Specific Food Hygiene (Regulation (EC) No. 853/2004) (Amendment) (EU Exit) Regulations 2019

George Hollingbery Excerpts

Monday 7th October 2019 General Committees

[Jo Churchill]

Thank you, Dame Cheryl. I will resist the temptation to say “Howzat!”

I will first go over some general points that address several of the questions, and then I will address a couple of the specifics. The importance of food safety is paramount, and leaving the EU does not change that. Food safety in all cases remains our key priority; that means that business will carry on as normal. It is important that we acknowledge that, in many areas, food standards in this country are above those of other member states. Hon. Members commented that there will potentially be a race to the bottom, but actually we are trying to spread some of the good practice that goes on in all four parts of the UK in order to get others to raise their standards.

[Sir George Hollingbery (Meon Valley) (Con)]

The hon. Member for Wallasey implied that there is some sort of mercantilist imperative for us to drop standards so that we can sell our goods around the world, but does the Minister agree that to do so would be to shoot ourselves in the foot? It is quite clear that our food standards are what sell our goods overseas. The quality of British produce means that, for example, 35% of Chinese consumers surveyed said that they would particularly buy British products because they are of a higher standard.

[Jo Churchill]

I could not agree more. It is a great tribute not only to producers in this country but to the Food Standards Agency that people feel that our food and brands are to be trusted. I hope that will continue.

On the point raised by the hon. Member for Washington and Sunderland West, this was not missed. This instrument is purely to give clarification—hopefully that is what it does—to make doubly sure that everybody is clear. The devolved Administrations in Wales and Northern Ireland have said that they are fine; it is only Scotland that has not. Once again, I apologise for that. Scotland produces some of the finest quality products that go out of this country, so making sure we have done this properly is important to all the devolved nations.

Ensuring continuity of trade is important, and ensuring food safety here is hugely important. Mostly, we must ensure that we are open and transparent. The hon. Member for Washington and Sunderland West wanted clarification about the system. If there were to be any other form—the hon. Member for Wallasey alluded to chlorinated chicken, but it might be something else that is brought forward—it would first be risk-assessed by the FSA and would go through its very rigorous programme. It would then come to the Minister, and would come before the House by way of an SI. If there are any issues, that process must be walked through to ensure a degree of safety.

Specifically on chlorinated chicken, any substance used to remove surface contamination from chicken carcases must be specifically approved. Chorine has not been approved, and so cannot be used and could not be approved until it had walked through those processes. Each devolved Administration would then have individual responsibility for it. I feel that the concerns expressed in the media have perhaps over-egged the situation—we are all used to that—because those safety nets are in place. This SI simply helps to ensure that we are ready for Brexit on 31 October, whatever the circumstances, and that we are ready for all eventualities. Making sure we are prepared is the key job.

In closing, I hope I have answered hon. Members’ questions. As I said, the Government are working to agree a deal with the EU, but while we do that and until we have a finalised agreement, it is important that we prepare for the possibility that we will leave without a deal.

Adult Social Care

George Hollingbery Excerpts

Thursday 8th March 2012 Commons Chamber

[Heather Wheeler (South Derbyshire) (Con)]

I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) and the hon. Member for Worsley and Eccles South (Barbara Keeley) on bringing this debate to the House.

In South Derbyshire, social care is a very big issue, and I praise Derbyshire county council for grasping it with both hands. For the first time, an older people’s village is being built in my constituency, in Swadlincote. It will take anybody over the age of 55 when they do not need any care, until they need intermediate care, and then right until the end when they need dementia care. It is an absolutely brilliant new way of coping with care for the elderly, and I congratulate the council. Interestingly, there is now a strong debate about the typical old people’s homes that councils have run over the years, and people are concerned that the new style of looking after people will have to bed in a bit.

What is important about the older people’s village is not only that people will choose to buy or rent flats in it, or be put there by the state if they cannot afford it, but that respite beds will be available so that carers can have a break. People can have step-down or step-up beds, get themselves well again, and be able to look after themselves with total 24-hour care.

[George Hollingbery (Meon Valley) (Con)]

I want to develop my hon. Friend’s point a little more generally. As many colleagues will know, I am something of a bore on planning, but I think that the planning system has an important role to play in this in future. Does she agree that neighbourhood plans—the new local plans that are coming forward—are an essential part of catering for the needs of the elderly on an ongoing, 20 to 25-year basis?

