Under-age Vaping

Helen Hayes Excerpts

Wednesday 12th July 2023 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I am grateful to all right hon. and hon. Members who have taken part in what has been a largely consensual debate. We have heard from colleagues across the House about the growth in the number of children who are vaping, concerns about physical and mental health impacts, the disruption to education and the drain on staff time in schools.

The Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), spoke of the evidence that the Committee has heard on the impact of vaping on the education of students, including interruptions to exams. My hon. Friend the Member for Ealing, Southall (Mr Sharma) highlighted the ongoing prevalence of smoking and the need for further work to tackle illegal tobacco sales as well as work to tackle vaping. The right hon. Member for Romsey and Southampton North (Caroline Nokes) spoke about the important role of vapes in smoking cessation. There is no disagreement from the Opposition on that. I am not so grateful to her for taking me back to the revolting smoke-filled environment of the toilets in my secondary school in the 1980s, which is a memory that I had long since sought to banish.

My hon. Friend the Member for North Tyneside (Mary Glindon) spoke about the need for better enforcement of the existing age verification regulations regarding vapes. The hon. Member for Erewash (Maggie Throup) highlighted the sophistication of the packaging, design and presentation of vaping products in retail outlets and how attractive that makes them. My hon. Friend the Member for City of Durham (Mary Kelly Foy), who has a long track record of work on this issue, highlighted the extent of the evidence on vaping that is already available to the Government. The hon. Member for Darlington (Peter Gibson) highlighted the impact of disposable vapes on the environment and the increase in plastic pollution. My hon. Friend the Member for Birmingham, Erdington (Mrs Hamilton) spoke from her experience as a former nurse and highlighted the serious problem of vaping equipment being used to distribute more dangerous substances by young people.

The hon. Member for Sleaford and North Hykeham (Dr Johnson), who spoke from her extensive work on this subject, highlighted concerns about the accuracy of data on the safety of vaping. The hon. Member for Tiverton and Honiton (Richard Foord) spoke about work in his constituency that shows it is possible for retailers to take a different approach to vapes. My hon. Friend the Member for Stockton North (Alex Cunningham) highlighted the Government’s failure to act on advertising. My hon. Friend the Member for York Central (Rachael Maskell) spoke about the lessons that can be learned from the anti-smoking measures that have been so successful as well as the need to recognise this issue as one of addiction and to locate it in the wider landscape of the addiction economy.

Vaping has shifted from a smoking cessation tool to a recreational activity in its own right, driven by the rapacious desire of tobacco companies—which fund many of the largest vape suppliers—to keep making a profit from the highly addictive substance of nicotine. The growth in the use of vapes by 11 to 15-year-olds has been rapid, increasing by 50% in the past three years. One in five 11 to 15-year-olds in England used vapes in 2021. The figure will be higher now.

The important role of vaping in smoking cessation has led to a widespread perception that it is a harmless activity, rather than a less harmful activity than smoking. Last year, 40 children were admitted to hospital for suspected vaping-related disorders. Young people using e-cigarettes are twice as likely to suffer from a chronic cough than non-users. There are reports that nicotine dependency contributes to cognitive and attention deficit conditions, and worsened mood disorders.

[Dr Caroline Johnson]

The brain develops gradually over time, and is thought to continue developing in people until they are 25. Some countries have different age limits for different things. Does the hon. Member think that 18 is the right age limit for vaping?

[Helen Hayes]

The hon. Member speaks from her experience on this issue. We have set out a motion containing some immediate actions that the Government can take, which are well-evidenced, particularly from the approach taken to combat smoking. I agree that the Government should look urgently at other aspects of the regulatory framework on vaping, some of which we have heard about today.

Vaping products are marketed directly to children, named after sweets such as gummy bears, Skittles and tutti frutti, in brightly coloured packaging decorated with cartoon characters. There is also evidence, including from research undertaken by one of my constituents who I met during evidence week last week, of the burgeoning growth in vaping among 18 to 25-year-olds, almost entirely unrelated to smoking cessation. A new generation of vaping products has been designed to be desirable objects in their own right. If action is not taken to tackle the accessibility of vaping to children, we can only expect vaping among young adults to continue to grow.

[Maggie Throup]

The hon. Member talks about children and 18 to 25-year-olds. What age does she think is appropriate to ban vaping—16, 18 or 25?

[Helen Hayes]

The current law prohibits the sale of vapes to under-18-year-olds. We are not proposing a change in the law on the prohibition of sale. I was simply highlighting that young people grow, and those who become addicted to vaping under the age of 18 are much more likely to carry that addiction into young adulthood. That was the point that I was seeking to make. We can expect a pipeline of young people becoming addicted to vaping, which may stay with some of them for the rest of their lives.

This Government have been asleep at the wheel on children and vaping. They had the opportunity to vote for measures to protect children from vaping last year but failed to do so. The measures that the Minister has announced most recently are better late than never, but are simply inadequate to the task. ASH is clear that while educating young people on the risks of vaping through a new resource pack for schools is welcome, the evidence suggests that education alone will not stop children from vaping.

There is substantial evidence on what worked in reducing smoking rates among children. In 1982, when England first started monitoring smoking rates among children, just one in five children was a current smoker. Eighteen years later in 2000, the proportion was exactly the same—not because children were not educated about the dangers, but because adolescents are risk takers. Between 2000 and 2021, smoking rates among children fell from 19% to just 3%—not because of better education or enforcement but because the regulatory framework during that time ratcheted up year by year. Under the last Labour Government, all point of sale advertising and display of tobacco was prohibited. A comprehensive anti-smuggling strategy was implemented by HMRC and the UK Border Force, which dramatically reduced sales of illicit tobacco, and cigarettes were put in standardised packaging, with all the brightly coloured glamourised packaging removed.

