Oral Answers to Questions

Gagan Mohindra Excerpts

Tuesday 11th July 2023 Commons Chamber

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

2. What steps his Department is taking to reduce waiting times for NHS treatments.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

15. What recent progress he has made on reducing the number of patients waiting more than 18 months for elective care.

--- Later in debate ---

[Steve Barclay]

On the last bit of the question, the average waits in Wales are 20.4 weeks as of April, and in England they are 13.8 weeks, which is the exact opposite of the point the hon. Lady raises. We are taking action. We are boosting diagnostic capacity; 111 community diagnostic centres are now open. We are increasing treatment capacity through our surgical hubs programme. We are giving patients choice, which is not available in Wales under the Labour Administration—we are giving them more choice. We are also making better use of the independent sector, which some on the Labour Front Bench support but others do not.

[Mr Mohindra]

One of my constituents has now been waiting 14 months for a hysterectomy, while another waited years to receive a much-needed hip replacement. That is way over the 18-week standard set out by the NHS Constitution. Can the Secretary of State tell the House what is being done to get wait times down to that 18-week mark?

[Steve Barclay]

We recognise the challenges from the pandemic, and that is why we are boosting capacity, particularly through our community diagnostic centres. The additional capacity has already delivered more than 4 million extra tests and scans. We are rolling that programme out with the target of 160, and 111 are already in place.

Sudden Unexplained Death in Childhood

Gagan Mohindra Excerpts

Tuesday 17th January 2023 Westminster Hall

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

It is a pleasure to serve under your chairmanship, Mr Twigg, and I commend my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for securing this really important debate.

Nikki Speed was referenced earlier, and she is in the Public Gallery. She is actually one of my constituents, and I will use the words the hon. Member for Hammersmith (Andy Slaughter) used earlier: “Thank you for educating me.” As someone who has not been blessed with children, I was not aware of SUDC until the run-up to this debate. The really important point about today’s debate is that it is about educating more people about SUDC.

I will come on to various themes a bit later, but I hope the Minister will take away three important aspects: one is about education, the second is about research and the third is about the need for more public information. In my eyes, it would be quick win to update the NHS website with details about SUDC.

[Robert Courts (Witney) (Con)]

I have also been very moved by the many constituents who have written to me on this issue. My hon. Friend mentioned three points, all of which are important, but does he agree that the key one is perhaps research, which focuses in on causation? Although we will be able to see some common factors, no information we give will be helpful unless we understand the causation?

[Mr Mohindra]

Unsurprisingly, my hon. Friend makes an excellent point, and I will cover it in a short while.

Mortality statistics from Nomis indicate that about 128 children between one and 19 died of SUDC between 2013 and 2021. That is 128 families and their friends who have been devastated by sudden death. Unfortunately, in Hertfordshire, we had six deaths between 2017 and 2022; indeed, they were all in 2020.

I know that Nikki has put her own journey—her own story—on her website, and would I direct people to visit SUDC UK website. She went through great trauma back in 2013 when she lost her second child, Rosie. When my staff and I were researching for this debate in my office, all of us were emotionally moved by that, because we could all relate to the fact that this could potentially have happened to a loved one. Actually, not that long ago—back in December—I referenced the fact that I have another new niece, and I remember the joy I felt when I described her in the main Chamber. The other side of the coin would be the emotional shock of having to talk about the distress of losing someone at a young age.

With Rosie’s story, what made things worse was that it was the run-up to Christmas—there was a reference earlier to another family who unfortunately lost their child on Boxing day. For those families, what is meant to be a joyous time for families and friends will, unfortunately, forever be a real sore spot of emotional trauma, and the unknowns mean there has not really been much in the way of closure.

We have spoken about research. Hopefully the Minister, who is a very good Minister, will take away from the debate the fact that more research needs to be done. The Government have levers to help influence that, but I would urge academia to do more as well. It should not always require a Government steer to do the right thing.

We have spoken about the success of research into sudden infant death syndrome and about how, off the back of 13,000 research papers, there has been an 80% decline in deaths from SIDS. To date, according to my research, we have had only 55 research papers on SUDC, so there is a huge gap there, which can potentially—hopefully—be rectified.

In December 2022, the National Child Mortality Database reported data on SUDC for the first time ever. I hope we will continue to be report it, and in more detail, because what we have heard in other speeches today—my right hon. Friend the Member for Spelthorne articulated it amazingly well—is that the lack of knowledge is the main barrier to finding a long-term solution.

I will leave it at that, because I am sure there will be other excellent speeches forthcoming. However, I echo my right hon. Friend in saying that I believe that this is the start of the journey in educating more people in this place, and hopefully up and down the country, about SUDC.

[Derek Twigg (in the Chair)]

I call Robbie Moore, and I ask you to take account of the time as well.