[Heather Wheeler]

I am grateful to my hon. Friend for widening out the possibilities of my speech. I agree with him. As leaders in our areas, we need to direct people, as part of the consultations with their local development frameworks, to say, “This area could be zoned for bungalows”, or “That area could be zoned for an older people’s village”, or “That area, particularly if it has a section 106 agreement, could have some money allocated not only for the police, for education, or for a children’s play area, but for areas for older people.” We have recently had a planning application approved for a village for 2,500 people on a brownfield site, which included a zoned area for older people. The person who had the brilliant idea of building the village was inspired to do so by what he had seen his older relatives go through in their later years. He wanted to take a completely —dare I say it—holistic approach so that such people could in future grow old gracefully.

As well as championing what Derbyshire county council is doing on my patch, in connection with Trident Housing Association and South Derbyshire district council, I am also chairman of the all-party parliamentary group on local government. We will be conducting a new inquiry into social care, which will dovetail with the findings of the Dilnot report. We hope that, as an all-party group, we will be able to examine the issue a bit more widely and think outside the box, in order to be helpful to Ministers and give them as many ideas as possible. I know that a number of Members who are in the Chamber today will be sitting on that inquiry with me, and I am grateful for the all-party support.

When the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow) came to speak to the all-party group, the room was packed. There were 70 people there, which is pretty good going for 2.30 on a Monday afternoon. People came from all over the country to hear him. It was a very uplifting afternoon, and I am grateful to him for giving us so much of his time.

This is an important issue for all of us, but it has been kicked around like a political football. The deficit is horrendous, and we all know that there really is not enough money in the world to deal with the problem, but the mood in the House leads me to hope that we will have some answers before the next general election in 2015. We need to put those answers on the table and get this done, for everyone.

NHS Risk Register

George Hollingbery Excerpts

Wednesday 22nd February 2012 Commons Chamber

[George Hollingbery (Meon Valley) (Con)]

I want to begin by challenging something that was said by the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham), when he opened the debate. He has also shouted it several times from a sedentary position, and indeed he intervened on my hon. Friend the Member for Dartford (Gareth Johnson) a moment ago to make the same point. He keeps saying “It is a different register”.

Let me quote, at some length, what the right hon. Gentleman said earlier: “This led my predecessor”—the right hon. Member for Wentworth and Dearne (John Healey)—“to initiate a freedom of information request for the transition risk register. I wish to point out that my right hon. Friend did not request the full departmental risk register, which was subject to a similar request in 2009”, which was, indeed, released by the right hon. Gentleman. The right hon. Member for Leigh went on: “There are three crucial differences between the situation and the subject of today's debate. They would do well to listen because the Prime Minister got his facts wrong at Prime Minister's Question Time. The first important difference is that this relates to a different document. This debate is about the transition risk register, not the strategic risk register”.

I may have misinterpreted this, because it is not my key area, but let me refer briefly to the decision notice issued by the Information Commissioner. Paragraph 16 about the “Scope of the request” states:

“At the internal review stage the public authority referred to two separate risk registers which it said were relevant to the request and held by the department – the ‘risk register centred on the Health and Care Bill’ and the ‘strategic risk register'… For the avoidance of doubt, the Commissioner wishes to state that he agrees with the public authority…and that it is the strategic risk register which should properly be seen as falling within the scope of the request.”

In short, the document that is requested now, and the one that the right hon. Member for Leigh refused to release in 2009 are, as adjudged by the Information Commissioner, exactly the same document. The right hon. Gentleman may wish to refer to that later, and I am entirely happy for him to do so. If I have got it wrong, I am happy to be corrected.

[John Healey]

I am grateful to the hon. Gentleman for giving way because, uncharacteristically, I think that he has got it wrong. The Information Commissioner’s notice considered two different freedom of information requests: one for the transition risk register from me, and one for the strategic departmental register from a journalist from the Evening Standard. The decision notice was a decision on both those registers. My right hon. Friend the Member for Leigh (Andy Burnham) is absolutely right: in our motion and the debate, we are talking about a different document—different in nature—from the one to which he referred and the one which was relevant in 2009.

