Oral Hormone Pregnancy Tests

Guto Bebb Excerpts

Thursday 23rd October 2014 Commons Chamber

[Guto Bebb (Aberconwy) (Con)]

It is a privilege to follow the hon. Member for Bolton South East (Yasmin Qureshi). I pay tribute to her for her work on the all-party group on oral hormone pregnancy tests, and for securing this debate. I thank the Backbench Business Committee for making time to debate such an issue in the Chamber. Once again, the Committee has highlighted the House’s ability to work on a cross-party basis. I was particularly impressed by the fact that the hon. Lady’s speech was non-partisan in condemning all previous Governments, rather than just one Government; that has been much appreciated.

I have come to this debate late in the day, but after a constituent of mine informed me about the impact of the issue on her life and her family, I was lucky enough to be briefed by the campaign. The campaign should be congratulated on the work that it has done in talking to Back-Bench MPs to ensure that we are willing to speak on the issue.

It is important to point out that my constituent Mrs Margaret Roberts has provided a fantastic example of why lobbying your MP does make a difference. To be perfectly frank, if it had not been for her persistence and the fact that she came forward to explain the impact of what happened to her family, I might not have spoken in this debate. People complain that MPs are too easily lobbied, but I argue that when constituents lobby their MP, it is often an essential part of our democratic process. I am very pleased that Mrs Roberts made the effort to come to talk to me.

Having read Mrs Roberts’s testimony and listened to her talk about her experiences, it is difficult not to be moved. As a parent, I found it difficult not to be moved when I heard about the joy, grief and guilt she has felt because of the impact of the drug on her son Garry. It is worth touching on such issues because, ultimately, we need to try to shine a light on what actually happened. Nothing can change the impact of what has been done, but it is important to recognise that people want to understand exactly what happened.

In speaking to Mrs Roberts about her son Garry, it was very apparent that he brought immense joy to the family. Despite the fact that he had severe disabilities from birth, he battled on for 37 years. He was born in 1964, but passed away in 2001. What is remarkable in Mrs Roberts’s testimony is that somebody with such significant disabilities should live such a fulfilling life. Wherever he went, he clearly touched the lives of other people, not least those of his three siblings and his parents, and he had a significant impact on his carers, whether they were care in the community support staff or hospital staff. It was difficult to listen to all her testimony without feeling moved by the impact that somebody with such severe disabilities can have on others for the greater good.

What also came through was the grief of a family who expected their first-born to be healthy, but who knew within a few hours that something was wrong. I could not help but feel very affected by that. As a father who had twin boys born at 30 weeks, I know what it feels like to see one’s children taken away to be given special care. I am lucky that they came back and that they are healthy and fit.

It was hard to hear the testimony of somebody who knew that something was wrong for months and years. They have never been given a full explanation of what exactly did occur. The joy that Garry brought to their lives is clear from Mrs Roberts’s testimony, but so is the grief of knowing that they were the parents of somebody who suffered the constant visits to the hospital and the constant need to talk to the medical establishment. Throughout all that, no explanation was given of the cause of the significant health problems that he faced.

Finally, I want to touch on the issue of guilt. That is the reason why this debate is so important to people such as Mrs Roberts. She went on to have three healthy children, so she constantly asks herself whether her decision to take the tablets back in 1964 was the cause of the suffering of her son Garry. Does she need to blame herself or was it beyond her control? She needs an explanation of exactly what happened. That is why this debate is important.

We have an obligation to highlight the information that is available to Government, and to ensure that it has been looked at carefully and taken into account. We must also have the ability to look at that information afresh to see whether mistakes were made, where they were made, why they were made and how we can avoid them in future. That is the key point that comes across from the campaign group. Of course they want answers, but they want answers to ensure that such a situation does not happen in the future.

Having spoken about the issues that my constituent and her son have faced, I think it is important to associate myself with the cause made by the hon. Member for Bolton South East. We need to ask why the evidence that was collated was not acted on at an earlier date. We have heard testimony that the authorities in the United Kingdom were aware of the issues before the authorities in other countries, yet it appears that other countries acted to ban the substance before the United Kingdom. We need to know why that was.

Now that so much information has come to light from documents that have been released under the 30-year rule, why can we not instigate an inquiry with a panel of experts to evaluate what went wrong and how it can be rectified for the future? It would not have to be a far-reaching inquiry. Most important, an expert panel of the nature envisaged by the hon. Member for Bolton South East and the all-party parliamentary group would be able to tell people whether they were in any way responsible for what happened. I suspect the answer is that they were clearly not, but if that information was provided by reputable experts who had looked at the information afresh, it would give people like Mrs Roberts a degree of closure. People who are suffering the effects of what they believe to have been the ill-advised use of the hormones would also be able to understand what happened and why they have suffered.

I call on the Government to make good the mistakes of previous Administrations by taking seriously and giving due consideration to the simple request that an expert panel be put together. I am hopeful that the Minister will say that the Government will, in the interests of transparency and honesty, appoint such a committee.