What is true for the strategy to tackle smoking is true for the challenge of vaping. Without much tougher regulation, we will not succeed in driving down vaping among children and young people. Regulations on packaging, advertising and labelling are essential. Labour is calling on the Government to ban vapes from being branded and advertised to appeal to children, and to work with local councils—

[Peter Gibson]

I am very grateful to the hon. Lady for giving way. She has taken a number of interventions from colleagues. The motion refers to children. The shadow Minister commented that there is no proposal, under a Labour Government, to change the age of 18 for purchasing tobacco. By process of elimination, does the word “children” in the motion refer to anyone under the age of 18? Will she clarify that point?

[Helen Hayes]

I am sure Members across the House do not need much help from me to identify the definition of a child in law as being a person under the age of 18. I will simply move on from there.

What I will say about the motion is that it sets out measures over which I think there can be no disagreement. There can be no disagreement about advertising targeted at children. Measures to deal with packaging that appeals to children could be introduced right now and would have a direct impact on the very alarming numbers of children and young people who are vaping. This has been a very consensual debate, which has acknowledged and set out some of the complexities around the issue, as well as some areas where the Government should be looking at additional regulations and the wider regulatory framework around vaping. I do not think there is disagreement on that either. What we are setting out today is immediate action that is long, long overdue. Frankly, we struggle to see why the Government have been dragging their heels, refusing to act and not accepting these measures.

As I said, Labour is calling on the Government to ban vapes from being branded and advertised to appeal to children, and to work with local councils and the NHS to help ensure that e-cigarettes are used as an aid to stop smoking, rather than as a new form of smoking and addiction. It is inexplicable that the Government are resistant to those entirely proportionate and evidence-based proposals. If they will not act to protect children and young people, the next Labour Government certainly will.

Government PPE Contracts

Helen Hayes Excerpts

Tuesday 6th December 2022 Commons Chamber

[Angela Rayner]

My hon. Friend is absolutely right. He made two points, which I will come to in greater detail in my speech, but one was the lack of PPE for those on the frontline, as well as the total disrespect in the way that contracts were handed out through the VIP lane, at the expense of businesses up and down the UK that had experience and could have helped during the pandemic, but which were not party to WhatsApps or whatever else got them to Ministers and access to the VIP lane.

Take the mystery of a PPE company with links to a Tory politician. While it is for the authorities to decide whether any law is broken, and I will not comment on the ongoing investigations, we do know that PPE Medpro was referred to the VIP lane by a sitting member of the Cabinet after lobbying from another Tory politician five days before it was even legally registered as a company. The House may recall that that particular company was subsequently awarded two contracts worth £203 million to supply PPE, with £81 million to supply 210 million face masks awarded in May 2020 and a £122 million contract to supply 25 million surgical gowns awarded in June 2020. The face masks were bought by the Government from PPE Medpro for more than twice the price of identical items from other suppliers, and the surgical gowns were rejected for use in the NHS after a technical inspection. All of them were never even used. It points to a total failure of due diligence and the rotten stench of cronyism.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

During the early months of the pandemic, I was contacted by PPE suppliers known to the NHS—they were long-term suppliers—who told me that their offers of help were being rejected. One wrote to me and said that before April 2020

“there was a degree of total incompetence about government handling of PPE purchases. However, by the way they scrutinised our own offers, thereafter, we believe they knew, at least specification-wise, exactly what they were doing and that senior managers were taking steps to use ‘preferred suppliers’, even though they were aware these suppliers had neither the track record nor the level of competence to produce compliant goods”.

What does my right hon. Friend think about that?

[Angela Rayner]

I think it absolutely stinks, and my hon. Friend is absolutely right, in that the public can see through it, as can those businesses, who are pretty angry. They knew that Britain faced a situation with a global pandemic that it had not faced before and they wanted to do the right thing by doing their bit. The frustration—my hon. Friend is right to quote her business—is that there is no question that the specifications should have been known. Therefore, why was all this PPE bought knowing full well it could not be used?

NHS Workforce

Helen Hayes Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

I am grateful for that intervention. We are in the worst of all worlds on immigration and the NHS. The Government try to have it both ways. They talk tough on rhetoric, so we end up with a very bureaucratic, ineffective and costly system, but because they fail to invest in our own homegrown talent, they are over-reliant on immigration from other countries, including those who desperately need their own doctors and nurses. I do not think it is good enough, after 12 years of Conservative Government, that we are turning away bright potential doctors, nurses and allied health professionals because the Government cannot be bothered to pull their finger out and train our own homegrown talent. We need to see improvement, so we that can draw the best international talent and make the system smooth, efficient and effective, but it is also crucial that we train our own homegrown talent.

Turning to more of the Conservatives’ excuses—we have heard the excuses of the pandemic—let us now look at the excuse they are planning to deploy this winter. There is no denying that this winter could be the most challenging the NHS has ever faced. The Royal College of Nursing, for the first time in its more than 100-year history, is planning to undertake strike action. Just this lunchtime we got strike dates from Unison, the GMB union and Unite the Union. That raises the question: why are the Government not even trying to stop the strikes in the NHS from going ahead? Surely, when the NHS already lacks the staff it needs to treat patients on time, the Government ought to be pulling out all the stops, getting around the table and negotiating to stop industrial action? So why aren’t they?