[George Hollingbery]

I am grateful to the right hon. Gentleman for clearing up part of this, but I think that the decision that was made by the Information Commissioner was on the strategic risk register and its release. No doubt we can discuss that later, but I am grateful to him for his intervention and for clearing that up.

More generally, we must consider whether the Bill has been properly assessed both in the House and outside by many people. There are 443 pages of closely worded analysis on the impact of the Bill, and the impact assessments cover every possible aspect imaginable, including risk management and the risks associated with the new Bill. That information has been in the public domain for many months, and I do not honestly believe that there is anything to be gained by issuing further risk registers that may scare a number of people about the things that they have to consider. The risk register would add very little. The answer, basically, is that it is an expedient hook on which to hang a debate: to raise again in the House a topic that has been raised a great many times—quite rightly, in many ways, as many amendments have been made to the Bill. However, the quality of speeches from the Opposition demonstrates to me at least that the point of the debate was not to discuss the risk register but to use it as a hook on which to hang a particular viewpoint.

It is well known that when the right hon. Member for Leigh was Secretary of State he refused to release the risk register. I have examined that, and I was going to quote him further at length, but the House has heard that quote several times today, so I will not trouble hon. Members with it again. The argument that he made then was a sensible one, and it remains sensible now. Do we really believe that it is good for the Government to make public all their plans for the management of every conceivable risk that they might encounter? Some of those risks will scare people rigid, and I do not honestly believe that that is the right use for the strategic risk register.

[Charlotte Leslie]

Does my hon. Friend agree that the Opposition should be careful about what they wish for in setting a precedent of publishing every single risk register? It may seem unlikely at the moment, but one day, they might be in government.

[George Hollingbery]

That is a fair point. As we have heard again today, Tony Blair says that he very much regrets parts of the Freedom of Information Act. We have all come to regret parts of the Act, and setting such a precedent could be awkward for the Opposition. When, inevitably, they return to power, they will find that equally difficult to manage.

If officials are inhibited in any way from having full and frank discussions with Ministers on challenging issues for the Government, that is a retrograde step, and we cannot afford to take it. I have no argument with the Information Commissioner, as it is his job to make assessments based on rational arguments made to him in the light of documents under review and, as he explained in his judgment, on the timing of the initial request. It is germane, however, to point out that in paragraph 29, the judgment discusses exactly the issues to which I have referred, and cites

“the ‘safe space’ and ‘chilling effect’ arguments which are well understood and have been considered in a number of cases before the Information Tribunal.”

In paragraph 35 the commissioner makes his judgment and states:

“The Commissioner finds that the factors are finely balanced in this case”.

It was not an open and shut case; he had to make a fine judgment. The Information Commissioner himself clearly found that a difficult decision to make.

As I have said, it is entirely right and proper that the Information Commissioner should make his judgment as he sees fit. That is what he is there for, but for my part, I believe that that is a dangerous precedent to set. We have to wait for the result of the Government’s appeal and any further iterations of the statutory process before we receive the final answer. I recognise the shadow Secretary of State’s challenge, asking why the Secretary of State would not simply acquiesce and open up the information to all. The simple answer is that there are very good reasons for not doing so, and I have just talked about those.

What of the Opposition’s plans for the national health service? Will the shadow Secretary of State publish the likely contents of the NHS risk register for and the relevant impact assessments of his own plans for the service? That might be tricky because, other than the fact that they want to cut the NHS budget, we have absolutely no idea of the Opposition’s plans, and, as far as I can tell, neither do they. I trawled the party’s website today and I could find literally nothing about Labour’s plans for the future of the NHS; as is the case in a great many policy areas for the Labour party, confusion seems to reign on the Labour Benches. At a time when there is an exponential increase in demand on NHS services and a huge increase in available treatments, and when money is in very short supply for the Government, the Opposition’s response, judging by today’s debate, is nothing, except what seems to me to be naked opportunism.

I shall offer a final thought. Perhaps political parties should also be forced to publish impact assessments and maintain risk registers on their internal musings at election time, in the interests of transparency. Had Labour had to do that in 1997, it would have been extraordinarily unlikely that the party would ever have been elected.

