World Autism Awareness Week

Fiona Bruce Excerpts

Thursday 28th April 2016 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

It is said that a society is judged by the way it treats its most vulnerable. Among our most vulnerable are children with special educational needs, including those on the autism spectrum. I therefore want to give a voice to just a few of the many parents who have come to me over the past six years, including the Middlewich parents and carers support group, to describe their challenges in trying to get appropriate support for their autistic children. The situation is described by far too many with these words:

“every day feels like a fight.”

Time prevents me from quoting all the material I have available to describe their struggles of seeking often inadequate, slow or no diagnoses; of insufficient teacher training; of a feeling as parents that they have little voice or are inadequate, or worse, not believed; of struggles with bureaucracy, with too many different organisations; of, as one said, being pushed from pillar to post; of funding and resource frustrations; and of being, as another said,

“at a loss as to what to do.”

We need to do better for them.

One says:

“We have two children who have autism and face huge challenges getting the understanding and support they need.”

Another says,

“teachers in my child’s school in charge of special educational needs do not have sufficiently specialised training.”

Another says:

“Teachers are given…very little training. Many teachers have had only half a day’s training to cover all SEN.”

One said that more training is needed so teachers can help older children in secondary school to understand themselves when there may be an onset of distress and how to get help early. Another said:

“my son has had difficulties in school, and what hasn’t helped is that…the educational psychologist and the school, I am being told I should not say he is autistic spectrum…rather…he is a ‘complex child with complex needs’. The letter from the community paediatrician does say he has a diagnosis of ASD”.

One mother, like a number of parents, says:

“all the experts in the field of ASD would tell you that children can hold in their anxieties and control their behaviour at school, in order to ‘fit in’; but when they come home to an environment where they can be themselves, they act completely differently.”

Another said:

“I had three uniforms for him. These were all ripped when he returned home due to what had gone on during the day.”

Yet doctors often listen more to the opinion of teachers than parents. Another parent said that parents are made to feel that they are not believed—that they are

“bad parents and trouble makers. Yet what parents would want to go to so much effort to ‘pretend’ that their child has a disability?”

Another said that, as we have heard:

“The diagnosis process is not working…waiting times for diagnosis are too long…some children are being deliberated over for too long or even discharged, when there is clearly an issue which requires diagnosis.”

Another said that too much attention is paid to the opinion of teachers and not enough to parents. One mother told me she has spent three years trying to get her son statemented, but because they did not have a statement they could not get any support at primary school because money comes with the statement. He is now 12, at senior school, and has ASD as diagnosed by a paediatrician but is still not statemented.

[Tom Elliott]

One line from one of the parents the hon. Lady has mentioned has captured what this debate is about:

“every day feels like a fight.”

We have talked about this for so long. Surely there should be more progress to try to get more co-operation between the statutory agencies and Government Departments to ensure that every day is not a fight for parents and for those affected.

[Fiona Bruce]

The hon. Gentleman is correct. As long ago as 2009, following the Autism Act 2009, the Department for Health published an autism strategy that focused on five core areas of activity, one of which was the importance of

“developing a clear, consistent pathway for diagnosis in every area, which is followed by the offer of a personalised needs assessment.”

That was for adults. How much more important is it that this happens for children, and at the earliest possible age and stage? Waiting times for assessment should follow the NICE guidelines of three months. That is a long time in a childhood; three years is an eternity.

One parent wrote that when diagnosis occurs there needs to be a greater understanding of the different ways in which autism presents itself between girls and boys. She said that

“there is not enough knowledge about girls on the spectrum...It is now recognised there are far more girls with ASD than previously thought. Girls develop the ability to mask their condition much more effectively. However, this knowledge is not being passed through the system. Far more training is needed for…professionals in the field, to ensure that our girls get equal access to assessment and diagnosis...my son was diagnosed locally by the paediatrician, yet the same doctor had quite evidently decided my daughter was not on the spectrum, without really investigating the possibility...So I had to take my daughter privately to a psychologist who was much more well informed...this needs to be addressed…we are doing our girls a disservice at present.”

Another said that autism is a spectrum of conditions and every one requires an individual solution, particularly as autism can be accompanied by another condition. As we have heard, a further problem arises when, as parents tell me, their child reaches late teens and falls between child and adult care. One mother told me that children with autism have an adolescence lasting 10 years longer than anyone else, but at 16 to 18 schools and colleges stop talking to you, but your child still needs support for a very long time. Another said:

“there are so many stumbling blocks on the way”

that it is no wonder that some of the children end up in the juvenile justice system, or self-harm.

Then there is the problem of employment. A mother told me of the struggles she is having trying to find employment for her son with mild Asperger’s syndrome. There is no support available and there are huge levels of ignorance among potential employers.

Given the right help, appropriate support can be really effective. Surely, we want for every child, including those with autism, the best start in life, and it can be achieved.

Conception to Age 2: The First 1001 Days

Fiona Bruce Excerpts

Thursday 17th December 2015 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

I must apologise to the Minister. I have a long-standing engagement in my constituency this evening, and I would be grateful to him if he released me to attend it. I will not therefore be able to listen to his winding-up speech.

I want to concentrate on the first part of the 1001 days—the period between conception and birth. A report was published earlier this year by a team from leading UK and US universities who had studied pregnant women in rural Gambia and the children to whom they gave birth. It is clear that the children conceived in the dry season, when there was not an abundance of leafy green vegetables, were seven times more likely to die in young adulthood than those conceived in the wet season, when their mothers’ diet was so much better. The research team said that later in life the impact could be seen in a lack of ability to fight viral infections and in their chances of surviving cancers such as leukaemia and lung cancer. That report shows the clear impact of what the mother ingests on her system and that of the unborn child.

Something that we ought to be much clearer about in this country, but that we sadly are not, is the effect of alcohol consumed by the mother during those first precious days of a child’s life in the womb. The National Society for the Prevention of Cruelty to Children estimates that about 7,000 babies born in the UK each year suffer the effects of alcohol drunk during pregnancy.

I pay tribute to the hon. Member for Sefton Central (Bill Esterson), who is chair of the all-party parliamentary group for foetal alcohol spectrum disorder, of which I am the vice-chair. This week, we published a report on the picture of FASD in the UK today, following an inquiry that ran throughout the autumn. We held a number of hearings with families and young people who have been affected by FASD, as well as with members of the medical professions and other interested organisations. The report is so substantial and so deeply concerning that, although you have been good enough to call me before the chair of the all-party group, Madam Deputy Speaker, it might have been more appropriate if we had been called the other way around. None the less, the report has such a lot of substance that I hope what I say will complement, rather than duplicate, what he will say.

The evidence that we gathered was severely alarming in respect of both the far wider impact of FASD compared with what is understood in this country and the lack of clinical and other support available to families who are affected. We learned that a mother need not consume large amounts of alcohol during her pregnancy to be affected, because individual women’s constitutions respond differently to alcohol consumption.