The Secretary of State said in Health questions earlier that his door is open—as if we can just sort of wander in off the street into the Department of Health and Social Care, where there will be a cup of tea and a biscuit waiting, and he will be just waiting for the negotiations. That is not how this works. Everyone knows that is not how it works. He had a nice little meeting with unions after the summer, after Labour complained that we had not seen a meeting between a Secretary of State and the unions since the right hon. Member for Bromsgrove (Sajid Javid). Goodness me, we have had three Secretaries of State since then—and two of them are the Secretary of State on the Front Bench today. Why on earth are they not sitting around the table and conducting serious negotiations? I will tell you why, Mr Deputy Speaker: they know that patients are going to suffer this winter and they do not have a plan to fix it, so instead of acting to improve care for patients and accept responsibility, they want to use nurses as a scapegoat in the hope that they avoid the blame. We can see it coming a mile off. It is a disgusting plan, it is dangerous and it will not work.

If I am wrong, perhaps Conservative Members could explain why the Government are not trying to prevent the strikes from going ahead. Perhaps they could explain why the Secretary of State ignored all requests from the health unions for meetings and conversations this summer while the ballot was under way. Perhaps they could explain what the Government’s plan for the NHS is this winter. Perhaps they could explain why a Government source told The Times newspaper that

“Ministers plan to wait for public sentiment to turn against striking nurses as the toll of disruption mounts”.

They said the quiet bit out loud and they gave the game away.

What else would explain the unedifying and embarrassing spectacle of the chair of the Conservative party going on national television to accuse nurses of doing the bidding of Vladimir Putin? I should not have to make this point, but nurses are not traitors to this country. They bust a gut day in, day out to look after all of us. We clapped them during the pandemic and now the nurses are clapped out. They are overworked, overstretched and undervalued by this Government. Let me say to the chairman of the Conservative party that he would speak with greater authority on what is in Britain’s national interests if he did his patriotic duty in his own tax affairs.

When it comes to sending a message to Vladimir Putin, why does the burden consistently fall on the working people in Britain? Why is it that NHS staff must make huge sacrifices because of the invasion of Ukraine, yet people who live in Britain but do not pay their fair share of taxes here do not have to lift a finger? When it comes to paying the bills, the first and last resort of this Conservative Government is always to pick the pockets of working people, yet the enormous wealth of tens of thousands of non-doms is left untouched. They may blame covid, they may blame health professionals, they may even blame the weather, but it is 12 years of Conservative mismanagement and under-investment that has left the NHS without the doctors, nurses and staff it needs, and patients are paying the price.

I am sure every Member of this House, indeed everyone in the country, knows someone who has been let down when they needed healthcare in recent months. They all say the same thing: the NHS staff were brilliant, but there simply are not enough of them. There is no NHS without the people to run it, yet today there are more vacancies in the NHS than ever before: 9,000 empty doctor posts, 47,000 empty nursing posts, and midwives leaving faster than they can be recruited. There are 4,600 fewer GPs than there were a decade ago, and the right hon. Member for Bromsgrove admitted last year that the Government are set to break their manifesto promise to recruit them back.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I was looking at a message from a constituent this morning who told that he went to A&E having waited four weeks for a GP appointment. Does that not speak to a lack of investment in the NHS workforce over 12 years and a lack of adequate planning? I know how hard GPs work in my constituency, but the lack of GP availability to staff surgeries and provide those appointments is placing unneeded pressure on A&E. That is on this Government’s watch.

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As we see so often with this Government, they make promises but break them. They try to fool the public into thinking they are delivering more GPs—or indeed more police officers—when it was the Conservative party that cut them. They try to give with one hand, but they take with the other, and after 12 years people have had enough.

Of course, it is not only the promise to recruit more GPs that the Conservatives are breaking. We had the promise of 40 new hospitals, which the Secretary of State repeated today, yet in response to the question posed by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), the Secretary of State said that of those 40 new hospital schemes

“five hospital schemes are in construction, two are now completed and we aim to announce the next eight by the end of this year.”

So, where are the other 25? Where are these 40 new hospitals? As far as I can tell, they exist only in the imagination of the former Prime Minister. Yet the script has not changed—Ministers are still here claiming 40 new hospitals.

When I visited Leeds with the shadow Chancellor, my right hon. Friend the Member for Leeds West (Rachel Reeves), I saw a vast pile of dirt where a new building was due to go up. We heard today that the Government cannot even negotiate an agreement with the hospital to get the site working and get the new facilities built. With every minute, every month and every year of delay construction costs are going up, so taxpayers are left in the worst of all worlds: broken promises, no 40 new hospitals, and paying through the nose for the ones that are being built because of Government incompetence.

We see the tragic consequences of the shortages and broken promises in the NHS. My hon. Friend the Member for Rotherham (Sarah Champion) raised the tragic case today at Health questions of a five-year-old boy who had what his doctor described as the worst case of tonsilitis he had ever seen. He was turned away from hospital, with his parents told there were no beds and not enough doctors. His infection worsened and five-year-old Yusuf later passed away. His death certificate recorded the primary cause of his death as pneumonia and the secondary cause as tonsilitis. What kind of country are we living in when a five-year-old boy can die of tonsilitis? This is criminal.

