Access to Migraine Treatment

Gregory Campbell Excerpts

Wednesday 20th March 2024 Westminster Hall

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Lady on securing the debate. On making the blockers more widely available, does she agree that, as well as the requests that she has put to the Minister, there should be discussion and consultation with the devolved institutions, so that people right across the United Kingdom can avail themselves of the same?

[Dehenna Davison]

I completely agree with the hon. Gentleman. As I said, migraine is a condition that does not discriminate. Roughly one in seven people in the world live with migraine, so it is as relevant in the devolved authorities as it is anywhere else. We want to ensure that migraine patients across the whole of the UK have access to the best possible treatment.

For those who cannot access CGRP blockers or alternative treatments through their local NHS trust, or who simply cannot bear the extensive waiting lists to see specialists, drugs bought privately can be incredibly expensive. For example, rimegepant is around £270 per month when taken as a preventive, Botox injections for migraine are around £700 every 12 weeks and Vyepti infusions are around £600 every 12 weeks, and that does not include the cost of seeing specialists and having the prescriptions written, which of course means an additional fee. For those on low incomes, those options are completely inaccessible without NHS treatment, yet some are unable to access them regardless because of the decisions of their local NHS trusts. One survey respondent said:

“I had to spend £8,000 on CGRP treatment privately before moving to a hospital who would fund me under the NHS.”

Nobody should be priced out of quality healthcare, particularly when that healthcare can be truly life changing.

In all, I have outlined a number of tangible steps that could be taken and which would have a real and positive impact on those living with migraine, but let us return to Mollie’s story because, sadly, her experience is an example of how the current system does not always work for patients. In her words:

“Four and a half years later, there is not one second of any day in which I am not in pain. My pain is an average of 7/10 a day, and it soars up to 10/10 at least ten times a day...When it reaches these levels on a daily basis, every single day, you simply cannot live life normally anymore. I can no longer work, see my friends, or do any of the hobbies I used to enjoy. Every single thing that brings me pleasure is now impossible for me.”

For those living with severe chronic migraine, the huge detrimental impact on day-to-day life should not be understated. I have reached the point where I get anxious making plans, either for work or with family and friends, for fear that a severe attack may mean that I have to cancel at the last minute. With attacks seemingly getting more and more frequent, it feels increasingly like cancellation is an inevitability. This may sound really silly to some, but it is a really human example for me. I am a lifelong Swiftie and I managed to achieve the holy grail of getting Taylor Swift tickets for the Eras tour, but I am petrified that on the day a migraine attack might hit and take away my opportunity to see her live, because I would be devastated. Some might say that that is a silly example, but it is one of the things that are on my mind. If someone is living healthily, they do not have to have those sorts of considerations when making plans.

Many survey respondents reported similar concerns. One said:

“Migraine has impacted every job, social occasion and holiday over the last 15 years...It’s caused me countless days of agony. Migraine is a curse I wouldn’t wish on my worst enemy.”

Another said:

“I can’t make plans with people due to migraines making me cancel them last minute. I missed an expensive, once in a lifetime concert opportunity that I had been waiting 12 years for as I had a migraine that day. I had to leave a friend’s funeral early and not attend his wake due to a five-day migraine.”

One said:

“I have missed many family gatherings—New Years, Anniversaries etc. I have also missed events that I have purchased tickets to as I have been too unwell, losing out on both money and experiences.”

Another said:

“I gave up working 14 years ago, stopped socialising and even dread going on holiday, and travel was the thing I always most looked forward to.”

I received an email yesterday from June about her daughter. She is 35 and her migraine attacks are so severe that, in June’s words,

“she can no longer look after her children. At this moment in time,”

she

“cannot complete a simple jigsaw with her two-year-old daughter. This is my daughter who gained a first in her degree...She is upset about missing out on so much of her children’s lives, aged 5 and 2.”

I raise these examples to show that migraine has more than just a trivial impact on the individuals who are suffering; it has a real impact on them and on their loved ones and wider circle.

Many also spoke about the impacts of migraine on their working life. Mollie had just embarked on her dream internship when migraine hit, so she was unable to complete that internship and has struggled to work since. She is not alone. Many here will know that I gave up my ministerial role, as migraine meant that I could not keep up with the additional demands of government. Research by the Migraine Trust found that 29% of people with migraine had to move from full-time to part-time work and 25% had left a job altogether. One survey respondent said:

“I have been at risk of losing my job in the past due to having to take time off for migraines.”

Another said:

“I recently lost my job due to the number of migraine related absences I had.”

Oral Answers to Questions

Gregory Campbell Excerpts

Tuesday 5th March 2024 Commons Chamber

[Dame Andrea Leadsom]

I am very happy to discuss that matter with my hon. Friend, who is a huge advocate for her constituency. It is always disappointing when a community pharmacy closes, but she will know that the launch of Pharmacy First on 31 January expanded the value and contribution of all our community pharmacies. It has been met with a £645 million investment over this year and next.

[Mr Gregory Campbell (East Londonderry) (DUP)]

On access to primary care provision, will the Secretary of State assure the House that she will liaise with Health Ministers in the devolved Departments to ensure that rural communities do not lose out because of their isolated locations?

[Victoria Atkins]

I am very happy to give that assurance. I was delighted to meet Minister Swann yesterday to discuss his plans for Northern Ireland healthcare, including access to primary care.

Oral Answers to Questions

Gregory Campbell Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Helen Whately]

I thank my hon. Friend for his invitation. He has been a tireless campaigner on this issue on behalf of his constituents. The future of healthcare is about getting people the care that they need, where they need it and when they need it, and Rugby is no different. New local NHS services are bringing care closer to home in his area, such as the new imaging unit at the Hospital of St Cross that opened in September.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Access to urgent and emergency care can be greater facilitated when greater protection is offered to staff, particularly the many who suffer attacks in emergency departments at hospitals across the United Kingdom—often by people who are intoxicated.