The impact on the unborn child, which can last for the rest of their life, can be profound. FASD causes organic brain damage in an unborn child. We were told that it causes heart defects, dental issues, eyesight problems, bladder difficulties, walking difficulties, cognitive challenges and memory and behavioural difficulties. Often it means that babies are premature. We heard about the emotional impact on those affected by FASD as they develop into young people and move into adulthood: they can withdraw from society, become unpredictable and even become suicidal. That places great stress on parents and carers, many of whom experience periods of isolation and ill health. The inquiry heard that it is likely that a much higher proportion of children are born with FASD than is currently recognised. Those children will have a variety of difficulties in childhood and in later life.

The tragedy is that, theoretically, FASD is 100% preventable if all pregnant women are given clear advice on the risks of alcohol intake to their unborn child. We were told that the best advice for young women is not to drink if they are considering becoming pregnant, since there are effects even at the earliest stage.

Equally tragic is the fact that in the UK there have been decades of mixed messages regarding the right level of alcohol intake during pregnancy. I remember that from when I had my children, which is well over 20 years ago. The all-party group was advised that a clear message should be given by Government Departments that, just as smoking during pregnancy affected the unborn child and should be avoided, so too did alcohol and it too should be avoided.

For the UK not to be sending that message is not only tragic for the families concerned; it goes against international best practice, which is to advocate that alcohol be avoided if a woman is pregnant, thinks she might be pregnant or is trying to conceive. In Canada, children as young as primary school age are taught that. Pregnant women in Denmark, France, Israel, Norway, Mexico, Australia, Ireland, New Zealand, Spain and the Netherlands are advised to abstain completely from alcohol. Since 1981, the USA has advocated that

“no alcohol is safest for baby and you.”

Without such a clear message, pregnant women in the UK are left confused and uncertain. I know from my work as the chair of the all-party group on alcohol harm that few people can accurately measure one unit of alcohol. If a message is sent out that one or two units a week is okay, it is probably easy to think, “Well, why not three or even four or more?”

One of the reasons that women are confused stems from the unclear guidelines provided by UK professional and governmental bodies. Although NICE and the Department of Health warn of the potential for alcohol to harm an unborn child, incredibly they do not go on to stipulate that women should abstain from drinking during pregnancy. The Government are currently carrying out an alcohol review, and I hope they will seriously consider that issue. By contrast, the British Medical Association advocates that no alcohol should be drunk during pregnancy. As a result of those mixed messages, not only are women confused but many midwives are uncomfortable about giving advice on alcohol. A study that questioned 200 midwives found that only 60% asked women about their drinking habits, 30% advised against binge-drinking, and only 10% were aware of FASD. As our report says:

“this is astonishing and deeply worrying, and something which must be rectified as a matter of urgency.”

More encouragingly, 93% of midwives said that they would be comfortable advising that no alcohol should be drunk during pregnancy if that was the consistent message from the Government. In the absence of such clarity, however, they are afraid to offer such advice.

Our inquiry also revealed a similar lack of in-depth knowledge about FASD across the medical profession. There is only one specialist FASD clinic in the UK, and it is wholly overstretched. That lack of in-depth knowledge means that children with FASD are often given multiple inaccurate diagnoses, such as ADHD, autism or an attachment disorder. Appropriate support mechanisms are rarely put in place, and families are left frustrated and confused. It is critical that FASD is given a higher priority within the NHS for research, diagnostic, and support services.

[Mr Graham Allen]

The hon. Lady is making a fascinating contribution. Given that the Minister is in his place, is this a good moment for her to comment on the failure to fund research into the prevalence of foetal alcohol syndrome? I am sure she is coming to that, but given that the Minister is paying great attention, perhaps this is a good moment to get that message sprayed on to the Department’s eyeballs.

[Fiona Bruce]

I thank the hon. Gentleman for that intervention. Our report states that because of inadequate research in this country, there is insufficient information to encourage those involved—including, we believe, Government representatives—to take action.

Several of our witnesses testified that there must be more appropriate training on FASD among the medical profession, and national standards must be adhered to. For example, we heard how diagnosis could take place as early as for a one-month-old child, or as late as at 10 years, or not at all. It appears to rely on which professional a child sees. Time and again we heard from families, including parents, grandparents, adoptive parents and foster carers, that they had to explain to medical staff the diagnostic nuances of FASD.

As I have said, the extent of this condition has been under-recognised by successive Governments. Research now indicates that 30% to 50% of children in foster care could be affected by FASD, and a study mentioned in our report from an audit in Peterborough, published in October 2015, showed that 75% of children referred for adoption had a history of pre-natal alcohol exposure. If those figures are extrapolated across the UK, that should have major implications for Government policy on fostering and adoption. Sadly, there are also impacts on the criminal justice system, and our inquiry heard of vulnerable young people with FASD who move into adulthood where they cannot meet societal expectations and behavioural norms. Those people are being exploited by criminal gangs and sexual predators, which is a result—certainly in part—of a lack of concern, understanding and support for them and their condition.

In conclusion, the seriousness of the problem cannot be overstated. Our report makes a number of recommendations that the hon. Member for Sefton Central may well go into in more detail. The impact on the early stages of a child’s life cannot be overstated. Even the alcohol industry has taken considerable steps to send warnings not to drink during pregnancy. Ninety-one per cent. of alcoholic drinks in bottles and cans now carry a warning.

That is not enough, however. A study by Drinkaware revealed that more than half of pregnant women in the UK receive no advice at all about drinking while pregnant. The original clinical diagnosis of FASD was made in 1973. Our inquiry showed that

“in the four decades since then, the UK as a whole has still barely acknowledged its existence.”

That must change, and the Government must take a lead.

Oral Answers to Questions

Fiona Bruce Excerpts

Tuesday 17th November 2015 Commons Chamber

[Mr Speaker]

Forgive me colleagues, but what we need at Topical Questions is short inquiries, without preamble, if we are to make progress. Let us be led in this exercise by Fiona Bruce.

[Fiona Bruce (Congleton) (Con)]

T3. This is alcohol awareness week. In Scotland, the number of drink-driving offences dropped by 17% in the first three months after the introduction of a lower drink-driving limit. In the light of this encouraging evidence, is the Minister’s Department looking at the public health implications of reviewing the drink-driving limit in England and Wales as part of its alcohol review?

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

Obviously, tackling drink-driving remains a priority for the Government. We will be interested to see a robust and comprehensive evaluation of the change to the Scottish drink-driving limit, and I can confirm that Public Health England’s review of the public health impacts of alcohol will include drink-driving. Obviously, some of the issues my hon. Friend raises are for the Department for Transport, but I can confirm that we will be looking at this issue, and I will be interested to see the evidence.

Alcohol Harm and Older People

Fiona Bruce Excerpts

Thursday 15th October 2015 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

It is a pleasure to be here and I welcome the opportunity to speak about the very real and damaging effects of alcohol harm on older people. I am pleased that the Minister for Public Health, my hon. Friend the Member for Battersea (Jane Ellison), is present and commend her for her passionate commitment to ensuring that key public health matters, and a strong preventive health agenda, remain high on the Government’s set of priorities for this Parliament.

