Oral Answers to Questions

Fiona Mactaggart Excerpts

Tuesday 18th October 2011 Commons Chamber

[Fiona Mactaggart (Slough) (Lab)]

One reason for those increases in resources is the growing birth rate in that part of Berkshire. Slough mums who want to use the Ascot birthing centre at Heatherwood have been locked out since the end of September because of a lack of midwives. If the Government had provided the 3,000 midwives they promised, that centre would not be shut. What does the Secretary of State say to that?

[Mr Lansley]

As the hon. Lady knows, I am very familiar with Heatherwood, because I have two daughters who were born there in the days when it had an obstetrics service, which disappeared under the previous Government. She also knows that I visited Wexham Park in September last year to announce support to the trust in the form of loans, based on commercial principles, totalling £18 million. There is no shortage of midwives under this Government compared with the previous one. Since the election, 522 additional midwives have been recruited, and we are maintaining a record level of midwifery training places.

Decisions made locally are a matter for local commissioners. If they seek to change services, they must meet the four tests that I set out shortly after the election.

Ovarian Cancer

Fiona Mactaggart Excerpts

Wednesday 12th October 2011 Westminster Hall

[Fiona Mactaggart (Slough) (Lab)]

I should start this speech by telling the House that I should be dead, because only two out of every five women with ovarian cancer survive beyond four years and my cancer was diagnosed eight years ago, at the start of 2003. I remember the dates well. Throughout that autumn term, I had been on a very serious diet. As hon. Members know, I need to do that, and I was completely unaware that the loss of appetite that was caused by my cancer was being helpful to my dieting. At the end of that autumn term, I went to see my GP about symptoms that actually were irrelevant to the cancer, but she is a very insightful woman. She took a very careful history from me and did a CA 125 test. This was about December. She referred me and I did the CA 125 test. I remember the dates fairly well because it was just before I went away for a Christmas holiday. The level was elevated. Of course, I had no idea how significant that was. I cannot remember what it was at that point—45 or something like that. I said, “Is that serious?” She said, “Well, yes.” I did not quite work out how serious it was, but she had referred me to a specialist. I came back from my Christmas holiday and had an intravaginal ultrasound in January. I went to see the doctor about the results and was told on, I think, 15 January that I was going to have a hysterectomy in an operation that might be related to cancer on 14 February—not a date one forgets.

Although I was late detecting the symptoms and, indeed, the symptoms that I went to see my GP about were not symptoms caused by my cancer, it was a very short time before I had an intervention. In fact, it was quicker than that. It was this time of day on a Wednesday. The day before, we had lost, by just three votes, a cross-party vote on an 80% elected House of Lords. Those three votes were hon. Gentlemen who had had too good a dinner. I was trying to do press and so on about the House of Lords vote. I was trying to get across the point that a majority of the House of Commons thought that we should have an 80% elected House of Lords, but some hon. Members went in the wrong door because they cannot manage when they do not have Whips telling them where to go. Those calls were interrupted by a telephone call from St Thomas’ hospital, which said, “We have a cancellation. Can you come in today?” I burst into tears. Then I went to the Army & Navy Stores and bought a nightie and a pair of slippers and set off to St Thomas’ hospital.

As can be imagined, I arrived at the hospital not with my head in the place where a cancer patient needs it to be, but still trying to sort everything out, because although I had known that I was to have the operation, it was originally to take place about two weeks after the House of Lords vote that I was working towards. So I arrived all shouty and dictating things, putting out press releases, bellowing into a phone and so on. I was put in my bed and was still shouting down the phone, but then this woman came up to me, took my hand and put it in a bowl. I was on the phone and I said to her, “What are you doing?” She said, “I’m giving you a manicure.” I said, “Why?” She said, “I’m a volunteer. I come into the women’s ward in St Thomas’ hospital on a Wednesday and give women manicures.” I have told the Minister that story because that volunteer helped me through the experience, as I stopped being an MP and started facing being a patient. I strongly urge the Minister to recognise how powerful such roles, which do not look clinically essential, are in the care of people. That is my first message.

My second message is that my story tells us how good the NHS can be—how fast it can respond. In my case, it was eight to 10 weeks between first going to the GP—and not reporting the right symptoms—and having an operation. One cannot ask for better than that. I know that a big reason for it was the targets that we had set, because when I was told when my operation would take place, the consultant said to me, “Oh, I’m bumping up against the date.” I therefore urge the Minister both to look after the role of volunteers and voluntary organisations and to retain those targets that put pressure on the system to help people like me to live.