Oral Answers to Questions

Gagan Mohindra Excerpts

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

I simply direct the hon. Member to the Barnett consequentials. As a former Chief Secretary who has had those discussions with the Welsh Finance Minister I know, and the hon. Lady should know, that Wales gets significantly more funding per head of population than England. I hope she welcomes the fact that, through the extra £6.6 billion in the autumn statement, the First Minister will have a significant uplift, and it is for him to decide how he wishes to spend that money.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

I was recently contacted by Amanda in my beautiful constituency of South West Hertfordshire, whose 88-year-old mother had fallen in her flat and unfortunately broken her hip. After waiting for five hours and making two calls to 999, her mother was still lying on the floor. Once they arrived at A&E, Amanda and her mother waited several more hours before being seen. Can my right hon. Friend assure the House that he is doing everything possible to find a solution to this system-wide issue?

[Steve Barclay]

My hon. Friend raises an extremely important case. I am happy to meet him to discuss it further, because it is a concerning case and I am keen to engage with him on it.

Down Syndrome Bill

Gagan Mohindra Excerpts

3rd reading
Friday 4th February 2022 Commons Chamber

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

Like others, I start by congratulating my right hon. Friend the Member for North Somerset (Dr Fox) on his important work in bringing the Bill to the House and on reaching Third Reading. Like my hon. Friends the Members for Eddisbury (Edward Timpson) and for North Devon (Selaine Saxby), we all know individuals with Down syndrome. My experience is similar to that of my hon. Friend the Member for Eddisbury: when I was growing up, living in the house next door was a young lad by the name of Mark, who was the great love of his parents, Tony and Carol. It just so happened that he had this condition, Down syndrome, but that was not a barrier to the fulfilment of his life chances. Unfortunately both Tony and Carol have since passed away, but I am aware that Mark is leading a very full life. He is in work, and I believe he has his own individual accommodation, although he may require support and has a large network around him.

Our role, as legislators, is to ensure that people are able to achieve their full potential, and also to strive to give them the confidence to be ambitious. We who have been brought up in this country are very fortunate, in that the barriers to success are very limited. As a second-generation immigrant, I still pinch myself to make sure that I really am sitting on the green Benches in the House of Commons.

My previous experience as chairman of the board of governors of a further education college, and also as a governor on the board of a school for young people with autism, has shown me directly that when we do things right, we do them really right. That means being able to say to people, whatever their status or condition, “Be good, be great, and be a real world leader.”

[Ruth Edwards]

My hon. Friend is advancing an excellent argument. Can he outline some of his experience of best practice on the board of governors, and of what works and is successful?

[Mr Mohindra]

That returns me to my hon. Friend’s own earlier comment. The skills required in certain industries may not necessarily be academic. I suffer from dyslexia and have always regarded that as a superpower, although I am sure that if I had been diagnosed at an earlier age, others might have regarded it as a disability. The ability to think differently, to be a disruptor and to question the status quo, which conditions of this type may typically entail, benefits us as a society, and—here I allude to the previous role of my right hon. Friend the Member for North Somerset in defence—it makes our country even more secure than it might otherwise have been.

My right hon. Friend is an astute and successful legislator, and I am personally reassured that his Bill will have a lasting impact, but as others have said, this is the start of a process and not the end. Today we are focusing on Down syndrome, but I think it would be easy to replicate this model for the purpose of other conditions. I believe that these measures should be adopted as soon as possible, and I look forward to the fulfilment of the ambition of my right hon. Friend to complete the Bill’s passage before World Down Syndrome Day in March. I hope that the Government can provide us with some confidence that that will be the case.

The role of politicians at whatever level, whether in local or in national government, frequently involves signposting. The provision of a named individual in the integrated care system will be a game changer for the families and loved ones who may not understand the bureaucracy of whatever public service they are having to deal with. The ability of a Member of Parliament to direct a constituent to a named individual with an email or other correspondence address can only help the system and make it smoother. Our role as politicians is to reduce the barrier, to make life as easy as possible for our constituents. The Government have a proud history in this regard, given the work we have done to date. We spent £2.6 billion over the 2021 spending review period on new school places for children with special educational needs and disabilities in England, and will more than triple the current capital funding levels to over £900 million by 2024-25.

I was not going to mention this, but I will, because I think it important. I read an article in the media today about a lady called Beth Matthews. She is a young lady of 22 who has achieved in her life: her story is important because she is now a model and she also happens to have Down syndrome. For me, that is an irrelevance, but people feel the need to show her as a leading light. Similarly, there is Tommy Jessop, an actor in “Line of Duty”. It is good that we normalise people with a condition, whether hidden or obvious. I look forward to the day when they are getting named not for their disabilities but for their ability and the fact that they are a master of their art.

[Ruth Edwards]

Does my hon. Friend agree that it is important to have role models from neurodiverse conditions in all areas of life, and that that will encourage others to believe they can also fulfil their ambitions and dreams?

