Oral Answers to Questions

Helen Goodman Excerpts

Tuesday 29th October 2019 Commons Chamber

[Ms Dorries]

Obviously I cannot comment on an individual case, but what I can say is that the NICE guidelines on assessment for suicide were recently sent out to A&E departments to ensure that people who present with mental health problems are treated holistically and looked at in the round to assess whether they are a suicide risk.

We are investing £2.3 billion in mental health services—more than invested by any previous Government—and a huge amount of that is going towards children and young people. I hope cases such as the one highlighted by the hon. Lady will be a thing of the past. We have turned a corner. We are rolling out these mental health teams and, in the last year alone, 3,000 more people are working with young people and young adults. We have the new training scheme and the school mental health support teams. There is more to be done, but I hope such stories will become a thing of the past.[Official Report, 5 November 2019, Vol. 667, c. 8MC.]

[Helen Goodman (Bishop Auckland) (Lab)]

9. What recent assessment he has made of the effect of prescription costs on the health outcomes of people with chronic illnesses.

[The Minister for Care (Caroline Dinenage)]

Extensive arrangements are in place to help people to afford national health service prescriptions. Those include a broad range of prescription charge exemptions, for which someone with a chronic illness may qualify.

[Helen Goodman]

I think the Minister is being too complacent. The chronic illnesses list has not been updated for years, and I have had complaints from Mr E with coeliac disease, Mrs L with multiple sclerosis and Mr A with cystic fibrosis—he is taking up to 50 tablets a day. With each item costing £9, can the Minister not see how much hardship this is putting on people?

[Caroline Dinenage]

There have been NHS prescription charges in England for decades, and successive Governments have concluded that patients who can afford it should pay prescription charges in order to contribute to the running of the NHS, but a huge number of exemptions are in place and mean that, in England, 89% of NHS prescription items dispensed in the community are currently provided free of charge. People on low incomes who do not qualify for an exemption will be eligible through the NHS low-income scheme.

The National Health Service

Helen Goodman Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Helen Goodman (Bishop Auckland) (Lab)]

It is a pleasure to follow the hon. Member for Harwich and North Essex (Sir Bernard Jenkin).

One of my constituents had a stoma operation in the summer, and he received a letter a fortnight ago from the private company that supplies his stoma bags. This letter said that, in the event of a no-deal Brexit, the company hoped to be able to continue the supply—not guaranteed but hoped. This is completely unacceptable. He had his operation under the NHS on medical advice, but the stoma bags are supplied by a private company. In other words, the aftercare is privatised.

Ministers must accept responsibility for these essential supplies. I do not know how many thousands of people would be affected if these companies were not able to supply the stoma bags, and I cannot imagine how awful it would be for them to sit with faeces oozing from their stomachs if Ministers cannot make sure this is properly sorted out.

The Government simply have to get a grip. They must stop the constant process of privatisation, undermining and attrition of the NHS. The last nine years have seen a constant stream of salami-slicing in my constituency. NHS managers struggle with inadequate resources, recruitment difficulties and inadequate funds. Staff are doing an excellent job, but they are under huge pressure at the moment.

To deal with this, managers constantly reorganise services in the hope of squeezing more money out of the system. None of the 20 refurbishments announced by the Secretary of State will benefit my constituents, not in Bishop and not when they go to Darlington or Durham. Darlington Memorial Hospital, in particular, needs proper attention. It is a collapsing building with huge problems, and it needs to be rebuilt.

In 2013 we lost the maternity ward from Bishop Hospital. In 2017 the CCG had to launch a fundraising campaign to raise money for an MRI scanner. The public responded very generously, but we cannot only have new kit if the public get the campaign funds together. That way, we will have much better healthcare in wealthy areas than in poor areas.

Last year, there was a proposal to close ward 6 at Bishop Auckland Hospital, which through energetic campaigning we have staved off. Now, the closure of Bishop’s stroke rehab wards is proposed. No doubt some of their work would be done in the community, but other patients would have to go to Durham hospital, which is already crowded. All the time, we see my constituents having to travel further—to Durham, to Darlington, sometimes to Stockton, with journeys taking an hour. This debate is not about buses, but the fact is that Ministers must get their heads around the reality of delivering healthcare in rural areas. The rhetoric simply does not match the reality. We have also lost one of the two wards at the Richardson Hospital in Barnard Castle, and I have not begun to talk about the problems of getting GP appointments and the terrible difficulties young people have getting the mental healthcare they need.