I should perhaps clarify at the outset that I am seeking not to promote further legislation or regulation in this sphere, but to highlight the need for more education and information to help people make positive choices about their drinking; to enjoy it but at the same time maintain their own health and wellbeing. We all want to live longer—and we are—but, importantly, we want to live longer and healthier so that we can enjoy those later years. That is why this subject is so important.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way so early in her speech—I indicated to her before the debate that I intended to intervene. The theme that she is talking about, which many Members of the House, including me, would agree with, is this: everything in moderation. In other words, people should be careful about what they take and how often they take it.

[Fiona Bruce]

The hon. Gentleman is absolutely right. Although most people are able to drink in moderation and enjoy the benefits of the socialising and relaxation often associated with drink, for many others it comes with significant costs.

Before proceeding any further, I ought to clarify what I mean by “older people”. Depressingly, I am referring to those of us who are over 45. A huge amount has been done in the past few years to tackle excessive drinking by the young, and encouraging figures show that drinking among young people is falling. I am also referring not so much to binge drinking, which perhaps is what we all associate with drinking among young people, but to harmful drinking. That does not have to mean getting wildly drunk and being hungover the next day; it can be continuous drinking, perhaps every day of the week, which does not allow the body’s organs to have a break from alcohol. People are often unaware that that can be extremely harmful.

Alcohol is a leading risk factor for death and disease in the UK; it is the leading risk factor after smoking and obesity. As a toxin, it is the cause of many acute and chronic diseases, and—Members might be surprised to hear this—it affects almost every organ in the body. The relationship between alcohol and liver disease is well known, but alcohol is also a risk factor in a number of cancers, in cardiovascular disease and in gastro-intestinal diseases such as pancreatitis, and of course it is also a leading cause of accident and injury. On that topic, the all-party group on alcohol harm, which I chair, is currently conducting an inquiry into the considerable impact of alcohol on the emergency services. I look forward to being able to update the House on that work in due course.

Given its associations with so many and such serious health conditions, it is unsurprising that the impact of alcohol on NHS services is considerable. In 2012-13 there were more than 1 million alcohol-related hospital admissions, where an alcohol-related disease, injury or condition was the primary reason for the admission or a secondary diagnosis. As the Minister will be aware, the costs of this to the NHS are estimated to be at least £3.5 billion per year—on its own, more than a third of the Treasury receipts from alcohol—yet estimates for the wider personal, social and economic costs of alcohol vary from £21 billion to £55 billion in England alone. We therefore have much to address.

I must emphasise, though, that recent trends in the decline of underage drinking and drinking among young people are encouraging, which leads me to believe that we can similarly address and support improved positive drinking among older people. The proportion of 11 to 15-year-olds who have ever had a drink fell from 61% in 2003 to 38% in 2014, and the proportion of those who got drunk in the past week declined dramatically from 26% to just 8% in the same period.

Encouragingly, this positive trend is beginning to extend to the 18 to 25-year-old age group, many of whom, interestingly, now choose not to drink at all. That includes my own son, a young man in his 20s. He is a sportsman who simply does not drink. A huge amount of work has been done in this area. I commend the Government and their partnership working with many agencies to educate and support this age group to reduce levels of harmful drinking. One of the successes has been the introduction of street pastors. Another has been the presence of club hosts in clubs and pubs, where people on the “older sister” model, perhaps slightly older than those who might drink irresponsibly, will approach a young person they think is drinking too much and say, “Perhaps you need to think about how much you’ve drunk.”

[Jim Shannon]

I thank the hon. Lady for her comment about street pastors. In the past month, street pastors have started to be active in my constituency, with 13 churches and 43 volunteers coming together on this. That is a very clear commitment by community members themselves to address the issue. I recommend those in any constituency where there are no street pastors to ask the churches to be involved, because the benefits are great.

[Fiona Bruce]

I entirely agree. In my constituency, similarly, there are some excellent street pastor groups.

Voluntary organisations, the drinks industry, publicans and the police, together with local and national authorities, have done a huge amount to address drinking by younger people. With older people, though, much of their drinking is a hidden problem, particularly among the baby boomer generation who often drink at home, many of whom have a dangerously limited awareness of alcohol’s harmful effects. This is a ticking time bomb not just for the individuals concerned but in terms of the public cost of their healthcare in the years to come, with an increasingly ageing population.

According to the Health Survey for England 2013, 10 million people in England drink at a higher level than the Government’s lower-risk guidelines, with serious long-term implications for their health. This is particularly true of older people. Many of those in the baby boomer generation drink on an almost daily basis. The survey found that 14% of 45 to 64-year-olds drank alcohol on five or more days in the past week, compared with just 2% of their younger counterparts in the 18 to 24-year-old group. Alcohol-related hospital admissions among this middle-aged group account for 40% of all alcohol-related hospital admissions and 58% of all admissions for alcoholic liver disease. Tragically, this age group also accounts for the majority of alcohol-related deaths.

Some of the impacts of alcohol are rather less obvious but no less devastating. For example, there is a significant link between alcohol use and the risk of hypertension, which is a factor in a number of related illnesses such as stroke, heart disease and other vascular diseases. Alcohol is generally associated with poorer mental health. In later life, alcohol can be used as a comfort for many of the shocks that people experience in middle age, such as adjustment to life after divorce, redundancy, retirement, children leaving home, or bereavement. Loneliness or depression can also be a factor. These points in life can be very challenging, and they are all associated with higher rates of alcohol use. People need to be made aware that when these life shocks hit them in later life, as they do the majority of us, they need to look out to avoid slipping into harmful drinking patterns because the consequences can be catastrophic in just a few years.

The majority of older people are not aware of the potential damage they are doing to their health or relationships through unhealthy drinking. Office for National Statistics figures show that the greatest number of people who did not drink but now do drink are women over 65, many of whom live alone. That is a particularly concerning statistic that we need to bear in mind. Research by charity Drinkaware and by Ipsos MORI suggests that there is a large group of people who are sleepwalking into poor health. Only 20% of 45 to 65-year-olds think they will have health problems if they continue to drink as they do, yet more than a third are drinking at above the level of Government guidelines. Shockingly, one in nine says that they have already been told by a friend, family member or health professional that they should cut down.

Interestingly, this issue was raised in the previous debate—I do not think the Minister was here—when the shadow Defence Minister, the hon. Member for North Durham (Mr Jones), spoke about needing to address it for those who had been in our armed services, although not in a nanny-culture way. I strongly echo that.

For many, drinking is an everyday occurrence, but when confronted with it, people do not realise that even drinking at relatively low levels but on a continuous—that is, virtually daily—basis can be harmful. Here is a typical comment:

“On reflection when you look back it’s not the fact that I drink to get drunk constantly—that would be a separate issue…but as part of the relaxing process…on a daily basis at home. I just didn’t realise how many excuses I have to…drink.”

Misuse of alcohol has a devastating impact on relationships and families, and on children in particular. That should be given greater prominence. In 2012, a survey by the Children’s Commissioner, “Silent voices: supporting children and young people affected by parental alcohol misuse”, estimated that between 1999 and 2009 more than 700,000 children were affected by parental or other significant adult drinking. It said that parental alcohol misuse is far more prevalent than parental drug use and called for a greater emphasis on it in policy and practice. It is a matter of social justice that we address this, not just for children but for the poorest in our society, because research shows that those who are less well-off are less resilient and more vulnerable to the impact of harmful drinking. Professional people, some of whom drink more, are able to withstand the impacts better.