[Helen Whately]

The hon. Member makes an important point. The safety of our staff in the national health service is important, including those in urgent and emergency care departments, as well as the ambulance services. He is absolutely right to point that out, and it is never acceptable for anyone, including patients, to be violent towards staff.

Oral Answers to Questions

Gregory Campbell Excerpts

Tuesday 11th July 2023 Commons Chamber

[Neil O'Brien]

My right hon. Friend is completely correct. That £645 million, of course, comes on top of the £100 million that we have already put in. We have grown the pharmacy workforce hugely—there are 82% more pharmacists now than in 2010—and we are also enabling those people with their high-end skills to do more by reforming regulations. That is not just the blister packs issue; we are enabling them to do convenient things such as hand out bagged medicines even if the pharmacist is not present.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Will the Minister undertake to liaise closely with local community pharmacy representative groups to ensure that the excellent work they have been doing can be maximised, particularly given that the NHS is under severe pressure at the moment?

[Neil O’Brien]

Absolutely, and I always try to learn lessons from right across the UK. In fact, some of the ideas for reforms have come from listening to local partners. For example, our reforms to enable modern ways of working, hub-and-spoke dispensing and empowering pharmacy technicians have come from talking to those local partners.

Pancreatic Cancer Awareness Month

Gregory Campbell Excerpts

Tuesday 8th November 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered pancreatic cancer awareness month.

It is good to see everyone here. I thank Members for attending and look forward to their contributions, especially those from the shadow Ministers. In particular, I look forward to the contribution from the Minister, who is back in post again. I wish her well and look forward to her summing up of the debate.

It is a pleasure to speak on the subject and I declare an interest as chair of the all-party parliamentary group on pancreatic cancer. I am pleased that my application to the Backbench Business Committee for a debate was successful, and I have a number of asks. I pay special tribute to the hon. Member for East Dunbartonshire (Amy Callaghan), who is sitting to my right. She was chair of the APPG, and when her health was not the best, she asked me whether I would take it over. That seemed to be the unanimous opinion of the members of the group, so I was pleased to do so.

I owe the hon. Lady a special thanks. She is the lady, as she always is, who presented the issue and pushed it, and I just follow in her footsteps. That is a fact. I am pleased to see her getting back to health and strength, and look forward to her contribution, which I am sure will be factual and helpful to the debate.

With pancreatic cancer, silence is deadly. That is where we are—very much conscious of pancreatic cancer and what it does. It is a disease that gets too little attention and too little funding. That is one of my asks of the Minister, and I prepare her for it in advance. Later, I will refer to some stats and figures, which will reinforce the issue. Thousands of people die of pancreatic cancer every year, so it is critical that we secure early diagnosis and ensure that the funding for research is there. Ultimately, we must raise awareness of the disease—for example, through today’s debate.

Pancreatic cancer is the deadliest common cancer of all, which underlines the importance of the debate, and the stats surrounding it are truly shocking: 10,000 people across the United Kingdom of Great Britain and Northern Ireland are diagnosed with the disease every year, and half the people diagnosed die within three months of their diagnosis. That is alarming, and I want to present some evidence about how the disease affects people, particularly those in my constituency.

Sadly, only 7% of those who are diagnosed survive five years, and even fewer survive longer than that. The five-year survival rate for pancreatic cancer in Northern Ireland is one of the worst in the world at 4.9%, and it puts us 32nd out of 36 countries in the survival charts. That tells us all about where we are. The Minister is not responsible for health in Northern Ireland because health is a devolved matter, but I want to use the debate to highlight the issue and to show where we can push for the improvements that we would like to see and wish we could have. Back home, I have been pushing the Minister of Health on that for a long time, and I want us to have such a strategy on the UK mainland in the hope that we can do the same in turn in Northern Ireland.

When I am in my constituency office, my heart sinks when people come in for help with their personal independence payment form and inform me that their illness is pancreatic cancer. I feel my stomach sinking and my heart dropping, and I take a deep breath, because I know that I am looking across the counter at someone—man or woman—who, unfortunately, has limited time left in this world. Much more often than not, pancreatic cancer is a death sentence. My office helps people with benefits, PIP forms and universal credit, which eases them through the financial issues. There is a health burden, but the other burden is finance—when someone can no longer earn the money that they need to pay the bills and get through.

November is many things, but we are here because it is Pancreatic Cancer Awareness Month. All around the United Kingdom of Great Britain and Northern Ireland, people have been lighting up their homes and local landmarks purple, holding fundraising events for charities such as Pancreatic Cancer UK, and having conversations. It is so important to have conversations to raise awareness of the deadliest common cancer of all.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate my hon. Friend on securing the debate and on the work that he is doing in the all-party parliamentary group. He is highlighting the importance of November being Pancreatic Cancer Awareness Month. Does he agree that early detection is key? Unfortunately, at the moment pancreatic cancer has the lowest survival rate of all common cancers. Awareness is critical in assisting people, moving toward early detection and trying to get those figures down.

[Jim Shannon]

I totally agree with my hon. Friend. I will give an example and mention a lady’s name; I have her permission to do so. I am pretty sure that the hon. Member for East Dunbartonshire knows this lady, and others may also know her story, which illustrates where early detection and diagnosis can make all the difference. We need to focus on the three symptoms to look out for, which can lead to the early detection and diagnosis that are so important.

Pancreatic cancer is a brutal illness, and there is no better way of understanding how brutal it is than by hearing how it impacts an individual and their family. To that end, I will take the opportunity to share the story of Rebecca Buggs, who is the face of the Pancreatic Cancer UK campaign this Pancreatic Cancer Awareness Month. She is a nurse, who looked after pancreatic cancer patients and was well aware of the symptoms. Ultimately, her awareness of those symptoms saved her life.