I met Yusuf’s uncle, Zaheer Ahmed, last week, and I did not know what to say to that poor man and his grieving family, who lost that little boy in the most unimaginable circumstances. I invite the Secretary of State to meet Yusuf’s family to hear how that little boy was failed and to hear at first hand about some of their interactions with the NHS, which I thought were completely unacceptable and intolerable. On that note, I welcome the independent inquiry that has been committed to. That is really important for the family who have been failed in this heartbreaking case. We do not want to see more cases like that.

At the heart of the crisis in the NHS—as with so many of the problems facing our country—is a failure to plan. The NHS has not had a workforce plan since 2003. That would be unacceptable in a multinational company one one-hundredth the size of the NHS. The failure to plan means that short-term fixes are always favoured over what is in patients’ long-term interests. That is why the Government cut the nursing bursary and why, this summer, in the middle of the biggest crisis in the history of the NHS, they took the infuriating decision to cut a third of medical school places.

Oral Answers to Questions

Helen Hayes Excerpts

Tuesday 6th December 2022 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Steve Barclay)]

We know that women can benefit from more personalised care, especially in pregnancy. The Tommy’s app is a new clinical decision tool for the NHS and for women, another example of how we are using artificial intelligence to improve our maternity system. That will help to end some of the variation in maternity care from hospital to hospital. I am pleased to tell hon. Members, particularly my hon. Friend the Member for Rutland and Melton (Alicia Kearns), who is a great champion of improved mental health, that today my Department, through our National Institute for Health and Care Research, has agreed to provide the funding needed for the next stage of the app’s development. I pay tribute to Sienna and all those other babies born stillborn to their parents and thank all those in this Chamber who have campaigned passionately on this important issue.

[Helen Hayes]

Another dental practice in my constituency recently handed back its NHS contract. When I contacted local NHS management about the impact of the closure, it stated that the area in question was adjudged to be well served for NHS dentistry practices because there are 11 practices within a half-mile radius. The experience of my constituents, now left searching for NHS dental services, is that none of those practices is accepting new NHS patients. What is the Secretary of State doing to ensure that assessments of the sufficiency of NHS dental services reflect the real situation on the ground, and when will we see a sustainable solution to the problems my constituents face?

[Steve Barclay]

The hon. Lady raises an important issue that is of concern across the House, as we have already seen in the exchanges the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) answered. That in part was why, during the pandemic, we used £1.7 billion of funding to protect dentistry and why we got a commitment through the £3 billion a year funding of dentistry, but we are looking at how we localise that commissioning to get better value out of the contract, which was the point my hon. Friend raised.

Pulmonary Embolisms: Diagnosis

Helen Hayes Excerpts

Wednesday 30th November 2022 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I am grateful for the opportunity to bring to the House the issue of the diagnosis of pulmonary embolism. Given the content of this debate, I put on the record that my husband is employed by the NHS.

I applied for the debate on behalf of my constituent Tim Edwards, who is watching the debate from the Public Gallery. Tim’s mother, Jenny, taught for 27 years in Lewes, East Sussex, before retiring in 2012. Jenny sadly lost her life to pulmonary embolism in February 2022. My speech is about the experience of Jenny and her family, and the research that Tim has undertaken in the aftermath of his mother’s death, which points to a significant issue with preventable deaths occurring as a consequence of misdiagnosed pulmonary embolism.

First, I want to put on the record my sincere condolences to Tim and his family on the loss of his beloved mother. I understand that in the weeks immediately prior to her death, Jenny had been enjoying time with her first grandchild. I am sure that, as Tim and his wife watch their daughter grow, they are constantly reminded of the relationship that she will now not be able to enjoy with her grandmother. Tim is motivated by his loss to seek to ensure that positive learning is derived from his mother’s case and many similar cases, so that diagnosis and the prompt treatment of pulmonary embolism is improved.

Globally, venous thromboembolism, which presents clinically as either deep vein thrombosis or pulmonary embolism, is the third most frequent acute cardiovascular syndrome behind heart attack and stroke. Pulmonary embolism is a blood clot in the vein passing to the lung and causing heart failure. The disease is serious but eminently survivable—if it is promptly diagnosed and treated, the death rate is 8%. Unfortunately, many pulmonary embolisms are misdiagnosed and attributed to other acute cardiovascular conditions because of the overlap of symptoms and the greater ease in identifying heart attacks and strokes.

My constituent has undertaken considerable research since his mother’s death, working with the charity Patient Safety Learning. He has estimated that there was a minimum of 400 excess pulmonary embolism deaths across England from April 2021 to March 2022, and that that excess figure is attributable to cases that were missed. He also looked at the age-adjusted mortality rates for pulmonary embolism across counties in England and Wales. There are some regions where the number of fatalities from the condition is almost three times the national average. The Minister may want to inquire as to what drives that discrepancy.

Let me give a sense of what can and does go wrong. In early February 2022, despite exhibiting risk factors and sudden symptoms, including fainting and collapse, my constituent’s mother, Jenny, was wrongly misdiagnosed in the care of an emergency department as having had a heart attack. She was then needlessly fitted with a stent. Upon her discharge from hospital, Jenny’s condition got worse again at home. She was dying. Yet she was reassured by a cardiac nurse who, over the phone, missed the clinical signs that indicate pulmonary embolism: shortness of breath, chest pain in the centre of the chest and fainting. The nurse advised that if these symptoms continued, Jenny should call her GP, and she did so, but she never made her GP appointment. My constituent does not want this to happen to other family’s loved ones, because it was entirely avoidable.

