last year, Samara married her fiancé, Ben, and the couple now want to start a family. However, it is not at all advisable for her to become pregnant while taking mycophenolate, because it may well cause a miscarriage or birth defects. An anti-TNF drug could allow her to retain her eyesight and probably to conceive safely and be able to see her child grow up.

Let me move on to why adalimumab or infliximab should be available immediately on NHS prescription for adults with sight-threatening uveitis. I am aware that the National Institute for Health and Care Excellence is about to conduct a multiple-technology appraisal of adalimumab and infliximab and that responses to the draft must be received by 16 December—this time next week. From my conversations with Teifi James, one of the country’s leading eye surgeons, and from my research into that treatment it would seem that drugs such as Humira are highly effective in the treatment of uveitis, so much so that researchers in the Sycamore trial in Bristol, to which the Minister referred in his letter to me of 4 November, have stopped recruiting to it because the children being treated are doing so well on the drug. However, NHS England did not take that into account when it made its most recent decision on the use of adalimumab and infliximab for the treatment of adult uveitis alone.

According to Mr James, approximately 120 patients with sight-threatening uveitis are waiting for anti-TNF treatments in England, whereas patients in Scotland currently have access to adalimumab and infliximab. Treatment using Humira costs just under £10,000 a year per patient, which means that approval of the use of this drug for treating refractory uveitis alone would cost no more than £1.2 million a year.

[Mr Andrew Smith (Oxford East) (Lab)]

I commend the argument that my hon. Friend is making on behalf of his constituents. I too have been contacted by a constituent about this issue, who points to the excellent work being done by the Olivia’s Vision charity, which my hon. Friend may have heard of. My constituent says:

“My daughter currently suffers from Uveitis and is receiving Infliximab to treat the condition, so far successfully. I would like to live in the hope that this would be available to her in the future should her conditions change, and indeed others to whom this could be a sight saving drug.”

Is it not important that patients such as my constituent’s daughter have that assurance?

[Fabian Hamilton]

I agree with my right hon. Friend. In fact, the Olivia’s Vision charity has been in touch with me and offered its full support for this debate and any future effects of it, which will hopefully include a decision from the Government that both infliximab and adalimumab will be available on the NHS. Those anti-TNF drugs are clearly completely effective in the treatment of refractory uveitis alone. I will talk a bit about the effects of anti-TNF drugs on other conditions.

[Dr Tania Mathias (Twickenham) (Con)]

I greatly appreciate the hon. Gentleman giving me time to speak. For information, I am an eye doctor. Does he agree that what is important with severe conditions such as refractory uveitis is the principle that it must be up to the senior clinician—no one else; not NHS England and not a Minister—to decide if and when these treatments should be prescribed, and that the clinician must not be prevented from doing so?

[Fabian Hamilton]

I am grateful to the hon. Lady for her contribution, especially given her expert knowledge in the field. I agree 100% with her; it should be for clinicians to make such judgments and decisions, provided the drug is deemed safe. Enough testing and evaluation has so far been done to show that these drugs are not only safe but highly effective.

The point I was going to make, before those helpful interventions, was that it would cost no more than £1.2 million per year for all the patients in England to be treated with adalimumab or infliximab. To put that in context, I ask this question of the Minister: what would be the cost of paying benefits to all the young adults—most of the sufferers are young, working adults—who will suffer from sight-threatening uveitis for the rest of their lives if they lost their remaining sight for lack of a sight-saving drug that has already proven highly effective, as the hon. Member for Twickenham (Dr Mathias) said? Surely the taxes that they pay now and will pay in the future would more than outweigh the cost of allowing the use of this medication, never mind the additional cost of paying benefits to blind people who can no longer be as economically productive.

Teifi James is one of about 50 eye surgeons in England who specialise in the management and treatment of uveitis, out of a total of around 1,200 eye consultants in the country. He and his colleagues know from their work and the clinical evidence that adalimumab and infliximab work well, yet they are being denied the opportunity to prescribe that sight-saving treatment. Members may be forgiven for assuming that the use of biologic drugs such as adalimumab is a novel step, but that is not so. Teifi James first used Campath, one of the original monoclonal antibody therapies, to treat ocular disease as long ago as 1997. Uveitis specialists had been effectively using infliximab and adalimumab in appropriate cases for over a decade since 2000, until the NHS reorganisations changed the commissioning regulations. English uveitis specialists are frustrated that the treatments they had been using have become inaccessible as a consequence of recent changes to NHS commissioning.

If Samara or any of the other 120 young adult sufferers of uveitis were suffering from another condition as well, such as Crohn’s disease or arthritis, they could be prescribed these drugs, which would prevent the further development of uveitis. Sadly, however, without multiple conditions, uveitis alone cannot be treated with Humira or similar anti-TNF medication. I hope the Minister and anyone else listening to this debate will agree that that is highly unfair and just plain wrong.