[Mr Mohindra]

Absolutely; my hon. Friend is on a roll with her interventions and I look forward to more of them.

When I was growing up—I am sure others will have had a similar experience—I always looked at the TV screen, the media or the newspapers and asked where the people of my ilk had got to and what they had achieved. It can only be a good thing for people to be able to see others who look or sound the same as them being world leaders or industry leaders or social activists—people who change others’ lives.

Locally to me, I want to give a shout out to DS Achieve and its teamwork across Hertfordshire. I did a bit of research—unfortunately for my right hon. Friend the Member for North Somerset I was unable to be involved in previous iterations of this Bill—and reading its website and understanding what it is doing is reassuring: it is about people achieving their potential and not being regarded as just having a disability. There is lots of work going on—my right hon. Friend commented earlier about the expected lifespan now associated with this condition, which is to be applauded—but we need to make sure that we consider not just living but quality of life. This Bill goes hand in glove with that aim, ensuring a safety net of local councils and communities so that additional support is in place if individuals feel they need it. Others have spoken about the fact that people’s needs are different: different individuals will need support at different times in their life, and not all the time, and being able to dip in and out knowing there is a named person they can go to as a one-stop shop for support is a smart idea, so I applaud my right hon. Friend for his foresight.

[Edward Timpson]

I am enjoying my hon. Friend’s speech and agree with his comments. Does he agree that in the past too often the default position for those with Down syndrome as they grew up was to envelop them in cotton wool and not give them a chance to grow and develop and demonstrate what they are capable of with the right support in place? The societal attitudinal change coupled with this Bill presents an opportunity for them to demonstrate, as we have seen on our TV screens and elsewhere in the media, that they can have a successful career and loving and meaningful relationships as long as we ensure, as we would for anybody else with a condition or difficulties in their lives, that they have the support and networks in place to be able to progress. In the past, those with Down syndrome have potentially been seen as simply to be managed, as my right hon. Friend the Member for North Somerset (Dr Fox) said in his opening speech.

--- Later in debate ---

[Mr Mohindra]

My hon. Friend speaks from a position of significant knowledge and is absolutely right: the culture change both in the community and in the public bodies involved in this sector has moved on in leaps and bounds within the space of a generation, and rightly so. The message now is, “Be great at what you’re doing.” That does not necessarily mean being an excellent employee. It could mean being brilliant in a charity, brilliant at community work, or brilliant in a sport. There are so many different aspects. Success should be what a person thinks it is internally, and not what society thinks.

When I was growing up, I was very much steered towards certain careers. Admittedly, politics was not actually one of them, so in some eyes I may have failed in my life. I assure Members that I really enjoy being in this place; having spoken to colleagues across the House, I know that we all feel truly honoured to be here. I look forward to the day when, whatever disability our colleagues may have, no one bats an eyelid. There is nothing stopping that from happening. I look at some of our colleagues in this place. For example, my right hon. Friend the Member for Harlow (Robert Halfon), who is a very good friend, has not been held back by his disability.

Our role as parliamentarians is to say loudly and clearly that people’s perceived disability is not really a disability. We face so many challenges in life. Hopefully, when statesmen or community leaders say enough times, “Actually, you have very few barriers,” people will begin to believe it. I look forward to providing support in whatever small way I can.

I will wrap up now, because I know others wish to contribute to debate on this Bill. In conclusion, this Bill not only helps people with Down syndrome, but, as my right hon. Friend the Member for North Somerset has already said, sets out a framework for how we can provide services in the future for those with a range of disabilities and special needs. This is the first in what I hope will be a series of legislative measures that we can all get behind.

[Siobhan Baillie (Stroud) (Con)]

It is a pleasure to speak in this debate. I congratulate my right hon. Friend the Member for North Somerset (Dr Fox) on all of the work that he has done. I see that team Freddie and a number of friends are in the Public Gallery providing their support.

This Bill means a lot to thousands and thousands of campaigners. There are 47,000 people with Down syndrome and their families around the country. I give particular credit to the families from Stroud and Gloucestershire who have reached out to me to express their delight that this Bill has been introduced and also to explain their experiences and why it is so important. This is actually a spectacular use of a private Member’s Bill. I am also thrilled that the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is at the Dispatch Box. We have discussed Down syndrome for many, many years, because we are both blessed with nephews with Down syndrome. Those boys give us great joy, particularly as a distraction from this mad job.

The Bill proposes, for the first time, a duty on the Secretary of State to give guidance on housing, education, youth offending and national health authorities. It also imposes a similar duty on the relevant authorities, which is very important. The guidance will set out the steps required to meet the needs of people with Down syndrome, and I sincerely believe that it will be the start—and it is the start—of many other areas of policy and work to undo some of the problems that people with Down syndrome face in their daily lives.