All this takes place against a background of deprivation and poverty. In one part of my constituency, male healthy life expectancy is 68; in another, it is 54, yet the Government are cutting Durham’s public health budget by £19 million. I was really disappointed—no, angered—when the Prime Minister, during his campaign to become Tory leader, said that he wanted to cut taxes for the top-earning 3 million people, putting £6,000 into the back pockets of people earning £80,000 while my constituents have to go to one of the seven food banks that have opened in recent years.

Health Infrastructure Plan

Helen Goodman Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

My right hon. Friend rightly campaigns vociferously for his constituents in Hemel Hempstead, and I know he has spoken to the Secretary of State about this issue on several occasions. No formal decision has been made on the detail. He will know that his hospital trust has a view. I hope he will continue to engage with the trust and with us Ministers, and that he will put the points that he just put to the House to us in a meeting.

[Helen Goodman (Bishop Auckland) (Lab)]

Around 15 years ago, when there was a Labour Government, we had a new hospital in Bishop Auckland. My constituents want to know why it is not used properly. In particular, will the Minister look at the latest proposal to close the stroke rehabilitation ward—ward 3—and reverse it?

[Edward Argar]

The hon. Lady highlights an issue of great importance to her constituents and her local hospital. As she will be aware, decisions on changes to services are made by local NHS trusts and clinicians, to reflect their assessment of the best way to deliver care and meet clinical need in a particular locality. If she wishes to write to me about the details of her local hospital and the issue she just highlighted, I would be happy to respond as swiftly as possible.

Oral Answers to Questions

Helen Goodman Excerpts

Tuesday 23rd July 2019 Commons Chamber

[The Minister for Care (Caroline Dinenage)]

I thank the hon. Gentleman for raising that, because one of the things that I have learned in this role is that working in care should never be described as unskilled. It is probably one of the most skilled professions, and it requires people with exactly the right principles and values to deliver it. We are clear that people should be paid a fair and decent wage, and I am more than happy to meet the hon. Gentleman to discuss it further.

[Helen Goodman (Bishop Auckland) (Lab)]

The Minister with responsibility for mental health is a very sympathetic person. Unfortunately, that does not seem to translate into action. Our clinical commissioning group has stopped funding the voluntary sector to provide counselling, and now it is taking counselling services out of GP surgeries as well. Will she look into that?

[Jackie Doyle-Price]

Yes. What the hon. Lady has just outlined to me flies in the face of the advice that I and the clinical directors of NHS England are giving CCGs. We are clear that voluntary sector provision of additional services is crucial in the support of people with mental ill health. Unfortunately, some commissioners seem to want to medicalise everything, but that is not the key to good treatments, and I will look into it.

Public Health: County Durham

Helen Goodman Excerpts

Wednesday 12th June 2019 Westminster Hall

[Mr Kevan Jones (North Durham) (Lab)]

I beg to move,

That this House has considered public health in County Durham.

It is a pleasure to serve under your chairmanship, Mr Owen. I am pleased to have secured this debate, but it is unfortunate that we have to have a debate on public health to highlight the effects that the Government’s cuts have on one of the poorest counties in our nation. I thank the men and women of the NHS, those who work in public health for the county council, and the voluntary and community sectors, which are part of the matrix of support for delivering in County Durham not only general healthcare, but, importantly public health.

In recent years, there has been debate about Government funding not just in health, but in local government and other areas. That debate starts from the premise that everywhere is the same, so a fair funding formula spreads the jam evenly around the country, but I am sorry—that is just not the case. Deprivation and need are factors that must be taken into consideration. In local government funding, fire service funding and police funding, need and poverty have been removed as determinants.

County Durham is a large rural county of 525,000 people. It faces some unique issues on health, partly because of the legacy of the county’s industrial past of coalmining and heavy industry, which means a high incidence of diseases associated with those industries, such as respiratory diseases, which put particular demands on the health service.

We also have a legacy of rapid deindustrialisation in the 1980s, when the hearts of many of the coalmining and steel communities across County Durham were ripped out by the policies of the Thatcher Government. That legacy remains in terms of hopelessness, drug and alcohol abuse, obesity and smoking, as well as the poverty that goes with all that. Previously, I have described County Durham as a rural county with urban problems, but those urban problems are sometimes ignored because of County Durham’s rurality.