Jenny was waiting in accident and emergency for more than 12 hours, and there were nine independent decision-making points, at any one of which pulmonary embolism could and should have been diagnosed, but the condition was only discovered in an autopsy. My constituent has subsequently been motivated to write a report about what went wrong, given the mistakes that Jenny experienced and his sense that the NHS trust involved was unable to learn from what happened. His background is in the financial services sector, working in reinsurance, and he has a strong understanding of risk management. From a review of Jenny’s case and a report released by the Healthcare Safety Investigation Branch on this topic, part of the problem contributing to misdiagnosis appears to be that many emergency departments are frequently under-resourced and over-reliant on junior staff who may be ill-equipped to reliably suspect, assess and then treat pulmonary embolism, which is a relatively complex condition. That is supported by information provided by the Royal College of Radiologists, which commented on the lack of workforce sufficiency and a shortage of equipment.

Clinical staff in these settings have commented that either they do not have time or, astonishingly, do not feel that they need to follow clinical guidelines on how best to diagnose pulmonary embolism. On that last point, my constituent observes that there appears sometimes to be a culture of excessive leeway for clinicians to make their own decisions and a reluctance to follow clinical best practice. This is a source of concern.

My constituent has also discovered by interviewing a leading European professor in this area that the British clinical guidelines for diagnosing pulmonary embolism are out of step with those adopted across Europe and appear to exacerbate the risk of misdiagnosis, because the guidelines are thought of as subjective. He welcomes the news that these clinical guidelines are currently being reviewed. My constituent is also concerned that prior covid-19 infection has complicated the process of diagnosis in recent years, because some symptoms may be dismissed as linked to covid. However, this is inexcusable, as covid-19 was first established as an additional risk factor for pulmonary embolism by studies across Europe and the US in 2022. Prior covid-19 infection should give rise to greater, not lesser suspicion for patients presenting with symptoms.

In Jenny’s case, well-documented symptoms of pulmonary embolism were discounted because of her prior covid-19 infection, although it had been asymptomatic and she had made a full recovery. My constituent reports that it seemed that clinicians were assuming that covid-19 had been beneficial to Jenny’s health. Upon my constituent’s complaint to the NHS trust responsible for Jenny’s care, a serious incident report was commissioned and an inquest took place. However, in my constituent’s opinion, the NHS trust appears to have exhibited what he describes as a “shrug of the shoulders, these things happen” conclusion, inhibiting sufficient learning.

My constituent demonstrates in his report that the clinicians who treated his mother are at odds with academic literature on the symptoms of pulmonary embolism when they discuss the rationale behind their decisions. That is deeply troubling, given the alarming rise in pulmonary embolism fatalities across the country. The trust used the lowest level of investigation to contribute to its serious incident report, meaning that the subject matter experts chosen to contribute to the report were all involved in Jenny’s original care. The report’s conclusion was that a pulmonary embolism could not have been detected, even though Jenny displayed symptoms consistent with 90% of pulmonary embolisms. My constituent disagrees with the report conclusions, and he is concerned that it lacks objectivity and that there is insufficient learning to prevent such misdiagnosis from happening again. A higher level of investigation would have ensured independent contributors to the report, and the lack of that gives rise to concern about how many other cases may have been inadequately reviewed.

The sadness and frustration that my constituent feels at the circumstances of his mother’s death have been compounded by the intransigence he has witnessed in the NHS trust responsible for her treatment and the discovery that Jenny’s case was not alone. My constituent has been working with the charity Patient Safety Learning and his report will be published in December. The report contains nine calls for action. I have read the report and I have also received a response from NHS England to the recommendations in the draft. I share my constituent’s concerns that the response falls back on existing guidelines and current practice. It does not acknowledge my constituent’s finding of around 400 potentially preventable deaths a year due to misdiagnosed pulmonary embolisms. It makes no commitment to any process of review or change.

The Royal College of Radiologists has also expressed concerns consistent with my constituent’s observation about resourcing issues in emergency departments, and workforce and equipment sufficiency to enable scans to be undertaken. It stated that clinicians do not always have the equipment necessary to provide optimum care. The current vacancy rate in clinical radiology consultants is 8%.

My constituent’s research on this issue following the tragedy that his family has suffered is commendable. It highlights serious problems with excess deaths and misdiagnosis, raises serious questions about a postcode lottery, workforce sufficiency and the availability of equipment, and raises concerns about the culture of learning in the context of misdiagnosis.

I ask the Minister to agree to work with NHS England to commission a review of the data set out in my constituent’s report and the concerns raised by the Royal College of Radiologists, with a view to ensuring that the rate of misdiagnosis of pulmonary embolism is greatly reduced, and fewer families have to suffer the loss that my constituent and his family have suffered.

Urgent and Emergency Care

Helen Hayes Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

That, I think, relates to the point that I just made about the need for flow in the system and an appropriate step-down capacity. Sometimes patients are not yet ready to be discharged to their homes, but some additional physio or other support may enable them then to go home, which is where they usually want to be. This is all part of taking a much more integrated approach, and part of that must be improving the quality of data in relation to the activity that takes place within community settings.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

In July, the average wait time in London for an ambulance needed by someone describing the symptoms of a stroke was more than an hour—more than three times longer than the target time. Many of my constituents have told me that they are living with genuine anxiety and fear that if they or a loved one were stricken by illness or involved in a serious accident, the emergency help that they needed would not arrive in time. The Secretary of State has announced some measures today, but what my constituents want to know is when we can expect the time targets in London to be met once again, so that they can rest easy in the knowledge that if they need an ambulance, it will be there.