As I have said, Samara’s remaining vision in her right eye is now failing. Mr James can operate on her eye to remove the cataract and correct the problems she is currently experiencing, but he is reluctant to do so unless she is established on treatment with Humira. He feels that the risks are too great on her present medication.

I hope the Minister will answer the following questions when he responds. First, does he acknowledge that time is of the essence and that young adults in danger of losing their eye sight cannot wait for sight-saving treatment much longer? Secondly, will he use the points I have made today to persuade NICE to speed up its review? Thirdly, will he offer my constituent, Samara Ullmann, and the 120 other patients like her the hope that a treatment senior clinicians say is highly effective can be used for their benefit without further delay? Finally, does he agree that Samara should have the chance to have a family and to see her children grow up, just like every other parent in the country?

Sugary Drinks Tax

Fabian Hamilton Excerpts

Monday 30th November 2015 Westminster Hall

[Mark Field]

As the father of two young children aged seven and four, I entirely endorse what the hon. Lady has to say about the prevalence of treats for today’s youngsters compared with that which our generation grew up with. Does she accept, however, that the issues here are the responsibility of parents and of the companies who produce such goods? Many of those companies have shown a level of responsibility, and the average size of confectionery such as the Mars bar has fallen as time has gone by. There is more information on all such products about the amount of fat and sugar that they contain. In many ways, we are living in an age of more responsible and more informed consumers, both young and old. That is where the responsibility lies, and that responsibility has been put into place to a large extent—

[Fabian Hamilton (in the Chair)]

Order. I remind hon. Members that interventions should be kept brief, and that they should be questions.

[Helen Jones]

The right hon. Gentleman flatters me by saying that we are of the same generation; I think he is quite a bit younger than me. As I will come on to say, I do not think that the public health responsibility deal has delivered, and although it is true that there are responsibilities on parents and all of us, we have to look at the environment in which people operate. In this country, I think we face a real health emergency that is equivalent to an epidemic, and sugar is one of the worst culprits. Sugar is added to processed food, and that changes our tastes over time. A small can of drink can contain up to nine teaspoons of sugar. The result of that is that we are all growing bigger, particularly our children. Thirty per cent. of our children are overweight or obese. Many adults are too, and they often live in the poorest communities.

--- Later in debate ---

[Mark Field]

Do you want a debate?

[Fabian Hamilton (in the Chair)]

Order.

[Helen Jones]

I have said to the right hon. Gentleman that I will not give way again.

The Government need to introduce a much tougher responsibility deal, with targets for improvements in individual products. A cross-Government strategy is also needed. As well as looking at schools, the health service and other public services, Ministers need to come out of their silos—after a time, all Ministers get into silos in their Departments—and look at what is happening overall. We do not want to see a repeat of what happened in the previous Parliament, when the Department of Health urged us to take more exercise while the Department for Education was cutting funding for school sports partnerships.

We need to consider that seriously, because what the petition asks for has to be part of an overall strategy to ensure that we promote healthier diets and get people more active, and not just by playing sport—sport is important, but I speak as someone who spent more time avoiding games at school than I ever spent playing them. There are other ways of getting people active. We need to encourage more walking and cycling, which is a role not just for the Department for Transport but for the Department for Communities and Local Government and for local councils, too. There is no reason why we cannot design new developments better to encourage more walking and cycling. There is no reason why we cannot ensure that new developments have children’s play facilities, communal gardens or even allotments, which are in very short supply, to encourage people to take exercise out in the open air.

We cannot continue with the current hands-off attitude. The problems are too great for that. The Government need to accept that the things they have done so far are—[Interruption.] The Minister will have a chance to speak when she winds up; she need not chunter from a sedentary position. Ministers ought to be above that sort of thing.

We need to have a full look at the situation and to encourage a proper national conversation, because the only way that such initiatives can be successful is if we take people with us.

[Helen Jones]

No, I have said several times that I will not give way again. I will now wind up my speech. The hon. Gentleman can make a speech later.

We must take people with us. We must get people to understand the need for a healthy diet, we must get people to understand the risks that many of us are currently taking with our diets and, most of all, we must get people to understand the future risks to their children. As I have said, a sugar tax is one of the things that we need to have, but the Government need to go much further and introduce a proper, co-ordinated national strategy to ensure that, in future, our people are healthier than they are now.

[Fabian Hamilton (in the Chair)]

Owing to the number of Members who have requested to speak, I may have to impose a time limit on Back-Bench speeches after the Chair of the Health Committee has spoken.