The Pancreatic Cancer UK campaign is called “No Time to Wait”, and there is no time to wait. There must be an instantaneous response to symptoms—my hon. Friend the Member for East Londonderry (Mr Campbell) mentioned the importance of that—because for patients with pancreatic cancer, delay means disaster. Rebecca, who is 43, knows that all too well. She has been a nurse for 21 years, and over the course of her career she has prepared many patients for the Whipple procedure—the only operation that provides a possible cure for pancreatic cancer. When Members hear her story, they will understand the importance of that.

On Christmas day last year, almost 11 months ago, Rebecca began to feel very unwell. She believed it was just a covid-19 infection, as many do; if someone is not well, they think it must be covid, because covid has been prevalent for the last two and a half years. Three days later, her husband noticed that she was jaundiced and said, “Becki, you look like a Minion”—not because that is a derogatory term, but because Minions all have yellow faces. After contacting the on-call registrar, whom she fortunately knew because of her role as a nurse, she was told to head straight to her hospital for blood tests and scans.

On 4 January this year, 10 days after her symptoms began, Rebecca was told the devastating news that she had pancreatic cancer. Luckily, her cancer was caught early enough for her to have the Whipple procedure, for which she had prepared many patients over all those years in her job. For most patients, it is far too late; only 10% of people are able to access that surgery. One of the things I will ask the Minister about is access to surgery; I know that she will have an answer to our queries, as she always does.

In the campaign, Rebecca talks incredibly powerfully about how this time was for her and her family. It is not just about the impact on the person who has the disease; it is about the impact, in this case, on her husband, her children, her mum and dad, and everyone else. She talks about how scary it was to be the one on the operating table after preparing so many for the procedure herself, highlighting the experience of so many with this devastating cancer. She said:

“These were the hardest 11 days of my life. I was away from my children, Jacob who’s 9 and Georgia who’s 8, and they couldn’t come and visit me because of COVID.”

It is vital that we drive improvements so that more people like Rebecca can get access to life-saving treatment for this cancer. That is why Pancreatic Cancer UK’s “No Time to Wait” campaign is vital. We need to ensure that people can get a diagnosis and treatment or surgery—whichever is the case—as soon as possible in order to give them the best chance of survival. I share Rebecca’s concern that so many people are struggling to get GP appointments or referrals for the right tests when they have concerning symptoms such as stomach ache, backache and indigestion. As Rebecca says,

“they become so ill and jaundiced that they get admitted to A&E and by then it’s too late.”

When the symptoms and the diagnosis are there and the tests are done, access to surgeons and surgery is so important.

Rebecca’s point about people with pancreatic cancer being diagnosed in A&E is particularly important. We often think in this day and age that if someone receives a cancer diagnosis, that will happen in a quiet consultation room in a hospital or perhaps in their local GP surgery, but more often than not it happens in a crowded room. More often than not—I say this with respect to doctors and GPs—it may become repetitive for GPs to tell patients that they have a diagnosis of whatever it may be, but that is a life-changing statement for the patient.

A person came to see me this week and told me that his wife had been diagnosed with cancer, albeit not pancreatic cancer. The doctor had told her very matter-of-factly that she had it, and she was absolutely devastated. What the doctor perhaps could have done was told her husband, who could then have conveyed the news to his wife in a way that would not have been such a shock.

People might expect that the doctor will give them their diagnosis and follow that up with a clear treatment plan for how they will treat and beat their cancer. In 2022, we expect that there will be a clear path to a cure and a good chance that, eventually, the person will be given the all-clear. But with pancreatic cancer, that just is not the case. More than 60% of patients with pancreatic cancer get diagnosed only in an emergency setting. I think that if anything at all indicates pancreatic cancer, the doctors and those who are aware of it need to prioritise it immediately, because speed is of the essence. Some 70% of people do not receive any active treatment at all, because they are too unwell by the time they are diagnosed; it is almost too late for them. Let that sink in. Imagine receiving a pancreatic cancer diagnosis and then immediately being told, “By the way, there is no possible treatment plan or cure.” That is devastating.

We have to improve; we have to make the situation better. We have to try to respond in such a way that we add comfort, compassion and understanding—and, more importantly, the opportunity for surgery. It bears repeating that more than half of people who receive a pancreatic cancer diagnosis will die within three months. Wow—that is another blinder of a statement. It really underlines the seriousness of the matter. For people with pancreatic cancer, there really is no time to wait.

What is the reason behind my saying all this? Primarily, it is that people with pancreatic cancer are being diagnosed far too late. We are all familiar with the fact that the earlier someone is diagnosed, the better their chances of survival. But some things are needed before people can get that crucial early diagnosis. I will outline some of them, and I hope that the Minister will be able to respond in a way that is helpful.

First, we all need to spread awareness of the symptoms of this cancer, which are stomach and back pain, indigestion, unexplained weight loss, and jaundice. The colour caused by jaundice would obviously be noticeable right away, but all the other things are more difficult. Someone might have a bit of backache and a bit of indigestion now and again. People should always look out for any weight loss, and sometimes even weight gain. Of course, it is striking how common the symptoms on that list are. We would not naturally associate them with pancreatic cancer, but it is vital that people get checks if they experience those symptoms with no explanation. It might not be just backache or a bit of indigestion; it might be more.

Secondly and simply, there needs to be a test. It is all well and good going to the GP with these types of symptoms, but we also need to equip GPs with the tools that they need to start ruling things out. Will the Minister tell us how we can help our GPs to have all the equipment in place to make early diagnoses, and to refer people for the right test as soon as possible if they have even a minute suspicion that a person might be facing pancreatic cancer? Currently, there is no such test, but research is ongoing to try to create one, which could make a huge difference by allowing people to be diagnosed at an early stage.

We often speak about research and development. I probably mention it in every health debate—not to be repetitive, but because it is a real issue. Research and development is so important to find a cure and a way to help patients. Will the Minister tell us what can be done to increase research and development in this area? I will give a shocking figure that underlines the importance of research, which is the third key to unlocking earlier diagnosis. Currently, pancreatic cancer is the fifth most common cause of cancer death, but it receives just 1.4% of cancer research funding in the UK. Without sustained investment in innovative research, we will not be able to improve survival rates at the pace that we must.