[Dr Sarah Wollaston (Totnes) (Con)]

I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on initiating this important debate. Does the hon. Member for Slough (Fiona Mactaggart) agree that although it is wonderful that she had such rapid access to treatment, such access to diagnosis is not uniformly available throughout the country? My experience is that it is difficult for general practitioners to gain rapid access to ultrasound scans, which was a crucial factor in the hon. Lady’s diagnosis. Equally, access to CA 125 measurements, although included in the NICE draft guidelines, which is welcome, is not uniformly available to GPs throughout the country.

[Fiona Mactaggart]

The fact that those things are not accessible is condemning women to die. It is very simple, and they are not complicated tests. I have had an awful lot of CA 125 tests because women have a lot before and a lot afterwards to see what is happening to the markers in their blood. It is a very simple test and certainly should be available in primary care so that GPs can do it quickly and reassure themselves and their patients. It was thanks to Ovacome that I began to realise how important knowing one’s CA 125 level is. Until I started reading the educative materials produced by voluntary organisations, I did not know that.

I want to say one thing about all the voluntary help available to people with cancer. It is very confusing. People never really know who does the thing that they need—who provides the help. Today, the question might be, “Should I wear a wig, or are they all horrible and uncomfortable?” The answer is yes, by the way. It might be, “Do I need someone to hold my hand and explain what’s wrong with me?” People do not know these things. I wish that somehow all the wonderful charities could get together and have one doorway through which the patient goes and can say, “This is what my life’s like. I can’t afford to park at the hospital” or “The wig that I got is itching” or “Is my reaction to chemotherapy appropriate? Do other people have it?” Who are the right people to help? People in this situation never know who the right people are, so one thing that I wish the Department of Health would do is find some way of resourcing those organisations to provide a better entry to their services for people with cancer.

However, I want to focus on diagnosis and helping people to detect their symptoms early. I did not detect mine particularly early; indeed, it was my GP who detected them, not me. Many hon. Members have written to the Minister, and at the annual general meeting of the all-party group in July we considered the response that he had sent us. Frankly, to me, it seems that the message is not getting through. The work being done to improve early diagnosis of cancer, particularly awareness, will not make a difference to the women who have ovarian cancer. I am very glad to receive an account of the work being done on breast, lung and bowel cancer, but frankly it is a bit insensitive. Someone who is concerned about ovarian cancer will see all those wonderful information campaigns on other cancers, but none of them applies to the symptoms of ovarian cancer. That will not do, and it particularly will not do when ovarian cancer is such a killer.

In the letter to the all-party group, the Minister said that

“future activity will depend on the success of the Be Clear on Cancer campaigns”.

His Department has since announced that following the success of the regional pilot campaign for bowel cancer, it will be rolled out nationally. Now that we know that those awareness campaigns work, when will we have a commitment to work on ovarian cancer? We have extended the work to include stomach, oesophageal, bladder and kidney cancer. Why not ovarian cancer? It was not until long after I had had a hysterectomy, chemotherapy and so on that I realised which of the symptoms that I had had were clues to my cancer. We really must help people to know that they are at risk. Ovarian cancer is the fourth most common cause of cancer death in women. Is it just because it affects women that we are not seeing action? If men had it too, we might be doing better, although, of course, we have a good history on breast cancer.

I worry that ovarian cancer is being put in the “too difficult” box, and it is not acceptable to do that with the most fatal gynaecological cancer. Ovarian cancer kills four times as many women as cervical cancer, for which we have a national screening programme. Is it not time that we put in place a national screening programme for ovarian cancer and gave GPs and others proper access to diagnostic tests that will save thousands of women’s lives? It is not acceptable that so many women die of this cancer when we know how to stop it, and I urge the Minister quickly to put in train action to deal with this issue.

Health and Social Care (Re-committed) Bill

Fiona Mactaggart Excerpts

Wednesday 7th September 2011 Commons Chamber

[Fiona Mactaggart (Slough) (Lab)]

rose—

[Mr Chuka Umunna (Streatham) (Lab)]

rose—

Health and Social Care (Re-committed) Bill

Fiona Mactaggart Excerpts

Tuesday 6th September 2011 Commons Chamber

[Mr Lansley]

Yes, I understand that and I think that my hon. Friend makes entirely the right point. This is not about a bail-out; the commissioning board and Monitor will need to agree the methodology, because neither side will wish to undermine the integrity of the regulatory structure and the price structure that Monitor is responsible for, nor will the NHS commissioning board and commissioners want to pay any more for services than is necessary to secure continued access. None the less, continuing access to quality services for patients is the essential principle, and so there will be circumstances, particularly where it has become evident that in the absence of this there would be an unacceptable deterioration in or failure of services, in which it is necessary for the methodology to add to the tariff price.