--- Later in debate ---

[Mark Field]

It is only fair that we give some credit to the industry, as my hon. Friend has done, particularly for the changes that have been made in relation to salt products. However, it seems to me somewhat insidious that, as we heard in an earlier contribution, the financial interests are being questioned, as though health professionals, who are often well funded by public funding, did not have a financial interest in this particular debate, as well as—[Interruption.]

[Fabian Hamilton (in the Chair)]

Order.

[Mark Field]

A significant number of health charities also have a big financial interest in this debate, and it is right that that interest should be balanced against those with clear financial interests in the industry.

[Fabian Hamilton (in the Chair)]

Order.

[Dr Wollaston]

I thank my right hon. Friend, and I should say for the record that I have no financial interest in any of this whatsoever. However, he is right that the industry has a role to play, and there is no point just beating industry over the head, because we would like to bring it with us. I was rather encouraged to see that, during our inquiry, the British Retail Consortium was very helpful in a lot of what it said, but it told us that it would like a level playing field. A very important strand of our recommendations was around price promotions and the kind of deep discounting that goes on in relation to the most unhealthy junk food and drink. It is very difficult if only one section of industry takes action on discounting. An extraordinary point that came out in our inquiry was that 40% of all the food and drink that we have in our homes tends to come through very deep discounted routes, and discounting is absolutely key to retailers’ marketing strategy in the retail environment, so we need a level playing field as far as industry is concerned.

--- Later in debate ---

[Paul Flynn]

We have had a—[Interruption.] Exactly, and I thank my hon. Friend the Member for Swansea West (Geraint Davies) for saying so. I respect my hon. Friend. We had a little exchange in Welsh about who made the remark in question. I find the story most unlikely, and I would like to check on it.

The Conservative Government have abused their position repeatedly to attack the achievements of the health service in Wales. In one week, the Daily Mail had the Welsh health service as its No. 1 story for four days running. There is no way, by news standards or by the value of the stories, that that was justified. I am proud of the achievements of the health service in Wales, and I am glad that today is the day when the presumed organ consent system begins. Wales is leading Britain on that matter, and there is much other pioneering work being done by the Labour party and the Labour Government in Wales.

Unfortunately, the Tory Government like to use the Welsh health service as a stick with which to beat the Labour party. That is irresponsible and dangerous, because one of the most important things is that people should have faith in their own health service. It is an important part of therapy and confidence: when people go into hospital, they are of course nervous and concerned, and when they read these lying stories about political—

[Fabian Hamilton (in the Chair)]

Order. May I remind the hon. Gentleman that the subject of the debate is a tax on sugar and sugary drinks?

[Paul Flynn]

Yes, Sir. Thank you, Mr Chairman. I was unfortunately—inadvertently—diverted from the point involved, but I shall return to it.

--- Later in debate ---

[Several hon. Members rose—]

[Fabian Hamilton (in the Chair)]

Order. I am hopeful that it will not be necessary to impose a time limit on Back-Bench speeches, but that will be the case only if Members exercise restraint and endeavour to keep their speeches to around 10 minutes.

Junior Doctors’ Contracts

Fabian Hamilton Excerpts

Wednesday 28th October 2015 Commons Chamber

[Fabian Hamilton (Leeds North East) (Lab)]

On a point of order, Mr Speaker. You might recall that on Monday you granted me an urgent question about the arrests of a Chinese dissident, who is now a British citizen, and two Tibetan students following demonstrations against the Chinese President during his visit last week. Can you advise me whether there is any way in which I can record the fact that all charges have been dropped against the two students and the dissident Chinese British citizen?

[Mr Speaker]

There is, and the hon. Gentleman has found it. On reflection, he will know that he has found it. The matter is on the record forever thanks to the ingenuity of the hon. Gentleman.

[Fabian Hamilton]

Thank you, Mr Speaker.

[Mr Speaker]

We will leave it there.

Jimmy Savile (NHS Investigations)

Fabian Hamilton Excerpts

Thursday 26th February 2015 Commons Chamber

[Mr Hunt]

Yes, we are; that is very important. We absolutely accept the principle that all hospitals must have explicit policies on the use of social media. We must do everything we can. It is difficult to stop people going on to Facebook, for example, but when it comes to internet access by children, there are things that we can do, and we will absolutely be implementing that recommendation.

[Fabian Hamilton (Leeds North East) (Lab)]

I was Savile’s Member of Parliament and, as the Secretary of State can imagine, Leeds North East has its fair share of his victims. One such victim approached me recently in great distress. He had been abused as a child by Savile and had given his story to the police after decades, but it was not a complete story. When he was subsequently interviewed by NHS staff, they did not believe his story because it was inconsistent, owing to the fear that he had felt over the decades following the abuse. Will the Secretary of State reassure my constituent and the many others like him that they will not become victims twice?

