Suicide Risk Assessment Tools in the NHS

Hugh Gaffney Excerpts

Wednesday 4th September 2019 Westminster Hall

[Kevin Hollinrake]

I entirely agree with the hon. Lady. I know that the Bellerby family would very much like to meet the Minister here today—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries)—to see what can be done to make sure these situations do not happen again, and I think they would be very pleased to meet the hon. Lady, too, because I know that she does tremendous work in the all-party parliamentary group.

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

Will the hon. Gentleman give way?

[Kevin Hollinrake]

I am happy to give way again and then I will make some progress.

[Hugh Gaffney]

I will just add my point, from Scotland. In emergency departments, the staff have not been trained up to the level that we are hearing about today. Suicide is a big risk, especially among young people, and all we are asking for is that people look at this situation and give emergency staff the proper tools and training. If that had happened before, Andrew would be with us today.

[Kevin Hollinrake]

The hon. Gentleman is absolutely right and I am grateful to him for his very kind contribution. I know that Andrew’s family will also be grateful to him.

The fact is that the Sheffield trust had been treating Andrew for many years; it knew him well and knew that he was a serious suicide risk, yet none of this was taken into account when he was admitted to hospital for that fateful final time. The untrained nurses carried out the assessment using a crisis triage rating scale, CTRS, and deemed Andrew fit to be discharged. They rated Andrew 14 on a scale of zero to 15, where 15 means that there is no serious or immediate risk of suicide, despite the fact that Andrew had a history of suicide attempts and also threatened to jump out of a fifth floor window while he was being assessed.

The insult to fatal injury in this case is that Mr Richard Bellerby has had to fight for justice and answers for years. He describes the trust’s role in this process as a campaign of dirty tricks—dirty tricks, denial and deceit. In February 2018, the trust finally admitted its wrongdoing, apologised and agreed to settle out of court, but before doing so it had persistently and gratuitously maintained that it was not at fault. For instance, the trust had said that it had an expert witness whose opinion was that whatever the trust would or could have done, Andrew would still have taken his own life. However, the trust refused to supply that expert witness’s evidence and it appears that such an expert never even existed.

The inquest established that the trust was guilty of missing numerous opportunities to provide help. The trust’s own internal investigation revealed that the nurses who had seen Andrew had no training in this area, which directly contravenes national guidelines. At the inquest, there was an embarrassing blame game between Andrew’s GP and the trust, with each pointing the finger at the other. As Mr Bellerby has said, it was like musicians in an orchestra playing from a different sheet of music, with no conductor.

There appears to be a complete lack of accountability; nobody has been properly held to account for these errors. The trust admitted in its internal investigation that it had failed to carry out adequate risk assessments. In Richard Bellerby’s profession, which is construction, failure to carry out proper risk assessment or failure to train people properly can lead to a charge of criminal responsibility for manslaughter in the event of a fatality.

Instead of being open and honest about the circumstances surrounding Andrew’s death, the trust only corresponded when it was forced do so. There were no responses to Mr Bellerby’s letters unless they were sent by recorded delivery, and even then the only responses came from corporate affairs managers rather than from clinicians, and they still failed to provide answers. The trust has not even responded to my letters, other than to send a holding response. I wrote to the trust on 28 January asking for answers to questions and I chased things up on 6 March, but there was still no full response. When the trust finally agreed to meet Andrew’s father, Mr Bellerby, it was of course a meeting with the corporate affairs director. When Mr Bellerby insisted on a clinician being present, the meeting was cancelled.

The trust refused simple requests for information, such as how long the nurses who saw Andrew had worked at the trust and what their qualifications were. The two-year battle cost the NHS around £40,000 just to reimburse the Bellerby family’s legal costs, in addition to any costs that the trust itself and NHS Resolution would have incurred. The total bill is likely to be in excess of £100,000—all for £9,000 in compensation. Critically, there was no compassion, no condolences and no remorse. Instead, there was contempt, denial and disregard.

To say the Bellerby family won is a travesty. They lost their son, a grandson, a brother, but they did defeat the trust. With the help of their solicitors, Irwin Mitchell, whose efforts were instrumental to their success, they won their case, they received their grudging apology and the trust has now stopped using the CTRS. All the family wanted was recognition of the failures and an apology. Given that, everything could have been sorted on day one. Instead the family had to fight against our own bureaucracy. It beggars belief that we tolerate a system that behaves in this manner.