To date, Pancreatic Cancer UK has invested over £10 million in pancreatic cancer research, including research that aims to develop a simple test for the cancer, but it is a charity, so its funds are limited. Will the Minister tell us what can be done to help pancreatic cancer research and development? It is sometimes easy to say this, but I genuinely believe in my heart that the Government have to step in and help, because pancreatic cancer is so brutal and singular, and it ends life very quickly. Can we please have some direction on what can be done to help?

To achieve major breakthroughs, we need the research and development upgraded. We need extra money spent, well above the 1.4% of cancer research funding that pancreatic cancer receives at the moment. I say with respect that if Pancreatic Cancer UK can raise some £10 million, which is quite a bit for a small charity, the Government need to match that and do a wee bit better. Despite everything we have heard today, we need the charity’s ambition and spend to be matched by the Government and other national research funders.

In addition to driving crucial research breakthroughs, the Government must ensure that they take action to improve outcomes for people with pancreatic cancer. I know that lots of cancers are deadly, but pancreatic cancer is the deadliest. Because of that, it needs a wee bit of extra assistance. That is particularly important at the moment, as we are heading into what will be a very challenging winter for the NHS, with the pandemic, staff shortages and underfunding pushing it to breaking point. By its very nature, the press is quite negative, and it is sometimes hard to be positive about all the different news that we hear in the media, on TV and in the papers, but we need to have pancreatic cancer research and development, and response, at the centre of our cancer strategy.

Without action, there is a risk that things will get even worse for people with pancreatic cancer, as any additional delays to vital appointments, tests and treatments—the three things we need, along with an assurance on the speed of response—will have an adverse impact on people who have no time to wait. There has been inaction on pancreatic cancer for too long, but together we can change that. Indeed, I believe it is our duty to push for better for those who are faced with this deadly cancer.

We need to see urgent action, and there are things that the Government could do now to start shifting the dial. First, they must publish the 10-year cancer plan as soon as possible. Back in January, the then Health and Social Care Secretary, the right hon. Member for Bromsgrove (Sajid Javid), committed to publishing a 10-year cancer plan that would transform this country into a world-leading force for cancer care and treatment. Our previous Prime Minister recommitted to doing that, but we have since had silence—I say this with respect—from the new Prime Minister, who has had plenty on his plate, and the new Health and Social Care Secretary. Pancreatic cancer has been neglected by successive Governments, as have cancer plans. As a result, survival rates have not improved in decades. There has been a lack of action over time on pancreatic cancer, and we really need to ensure that work is put in place.

A funded and ambitious cancer plan would be a real step in the right direction, demonstrating our national ambition. I am proud to be British and proud to have a Government that lead. We need to lead on this, and we need to do so very quickly. That will give us something to aim for in driving up outcomes and survival, and it will help us to give people hope. That hope has not been there for years, and it needs to be there now. I say this very politely but sincerely and firmly: currently, we are a rudderless ship, and a cancer plan would give us direction and hope. The World Health Organisation advises that all nations need a cancer strategy to give this killer disease the attention it deserves. Through this debate, through our Minister and through our Government, let us become a country that can do better and does not fail to meet that standard.

To make a real difference, the cancer plan must have a specific focus on less survivable cancers, including pancreatic cancer—the ones that kill the most and kill the earliest. Unfortunately, it is possible to receive a diagnosis of pancreatic cancer and, within three months, to be no longer in this world. The plan must include investment in the workforce so that everyone can have a diagnosis and treatment plan within 21 days. That is the best practice that Pancreatic Cancer UK and clinical experts believe should be the reality everywhere. I make a special request for the Minister to address that. I say this often, but it does not lessen the issue, because it is important: I am proud of being in this Parliament of the United Kingdom of Great Britain and Northern Ireland, but we need to share what we have done regionally in Scotland, Wales, Northern Ireland and England in order to do things better. There may even be a necessity for a UK-wide policy and strategy.

Getting a diagnosis quickly is crucial in ensuring people can get the treatment they need as soon as possible. In addition, the cancer plan must deliver the funding needed to enable specialist cancer nurses to support everyone with pancreatic cancer as soon as possible after their diagnosis, helping them manage their symptoms and maintain a good quality of life. We must ensure that, when the family and financial pressures are gathering around someone and they sometimes feel like it is just them fighting the disease, that is not the case. We need to wrap our arms around people and tell them that they are not on their own.

I hope the Government will commit today to publishing the cancer plan. That is critical; it is at the core of the issue, and we need it. I encourage the Minister to meet Pancreatic Cancer UK and people affected by this awful disease to find out more about the “No Time to Wait” campaign and how the 10-year cancer plan can finally shift the dial. I know the answer will be yes but, for the purpose of having it in Hansard, will she commit to having that meeting, which I think will enable Pancreatic Cancer UK to press, push, emphasise and raise awareness of the matter?

There has been silence around pancreatic cancer for too long, but through this debate, together—collectively as MPs, with the Minister and regionally—we can change that attitude. We need to speak up and demand immediate change on behalf of those who have already lost their lives and the families left to grieve, those who are living with pancreatic cancer right now, and those who face a diagnosis in the coming months. We want to give them hope. We want them to know that if they get the disease, their treatment will be prioritised through A&E, their diagnosis will be quick, the response will be equally quick, and surgery will follow.

We have work to do in Northern Ireland, and I understand that—the figures I gave earlier emphasise it only too well—but we also have work to do across this great United Kingdom. I am asking for attention to be paid UK-wide in the form of a pancreatic cancer strategy, with information and guidance shared in every area of this United Kingdom of Great Britain and Northern Ireland.

I am conscious that others want to contribute and I very much look forward to their contributions, including those of the shadow Ministers and, in particular, the Minister. I know that she, along with all of us, will want to do all she can to save lives. I look forward to her response, and I thank the Backbench Business Committee for giving me the opportunity to speak on this subject.