[Mr Hunt]

The hon. Gentleman makes an important point, and I have great sympathy for his constituent. The information was not collated centrally. There were a number of reports about which we might have been sceptical if we had read them in isolation, but when we read them together with other reports, we see a pattern and we can conclude, as the investigation has done, that those incidents did indeed take place. That is one of the big learning points: we have to collate information that different victims provide at different times, to ensure that proper judgments can be made and that action can be taken.

Hospices (Children and Young People)

Fabian Hamilton Excerpts

Wednesday 18th December 2013 Westminster Hall

[Stuart Andrew]

Absolutely. I will talk in a little more detail about transition later. The Care Bill had its Second Reading on Monday, and I raised specific points about transition during that debate, because it is a big issue for many of those young people.

The conversations those young people had were very moving. I will never forget one particular young man. We were recording a promotional video to show to health professionals and as a fundraising tool, and we asked the young people at the hospice to say what it meant to them. The head of care was interviewing them, so that they were with somebody they knew and felt as comfortable as possible; she asked that young man, “What is the most difficult thing about your condition?” He considered the question for a moment, and what he said had a profound effect on me. He said: “Falling in love.” At that moment, it hit me that despite their physical limitations or their conditions these are still young people, with all the same feelings and hopes that we all experience. He wondered if anybody would ever love somebody who was, as he put it, “Like him.”

That local experience at Martin House is but one piece in a huge jigsaw. Support and palliative care do not come only through hospices such as Martin House, Hope House or the others that have been mentioned. I want to cover three areas: NHS funding for children’s palliative care; short breaks; and support with mobility for children under three.

[Fabian Hamilton (Leeds North East) (Lab)]

I congratulate the hon. Gentleman on securing this debate. Two organisations that help hospices and the hospice movement throughout the country are the National Council for Palliative Care and the Help the Hospices movement, which has already been mentioned. Both ensure that the high standards that all hospices aspire to and achieve are maintained through mutual good practice and the sharing of experience. Does he agree that those organisations give superb support not just to Martin House, which he has mentioned, but to St Gemma’s in my constituency and all the other hospices that hon. Members have mentioned?

[Stuart Andrew]

The hon. Gentleman is absolutely right. Those umbrella organisations help to share best practice, and it is through them that the hospice movement has grown so significantly. The movement is something that we can be proud of worldwide: we now have visitors from all over the world coming to our hospices to see how it is done—and, frankly, it is done brilliantly.

As I was saying, the national picture is much bigger. There are some 49,000 children and young people in the UK living with a life-limiting or life-threatening illness that means that they need palliative care. There are some wonderful and committed professionals providing that care in some inspirational places—not just in hospices, but in the family home, in hospitals and in community settings. Families with children with life-limiting illnesses are some of the people most in need in the UK, but many are still not getting the help and support that they require. Although services offer a day-to-day lifeline to families, many of the challenges that they face can be addressed only by changes to policy, both nationally and locally.

In November, I was proud to co-host a reception in Parliament for Together for Short Lives, the UK charity that supports all children with life-limiting illnesses. At that event, the charity launched its policy priorities for the next Parliament. During the reception, the audience heard from Lucy Watts, who is 20 years old. Lucy described the impact that her condition has on her life, the care that she receives and the needs of young people like her. She became ill at 14, and was diagnosed just after her 15th birthday. Lucy is fed straight into her bloodstream, via a central line, and can sit up only for up to five hours a day. She is wheelchair-bound, but has to spend the majority of her time in bed. Speaking about the gap in services for young people with palliative care needs, she said that

“what has been forgotten is that in between children’s and adults, there are the young adults. We deserve the same recognition and distinction as children’s and adult services, but it’s barely recognised. There is the transition period, but young adult care goes beyond transitioning from children’s services to adult services. As a result, the transition can be a huge leap, too many changes too soon without factoring in the needs of people who are not children, but not mature adults yet either.”

That is a powerful quote from that young lady.

Making sure that the right children’s palliative care services are available, in the right place, at the right time, is crucial. Those services should cover the whole spectrum of care, including short breaks for children and families. Commissioned and delivered effectively, children’s palliative care can play a cost-effective role in supporting early discharge for children from acute care settings through step-down care. It can also help to reduce unplanned admissions among children to acute care settings. A Government-commissioned funding review has highlighted that hospital admissions in the last year of life for children who need palliative care can cost an estimated £18.2 million. That far outweighs the cost of providing palliative care to children outside the hospital setting.