[Fiona Mactaggart (Slough) (Lab)]

The right hon. Gentleman will recall that very shortly after Monitor had approved the granting of foundation trust status to my local district general hospital, Wexham Park hospital, it ended up in very serious financial difficulty, and I was grateful to him when he arrived with a loan to ensure the continuation of service. What I am not clear about in the regime that he proposes is who will be able to provide those kinds of resources when something as important as the district general hospital’s future is at risk.

[Mr Lansley]

I am grateful to the hon. Lady for that. I will deal with that matter in a moment, because subsequent amendments in this group continue the capacity of the Department of Health, for example, to make a loan in those circumstances—that would not change.

Of the five principal changes that I was talking about—

Winterbourne View Care Home

Fiona Mactaggart Excerpts

Tuesday 7th June 2011 Commons Chamber

[Paul Burstow]

I think I will say yes to that, but I want to make it clear that I am not answering in the context of hypotheticals. I do not know the conclusions of the exercise, and Ministers who come to the Dispatch Box and promise that things will never happen again are all too often and too soon proven wrong. We must make sure that we do everything we can to learn lessons from this to minimise the risks in the future, and we need to make sure that responsibility and accountability are at the heart of the reforms that the Government are making to health and social care.

[Fiona Mactaggart (Slough) (Lab)]

The Minister is right to say that we need to learn lessons from this, but how long will it take us? The CQC has admitted inspecting Winterbourne View three times in the past two years. The South Gloucestershire safeguarding board was informed in October, but apparently took no action before the programme was aired on television. This is not the first such scandal. When I was first elected, one of the first things I did was to persuade the Department of Health to commission the Bergner report into the Longcare home scandal on the borders of my constituency —a similar huge institution in which residents were raped, abused and tortured by the people who were given care of them. It seems to me that it is not just the individual institutions but Government who need to learn the lesson. How much money is the Minister putting into advocates and listeners of the volunteer kind mentioned by my right hon. Friend the Member for Croydon North (Malcolm Wicks), or of the professional kind, so that the voices of those who cannot always speak for themselves are heard in the inspection process?

[Paul Burstow]

I mentioned in my statement that each of the individuals who have been affected in this terrible way have advocates. The hon. Lady makes an important point about the role that advocacy plays for those who lack capacity or the ability in certain circumstances to advocate on their own behalf. We are looking at that as part of the overall reforms of health and social care, but as for a precise sum of money, I do not have a figure in my head that I can give her now. I will write to her on that point.

Oral Answers to Questions

Fiona Mactaggart Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Burns]

My hon. Friend is absolutely right. I am certainly aware of the King’s Fund publication. The report was cited as a key source of evidence in the consultation document, “Liberating the NHS”. The Department of Health welcomes this significant contribution to the evidence base, which will inform how we implement the choice commitments set out in the White Paper, “Equity and excellence: Liberating the NHS”.

[Fiona Mactaggart (Slough) (Lab)]

When I was first elected, I regularly received letters from constituents who were concerned about how long they had to wait for treatment. During the years of the Labour Government, those letters went away, but they are coming back again. What I know from my constituents is that their main choice is not to have to wait. Is that a choice that this Government are going to offer them or will waiting times increase?

[Mr Burns]

The choice this Government will offer them will make sure that they get the finest quality health care, where they can exercise their choice of which hospital to go to, which consultant to see, which GP to see, without having to wait unduly for that treatment.

Oral Answers to Questions

Fiona Mactaggart Excerpts

Tuesday 25th January 2011 Commons Chamber

[Mr Burns]

Under these reforms, by concentrating on raising quality and outcomes, we will give improved quality health care for patients. What I can guarantee is that under these reforms, when implemented, people will not only get improved quality treatment but will see times based on clinical decisions rather than being distorted by political processes.

[Fiona Mactaggart (Slough) (Lab)]

14. What recent discussions he has had with primary care trusts on their policies on halting elective treatments in cases where such treatment has been demonstrated to be effective.

[The Minister of State, Department of Health (Mr Simon Burns)]

Strategic health authorities have recently been reminded of the statutory commissioning responsibilities of their primary care trusts in this area, and the need to base commissioning decisions on clinical evidence and discussions with local GP commissioners, secondary care clinicians and providers.