In Pancreatic Cancer Awareness Month we have a duty as elected representatives in this House to deliver a message. With respect, we hope that the Minister and the Government will respond centrally, with a pancreatic cancer strategy that we can all look up to, so that when people with pancreatic cancer come to my office, as they often do, to fill in PIP forms, I can then tell them that there is some hope and show them what they need to do.

Smokefree 2030

Gregory Campbell Excerpts

Tuesday 26th April 2022 Westminster Hall

[Bob Blackman (Harrow East) (Con) [R]]

I beg to move,

That this House has considered progress towards the Government’s smokefree 2030 ambition.

It is a pleasure to serve under your chairmanship, Ms Nokes. For those who do not know, today is my birthday. What better way to celebrate my birthday than to speak in Westminster Hall? On a personal level, it is tinged with sadness, because tomorrow is the anniversary of my mother’s death. She died from smoking—officially, it was lung and throat cancer, but I am clear that smoking killed my mother. That is one of the reasons I am so passionate about ensuring that young people do not start smoking and that those who smoke give up as quickly as they can, because the medical reality is that the lungs can recover. In fact, if smokers quit at an early enough stage, even seasoned smokers who have smoked for many years will see their lungs recover.

I thank the Chairman of Ways and Means and the Backbench Business Committee, on which I sit, for granting this debate. Originally, our intention was to focus on Javed Khan’s long-awaited review. The officers of the all-party parliamentary group on smoking and health and I believed that the review’s recommendation would be published last Friday. Javed has had to delay his publication, but I hope that when we see it, it will be as radical as we believe it to be. Given the delay in publication—until the middle of May, I believe—we were left having to decide whether to proceed with this debate or wait. My view is that, given that we have the opportunity to debate this issue, and possibly even shape Javed Khan’s views and recommendations, it is better to proceed and get the answers from the Minister about where we stand on the review. I hope the Government will commit to introduce all the recommendations of Javed Khan’s review, whatever they may be, to achieve what I am sure we all in this room wish to achieve: a smokefree 2030.

The hon. Member for City of Durham (Mary Kelly Foy)—I will call her my hon. Friend—and I have co-sponsored this debate, and I am sure she will speak on many of aspects, particularly levelling up. The Government have a bold ambition, which I strongly support—I am sure we all do—to bring the end of smoking within touching distance. But it is deeply disappointing that, three years on from that being announced in the Green Paper, we do not seem to have made much progress. There is no road map to put us on the route to success. The purpose of this debate is to remind the Minister of the urgent need to deliver the bold action that was promised in the 2019 Green Paper.

The 2030 ambition was acknowledged by everyone to be extremely challenging only three years ago. We have lost three years, so it is even more challenging now. We should be clear that if we do nothing, we will not achieve that target, so there is no time to be lost. When the ambition was announced, we had 11 years; now, there is only eight. We are nowhere near achieving our ambition, particularly for our more disadvantaged communities in society, which have the highest rates of smoking.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Member not just on jointly securing the debate but on his birthday. He talks about the harder-to-reach, socially disadvantaged communities. Does he agree that if we do not get the younger elements in particular to a smoke-free society, we will not get future generations, and the 2030 target will not be met?

[Bob Blackman]

I thank the hon. Member for that intervention. Clearly, people start smoking when they are young. They continue to smoke well into their later life, and it is very hard for people to give up if they have already committed to smoking cigarettes, because nicotine is the most addictive drug that we know of. Therefore, it is very hard for people to get off it once they have started, so it is far better that we prevent people from starting to smoke in the first place. At the moment, I believe that around 200 to 300 young people start smoking every day, which is why it is imperative to stop them doing so right now. Indeed, Cancer Research UK has estimated that we will have to wait until 2047 for the smoking rate in disadvantaged communities to reach 5% or less, which is the smokefree ambition.

Covid-19: Impact on Social Work

Gregory Campbell Excerpts

Wednesday 23rd March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Lancaster and Fleetwood (Cat Smith) for raising such an important issue. I had hoped that we would have more people here today to participate because there is not one MP who does not have regular contact with their social workers on behalf of constituents; it happens in my office every week. I want to mention some of the issues and care packages in place, and I will mention some figures for my constituency.

I am pleased to see the Minister in her place. I always look forward to her response—not just because she is a good friend, but because she always answers with knowledge and help, which I think we all wish to see. That is exactly what the hon. Member for Lancaster and Fleetwood is seeking with the debate. I am also pleased to see the shadow Minister, the hon. Member for Bristol South (Karin Smyth), in her place—I look forward to her contribution—and my good friend the hon. Member for Linlithgow and East Falkirk (Martyn Day), who speaks on behalf of the Scottish National party. We are pleased to participate in this debate on such an important issue.

It is not the fault of anyone in this room, but the outbreak of the pandemic has cruelly exacerbated the social work situation. How we respond is the subject of the debate and the Minister’s responsibility. There is no doubt those in the profession have faced unprecedented challenges, and it is great to be here today to illustrate some of them and to discuss how we can support our brilliant social workers.

We have mentioned the NHS and many of those who kept the wheels turning and the shelves filled, who visited people and who made everything happen through a pandemic of unprecedented ferocity. All of society gelled together as a team to make that happen. I meet people every week in my constituency of Strangford who make the lives of the vulnerable and those in need better. That is their responsibility, and I have that responsibility on their behalf.

We are sometimes confronted with incredibly difficult cases. I am no different from anybody else, so I suspect that my response is the same as everyone else’s. Social workers are involved in some awful cases: the lives that people are confronted with, probably through no fault of their own, and the impact on children. I have a special place in my heart for children, because I am not only a father, but a grandfather; it is a great stage. Those of us in the Chamber who are grandparents will know that it is a wonderful experience. The great thing, Mr Robertson, is that we can give our grandchildren back at 7 o’clock at night! Whenever they get tantrummy and want to go to bed, or do not want to go to bed—it depends what mood they are in—we can always phone up their mum and dad to say, “By the way, the kids are ready to collect.” We can enjoy all the fun, but for others on the frontline, I am afraid that there are real problems.