Research has also shown that short breaks provided by children’s hospices, which often include health care interventions, help to reduce stress on families and demand on public services. Children’s palliative care services, including children’s hospices, must be funded fairly and sustainably. Families need to know that their local services will continue to be able to provide the care that they need—an issue that was reflected in the 2010 coalition agreement.

I pay tribute to my field within the hospice movement: the wonderful fundraisers, who raise millions and millions of pounds for hospices. My job as head of fundraising was made much easier by the dedication of many volunteers and supporters. We had to raise over £4 million a year to run the hospice, and somehow—I do not know how—those volunteers managed to do that year in, year out.

--- Later in debate ---

[Mr Kevin Barron (Rother Valley) (Lab)]

I congratulate the hon. Member for Pudsey (Stuart Andrew) on securing this debate. I will try to keep my contribution as short as possible as other hon. Members want to speak. First, I think it right and proper to say a few words about Bluebell Wood children’s hospice in North Anston in my constituency. It is in 6.5 acres of land that was regenerated after closure of the local coal mine, and has its own exclusive access road. Its highly specialised care team look after children with a vast range of complex medical needs and support the whole family on their life journey, offering short respite breaks, day care provision, community support, crisis intervention and end-of-life treatment and care.

Families often come to Bluebell Wood hospice exhausted after caring for a child with a life-limiting condition requiring 24-hour, seven days a week care. It is there to help, and offers respite care to the whole family and gives them the opportunity to spend quality time together knowing their child is in safe hands. It gives families the chance to recharge their batteries and to come and go as they wish. It is a relaxed, fun and happy place to be, where brothers, sisters, mums and dads can enjoy the fun and games. Its motto is “living with love and laughter”.

The hospice provides eight beautifully appointed bedrooms for children and young people as well as accommodation for families. It also has two end-of-life suites, “Primrose” and “Forget-Me-Not”, which are self-contained accommodation suites where parents can stay after their child has passed away. The deceased child can stay in a special adjoining room to be close to them. They can stay until the funeral, giving family and friends the opportunity to visit at any time. The staff are also on hand to help the family with any funeral arrangements if necessary.

The hospice boasts a music room, messy play room, sensory room, cinema room, soft play area, teenage room and Jacuzzi. It is surrounded by beautiful and tranquil gardens, including a dragonfly remembrance garden, which was built by Alan Titchmarsh and was featured on his ITV programme, “Love Your Garden”. It offers care and support for children and young people with a shortened life expectancy, both in their own homes and at the hospice. There are only 43 children’s hospices in the country and Bluebell Wood cares for more than 170 children from south Yorkshire, north Derbyshire, north Nottinghamshire and parts of north Lincolnshire.

Fundraising for the hospice started in 1998 after the death of an 11-year old boy, Richard Cooper, who had a rare degenerative disease and longed for care and support outside a hospital environment. The charity was established, and community support to build a children’s hospice in south Yorkshire was quickly forthcoming. After a lot of fundraising and working with families in the community for two years, Bluebell Wood children’s hospice proudly opened its doors to children with life-limiting conditions on 19 September 2008.

[Fabian Hamilton]

I would like to pay my own tribute to Bluebell Wood, as well as Martin House, both of which I know. Does my right hon. Friend agree that one of the best ways in which all hon. Members here can help to support the hospice movement—as he and the hon. Member for Pudsey (Stuart Andrew) have done—is to come and support the all-party group on hospice and palliative care, which meets regularly in this place, at least every three months, and brings together professionals from hospices all over the country? Will he please endorse the request to attend those meetings and support the all-party group?

[Mr Barron]

I am a member of the all-party group—indeed, I am an advocate of all-party groups—and I believe that bringing together professional people from the hospice movement leads to advancement and educates us about what is happening out there in the real world.

Bluebell Wood has 90 employees, including the care team and administrative staff, and currently more than 350 active volunteers. The hospice and I are extremely proud of them. It would not be the place it is today without them. They work on reception and in the kitchen, they help with the housekeeping and administration, they dig the gardens, paint rooms and help in the shops, to name but a few tasks they carry out. The hospice has eight shops in the surrounding region which raise funds. They are based throughout south Yorkshire, and there is also one over in Derbyshire, in Bakewell. I want to point out to the Minister that it costs more than £3 million for Bluebell Wood.

Children’s Heart Surgery

Fabian Hamilton Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

That is a very interesting thought. My hon. Friend will be pleased to note that the IRP report states that the whole care pathway, not just the surgery on its own, needs to be considered when we make this very difficult decision. I agree with her that this has been a very distressing process for every family involved and although we are suspending the process today, we have a responsibility to be honest with people. At the end of the process, there will be a difficult decision to take and we will honestly do our duty as Members of this House.