[John Healey (Wentworth and Dearne) (Lab)]

It is good to follow the hon. Member for Meon Valley (George Hollingbery), although he is wrong to say that this debate is simply a device for having a bigger debate. The motion is very simple and I had hoped that it would command wide support across this House, because this is not about being for or against the NHS Bill, or about being for or against the NHS reorganisation. The matter before us is whether we are for or against good government and the proper accountability of government to the public and to Parliament. A more open Government—a Government required to be more accountable—must raise their game and are more likely to be a better Government.

The Prime Minister said as much in the first month after the last election. He said that

“we’re going to rip off that cloak of”—

Government—

“secrecy and extend transparency as far and as wide as possible. By bringing information out into the open, you’ll be able to hold government and public services to account.”

Not for the first time, people are looking to the Prime Minister now to honour the promises he made, especially on the NHS. I have to say that 15 months after I made the original freedom of information request and 13 months after the Government introduced the NHS Bill, they are now dragging out the refusal to comply with the Information Commissioner in a way that prevents the public from getting a better understanding of the plans and prevents Parliament from doing our proper job of legislating well and legislating wisely.

[George Hollingbery]

rose—

[John Healey]

I will give way to the hon. Gentleman, as I have followed his speech.

[George Hollingbery]

I wonder whether the right hon. Gentleman could provide the House with a single example of where, in the transition of a Bill, a risk register of this sort has been used to inform the House’s debate. He may well be able to do so, and I would be grateful if he could.

[John Healey]

There is the precedent of releasing a programme risk register connected with the third runway at Heathrow, but the principle of the Freedom of Information Act is that each case is different—every risk register is different. The reason why this case is important and exceptional and why the Information Commissioner has, on balance, required the Government to disclose rather than withhold the risk register is that the Government’s health reforms are the biggest ever reorganisation in NHS history; that the legislation is the longest in NHS history; and that it has been introduced at a time of unprecedented financial pressure.

Social Care Funding

George Hollingbery Excerpts

Thursday 10th November 2011 Westminster Hall

[John Pugh]

rose—

[George Hollingbery (Meon Valley) (Con)]

rose—

[Mr Peter Bone (in the Chair)]

Order. I intend to begin the wind-ups at 5 o’clock. Two more hon. Members wish to speak, and it is now 4.26 pm. I do not know whether this has been mentioned, but the Leader of the House has attended the debate, which shows its importance.

--- Later in debate ---

[George Hollingbery]

Perhaps the problem is even deeper. People in my constituency surgery do not just say that they think others have had a free ride; they say that they are actively advising younger people and their families not to save for old age, because it is no longer worth doing so. Plainly, the system is stacked so far to the advantage of those who do not save that people should not save at all.

[John Pugh]

The hon. Gentleman has usefully illustrated my point. We can argue that the state does not have a duty to preserve a family’s inheritance, notwithstanding the valiant defence of inherited wealth from the hon. Member for Luton North (Kelvin Hopkins). In normal circumstances, that is an unusual stance for him to take.

--- Later in debate ---

[George Hollingbery (Meon Valley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bone, and I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this important debate. Had I not come last in the roster this afternoon, I would—of course—have made a philosophical, wide-ranging and sparkling speech on the philosophical implications of the Dilnot report. Hon. Members will be glad to hear that I am not going to do that, and I will restrict myself, if I can, to a few small points that have not yet been covered in any great depth. I apologise for being absent from the debate for an hour, but next door to the Chamber the Surviving Winter appeal was being launched. The appeal transfers the winter fuel allowance from those who do not need it to those who do and, if I may make a quick plug, anybody who would like more details about it should speak to me after the debate.

Some difficulties over the local funding of care for the elderly need to be pointed out, and I know that the Minister will have seen the submission to the process by Hampshire county council. My hon. Friend the Member for Stourbridge (Margot James)—who unfortunately is now leaving the Chamber—talked about private citizens having to pay more than the county council for care, and that view is supported in a letter that I received recently from Mr Winterton-Smith, who wrote to me at great length about the difficulties he faces in financing care for his mother.

I looked up some statistics. Market research by Laing and Buisson in “Care of Elderly People UK Market Survey 2010-11” estimates the average weekly cost of nursing care in the southern home counties, which includes Hampshire, as £787. On average, Hampshire county council’s nursing care beds cost £650 a week. That is a difference of over £5,000 a year for the private carer, and it is a substantial gap that needs to be looked at.