[Steve Barclay]

One of my reasons for going out with the London Ambulance Service—among others—over the summer was to answer the charge about what Ministers were doing, and to observe at first hand the challenges that the service had been facing. As the hon. Lady will know, performance has improved since the summer, but the service remains challenged. That is why we are considering a range of measures, such as boosting emergency departments, looking at pre and post-cohorting, looking at how we work with the taskforce, and looking at single points of access. One issue that paramedics emphasise to me is the need for, in particular, a better way for frail elderly patients to gain access to a single point for social care provision. We are working closely on that range of measures with colleagues in the London Ambulance Service.

Childhood Cancer Outcomes

Helen Hayes Excerpts

Tuesday 26th April 2022 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I congratulate the hon. Member for Gosport (Dame Caroline Dinenage) on securing this very important debate. My constituent, Emma, contacted me about the experience of her family, when her 17-year-old daughter, Ruby, became ill with T-cell lymphoma, an aggressive form of blood cancer. Ruby passed away in May 2020 aged just 18. I am speaking today for Ruby; for my constituent, Helena, who is currently going through cancer treatment, whose mum Katherine has been in touch; and for every other family in Dulwich and West Norwood facing a diagnosis of childhood cancer.

Ruby and her family really struggled to get a diagnosis after she became ill. She had six GP visits, while her family became increasingly concerned, before a GP referred her for the hospital tests that revealed that she had a 9 cm tumour in her chest. By the third GP visit, Emma had googled Ruby’s symptoms—a very swollen face, shoulder pain, tiredness and odd bruising to her abdomen—and she asked the GP whether Ruby could have a cancerous tumour obstructing her vena cava. She was told, “Not in one so young”, and was made to feel that she was an over-anxious parent, but that is exactly what Ruby had. It took three further GP appointments before she was referred for tests.

Ruby’s family now live with the additional pain of knowing that an earlier diagnosis might have saved her, and they are calling for better training for GPs in spotting cancer in children and young people and better practice in listening to and taking seriously parents’ concerns. Improvements in both those areas would increase early diagnosis, with life-saving consequences.

Ruby had 10 months of gruelling cancer treatment, and her mum highlights the lack of funding for research or progress in developing new treatments. The drugs used to treat Ruby’s cancer were approved in the 1950s, 1960s and 1980s. They have terrible side effects and long-lasting health consequences for children who survive their cancer.

Ruby’s family also highlight the impact that a childhood cancer diagnosis has on the wider family and the lack of support that is available. One parent often has to give up work and the average estimated additional costs associated with supporting cancer treatment are £600 a month.

Ruby was a remarkable young woman. She believed that the most important thing in the world was to be kind and to speak out against injustice and unkindness. Her motto was, “Live Kindly, Live Loudly”, and her family are seeking to keep Ruby’s memory alive by raising £500,000—roughly what the NHS spent on treating Ruby’s cancer—for the Children’s Cancer and Leukaemia Group. I recognise and encourage that vital and inspirational work. However, I also call on the Government to recognise the avoidable suffering that families such as Ruby’s face when a precious child or young person receives a cancer diagnosis, and to commit to the change that is needed—better training, more research and additional support for children and their families—to ease their suffering at this most difficult of times.

--- Later in debate ---

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

I pay tribute to the hon. Member for Gosport (Dame Caroline Dinenage) for securing this enormously important debate, and to the right hon. Member for Alyn and Deeside (Mark Tami) for his very moving personal account.

My observations are based on a lifetime working in NHS cancer care and on having led the first Teenage Cancer Trust unit at the Middlesex Hospital for a period of time—this was the world in which I existed. I hope that the Minister will pay attention to some of my observations from that career, because I think they will be useful in informing policy.

I agree that there is a need for an overarching strategy, but some of the problems discussed today are perennial; they have been there forever, and there really needs to be a concerted effort to address them. Unfortunately, some of them cannot just be solved with money. In addressing diagnosis, treatment and ultimately outcomes and survivorship, we need to think about why diagnosis is delayed, about why diseases are considered to be rare and about the ultimate impact on outcomes for children and young people. The reason for many late diagnoses is that most GPs never see a case of childhood cancer, let alone cancer in an adolescent, so the effort that goes into raising awareness and training may seem misplaced, given how rare an occurrence it is.

The other challenge is that many of the symptoms with which children present are things that GPs see day in, day out. Fevers, lumps and bumps, lethargy, pains in the tummy—all those symptoms are standard fare, so it is very difficult to cut through to the truth and identify types of cancer. The essential thing is a greater emphasis on driving awareness. It has to be a core part of any differential diagnosis when examining a child that there is always a chance that they have something much more sinister than a cough, cold or fever. It is about making sure that that is built into standard practice.

Another point that I would like to make, although I may run out of time, is that these diseases are incredibly rare. Because the subsets are so rare, it is very difficult to do longitudinal studies.

[Helen Hayes]

The hon. Member speaks about the rarity of these diseases. Will he join me in recognising, as other hon. Members have done today, the work on brain cancer that is being done in the name of my predecessor Baroness Tessa Jowell? It provides a model for a children’s cancer mission to bring together expertise in the area.

[Neale Hanvey]

I thank the hon. Lady for that intervention. I agree: there has been an enormous amount of work across a range of disease profiles, and I want very swiftly to name some of the key people with whom I have had the great pleasure to work in my time. Professor Jeremy Whelan has done a huge amount of work on soft tissue sarcomas and bone tumours, and Professor Andy Pearson from the Royal Marsden Hospital has done a huge amount of work as well. I also want to mention all the members of the multidisciplinary teams who make that kind of research and progress viable.

