Lower Limb Wound Care

Jamie Stone Excerpts

Tuesday 23rd July 2019 Commons Chamber

[Ann Clwyd]

I am grateful to the hon. Gentleman for making my speech for me. I am sure we will be in total agreement as my speech develops.

Some interesting points were made during the debate in the other place, including the point that wound care is a massive challenge to the NHS, but it currently lacks priority, investment and direction. I want to push the Government, if they need pushing, on the need for urgent action and the development of a strategy across care providers to improve the standard of wound care.

A staggering 2 million patients are treated for wounds every year, at a cost of more than £5 billion and rising. While 60% of all wounds heal within a year, a huge resource has to be committed to managing untreated wounds. The NHS response is very variable. Healing takes far too long; diagnosis is not good enough; and inadequate commissioning of services by clinical commissioning groups compounds the problem, with under-trained staff and a lack of suitable dressings and bandages.

There has also been a very worrying drop in the number of district nurses, whose role in ensuring safe and effective wound care in the community is crucial. I was shocked when I talked to a friend in Cardiff about the problem of putting on surgical stockings, and her experience highlights the need for district nurses. My friend had had a serious operation, and she could not bend to pull on the stockings. I asked her what she did, because she is a widow who lives on her own. She said, “I go out in the street and ask somebody to help me.” I am sure that people are very ready to help, but no one should be in that situation. I think we would all agree that the drop in the number of district nurses is very worrying.

I am told that, ideally, 70% of venous leg ulcerations should heal within 12 to 16 weeks, and 98% in 24 weeks. In reality, however, research shows that healing rates at six months have been reported as low as 9%, with infection rates as high as 58%. Patients suffer, and the cost of not healing wounds swiftly and effectively can lead to more serious health problems, such as sepsis, which is often the result of an infected injury. We also know that foot ulcers on diabetics can unfortunately lead to amputations if they are not dealt with properly.

In the other place they talked about the Bradford study, and there is a very good summary of it in the House of Lords Library. It underlines the importance of evidence-based care, with nearly one third of patients interviewed in the study failing to receive an accurate diagnosis for their wound. As the study puts it:

“Wound care should be seen as a specialist segment of healthcare that requires clinicians with specialist training to diagnose and manage…There is no doubt that better diagnosis and treatment and effective prevention of wound complications would help minimise treatment costs”.

We learn most of all from our own experience. My experience is that when I first developed a farthing-sized spot on my leg, I did not know what it was. I asked my chiropodist, who looked at it a few times and said, “I think you had better go and see your GP.” I went to see my GP—a very good GP—who did not know what it was either. Eventually, I was referred to a skin specialist—this is some weeks ago, now—who looked at it and said, “I don’t know what it is, but why don’t you try putting Vaseline on it?” Now, I do not think the experts up there in the Gallery would think that that was a very good idea, but I did put Vaseline on it and I do not know whether that did me any harm or not. You do worry a lot when something like that happens, whether you have knocked your leg or injured yourself in some other way, and you wonder what on earth it could be.

I think that maybe diagnosis is difficult, but rapid diagnosis is absolutely essential. I am sure the Government would agree that we need to get to grips with a nationally driven strategy. Without it, patients will receive worse care for their injuries and the financial burden on other parts of the NHS will continue to increase, because patients develop chronic wounds or catch an infection that could lead to life-threatening illness.

During the course of my journey, I have met many interesting people. For instance, I did not know there was an all-party group on vascular and venous disease. I just happened to see it in the all-party notices the day after I had been in St Thomas’s. I rang up the chair, the hon. Member for St Ives (Derek Thomas), and asked him if I could come along to a meeting. He said that I was welcome to. I went along and, apart from the chair, I think I was the only MP there. There was a fascinating mixture of people, who were all involved in this problem in some way.

There was somebody who runs a leg clinic, who had a lot of stories to tell. In fact, she sent me a whole pile of patient stories—there is not time to read them out today, but they are very interesting. I realised how difficult it is for patients to get the right diagnosis and the right treatment. I took a list of all the people—they are mainly consultants—and I know that some people in St Thomas’s would have come along if they had known of the existence of such a group. It introduced me to the Lindsay Leg Club Foundation, which is run by Ellie Lindsay OBE, who is the president. There are leg clubs in many towns and cities around the country. She was very encouraging—I say that as somebody who was a bit afraid when they realised what they had. She rang me up several times, and her patient stories were fascinating.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I am listening with great interest to what the right hon. Lady is saying, not least because this is an important debate on something that we do not talk about as much as we should in this place. Am I picking up correctly what she is saying on patient experience? Is she saying that we should encourage patients who have been through this transition and experience to share that experience with others in order to make other potential patients more aware of what might be out there and what they could do?