My nephew, Rhys, is now 19 years old. He is the light of every room he enters. He works for the Thames Valley Cleaning company at the Select Car Leasing Stadium for the Reading Royals. He is right royally unimpressed with me—I am not cool, particularly when I am in a suit on the telly, so I hope he is not watching now. Let me relate part of Rhys’s story—[Interruption.] I am sorry if I get upset. It is not just because I am pregnant; I once tried to talk about Rhys in Camden Council many years ago and cried then as well—

[Mr Mohindra]

Let me give my colleague a brief respite. I know that she is a massive fan of the Bill of my right hon. Friend the Member for North Somerset (Dr Fox) and I look to hearing further words from her.

[Siobhan Baillie]

I am blessed by having great colleagues in this Chamber.

Alice fell pregnant aged 15. As she was so young—we had no Down syndrome in our family and there is a common belief that only older, geriatric mothers as they are often referred to in maternity terms have Down syndrome children—Alice was not offered any advice. She did not have any discussions about Down syndrome. She was 15 and scared. Her family was not around her, we did not know about the pregnancy in the early stages, and I doubt that she asked any questions. It was 20 years ago, too, so there were few smartphones and limited ability to google.

When Rhys was born, Alice was immediately in love with her baby son, but a few days later, my nurse mum spotted signs of Down syndrome. Notwithstanding the absolute love that she felt for her child, it is fair to say that my sister was pretty shocked by what was happening. Remembering that she was still a child herself and all the hopes and dreams that go into a pregnancy, I have since spoken to other parents of Down syndrome children and parents of other children with disabilities—

[Mr Mohindra]

On that point, does my hon. Friend agree that we need a real focus not just on the person with Down syndrome but on the bubble around them—carers, friends and family—because they are involved in the potential ups and downs of the journey as much as the person with Down syndrome themselves?

[Siobhan Baillie]

I completely agree. I have spoken to other parents who have discovered upon their child’s birth that they have a child with a disability about their fear, and about the loss of their hopes and dreams; their belief that they would take the child to university, or to get married, is dashed. With Down syndrome in particular, people believed that the child would die aged about 30. There is such a lack of education. That was particularly the case when Rhys was born, but I think it is still true now. Thinking about the bubble—the whole family—is incredibly important, and that is hopefully what the Bill will do. So much of what we think we know when it comes to disabilities is often not true.

--- Later in debate ---

[Mr Mohindra]

One thing I wanted to mention was to ensure that we realise that this affected all communities up and down the country. It is not specific to a particular geographical area or heritage. Does my hon. Friend agree that the Bill will be beneficial to all communities?

[Siobhan Baillie]

Absolutely. That is so important. When I reel off this list, if I can get through it, Members will understand why it is so important.

I have seen my little sister battle for understanding about Down syndrome. I have seen her battle for the right to medical care for operations in a timely fashion. She has battled for education. She has battled for housing. She has battled to get landlords to take people with benefits. She has battled during the transition from Rhys being a child to an adult, and she is still doing that. She has battled to get the council to complete the required assessment. She has battled with the welfare system and disability living allowance appeals. She has battled with endless application forms and then had to re-do them because they have been lost by various authorities and had to start all over again. She has battled during covid. I know that a lot of families battled really fearing for their loved ones with Down syndrome, who are vulnerable, often with respiratory issues. Covid was thrown at all of us, but we found that parents were being ignored, or certainly felt they were being ignored, and not prioritised for vaccinations. The whole family was not being prioritised for vaccinations to protect the people with Down syndrome in their homes.

--- Later in debate ---

[Jo Gideon (Stoke-on-Trent Central) (Con)]

We have had some amazing contributions today. First, I obviously thank my right hon. Friend the Member for North Somerset (Dr Fox). This is an incredibly important Bill. At the beginning of the debate, he said that the narrowness of the Bill was important to getting it through as a private Member’s Bill, and I want to reflect on that.

I have my own private Member’s Bill, the Button Batteries (Safety) Bill, for exactly the same reason: when we talk about protecting the vulnerable, sometimes we have to be very specific. Following the tragic death of Harper-Lee Fanthorpe at the age of two after swallowing a button battery, I hope my Bill will protect more children by making parents, carers and others aware of the dangers. I was lobbied by others to broaden my Bill to include things such as magnets, because they are also things that young children ingest. The more vulnerable the children, the more likely they are not to recognise the dangers of things such as button batteries, so I have been campaigning long and hard on that important issue.

I recognise that it is important to focus on the key issue. In this case, that is the rights of people with Down syndrome, and my right hon. Friend the Member for North Somerset makes a very good point about life expectancy. I do not know whether Members saw “Call the Midwife”, where it looked at how Down syndrome was viewed back in the ’50s and ’60s and how far we have come in understanding and on life expectancy. It means we have to protect, as well as ensuring that there is much better preparation, I guess, for a longer life—and that preparation starts in school. As chair of the all-party parliamentary group on youth affairs, I have looked at the issues with education. Sadly, only one in four young people with Down syndrome finds themselves in mainstream education.