As of 2021, 105,000 people were employed as social workers for children, the elderly, and those who are vulnerable and in need. I am not asking the Minister to answer for Northern Ireland as that is not her responsibility, but I want to sew the Northern Ireland perspective into this debate because it echoes what the hon. Member for Lancaster and Fleetwood said in her introduction. The Minister always gives me some succour and encouragement in her response, and that is important.

There is predicted to be a mismatch between the supply and demand of social care professionals, with 1 million workers needed by 2025, which is not that far away. We seem to be having anniversaries regularly—whatever they may be for—and I look back and think, “That can’t have been four or five years ago”, but it was. Three years will pass quickly, and it is predicted that there will be a 35% shortfall in social workers. Will the Minister tell us from a UK perspective what has been done to recruit and train social workers, and to have the support at every level that is critical to a good response?

[Mr Gregory Campbell (East Londonderry) (DUP)]

My hon. Friend is outlining the extent of the problem and the imminent mismatch between supply and demand, which is just two and a half years away. Does he agree that what we need to see and hear from Government, both centrally and throughout the devolved regions of the UK, is an acknowledgement and admission of an impending problem? Action needs to be taken now, so that social workers and others in the care sector can see that our Governments are looking ahead, planning and preparing for the problems that we will all face.

[Jim Shannon]

My hon. Friend has summed up in a few seconds exactly what the debate is about, whereas I will take 10 or 12 paragraphs to explain it. His point is that we have to be strategic and visionary, and have a plan of action. Today is all about what that plan of action is.

Tourette’s syndrome

Gregory Campbell Excerpts

Tuesday 25th January 2022 Westminster Hall

[Conor McGinn (St Helens North) (Lab)]

I beg to move,

That this House has considered the treatment and study of Tourette’s syndrome.

It is a pleasure to serve under your chairmanship, Ms Cummins. I am delighted to have secured this debate on Tourette’s syndrome and how a lack of provision for research, diagnosis and treatment is impacting on individuals and families across the United Kingdom.

First, it is worth explaining what Tourette’s syndrome is. In short, it is an inherited neurological condition that causes involuntary and uncontrollable motor and vocal tics. Tics usually start in childhood, around the age of six or seven, and can fluctuate in severity and frequency, potentially occurring in nearly any part of the body and in any muscle. This can be painful, as one might imagine, and of course very debilitating, even disabling. Tourette’s is not often experienced in isolation. Up to 85% of those with Tourette’s syndrome will also experience co-occurring conditions and features, which might include attention deficit hyperactivity disorder, ADHD, or obsessive compulsive disorder, OCD, and indeed anxiety. These can be equally challenging, if not in some cases more challenging to manage than tics.

By far the biggest misconception about Tourette’s is that it is a condition that simply makes people swear or say socially inappropriate things. Involuntary swearing is a symptom of Tourette’s syndrome, but it affects only a minority. Ninety per cent. of people with Tourette’s do not have this symptom. However, having secured this debate, in my experience it is the single factor that those I have spoken to—colleagues in this place and others—commonly think of as the defining characteristic of Tourette’s. That goes to the heart of the challenge that we have in addressing some of the misconceptions about this condition.

Despite Tourette’s syndrome affecting the quality of life of over 300,000 people here in the UK—including, figures indicate, approximately one school-age child in every 100, most of whom are undiagnosed—this is a condition that, although relatively prevalent, remains widely misunderstood. Indeed, it is often deeply stigmatised and mocked throughout society. The stigma cannot be overstated, and the impact of it is very real. A recent study published in the Journal of Developmental and Physical Disabilities in 2021 outlined just how many participants faced discrimination in numerous aspects of life: 75% in education, 71% in their social lives, 61% on public transport and 54% in employment. A 2017 study concluded that people with Tourette’s are over four times more likely than the general population to take their own lives.

The reason I applied for and am leading today’s debate is to support my constituent Emma McNally, a St Helens mum who first wrote to me in July 2020. Her son was diagnosed with Tourette’s syndrome aged nine and could access regular appointments under the care of an excellent neurologist at Liverpool’s Alder Hey Hospital, which I know is familiar to the Minister. The retirement of the specialist in March 2020 left a gaping hole in provision locally and Emma’s son was discharged, with no one able to take him on. Unacceptably, to this day he has been left without the care he needs.

Emma’s journey—from local St Helens mum, living in Parr in my constituency, who contacted her local MP—to national campaigner and now the chief executive of the national charity for Tourette’s has done a great deal to highlight and raise awareness of this condition. Her e-petition on Tourette’s, submitted through the mechanism we have in this House, secured 71,000 signatures, which reflects the clear strength of feeling across the country for better care and services. She is fighting tenaciously on behalf of families around the country. Although her petition sadly fell just short of the threshold required for automatic discussion in this House, I am glad that we are having today’s debate, which goes some way to doing justice to her brilliant work and the importance of this issue. I have been contacted by more than 30 colleagues from all parties across the House, from all parts of the United Kingdom, who have expressed their support. I want especially to mention the Minister’s colleague and the erstwhile Parliamentary Private Secretary at the Department of Health and Social Care, the hon. Member for St Austell and Newquay (Steve Double), who has worked with me over the last year on this issue. He is prohibited from actively participating in this debate because he is now in the Government Whips Office.

The debate is long overdue. The last time the House met to debate Tourette’s syndrome was in 2010. Back then, the charity Tourettes Action held a list of 44 consultants in the UK with a special interest in Tourette’s syndrome. Now, there are only 17 who provide care in the NHS and will see children, and there are none in the north-west. I am sad to say that the picture for those living with this condition and their families has got worse over the last decade, and it should be getting better. We need to change this.