We also have a growing elderly population. In the period to 2035, the number of people aged 65-plus will rise by 31%, and the number of people aged 85-plus will rise by 82%. That puts particular demand on the health service at all levels, in both the community and the acute sectors. Life expectancy in Durham is 78.3 years for men and 81.4 years for women. I will mention two other counties, and allude to the reasons for doing that later in my remarks: in Surrey, life expectancy is 81.5 years for men and 84.8 years for women, while in Hertfordshire, it is 81 years for men and 84.2 years for women.

The figures for healthy life expectancy, which indicates the age at which people develop serious health concerns, are even worse. In County Durham, they are 58.9 years for men and 58.7 years for women, whereas in Surrey, they are 68.3 years for men and 68.7 years for women, and in Hertfordshire, 64.9 years for men and 65.9 years for women. People in County Durham who get long-term health issues get them sooner than people in more affluent areas, which leads to demand on our health service. We are always told by the Government that we need to stop people using the health service to reduce the demand placed on it, but unless we tackle some of the underlying causes of the problem that pressure will continue.

Responsibility for public health funding was transferred from the Department of Health and Social Care to local government in 2013-14. I supported that move because public health is best delivered locally. The budget devolved to County Durham in 2013-14 was £40.5 million, based on the assessment of health needs by the primary care trust, which was abolished under the same legislation that introduced the transfer of responsibilities. To give credit to County Durham, it has used that money effectively, with services commissioned both directly by the county council and externally by private and third-sector organisations.

As with many things, however, devolution of responsibility for public health came with a sting in 2016, when the budget was reduced by 12.8%. That was part of George Osborne’s strategy, in a host of areas, to devolve money locally and tell the local authority to decide where the cuts would come. He could then stand back and say, “That decision has to be made locally.” But that misses the point. By sleight of hand, he sought to give the idea that somehow he had no responsibility for the cuts when he had top-sliced the budgets.

To be fair to County Durham, its public health priorities were the right ones to tackle. The funding was directed towards the control of tobacco and cessation of smoking, teenage pregnancies, obesity and weight reduction, mental health—an issue close to my heart—and improved dental services. I do not know whether the Minister is aware of this, but when I was first elected in 2001, certain areas of my constituency had no access to dental services at all. That has changed—not since 2010, I hasten to add, but certainly under the last Labour Government.

County Durham also targeted drug and alcohol addiction. I give it credit for the work that it has done on that. In the light of the recent confessions of the Conservative party leadership contenders, I think that they could take note of the available drug and alcohol services. However, unlike those middle-class people who have confessed to drug use, the young people we are talking about will not go on to glittering careers in the media or elsewhere. They will be pushed into a cycle of poverty and desperation at local level, and will add to our shared tax burden, because their demand on health, police and other services will increase. I always look at public health as an investment in our local communities to ensure not only that we have good public health outcomes, but that we reduce demand elsewhere in the system.

[Helen Goodman (Bishop Auckland) (Lab)]

Before my right hon. Friend moves on to the next section of his speech, I want to congratulate him on securing this important debate. What shocks me is the fact that in Woodhouse Close in my constituency, the healthy life expectancy is 10 years lower than that in Barnard Castle, yet those two places are only 10 miles apart. The notion of cutting public health funding seems grotesque.

[Mr Jones]

My hon. Friend is correct. She highlights that example in County Durham, but there are many more between the more affluent areas and the pockets of poverty. They have been there since the 1980s and they need to be addressed. I am passionate about this issue; the idea that where someone lives should determine how long they live, in a wealthy country such as ours, is wrong. We should be able to tackle that in this day and age.

The new funding formula, ironically called the fair funding formula—trades description comes to mind—is based on the premise, pushed mainly by a lot of Conservative Members, that somehow the needs of individuals in health and other areas are the same across the nation. That is just not the case. The methodology put forward by the Ministry of Housing, Communities and Local Government means that County Durham will lose 38% of its existing budget—that is £18 million a year. It is the worst loser in this process, because the dedicated, ring-fenced public health budget is being abolished. It is being pushed in terms of the business rate retention scheme, which concerns me because it means that there will be areas where councils—I will refer to two in a minute—that get a budget increase will have no duty at all to ring fence that money and put it into public health. That is a retrograde step.