Tobacco Packaging

Guto Bebb Excerpts

Thursday 7th November 2013 Commons Chamber

[Guto Bebb (Aberconwy) (Con)]

It is a pleasure to follow the hon. Member for Worsley and Eccles South (Barbara Keeley). I congratulate my hon. Friend the Member for Harrow East (Bob Blackman) on securing the debate and the other Members who went to the Backbench Business Committee to ensure that it took place. However, my comments will not be particularly supportive of my hon. Friend’s views on the issue. I look at the matter from the perspective of a member of the Public Accounts Committee, which recently produced a significant report on the impact of tobacco smuggling on the loss of tax revenue in the UK. Having seen the evidence, I came to the strong conclusion that the case for plain packaging is certainly unproven.

The hon. Member for Worsley and Eccles South said that she wanted to ensure that 1,000 children in her constituency do not take up smoking. I wonder what the evidence is to suggest that those 1,000 children will not take up smoking simply because of a change in the product’s packaging. The right hon. Member for Rother Valley (Mr Barron) explained that he started smoking by stealing cigarettes from his father. I wonder whether his father’s choice of brand had any significant impact on his decision to steal a single cigarette. When I was growing up in Caernarfon, when people wanted to smoke they went to a local post office to buy singles. I suspect that they gave no consideration whatsoever to the brand; the point was that they could buy cigarettes very cheaply, usually one at a time. It was an important development when that was made an illegal practice that would not be tolerated. However, it is still the case that the driver is the price, not the branding. That is what I want to talk about.

When the Public Accounts Committee researched the smuggling of tobacco products into the UK, some of the information that emerged from that work was shocking. For example, in the top 10 recognised consumer brands of cigarettes in this country there are often two or three that are illicit and that it is illegal to supply in this country—for example Jin Ling, Richman and Raquel. Strictly speaking, those brands should not be available and so they would not be affected by legislation on plain packaging, yet independent consumer surveys show that those brands, despite being illicit and illegal, are recognised by the public.

The question we must ask, therefore, is why and how those brands are gaining a foothold in this country. Clearly it is unacceptable that they are smuggled into the country, and at such a rate that they are now recognised consumer brands. The key point we must recognise is that the driver for the sale of those products is not the branding or the so-called attractive packaging; it is the price. A packet of 20 cigarettes costs between £7.50 and £8. My son, who is lucky enough to have a paper round, would have to spend half his weekly wage if he decided to buy a packet of cigarettes legally, yet he could go out to any estate or high street in my constituency and, if he was switched on, find a packet of illicit tobacco for between £2 and £2.50.

I therefore argue that the driver encouraging young people to start smoking is more likely to be the price than the branding. If a young person can buy a packet of 20 cigarettes for 15% or 20% of their weekly paper round wage, they would be more tempted to do so than if they could buy it for 50% of their wage. By concentrating on plain packaging, we are ignoring an important fact: price is a driver for the sale of these products.

Time and again hon. Members have argued that plain packaging is about protecting young people, yet in university towns the young people often smoke roll-your-owns. The figure for roll-your-own tobacco is absolutely atrocious. In my constituency, which has no higher education facility, 48% of loose-leaf tobacco will be smuggled and illicit. The vast majority will not be recognised UK brands. In any town with a university or further education college, the percentage of illegal and smuggled loose-leaf tobacco will be even higher. What is the driver? What is persuading young people to buy tobacco products that are not officially marketed in the United Kingdom? The answer, I argue, is price.

[Barbara Keeley]

The hon. Gentleman seems to be arguing that people who are already addicted, such as older students, will smoke anything, but that is not surprising. We have repeatedly argued that young people get addicted in their early teens, and his arguments do not negate that.

[Guto Bebb]

The hon. Lady completely misrepresents my view. I said clearly at the outset that the temptation for young people is much enhanced if the product is affordable, and I think she fully understood my point.

It is important to recognise the problem of illicit and smuggled products because evidence—yes, to be tested and argued about—has been presented to suggest that plain packaging will actually make it easier for these products to be made available. I am fully aware that there are arguments on both sides. However, what is being said in this debate is, in effect, that the Government’s decision to wait to look at the evidence from Australia somehow indicates that they are in league with the tobacco companies. I find that quite distasteful.

I genuinely approach this debate from the point of view that I would like the number of people who smoke to be reduced—to nothing, I hope. I have never smoked, and if any of my children smoked I would be absolutely furious. Indeed, I lost my father to lung cancer at the young age of 63. My children never saw their grandfather simply because of his smoking. If the evidence was clear that plain packaging would be the answer, I would be supportive. I find it very odd that Members are saying that looking at the evidence is somehow condemning people to die. That is emotional and unacceptable language.

When Populus recently surveyed a number of police officers about whether they thought that plain packaging would be helpful, 86% of them clearly stated that they thought it would make it easier for illicit tobacco products to be supplied and that those products would be targeted at young people who could afford them. Sixty-eight per cent. of the police officers thought that plain packaging would lead to an increase in the size of the black economy in relation to tobacco products. A full 62% thought that an increase in cheap tobacco products would result in an increase in the use of tobacco products by children. Those are very interesting and important findings from a poll of police officers. Are their views correct? We need to look at the evidence and consider very carefully whether it supports them.

[Mr Barron]

The latest figures from HMRC, at a mid-point estimate, show that the market share of illicit cigarettes has fallen from 15% in 2006-07 to 9% in 2010-11. There is no evidence that this is not going the right way; it is enforcement that we lack.