[Fiona Mactaggart]

What is the Minister’s response to the trusts that have been saving money by halting procedures such as hip and knee replacements, hernias and hysterectomies, which have proved to be clinically effective? My constituent, John Deas, has just lost the care of the nurse practitioner who has managed his prostate cancer over some years and has been referred to a GP who will not see him. As the president of the Royal College of Surgeons said that the immediate need to

“save money by going for the soft targets of elective surgery will leave a lot of people with unpleasant symptoms and build up future health problems. Medically that makes no sense.”

Does it make any sense governmentally?

[Mr Burns]

I am sorry to hear about the example that the hon. Lady mentioned; if she would like to write to me with the details, I would be more than happy to look into it. PCTs have a continuing responsibility to provide clinical treatment for their patients. Obviously, once the PCTs cease to exist, that will happen through the GP consortia and the national commissioning board. There is also a legal right in the NHS constitution for patients to be treated when they need to be.

Oral Answers to Questions

Fiona Mactaggart Excerpts

Tuesday 7th December 2010 Commons Chamber

[Mr Lansley]

I do not know the particular circumstances in Gosport, but I shall happily write to my hon. Friend. Nationally, we have more midwives than we have ever had—[Interruption.] I am being provoked by those on the Opposition Front Bench. There was a 16% increase in the number of live births in this country, but only a 4.5% increase in the number of midwives. That is the point I was about to make. The Government of whom the hon. Member for Halton (Derek Twigg) was a member failed to invest in midwifery when there was an increase in live births. That is why hospitals across the country have too few midwives, and that is why we are putting the investment in—because we did not listen to the Labour party when it said, “Cut the NHS budget.”

[Fiona Mactaggart (Slough) (Lab)]

Will waiting times for in-patient treatment in hospital increase or decrease next year?

[Mr Lansley]

They will respond positively to patient choice and GP referral.

Public Health White Paper

Fiona Mactaggart Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

Yes, I do. My hon. Friend is absolutely right. The structure proposed in the NHS reform White Paper in July was to bring local authorities and the NHS together to undertake joint strategic needs assessments leading to a combined strategy. Understanding the causes of ill health, and understanding where ill health is occurring and where the greatest areas of unmet need are in a community, will impact positively both on NHS commissioning and on local authorities.

[Fiona Mactaggart (Slough) (Lab)]

I welcome the proposal to give public health responsibility to local government, but will the Secretary of State assure the House that his intention is to build on proven successful initiatives, such as the family nurse partnership that works with teen mothers in my constituency, and health advocates? In contrast to GPs who, when offered an opportunity to give out membership of slimming clubs, managed to give only one in six months, health advocates managed to gain about 2,000 regular participants in slimming clubs, thus helping to deal with the obesity problem in Slough.

[Mr Lansley]

I am grateful to the hon. Lady. At least I know that she supports the proposal to transfer the responsibility to local government—not something I discovered from the reply of the right hon. Member for Wentworth and Dearne (John Healey). The short answer is that I have already announced that over the next four years we will double the number of family nurse partnerships, so we shall indeed support them. More than that, as Sir Michael Marmot made clear, it is vital that we combine the targeted support that the FNPs can give and a restored universal health visiting service to help every family as they start out.

Oral Answers to Questions

Fiona Mactaggart Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend for that question, because it enables us to point out that over the period of the previous Labour Government health inequalities in this country widened—life expectancy, for example, widened by 7% for men and 12.5% for women between the richest and the poorest areas of this country. We are very clear. Our public health White Paper, which will be published shortly, will focus on how we can not only deliver a more effective public health strategy, improving health outcomes for all, but improve health outcomes for the poorest fastest.

[Fiona Mactaggart (Slough) (Lab)]

There is an area of the country where public health inequalities have not widened, and it is the borough of Slough. Will the Secretary of State come to Slough and look at the work of health advocates, who are ordinary citizens who help to engage people with their health and avoid some of the conditions that have led to early deaths in Slough?

[Mr Lansley]

The hon. Lady might not recall, but about five and a half years ago I visited Slough to meet the health trainers, particularly in the Asian community, who were going to help people. Their focus was on diabetes. It has been a very effective pilot and we will need to work—we will do so—with local authorities and the NHS. We should work together, using dedicated public health resources of precisely that kind, to identify the risk of diabetes and to tackle it at source.