County Durham has achieved a lot: smoking is 22% down and teenage pregnancy is down to a level that is no longer statistically different from national averages. That certainly was not the case when I was first elected in 2001. We have made great strides getting cardiac mortality down from 31 deaths per 100,000 in 2001 to 5.7 deaths per 100,000 by 2015. A lot of effort has gone into addressing suicide rates, particularly among men. That is a credit to multi-agency work, including the police, the voluntary community sector and others. We have a good-news story in the sense that we have a good partnership-working approach in County Durham, yet the Government want to take that budget away.

People ask, “Why can’t it be made up from elsewhere in the council budget?” This is a county council that has had its budget slashed by nearly £240 million since 2010. It is due to lose another chunk of funding under the so-called local government funding formula. The scandalous situation, and the reason I mentioned Surrey earlier, is that, while County Durham will have its budget cut by 38%, Surrey County Council’s budget will be increased by £14.4 million a year, and Hertfordshire’s by £12.6 million a year. It cannot be right—I will give some reasons in a minute—that money is being moved from deprived areas such as County Durham in the north-east to some of the most affluent areas in the United Kingdom. The life expectancy and other figures that I mentioned earlier are not comparable. That is not a fair way of distributing that money.

It is not just County Durham that is affected; the north-east loses some £40 million under the proposals, in some of the most deprived parts of this country. Gateshead, for example, loses 12.44% of its budget; Redcar and Cleveland loses more than 27%; South Tyneside, one of the most deprived parts of the region, loses 29%; and Sunderland loses 24%. That will not address health inequalities and stop people going into the health service; the cuts to the most deprived areas cannot be right.

There is a deliberate policy—not just here, but in other areas—of moving the central Government grants or funding formulas to benefit mainly Conservative-voting southern areas. That is the worst example of pork barrel politics. The Conservative party leadership contenders talk about one-nation conservatism. If this is one-nation conservatism, they can keep it. The cuts will have a direct effect on the ability of healthcare professionals to provide services. It is not acceptable to go backwards on smoking cessation and drug treatment.

What has been going on? The county council has lobbied; it has written to the Minister, met Public Health England and worked with other local authorities not just in the north-east but elsewhere, such as Blackpool Council, which is also affected. It has contributed to the fair funding review. It is not just politicians on the Labour county council; the health and wellbeing boards, the police and crime commissioner, and the local NHS trusts have all argued that this is not correct, because they see what is coming down the road. If these short-sighted cuts take place, the demand on local acute services will go up—exactly what the Government and NHS England want to avoid. That disjointed approach beggars belief.

What do we want in County Durham? We want and need a clear commitment to public health. That is referred to in the NHS forward plan, but with no funding commitment or power to ensure that local councils deliver good-quality public health. We need a form of funding that reflects need. We also need a clarification on timetable. I understand that a decision is being kicked right back to the spending review. When the spending review will take place, given the chaos in the Conservative party, I do not know.

There is real pressure on the county council and other bodies because they have to let contracts—the current contracts come to an end in March next year. If there is no clarification by the end of this year, that will not leave much time for those organisations not only to tender but to let those contracts. That will lead to a lot of organisations worrying about their future. A lot of public health is delivered by the local voluntary community sectors. They rely on that, and they do a fantastic job. We cannot have money deliberately moved to areas of prosperity. I challenge the Minister to conduct an impact assessment on the effects of the cuts, to highlight those effects.

It does not surprise me what the Government are doing because they have done it in every other area, particularly local government funding. I do not question the commitment of the Minister to good-quality public health, but there is a disconnect in relation to the funding formula and the Ministry of Housing, Communities and Local Government. On 7 January, I asked the Health Secretary directly about the issues concerning County Durham. He said:

“That is obviously not right. Indeed, there is a whole section of the plan on reducing health inequalities, which is extremely important.”—[Official Report, 7 January 2019; Vol. 652, c. 77.]

He might recognise the importance of public health, but MHCLG does not. That is not a very good example of joined-up government.

This is not charity; it is an investment, not just in the lives and wellbeing of individual constituents in County Durham but in the future of the country. Unless we tackle some of these health inequalities through good public health, our efforts to relieve the pressures on our health service will come to nothing. In a statement on exiting the EU, the Prime Minister, who will not be with us much longer as Prime Minister, said she wanted to work

“across all areas to make this a country that truly works for everyone, and a country where nowhere and nobody is left behind.”—[Official Report, 10 December 2018; Vol. 651, c. 25.]