Hampshire county council’s submission shines a spotlight on the number of self-funders in the southern counties, and in Hampshire, nearly 60% of those who receive elder care are self-funders. One imagines that the funding pattern could become enormously complicated if some parts of the country need massive cash inputs to deal with people converting from self-funding to being funded by the state. I point that out in passing because I was asked to do so by Hampshire county council, which I am partially representing today.

I was always attracted to the insurance model; it seemed to be a way of providing for future care in a proper way. Unfortunately, however, it looks as if that model is too complicated for institutions to price properly, and even the guarantee provided by Dilnot does not provide sufficient certainty for insurers to enter the market in any real number. The Joseph Rowntree Foundation and the International Longevity Centre have pushed forward insurance models, but Dilnot speaks about the market and explicitly rejects such models as stand-alone solutions. He believes that insurance models can be part of a solution and that some schemes will help, but the overall model is rejected.

Policy Exchange—not the favourite think-tank of Opposition Members, I know—published a report last year entitled “Careless.” I have spoken widely about countries such as Germany and Japan that have partially insurance-funded models of care, but are beginning to struggle with the implications of rising costs, and such models are beginning to look unsustainable. The Policy Exchange report gives a figure of £106 billion for the full cost of replacing care that is provided throughout the community, both privately and publicly, to those who need elder care. All sorts of perverse incentives might arise in a system that provided universal care. People who now provide care for nothing would, quite understandably, not provide it in the same way as they used to. The sum of £106 billion is a frightening figure to consider. I have no particular basis on which to back up that number, however, but I merely cite it from that report.

We have talked a little about the link between adult social care and health spending, and cross-departmental spending. When I was reviewing the literature, I noticed a reference to a spat that occurred in County Durham when the local PCT spent money on gritting the roads. It did so because it felt that it was a good way to prevent accidents and stop people needing adult social care. To me, that made a great deal of sense. The council, however, got into the most terrible trouble; all sorts of newspaper articles said that it was foolish or idiotic and did not know what it was doing. The harsh reality is that trips and falls cost the health service money, and they cost many elderly people their independence, and later their freedom.

The council’s decision is exactly the sort of thinking that led to what I will happily call the excellent Total Place initiative launched by the previous Government. That agenda has real potential to provide some of the funding that we require to solve the problem of care for the elderly in the long term. Breaking down the barriers between Departments, and pooling spending to deal with complex objectives, are ideas that the coalition must pursue if we are to make real inroads into solving problems such as the care of older people in times of increasing complexity and tighter spending.

[Sarah Newton]

My hon. Friend makes an incredibly important point. Does he agree that we have huge unmet housing needs for the ageing population, and that we have not thought about the types of homes that would most appropriately enable people to live comfortably at home? By planning services in a particular location, all the aspects that impact on whether people live healthier and longer lives could be better developed and delivered.

--- Later in debate ---

[George Hollingbery]

I am grateful for that intervention, which leads me neatly into my next point, which is always the danger of briefing one’s colleagues about what one might say, then being called last in the debate.

There could be a great deal of entrepreneurial thinking on cross-departmental spending and other areas that do not immediately seem relevant to social care. As many of my colleagues will know—including the hon. Member for Lewisham East (Heidi Alexander) who is a member of the Select Committee on Communities and Local Government—I am slightly obsessed with planning and I have become an appalling anorak since I came to Parliament whenever we talk about planning. I believe, however, that there is potential in the planning system to mitigate costs. If, when designing new communities in major and strategic development areas—6,000, 7,000 or 8,000 houses at a time—we plan properly for the needs of older people, and build the right sort of accommodation and adaptable homes that can be used in future and adapted later, people will be able to stay in their community and be close to their support networks. If such centres are built near shops, supermarkets and hairdressers, people can carry on living in the same place for a long time. By then moving a few hundred yards out of their house into one of these facilities, they can leverage the asset that they have grown over the years and look after themselves more efficiently.

In short, this issue is not only about adult social care or Department of Health budgets: we need entrepreneurial thinking across the public sector to ease the problem. I hope that the Minister will encourage all his colleagues across Departments to do just that.