[Mr Mohindra]

My hon. Friend mentioned APPGs. Does she agree that the role of APPGs is important in ensuring that we have an informed debate? They give colleagues and professionals the platform to go in depth into topics, so that when we are discussing them in this place we come from a position of experience and knowledge.

[Jo Gideon]

I absolutely agree. The key thing is that APPGs by their very nature are cross-party. On issues such as those we are discussing today with this Bill—this is a cross-party topic—the more that we can find consensus, the better it is for the people we represent.

Looking at schools, the Bill asks for a curriculum tailored more towards children with Down syndrome and for more teachers to be trained to understand how to teach children with the condition and the specific learning profiles of that condition. It is a fact that Down syndrome pupils in mainstream schools achieve on average at two years above the academic level of those in special schools.

Having said that, there are some fabulous special schools, and I want to give a shout-out to Aurora Hanley School in Bucknall in my constituency. There is some wonderful work going on. I also want to mention Stoke and Staffordshire Down syndrome social group, who have posted a lot about this issue. They meet regularly at the Bridge Centre in Birches Head, and they make a difference to about 50 families. It is a massively important contribution that everybody can make.

Oral Answers to Questions

Gagan Mohindra Excerpts

Tuesday 18th January 2022 Commons Chamber

[Edward Argar]

Decisions on hospital reconfigurations and changes to local hospital systems are a matter for the local NHS, following full consultation and consideration of the needs of local communities. The hon. Gentleman is right to highlight the importance of bed capacity in the NHS. The NHS as a whole will continue to look at what bed capacity is needed to meet future need.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

My constituent David Hulbert contacted me to ask that I pay tribute in the Chamber to the phenomenal NHS teams from both Mount Vernon Hospital and Watford General Hospital for the care he has received, following his admission for cancer. Will the Minister join me in thanking the NHS for its tireless, backlog-clearing work, and for continuing with lifesaving non-covid operations, alongside its ongoing heroic actions leading our covid fight and vaccine roll-out?

[Edward Argar]

I am always happy to take the opportunity, as I know the Opposition Front-Bench team and my colleagues are, to thank the amazing NHS workforce for the work they have done. I pay tribute to the work of the teams at Mount Vernon and Watford General and, in the context of the pandemic, I pay tribute to my hon. Friend the Member for Watford (Dean Russell), who volunteered to help out at the hospital.

Cancer Diagnoses: Young People in Hertfordshire

Gagan Mohindra Excerpts

Friday 19th November 2021 Commons Chamber

[Julie Marson]

I thank my right hon. and learned Friend for those comments. He has followed the case closely and has supported me. He puts his finger on some of the key lessons that we want to learn from the Brady’s tragic experience to improve the situation for the future. I will expand on the exact points that he has made.

Andrea and Simon first got in touch with me in April. They told me how Jessica, their 27-year-old daughter, had been unwell since mid-2020 suffering with abdominal and back discomfort. We know how difficult it has been to get a face-to-face appointment with a GP during the pandemic, so Jessica had an online consultation and was diagnosed with a kidney infection and prescribed antibiotics.

Over the ensuing weeks, Jessica was prescribed numerous medications, including countless courses of antibiotics and steroids, all without an examination. For months, she was told that she was suffering from long covid, despite the fact that she had never tested positive. Unconvinced by the assessments and desperately worried, Andrea and Simon decided to go down the private healthcare route.

On 26 November 2020, Jessica received the worst news imaginable: she was diagnosed with an extremely aggressive stage 4 adenocarcinoma with an unknown primary. Jessica’s dependency on oxygen from that date meant that she did not leave the hospital or ever return home. By the time the cancer was discovered, it had already spread to her spine, liver, stomach, lungs, bones and lymph nodes. Jessica passed away on 20 December 2020.

I never had the pleasure of meeting Jessica, but by all accounts she was a remarkable young woman. She worked as a satellite engineer for Airbus in Stevenage and on the day of her funeral, a satellite that she helped to design was launched into space from Cape Canaveral inscribed with the words, “Thank you, Jess!”.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

I commend my hon. Friend for bringing this Adjournment debate on an important issue for Hertfordshire residents. Does she agree that early diagnosis of cancer would mean that stories such as that of Jess, which she has eloquently put forward, will not necessarily happen again?

[Julie Marson]

My hon. Friend is right: early diagnosis is key. From Jess’s experience, I want to dig into some of the ways that we can get early diagnosis and a diagnosis that speeds up the process to help to stop unnecessary suffering and death from cancer.