[Fabian Hamilton (Leeds North East) (Lab)]

I know that all the families of children affected throughout Yorkshire will welcome today’s statement from the Secretary of State. Will he reassure the House that any future review panel, following whatever timetable he decides, will comprise representatives fairly and equally chosen from all the centres that will be affected by any decisions? Secondly, what assurances can he give that rather than the data used in flawed reports, such as the now infamous National Institute for Cardiovascular Outcomes Research 8 April report on mortality data in children’s heart surgery units, we will use data that are consistent and reliable?

Heart Surgery (Leeds)

Fabian Hamilton Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

I simply say to the hon. Gentleman that if, as he has alleged consistently in the media, this was some kind of political ploy linked to Safe and Sustainable, we would not have reopened children’s heart surgery in Leeds on 10 April as we did. I spoke to him at the time and told him that it was my hope that operations would be able to resume as soon as possible and that we would get to the bottom of the data to find that the concerns were unnecessary because the unit was safe. In the end, that is what happened.

It would have been utterly irresponsible for Professor Sir Bruce Keogh, in view of the evidence he was faced with—including incomplete data that the hospital had not supplied in the way that it should have done—not to ask the hospital to suspend surgery. That would have been taking a risk with the lives of the hon. Gentleman’s constituents and the people of Leeds in a way that would have been wholly inappropriate. The NHS needs to move in a totally different direction on patient safety, and this is a good example of the NHS medical director behaving promptly and properly in exactly the way he should.

[Fabian Hamilton (Leeds North East) (Lab)]

In his opening statement, the Secretary of State mentioned that one of Sir Bruce Keogh’s concerns was the complaints made by families in Yorkshire about the treatment their children had received at Leeds children’s heart surgery unit. If there had been those concerns, does the Secretary of State not think that over the three years of the Safe and Sustainable review at least one complaint would have been made via Members of Parliament in Yorkshire or local media outlets? The fact that no complaints were received over three years surely tells him that generally the families were very satisfied with the way their children were treated. Will he now apologise to the families of Yorkshire for the closure between 28 March and 10 April?

[Mr Hunt]

The apology would have been due to those families if Sir Bruce Keogh had not acted promptly in the face of data that showed the possibility of a serious problem at that hospital. He was right to react promptly and to get to the bottom of those data. I put it to the hon. Gentleman that if he had been a Health Minister at the time he would not have wanted the NHS medical director to do anything other than give absolute priority to patient safety. That is what happened. Like the hon. Gentleman, I am delighted that it was possible for operations to resume on 10 April.

Leeds Children’s Heart Surgery Unit

Fabian Hamilton Excerpts

Tuesday 30th October 2012 Westminster Hall

[Stuart Andrew]

The answer is that I do not know. I have not been given any assurances that that will happen, which again highlights the crucial problem with the decision: we will be subjecting our constituents to a lesser service.

I spoke to another family at the unit. Libby was diagnosed at 20 weeks with complex heart problems, and her mum was referred for the rest of her antenatal care to LGI, where the baby was delivered; that again demonstrates the crucial co-location of services. It was clear that the daughter needed treatment immediately after birth, and at six days old she had her first of many operations. As she has complex medical needs, she has also needed support from the paediatric neurology and renal teams, and all those services are under one roof, which provides first-class care. My final example is of a child who had an operation in Leeds at 18 months. All the care was then delivered in Barnsley by doctors from Leeds. Leeds doctors have been out working in all the towns and cities across Yorkshire, at 17 different locations, over the past decade. We have a well-established network of services. Those are just a few examples of the kind of impact that the proposal could have on any of our families.

[Fabian Hamilton (Leeds North East) (Lab)]

I congratulate the hon. Gentleman on securing the debate, which, as he rightly points out, is extremely important. Does he agree that it is not just the children’s congenital heart problem services that serve us so well at Leeds general infirmary, but the post-16 services, which the review did not take into account? Does he also agree that Leeds is perhaps the leading centre in the country for training post-16 congenital heart problem surgeons in what is a valuable and important skill?

[Stuart Andrew]

The hon. Gentleman makes an absolutely first-class point. Indeed, I think we have all asked the question: why is the review into children’s services being held separately from that into adults’ services? It is bizarre. We know that the surgeons operating on adults are often the same people who operate on children. We have yet to get a sufficient explanation of why the reviews have not been run in tandem, and we expect, or at least hope, that the Independent Reconfiguration Panel will consider that issue.