As chair of the all-party group on alcohol harm, I urge that greater prominence be given to this issue, particularly to the harms caused to older people. A number of strands could be taken forward, alongside other initiatives that I am sure the Minister will consider. One very practical example was given in an excellent report that I had the privilege of launching here in the House last month: “Under Pressure” by the Treat 15 Expert Group, which comprises doctors, nurses and other health professionals. It suggested that whenever an individual has their blood pressure taken, mention could be made, just in those few minutes, of drinking being linked to the risk of high blood pressure, and indicators of the harmful health implications associated with that. It is estimated that about 7.5 million people in this country are at risk of high blood pressure. Just identifying the link with harmful drinking could help a large number of people to improve their health prospects. In those few moments, often when nothing else is done or said, there is a real opportunity, at no cost at all, for the medical profession to provide an important service.

There is also an urgent need for public education on the harmful effects that drinking can have on older people. People need information that is simple, accessible and non-judgmental. There are some innovative resources, such as the Drinkaware app and the Change4Life booze buster programme, which help people make informed choices about their drinking and support them to make a change that could have significant benefits for their health and wellbeing.

We also need more prominent, comprehensive and consistent public health messages from Government, the NHS and Public Health England about the risks of harmful drinking. A report will be released shortly and I look forward to reading its suggestions as to how the issue can be addressed. Given that people are living longer, it is important that they are informed about how to live healthier longer lives.

The alcohol industry also has an important role to play by working in collaboration with others. It is a key partner and has made a great deal of progress working in partnership with pubs and clubs and with the Government. The Government challenged the industry to remove 1 billion units from the alcohol market over two years. In fact, 1.3 billion units were removed—the equivalent, apparently, of the whole nation going dry for one week a year. One of the means by which that was achieved was through providing house wines of less alcoholic strength and smaller glasses. I also commend the industry for the fact that almost 93% of alcohol bottles now warn women that it would be better for them to consider not drinking during pregnancy.

[Jim Shannon]

There has been talk in the press over the past two weeks about the best message to give to pregnant women about alcohol consumption. Does the hon. Lady agree—perhaps the Minister will say this in her response to the debate—that the best message and policy would be that pregnant women should drink no alcohol whatsoever?

[Fiona Bruce]

That is my personal view. Women have suffered from mixed messages over the past 20 years and more. It would be very helpful to have a clear message. Just six years ago, only 17.6% of products carried a warning label about drinking in pregnancy; the figure is now 93%. I would like it to be 100% and it would be very helpful if the Government gave a clear message that not drinking in pregnancy is probably the wisest choice of all for the woman and her child.

In conclusion, I ask the Government to consider working in partnership with us to develop strategies to reduce alcohol-related harms in older people, just as they have done, with some success, to reduce unhealthy drinking in younger people. No one now questions the role of Government in promoting healthy eating. The same rule could, I hope, be undertaken in future, with similar, commendable vigour, by the Government with regard to encouraging healthy drinking.

--- Later in debate ---

[Fiona Bruce]

The Minister is quite right about variation. One of my concerns is about the increase in drinking among older women. Is anything being done specifically to look at how they can be helped to reduce the effect of alcohol harm?

[Jane Ellison]

I will come on to matters relevant to that, but I will also say more about a possible opportunity for a wider debate on this important issue a bit further down the line.

It is important to consider what can be done through secondary care. About 139 district general hospitals already offer some level of specialist alcohol service. I saw for myself such specialist work when I visited Blackpool in 2014. One team told me about how it took the opportunity of people being admitted for something related to alcohol to talk to them about their drinking. They described, with huge understatement, as a “teachable moment” the time when someone is in hospital having suffered, either through a disease or an accident, an unfortunate effect from alcohol. They are right: the idea of talking to people at the moment when they are most receptive is vital.

We would like to have similar alcohol care teams in every hospital to take such opportunities to identify the problem and provide brief advice to patients, as well as medical management. That is again based on the evidence that higher-risk and increasing-risk drinkers who receive brief advice are twice as likely to have moderated their drinking six to 12 months after an intervention—a quick response—compared with drinkers who get no intervention. We want greater use of such really good opportunities. It is not costly or, indeed, lengthy; it is about timeliness.

There are means for people to monitor and manage their own alcohol intake. Technology is increasingly deployed to good effect in a number of areas of personal health monitoring, and alcohol intake is no different. Apps such as the one developed by Drinkaware, which my hon. Friend mentioned, can help people to track how much they are drinking, what it costs them and even the number of calories. We know that personal estimates of weekly drinking are not always as accurate as keeping a log. That is quite well documented, so individuals may find apps and tracking mechanisms particularly helpful.

The Big Lottery Fund, in partnership with the support charity Addaction, is investing £25 million in an alcohol-related harm prevention and awareness programme for the over-50s. Rethink Good Health is a UK-wide programme aimed at those aged 50 and over. My hon. Friend very thoughtfully explored some of the reasons why people may find themselves in such a situation in later life. We would recognise from our constituency case load and perhaps from our social circles how life events can take a toll on health and lead to people drinking more. She mentioned some of them, but I would highlight how such problems can be a driver, and sometimes a product, of loneliness and isolation.

As the House will know, Dame Sally Davies, the chief medical officer, is overseeing a review of the lower-risk alcohol guidelines to ensure that they are founded on the best science. We want the guidelines to help people at all stages of life to make informed choices about their drinking. The guidelines development group, made up of independent experts, has been tasked with developing the guidelines for UK chief medical officers to consider. The group has researched and is developing a proposal on the guidelines, including a UK-wide approach for guidance on alcohol and pregnancy. We expect to consult on that.

I know that that is an issue, and that there are worries about people receiving different advice, so let me say a word about the consistency of health messages. As I have said before at the Dispatch Box, where the evidence base is not completely certain—leading experts to reach slightly different conclusions—there will be a certain level of debate. I appreciate that that can be extremely challenging for the public and that there is a role for trying to provide clarity, but guidance must always be based on the best evidence base.

Adult Stem Cells and Life Sciences

Fiona Bruce Excerpts

Tuesday 15th September 2015 Commons Chamber

[Mr Burrowes]

The hon. Gentleman and I have for a number of years been party to reports recommending to Government that we need to invest in research to provide better long-term outcomes in transplantation and future therapeutic treatments.

One key area is Alzheimer’s, and some of us may have received a briefing from the Alzheimer’s Society. We know from our constituencies the huge impact of Alzheimer’s. There are 850,000 people living with dementia in the UK today, and this is forecast to rise to over 1 million by 2025 and to exceed 2 million by 2050. A technique was developed in 2012 to turn adult cells into nerve cells, which again highlights the curative potential of stem cell transplantation. That can be particularly helpful in understanding and testing potential treatments for Alzheimer’s.