Surprisingly, given the facts of the case and its role in the two-year cover-up of the truth, NHS Resolutions agrees with having a position of openness. In its 2018 report, “Learning from suicide-related claims”, it states:

“Where compensation is due it should be given willingly and in a timely manner to prevent further distress and suffering to distraught families.”

It is time we lived up to those fine words.

The Bellerby family have worked closely with Manchester University on the inquiry I mentioned earlier, which is called, “The assessment of clinical risk in mental health services”. It has helped to establish the extent of the problem of inappropriate use of suicide risk assessment tools in the NHS and the figure of 636 deaths per annum. It has also established that today, 33 out of 85 trusts use a tool that has not been independently validated and 29% of trusts use it with untrained staff. The national inquiry into safety in mental health recently raised issues of the

“inconsistency across mental health trusts in the length and content of risk assessment tools”

and a

“variation in how tools are used and examples of use contrary to national guidelines”.

Everyone seems to agree that the incorrect use of such tools is wholly wrong. Mental health charity Mind is clear that the Government should standardise tools across the service, improve training and support in their usage and follow-up within 48 hours with those who have received assessments. The Royal College of Psychiatrists said that we should

“move away from a risk assessment model to a risk reduction model”.

I know the Minister will be appalled by the full details of the case and will be determined to help drive change in the system, and I have some questions for her. What has changed since Andrew’s death? Specifically, what action will she take to ensure that mental health trusts are only using risk assessment tools that have been independently validated as safe? What action is she taking to ensure that staff in mental health services receive training in risk assessment? What action is being taken to support staff to be able to talk to people about suicidal thoughts? Will she implement a process so that the Care Quality Commission or another body can check that best practice is adopted? Will she commit to an ambition for zero suicides among all those under the care of mental health services? Will she look at the behaviour of the trust and drive through a new policy of openness and honesty in our health services? Finally, will she meet me and my constituents to hear Andrew’s story and possible solutions at first hand, to ensure that Andrew did not die in vain?

Children and Mental Health Services

Hugh Gaffney Excerpts

Tuesday 16th July 2019 Westminster Hall

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate the hon. Member for Burton (Andrew Griffiths) on securing this important debate, and my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), who secured a debate on the issue in the main Chamber last week.

Good mental health is important to us all, especially in childhood and adolescence. If mental health problems in childhood and adolescence are not properly treated, they can continue into adult life. It is not a problem for just one part of the country. It is truly a national crisis. I appreciate that much of the debate will focus on children’s mental health services in England, but I want to highlight the situation in Scotland. The number of young people in Scotland who took their own lives increased by 50% last year—I repeat: there has been a 50% increase in suicides among young children in Scotland. We are losing young people, who have so much to offer, but who find themselves suffering in silence. It is a national tragedy across the UK. The Scottish Government pledged to reduce the number of suicides in Scotland by 20% by 2022. If that pledge is to be met, there needs to be some serious action to improve mental health support for children and young people in Scotland.

The children and young people’s mental health taskforce made a series of recommendations, including joint working between the Scottish Government and local government, to reform the way that mental health support is provided. I urge the Scottish Government to enact those recommendations in full. I back the call of the Scottish Children’s Services Coalition for an increase in investment in specialist mental health services, and I hope that the Scottish Government respond positively.

Investment alone is not the answer, however; we need to tackle the underlying causes of mental health issues among children and young people. Some 60% of young people in Scotland say that the pressure to succeed has led them to feel overwhelmed or unable to cope. One in five young people say that they are ashamed of the way they look. Others have experienced mental health issues as a result of their school environment.

We have to look for new ways to support the mental wellbeing of children and young people, which is why I welcome the “Give Youth A Chance” petition, started by the families of three young men who took their lives in Lanarkshire. The petition calls for suicide prevention and mental health support programmes to become mandatory in schools across England and perhaps the UK. That would be a positive step to ensure that the mental health support needed by children and young people was more readily accessible.

The state of children and young people’s mental health services is a national crisis. They are being let down across the UK by inadequate funding for specialist services and growing waiting lists. It is time for the Scottish Government and the UK Government to listen.

