World Cancer Day

Ged Killen Excerpts

Wednesday 30th January 2019 Westminster Hall

[John Lamont]

I am grateful to the hon. Lady for making that point. There is a range of options that we need to consider. I recently met my local NHS health board, and I meet a number of my GPs frequently. There are vacancies in all different parts of the health service, and we need to consider how we get more people in to do the jobs that we need. There is a particular challenge in my constituency—many rural communities do not have enough GPs or get enough nurses. Bursaries may be part of that. There are a range of things that we need to do, and that the Scottish Government and the UK Government can do, to address those issues.

For example, there is a 10% vacancy rate for radiology consultants across Scotland. One in five of the current workforce are expected to retire over the next five years. So, yes, there are challenges just now, but there are future challenges coming down the line.

[Ged Killen (Rutherglen and Hamilton West) (Lab/Co-op)]

I congratulate the hon. Gentleman on securing the debate. He talks about access to existing treatments, but does he agree that more work has to be done on conditions for which treatment is not yet available? The late Tessa Jowell worked very hard on this issue, right up to the end of her life, trying to improve access to new treatments and to improve care for people with conditions for which there is perhaps no treatment out there. Does he agree that we should pay tribute to Tessa Jowell and continue that work?

[John Lamont]

I absolutely agree. We need to do much more to promote awareness of those conditions. I will come on later to the availability of drugs.

The Scottish Government recognise that the high number of vacancies is a problem, but missed their target for increasing the number of nurse endoscopists by 40%. In England, nurse vacancies are similarly too high. The availability of drugs is also an issue that concerns charities and patients alike. The most high-profile example is the breast cancer drug Perjeta, which was rejected for use three times in Scotland but was finally approved just a few weeks ago. Quicker and more cost-effective access to the latest and best treatments must be a priority in future.

I know that colleagues will want to press the Minister on what the UK Government are doing to tackle cancer in England, but all these issues need to be addressed across all parts of our United Kingdom. As a Scottish MP, I am conscious that the Minister is not directly responsible for the cancer waiting times and treatments for my constituents. However, UK-wide approaches should be taken to help us tackle cancer head on, together.

World Cancer Day is all about recognising that cancer knows no boundaries, and that individual Governments cannot address these challenges in isolation. That gives rise to the question: are the UK Government and devolved Governments working as well together on this issue as they should be? For example, should we buy some drugs and equipment on a UK-wide basis? Current practice is that four separate bodies approve new drugs across the UK. While that allows different parts of the UK to make their own decisions, surely a UK-wide approach would make sense in some cases. We could make ultra-orphan drugs more affordable or use economies of scale to deliver common drugs at lower cost.

I am therefore interested in the Minister’s views on this suggestion. Have there been any discussions with the devolved Administrations about this possibility? Are health boards across the UK as good as they can be at talking to each other and sharing best practice? Representing a constituency on the border with England, I all too often see examples of that border acting as a barrier to co-operation. I certainly hope that that is not the case when it comes to cancer treatment.

I hugely welcome the extra funding coming the NHS’s way, which will of course mean an extra £2 billion a year for the Scottish Government to spend on health, if they choose. Will the Minister outline what that means for cancer treatment in England, and how much of that extra funding will be used to improve treatment and reduce cancer waiting times?

Can we do more to support families with the cost of cancer treatment? Parents spend an average £600 a month in additional expenses as a result of their child’s active cancer treatment, much of that on travel costs. Young people in my constituency often have to make a 100-mile round trip to Edinburgh for tests and treatment. Children’s cancer charity CLIC Sargent is calling for a cancer patient travel fund, as well as a review of the disability living allowance and personal independence payments, to backdate young cancer patients’ financial support to their day of diagnosis. I certainly think that these are reasonable suggestions.

Male Suicide

Ged Killen Excerpts

Wednesday 13th December 2017 Westminster Hall

[Ged Killen (Rutherglen and Hamilton West) (Lab/Co-op)]

I beg to move,

That this House has considered the matter of male suicide.

This is my first Westminster Hall debate and it is a pleasure to serve under you as Chair, Ms Ryan. I hope that this is the first of many opportunities to do so.

We are gathered in this Chamber to debate the single biggest killer of men aged 20 to 49, a bigger killer than cancer, heart disease or road accidents: I am talking about suicide. Suicide is of course a highly complex issue. It is not only men who are at risk of suicide, but women, lesbian, gay, bisexual and transgender people, people who have suffered family breakdown, black and ethnic minority people who live in deprived areas, and others who have suffered loss or structural disadvantage. They are all at increased risk. The focus of today’s debate is on men, but that should not come at the expense of the consideration of risk of suicide in other groups.