That brings me on to my next point. I wholeheartedly welcome the fact that the Secretary of State has decided to refer the decision to the Independent Reconfiguration Panel—that is great news—but it is absolutely crucial that we get the decision right. There is no point in simply reviewing the decision; we want the panel to consider the whole process, right down to the information that was used at the very beginning regarding what the services were like at the different units. That must include the scoring.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Pudsey (Stuart Andrew) on securing the debate, and on the way in which he and other Members across the House have put their case. The issues surrounding Leeds children’s heart surgery unit are important and certainly merit our debate. I also take the point made by the hon. Member for Leeds North West (Greg Mulholland) that a wider debate on the Floor of the House may be warranted.

I take this opportunity to pay tribute to the dedicated NHS staff who work in children’s heart services, both in Leeds and across the country. We are all incredibly grateful for the tremendous job that they do, more often than not in complex, difficult circumstances.

Clinicians and professional bodies, including the Royal College of Nursing and the Royal College of Paediatrics and Child Health, have been clear that children’s heart services need to change. Surgeons are too thinly spread, and services have grown in an ad hoc manner in England, which, to be fair, the hon. Member for Pudsey recognised in his opening speech. Changing how we provide any hospital service is difficult, but when changes are necessary to improve patient care, as they may be for children’s heart services, politicians on both sides of the House should be prepared to listen to that argument and, if necessary, support it.

I know, however, that there have been real concerns and a great deal of protest in the communities surrounding the unit at Leeds general infirmary, particularly about the plans to close it. A motion of support from Leeds city council has been supported by people from across the political spectrum in the city. There has also been a large protest in Millennium square in Leeds, where, I am informed, over 3,000 protestors were joined by local MPs, parents and nurses to campaign to prevent the closure.

As we have heard today, there are similar concerns about plans to close the Glenfield hospital in Leicester, and the Royal Brompton in Chelsea, west London. That could mean that in future, children’s heart surgery would remain at the London children’s hospitals, and in Southampton, Birmingham, Bristol, Newcastle and Liverpool. Although the Opposition support the principle of fewer, more specialist centres, we have concerns about the location of the selected sites, which would leave a huge swathe of the east of England, from Newcastle right down to London, potentially without a centre.

As we have heard, the unit based at Leeds general infirmary serves the 5.5 million residents of Yorkshire and the Humber, and performs 360 operations a year, done by three surgeons. We have heard, too, that there are concerns that the closure of the unit will leave millions of people in the region without local access to the children’s heart surgery expertise that currently exists in Yorkshire and the Humber at Leeds. The local Save Our Surgery campaign group, under the Children’s Heart Surgery Fund, believes that families from Yorkshire, north Lincoln and the wider Humber region may have to travel up to 150 miles for treatment at the nearest unit in Newcastle or Liverpool, if the closure goes ahead.

As an aside, I was privileged to visit the hospital in Hull, at the invitation of my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), as part of my duties as a shadow Health Minister. It took me an hour and a half to get from Manchester to Hull to visit the hospital. However, because there was a slight flurry of snow on the way back, the M62 ground to a halt, and it took me over five hours to get back over the Pennines to Manchester. I have never seen so many Lancastrians trying to desert Yorkshire at the same time as me, but it shows that geography matters in such decisions. We cannot ignore the fact that the Pennines are there, and sometimes they are impenetrable.

Clearly, there is concern that families may be faced with having to travel further at what is undeniably a very stressful time for them. That case has been made eloquently by Members on both sides of the House in the debate. It is also worth remembering that it is not only the care of poorly children that needs to be taken into account; the care of the whole family is important.

I ask the Minister, for whom I have a great deal of respect, whether she was satisfied that the NHS joint committee of primary care trusts properly balanced clinical decisions with practical and transport issues for families. Furthermore, does she believe that the review was fair to families in the eastern half of England, which is now left with no centre between Newcastle and London? As we know, the JCPCT came to the decision in July to close the unit. The SOS campaign group launched legal proceedings against the NHS to stop the unit being closed, submitting an application to the High Court for permission for a judicial review. Last week, as we have heard, the Health Secretary asked the Independent Reconfiguration Panel to review the decision to close three centres.

We know that children’s heart surgery matters greatly to many people. However, as we also know, the issues surrounding children’s heart surgery have needed to be resolved for some time. The findings of the Bristol Royal infirmary inquiry into children’s heart surgery 10 years ago highlighted that between 1990 and 1995, a number of children died at the infirmary as a result of poor care. It is clear that children’s heart surgery has become an increasingly complex treatment. The aim must be for children’s heart services to deliver the very highest standard of care. The NHS should use its skills and resources collectively to gain the best outcomes for patients. The Government rightly want changes to children’s heart surgery services, so that they provide not only safe standards of care, but excellent, high quality standards for every child in every part of the country.