[Guto Bebb]

The right hon. Gentleman should perhaps read the report by the Public Accounts Committee, which presented evidence that there has been an uplift since 2010-11. I thought that the whole point of this Chamber was to debate on the basis of the facts, and that we liked evidence to be up to date. If he wants to quote evidence from 2010-11, that is absolutely fine, but I refer him to the PAC report, which has updated figures. It is interesting that he would probably be very supportive of today’s PAC report on universal credit, but when the facts do not suit him he seems to ignore them.

The key thing we need to remember is that time and again this place has legislated in haste. There is a significant question mark over both sides of the debate. What the Government have said is very simple: let us see the evidence and consider it. If the evidence from Australia and other countries that decide to go down this route proves that there has been a reduction in the use of tobacco products, a reduction in illicit tobacco being taken into the country, a fall in the availability of illicit products, and a fall in the number of smuggled products, it would be worth taking the issue extremely seriously and moving to legislate. However, the argument advanced by some hon. Members is about their prejudice rather than the facts. We should congratulate the Government on being willing to wait and legislate correctly rather than acting in haste and possibly contributing to and supporting the behaviour of people who are making tobacco products available to young people not at £7.50 or £8 but at £2.50 or less.

We should consider very carefully what is tempting young people to take up smoking. I am very clearly of the view that the temptation is not necessarily branding but more likely to be price. Labour Members might like to have a good feeling about doing something in this place to help young people, but they should do it on the basis of facts, not their ill-informed opinions.

Cancer Care (England and Wales)

Guto Bebb Excerpts

Tuesday 12th February 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

As ever, it is a pleasure to serve under your chairmanship, Mrs Riordan.

I congratulate my hon. Friend the Member for Vale of Glamorgan (Alun Cairns) on securing this debate. He makes the important point that it is not acceptable for cancer, of all the conditions that touch the lives of so many families, to be a party political issue. He is right, however, to bring to this place his concerns about the treatment of people in Wales who are suffering from cancer so that a comparison may be made with England and lessons might be learned by both countries. As he said, I am unable to respond to the detail of his concerns because Health Ministers in England are not accountable for health services in Wales, which are matters for the Welsh Assembly. I am sure the Assembly will read the account of this debate in Hansard and make particular note of some of my remarks on what seems to have been put about in the Principality.

[Guto Bebb (Aberconwy) (Con)]

In my constituency of Aberconwy in north Wales, and also in other parts of Wales, we are dependent on the health service in England to provide specialist services unavailable in Wales. We have been told time and again that patients from Wales often have to wait longer for treatment in hospitals in England. As a Health Minister in England, will my hon. Friend provide any guidance to Welsh Members on whether that is true?

[Anna Soubry]

As ever, my hon. Friend asks a particularly pertinent question, and, to be frank, I cannot immediately give him the answer. I can and will ensure that he receives a full response in a letter. He may also talk to any of my officials at the conclusion of this debate.

In England, the Government have committed to improve survival rates, reduce mortality rates and put patients at the heart of the service. In January 2011, we published a four-year cancer outcomes strategy that set out a range of actions for improving early diagnosis, screening, access to treatment and drugs and providing support to people living with and beyond cancer. That strategy is backed by more than £750 million for implementation, including more than £450 million for early diagnosis.

To improve early diagnosis, we must encourage people to recognise the symptoms and signs of cancer and to seek advice from their GP as soon as possible. Of course, we also need GPs to recognise cancer symptoms and, if appropriate, refer people urgently for specialist care.

Since 2010-11, the Department has been funding and delivering local, regional and national “Be Clear on Cancer” campaigns to raise awareness of cancer symptoms. We are currently running a regional pilot campaign for kidney and bladder cancers that is rather charmingly know as “blood in pee”; a regional breast cancer campaign aimed at women over 70; and a local pilot campaign for ovarian cancer.

I had the great pleasure of attending the all-party group on ovarian cancer, chaired with great ability, compassion and campaigning skill on behalf of ovarian cancer sufferers and their families by the hon. Member for Washington and Sunderland West (Mrs Hodgson). That is an example of a cross-party initiative on cancer, which is as it should be.

As part of the pilots and schemes to raise awareness, there is a more general campaign on cancer symptoms called “Know 4 Sure”, which lists four key symptoms: unexplained blood not from an obvious injury; an unexplained lump; unexplained weight loss; and unexplained pain that does not go away. If someone has one or more of those symptoms, the message is clear: “Go and see your GP.” There is information on GP attendance, and urgent referrals for suspected cancer and diagnostic tests will be analysed to assess the impact of the campaigns. We will study the campaigns to see how effective they have been. If we need to roll them out across England, we will do so. I hope the Welsh Assembly will look at the success or otherwise of those campaigns and learn accordingly.

Support for GPs is important, and a range of support is available to help them assess when it is appropriate to refer patients for suspected cancer, but we know we can do more. As part of the preparation for all the campaigns, we commissioned Cancer Research UK to produce briefing materials for GPs within the relevant networks. We are promoting GP direct access to four key diagnostic tests to support early diagnosis of bowel, brain, lung and ovarian cancers. We have provided GPs with best practice guidance on using those tests, and we are publishing data on their usage. We are also working on providing electronic and desk-based cancer decision support tools to help GPs assess and identify patients with possible cancer more effectively.