If these cuts go through, those words will be pretty hollow, because County Durham will be left behind.

Whorlton Hall

Helen Goodman Excerpts

Thursday 23rd May 2019 Commons Chamber

[Caroline Dinenage]

My hon. Friend is absolutely right to raise that point. I think the CQC itself admitted to this. In fact, some of its social media engagement over the past 24 hours has been unprecedented in its level of frankness and openness, and in the way in which it has shown a desire to change and make this situation better. It has been very disturbing for everybody concerned, and it is true that NHS England has started enhanced oversight and scrutiny of this particular group’s other learning disability and autism settings to try to ensure that we are not going to uncover any more stories of such horror.

[Helen Goodman (Bishop Auckland) (Lab)]

What was revealed on “Panorama” last night was truly horrific. This was public service broadcasting at its best, but it should not have taken the BBC to uncover the case; the CQC got this totally wrong. However, whatever the failings of the CQC, ultimate responsibility must lie with those who own and manage these homes and make money out of them. I am therefore extremely concerned to hear that the Minister has put Cygnet on the body that is to look into this matter. There is a clear conflict of interest because Cygnet may end up needing to be prosecuted. Finally, the Government need to fund these services properly. It is no good having people who are not qualified and not properly paid working with the most vulnerable people in society.

[Caroline Dinenage]

Let me clarify what I said, because I think the hon. Lady might have slightly got the wrong end of the stick. I did not say that Cygnet was being put on a group that is investigating this situation. I said that a group was established to deal with the immediate problem as soon as the issue came to light. That immediate problem was the safety of the individuals living in this particular setting and the conduct of those whose behaviour had been so outrageous. At that point, we were told that 21 people had been suspended. The safety of the individuals living in the setting was therefore our immediate concern, as well as finding alternative places for many of them to go. At that point, there was an incident co-ordination group that included Cygnet because it is the owner, but that group was set up to deal with the immediate situation that needed to be dealt with very promptly.

Human Medicines (Amendment) Regulations

Helen Goodman Excerpts

Monday 18th March 2019 Commons Chamber

[Jonathan Ashworth]

The right hon. Gentleman hits the nail on the head. That is exactly the point that has been put to me when I have visited community pharmacists and discussed this with them. Of course there are other pharmacists who have perhaps done more training and want to work at the top of their licence and believe that there is a role for more autonomy. However, there are real concerns about the way in which these changes are being rushed through without any resource put into education, explanation or wider training that may be needed. In those circumstances, it is appropriate that we raise our concerns, support our motion and oppose the Government’s proposal today. He is absolutely right—I have heard that concern expressed directly. Many community pharmacists do not necessarily want this responsibility, given the wider concerns and implications that he highlighted.

[Helen Goodman (Bishop Auckland) (Lab)]

The point made by the right hon. Member for North Norfolk (Norman Lamb) raises two issues. First, what is the point of doctors having all this training if anybody without it is suddenly able to dole out prescriptions? Secondly, are pharmacists insured, and is there an insurance scheme for them if they make mistakes? Doctors have a professional insurance system, and pharmacists presumably have a completely different one.

[Jonathan Ashworth]

My hon. Friend is right. That is exactly the point that community pharmacists put to me in Loughborough about three weeks ago when I visited them to discuss this. Echoing her point, the BMA has said that it does not support a “blanket approach” to allowing pharmacists to provide therapeutic equivalents where a prescribed drug is not available. The National AIDS Trust has said:

“The only person qualified to safely alter the medication prescribed to a person living with HIV is that person’s HIV consultant.”

SUDEP Action, alongside a broader coalition of epilepsy charities, is particularly worried about these proposals.

After facing pressure from those groups, the Government accepted that replacement drugs were unsuitable for epilepsy patients, but they have left it open to pharmacists to reduce the strength or dosage of epilepsy medication. I am not convinced that that will eliminate the big risks faced by these patients. As the right hon. Member for North Norfolk (Norman Lamb) said, many patients with epilepsy—especially the elderly—are on other medications, and any changes require careful management because of the interaction between different medicines. Up to 90% of people with epilepsy state that even a deterioration in their mood can have a negative effect on seizure control. Anti-epileptic medications have more significant interactions than any other group of drugs.