The Minister will know that the estimated cost of Alzheimer’s is a staggering £4.3 billion, which is approximately 3.4% of total NHS spending in the UK in 2013. Observing the initial stages of Alzheimer’s in nerve cells can give scientists clues to help them identify genetic risk factors. It can also be used to test potential treatments to see whether the damage from Alzheimer’s can be stopped. We are a long way from that, but it is an illustration of how important it is for us to carry out further research into adult stem cell transplantation. Indeed, it is vital; it makes economic sense and will save lives.

I wish to focus on my involvement with the all-party group on stem cell transplantation and to highlight the potential of cord blood donations to transform our ability to meet the needs of every patient who requires a stem cell transplant, including black, Asian and minority ethnic patients, who have suffered from such poor transplantation outcomes. It is a scandal that, in 2010, just 40% of BAME patients were able to find a well-matched stem cell donor. That figure has increased now to 60%, which is really welcome, and the Government can take plaudits for that. The £4 million that was pledged in 2013 and the total investment of more than £12 million since 2011, along with all the investment from the charitable sector, have made a difference, but we still face a situation in which four in 10 people from the black, Asian and minority ethnic community are unlikely to find a match, which is not good enough. We must do more, and I urge the Minister to support continued and sustained investment as we approach the next spending review.

We need to focus on the outcomes. Of the 6,200 patients who will receive a stem cell donation between now and 2020, one in three will not survive their first year after transplant. Of those who do survive their first year, many will suffer a number of post-transplant complications, including relapse, infection and graft versus host disease.

Since 1993, the collection of stem cells from cord blood and bone marrow has increased at impressive rates, meeting the needs of many patients in the UK. Over the past three years, we have seen progress in a number of areas. Cord banking rates have tripled, a quarter of all cord transplants in the UK are now sourced domestically, and the cost of transplants to the NHS has decreased dramatically. But the urgent need for improvements in long-term outcomes remains. In order to make the necessary progress, the UK needs to ensure that the early-stage advancements are sustainable by investing in long-term research, which is the focus of this debate, identifying improvements to treatments and developing potentially new life-saving therapies. So what needs to be done?

[Fiona Bruce (Congleton) (Con)]

I thank my hon. Friend for securing this debate. He referred to the fact that the potential for about 80 treatments has been discovered through adult stem cell research. Does he agree that it would have been preferable to have put all the resources that have gone into embryonic stem cell research, which has produced negligible results, into the work on adult stem cells?

[Mr Burrowes]

My hon. Friend will know that I was very much making that case in 2008 in the debates that we had on the Human Fertilisation and Embryology Bill. Strong lobbying went on in relation to therapeutic treatments. I remember being in Central Lobby when many charities said that we had to pass that measure to provide immediate treatments. I do not want to get too involved in that debate today, beyond saying that adult stem cell transplantation is saving lives now, and has potential for the future. We need to have a really good mutual circle of which everyone can be part. Such a circle must lend itself to looking at the big ask of the Government today, which is a national stem cell transplantation trials network to ensure that we save more and more lives. We also need to look at future therapies as well.

I urge the Minister, as he steps up to the Dispatch Box, to show his support for a national stem cell transplantation trials network. This will not only provide a turbo boost for improving patient outcomes and make the UK a world leader in stem cell transplantation, but also support the economy by growing the life sciences industry, and I know how seriously the Minister takes that.

The UK Stem Cell Strategic Forum, which was established at the request of the Minister of State for public health in 2010, stressed the need for further research into stem cell transplantation in 2014, and that included the recommendation that the network be established. Furthermore, the all-party group on stem cell transplantation has called for a clinical trials network a number of times over the past few years. Last year, the all-party group heard from experts in the field who pointed out some of the barriers to research into stem cell transplantation in the UK. They identified inadequate research infrastructure and inefficient data collection. Currently, the small number of patient cohorts and the complex regulatory environment—I ask the Minister to look at that aspect as well—mean that fewer than 5% of stem cell transplant patients are recruited into prospective clinical trials of any kind. Also, data collection at transplant centres is inefficient owing to inadequate staff training. The poor quality of the data means that they are unsuitable for research purposes, which significantly undermines the potential to achieving good outcomes in transplantations.

The infrastructure is ready to provide support for a national network, which would allow for the rapid recruitment of participants, standardise procedure and provide a central data hub to manage and evaluate research and share information which could be used to improve patient outcomes.

NHS Success Regime

Fiona Bruce Excerpts

Thursday 4th June 2015 Commons Chamber

[Ben Gummer]

I thank my hon. Friend for his kind comments. The success regime is locally based but must take into account the developing national opinion on the integration of health and social care. However, those can be properly integrated only on the basis of local considerations; this is not something that we can design from the centre, as some would wish.

[Fiona Bruce (Congleton) (Con)]

I thank the Minister for confirming that the Health and Social Care (Safety and Quality) Act 2015 will be at the forefront of the minds of those implementing these plans. The 2015 Act was passed by the House in the very last days of the last Parliament. Does not the fact that the Opposition have asked this urgent question today show that they have already forgotten the central tenet of the Act: that patient care and safety will be at the forefront of everything that the Government do?

[Ben Gummer]

I repeat to my hon. Friend the observation that I made earlier: it is interesting that in his opening contribution, the right hon. Member for Leigh did not make a single statement about patients and their centrality to what we are trying to do. The NHS has devised its own plan for its own success over the next five years, and the safety and care of patients lie at the heart of it. Only one party is supporting that plan, and that is why the Conservatives are the only party backing the NHS.

Health Services in Staffordshire

Fiona Bruce Excerpts

Wednesday 3rd June 2015 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

I commend my hon. Friend for securing this debate and I share his concerns, particularly because these issues also affect my constituents in Congleton. One of them has written to me expressing concern that cardiac patients needing to be urgently

“transferred to The Royal Stoke immediately on arrival at our local hospital A&E, Leighton”

can be at serious risk as a result of the additional pressures on services. Indeed, he says that if this issue is not resolved

“fatalities may be the consequence.”

[Jeremy Lefroy]

I thank my hon. Friend. She makes a point that I think will be echoed by other hon. Members in the area.

The reason given for the potential closure of the community beds was that more care would be provided at home, but how precisely will that be done? I have to declare an interest in that my wife works as a GP in Stoke-on-Trent. From what I hear, community nursing teams sometimes have difficulty in managing the workloads they have at the moment, so where will the extra capacity come from? Surely it would be more sensible, before those beds disappear—if indeed they are scheduled to disappear—to ensure that the extra community nurses are in place and to show that there is a clear reduction in the need for such beds. I urge the Minister to question any proposed reduction in community beds—even if it is not of the order mentioned in the press last week—at a time when they seem to be most in need.

I will now turn to acute services in general. The University Hospitals of the North Midlands Trust has recently announced the closure of in-patient oncology and haematology at the County hospital. In future, there will be outpatient chemotherapy treatment, but in-patients will be seen in the Royal Stoke hospital. This move was not dealt with in any detail during the public consultation on the proposals of the trust special administrator, nor was it mentioned by the NHS in its information about the changes in services provided to my constituents or to those of my hon. Friends the Members for Cannock Chase (Amanda Milling) and for Stone (Sir William Cash), and my right hon. Friend the Member for South Staffordshire (Gavin Williamson) who are affected.