[Ann Clwyd]

Yes. That is a very positive idea. People need to talk to one another, particularly in this House because of the age differences. A lot of people talk about this in the other House, because on the whole they are much older than we are—except for me in this place; I am pretty old. I am just surprised that I had never heard of this before. Talking encourages people when they have discovered that they have this problem to seek the right advice.

[Jamie Stone]

Can I make absolutely sure that I understand this? By age difference, the right hon. Lady means people of my age—I am considerably older than some hon. Members—sharing experiences with people who are younger and might need to know these things. Is that correct?

[Ann Clwyd]

Sorry; I did not hear the last part.

[Jamie Stone]

Is this about the older generation, who might have had some experience in this regard, sharing experiences so that the younger generation—considerably younger than I am—might know the potential of what they will look at or deal with in future?

[Ann Clwyd]

Yes. I am very glad that there is an all-party group, for example, because it is important that such groups exist. I have seen the work that has gone on there over several months. As the hon. Gentleman knows, there are dozens and dozens of all-party groups in this place—I am sure that we do not know of the existence of most of them, but it is good to draw attention to this one.

Another person I met was Professor Julian Guest, who is a health economics consultant. People are very good at sending information. He sent me a list of things that, as a health economist, he has been working on. He says that wound care requires

“a change in its service delivery model that could include…Enhanced support for safe self-care (possibly by integration with local pharmacy support and supervision)…Improved diagnostic support underpinned by increased training and education of non-specialist nurses in the fundamentals of wound management…Consistent and integrated progressive care pathway with agreed defined trigger points for senior involvement and onward referral for investigation and differential diagnosis and a shared management plan to be implemented regardless of care setting…Establishment of dedicated wound care clinics in the community, possibly in general practices.”

So there are several papers by people working in this area who are thinking deeply about it.

I heard from consultants at St Thomas’s about an excellent development called the Camden Health Improvement Practice pilot wound clinic. Dr Geraghty, who runs it, is working on wound care for people who are sleeping rough—for the homeless. I think everybody would applaud that as a very necessary and useful thing to do, and we look forward to hearing more about it. I am looking at the clock, and there is not much time left, but I hope the Minister will respond on this issue, because when I think of the pain inflicted on people—luckily, my pain is managed, but the pain of the homeless, for example, who are sleeping rough on the streets, is not generally being managed—it is clear that this Camden project is a very welcome development.

I had a new knee about a year ago, which is not a pleasant thing to have done. However, I have known nothing as painful as this leg wound, and I am grateful that so many good people are working in this area and highlighting its importance. It is probably not as glamorous as others in the health service, but it is absolutely necessary for people’s wellbeing, comfort and health, and I hope we can do a lot more to support people in this area, to support new initiatives and to assist the doctors, nurses and other practitioners who do such an excellent job.

I am out on parole, Madam Deputy Speaker. I will, I hope, be returning to my bed in St Thomas’s before too long, and I hope to come back after the recess with very positive views and a continuing interest in the whole subject of wound care in the NHS.

--- Later in debate ---

[Caroline Dinenage]

The hon. Gentleman is always full of brilliant ideas and we will only move forward as a nation if we share best practice and the expertise gained from different parts of our country. So I would be very keen to speak to his colleagues at the Northern Ireland Assembly and see if we can gain any learning from that.

[Jamie Stone]

I could not possibly let the occasion pass without commenting. Can I take it that that promise will be extended to the Scottish Parliament and the Scottish Government? The issue we have heard about today is no less a problem in Scotland.

[Caroline Dinenage]

Yes. We do not discriminate. We are keen to talk to everyone to get the best possible learning so that patients up and down the country can benefit from all the expertise that is available.

In thanking the right hon. Member for Cynon Valley for making the supreme effort to be here today, I reassure her that both the Government and the NHS recognise the importance of ensuring that patients have access to high-quality lower limb wound care and will continue to support the work of the national wound care strategy programme for England on improving the quality of wound care, including lower limb wound care, in the country. I thank her once again for being here to make her case so incredibly powerfully. I wish her a speedy recovery and send her all our love from this House.

Acquired Brain Injury

Jamie Stone Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Chris Bryant]

Yes. The all-party parliamentary group on acquired brain injury—I see that two of the vice-chairs are in the Chamber—has been campaigning to ensure that everyone who does any kind of assessment for the Department for Work and Pensions, whether for personal independence payments, the employment and support allowance, or any other benefit, has a full training in acquired brain injury, so that they understand the variable nature of the condition.