Since 1981 the Office for National Statistics has collected the figures for suicide in the UK. In almost every year from 1981 to 2016, men have been at least three times more likely to kill themselves than women. That is not a problem that has gone away over time and it is evident from the figures that both historically and contemporarily suicide is a problem that disproportionately affects men.

For me, and I am sure many other men in this place, suicide is not only an issue of public health but something personal. From 2012 to 2016, 198 people have taken their own lives in South Lanarkshire, of whom 147, or 74%, were men. People I care about have been directly affected by male suicide in recent times. The wider community of each death by suicide is substantial. The Local Government Association estimates that, for every person who dies, between six and 60 people are directly affected.

Suicide among men is complex. It is not helpful to speculate why an individual might have taken their own life. However, there has been research into factors that increase the risk of suicide in men. Research by the Samaritans and data from the ONS highlight some of those factors: loneliness from family breakdown or the death of a spouse; the decline of traditionally male-dominated industries; inequality; and social expectations about masculinity.

Today I will focus on how views of masculinity can increase the risk of suicide in men and on the idea that suicide among men is not just a health issue but one that is often linked with social deprivation and inequality. Many in this House and wider society have made great strides to challenge how we conceive masculinity, but for many men the key tenets of masculinity remain important to their identities and conceptions of how they believe they are meant to behave. It is not just the men themselves—society at large can be guilty of holding men to those unrealistic standards.

Having grown up in the west of Scotland, I know that that masculine ideal requires that men should never be depressed, anxious or unable to cope and, if they are, they should never admit it—they should be strong. That can often mean that when men are most in pain, they are also at their most determined to hide that pain and to shrink away from help due to a fear that their vulnerabilities will be exposed. That can lead men to respond to distress with denial, to angst with avoidance and to insecurity with isolation.

Rather than seeking out the help and support they need—often the help and support that may save their life—many men will suffer in silence. That presents a problem. Across the UK health services are being retooled to provide parity of esteem between mental and physical health, but the problem for suicide among men is often not treatment but identification. We could have the best mental health service in the world, but until we start better identifying those who need to access it, we are unlikely to see an improvement.

At present, 70% of people who take their own lives are not under the care of a specialist mental health service. Changing the culture, in particular among men, is central to reducing suicide.

[David Linden (Glasgow East) (SNP)]

I commend the hon. Gentleman on a very powerful speech. I spoke on this very issue on International Men’s Day. Does he recognise a particular role for men’s sheds, where men can come together to have conversations about mental health? We welcome the work being done in Shettleston Men’s Shed, where people can come together to have exactly those conversations, getting them out in the open.

[Ged Killen]

The hon. Gentleman is absolutely right. A lot of good work is going on around the country to encourage men to talk more.

Initiatives by the Samaritans and Time to Change encourage us all to think differently about mental health and suicide and to be alert when the behaviour of our friends, families and colleagues changes. Personal interventions can save lives and it is incumbent on us as individuals and as representatives to challenge traditional conceptions of masculinity, in particular when they pose a risk to life.

Put simply, men need to get better at talking to each other. I include myself in that. I have not always been good about talking about my own mental health and my experience of anxiety and OCD, obsessive compulsive disorder. We need to get over any embarrassment or awkwardness we might feel, and realise that sitting down for a simple cup of tea or coffee and asking a friend how he feels might be the thing that saves his life.

[Dr David Drew (Stroud) (Lab/Co-op)]

My hon. Friend is making a very powerful speech. Does he agree that we need to start very young with that? There is a lot of evidence to suggest that if people can talk about that when they are at school, that may be the greatest preventer of all.

[Ged Killen]

My hon. Friend is absolutely right, though early intervention with mental health is an entirely separate debate, which I suggest would want its own time. I certainly agree with his point.

As I was saying, if a friend is experiencing a suicidal train of thought, a simple chat might be just the thing to break that cycle of thought. It might refer the person to the help they need.

Suicide among men, however, can no longer be seen purely as a health issue. There is a statistically significant relationship between high levels of deprivation and high levels of suicide. That association means that as area-level deprivation increases, the likelihood of suicidal behaviour will probably increase as well.

[Martin Whitfield (East Lothian) (Lab)]

On that very point about deprivation in what is a very passionate speech, does my hon. Friend agree that such areas show clustering following a suicide? Conversation among all men is doubly important at that stage, to reduce stress in the area.