Child and Adolescent Mental Health Services: North-east

Hugh Gaffney Excerpts

Wednesday 10th July 2019 Commons Chamber

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

I thank my hon. Friend for bringing this debate to the Chamber, and for explaining the importance of mental health services in the north-east. In Scotland in the last five years, there has been a 50% increase in the number of suicides among 15 to 24-year-olds. We need to do something about this national crisis.

[Mrs Hodgson]

I thank my hon. Friend for his intervention. I would encourage him to apply for a debate with the same title, only with “Scotland” at the end instead of “North-east” so that he can explore that 50% increase in greater detail. If he is lucky, he might get a nice long session like me, but I know the Minister will have heard his comments.

Throughout all this incompetence it is Jane who has suffered. If this is an issue of recruitment and retention, which it seems to be, what will the Minister do to ensure that CAMHS staff are both recruited and retained nationally, and specifically in the north-east? Nationally, the number of consultant child and adolescent psychiatrists fell by 4.5% between October 2013 and October 2018, which might account for why it was so hard for the trust to recruit someone, while the Government are on track to miss their mental health workforce target by 15,000 staff. Labour research in January found that the total number of mental health nurses had fallen in every month the previous year. I should be grateful if, in her remarks, the Minister would address the issues that led to this decline in the number of mental health nurses and evaluate the impact that it is having on young people such as Jane.

If an A&E just closed its doors because of a lack of staff and stopped treating people, there would be an outcry—we would not stand for it—so why do we allow it to happen when it comes to mental health? The Prime Minister said she wanted mental health to be a priority, but the Government are nowhere near achieving that goal. Mental health awareness is one thing, but it must be matched by mental health support and treatment services, and that is where the Government are failing, especially with regard to staffing.

According to research carried out by the Children’s Society, more than 110,000 children a year are unable to access mental health support from a CAMHS service, despite being referred for support. Three out of four children with a diagnosable mental health condition do not receive the support that they need, according to similar research conducted by YoungMinds. This is therefore not a problem exclusive to the north-east—or even Scotland, as we have just heard from my hon. Friend the Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney)—which is why the Government must take action.

I wrote to Tees, Esk and Wear Valleys NHS Foundation Trust, which informed me that it did not operate a waiting list in County Durham and Darlington CAMHS. However, Jane and other young people, across the north-east and the whole country, are still waiting. It beggars belief that the trust could say that, but it is in the letter that it sent to me.

As I have said, Mr Thomas was left with no choice but to engage a private practitioner. That came at a huge cost to him and his family, but as a loving parent he felt that he had no other option. No parent should be put in that position, and not all parents have the means to step in when the services let them down so badly, as was the case for Jane.

According to the Royal College of Psychiatrists, mental health trusts have less money to spend on patient care in real terms than they had in 2012. Of course, lack of funding means that trusts are strained and unable to provide vital services. Is that what led to the staffing problems in this trust? Was its inability to fill the vacancies down to the salaries being offered, or was the workload that was being demanded of staff too high? Why did that new person leave after only two days? Will the Minister support Labour’s calls for the ring-fencing of NHS mental health budgets and an increase in the proportion of those budgets that is spent on support for children and young people? Increased funding will relax some of the pressure on services, and will ensure that they can be sufficiently staffed and resourced to improve patient experiences.

As I said at the beginning of my speech, Mr Thomas and Jane were very brave to allow me to share their story with the House in so much detail today. However, it should not have come to this. Jane, having mental health problems, should have been referred to CAMHS, been assessed and then been given therapy appointments as necessary to support her recovery—unbroken, with no seven-month gaps in provision. Instead, she and Mr Thomas have been back and forth and have had to fight, and even pay, for the support that she needs and to which she is entitled.

Mr Buckley, from the trust, informed me that North Durham CAMHS had seen an 18% rise in referrals over the last year. It follows that as the number of referrals rises, the funding must also increase to meet that need. The Government must increase the proportion of mental health budgets spent on support for children and young people: they must make mental health a priority, with actions and not just warm words.

While the staffing crisis and mismanagement at Tees, Esk and Wear Valleys NHS Foundation Trust rages on, Jane still has no access to treatment and support on the NHS, although I have been told that she received a call yesterday suggesting that the problem might be resolved shortly. I therefore ask the Minister what she will do for Jane, and young people like her, to ensure that situations like this do not occur in future.