Congenital Cardiac Services for Children

George Hollingbery Excerpts

Thursday 23rd June 2011 Commons Chamber

[George Hollingbery (Meon Valley) (Con)]

I should like briefly to place on the record my grateful thanks to the 18 highly qualified consultants from Portsmouth who recently wrote to me to express their support for the Southampton unit. As time is short, rather than repeating much of what has been already said, I should like to concentrate solely on one element of the review: retrieval times and their effect on the volume gateway.

The number of operations that a centre undertakes is clearly important to generate wide experience across a team and maximise the accumulated wisdom in any unit and, crucially, its support services. That seems entirely logical and sensible, and it is, of course, at the very centre of the entire review, but the available volume is crucially affected by one absolutely critical variable: the distances of emergency admissions, or retrieval, as it is known.

The paediatric heart unit closest to my constituency is in Southampton—thus, of course, it has been the focus of my attention. I absolutely agree with the point made by many hon. Members that we should not let our local sympathies cloud our judgment on what is a national matter, and I hope I have not done so. It is worth pointing out to hon. Members that for many constituents in Meon Valley, my constituency, the reality is that the loss of the Southampton unit would not be a huge disadvantage. The change would result in their becoming clients of the Evelina children’s hospital at Guy’s and St Thomas’s—hardly a poor alternative for them—but we should notice that the insistence that a three-hour, road-based retrieval time for emergency admissions should act as part of the gateway excludes certain parts of the south-west and south Wales from Southampton’s potential catchment. Initially and puzzlingly, as we have also heard, the Isle of Wight was also excluded, but that seems to have been sorted out, for which we are all grateful.

Why is this important? Simply because Southampton has the second highest score for quality in the country at 513 points, with the Evelina at the top of the list with 535 points. Although I genuinely do not believe that it is the place of elected politicians to wade in every time that the NHS wants to reconfigure local services, I am concerned that the review is likely to result in the loss of one of the very best heart units in the country.

We have been told that quality was presumed to be the overall driver of the review and that quality trumped geographical proximity and convenience. So the decision to include the Southampton unit, which is rated second in the country for quality, in only one option must be regarded as running counter to the core principles of the decision-making process. I fear that the panel may choose to lose one of the highest-quality options available in favour of a lower-quality alternative, for reasons that do not necessarily stand up when looked at closely.

I believe that those who are tasked with making the decision need to satisfy themselves that the overall three-hour road retrieval criterion is truly as crucial as it seems. Can it really be right that, in a review driven at its core by quality, the population-level risk of closing the second highest-rated paediatric cardiac surgical unit in the country is truly outweighed by a possibly longer-than-three-hour retrieval for a small number of potential patients? Only the joint committee of primary care trusts can make that judgment, and I leave it to do so. I simply ask that it considers that key variable and wish it the very best in making a decision that, although entirely necessary, is bound to upset many people.

Neuromuscular Care (North-West)

George Hollingbery Excerpts

Wednesday 9th February 2011 Westminster Hall

[Graham Evans]

Okay. I thank the hon. Gentleman.

[George Hollingbery (Meon Valley) (Con)]

I apologise to my hon. Friend for intervening immediately after another intervention. He has just raised an interesting point about the transition from paediatric services to adult services. In my own area of the south-central region, which is clearly outside the geographical area that is the focus of this debate, we have recently managed to secure at least an advertisement for a new care adviser in the area. However, I understand that that care adviser will not be able to advise on paediatric conditions but only on transition and adult services. Is it not the case that we need a full range of services for all sufferers of this disease and a proper range of advice across all ages?

[Graham Evans]

My hon. Friend makes a very good point and I totally agree. A holistic approach is needed and there should be a seamless transition from being a young person and receiving paediatric services to receiving adult services. However, this point does not just apply to muscular dystrophy. For example, lots of mental health care services suffer from similar problems. Nevertheless, my hon. Friend is quite right. There should be a seamless transition from one service to another.

Greater support at transition from paediatric to adult services is necessary to provide evidence of services being removed or greatly reduced when patients leave paediatric services, even though, as I have said, their needs may well increase given the progressive nature of many of these neuromuscular conditions. There is a three-monthly transitional clinic in Manchester and a monthly transitional clinic that alternates between Alder Hey children’s hospital and the Walton centre, which are both in Liverpool. Both those services—in Manchester and Liverpool—are extremely vulnerable and entirely dependent on the availability of their respective consultants. A transitional clinic at Preston is evolving, but it is not formally funded and is based on the good will of the clinicians. The transitional clinic at Alder Hey children’s hospital is the only one that is attended by the required multidisciplinary team. None of the transitional services in the region is funded or appropriately staffed.