[Ged Killen]

My hon. Friend makes an important point. In those deprived areas people are on average two or three times more likely to experience suicidal behaviour. Socioeconomically disadvantaged individuals are more at risk and less likely to seek help for mental health problems than the more affluent. It bears repeating that, although each person’s suicide is complex and individual, this is a fact that cannot be ignored: a man living in the most deprived area of our country is 10 times more likely to take his own life than a man in the most affluent area. In no uncertain terms, I am saying that for men in deprived areas, inequality kills.

We cannot conclusively draw links between all Government policies and suicide—I would not seek to do so—but I have a growing fear that the Government’s roll-out of universal credit in its current form will exacerbate inequality and could present an increased risk of suicide in deprived areas.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

The hon. Gentleman is absolutely right to focus on deprived areas, but does he agree that there are areas in which people successful in business or agriculture—third or fourth generation—might have a business that slips away from them? They are not necessarily on a journey of deprivation, but they are losing something that the family had built up over the years. They may see the way out as taking their own life. That is the burden of a family business and its loss—does he agree that suicide includes a broad range of unfortunate individuals?

[Ged Killen]

As I said, there are a lot of complex issues that might affect suicidal behaviour. I am identifying specific areas that research shows are more likely to increase the risk of suicide. Living in a deprived area is one of those.

Sadly, many Members have said in the Chamber that they hear from increasing numbers of people showing signs of suicidal behaviour, as do I in my own office. I could not speak in the debate without acknowledging that. But I bring the debate in a spirit of collaboration. I am certain that every Member in this room wants a reduction in male suicides and wants strategies to be devised and implemented to achieve that aim.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

One note of encouragement is that the suicide rate in Glasgow has certainly gone down in the last 20 years: 64 men took their lives last year in Glasgow, but that is down from 122 men in 2000. Might that indicate a generational difference, where the generation of younger men feel more open to talking about their issues? Perhaps that represents a challenge for older generations, who still feel that certain social norms or taboos prevent them from opening up, but one that is changing slowly but surely.

[Ged Killen]

I hope that is the case and I think that, certainly, younger men are more likely to talk about their feelings than the older generation. Although there has been a strong downward trend in suicide rates in Scotland, in 2016 there was an 8% increase. Hopefully, that will go back down, but the issue still needs to be addressed, which is why it is important to have debates such as this.

[Liz Twist (Blaydon) (Lab)]

My hon. Friend is making a powerful speech. He talked about the Samaritans research, which showed, in summary, that less well-off men are ten times more likely to die by suicide than more well-off men. Does he agree that it is important that the Government try to tackle the problem through a suicide prevention strategy and through identifying specific ways of helping to address the rate of male suicides?

[Ged Killen]

My hon. Friend is absolutely right and I hope that the Minister will touch on that. I note that suicide is treated as a health matter.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The hon. Gentleman is quite correct to raise this hugely important subject. Sometimes, suicide is not any respecter of wealth. A much-loved local general practitioner in my constituency committed suicide, and there is a very moving memorial to him in my home town of Tain. The hon. Gentleman mentioned health, but does he feel that the education system might have a useful role in getting men to talk from an early age?

[Ged Killen]

I absolutely agree. I keep making the point that there are many different factors that influence suicidal behaviour, but certainly, if we can take the opportunity as early as possible in school, or even before, to look at mental health in general, we will go a long way in tackling the issue across the board.

Scotland, England, Wales and Northern Ireland pursue their own suicide prevention strategies, since it is a devolved matter, in line with devolution of health policy. This debate is important to raise awareness of male suicide. I hope that the Minister will talk about what the Government are doing to prevent suicide, particularly on the issues I have touched on, including inequality and perceptions of masculinity.

If those watching this debate—particularly men who are watching—take one thing away, I hope that it is that as we approach what, for many people, can be a difficult time of year—for many others it is a very happy time—and as we battle the elements to pick up last-minute gifts, we please keep in mind those who might be fighting battles with their mental health. There are some things that money cannot buy, so for many of those people, some company and a chat might be all it takes to save their lives.

I ask the Minister to tell us of any initial evidence or representations that she has received regarding the roll-out of universal credit and the increased risk of suicidal behaviour associated with that. What consideration has her Department given to equalising the maximum limit of eight days to register a death, as is the case in Scotland? That has been called for by the Samaritans, to improve the reporting of suicide. What assessments has her Department made of the misclassification of suicides by coroners and the effects that that may have on official statistics? Could she update us on the Government’s strategies for tackling suicide among men in deprived areas?