From a visit to a patient on the oncology unit at the County hospital last week, it was clear to me that the service was not only very busy, but greatly appreciated. Constituents have written to me saying how important it was to have the unit relatively close, so that they could be with their family through stays which were very difficult and often lengthy. Why move what is appreciated and working well? I understand that there are staffing problems, but surely those could be tackled. I ask the Minister to look at this again.

Health and Social Care

Fiona Bruce Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

Her Majesty’s Gracious Speech included the welcome commitment to give every child the best start in life. I am optimistic that our Government’s legislative programme will prioritise strengthening families and boosting family stability, particularly given the Prime Minister’s own passion for these issues, which are vital for the nation’s economic and social welfare, and the fact that families were mentioned nearly 100 times in the 2015 Conservative party manifesto. Without the constraints of coalition, we have the opportunity to develop a robust and comprehensive range of family policies.

States have a vested interest in making families stronger. They make a contribution to society by producing a competitive labour force, caring for family members of all ages, playing an instrumental role in healthy child and youth development and putting a heart into local communities. However, there are profound social consequences when, for whatever reason, families fail. The high level of family breakdown in our country costs £48 billion per annum, and disproportionately affects people in our poorest communities, where two thirds of 15-year-olds no longer live with both their parents. With our Conservative commitment to compassion and social justice, we simply cannot ignore this issue. If it is sensitively handled, this could mark us out as the true party of the family.

I urge the Prime Minister to appoint a family champion—a Cabinet-level Minister to strengthen families. Our ground-breaking family test for all policies is welcome, but it is reactive to the proposals of other Departments, rather than proactive in forming a family-strengthening approach across all areas of policy, as a champion for families at Secretary of State level would do. We need to match the promises we have made on economic support for families with more policies not only to prevent family breakdown but to promote healthy relationships, just as we promote physical health and wellbeing. Children’s health and wellbeing are fundamental to their educational attainment, and their ability to thrive in the workplace and in wider society rests on their benefiting from safe, stable and nurturing relationships with those closest to them—and for most, that means their family.

We ignore this at our peril. The state cannot be a surrogate family. Supporting family relationships is one of the driving principles of the troubled families programme, which has rightly been extended, but we must do more. We need places in every community where people can go when relationship problems are beginning to emerge, in order to enable everyone—including couples, and parents of toddlers and teenagers—to build strong relationships from the outset and to maintain healthy relationships into later life. This, in turn, could help to address many other challenges, such as mental ill-health, obesity, self-harm, addictions, loneliness and child poverty. However, many families have no role models to look to as the basis for a successful family life. Family life throws out challenges for us all. Real complexities can ensue, as we have seen from the troubled families programme, if families are not equipped to make a go of it. For almost a decade, organisations such as the Centre for Social Justice, and individuals such as its associate director Dr Samantha Callan, have been calling for change.

One important change would be for Sure Start children’s centres to broaden their offer and become family hubs—local nerve centres co-ordinating all family-related support. Relationship support and education, at all life stages, would be part of a family hub’s core offer, whether supporting couples in their own relationship, or as parents, or grandparents, or in marriage preparation, or strengthening father involvement, or supporting families as carers for elderly relatives, or when specific challenges occur. For example, many couples will not, or cannot in a timely way, go to Relate, which is one of many organisations that family hubs could host or help families access. To ensure that as many parents as possible know what is on offer at a family hub, local health commissioners should ensure that all antenatal and postnatal services are co-locate there. The Field review on poverty and life chances recommended that all birth registrations should take place there, too.

The social justice directorate in the Department for Work and Pensions is piloting a family offer in some children’s centres that takes in some of the aspects I have mentioned, but more is needed. More national leadership will be essential if this scheme is to be implemented at a pace that this country needs to strengthen family life. This brings us back to why we need a family champion.

Education, early intervention and prevention will ensure that families are less dependent on social services and welfare. I stress that I am not just talking about deprived areas here. Broadening Sure Start centres into family hubs would provide an effective means of tackling family breakdown, strengthen family life and help deliver the Conservative vision of giving every child the best start in life.

Finally, I urge the Government to work towards a fully transferrable tax allowance for all married couples. Thirty hours of free childcare amounts to £5,000 a year, and the value of the Government’s tax-free childcare offer is £2,000 a year. What message do those figures send out when the marriage allowance for single earners is just £200 per family? It must be recognised that doubling free early years education and making childcare tax free when both parents work without reviewing the marriage person’s tax allowance skews support overwhelmingly towards a particular type of family.

Families in which one parent chooses to take time at home—working and caring within it and investing in their children’s future—while the children are young are doing the right thing just as much as those families in which both partners choose to work outside the home. Stay-at-home parents deserve our appreciation, respect and support.

Over this Parliament, reversing Britain’s tragically eye-wateringly high family breakdown rates must be our ambition—it must be a priority—and strengthening families by supporting healthy family relationships at all ages and stages of life and rolling out family hubs to achieve that should be our vision.

Nurses and Midwives: Fees

Fiona Bruce Excerpts

Monday 23rd March 2015 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

It is a pleasure to serve under your chairmanship, Mr Havard. I thank the hon. Member for Blaydon (Mr Anderson) for bringing forward the debate, although I do not agree with everything he said. With particular reference to the concerns he expressed on NMC registration fees, I will relay to Members and the Minister the experience of a constituent in Congleton whom I have recently had to assist.

My constituent is a registered general nurse. She qualified in 1987 and has practised as an RGN for 27 years. Sadly, the NMC recently nearly barred her from practising for a period, through no fault of her own. My constituent paid her £100 NMC re-registration fee by automatic bank transfer. The fee was debited from her account in October last year and she heard nothing more about it. She assumed that her re-registration had taken place automatically.

By chance, four months later, at the very beginning of February, my constituent was checking the NMC register regarding a colleague, and she decided to put in her own details. The system had no record for her. She contacted the NMC four times in two days, as she was very concerned. Eventually, she received a response. To her consternation, she was told that her registration had lapsed. She was informed that a form had been sent to her home, but had apparently been returned marked with “No longer resident at this address”, even though she had lived in the same house for four years and continued to receive other correspondence from the NMC throughout the period between October and February. Without contacting her or her employer, or reimbursing her money, the NMC had cut off her registration.

My constituent e-mailed me at the beginning of February, as she was extremely concerned. She said:

“I was then informed I would have to re-register”—

effectively, she had to apply for readmission—

“and could not work as I am no longer registered as a nurse and that sending the initial letters back could take up to 10 days and that I would also have to do a PREP audit which could take a considerable number of weeks to process. I do not have an issue with PREP as I do keep myself updated”.

She told me that last year she not only completed the 35 hours of continuing professional development that she should have done, but that she actually did around 100 hours of CPD. We are talking about a responsible member of her profession. Her issue was

“the length of time I will not be working because of the NMC incompetency. I have never received the renewal for registration form…I have received numerous letters from different departments at the NMC during the periods of October and up until last week”.

That was when she contacted me. Of even more concern is that she was also informed that

“the company I work for could request my wages back from October as I have not been registered or that they could discipline me. This situation is not my doing. I feel the NMC must have sent letters to the wrong address…why would I not receive some and receive others...I feel totally let down by a board that I have continually adhered to since 1987 without any blot on my career as both a Nurse and Midwife and now find myself in this diabolical situation which is not my doing.”