One element of the personality change that may come about is that somebody with a brain injury might be desperate to please the person in front of them, so they might want to give what they think is the “correct answer” to the question being asked by the official. That can give a misleading idea of what that individual’s abilities are.

I have not asked Tom whether it is all right to say all this today—I see that he is nodding, so it is fine. When the Duracell battery inside someone’s head is running low, they talk to themselves to try to re-energise it, but that uses even more energy. That can lead to a vicious cycle: further depression and anxiety makes it more difficult to recharge the battery, in turn making it more difficult to get better.

There are others who have had much more dramatic and traumatic injuries, perhaps where something has penetrated the skull. However, in the vast majority of cases, the injury will be inside the brain. A fundamental part of what we have to address is how the mind and the personality sit inside the brain. Right hon. and hon. Members might have seen the television series “MotherFatherSon”, which deals with someone who has had a massive aneurysm and then a stroke. Lots of things in the programme are not entirely accurate, but many families and individuals have to cope with the very real element of personality change. I met a wonderful woman three months ago told me that she wished that her old self would come back. She could remember what her old self was like, but it is not the person she now is. She just does not know how to recreate that personality inside herself. Again, it is this thing of talking to yourself all the time.

If there has been impairment of the executive functions due to a brain injury to the frontal lobes, particularly in teenagers or as the young brain is still developing, it can lead to all sorts of other problems in terms of employability, and being able to engage with the wider world and their family. Sometimes people share far too much information; sometimes they are far too timid about being able to share information.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

On that point about sharing, as I told the Chamber in the debate on 9 May, my wife suffered from a meningioma. As I think the hon. Gentleman mentioned, a certain fretfulness can come into the character. On sharing, perhaps it is because I live in such a remote area, but I am surprised those who have come through the treatment are not encouraged more to share their pre-operative and post-operative experience with people who are suffering or are about to have a medical intervention, because it would give them great courage and help.

[Chris Bryant]

Yes, that is true. Because of the pattern of brain injuries across the country, it may be difficult for people to gather with people of a similar age and background. Lots of people with brain injuries arising from road traffic accidents are quite young—in their teens or early 20s. Sometimes they get put into support groups with people in their 60s or 70s. That is not an impossible combination, but sometimes it is not the most natural grouping for those with a much longer life expectancy.

The most difficult element for a lot of people is the significant impairment in their ability to speak and communicate. Speech therapists are an essential part of the mix in bringing people back to a degree of independent living after a significant event. One worry across the whole of the UK is the shortage of people working in this field, who sometimes do not feel as valued in the team as they might. We need to ensure that speech and language therapy is still available for some time after someone has had their immediate intervention.

One of the most common things that people tell me is that they are accused of being drunk, when in fact they have difficulty speaking properly because they have had a brain injury, not because they are a bad person. They feel the sense of stigma that attaches to not being able to speak as clearly as they might have been able to before their brain injury.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 18th June 2019 Commons Chamber

[Matt Hancock]

My hon. Friend is dead right to say that this provides a better service and saves money. I do not have the figure at my fingertips, but I will write to him with the answer and ensure that it is published for the whole House to see.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Patients in my constituency have to travel vast distances—often in excess of a 200-mile round trip—to be seen at Raigmore Hospital. As and when properly working visual teleconsultations are brought into being, when that technology is developed, may I appeal to the Government to share the technology with the Scottish Government and with NHS Highland?

[Matt Hancock]

Absolutely. Places like Caithness are a great example of where GP consultations that can be done over the phone or over a video conference can save people hours and hours. Of course they sometimes need to see their GP in person, but not always. We are driving this agenda hard in England, and I would be happy to work with the NHS in Scotland to ensure that that technology is taken up there, too.

Interim NHS People Plan

Jamie Stone Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

The hon. Lady is right: that culture is not acceptable and must be driven out. She will have read the interim people plan, which talks explicitly about ensuring that we create leadership that stops that culture. There is a chapter on making the NHS the best place to work. She will know that we have been working across the country to ensure that all staff know that they are valued, that they have the right to speak up and that the culture of bullying must be driven out. I shall speak with Baroness Harding, as I do regularly, to ensure that that message is spread throughout the NHS and that staff know that they are valued.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I realise that health is devolved to the Scottish Government. Nevertheless it has to be said that the Scottish Government are having enormous trouble with their workforce planning, which means that doctors and nurses have to pick up the slack and that we are wasting good money on employing agency staff, which need not happen. May I make a plea to Her Majesty’s Government to share workforce planning and best practice with the Scottish Government so that they can get that right?