[Fabian Hamilton]

Does my hon. Friend agree that it is not only the continuum of children’s heart services and the care of parents and other family members that is important? The treatment should continue beyond 16, if it has to. There needs to be an overview of pre- and post-16 services; they should be taken together, because that is how we ensure that the young person, who becomes an adult, survives and lives the rest of their life.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Here we are again. It is a pleasure to speak under your chairmanship, Mr Hollobone. It is about a week since we had a very similar debate, also under your chairmanship. That has already been described by my right hon. Friend—sorry, I always call my hon. Friend the Member for Pudsey (Stuart Andrew) the right hon. Member for Pudsey. [Hon. Members: “Soon!”] Perhaps I am trying to elevate him too soon, but as he has explained, we had a similar debate only last week about the situation at Glenfield. I join everyone else in paying tribute to him for securing this debate.

I pay tribute to all hon. Members who have spoken, of whatever party. In many ways, this has not actually been a debate, because normally in a debate there is a degree of disagreement and people put forward their arguments for or against a particular motion or notion, but that has not been the case in this debate. Here, we have had an outbreak of complete unity, which I acknowledge, between all political parties. It is right and proper that, on this matter, people come together, are not divided by political party and are determined not to score any form of party political point in making their argument. All hon. Members have come to this debate for the right reasons. They have come to represent their constituents and to put forward all the arguments that they can on behalf of their constituents and with full force. That is absolutely right and as it should be, but I want to make this point as well, and not because I am any form of coward—after all, I spent 16 years defending, largely, the indefensible.

I have to say that the hon. Member for Denton and Reddish (Andrew Gwynne) was treading somewhat on my good humour with some of his remarks when he was asking me for my opinion because, as we all know, this whole review has taken great pride in the fact that it has been an independent review—independent of Government. It was set up, quite properly, by the last Government, on a cross-party basis, and it was on the basis that we needed fewer but larger and more specialised children’s heart services in England. It was accepted—I say this with great respect to my hon. Friend the Member for Cleethorpes (Martin Vickers)—that that was the basis of it all and that it was being done so that we could secure the best children’s heart services for babies and young children that we could possibly obtain, and so that we could ensure that those services were sustainable. We wanted to concentrate the specialist heart surgeons in a smaller number of centres to ensure that they had the best skills for dealing with babies and young children.

At the end of the day, we are talking about arguably some of the most specialised surgery that exists. There are instances in which surgeons are operating on a baby’s heart that is no bigger than a walnut. As I say, it is perhaps the most specialised and the most precarious of all types of surgery, so their skills have to be the best. It is also the case that if we have fewer, but larger, more specialised units, we can ensure that those surgeons, those doctors, those nurses and the other health professionals are training the future surgeons, doctors, nurses and other health professionals to do this very important and highly specialised work.

I pay tribute to my hon. Friend the Member for Pudsey. As we would all have expected, he advanced a thoughtful, well researched and sound set of arguments on behalf of his constituents. He gave the examples of Lauren, Libby and Abi. The hon. Member for Scunthorpe (Nic Dakin) also spoke with considerable feeling about what his constituents had told him. That is only right and proper. I am sure that all those constituents will welcome the comments of their Members of Parliament in advancing their arguments for keeping their children’s heart surgery unit open. It is quite clear from the various interventions that this has all-party support. We heard from my hon. Friend the Member for Shipley (Philip Davies), the right hon. Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Skipton and Ripon (Julian Smith) and for Brigg and Goole (Andrew Percy). As I said, people are coming together, whatever political differences they might otherwise have, in agreement and in support of children’s heart surgery at Leeds general infirmary.

A number of matters strike me from the speeches that have been made. In addressing some of the remarks made and arguments advanced by hon. Members on both sides of the Chamber, I shall try to give a response that perhaps allays some fears and certainly answers some questions.

[Fabian Hamilton]

I am sorry to intervene when the Minister is about to give those responses, but she said that the review, quite rightly, was independent; it was set up by the previous Government to be independent of Government. I think that the prevailing view this afternoon is that it was not impartial. Will she comment on that?

[Anna Soubry]

I will not comment on that, quite deliberately, because it is imperative that I am seen and, indeed, fellow Ministers are seen to be completely independent and impartial ourselves. Of course, that does not prevent hon. Members from making their own judgments and vocalising them, and there may be merit in them, but it is not for me to say whether there is, because, as hon. Members know, this has all been referred to the Independent Reconfiguration Panel—that is right and proper, in my view—and it will look at all aspects of how these decisions have been made. It will take evidence not just from the NHS, clinicians and local authorities, but from Members of Parliament. I am in no doubt that all hon. Members who are here today will make their own representations to the IRP on behalf of the children’s heart services at Leeds general infirmary and will make them with the force with which they have made them today and on the basis of as much information, sound evidence and argument as they have shown us here today.