We know how valuable screening is, and we are working to deliver age extensions for bowel and breast screening programmes. We will continue to support the roll-out of evidence-based screening programmes. For example, we are introducing bowel scope screening to the existing national bowel screening programme. We are aiming for 60% roll-out by March 2015. Experts estimate that the bowel scope programme will prevent some 3,000 cancers every year and save thousands of lives.

The hon. Member for Nottingham South (Lilian Greenwood), who is no longer in her place, rightly mentioned some of the difficulties we face with some men, notably in the black community, who are more at risk of prostate cancer. I will provide her with details on the Department’s various initiatives to ensure that we pay particular attention to those parts of our community that need such information to ensure they go along to have the screening and to see their GP if they have any concern about that aspect of their health.

As my hon. Friend the Member for Vale of Glamorgan explained, once cancer is diagnosed it is important for patients to have access to appropriate treatment delivered to a high standard.

The latest cancer waiting times show that 95.4% of patients in England—or 291,974 patients out of 306,011—were seen by a specialist within two weeks of an urgent GP referral for suspected cancer. We set high levels of expected performance, which in that case is 93%, so I am pleased that we have exceeded our own high standards. Some 87.3% of people treated began their first definitive treatment within 62 days of being urgently referred for suspected cancer by their GP, and 98.4% of people treated began first definitive treatment within one month of receiving their cancer diagnosis. We should celebrate those figures, but, of course, we can always do better.

We are expanding radiotherapy capacity by investing more than £173 million over four years and ensuring that all high-priority patients with a need for proton beam therapy get access to it abroad. That includes £23 million for the radiotherapy innovation fund, which is designed to ensure that, from April 2013, radiotherapy centres are ready to deliver advanced radiotherapy techniques to all patients who need it. From April, cancer treatments will be planned and paid for nationally by the NHS Commissioning Board, which means that, for the first time, cancer patients will be considered for the most appropriate radiotherapy treatment regardless of where they live.

My hon. Friend mentioned the cancer drugs fund. Between 1 October 2010 and December 2012, the fund stood at £650 million and helped more than 26,500 cancer patients in England to access the additional cancer drugs their clinicians recommended.

When I was first elected to this place, I received letters from constituents who were rightly upset and concerned that they spent so much of their own money to access certain drugs, and I do not think I have had one such letter or e-mail for at least 18 months. That is a mark of achievement.

To be absolutely clear about the funding of the cancer drugs fund, it is not true that any reduction has been made in any service. It is not true to suggest that money has been taken from the NHS budget. If anybody says such a thing, I am afraid they are either deliberately not telling the truth or just plain ignorant. I am happy to explain how the coalition Government have funded the cancer drugs fund in England. Raising the threshold for national insurance effectively saved the NHS £200 million. That £200 million was not secreted away or given to the Treasury or anybody else; it was the start and has been the continuation of the cancer drugs fund. I hope that that is clear. I know that it will be recorded in Hansard, and no doubt my hon. Friend and others will be able to publicise it widely in Wales and set the record absolutely straight.

In the last minutes available to me, I will explain cancer networks. The NHS Commissioning Board has set out its plans to establish a small number of national networks from 1 April to improve health services for specific patient groups or conditions such as cancer and cardiovascular disease. The cancer networks have existed for some time, and they have worked extremely effectively. It seems a bit odd, but those involved in the delivery of care and treatment for people suffering from cancer, for example, were not always the best at communicating among themselves, so the networks were set up, with great success. We are building on that success.

We have increased the amount of money going into the new strategic clinical networks, and we are confident that they will continue to work closely with providers and commissioners in the new health system and to play an important role in improving cancer care. I understand that transition arrangements, which concerned a number of people, are now well developed, and good progress is being made, with appointments in key positions in the clinical networks.

We are committed, however, to improving the experience of cancer patients. It is not all about early diagnosis, screening and treatment; it is also about cancer patients’ experience. The 2011-12 national cancer patient experience survey found that 88% of cancer patients in England rated their care as excellent or very good; of course, we aim to increase that figure. The results are helping trusts to identify areas in cancer care that need improvement locally and to raise standards across the service.

A 2012-13 survey will commence later this month. I am not sure how a 2012 survey can begin later this month; it looks like a bit of a typing error. That will get me into trouble with my officials. Such a survey is about to commence. It is an important piece of work, because it will enable us to identify and build on progress already made. From April, responsibility for such surveys will move to the NHS Commissioning Board, but hon. Members can be assured that this Minister will keep a close eye on it. The clinical commissioning group outcomes indicator set is the responsibility of the NHS Commissioning Board, but again, it drives improvements across the piste, as we say.

I add my profound support for Maggie’s cancer caring centres, whose praises the right hon. Member for Oxford East (Mr Smith) rightly sang. I visited the one in Nottingham the other week and saw there the excellent support that it gives, not just to cancer patients but to their families. Even if there has been a bereavement, the care and loving support continues. It is a remarkable organisation, and I hope that it will grow and become available to even more people.