Mental Health Support: Young People

Hugh Gaffney Excerpts

Tuesday 9th April 2019 Commons Chamber

[Ruth George]

I absolutely agree with the hon. Gentleman. I will come on to some of the additional stresses that young people are facing at the moment.

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

I met the Teenage Cancer Trust, which talked about young cancer victims who have mental health problems. They, too, do not have enough support, so I thank my hon. Friend for securing this debate.

[Ruth George]

I agree.

World Cancer Day

Hugh Gaffney Excerpts

Wednesday 30th January 2019 Westminster Hall

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

Thank you for calling me to speak in this debate, Sir Christopher, and I congratulate the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on having secured it. World Cancer Day reminds us all that although much progress has been made, there are still many challenges to be tackled in improving treatment, support and outcomes for individuals with cancer.

Today, the importance of World Cancer Day could not be greater. Macmillan Cancer Support estimates that 2.5 million people in the UK are currently living with cancer, and about another 360,000 people will be diagnosed with cancer this year, with nearly 1,000 diagnosed every day. Those people are our colleagues, neighbours, friends and family: everyone will have their own experience of a loved one who has been taken from them because of this dreadful illness. Tomorrow, I will be attending the funeral of my brother-in-law, Jimmy Boyle, who was taken from us by cancer. He was a loving husband to my sister Mary Jo and a fantastic father to my niece Lorna. Both spent the last six months caring for and looking after Jimmy, and both know that he will be in peaceful rest, free from pain, and will never stop loving them.

This Saturday, I will be attending a teenage cancer fundraiser with my other nieces, Eva and Lia, who along with their friends wanted to do something for teenagers who are living with cancer. It is my family’s experience and those of families across the country that motivate all of us in this House to campaign for better support for those living with cancer, or living with someone who has cancer. I am sure that other Members have been contacted in the days leading up to this debate, be it by those living with cancer, their loved ones, or charities fighting on their behalf. It is staggering to me that when a person is undergoing cancer treatment, as mentioned earlier, the average cost to their family is £600 a month. The idea that people undergoing treatment and their families should face such a financial burden at a time of emotional and personal distress is shocking, and we have heard from hon. Members about universal credit.

The UK, Welsh and Scottish Governments could and should do more to provide financial support for these families. Young Lives Vs Cancer has proposed that a young cancer patient travel fund should be established to help families with the cost of transport to and from treatment, as other Members have already mentioned. That is a great idea that is worth exploring and indeed we should look at reducing the cost of travel for treatment.

We should also look at improving the public transport links to our hospitals. My local bus and rail services are at their worst level. That is another debate. In my own area of North Lanarkshire, Breast Cancer Now estimates that around 120 local women develop breast cancer every year and it is expected that there will be a 27% increase in breast cancer diagnoses in Scotland by 2027. Yet Breast Cancer Now suggests that 20% of Scotland’s cancer radiologists will have retired by 2025.

I call on the Scottish Government and NHS Scotland to ensure that we recruit the next generation of radiologists, so that women can access the service they need. Whether we are considering breast cancer or other types of cancer, we must ensure that the NHS is properly funded and staffed, and capable of improving the treatment, care and positive outcomes that those who are living with cancer deserve. That matters not just in Scotland; it matters here as well, and across the whole of the UK.

I conclude by paying tribute to my local Maggie’s Centre, the Lanarkshire Beatson and of course St Andrew’s Hospice, which cared for my brother-in-law, Jimmy, for their care and support, and the services that they provide for those living with cancer, their families and their friends, and I urge everyone in this House to show their support for World Cancer Day.

Social Care Funding

Hugh Gaffney Excerpts

Wednesday 17th October 2018 Commons Chamber

[Matt Hancock]

That is an interesting proposal, and I have seen others similar to it. We are looking at the link with housing as part of the Green Paper, and I have been discussing that with the Department concerned. The point the hon. Lady raises is important. I note that £731,800 has been allocated today to improved adult social care in York, to take the pressure off the NHS in York this winter. I hope that she will acknowledge that fact.