[Stephen Hammond]

As the hon. Gentleman rightly pointed out, health matters in Scotland are devolved, but I am delighted to share any of the excellent initiatives that are set out in the draft people plan with the Scottish Government.

Tessa Jowell Brain Cancer Mission

Jamie Stone Excerpts

Monday 13th May 2019 Commons Chamber

[Matt Hancock]

The hon. Gentleman is right to say that, and I send my condolences to his constituents. The truth is that brain cancer is one of the most, if not the most, predominant cancers among children. Although it is relatively rare among all cancers, that is not true among children. Thousands of people still die from brain cancer, which is why it was right that Parliament and Tessa Jowell came together to highlight the lack of research in the area—something that we are determined to put right.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

May I too thank the Government for today’s statement? I was heartened by the answer given to the hon. Member for Worthing West (Sir Peter Bottomley), because early diagnosis is incredibly important. There are certain things that people can recognise, such as the effect on vision. Ironing a pinstripe shirt, for example, can lead to an odd effect, which is an early sign. Early screening in built-up areas and cities is quite easy, but it is harder in rural areas, so I make a plea for the Government to consider sparsely populated regions such as mine.

[Matt Hancock]

The hon. Gentleman is right that screening is vital. One of the reasons why we are looking at the whole screening programme is that the use of technology has not been nearly good enough. For many people, but not all, that can be valuable, especially in rural areas. Technology is not only used for the screening itself, but for notification and for ensuring that we get to everybody who needs to be reached. Professor Sir Mike Richards is undertaking the review of all screening, and I would be happy to put Sir Mike in contact with the hon. Gentleman to ensure that the review properly considers the impact of rurality on the need to get screening to everybody who needs it.

Acquired Brain Injury

Jamie Stone Excerpts

Thursday 9th May 2019 Commons Chamber

[Chris Bryant]

That is one of the key points that everyone on the all-party group wanted to make. It is all very well saving someone’s life but, because we have seen so many miracles done by good neuro-rehabilitation in the community, we need to make sure it is available where people live. Otherwise we are condemning people to a half-life existence when we could restore real quality of life—they might go back to work and be fully independent.

The hon. Gentleman is absolutely right to say it is a matter of getting social care to work with NHS and getting all the different organisations to work as a whole. That is why we hope that the Government—there are signs of this, but we would like to see more signs—will not work in silos of departmental and organisational thinking. We have to think across the whole, because this affects nearly every Government Department.

Many patients lose their executive functions, so they find it next to impossible to plan, make decisions, monitor what they are doing or control their emotions—that can make it difficult even to cook for themselves. In particular, a brain injury to the frontal lobes during the teenage years, when that part of the brain is still developing, can turn a charming, ambitious and able young person into an out-of-control youngster. All too often, if the brain injury is missed or misunderstood, they get into trouble, they are excluded from school and they fall into the criminal justice system. I read Edward Timpson’s report this week. It is an important piece of work, but it is a shame that it does not mention brain injury at any point. I will be writing to him about that to see whether it is another element that we need to address if we are to stop exclusions, which are currently so prevalent.

Even a minor brain injury can lead to headaches, dizziness, fatigue, depression, irritability and memory problems. Sometimes the effects last long after the injury, and sometimes they do not even appear until some time after the injury, which makes them particularly difficult to spot.

Partners and family members have a tough time, too. The hon. Member for Ochil and South Perthshire (Luke Graham) will know from his own family how complicated it is to make sure that people get the support they need. Loved ones have the terrible fear of the unknown. What is going on inside their loved one’s head? Will the anger and frustration they seem to be suffering get stronger, or will it ease off? How much will they be able to recover their former abilities and personality? And how hard will they have to struggle to get the support they need?

In too many instances, families and patients are being pushed from pillar to post when it comes to benefits. Listen to what happened to Jordan Bell, who had a motorcycle accident some six years ago, when he was 17. The accident left him in a coma for six weeks and in rehabilitation for six months before he went home. He had to learn to walk, talk, eat and socialise all over again. I am glad to say that he has made a remarkable recovery and is now a father, but he lives with significant, serious and completely unseeable impairments.

Jordan’s father describes dealing with the welfare system as

“the most demoralising and depressing experience for us all.”