In partnership with Macmillan Cancer Support, we are working on the national cancer survivorship initiative to implement improved care and support for cancer survivors. We want health services that are responsive to individual needs and that ensure access to specialist care when needed. We will shortly publish a document setting out the evidence base for future services to support people living with and beyond cancer in England. I hope that the Welsh Assembly Government will look to the experience in England and learn from it; I am sure that there are elements that we can learn from them as well. It is to be hoped that the outcomes in Wales will meet the success of the outcomes in England.

Question put and agreed to.

Regional Pay (NHS)

Guto Bebb Excerpts

Wednesday 7th November 2012 Commons Chamber

[Guto Bebb (Aberconwy) (Con)]

It is a pleasure to follow the hon. Member for Hartlepool (Mr Wright), although I am concerned about his claim that regional pay is being introduced by the back door. The Government have made no change to the legislation, so I suspect that the change taking place is a result of policies and Bills passed by the previous Administration.

I speak in this debate as a Welsh MP—perhaps my red plaster cast gives that away, although I stress that I have it because the plaster technician at my local hospital wanted to give a Conservative MP a red cast in which to go to the House of Commons and make an impression.

I must take issue with the right hon. Member for Leigh (Andy Burnham), who stated that he was responsible for the national health service in England. I accept that devolution has changed and complicated the situation, but when my constituents in north Wales think of the national health service, they do not think about what happens in Wales and what happens in England, because that is not how it works. The health service in north Wales is regularly dependent on specialist services offered in north-west England, and when we think of the health service, we think of it as one body.

There is no doubt, however, that the differences between what is happening in England and in Wales should be taken into account. It is all well and good to carp that figures suggest that spending on the health service in England is more or less flat in real terms—that was the claim made by the right hon. Member for Leigh—but that should be contrasted with actual and significant cash cuts to the health service in Wales that are being implemented by the Labour Administration as a choice. Those cash cuts would have been implemented in England too if the right hon. Gentleman and his party had won the last election.

When trying to ensure best value for money within the NHS, it is crucial to take into account that the health service in England is facing real challenges while maintaining a position that takes inflation into account. In Wales, however, the hospital staff who serve me, my family and my constituents are facing significant cuts as a result of decisions by the Welsh Assembly Government. That is the context and it is important to make that point.

The hon. Member for South Down (Ms Ritchie) made the important point that public sector workers have recently been facing difficult situations due to a pay freeze and increases in pension contributions. Those two provisions, however, were implemented in an equitable manner throughout the United Kingdom. People may disagree with the changes to pension contributions in the public sector, but there is no doubt that workers in Wales, Northern Ireland and south-east England have been treated in the same way. People might complain about the freezing of public sector pay, but that too has been done in an equitable manner throughout the United Kingdom.

There is real concern in constituencies such as mine that a change to regional pay—which is not being implemented by the coalition Government, merely consulted on—would be inequitable. Somebody in my constituency would be paid at a different rate from someone doing exactly the same job 40 miles down the road in Chester, for example. That is the difference between the pay freezes in the public sector and the pensions changes—those were difficult choices but were implemented in an equitable manner throughout the United Kingdom—and moving forward with regional pay, which would be damaging.

[Jim Shannon (Strangford) (DUP)]

I appreciate this opportunity to make a quick intervention. As the hon. Gentleman rightly said, the four regions of the United Kingdom have parity and equity. Will he explain what will happen when it comes to retrospective payments? In Northern Ireland, a number of retrospective payments have had to be made. Are the same retrospective payments applicable in Wales as in Northern Ireland, for those who have been upgraded and should therefore get more money?

[Guto Bebb]

I am not sure whether I am qualified to answer that question in detail, but perhaps the Minister will respond from the Dispatch Box in due course.

The changes in the south-west are taking place under current legislation and without any changes to the law, and we must be careful. We are proud to have a national health service and national public services that we take seriously. Although sacrifices are asked of people in the public sector, it is important that they are requested on the basis of equality throughout the United Kingdom. Ultimately, I am concerned that we are discussing a Labour motion that contradicts a lot of what has happened over the past few years.

I recently took part in a television debate on regional pay in Wales with a Labour Member who said that the changes to HM Courts Service pay rates were not about regional pay but about zonal pay. As it happens, zonal pay in Wales is lower than in other parts of the United Kingdom. I am sure that workers in Wales were cheered that they were subject not to regional pay in that context, but zonal pay, which made it all right.

There is a degree of opportunism from the Opposition Benches in initiating this debate at this time, and there is no recognition that many of the issues that have given rise to concern are a direct result of policy changes that the Labour party implemented when in power. I accept, however, the need to ensure we get the best possible value for money for the taxpayer from public services, and it is important to look at the degree to which we can be flexible in the way we deliver public services, whether in England or Wales. My view is that a person should not be discriminated against in pay if they are doing a similar job in the same manner as someone within 40 miles of them. The Government should take that extremely seriously.

The economic argument for regional pay is difficult to make by a party that claims to believe in the Union. One advantage that a rural, low-pay area such as mine derives from the relationship with the UK is the transfer of money from richer to poorer parts of the country. We could argue for a stronger regional policy and that we need to do more in that respect, but it would be difficult for me, as someone who believes that the Union brings a great deal of benefit, to argue that workers in my part of the world should be given a different degree of support from the state from workers doing exactly the same job in other parts of the country.