Jessica had her whole life in front of her, but because of the restrictions on face-to-face GP appointments and misdiagnoses, she finally received the correct diagnosis just three and a half weeks before she died. I was immeasurably moved by her story and immediately contacted the then Secretary of State for Health and Social Care, my right hon. Friend the Member for West Suffolk (Matt Hancock). I take this opportunity to thank him, because he immediately met me, and Andrea and Simon, and we agreed numerous follow-up points. I thank the current Health Secretary for carrying on that work. Andrea and Simon also shared Jess’s story at the Health and Social Care Committee.

There are four key elements to Jessica’s story: the fragmented nature of the GP care and provision that she received; the misdiagnosis that caused so much pain to her and her family; how her age helped to shape the process; and how we need to use her story to make sure that the same mistakes are not repeated. I will take those elements in turn.

Jessica’s experience of the GP care she received was, at best, fragmented and, at worst, insufficient to deal with the specific needs that she faced. The problem here was not the individuals involved; the problems for Jessica often came from the organisation of the system itself. The GP provision that Jessica experienced was definitely exacerbated by covid. At the Select Committee session, Andrea described how, at Jessica’s lowest ebb, she struggled to navigate receptionists and switchboards while trying to receive any kind of contact from a doctor. In Andrea’s own words, “Nobody listened” and “Nobody took it seriously.” I cannot imagine your child suffering such pain and yet saying, “What's the point? Nobody will do anything.”

We talk so much about how crucial an early cancer diagnosis is, but all parts of the system need to be working for the process to be efficient and, above all, effective. Andrea Brady summed this up perfectly at the Health and Social Care Committee session. She explained:

“No one looked at the big picture and assembled the jigsaw puzzle pieces.”

Jessica really needed one person on her case, looking at all the evidence and looking at things holistically. Whether we see it as an umbrella model, a wheel and spoke model or whatever, they all need a focal point that holds the rest of the process together. Without this, we know just how awful the results can be. In the end, Jessica saw four different doctors, with not one of them taking ultimate responsibility for her care.

The impact of not having that single point of contact was profound. Vital clues were lost or not examined properly. At one point, a blood test revealed high levels of D-dimer in Jessica, which is often indicative of a clotting disorder, but can also be a cancer warning. Jess was fighting two battles: on the one hand, coping with her debilitating symptoms and, on the other, persuading anyone to listen to her. The results can be catastrophic. I would be grateful to the Minister if, when he responds, he detailed what steps are being taken to create a more joined-up strategy in this field. For example, after the third contact with a GP surgery, could that case be elevated for review? Similarly, after perhaps five pieces of correspondence, could the case not be red-flagged and set procedures followed? I remind the House again that Jessica contacted her surgery on 20 occasions in five months. Some kind of escalation procedure could certainly help with cases such as this.

To give proper care, a named GP could handle the case in its entirety—not just in principle, but in practice too. Someone needs to take the time to listen to the case fully to make sure that every facet is assessed. I would be grateful if the Minister also addressed that. Will he detail what steps are being taken to ensure that each GP surgery has access to a designated cancer specialist? Having this available to every surgery would aid the diagnosis of cancers in the young and would come into its own especially when reviewing rare cancers and seemingly inexplicable symptoms.

We absolutely can and should trust our medical professionals. In the vast majority of healthcare situations, they get it right, but we cannot ignore the danger of misdiagnosis, particularly in unusual circumstances. In Jessica’s case, her raised D-dimer levels indicated a significant clot formation and breakdown within her body. It was only later, in their own research, that Andrea and Simon discovered that D-dimer levels are elevated in the plasma of patients with various solid cancers, suggesting a possible link to Jessica’s later diagnosis. However, this possible link was not investigated further at the time, because no medical professional asked further questions when they had the test results. If Jessica’s test results had been coupled with critical thinking from those in medical positions, proper decision-making would have taken place and, in Jessica’s case, it could have led to a different outcome.

I hugely welcome the Government’s commitment to better cancer research. The recent spending review announcement of £5 billion into health research will help us to identify new treatments, but will the Minister explain to what extent research will be carried out that looks specifically into new blood tests that accurately highlight incidence of cancer early. Such a test would have been a game-changer in Jessica’s case, providing a much clearer answer much earlier in the process. Such a test would have been a game-changer in Jessica’s case, providing a much clearer answer much earlier in the process. Will the Minister detail how improvements are being made in respect of misdiagnoses that derive from such a lack of information and questioning?

Jessica’s age, 27, was also a factor. Simon and Andrea have described Jessica and other young adults in a similar situation as

“too old for their diagnosis to be truly shocking and too young to be deemed at serious risk.”

Every diagnosis of this nature is shocking, yet Jessica was seemingly caught between two different age groups. Even her dramatic weight loss and vomiting and the swollen glands on her neck were not taken seriously or linked to possible cancer, because she was not deemed at high risk of cancer, partly because of her age. We really need to think about how this can affect young people.