Let me finally say something about the bigger picture. Cancer does not exist in a bubble; it exists in the social fabric of where we live, and people with cancer, particularly children, are not immune to challenges such as the cost of living crisis. If we want to do a robust piece of work in order to make progress, it must involve research and treatment, but it must also improve the life chances of children more generally.

Oral Answers to Questions

Helen Hayes Excerpts

Tuesday 19th April 2022 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend for her question. I had an excellent visit to the surgery in East Leake, and I look forward to the submission of the business case so that we can look at it further. She is right that investing in primary care does a huge amount to support the health of the local community.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

T10. A survey by the charity stem4 has found that 95% of GPs believe that children and adolescent mental health services are in crisis, with children and young people waiting up to two years for treatment after referral. Will the Secretary of State stop treating children as an afterthought and act to provide open access mental health hubs for young people in every community, to put an end to these agonising waits?

[Gillian Keegan]

The hon. Lady raises a very important point. I know that children’s mental health services are treating more young people than ever. However, the demand has quadrupled since the pandemic and that is why we have invested £79 million in these services. By 2023-24, an extra 345,000 more young people will be accessing support. I mentioned the call for evidence. It is important that we work through our vision for our 10-year plan. We are also introducing mental health support teams in schools, which will help, plus access to community and mental health hubs, and more young people will have access to eating disorder services, but there is a lot of work ongoing.

Special Educational Needs and Children’s Mental Health Services

Helen Hayes Excerpts

Wednesday 9th February 2022 Westminster Hall

[Helen Hayes (Dulwich and West Norwood) (Lab)]

It is a pleasure to see you in the Chair, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing this very important debate during Children’s Mental Health Week. She has been a powerful advocate for her constituents who are struggling to access the support that they need for their children. I thank all the hon. Members who have spoken this morning. We have heard many powerful and distressing examples of the impact that the combination of the pandemic and the underlying gaps in support for disabled children is having on their mental health and the mental health of their families.

My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) spoke movingly about her own experience and the impact that a lack of access to diagnosis can have, even into adulthood. The hon. Members for Newcastle-under-Lyme (Aaron Bell) and for Keighley (Robbie Moore) spoke about the battles that families in their constituencies face and about the need for a “tell it once” approach when dealing with services. My hon. Friend the Member for Bristol East (Kerry McCarthy) and the hon. Member for Cities of London and Westminster (Nickie Aiken) made a really important point about the lack of co-ordination among health, education and social care services, which leaves so many families being passed from pillar to post and without the support that they need.

My hon. Friend the Member for Vauxhall (Florence Eshalomi) paid tribute to the brilliant work of Lansdowne School, which is also attended by many children in my constituency, who progress to Lansdowne from Turney Primary School in my constituency. Both schools provide a brilliant education for their children.

It was very moving to hear the hon. Member for Bury North (James Daly) speak about his own experience and the battle that his family have faced and continue to face on behalf of his precious son. It is so important that the hon. Member has brought here today the insights into the system as a whole that that personal experience has provided. I do hope that his son is able to access the support that he needs in order to enable him to continue to flourish in the future.

The hon. Member for Winchester (Steve Brine) made a really important point—there is far too much distraction at the top of Government just now. The disgraceful reality of that is illustrated no more powerfully than by the plight of disabled children, up and down the country, who are struggling to access the support that they need.

From listening to those accounts and looking at the evidence on disabled children’s mental health, it is impossible not to draw the conclusion that the most vulnerable children are being profoundly failed by this Government. According to research by the Disabled Children’s Partnership, nine out of 10 disabled children have been socially isolated during the pandemic, with 72% of parents and carers reporting that their child was often unhappy, downhearted or tearful. The impact of the withdrawal of vital support services, both in and out of school, has been devastating. The situation is of course complex, because many disabled children have physical health vulnerabilities that increased their risk in relation to covid-19 and it was important that protections were put in place.

I pay tribute to the staff working in SEND education and support, who adapted their services very quickly to provide online learning and undertake home visits. I recently visited Cherry Garden School in Southwark, a brilliant primary school for children with special educational needs. I heard from staff about the rapid action they took to develop an online curriculum and the learning packs that were delivered to children via home visits. I know that those visits were a lifeline for many families.

Despite the undoubted commitment of professionals, there was no systematic approach. The necessary precautions that were taken to reduce the risk of covid infection were, all too often, not supplemented with any additional support. At the start of the pandemic, 76% of families surveyed by the Disabled Children’s Partnership said that the vital care and support they relied on had stopped altogether, leaving parents and siblings taking on all care responsibilities around the clock. The support has been very slow to come back. As late as June 2021, more than 70% of disabled children were still unable to access pre-pandemic levels of therapies and health services. The pandemic has been challenging for everyone. It has been particularly gruelling and exhausting for far too many families with disabled children.

However, we know that the challenges facing disabled children and their families are not only a consequence of the pandemic. Some 60% of families with disabled children have sought NHS mental health support due to the stresses of fighting for basic services. That is the story, again and again and again. Every Member of this House will know constituents who are battling with a system that simply does not work as it should, with thresholds for support that are getting higher and higher, and have been doing so for a decade. Parents battle for assessment and diagnosis, they battle for EHCPs, they battle for the right support or the right school place, and in many cases they battle for housing that is suitable for their children’s needs.