The Walton report, published in August 2009, expressed the concerns that the all-party group on muscular dystrophy developed as a result of its inquiry into access to specialist neuromuscular care. Martyn Blenkharn, chair of the Muscular Dystrophy Campaign’s North West Muscle Group, expressed in written evidence to the all-party group his frustrations about attempts to access NHS physiotherapy:

“No hydrotherapy available in the area - private arrangements can be made, but no assistance from NHS physiotherapists can be obtained. Compared with the previous PCT area (North Cumbria) which covered the area where I used to live, the service in my current PCT area (North Lancashire) is totally unsatisfactory - the quality of care from those who treat me directly is fantastic, but their hands are tied to provide what is really needed.”

The all-party group concluded in its regional summary about the NHS North West region:

“We heard from clinicians in the North West region about the problems facing the multi-disciplinary North West Neuromuscular Network - founded and chaired by Dr Stefan Spinty, Consultant Paediatric Neurologist and lead neuromuscular clinician at Alder Hey Children’s Hospital, Liverpool. Dr Spinty is currently managing this vital network single-handedly without any funding. We believe that the Network should at least be supported by a Network Coordinator. Greater support at transition from paediatric to adult services is also needed, given the evidence of services being removed or greatly reduced when people leave paediatric services. Existing transition services are extremely vulnerable and we were concerned to learn from clinicians that none of the transitional services in the region are funded nor appropriately staffed. Having met with commissioners from the North West Specialised Commissioning Group to discuss these concerns, local clinicians and representatives from the Muscular Dystrophy Campaign were disappointed to be told that there are competing priorities in the region, and that PCT budgets were under strain. We urge the North West SCG and the local PCTs to undertake a service review to address the weaknesses highlighted by clinicians, patients and the Muscular Dystrophy Campaign.”

The NHS North West specialised commissioning group has taken significant steps forward since those findings, and I will outline them shortly.

The North West Muscle Group raises awareness of neuromuscular conditions and provides a forum for people living with the condition to share experiences and advice about access to local and regional services. Since its launch in June 2009, the group has been actively campaigning to improve access to neuromuscular services in the region, engaging with MPs and with the NHS North West specialised commissioning group. Pressure from the North West Muscle Group, alongside the Muscular Dystrophy Campaign and the all-party group, was instrumental in ensuring that the NHS North West specialised commissioning group conducted a thorough review of neuromuscular services.

Joanne Ashton, a member of the North West Muscle Group, commented:

“I’m glad I joined the Muscle Group. It means I’ve got all this information early on and I won’t come up against a brick wall later - I feel I’ve been pre-armed. It’s nice to know I’m not on my own and it’s good to meet other people at different stages. Every day I imagine how bad things could get, but at the Muscle Group I met young lads with Duchenne muscular dystrophy who are in wheelchairs and they’re fantastic, they’re doing so well. Everything had a real positive spin on it too, and I realised that it’s not all doom and gloom.”

The campaign in the north-west was further spurred on by a comment made by Mike Farrar, NHS North West’s chief executive, to Lord Walton of Detchant at an event in Parliament in November 2009. Having referred to the review of neuromuscular services in the south-west, which Sir Ian Carruthers, NHS South West’s chief executive pushed through, Mike Farrar commented:

“Anything Sir Ian Carruthers can do, we can do better”.

As a result of lobbying by the Muscular Dystrophy Campaign, a review of services was set up in the NHS South West specialised commissioning group in February 2008. In February 2009, local primary care trusts approved a new £1 million neuromuscular strategy to reduce the £6.9 million spent in the region on unplanned emergency admissions to hospital for people with neuromuscular conditions.