This is a professional family. The initial application for personal independence payment took six months, with interventions from the family’s MP. David Bell writes:

“A year or so after our son’s condition had improved we contacted the relevant department to advise them that he was in our judgement no longer entitled to some elements of the PIP. We were ‘quietly’ advised not to inform them of the changes at all, but as we are honest people we felt duty bound to inform them of our son’s improvement. The advice given to us was correct; instead of adjusting the PIP in what would have been a sensible way the PIP was cut entirely. This then set in motion another six months of huge effort and stress and again the involvement of our MP to get the PIP reinstated. We eventually succeeded. But two years later it was reduced again to nothing.”

I cannot emphasise enough the stress this process puts on people with ABI.

One woman told me:

“I know I should use all my energy to try and get my brain back together. But I end up spending all my energy on forms”—

filling in forms and fighting bureaucracy. An unresponsive, intransigent welfare system is effectively preventing people from healing. I beg Ministers to take this issue seriously and to make sure that all PIP advisers are trained in the fluctuating and unseeable nature of brain injury. After all, one common feature is that patients become over-keen to please people. Often, they will tell the assessor everything they think the assessor wants to hear, because that is part of the condition.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Notwithstanding what I will say later, in casework I find that a surprisingly high number of disability living allowance claimants are having the mobility element carved away as they move to PIP, perhaps because, as the hon. Gentleman says, they have exaggerated their ability to get from A to B or to move into work.

[Chris Bryant]

That specific point has not been raised with me in relation to brain injury because it is one of the seeable bits. It is the unseeable bits that are particularly difficult for PIP assessors and other assessors to get right, which is why it is important that they all have proper experience and training in assessing brain injury.

I do not want to take too much time because I know that many others want to speak, but I will refer to a few more elements, the first of which is the prisons system. All the latest research shows that a very high percentage of inmates, both male and female, have had a brain injury. One survey shows that 47% of inmates at Leeds Prison have had an ABI, and Huw Williams’s work shows that more than 60% of prisoners at Exeter Prison have had a traumatic brain injury. In both surveys, the majority of injuries occurred before the prisoner’s first offence, suggesting that the brain injury may be a key factor in why they offended in the first place. If we really want to tackle their reoffending, we will have to deal with their brain injury, too.

Research at HMP Send and HMP Drake Hall also finds that the most common way for women inmates to acquire brain injuries is through domestic violence— 45% of injuries. Again, we may be criminalising people who are actually victims. We need to get this right. If we really want to tackle reoffending, we must do a better job of recognising and treating brain injury. That means screening all new prisoners, training prison staff, providing proper neuro-rehabilitation for all prisoners with a brain injury and making special provision for women that recognises the likely different causes of their injury—particularly domestic violence.

I will not say much about education, because I know other hon. Members will. The Government have been good in responding to our report in detail, but the section of their response with which I am most dissatisfied is on education. There is a hidden problem across our schools estate, and we will store up problems for the future if we do not take this issue seriously. In particular, I urge the Government to reconsider our recommendation that acquired brain injury should be included in the special educational needs and disability code of practice.

The final area is sport. I make it clear that sport is good for people’s health, and I do not want to prevent anyone from taking part in sport. I do not want all our sportspeople and youngsters to be mollycoddled and wrapped in cotton wool, but the record on sports concussion is shockingly bad, particularly in football. I am no football expert.

--- Later in debate ---

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I thank the hon. Member for Rhondda (Chris Bryant) for bringing forward this debate and I compliment all the speakers on their contributions. It would be churlish of me not to say a word of congratulation to the Minister on her appointment. It is a delight to see her in her place. I am going to give the House something of a personal account, which I will try to keep fairly brief. I hope that I can draw from that personal account a number of conclusions and suggestions.

Yesterday and today, several Members have remarked on the fact that this is the 20th anniversary of the foundation of the Scottish Parliament. In early 1999, I was canvassing in north-west Sutherland. I always start canvassing early, but don’t tell the SNP. I pulled up at a phone box at Inchnadamph—this was back in the days when we had phone boxes even in remote parts of the highlands—I tried to ring home and there was no reply. So I carried on. When I got home at 5 or 6 o’clock that night, I discovered that my wife was in hospital—at Raigmore Hospital in Inverness.

My wife had been due to drive to Inverness to get the messages, as we say in the highlands, but found—as it turned out, very luckily—that the car had a flat tyre, so she caught the bus to Inverness. Having got her shopping, she was at the bus stop waiting to come home again when she took a massive epileptic fit. She woke up in Raigmore Hospital. Very shortly afterwards, when the staff took an X-ray of her head, they discovered that she had an extremely large meningioma, which is a form of tumour. Luckily, it is a benign tumour, but they reach some size. Within weeks, she had an operation to remove the meningioma. Unfortunately, in the recovery ward shortly after her operation, she took a further brain haemorrhage and had to go straight back into surgery. She was then in intensive care, but she did survive. I want to say that, for my family, for me and for my dear wife, it was an incredibly difficult time. How my eldest daughter, who was then aged 17, got through her studying for her highers, I will never know. I always think that my three children were in fact braver than I was; I put that on the record.