In fact, while my constituent was rather concerned, she continued to work. She needed to work, of course, and sought to correct the NMC’s error by reapplying. She was told that she would have to make a readmission application at the increased fee of £120, which she did. It was only after a number of letters from me and e-mails and calls from my constituent that just last week the NMC confirmed her readmission. She should have had her re-registration confirmed and backdated, but what she has had is an e-mail from the NMC that states:

“I have reviewed your readmission application, and I can now confirm that your readmission process is complete. As of today you are effective on the register with an expiry date of 31 March 2016.”

My constituent has been practising under this pressure for a considerable period. She was readmitted more than a month after she realised the situation and contacted me. She is extremely concerned, and so am I. In my constituent’s experience, the registration system has clearly lacked what I consider to be basic efficiency. It has fallen short of taking a reasonable approach to her. How can the NMC see fit to increase its registration fees in just two years from £76 to £120? Before it considers another increase, it should put its own house in order in respect of its relations with its members.

Human Fertilisation and Embryology

Fiona Bruce Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Jane Ellison]

We have made it clear that the removal of the faulty mitochondria will be passed on to the next generation. That is exactly what we have been describing, but I do not accept my hon. Friend’s description of it as genetic modification. It has to be said that there is no universally agreed definition of genetic modification, but for the purposes of these regulations, we have used a working definition and it involves not altering the nuclear DNA.

[Fiona Bruce (Congleton) (Con)]

rose—

[Jane Ellison]

I know my hon. Friend is going to make her own contribution. If she will forgive me, I want to outline for the benefit of Members less familiar with the regulations their detailed content.

Turning to that detail, the regulations are made under the powers in the Human Fertilisation and Embryology Act 1990. They were added to in 2008 to permit mitochondrial donation to prevent the transmission of serious mitochondrial disease, anticipating the advancement of science to this point. Regulations 3 to 5 set out the circumstances for mitochondrial donation techniques using eggs; regulations 6 to 8 set out the circumstances for mitochondrial donation using embryos. They would allow the use of the two techniques that have been subjected to extensive UK-wide review and consultation: maternal spindle transfer and pro-nuclear transfer.

Regulations 11 to 15 and 19 set out the information that can be provided about a mitochondrial donor to any child born from the donation and information to that donor. Regulations 16 and 17 set out special provisions around consent that were identified through the public consultation process. These regulations apply UK-wide, and the devolved Administrations have been kept informed of development and progress.

[Fiona Bruce]

Does the Minister consider that the Government’s own regulator, the HFEA, was wrong to state, in a consultation document that “PNT involves genetically modifying a human embryo”?

[Jane Ellison]

I shall deal shortly with the regulatory regime that the HFEA would introduce. However, that and many other points have already been examined in great detail and responded to in great detail in parliamentary answers, to which I refer my hon. Friend.

--- Later in debate ---

[Fiona Bruce (Congleton) (Con)]

I want to speak against the Government motion, and I draw the House’s attention to my alternative motion in part 2 of the Order Paper—page 54—although it is not votable.

Human mitochondrial disease is a dreadful condition and, as a caring society, we must do all we can to address it, and do so as sensitively as we can for those families affected by it. As a caring society, however, we must also do so in an ethical manner and with proper regard for safety. I believe that the regulations we are considering today fail on both counts—ethics and safety—and that they are inextricably interlinked.

Let me be straightforward: I do oppose these proposals in principle. However, that should not prevent my concerns regarding their safety from being given a fair hearing. One of the two procedures that we are being asked to sanction today—pro-nuclear transfer—involves the deliberate creation and destruction of at least two human embryos, and in practice probably more, to create a third embryo, which it is hoped will be free of human mitochondrial disease. Are we happy to sacrifice two early human lives to make a third life?

[Sir Paul Beresford (Mole Valley) (Con)]

I question my hon. Friend’s definition of “embryo”. We are talking about two ova being used to create one embryo.

[Fiona Bruce]

Let me put it this way. Some may take the view that at such an early stage of human life, it is acceptable deliberately to create human embryos to then destroy them. However, the truth is that once upon a time I was an embryo and so was every other Member in this Chamber.

This debate is about the principle of genetically altering—indeed, genetically creating—a human being, and no matter how well meaning the motives, and my heart goes out to the families with mitochondrial disease, this technique will not cure that disease. That answers the question asked in the intervention on the hon. Member for Liverpool, Wavertree (Luciana Berger), the shadow Minister. This technique will not cure that disease.

[David T. C. Davies (Monmouth) (Con)]

I am completely undecided on this issue. Can my hon. Friend tell me whether it is the case that any woman taking the pill could arguably be destroying an embryo? If it is the case, what is the difference morally between using this technology and using the pill?

[Fiona Bruce]

What we are talking about is a particular process, which we know—with certainty—will destroy embryos. That is what I am addressing. As I say, this technique will involve the permanent alteration of the human genetic code. The Nuffield Council on Bioethics, which was cited by the shadow Minister in support of her arguments, says that these techniques are

“a form of germline gene therapy.”

This alteration will be passed down generations. The implications of this simply cannot be predicted. However, one thing is for sure: as someone has said, once this alteration has taken place and once the genie is out of the bottle, and once these procedures that we are being asked to authorise today go ahead, there will be no going back for society, and certainly not for the individuals concerned.

[Dr McCrea]

Does the hon. Lady find it strange that while the shadow Minister was telling the House that we should support these regulations, she had no answer to the direct question she was asked by the right hon. Member for Chesham and Amersham (Mrs Gillan), and that all she could say was that she hoped the Minister would clear the matter up?

[Fiona Bruce]

I was indeed surprised, but in a sense that is why those who have made the case for much more parliamentary time and debate on this issue are quite right.

There will be no going back for society and certainly not for the individuals and children involved. My hon. Friend the Minister said that we have taken all rigorous steps before bringing this matter to the House, but it is profoundly concerning that the outstanding preclinical trials, as recommended by the HFEA panel, have still not been undertaken, written up and peer-reviewed. Will my hon. Friend confirm that, setting aside the completion of preclinical trials, there have been no clinical trials of these procedures, that there will be no clinical trials of them and that, in effect, if we pass the regulations the techniques will be applied to the creation of children without clinical trials? In other words, we will be approving uncontrolled experimentation—because there will be no controls—on children. In the absence of clinical trials, would that not effectively contravene EU regulations?

[Robert Flello]

There is a lot of muttering around the Chamber that there will be clinical trials, but there cannot be clinical trials because they would breach the EU directive.

[Fiona Bruce]

That is exactly the point I was about to make. As has been highlighted in a letter from 44 MEPs who have written from the European Parliament this week to the Secretary of State for Health, the EU directives—the European clinical trials directive 2001, which was confirmed by the 2014 directive in the same area—state:

“No gene therapy trials may be carried out which result in modifications to the subject’s germ line genetic identity.”