There are situations where the specific brand, type, form or strength of a treatment must be carefully tailored to the individual based on their responses, which is done by the prescriber and the patient over time. If that is changed by a professional who does not know the patient or their individual risks, some have warned that the consequences could be a loss of control of the condition, failed treatment and an unnecessary emergency, with very serious consequences indeed.

--- Later in debate ---

[Jackie Doyle-Price]

The protocol will be very tightly drafted, which will really limit the ability of the pharmacist, who would only be able to prescribe outside the terms of the prescription within the narrow confines of the protocol. As I say, this has been done to secure continuity of supply when there is a potential challenge, but I would expect to take advice from a pharmacy panel, in conjunction with those most affected, to make sure that we put in place appropriate risk management on those occasions.

[Helen Goodman]

What kind of timescale is the Minister considering? Let us take people with epilepsy. As my hon. Friend the Member for Leicester South (Jonathan Ashworth) said at the Dispatch Box, if somebody’s condition changes, it might take six months to work out what the right prescription ought to be. The Minister surely cannot say that we will write a protocol in Whitehall in the event of some sudden shortage and implement it across the land because, as we keep saying, different people have different medical needs.

[Jackie Doyle-Price]

We are talking about a protocol that can deal with an immediate shortage, but we would not expect that shortage to continue indefinitely. It enables us to manage the shortage, while trying to secure the ongoing supply.

Reference has been made to EpiPens, and that is exactly what happened in that context: we knew that we had a shortage and that there was a supply coming, so steps were taken to manage the supply so that everybody who needed EpiPens had a supply of two, with dispensaries managing that supply. We would expect the same to happen. Where we issue a protocol, we would expect prescribers to go back to their normal supply of medication once we had corrected the supply problem, and this is to get us through that period. It is also to encourage people not to stockpile medicines in the event of worries about a shortage. This is about giving people the reassurance that we will manage such shortages effectively.

The hon. Member for Leicester South mentioned that there had been criticism about a lack of consultation. It is worth noting that the Government have been challenged by the Good Law Project on a number of grounds, but it is also worth telling the House that the High Court decided last week that permission for judicial review would not be granted on the issue of lack of consultation.

I want to clarify the purpose of the regulations. First, they implement the EU falsified medicines legislation on certain safety features on the packaging of medicines. They also extend the exemption for the supply of naloxone hydrochloride, so that drug treatment services can supply all dosage forms of that medicine; at the moment, we can only supply injectables, but we now know that nasal administration is more efficient. In addition, and this is obviously the main crux of the debate today, they enable retail pharmacies, where appropriate, to supply against a serious shortage protocol, instead of against prescriptions, if such a protocol has been issued.

Not implementing this statutory instrument would have dire consequences. Not only would the Government lose this tool to manage shortages of medicines, but we would also deny drug treatment services the ability to supply all dosage forms of naloxone hydrochloride. Without this SI, we would not be able to introduce UK-specific flexibilities for the falsified medicines safety features scheme, meaning that a disproportionate burden would be put on the supply chain.

On the safety features, I would like to say that we are committed to stopping falsified medicines from reaching patients. Our No. 1 priority is safe access to medicines in the most efficient way. I can also say that we want to retain a close working partnership with the EU on medicines regulation, for all the reasons the hon. Gentleman outlined, and we wish to ensure that patients continue to have timely access to safe medicines and medical innovations.

The new safety features measures under the EU delegated safety features regulation are directly applicable, and they already require UK manufacturers to place a unique identifier and tamper-evident features on packaging for almost all prescription-only medicines. These medicines need to be scanned on supply to the patient to verify their authenticity. Our position is clear that, as a member state, we were obliged to implement these requirements. We worked extensively with stakeholders to understand the detail and to develop the best approach on the flexibilities and enforcement specifically for the UK, and this was tested through a formal consultation process.

It is worth noting that the UK has a very complex supply chain. Without the national flexibilities in this statutory instrument, the burden on industry would be disproportionate and it would risk patients not getting timely access to medicines; nor would we be able to enforce the requirements already in place. The reputation of UK medicines, the UK pharmaceutical industry and regulators could be seriously undermined. I have already mentioned the issue of naloxone hydrochloride. It is administered in the event of a heroin overdose, so we clearly want to make that available in the most efficient way possible.