I find it difficult to disagree significantly with the motion, but I welcome the Government amendment. The one thing we can say about the coalition Government is that they are willing to throw difficult, controversial matters out into the open—that often creates problems for MPs because we need to sell those policies on the doorstep. I feel comfortable with the amendment. Ultimately, when Members are elected, they have a responsibility to look into issues carefully, to read around them and take on board the evidence. The amendment states:

“there will be no change unless there is strong evidence and a rational case for proceeding”.

I can live with that—it is great deal better than the Labour motion. Labour Members are basically hiding behind a discussion in the coalition. The fact is that the changes are happening as a result of legislation they proposed and voted for, and now regret.

NHS Annual Report and Care Objectives

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Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

I do not construe what we are doing as Ministers stepping back from the consequences of our decisions. The Secretary of State will continue to be responsible for the comprehensive health service, and I fully expect, in the same way as I am making a statement today on the first annual report, that I and my successors will make statements in years to come on annual reports and be held to account for the performance of the service.

The point is that delivering the best possible care is not achieved by Ministers interfering on a day-to-day basis in how the NHS goes about its task. We have been very clear, through today’s mandate, about what we are looking for the NHS to achieve: consistently improving outcomes. We are not trying to tell the NHS to do so.

Any particular service change, such as the one the hon. Gentleman describes, has to meet four tests: being of clear clinical benefit; responding to the needs and wishes of local service commissioners; responding to strong patient and public engagement; and maintaining and protecting patient choice. If there are any questions and objections, stating that such a service change does not achieve those aims, his local authority has the right under legislation to refer the matter to the Secretary of State for its reconsideration, so I am not taking the Secretary of State out of the process completely.

The safe and sustainable review was set up independently by his right hon. Friend the Member for Leigh, and it has been conducted completely independently, but, in the same way as I have just described, if local authorities have grounds for objections, they have also a mechanism, if they wish to use it, for referral.

[Guto Bebb (Aberconwy) (Con)]

I applaud my right hon. Friend for his statement today and the publication of the annual report, from which I note that 12,500 patients in England have been able to access specialist cancer treatment as a result of the cancer drugs fund. The corresponding figure in Wales is zero, because the Labour Government in Cardiff refuse to put in place a similar scheme in Wales. Does my right hon. Friend agree that cancer patients in Wales deserve access to the same treatment as cancer patients in England?

[Mr Lansley]

Yes, I could not agree more. It was precisely because Professor Sir Mike Richards undertook an inquiry and produced a report identifying a lack of access in this country to new cancer medicines in the first year after their introduction that we instituted the cancer drugs fund. It is a matter of considerable regret to many of us that that example was not followed in a similar way in Wales.

Organ Donation

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Wednesday 30th November 2011 Westminster Hall

[Guto Bebb (Aberconwy) (Con)]

I congratulate my hon. Friend the Member for Montgomeryshire (Glyn Davies) on securing this debate. On whether this is an issue to be debated in Westminster or in the Welsh Assembly, is the hon. Member for Newport West (Paul Flynn) implying that no contribution to the debate can be made in a Westminster context? There is a real question mark as to whether the Assembly has the legislative competence to deal with the issue.

[Paul Flynn]

I served in Parliament before there was a Welsh Assembly, unlike the two hon. Gentlemen. Since it has come into being I have absolutely never, at any time, become involved with, made speeches on, or interfered in those responsibilities of education and health in Wales, which are the responsibility of the Welsh Assembly. We have to accept that and realise that there are Welsh Assembly responsibilities and other responsibilities here. I do not want to labour that point, however, because there is a more important point to be made—

[Guto Bebb]

Will the hon. Gentleman give way?

[Paul Flynn]

No, I will not. I have been asked to be brief. We must get away from what we are hearing from prattling prelates and procrastinating politicians and look at the real issue. We cannot talk about a system that is working well, as was suggested this morning, when 1,000 families were bereaved last year in the UK and 50 families were bereaved in Wales. I will not talk about one family in my constituency where a young woman died waiting for an organ transplant because it is too heartbreaking a story, but I want to say something about the reality. Despite all the fine theories and words ahead, what is happening to real people in our constituencies?

Some of us listened to the testimony of Matthew Lomas and his mother when they came to Parliament a month ago. It was a dreadful story of suffering that moved us all. Matthew and his brother were born with congenital heart defects and they both had pacemakers. Matthew was suddenly getting a great deal of pain and discomfort and was taken to the hospital, where the diagnosis was a sombre one. His heart was growing and he would eventually die. He was told that on a scale of one to 10 his chance of surviving was at 9.9, and the family prepared for Matthew’s death. They were told that a heart transplant was a possibility, so they arranged for him to go to Birmingham’s Queen Elizabeth hospital, where he had a series of assessments. When the doctor told them that he would have to have a transplant, his mother said:

“Matt and I stared at each other it was so surreal. Had we both heard the same thing? We didn’t talk. Matt may have wept, I can’t be sure. I felt numb and could only think about my son who I had just been told was dying.

The sister came back in. ‘Had you been expecting to hear that?’ she asked gently. ‘No!’ we said together. It was the first thing we had said since hearing the awful news. ‘I thought Matt would need a new pacemaker.’ I said.”