I have mentioned many times in this House my constituent Matthew Garnett. I am pleased to say that Matthew is now thriving as a young adult in supported housing, pursuing the things he loves, including his project to visit every football ground in the country. Matthew, who has autism and a learning disability, first came to my attention when he was, like far too many children, in a secure hospital, held under the Mental Health Act 1983.

I supported Matthew’s parents in their battle to get him out of hospital. As part of that battle, the then Mental Health Minister commissioned a review of Matthew’s care. The review made devastating reading. It documented, year by year, his parents’ struggle, over more than a decade, to get their son the support he needed. The consequence of the system failure they encountered was that Matthew, like far too many autistic children and children with learning disabilities, ended up in a secure hospital, far away from his loved ones, with his health deteriorating week by week.

According to the Disabled Children’s Partnership, only 4% of parents and carers of disabled children feel they get the right support to care safely for their disabled children; 53% have had to give up work to care for their child; and 40% have experienced relationship breakdown since their child was diagnosed.

The Minister will, I am sure, mention the £30 million of funding for short breaks for families with disabled children. That is very welcome, but short breaks should be genuine respite. They should not be respite from a system of support that breaks people. It is not enough to substitute for a system that is failing in its entirety the promise of access to a short break every now and again.

The SEND review was originally promised in September 2019. It is now shamefully overdue. The pandemic is simply not an adequate excuse for the lack of urgency in that work, given the impact that the pandemic itself has had on disabled children. It sends its own message about the level of priority the Government place on families with disabled children. I hope the Minister will set out today a firm date for its publication. We need the review to set out clearly the gaps in current provision and in resourcing, so that the Government can set out a clear plan for ensuring that every disabled child in the country is able to access the support they need.

The current system is failing far too many families, and the impacts are being felt in devastating consequences for their mental health. This cannot go on, and I hope the Minister will set out a plan for change today.

Children’s Mental Health

Helen Hayes Excerpts

Tuesday 8th February 2022 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I am grateful to all hon. Members who have spoken in this important debate. We have heard this afternoon many moving and devastating accounts of the ways in which children and young people who are struggling with their mental health are being let down by a system that simply cannot deliver the support they need, and by a Government who have no ambition for our children and young people and who refuse even to acknowledge the scale of the challenge.

There have been too many contributions this afternoon for me to mention everybody by name, but we heard from my hon. Friend the Member for Batley and Spen (Kim Leadbeater) about the shocking figures on suicide and self-harm in her constituency. My hon. Friends the Members for Ealing North (James Murray), for Streatham (Bell Ribeiro-Addy) and for Feltham and Heston (Seema Malhotra) highlighted the importance of mental health support being provided in our schools. My hon. Friends the Members for Bootle (Peter Dowd) and for Luton South (Rachel Hopkins) highlighted the vital importance of early intervention. The hon. Member for Twickenham (Munira Wilson) spoke movingly of some appalling cases in her constituency, including the suicide of a year 11 student.

My hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) highlighted CAMHS waiting times in his constituency, as did many other hon. Members. My hon. Friends the Members for Bristol East (Kerry McCarthy) and for Canterbury (Rosie Duffield) spoke about the terrible problems with out-of-area tier 4 placements, which are far too common. My hon. Friend the Member for Birmingham, Yardley (Jess Phillips) spoke powerfully, as she often does, of the impact of sexual violence and abuse on mental health.

Good mental health and wellbeing are vital for our young children, while poor mental health is a barrier to learning that prevents children from fulfilling their potential. It affects children’s sense of self and how positive they feel about the future. It can impact their whole lives and for some, poor mental health can, tragically, be fatal. For parents and carers, there are few experiences as devastating as watching their child’s mental health deteriorate, yet that is the experience of hundreds of thousands of families across the country. Parents are living with unbearable anxiety, having to stop work to keep their child safe and try to soothe their pain. No parent should be left in this position, without access to the support their child needs.

The covid-19 pandemic has taken a severe toll on children’s mental health, as children have been isolated from their peers, often unable to learn properly and at increased risk of online harms, with many suffering the trauma of bereavement or domestic abuse in lockdown. Before the pandemic, however, children’s mental health services were already in crisis, with waiting lists, acute admissions and out-of-area hospital placements far too high and with only around a quarter of children who needed mental health support able to access services.

We know what is needed to tackle the crisis in our children’s mental health. What is lacking is not the knowledge of what to do; what is lacking is the ambition of this Government for a country in which the mental wellbeing of our children is a priority and services are there for those who need them. We know that early support is key. While children languish on waiting lists, their mental health deteriorates and so does the length of their recovery and the impact that their illness will have throughout their lives. Delivering mental health support teams in just a fraction of communities is not a fit-for-purpose strategy. It is a half-baked plan that is worsening the postcode lottery of children’s mental health services.

Labour is pledging to end the postcode lottery. We will deliver specialist mental health support in every school, and open-access mental health hubs in every community. Hon. Members have asked about the detail of that service, and I would point them to one of my local authorities, Southwark, which has a service called the Nest. It provides open access to children who live in the borough and a really first-class standard of support for our children and young people, but we need such services to be available throughout the country to every single child who needs them.

We are also pledging an end to agonising waiting lists, with a new national commitment to mental health treatment within a month for every child who needs it. To those hon. Members who have questioned the value of targets I say this: if we do not measure it, it does not get done. Targets are not the whole solution, but they are a vital tool in ensuring that services are delivered to children who need them.

Today’s motion is for every child and young person who needs support for their mental health and for every parent and carer living with devastating worry for their child. It is a statement of Labour’s ambition for a country in which every child can thrive. I commend it to the House.