I want to say something else for the sake of the record. Reference has been made to the NHS and just how good it is. The then consultant neurosurgeon at Aberdeen Royal Infirmary, where my wife was operated on, was Mr David Currie. He and his team, as well as the nursing staff, were absolutely astonishing. I owe them and my wife owes them absolutely everything. They may think it was churlish for me to carry on canvassing to be an MSP but, when my wife could speak, which was not for a few weeks, I said, “Look, it’s only March and the election isn’t until May, I think I’ll pull out”, and she said, “Don’t.” She said it very quietly—she could only speak very softly. She said, “You must carry on. I think you might win.” And so I did. So there is a happy end to the story.

My wife is left somewhat disabled—she has a weak left leg and she has lost the use of her left arm—but, as we always say in my family, she is alive. She remains better than I am at the crossword. I cannot tell hon. Members how annoying that is, but that is just the way it is. She suffers from mild anxiety about things; much comment has been made about the side effects of this sort of surgery. However, I am intensely grateful to the NHS.

There are one or two conclusions that I would draw in this short contribution. The first is that we could see that Mr David Currie, the consultant neurosurgeon, and his staff—I admit this was 20 years ago—were stretched. Mr Currie always said to my wife for some years afterwards, “You see these white hairs. I got these operating on you for the second time.” But they were pushed. They were working extremely hard, but we could see they were pushed.

Secondly, as I have said already, we could see the sheer importance of the NHS and what a great British institution that is. I think, rightly, all parties in this place cherish and nurture it. I have to say, as an aside, that when I hear some of the comments coming across the Atlantic from the United States about how they do not want anything like the NHS, I think that they are just plain dotty. It is something of which we are very proud.

A third point arises from this experience, which was difficult. I admit that it was 20 years ago but, when my wife came out of hospital and came home, there was the business about what occupational therapy and physio help she could get, what was the social work package and how that was going to be handled. I think things have improved since then—I give credit to the Scottish Government for that—but how this is put together is very traumatic for the patient and for the patient’s loved ones. I was 44 and my wife was 42, and we had a family in their teens. An event such as this is a crisis and a change that you can hardly understand at the time. But, as I say, life goes on and we are where we are.

I have a habit of talking about disability issues because of my wife. One of the reasons why I volunteered—I was probably completely insane—to go on the small Committee charged with building the Scottish Parliament was that I could see that the old temporary Parliament at the top of the Mound in Edinburgh was utterly unsuitable for disabled people. Because of my wife’s experience, I got involved in what was known as the Holyrood project. It damn nearly lost me my seat at my second Scottish election because it was a very controversial issue, as I am sure the hon. Member for Ayr, Carrick and Cumnock (Bill Grant) will recall.

I have mentioned several times in this place the issue of getting disabled people back into work. At a time, whatever happens with Brexit, when we must play to all our strengths—we must play every card we hold—we have a lot of people who have been ill or are partially disabled who have great abilities that they could contribute to the functioning of the United Kingdom and to forging a new and better future for the United Kingdom. It remains a challenge for Governments of all colours to harness those people. If nothing else, it makes them feel that they are contributing to the country and it makes them feel useful and that they are important. Self-esteem and the esteem of your peers is incredibly important to happiness and to quality of life.

I want to take up the point, which I think was made by the hon. Member for Rhondda, that notwithstanding the desirability of local delivery of services, there is something to be said for amalgamation when it comes to something as crucial as neurosurgery. At the time of my wife’s treatment, there were four neurosurgical units in Scotland and Mr David Currie was the sole consultant neurosurgeon at Aberdeen Royal Infirmary. Had the four units been put together as one, there would have been better peer working and peer support. I think the hon. Gentleman made the point that, when it is something as traumatic as neurosurgery, people do not mind travelling. From the northern highlands, it did not really matter to me whether it was Aberdeen, Edinburgh or Glasgow—I just wanted my loved one to get the best possible treatment. I know it is always the case that we will get a local campaign saying, “No, no, no—not this”, but I think we can draw a line on some services, where centralisation for the maximisation of making people better is important. We should not lose sight of that.