My hon. Friend the Minister indicated that in some way these particular procedures were excluded from these trials. That cannot be correct. The European clinical trials directive 2001 applies to clinical trials involving germ-line engineering. It applies to all clinical trials using medicine, and to these procedures. For the Department of Health to argue that it can move straight to using these procedures on children without clinical trials gives us, apart from anything else, one reason to vote against these regulations.

If anyone doubts that, Lord Brennan QC has given a legal opinion on these regulations, which is of central importance. He says:

“It is a well-established principle that EU law is to be interpreted…in light of the purpose, values, social and economic goals the provisions aim to achieve. Given that…both the Directive and the 2014 Regulation…ban any gene therapy trials that involve modification of the subject’s germ line identity, then it would clearly fall within their purposes and values to prevent their use in clinical practice of any procedure with that effect without investigation or trials first having taken place.”

I believe that this Government are at risk of infringement proceedings being brought against them if these proposals go ahead.

[Several hon. Members]

rose—

[Fiona Bruce]

The answer has to be that we—

[Mr Speaker]

Order. I think Members thought that the hon. Lady had concluded her speech, but she has not. Let us have a courteous hearing for everybody. I call Fiona Bruce.

[Fiona Bruce]

Thank you, Mr Speaker.

Once we approve this procedure, where will it lead? The answer has to be that we stop here and say, “This is a red line in our country, as in every other country in the world, that we will not cross.” This is the place for that to be said. As MPs, we are accountable to the people of this country.

The Government’s own consultation in July 2014 received 1,857 responses, of which 1,152 were opposed to the introduction of these techniques. That has been confirmed by ComRes polling last weekend, which showed that more than twice as many people are against these proposals as are in favour—41% of respondents, compared with 21%. A third public survey, being conducted today on The Daily Telegraph website, shows that as of this morning 68% of the public oppose these techniques in principle. Do their concerns not deserve respect from those of us present here?

The truth is that the Government have not waited for the conclusion of trials, as they should have done, so that this House could make a fully informed decision, and that is wrong. Whether one ultimately approves or disapproves of these proposals, the right procedure on such a profound issue is for the elected representatives of the people of this country to have full information before being rushed into a decision, as we would be today if we voted for these proposals.

--- Later in debate ---

[Frank Dobson]

No, I will not give way, because I do not want to take up more than my allocated six minutes.

The question arises: will it be safe and will it work? The answer is that no one can make any guarantees, but that is the nature of scientific development. The thing to remember is that mitochondrial disease is horrible and that there is no treatment for it. I remind people that the team at Newcastle university did not start off with this riskier novel approach. It has been studying and trying to come up with treatments for mitochondrial disease for the best part of 20 years, and is still doing so now. Some 90% of its work is trying to come up with a treatment. The best that it has managed to come up with after all these years is helping parents cope with the horrible symptoms before their children fade away and die. As has already been said, the team has decided that if it cannot come up with a treatment—and it is still trying—it would be better to prevent the disease arising in the first place because prevention is better than cure. That is why I hope the regulations will be passed and handed over to the HFEA. Members should realise that it is a credit to this country and to this House that the HFEA was established. We must find a middle way between the free-for-all, which a few nutters want, and the total ban, which some others want because they are opposed to embryo research on principle.

The system that has been established is well regulated through the HFEA. Despite all the predictions to the contrary, there has not been a single scandal in all the time that the HFEA has been in existence. There has been no sign of a slippery slope. These people with great reputations at Newcastle think the time is right to take risks and to risk their reputations—

[Fiona Bruce]

Will the right hon. Gentleman give way?

[Frank Dobson]

No, I shall not. Those people are taking risks, because if the treatment does not work, there will be those who will gloat—even, I am sad to say, Members in this Chamber. The parents are also willing to take the risks. Parents with children do not want this to happen again, and we have the opportunity to do something about it. The results are uncertain, but that is in the nature of both medicine and science. We cannot guarantee that it will work, but the people most involved in the matter and all the scientific advisory bodies in this country think that it will work, and we should take note of what they say.

--- Later in debate ---

[Fiona Bruce]

I want to pick up on the point the hon. Lady makes about mitochondria not affecting characteristics. The Government’s own consultation document acknowledged that diverse characteristics are associated with mitochondria, including learning disabilities, neurological problems and dementia, and that every person’s symptoms are different. Is there not an insurmountable contradiction in saying that this is just like changing a battery if on the one hand one is saying that the aim is to prevent damage to those characteristics, but on the other hand one is saying that the techniques will not affect them at all?

[Liz McInnes]

I did not say it was just like changing a battery. In fact, I try to avoid using that terminology. The hon. Lady mentions learning disabilities, but as I just said, the organs affected the most by mitochondrial disorders are organs that require a large amount of energy, such as the brain, so that comes as no surprise to me.

Allegations have been made that the techniques are not safe.

[Liz McInnes]

No, I will not, because I need to make progress and let other people speak.

Last night, it was my privilege to attend the debate on the safety and ethics of this technique and to hear Professor Doug Turnbull, who leads the research team at Newcastle university, talk about the 15 years of work done by his team and the extensive safety checks that have taken place during those years. In the Chinese case to which my hon. Friend the Member for Stoke-on-Trent South (Robert Flello) referred, the treatment was carried out by an American clinician on a single patient in China. The patient became pregnant with triplets, one of whom was aborted and the other two were born prematurely and died. Importantly, the clinician attributed the outcome entirely to multiple pregnancy and obstetric complications, not to the method of conception. I do not accept that that one case represents a proper clinical trial.

What we have to remember is that mitochondrial disease is a life-limiting debilitating disease, causing severe distress to parents and their affected children. We have here a technique with the ability to alleviate their suffering and to allow affected parents the chance to have a healthy child who is genetically related to them in all aspects apart from a tiny proportion of mitochondrial DNA. The spectre of designer babies can be dismissed. There is no possibility of using this technique to select certain characteristics. It will simply allow mitochondria to function normally and for the child to be free of mitochondrial disease.

[Fiona Bruce]

Will the hon. Lady give way?

[Liz McInnes]

I will not, no.

In safety, the UK has a robust regulatory framework. A vote in favour of the motion will not in itself open the way for mitochondrial donation to be used in clinics. It will simply enable the HFEA to consider each individual family’s request for treatment on a case-by-case basis, taking expert scientific and medical advice and licensing the procedure only if the evidence shows that that is appropriate.

I am lucky enough to have worked at the Royal Oldham hospital, where the first IVF baby, Louise Brown, was born. When IVF was first introduced, there was no certainty that it was completely safe. Only after the first babies were born using the technique could scientists be completely reassured that their detailed research had led to the birth of healthy babies, but to this day research continues on IVF, just as more research must be done on mitochondrial transfer. That is the nature of science: it is a continuous process; it does not stand still.

For families affected by mitochondrial disease, this research has given them new hope that they may at last have the chance to bear a healthy child of their own. Last night I heard from a woman who suffered from mitochondrial disease, which had also affected her mother. That young woman had taken a considered decision not to have her own children, for fear of passing on the condition. The opportunity to have this treatment presents her and many other women in that situation with new hope. The science is there to alleviate the suffering of affected families, and in my opinion it would be unethical to withhold this treatment. I urge the House to approve the regulations.