She told the story—which some hon. Members will have heard—of the dreadful things that happened from then on. There were false alarms; a call from Birmingham came at 2 o’clock in the morning. They prepared themselves and started to drive up the motorway, only to be told when they were halfway there that the heart was not suitable. There were many other false alarms along the way. Eventually the transplant did occur—I find it difficult to read the whole story so I will cut it short. The family went through agony as the young man approached death. He was fitted with a device that would keep him alive for 28 days, but death was a certainty at the end. By good fortune—not from the wisdom of politicians or prelates—he survived. He is at home now and has a life expectancy of five years.

Another constituent of mine, a young woman the same age as Matt, died last year because there was no heart available. I believe we must say—because the overwhelming evidence is there in spite of what the hon. Member for Montgomeryshire (Glyn Davies) said this morning—that the weight of the medical evidence shows the best way forward, and that is the decision that the Welsh Assembly is about to take. For goodness sake, instead of going along as we are—particularly today—serving the few rather than the many and talking about our various political differences, let us realise that this is an area in which we politicians can save lives and lift the burden of anxiety from families waiting for organs. We know that all of the evidence—the fair evidence, not the procrastinating evidence we have heard this morning—shows that there will be more organs available. For goodness sake, let us allow the Welsh Assembly a free run to get on with it and lead the country as it has in the past with other reforms. We hope that England and the rest of the United Kingdom will follow suit when the reforms produced by the Welsh Assembly are proved to be a great success.

[Mr Mark Williams (Ceredigion) (LD)]

Thank you, Mr Crausby. It is a pleasure to serve under your chairmanship this morning and I will be as brief as I can. I must congratulate my hon. Friend the Member for Montgomeryshire (Mr Davies) on securing this debate. I know that he has taken a keen interest in this matter over many years and he spoke with customary conviction while presenting his case. I do not agree with his case, but nonetheless I respect his conviction.

[Guto Bebb]

Does my hon. Friend agree that there is a way in which we can present this argument that has been made by my hon. Friend the Member for Montgomeryshire, and to the contrary by the hon. Member for Newport West (Paul Flynn)?

[Mr Williams]

The hon. Member for Newport West (Paul Flynn) also spoke with characteristic passion, and he spoke with passion about constituents, which is an important point to make. Another important point to acknowledge is that this is not a partisan issue. I happen to support the stance taken by the Welsh Assembly Government. It is not a Government that my party is part of, but I support the initiative of both Health Ministers in the Assembly, who happen to be Labour Members.

I will briefly explore the Assembly Government case and endorse the work of the British Medical Association. I will also highlight the work of the Kidney Wales Foundation, the British Heart Foundation, Diabetes UK Wales, the British Lung Foundation and the Kidney Welsh Patients Association.

HIV

Guto Bebb Excerpts

Tuesday 29th November 2011 Westminster Hall

[Pamela Nash]

I completely agree with the Secretary of State’s remarks. I raised the issue during Deputy Prime Minister’s questions last week. I hope that the coalition will take that aim on board and that it will be raised by the Prime Minister. The all-party group on HIV and AIDS is a member of the “Halve It” coalition that campaigns for levels of late-diagnosed and undiagnosed HIV to be halved in five years through more testing. That will help to stop the spread of HIV, improve health outcomes for those living with the virus, and in the long term save the Government money.

Patients and doctors have a large role to play. A study of people of sub-Saharan African origin in the UK who were diagnosed late with HIV found that three quarters had visited a doctor in the year preceding their diagnosis. Doctors and patients must be more aware of the primary infection symptoms of HIV. Incentivising HIV testing, particularly in areas with a high prevalence of HIV, is vital to ensure that people are diagnosed in time. One powerful incentive would be to ensure the inclusion of the late HIV diagnosis indicator in the Government’s revised public health outcomes framework. We have heard several times that a decision on that will be made later in the year. Will the Minister assure hon. Members that that indicator will be included, or at least say when the Department will reach a final decision?

As I understand it, the Department is investigating the possibility of legalising home-testing kits. I look forward to the outcome of that investigation. It is clear from the House of Lords report that home-testing kits ordered from overseas, usually over the internet, are already in use in the UK. If legalised, that practice could be regulated and allow people to test themselves securely and safely in their own home, again producing savings for public health and the public purse.

How else can we prevent the transmission of the HIV virus? The House of Lords report stated:

“More resources must be provided at national and local levels… The current levels of investment in national HIV prevention programmes are insufficient to provide the level of intervention required.”

Hon. Members may be surprised to learn that the Department of Health currently spends just £2.9 million a year on two national HIV prevention programmes for gay men and black Africans. That compares with an enormous £762 million spent on treatment. Preventing one infection avoids lifetime treatment costs for HIV of between £280,000 and £360,000, but as local service cuts kick in throughout the country, HIV prevention programmes are being reduced.

Under the new NHS structure, local HIV prevention work, campaigns and testing will be commissioned by local authorities, leading—we hope—to additional national campaigns, but I am concerned about the possible fragmentation and subsequent prioritisation of prevention work between HIV treatment that is commissioned nationally by the commissioning board, prevention and testing work commissioned by local authorities, and national campaigns overseen by Public Health England. Within local authorities, HIV prevention work is likely to face strong competition for funding within constrained budgets. A fragmented health care system will not deliver the results that we desperately need, or enable us to make headway against the rising tide of new HIV infections. We do not want a postcode lottery, or for sexual health services to be sidelined because of local sensitivities.