Cancer Research UK tells us that adults aged 25 to 49 contribute 9% of all new cancer cases, with almost twice as many cases in females as males in that age group. That is far too large a number to ignore. Currently, the 24 to 49 age group is not prioritised, even though many cancers are found to be aggressive and require immediate treatment.

As well as raising awareness among the public of just how serious cancer can be for young adults, Andrea and Simon’s petition and campaign strives to do the same in GP practices, too. I am glad to have the opportunity to get this campaign on the Minister’s radar and hope he will remember this message long after we leave the Chamber today.

One of the biggest tragedies is that Jessica’s story is not an isolated incident: many other people have found themselves in a similar situation, and will continue to unless we can learn the lessons that we need to learn now. The petition has prompted countless people to come forward to tell their own stories of their young family members who have had their lives curtailed by late or undiscovered cancer diagnoses, including some people who were told that they were too young for cancer. We know that cancer can develop in children, elderly people and everyone in between. In 2021, it is just not good enough to tell someone they are too young to have cancer.

In Jessica’s case, it is deeply troubling that her symptoms were explained away with a long-covid diagnosis, despite her not believing she had ever had covid or having even registered a positive test. We need to ask more questions. We need to become better at using data properly. We need to improve cancer diagnosis among young adults.

I welcome the NHS’s introduction of rapid diagnostic centres—their focus on cancers that generate non-specific symptoms that are otherwise harder to diagnose will make a huge difference—but the point remains that a GP still needs to refer a patient to one of the sites. Rapid diagnostic centres are just one of a number of measures that are being introduced to tackle this acute problem; will the Minister outline the other measures?

We cannot help but wonder what would have happened if just one thing had been different about Jessica’s case. What if her case was escalated in the GP surgery? What if the raised D-dimer was investigated further? What if she had seen a doctor sooner? For her family, those are agonising questions.

I stand here and try to do justice for Jessica, and for Andrea and Simon, but I will never be able adequately to describe or encapsulate what they have gone through. Nevertheless, we can try to understand what went wrong in Jessica’s case. We cannot make it right for her, but we can prevent others from going through what she was forced to go through. Andrea and Simon deserve to see the change that will help so many families who find themselves in their shoes.

I am grateful for the support of my right hon. and learned Friend the Member for North East Hertfordshire. I hope that this debate can be a significant moment for cancer diagnosis among young adults, not just in Hertfordshire but right across our country, so that they too can say, like the message launched into space, “Thank you, Jess!”

Covid-19: Contracts and Public Inquiry

Gagan Mohindra Excerpts

Wednesday 7th July 2021 Commons Chamber

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

I welcome the opportunity to speak in this Opposition day debate on the awarding of covid contracts. It is probably worth starting with where we were 16 or 17 months ago. At the time, we were just hearing about the covid-19 pandemic and what it meant for our lives. With the benefit of hindsight, things may have been done slightly differently, but we should not use our experience over the past 16 or 17 months to prejudge the decisions that we had to make very quickly as a nation back in February and March last year.

I had the honour of sitting on the Public Accounts Committee earlier in my parliamentary term. Under the stewardship of Gareth Davies, the Committee works hand in glove with the National Audit Office. I know that the Committee, ably chaired by the hon. Member for Hackney South and Shoreditch (Meg Hillier), has done various investigations into the response to the pandemic, with a particular focus on procurement and money. Scottish National party Members will be grateful to know that their colleague the hon. Member for Glenrothes (Peter Grant) is a vocal member of the Committee and, I am sure, will give wise counsel in future debates.

When I saw the topic of the debate, I was a bit surprised that the SNP had decided to call for it. I refer to its manifesto earlier this year in the local government elections that we had up in Scotland.

[Gavin Newlands (Paisley and Renfrewshire North) (SNP)]

Parliamentary elections.

[Mr Mohindra]

Sorry—the national Holyrood elections. The manifesto, on page 9, committed to a Scotland covid review. Unfortunately, the leadership up there has now done a U-turn and has not committed to that, so on behalf of the Royal College of Nurses and the GMB union, I urge them to have a rethink and hopefully commit to delivering what was promised in the manifesto.

My hon. Friend the Member for South Suffolk (James Cartlidge) referred to the disappointing news that Edinburgh is regarded as the covid capital of Europe. I will not be political on this one; I just think that it is a disappointment and that all colleagues across the House will hope that, with our heated debate and constructive criticism, we will get a better result quickly. With that sentiment in mind, I urge colleagues: where Government Members can help, please do not be shy about asking.

Let me go back 16 or 17 months, with the benefit of hindsight—unfortunately the Leader of the official Opposition is not in his place; he uses hindsight a lot. There was a real fear that, as a country, we were potentially running out of PPE. It was this Conservative Government who gave a call to arms and said, “Actually, the United Kingdom needs a national effort”. We did that to ensure that we had the right PPE and other things in place for those on our frontline. Reference has been made to not using the normal procurement process and I urge colleagues to look at the Public Contracts Regulations 2015, which allow the accelerated procurement that has been used during this global pandemic—an event that fortunately happens only once every 100 years, approximately.