Families tell me that there is a significant and urgent need for specialist services and clinicians to bolster early diagnosis and rapid treatment. Early intervention in Tourette’s cases could reduce the more pernicious, longer-term strains on an individual’s mental and physical health and wellbeing, as well as on that of their friends, families, colleagues and teachers, by giving them a clear diagnosis and an idea of who to turn to.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Member on securing the debate. On the issue that he has explained—the much-misunderstood aspects of Tourette’s—would he agree with me that we need not only more finance and more professionals involved in treatment but a greater degree of research into the development of Tourette’s, to assure present and future generations that it can be seriously tackled?

Eye Health and Macular Disease

Gregory Campbell Excerpts

Tuesday 11th January 2022 Westminster Hall

[Jim Shannon]

The hon. Gentleman has, I think, passed on that information to the Minister. It is important that we see where innovation has moved forward. PolyPhotonix, the firm to which the hon. Gentleman referred, can bring beneficial and positive changes to those with eye issues. I thank him for that intervention, and I look forward to the Minister being able to visit the company.

Care for patients with diabetic macular oedema was deprioritised during the pandemic, and delays have led to a doubling in the number of patient with DMO losing between one and three lines of vision. It is very important that that issue is addressed. The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) referred to staff shortages, and again I look to the Minister to see how we can address that issue.

We know that, as with other areas of healthcare, there are inequalities in eye care. Some parts of the population are not accessing regular sight tests, even if they might be eligible for them for free on the NHS. Can the Minister tell us what can be done to ensure that people are accessing that care? I know that the pandemic has changed many lives, but how do we address that? It is about solutions, not about negativity, but we have to say these things in the introduction to the speech so that we can look to the changes that we wish to see.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate my hon. Friend on securing the debate. We are coming up to the winter Olympics, and if there was a ski slalom for getting Westminster Hall debates, my hon. Friend would win the gold medal every single year. Given the localised comments that he has very appropriately made about the need for people to get their testing done, it is often the case that when the reminders come through for an ophthalmology appointment, they are overlooked. It is important that people take them up and any problems are identified very early on.

[Jim Shannon]

How pertinent that intervention is. I will give a couple of examples now that I was going to give later because they are pertinent to this. The opticians and ophthalmologists in Strangford and Newtownards town have told me of two occasions in 2021 when people who went for their test were sent straight away to the Ulster hospital in Dundonald because they had a tumour. They had no other ailments, but their ophthalmologist or optician spotted something early on. They say the eyes tell the health of the whole body, and I think they do. In that case, two lives were saved, and there are probably many others.

Abortion Services Commissioning: Northern Ireland

Gregory Campbell Excerpts

Tuesday 14th December 2021 Westminster Hall

[Alex Davies-Jones (Pontypridd) (Lab)]

I beg to move,

That this House has considered the commissioning of abortion services in Northern Ireland.

As ever, it is a pleasure to see you in the Chair, Mr Pritchard. I am particularly pleased to lead this debate on a topic that is close to my heart. Members may be aware that I recently left my role as shadow Minister for Northern Ireland to join the shadow Digital, Culture, Media and Sport team. The issues on the ground in Northern Ireland are complex, but this topic was always the one that spoke to me the most during my time in the shadow Northern Ireland team. My successor, my hon. Friend the Member for Gower (Tonia Antoniazzi), will be an equally loud voice for women’s rights, and I wish her well in her new role. I look forward to hearing her comments.

Abortion in Northern Ireland is, as I hope we all recognise, an extremely sensitive and emotive issue that engenders passionate views on both sides. While I always look forward to a good debate, and I would expect nothing less on a topic such as abortion, I hope that Members will be respectful in their contributions. I politely remind colleagues that the focus of this debate should remain the commissioning and delivery of abortion services.

My personal opinion on abortion is clear: it is important that anyone considering an abortion, regardless of where they live, receives impartial, non-directive and clinical information on pregnancy in order to make an informed choice. While some argue that abortion is a devolved matter for Northern Ireland, especially now that the Northern Ireland Executive is able to legislate on this issue, the conformity of the whole UK with the European convention on human rights is a matter for Westminster, not Stormont. The UK Government ultimately have a responsibility for ensuring that all our nations across the UK abide by our international and domestic legal obligations, and that is what brings us to this place today.

We must remember that Northern Ireland has a pro-choice majority when it comes to abortion. A number of Members, including the hon. Members for Foyle (Colum Eastwood), for Belfast South (Claire Hanna) and for North Down (Stephen Farry), and others who represent constituencies in Northern Ireland, are committed to upholding that majority.

I must place on record my gratitude to the many individuals and organisations who have laid the groundwork for today’s debate. The right hon. Member for Basingstoke (Mrs Miller), my hon. Friends the Members for Bristol South (Karin Smyth) and for Walthamstow (Stella Creasy), as well as my right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) have spoken on this topic at length. I hope my contribution will do their work some justice. I have also been supported by the team at MSI Reproductive Choices and Women’s Aid Northern Ireland—long may their fantastic work continue.

The changes to abortion laws, which extended abortion rights to the women of Northern Ireland, were made in line with the recommendations made by the UN Committee on the Elimination of Discrimination against Women. Affording women in Northern Ireland these rights was a pivotal step in finally aligning abortion policy across all nations in the United Kingdom, and in my view it was a very welcome move. The legal framework for abortion services in Northern Ireland required under law came into effect in March last year, following an extensive consultation period. The circumstances around the legislation of abortions were clear. During that time, officials engaged with stakeholders, including the Northern Ireland Department of Health, healthcare professionals, the all-Ireland Church Leaders Group, abortion service providers and individuals with personal experience.

The initial regulations were replaced by the Abortion (Northern Ireland) (No. 2) Regulations 2020, which came into effect in May. The regulations, approved by both the House of Commons and the House of Lords, as required by the Northern Ireland (Executive Formation etc) Act 2019, will remain in force in Northern Ireland. These regulations outline the legislation on abortion under any circumstances by a registered doctor, nurse or midwife up to 12 weeks and up to 24 weeks where there is a risk to physical or mental health in the opinion of two registered medical professionals. Thanks to this change, abortions with no gestational limit are also now legal in Northern Ireland, where there is an immediate necessity to save a life or to prevent a grave permanent injury to the physical or mental health of a pregnant woman, or in the case of severe foetal impairment or fatal foetal abnormality.