A meningioma is a tumour that can kill you. It is a meningioma whether people live in Scotland, England or Wales—anywhere at all. I therefore appeal both to the Scottish Government and the UK Government for maximum co-ordination across borders on health delivery, the health service and making people better. I would hate to think that a line drawn by people on a map would in any way get in the way of that because this is about saving lives and making people better, which is surely one of the most important things.

I am going to end, as is my wont in this place, with a very short anecdote. I was lucky in May 1999. I would not say if they are sad enough, but if Members have a dull moment they can look at this week’s edition of Holyrood magazine and remark how young I looked then; I have aged terribly badly since then. I did win my seat. The Times decided to do a vox pop of my new constituents only a few days after I was elected. It asked one lady from the village of Kildary in Easter Ross, “How do you feel about Jamie Stone being elected to be an MSP for this constituency?” She replied, famously, “Well, at least it keeps him off the street.” When I read that to my wife in her hospital bed, she roared with laughter and I knew then that she was better.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 27th November 2018 Commons Chamber

[Caroline Dinenage]

I will of course meet my hon. Friend. She is right that we need to keep such valuable local resources right in the community, where they are most needed and where they keep people out of acute hospital services and surrounded by their friends and family.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The usage of Caithness General Hospital in Wick in my constituency is way below what it was originally designed for, causing my constituents great anxiety if they have to travel over 200 miles to Inverness and back. Mr Speaker, you will tell me that such matters are devolved, so will the Government share best practice on community hospitals with the Scottish Government and NHS Highland?

[Mr Speaker]

What a wily fellow to get the question in order. Well done, man.

Budget Resolutions

Jamie Stone Excerpts

Tuesday 30th October 2018 Commons Chamber

[Brendan O'Hara]

I refer the hon. Gentleman to the commission’s report and advise him to read it, rather than simply taking the crib sheet handed out by his party.

Much has been made of the Chancellor’s announcement that £20 billion of new funding would be made available to the NHS over the next five years. We are told that that funding will be transformational for the national health service, but let us put it into perspective. The new money, which we welcome, averages out at a 3.4% increase per annum for the next five years. That is actually still less than the average funding increases received by the NHS in the first 60 years of its existence. All the Chancellor announced is that NHS funding, having been squeezed mercilessly by the Tories in the past decade, is returning to a position that is a little below its historical average. The reality is that in releasing this money, the Chancellor has simply removed the Treasury’s heavy boot from the neck of the national health service. If the Chancellor had had the good manners to remain in the Chamber until my right hon. Friend the Member for Ross, Skye and Lochaber (Ian Blackford) had spoken yesterday, he would have heard him ask why the Scottish national health service is being short-changed in the Budget to the tune of £50 million a year, which makes a cumulative shortfall of £250 million over the five-year period. That £50 million is enough money to pay for 1,200 nurses in Scotland.

In his Budget, the Chancellor had the perfect opportunity to do the right thing: stop the roll-out of universal credit dead in its tracks until the well-publicised faults in the system, which are hurting the poorest and most vulnerable in our society, have been fixed properly, once and for all.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Further to that point, is it not a scandal that the Highland Council has to fork out £2.5 million of its carefully hained resources to pay for the roll-out of universal credit? What might that £2.5 million have done for some of the poorest people in areas such as Argyllshire and my constituency?

[Brendan O’Hara]

I could not agree more. The hon. Gentleman is absolutely right to highlight the cost to councils and individuals of the appalling roll-out of universal credit. The Government know that it is wrong, but they are pigheadedly determined to see it roll out. The Budget was the Chancellor’s perfect opportunity to stop it, but he refused. For reasons best known to himself, he decided instead to tinker around at the edges, with the promised money coming nowhere close to meeting the shortfall that was created by his predecessor. The Chancellor has decided to do almost nothing for those who are currently on universal credit and are struggling under the work allowance, the two-child cap and the benefit freeze.

As Gillian McInnes, the manager of the citizens advice bureau in my Argyll and Bute constituency, said:

“The Government has still not done enough to address the real problems of universal credit, which are causing serious hardship for many families. Without further support for families, many parents and children will be left in a desperate situation, with many”—

indeed, many more—

“forced into using food banks.”

This was the Chancellor’s opportunity to end austerity—he chose not to. This was his opportunity to stop and fix universal credit—he chose not to. Instead, he and the UK Government chose to hand out tax cuts to the wealthy while continuing to try to balance the country’s books on the backs of the poorest in our society. Heaven help us all if this was the Chancellor’s “good guy Budget”—the one that was based on the Government securing a half-decent Brexit deal. One shudders to think what he has up his sleeve when we are all forced to reconvene in this place early next year for his fiscal event, if and when the Brexit negotiations go totally pear-shaped.