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

In Scotland, like in England, Wales and Northern Ireland, we have seen unbearable cuts to councils, which have made the problems of funding social care get worse. Does the Secretary of State agree that the Tories and the Scottish National party have to get a grip of the situation and give the councils more resources? They have given out figures for the Barnett formula. What is Scotland actually getting?

[Matt Hancock]

Through the Barnett formula, we have made available funding for Scotland today, which in England we are spending on adult social care. I very much hope the SNP Government in Holyrood will make sure they do the right thing by this funding and ensure that it goes to helping people get out of hospital when they medically can leave hospital but need care once they get out. I think we are agreed between us that the SNP Government in Holyrood should spend this money wisely.

Baby Loss Awareness Week

Hugh Gaffney Excerpts

Tuesday 9th October 2018 Commons Chamber

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

It is a real pleasure to be here for this important debate in the Chamber today. I would like to pay tribute to colleagues across the House for sponsoring the debate and for the work they do to keep this important issue on the agenda. I do not want to speak for too long, but I do have a few words to say. Baby Loss Awareness Week is an important part of the calendar and provides important support networks for bereaved parents, their families and friends. I recall sitting in the House for the debate on this issue last year, and I know that all colleagues agreed that it represented Parliament and politics at their best. In its 16th year, I welcome Baby Loss Awareness Week 2018 and the 60 charities that support it. Those charities are based in all parts of our United Kingdom, and they are doing brilliant work.

Before talking about a link to my own constituency, I want to place on the record my own personal experience of facing the loss of a child. My son was eight months old when he took ill with meningitis and we were given 24 hours to see whether he would survive. Twenty-eight years on, he has survived, thanks to the NHS staff at Monklands Hospital. Today I thank them once again on behalf of my family.

Fifteen babies die every day in the United Kingdom either before, during or shortly after birth; the number of unexplained deaths in children aged over one is not easy to identify across the whole of the United Kingdom. I am particularly interested in the discrepancies in bereavement care. I am firmly of the view that there is a need for bereavement suites in all neonatal units, with increased training and improved staffing levels. This is because 41% of neonatal units have no access to a trained mental health worker and many still have no dedicated bereavement facilities. I hope that we will see the kind of policy decisions in all four nations of the United Kingdom that will allow progress to be made. I welcome the commitment in Labour’s 2017 manifesto that pledged to “significantly reduce infant deaths”. We support the Government’s commitment to reducing the rate of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or soon after birth by 50% by the year 2030.

I want to say a few words in honour of my colleague, Gordon Encinias. Gordon was a councillor in Coatbridge South and a colleague of mine in Coatbridge, Chryston and Bellshill. Gordon died earlier this year and I know that I speak for many in the Scottish Labour family—and, more importantly, North Lanarkshire Council—when I pay tribute to Gordon and thank him for all his work. I mention Gordon because he and his wife lost children to infant deaths themselves, and they committed themselves to championing this issue through supporting Bumblebee Babies, a charity based in North Lanarkshire. Gordon helped it to find a property and premises and gave it his support. It is led by Brenda Murray and now supports parents in all parts of our United Kingdom. I pay tribute to Brenda and all the staff at Bumblebee Babies, and to my late friend Gordon Encinias.

I want to pay tribute to all hon. Members involved in this, particularly my hon. Friend the Member for Lewisham, Deptford (Vicky Foxcroft) and the hon. Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince). Importantly, I also pay tribute to all those parents who have lost children, and I pledge to use my office to do all I can to ensure that the right support is there at the right time. Finally, I pay tribute to my mother, Helen Gaffney, who recently passed away at 86. Her first job as a young nurse was to look after stillborn children, and she looked after those angels as if they were her own. Rest in peace, Mum.

NHS Outsourcing and Privatisation

Hugh Gaffney Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

I thank the NHS’s public service workers for all that they do for us. They have stood against cuts under Tory austerity and a decade of SNP cuts in Scotland. Scotland’s NHS workers are underpaid, undervalued and under-resourced while millions of pounds are spent on agency staff. As Richard Leonard, the Scottish Labour leader, said recently, private companies are

“sucking money out of the NHS”,

but Labour in Scotland is ready to stand up to Tory austerity and SNP cuts.

[Mr Speaker]

Thank you very much indeed.