I had the great privilege of responding to those regulations on behalf of the Opposition in Committee earlier this year. At that time, I and a number of other colleagues spoke about the heartbreaking challenges that many women and girls requiring abortions face thanks to the delays in delivering safe and local abortion services. It would be remiss of me not to pay particular tribute to my hon. Friend the Member for Walthamstow —my good friend—who has led the way in her commitment to women and girls in Northern Ireland. It is only thanks to her amendment to the Northern Ireland (Executive Formation etc) Act 2019—I must add that the amendment was passed overwhelmingly by the House —that the situation changed, in theory, for women and girls. Finally, women and girls would no longer be required to use unsafe, unregulated services or to make the heartbreaking journey across the Irish sea to seek an abortion in Britain. Those changes were a very welcome move and a critical step for women’s rights and, ultimately, equality across Northern Ireland. However, years down the line, these women and girls are still waiting.

I fully recognise concerns around the devolution settlement, especially as a Welsh MP, and I am sure colleagues will want to raise such concerns today. Put simply, however, in the prolonged absence of a functioning Executive in Northern Ireland, it was right that the law was amended to reflect the UK’s human rights obligations. Despite the legislative progress that has been made, we all know that the reality for women seeking abortions in Northern Ireland is fundamentally unchanged. The law simply is not being properly implemented. The Department of Health in Northern Ireland has not commissioned or funded termination services for the purposes of implementing the abortion regulations across Northern Ireland.

According to the Northern Ireland Human Rights Commission, the Department has also failed to issue any guidance to health and social care trusts on the provision of abortion services, including when and in what circumstances medical staff may exercise their freedom of conscience when delivering a service. These are basic asks, and ultimately the Executive must abide by their responsibilities around abortion services, especially since they are now enshrined in law.

When it comes to service delivery, the five health and social care trusts across Northern Ireland simply do not have the resources to uphold their responsibilities. Earlier this year, the health and social care trusts collectively applied for additional funding to meet the new legislative requirements for abortion services, but frustratingly, the Health and Social Care Board did not consider that. Across the trusts, abortions were offered within existing services and only where resources allowed. Staff were transferred from other sexual and reproductive services that were on hold as a consequence of coronavirus. A simple glance at the reality of the situation suggests that that short-term plan is completely inadequate.

Colleagues will be aware of the timeline that various health and social care trusts across Northern Ireland have followed over the last year or so. In October 2020, the Northern Health and Social Care Trust was forced to transfer staff back to other sexual and reproductive healthcare services, meaning that it ceased to take any new referrals for abortion services. At that time, the remaining four trusts were unable to provide abortions for between 10 to 12 weeks, because of the lack of resources.

Just months after the regulations legalising abortion came into effect, barriers were clearly already in place for those requiring support, and that is simply not good enough. It is utterly frustrating that legal action from the Northern Ireland Human Rights Commission was required before any proper action was taken to fix the problem, which persists today.

Colleagues will be aware that in November 2020, the Northern Ireland Human Rights Commission initiated legal action against the Secretary of State, the Northern Ireland Executive and the Department of Health for Northern Ireland for failure to commission and fund abortion services in Northern Ireland. The judgment in that case was finally reached in October this year and, as we all know, the Secretary of State for Northern Ireland, the right hon. Member for Great Yarmouth (Brandon Lewis) was found by the High Court to have failed to uphold his duties to provide full abortion services in Northern Ireland.

Although it is not ordinarily the Opposition’s role to defend the Government—I hope Members will understand that this is a particularly rare exception for me—the failures of Northern Ireland’s Department of Health must be included in the dialogue. We all know that without funding public, services will undoubtedly suffer. That is a fairly basic linear pattern. Without funding or a commissioned framework, health trusts across Northern Ireland simply cannot provide these much-needed services.

In October, the High Court made its will clear—enough is enough. The Secretary of State must work with the Department of Health in Northern Ireland to push it to act. He must act swiftly if he is to comply with the law and stop those who oppose it from denying people access to the abortion process through bureaucratic channels. I am pleased to see that after the legal proceedings were launched, the Secretary of State formally directed Stormont to commission abortion services before the end of March 2022, but the Northern Ireland Human Rights Commission says that the situation has not yet improved. That absolutely must change.

The reality that is often lost in the conversation is that the decision to have an abortion is an emotive one. It is rarely an easy one. The pandemic has undoubtedly had an impact on both the commissioning and the delivery of abortion services in Northern Ireland, and that is understandable to a certain extent. What is not understandable is the cruel effect that delaying the availability of these services is having every day on women and girls in Northern Ireland. Many will have been forced to travel to unfamiliar cities, and at the height of the pandemic they would have had to do so alone, without a consoling hand or a smile to support them during this very difficult time. That is the case thanks to sheer political failure.

My final point, which I am sure other Members will refer to in their remarks, relates to abortion exclusion zones. Freedom of speech and the right to protest is a very important human right, and I know from having spoken on this topic before that there are many Members in this place today who will disagree with my position on abortion. When it comes to exclusion zones, however, I want to highlight the comments made by the Chief Commissioner to the Northern Ireland Human Rights Commission, Alyson Kilpatrick, who said last week that a law to introduce safe access zones outside abortion clinics would not stop pro-life campaigners taking part in public protest.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Lady on securing this timely debate. Does she agree that those who advocate a pro-abortion stance in this debate—which is more appropriately and properly dealt with in the Northern Ireland Assembly —often fail to take account of the plight of the unborn child when they, quite regularly, elucidate and elaborate on the issues affecting women in positions that she has alluded to for the past 10 minutes? Does she understand that there are others involved, such as the unborn child?