Clinical Waste Incineration

Jamie Stone Excerpts

Tuesday 16th October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend will be aware that the Environment Agency is an independent body, so it will be for the Environment Agency to reach a decision on whether such a suspension should be raised. I can reassure the House that the issue is subject to great scrutiny at present and that the Environment Agency is looking at it very closely.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It seems to me that there are two ways of looking at such issues. Factoring in numbers, statistics and logic is one way and leads to one conclusion, but when we think about human decency and human dignity it becomes something entirely different. The public’s confidence in the methodology is absolutely paramount at this stage. First, does the Minister recognise that, and secondly, can he tell me what he is doing to restore that public confidence?

[Stephen Barclay]

The hon. Gentleman is absolutely right, and I very much recognise that. The emotive nature of the topic and the way in which some of the headlines have been written do cause alarm. We are being very strategic. First, we are ensuring that our key priority, which is continuity of service in hospitals, is maintained. Secondly, we are ensuring that a supplier is mobilised as quickly as possible. He will recognise that to mobilise a supplier over so many contracts, where those contracts are not uniform—there are different legal provisions in them—is a complex issue. Thirdly, where there is an interregnum with regard to contingencies and waste that needs to be stored on site, we are ensuring that that is done in the safest way possible and that the waste is then cleared at the earliest opportunity.

Baby Loss Awareness Week

Jamie Stone Excerpts

Tuesday 9th October 2018 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is a great privilege to take part in this debate. The hon. Member for Eddisbury (Antoinette Sandbach) and others have set an almost unsurpassable standard in their comprehensive, thoughtful and moving accounts of the issue before us tonight. When I thought about what I was going to say today, I found myself strangely circumspect, reticent and shy about what I might or might not say, possibly because I am old fashioned—probably more so than I should be. At the back of one’s mind there is always the thought, “Is it in good taste? Should I go there? Should I not?” But in a flash it came to me: I have only one sibling, my younger brother, who is nine and a half years younger than me, and all my mother ever said about this—she is dead now—was that she had a number of miscarriages between me and my brother. It is very much to my detriment, to my dishonour, that I never broached this subject with my mother and said, “What happened?” I very much regret that. My parents were immensely British, and they got on with it and suffered in silence, but I wonder how many miscarriages she had and what that agony was like. It is too late now, and “too late” are some of the saddest words in English.

The point has been made about parents, and I am a parent, all three of whose children were born relatively easily and successfully. As one or two Members of this place know, I am also a grandparent and a brother-in-law, and for that reason am not untouched by the type of tragedy that has been described today. One thinks, “It is not going to affect me”, but it comes damned close. So I have the experience. The second thing I found to be almost like a searing wound to me personally: witnessing the extraordinary grief of what happened. This was a searing, dreadful, ghastly grief. The hon. Member for Colchester (Will Quince) has said that we must reach out, give people a hug and ask how we can help, but that grief has to be seen to be believed and it is terrible.

[Victoria Prentis]

I have really appreciated the hon. Gentleman’s input into our group. We should, of course, have mentioned the importance of grandparents and wider family. They have been present in the all-party group, in the form of my father, right from its inception in the middle of the night, when we were waiting for a late vote, and they play a crucial role in helping parents and others to get through the awful loss of a baby. Of course grandparents matter!

[Jamie Stone]

The hon. Lady makes the point much better than I can. I take great comfort in the thought that I may be slightly more than just a doddering old fellow who amuses the kids. I like to think, and I hope, that I helped my two daughters through their trauma.

The hon. Member for Colchester made the point about the partner—about the man in the equation—several times, and nothing was ever truer. How terrible it must be to witness a stillbirth—a child who arrives too early to survive. I would dare to suggest that the man is emotionally every bit as bruised as the woman.

I wish to conclude simply by saying that in a debate such as this the House is at its best, and I give credit to the hon. Member for Eddisbury and others for that. I hope and believe that if people out there chance upon this debate online or read the record of it, they will find some human comfort—some milk of human kindness—which shows that we care. The hon. Member for Banbury (Victoria Prentis) mentioned to me the service in the Crypt on Thursday, and I will take part in the service and contribute a reading with the greatest of pleasure. Finally, I cannot even begin to surmise how, but when we had my family traumas, to my great surprise several Members, from all parts of the House, came up to me and said, “We understand. We know what you are going through.” When a completely unexpected hand reaches out like that, it is pure gold and reminds one of what friendship is really all about.