Colleagues on both sides of the House refer to the quantum of PPE and I think we need to put that in context. We have an additional 22,000 ventilators, 11 billion pieces of PPE and 507 million doses of vaccine. Those are phenomenal figures. Did each procurement absolutely hit the spot? No, but the figures quoted earlier in this House, I suggest, were a very small percentage of poor delivery, and I am sure that the National Audit Office, the Public Accounts Committee and various other bodies in this House and in the Palace will look into that further.

There have been various accusations about relationships that Conservative Members of Parliament may have with business owners or others involved in procurement. I gently urge Members to be mindful that there have been multiple independent investigations, including some in this House and from the National Audit Office, that have all shown that there was no conflict of interest with Members of Parliament, and that if there were, they were properly declared at the time.

Reference has been made to the Boardman review, which reported at the back end of last year and the 28 recommendations that the Government have already committed to implementing. I know that Opposition Members were urging a quicker review and investigation on the pandemic, but the deputy chief medical officer has argued that this would be regarded as “an extra burden” and a “distraction” from the successful vaccine roll-out.

Reference has been made to the SNP Scottish Government’s procurement processes and the fact that £539 million of grants and contracts were awarded without a competitive process or proper scrutiny. I urge colleagues to have a look at the Audit Scotland review, which has investigated the three separate pandemic preparedness exercises that were undertaken, with some of the lessons that should and need to be learned from that. I will leave it there; I look forward to other contributions.

Covid-19 Update

Gagan Mohindra Excerpts

Tuesday 6th July 2021 Commons Chamber

[Mr Gagan Mohindra (South West Hertfordshire) (Con) [V]]

I welcome the statement from the Secretary of State and welcome him to his place. Does he agree that the UK’s portfolio of 517 million vaccine doses is evidence of the world-leading effort of this Conservative Government in securing our route out of this pandemic, allowing the restrictions to be lifted?

[Sajid Javid]

I agree absolutely with my hon. Friend on that. It is fair to say that our effort on vaccines, as a country, has been world-leading. It is certainly the best in Europe in terms of the number of people who have received the vaccine—ours is the largest of any of the large countries. That is down to the efforts of so many people, especially the scientists, the vaccine taskforce and all the NHS workers—the doctors, nurses and volunteers. It is a group effort, and when we look back at this pandemic it will be one of the things we will know has saved so many lives.

Social Care Reform

Gagan Mohindra Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I cannot at this point go into the details of the proposals that we are working on for social care reform. I have tried to give the House today a sense of the breadth and scale of our ambition. As to the point on timing, the way I see it is that the health and care Bill is a step on the road to reform, including the statutory role of integrated care systems and the development of the assurance system. I do not see them tied together in the timing in the way she sets out. What I can say is that we will be bringing forward our proposals for social care reform later this year.

[Mr Gagan Mohindra (South West Hertfordshire) (Con) [V]]

First, I wish the Minister a happy birthday. Can she reassure the House that the focus will remain steadfast on patient outcomes and happiness as part of the health and care Bill?

[Helen Whately]

I thank my hon. Friend very much for his birthday wishes. I was not particularly planning to spend my birthday in this way, but it is a pleasure to talk about social care reform because I feel strongly about it and am clearly spending a great deal of time working on it. What really matters is making sure that the outcomes and the experience of care are better for people. What really matters is that people get to live their lives to the full, whether they are of working age or older, and get to live as independently as possible, as part of a community and with their own front door for as long as they can. It is the outcomes of care that really matter.

Covid-19: Government’s Publication of Contracts

Gagan Mohindra Excerpts

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

The hon. Lady makes an important point about contracts that either failed to deliver or where PPE, for example, did not meet the required standards. I can reassure her that we are undertaking a stocktake—an audit—of exactly that, and we are already pursuing a number of cases where, if PPE was either not to the required standard or was not delivered, we will recoup the money from that.

[Mr Gagan Mohindra (South West Hertfordshire) (Con) [V]]

The Court’s judgment focused solely on the publication of contract notices. It did not make any judgment on the contracting process or on any of the individual processes in any way. Does my hon. Friend agree that the Opposition are wrong to play politics and to misrepresent the Court’s opinion in this way?

[Edward Argar]

My hon. Friend highlights something important, which is what the Court actually did and did not consider. It considered, quite rightly, whether the Government met the simple binary of publishing the notices within the required timeframe, and found that they did not. It did, however, find against the claimants and in favour of the Government that there was no policy of deprioritising transparency and publication requirements. As he says, the Court did not make any judgment on the appropriateness of the awards or the process followed for those awards.