[Guto Bebb (Aberconwy) (Con)]

I congratulate the hon. Lady on securing the debate. In my north Wales constituency there is an HIV respite centre, which is extremely well supported by the local community. The problem that the centre has is that many of the people who take advantage of the respite care are coming in from north-west England and are therefore not funded by the local health authority in Wales—health is devolved. A centre that is able to serve people from north-west England therefore finds it very difficult to secure funding, because it is based in Wales, but its patients are from England. Is that the type of postcode lottery problem that the all-party group could deal with?

[Pamela Nash]

We can certainly campaign on the matter. I will be happy to discuss that with the hon. Gentleman outside the Chamber. He makes a very important point: this issue is not just about the NHS and the Health and Social Care Bill in England, but about achieving agreements with the other Assemblies and Parliaments in the United Kingdom to ensure nationwide consistency in the treatment and support for people living with HIV.

I shall now discuss public awareness in the UK. Twenty-five years ago, Lord Fowler led huge public health campaigns about the virus. Leaflets were sent to every household in the country and there were very visible television campaigns. However, public awareness of HIV has undoubtedly fallen during the past 10 years. For my generation, it is just not a priority any more. Despite the very high increase in the number of young women contracting HIV, when I speak to my friends about this issue I find they rarely regard themselves as at risk.

Unbelievably, earlier this year, an Ipsos MORI poll found that one in five people do not realise that HIV is transmitted through sex without a condom between a man and a woman, and the same proportion do not know that HIV is passed on through sex without a condom between two men.

Future of the NHS

Guto Bebb Excerpts

Monday 9th May 2011 Commons Chamber

[Debbie Abrahams]

How will breaking up the NHS improve that? The hon. Gentleman should be concerned that some of the measures PCTs are having to take are increasing the risks of cardiovascular disease for many patients. As for international comparison of our NHS, it is known to be one of the most cost-efficient health systems in the world.

Bariatric surgery provides another example of where the National Institute for Health and Clinical Excellence guidelines have been replaced with more stringent criteria, rationing access to care in order to balance the books. There are many other examples. According to one survey published last week, demands for bariatric surgery have risen by 17%, but approval for such surgery has fallen by 22%. These are the so-called efficiency savings, as we heard from the Secretary of State, of £20 billion nationally and 4% each year.

[Guto Bebb (Aberconwy) (Con)]

We hear a lot about the effect of efficiency savings on the NHS in England. Under Labour party proposals, Wales is not suffering from efficiency savings, but from cuts of £435 million in the NHS budget this year and £1 billion in the next four years.

[Debbie Abrahams]

Does not the hon. Gentleman think that that is why we won the election in Wales?

The savings required are 4%, and if the Government get their way with the new economic regulator Monitor, they could go as high as 7% each year—far more than our NHS is capable of coping with.

My constituent, Peter, was refused a cataract operation, yet his vision was so poor that he was able to see the world only through a haze; as a precision engineer, furthermore, he was not able to do his job and faced the threat of redundancy. In other cases, non-compliance with NICE guidelines—on familial hypercholesterolaemia, for example—is leaving people at extreme risk of untreated cardiovascular disease.

Health professionals have almost without exception castigated the Bill for what it will do to the NHS in completely opening it up to the market, with competition law applying in full and allowing private health care providers to cherry-pick profitable services. A hospital medical director said last week that he did not know how his hospital could continue to provide care for unprofitable patients.

The unprofitable services for most hospitals are elderly care, mental health, paediatrics and maternity, which are essential services for all communities. Instead of service providers and commissioners working together to provide the best quality care they can for their patients, the trend is for hospital trusts to maximise income and compete against each other. We are already seeing that lack of co-operation when PCTs look at alternatives in commissioning. Trusts are reluctant to collaborate when they see that it might reduce their income, even if it improves the quality of patient care. Similarly, the Bill gives GPs a financial interest in restricting or refusing treatment in order to make savings and to get bonus payments from the NHS commissioning board.

Labour wants genuine savings that will enhance patient outcomes rather than produce the diminishing effect that we are currently seeing, and we believe that we can achieve that. We want hospital specialists and GPs to work together to deliver clinical care pathways that improve the quality of patient care and bring care closer to home. One local PCT is trying to introduce the use of drugs that are cheaper—and unlicensed—to treat age-related macular degeneration, but it is under severe pressure from the pharmaceutical industry. That is another way in which we could reduce costs.

There is no doubt in my mind that, unamended, the Bill threatens the founding principles and values of the NHS. It removes the duty to provide a comprehensive health service, and provides an opportunity for the new NHS commissioning board and GP consortia to charge for services. It involves a costly, ideologically driven reorganisation of the NHS that has no mandate from the British people, and no support from health professionals and that will mean the end of the NHS that we know and love. As I have said before, the NHS is not just an organisation that plans and provides our health care; it reflects the values of our society on which this country set such store.

I know that there are many members on this side of the House—