I am fully aware, as are several hon. Friends, of the excellent work by the NeuroMuscular Centre in Winsford, Cheshire, which is in the constituency of my hon. Friend the Member for Eddisbury (Mr O'Brien). That centre provides ongoing specialist physiotherapy, which reduces the number of falls among people with neuromuscular conditions, and it also offers social enterprise opportunities. However, although the physiotherapy provision is regarded as excellent by those who go to the centre, difficulties are encountered with PCTs and funding, as reported in the Muscular Dystrophy Campaign’s patient survey 2010. Mr A from Cheshire has Charcot-Marie-Tooth disease and travels to the centre for specialist physiotherapy and hydrotherapy, but his local PCT is unwilling to pay, despite not offering him any alternative physiotherapy or hydrotherapy provision. Following concerted pressure by the Muscular Dystrophy Campaign, the North West Muscle Group and the all-party group, Jon Develing, chief officer of the NHS North West specialised commissioning team, made a personal commitment to the all-party group in January to recommend that the NHS North West specialised commissioning group undertake a review of neuromuscular services.

The review was set up by the commissioning group in May 2010, and the steering group set up an effective model for the NHS working with the Muscular Dystrophy Campaign, patients and expert clinicians from the region. To further involve people living with neuromuscular conditions, a stakeholder day was held in September 2010, which represented a vital opportunity for people to have their say about the services that are crucial for an acceptable standard of specialist neuromuscular care in the region. That led to a gap analysis and a report with recommendations for service improvements— the first time ever that neuromuscular services have been looked at in this way, across the whole region.

The recommendations are currently being put to local primary care trusts to approve new investment for a neuromuscular strategy. The proposed minimal required investment to reduce the £13.6 million spent on unplanned emergency admissions to hospital for neuromuscular conditions and to sustain neuromuscular services across the north-west includes 2.5 new fully NHS-funded care advisers, 2.5 specialist consultants, two to three specialist physiotherapists and one specialist neuromuscular nurse.

Will the Minister agree to write to the specialised commissioning group and to PCTs, endorsing the recommendations as necessary steps to save money and reduce unplanned emergency admissions? Will he ensure that a named individual in the NHS in the north-west will take the work forward once the specialised commissioning groups disappear? The neuromuscular network approach is hugely important to ensure the co-ordination of neuromuscular services in specialist multidisciplinary teams, as demonstrated in the south-west of England and by the Scottish Muscle Network, and to ensure links to the primary and secondary care that plays a crucial part in the management of neuromuscular conditions.

Dr Stefan Spinty, consultant paediatric neurologist at Alder Hey children’s hospital, who played a leading role in the north-west neuromuscular service review, said:

“In order to improve patient outcomes and help to reduce unnecessary and costly hospital admissions, it is important that the recommendations from the North West Specialised Commissioning Group report, which is due to be published soon, are implemented. All neuromuscular clinicians who have been involved in the North West neuromuscular service review are committed to support the implementation process to further improve and secure service provision for individuals affected by neuromuscular conditions in the future.”

Christine Ogden, a campaigner and fundraiser from Bolton, whose grandson has Duchenne muscular dystrophy, said:

“It is vital, that essential increase in care, support and advice for families outlined in the North West Specialised Commissioning Group’s report recommendations, which will make a real difference for families living with muscle disease. It is also so important that information for health professionals about neuromuscular conditions is significantly developed.”

Beryl Swords from Liverpool, whose son John has FSH muscular dystrophy, has commented on the provision of physiotherapy for adults with neuromuscular conditions:

“I feel strongly that physiotherapy for adults with muscular dystrophy is totally inadequate. If improvements were made to North West neuromuscular services, then perhaps this area of care could be more freely available, keeping people with the condition mobile for longer.”

The urgency of improving neuromuscular services in the north-west is encapsulated in the following comments by Nicci Geraghty, a north-west campaigner and fundraiser:

“I have two nephews with Duchenne muscular dystrophy. This is not only a cruel condition for my nephews to suffer from, but also very harrowing at times for us as a family to watch each stage of progression knowing that the postcode lottery already exists throughout the country. This has a huge impact on survival rates and I don’t wish to see my nephews robbed of any chance they have to lead the best quality of life possible.”

The evidence provided makes a compelling case for the urgent necessity of developing and improving neuromuscular services in the north-west in order to save money. Will the Minister write to NICE stressing the importance of a NICE quality standard for Duchenne muscular dystrophy, as well as one on home ventilation and respiratory support? Will he attend the next meeting of the all-party group on muscular dystrophy on Wednesday 9 March to update the group on progress, and will he agree to meet clinicians who have been developing a neuromuscular curriculum with the Association of British Neurologists? Thank you for calling me, Mr Davies.