NHS 70th Anniversary

Hugh Gaffney Excerpts

Wednesday 16th May 2018 Westminster Hall

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

It is a pleasure to serve under your chairmanship this morning, Mr Hosie. I pay tribute to my hon. Friend the Member for Blaenau Gwent (Nick Smith) for securing this debate.

If we look back over almost a century, so much change has happened and so many developments have taken place, but one thing has remained constant: our world-leading, history-making and much loved national health service. Let us think about the founding principles of the national health service. It is comprehensive, universal and free at the point of delivery; millions of lives have been saved and millions of people treated and restored to good health; and it has tens of thousands of decent, hard-working and much-loved public sector workers.

As we approach the 70th birthday of the national health service, to those workers I say thank you for your compassion and sacrifices, for always going the extra mile and for standing firm in the wake of the millions of Tory cuts that we have seen since 2010 and the Scottish National party cuts in Holyrood since 2007. Decisions taken by politicians of all political parties have had an impact on our national health service. I was proud of the previous Labour Government’s record investment in our NHS. We delivered lower waiting times, faster operation times, a GP in local communities and vital investment in infrastructure and facilities. Sadly, it is not all good, and we cannot take our NHS, its workers or its mission for granted.

My local hospital, Monklands, serves many of my constituents in Coatbridge, Chryston and Bellshill. It is one of the busiest hospitals, and just a few months ago there were reports that it needed more than £30 million worth of repairs. There are leaks, and wards are closing. We will look at Monklands hospital. Sadly, on a personal note, one day when I was in Parliament my mother, who is 85 and has dementia, was sent home from Wishaw hospital in a taxi after waiting two hours, with no food and no toilet facilities. My father is 88 years old. They both saw the NHS born. They have been taxpayers all their lives. My father cannot understand why his wife, at her age and with her illness, was treated that way. All that in the 21st century. Thankfully, my mother is now back at her care home, and has settled down a little bit.

Sadly, thanks to the Scottish Government’s failure to invest, more than £3 million was spent on agency staff—that would have paid for more than 100 nurses. Across Lanarkshire in the year 2016-17, more than £10 million was spent on agency staff in three hospitals: Wishaw, Monklands and Hairmyres. To quote the leader of the Scottish Labour party—my leader—Richard Leonard, we need to stop these private companies

“sucking money out of the NHS”.

I do not want to sound too negative. I am proud of the NHS, and I am proud of its workers. I will work with anyone and everyone who wants to see it funded, supported, protected, defended and enhanced. That is why I am here: to defend and fight for public services, to champion public sector workers, and to fight for the right to a hospital bed, an appointment with a GP and an operation in good time.

As Bevan said in 1948, the national health service must meet everyone’s needs, be free at the point of delivery, and be based on clinical need, not the ability to pay. That is our mission; that is my focus. As we come together to acknowledge and celebrate the 70th anniversary of the foundation of the national health service, we must recommit ourselves to delivering that noble aim and objective. Happy birthday, NHS.

 Orkambi and Cystic Fibrosis

Hugh Gaffney Excerpts

Monday 19th March 2018 Westminster Hall

[Paul Scully]

I thank the hon. Lady for that intervention, and I totally agree with her.

I will finish on the issue of living with cystic fibrosis by saying that in addition to having physio and nebulisers, sufferers often have to take a huge cocktail of drugs, as the hon. Member for South Antrim said. The cupboard that I saw for Grace was bigger than one of my kitchen cupboards and it was just full of medicines. There have to be savings in that respect. To return to the hon. Lady’s point, it is really important that we have a system that is fit for purpose. We can sit there and put sticking plasters, as it were, on all these things, but that is what we need. When we are talking about the health service as a whole, it is not always about the big headlines that we argue about across the Chamber. It is about efficiency and ensuring that things work in the modern age. For modern diseases, there need to be modern treatments and so on.

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

The hon. Gentleman is making a great speech. Before he finishes, I would like to say that I have had more than 250 emails on this issue alone from my small constituency. The point I want to make to the Minister is that we have a full house in this Chamber and a full Public Gallery. I want this noted. The Government have to act on this issue—not just talk about it, but act on it. Let us take some action.

[Paul Scully]

I thank the hon. Gentleman for that intervention. I will give way one more time and then conclude.