To come back to the serious shortage protocol provisions, these will provide the Government with an additional tool to deal with a shortage of medicines. Over 2.5 million prescription items are dispensed in primary care in England alone every day, and the vast majority are not subject to supply problems. However, we must have a robust system in place for when they are. We work closely with the Medicines and Healthcare Products Regulatory Agency, the pharmaceutical industry and NHS England in operating and managing the supply chain to help prevent shortages, and to ensure that the risks to patients are minimised when shortages do arise.

The issue of EpiPens is a very good example. Last autumn, we faced a serious international shortage of EpiPens. That shortage had a knock-on effect on other adrenaline auto-injectors and, despite efforts by the Department and the industry, there was not enough supply to meet the demand in the country. We were therefore forced to ration the available injectors so that the available supply could be spread out across all patients who needed them until more stock became available. To be able to do that, we put in place a dispensing protocol.

The protocol required pharmacists to check with patients how many adrenaline injectors, including expired ones, they had so that pharmacists could decide on the number of injectors to supply. Patients below a certain weight had to be referred back to their prescriber. Again, another risk management tool that we would apply in issuing a protocol would be to make sure that pharmacists were referring people back to their prescriber if there was such a question. This ensured that, throughout the duration of the shortage, we managed the available stock in such a way that each patient had access to at least two injectors. It was this incident with the adrenaline injectors, as well as our EU exit preparations, that led the Government to formalise that what was done in the EpiPen situation should be put in place to manage other serious shortages, should they arise.

I say again that this is not the Government’s plan for dealing with medicine shortages in a no-deal exit. That is simply not the case at all. We wanted to introduce these provisions before 29 March so that we would have the option of issuing protocols, but only as part of our multi-layered approach to minimise any supply disruption in a no-deal exit. We are confident that our other management plans will deal with that. These include securing additional roll-on roll-off freight capacity for goods; buffer stocks and stockpiling; extra warehouse space; and space on aeroplanes for products with a short shelf life or specific storage conditions. The questions raised about radioisotopes are clearly relevant to that. These regulations will ensure that companies can continue to sell their products in the UK. They will strengthen the process and resources used to deal with shortages in the event, despite everyone’s best efforts, that they do occur.

--- Later in debate ---

[Helen Goodman (Bishop Auckland) (Lab)]

I am pleased to have an opportunity to make a short contribution to the debate.

It is ironic, given that one of the main Brexit campaign slogans, on the side of a bus, promised £350 million for the NHS, that one of the most serious problems we are having to consider is the problem of medicine shortages in the event of Brexit. The Minister has still not made clear the extent to which those shortages are related to Brexit. Common sense suggests that this is a Brexit statutory instrument, and I am assuming that it went through the usual Brexit process of being dealt with by the European Statutory Instruments Committee, but the Minister has not made clear why we are having these shortages in medicines, which are happening already. I have a constituent with a child with epilepsy who is finding it difficult to get their child’s prescription. If this is not Brexit-related, how come all these shortages are suddenly happening now, at a time when the pharmaceutical industry is being told it needs to stockpile?

[Matt Rodda (Reading East) (Lab)]

I wholeheartedly support the points my hon. Friend is making and the concern she is raising about the potential link to Brexit, which would seem to many Members to be an obvious connection. Does she agree that Brexit is not only threatening the NHS through these potential shortages of medicines, but threatening the staffing of our NHS? I represent a seat where 13% of the staff at the local hospital come from EU countries, and many are leaving and going home, which is of deep concern to our residents.

[Helen Goodman]

Of course what my hon. Friend says about staff shortages and Brexit is absolutely right.

I was going on to say that I have a GlaxoSmithKline factory in my constituency, and obviously I have discussed this issue with it. It is extremely underwhelmed by the Government’s no-deal planning, and extremely under- whelmed by the fact that it is having to pay for these extra stockpiles. All these Brexit costs that are being put on to the industrialists mean that there is less money for research and development, investment, job creation and all the things we would all like to see.

It is notable that there are very high numbers of people with the conditions most likely to be affected. There are 4 million people in this country with diabetes, 500,000 people with epilepsy, and 250,000 people whose allergies are so serious that they need an EpiPen. Given that we clearly have 5 million, 6 million or perhaps 10 million people whose health is likely to be at risk if there are medicine shortages, I would have thought that the Government would have not just done a full risk and impact assessment but produced for us today, alongside the statutory instrument, the protocols. The Minister knows which drugs and conditions we are talking about; surely, given all the problems we have had with the industry, doctors and patient groups not being properly consulted, it would have been sensible to make those protocols at this moment, so we could look at them alongside the statutory instrument. I hope the Minister will come to the Dispatch Box and answer some of these points. She is shaking her head.

[Jackie Doyle-Price]

This is a tool to manage serious medicine shortages. I do not expect any medicine shortages, but this tool exists in the event of them arising. As for the idea that we could bring together a list, we do not anticipate that there will need to be a list.

[Helen Goodman]

Brexit is now 11 days away. Collapsing out of Europe with no deal is obviously far less likely following the votes of last week, but it is still a possibility, and at that point the possibility—the probability—of these medicine shortages will increase very significantly. Here we are, less than a fortnight away, and the Minister has not got these protocols in draft at the moment. [Interruption.] The Minister is still chuntering; I am sorry, but she has not provided us with the reassurance that we want. I speak as someone who carries an EpiPen; I am not very taken with the idea that I will not be able to get an EpiPen, and my husband will not be very taken with the idea that he cannot get his epilepsy tablets. If the Minister and Department of Health and Social Care officials think that this is a way to save money, they could not be more wrong.

When things go wrong—when a person has a fit, or goes into anaphylactic shock—they are taken into A&E, and they might be there for 12 hours. That is not cheap; that is not a saving. Of course, it is extremely dangerous, too. The rate of death for people with epileptic fits is one in 100; one in 100 fits leads to death. Ministers are taking much too great a risk with their fellow citizens’ lives.

Question put.

Oral Answers to Questions

Helen Goodman Excerpts

Tuesday 15th January 2019 Commons Chamber

[Mr Speaker]

Order. I appreciate the natural courtesy of the Minister in looking in the direction of the person questioning him, but the House wants the benefit of his mellifluous tones, so he should face the House. We are grateful to him.

[Helen Goodman (Bishop Auckland) (Lab)]

T2. The closure of ward 6 at Bishop Auckland Hospital will mean the loss of 24 beds, which is why 14,000 people have signed a petition to keep it. Will the Minister now step in to ensure that we keep ward 6?

[Stephen Hammond]

The hon. Lady will know that in the long-term plan we have committed to ensuring that more people are treated and that more money is spent in hospitals. The decision on closure is for local organisations, as she will know, but, as I have said to other hon. Members, my door remains open and I would be delighted to meet her.

Oral Answers to Questions

Helen Goodman Excerpts

Tuesday 27th November 2018 Commons Chamber

[Caroline Dinenage]

First, I congratulate my right hon. Friend on his elegant Movember facial decoration. I very much recommend that he keeps it.

My right hon. Friend the Secretary of State was delighted to visit the East Devon constituency recently, where he was impressed by the work at some of the existing community hospitals and care hubs and discussed with Royal Devon and Exeter NHS Foundation Trust how it will work on a sustainable future for the constituency’s community hospital in Ottery St Mary.

[Helen Goodman (Bishop Auckland) (Lab)]

Since the Department says that it likes community hospitals, why are services and wards closing at the Richardson in Barnard Castle?

[Caroline Dinenage]

We know that patients prefer to be treated in their local area, which is much better for preventing hospital admission and getting people out of hospital for longer. However, such clinical decisions must be taken at a local level in consultation with local people.

Oral Answers to Questions

Helen Goodman Excerpts

Tuesday 24th July 2018 Commons Chamber

[Helen Goodman (Bishop Auckland) (Lab)]

22. May I congratulate the Secretary of State on his new appointment? Another new technology that really matters is MRI scanners. We have had a big fundraising campaign in Bishop Auckland for ours, but the problem with such fundraising campaigns is that they are of course easier in wealthy areas than in poor areas. Will the Secretary of State pay attention to evening out this uneven distribution of resources?

[Matt Hancock]

Yes, of course I will. I pay tribute to the hon. Lady for her work to raise funds for the MRI scanner in Bishop Auckland, which benefits from great levels of philanthropy in some areas. The whole purpose of having a national health service is that, wherever people live in the country, they can get high-quality healthcare, free at the point of delivery, according to need. I stand by that principle, and I honour it.