Medicinal Cannabis

Debate between Jerome Mayhew and Jim Shannon

Thursday 30th January 2025 Westminster Hall

[Jerome Mayhew (Broadland and Fakenham) (Con)]

It is a pleasure to see you in the Chair, Ms McVey. Do not worry, I have not defected. I just sat here, rather than where Conservatives would normally sit, because I did not want to interrupt the flow of the hon. Member for Strangford (Jim Shannon) while he was making his speech. I am grateful to him for securing this debate.

I am here because of one of my constituents, Matt Hughes, and particularly on behalf of his son, Charlie, who has severe treatment-resistant epilepsy. Mr Hughes has been to see me on a number of occasions. I am in the thick of a correspondence battle with the Department —the latest was in December last year—trying to deal with some of the problems that have arisen out of the 2018 NICE guideline change, which was brought in by Sajid Javid.

Somebody looking at the NICE guidelines would think, “Problem solved—wonderful! We can get access to these very important treatments for severely epileptic children.” But we are here today because that access is simply not available in practice. It is no good for us, as policymakers, to think that we have done the job because the policy has changed: if it is not working in practice, there was no point in changing the guidance.

There are a huge number of problems. There are licensing issues, to which I will return in more detail. There was the very unhelpful advice given by the British Paediatric Neurology Association in 2021, which seems to directly contravene the advice of NICE from 2018. There are many examples in which general practitioners have thought, after clinical assessment, that this kind of treatment, particularly second-generation drugs, should be supplied and yet local hospital advice was against it. Finally, there is the failure of the funding pathway. We have already heard about individual funding requests, but one problem is that the general application for many children to benefit from this kind of drug means that it fails the exceptionality test, so requests for individual funding are being refused on the grounds that the impact of the drug on the particular patient is insufficiently exceptional.

[Jim Shannon]

I thank the hon. Gentleman for coming along. I mentioned Joanne’s son Ben, who has failed 14 medications—the NHS says seven, so it is clear that there are failures in the system. We would think that the NHS should automatically respond, but it has not. That underlines the issue that the hon. Gentleman is raising.

[Jerome Mayhew]

That is the purpose of this debate: to encourage the Minister to get the NHS to change practice in this area. She could usefully start with the difficulty in licensing because second-generation medication is personalised. It does not have one or two active ingredients, but up to 20—that is probably not the right terminology but I hope we all understand—and the amounts of each of those active ingredients are personalised, in a patient-centric way. Yet we persist in applying a randomised controlled trial approach simply not appropriate for personalised medication. As a result, there is a failure to adopt licensing for medication that, anecdotally, is hugely effective, and has been hugely effective in supporting my constituent Charlie.

It is not beyond the wit of man to design an appropriate licensing system for this kind of medication because it has been done effectively elsewhere. We could look at the examples of Australia, Canada, the Netherlands, Spain, Portugal, Italy and even some states in the United States of America. If they can do it, why can’t we? I would be grateful if the Minister addressed that question specifically. Why do we persist with randomised control trials when we know that that acts against the adoption of this kind of modern medicine? Why does the Minister think that the licensing approach in all those first-world countries is in some way dangerous or inadequate?

Rather than repeating current policy, what change are the Government proposing to make to provide access through licensing for multiple active ingredient patient-centric dosing? What change are they proposing in relation to individual funding requests? Are they prepared to fix the problem of exceptionality, given that these drugs are routinely refused because they help too many children?

This is a huge issue. An estimated 35,000 children are affected. I hope the Minister will not dole out sympathy alone in her response, but set out the active change that the Government intend to make.

Dental Healthcare: East Anglia

Debate between Jerome Mayhew and Jim Shannon

Wednesday 11th December 2024 Westminster Hall

[Jerome Mayhew (Broadland and Fakenham) (Con)]

I beg to move,

That this House has considered dental healthcare provision in East Anglia.

It is lovely to see you in the Chair, Mr Dowd. I am grateful to colleagues from East Anglia for supporting this debate and, I hope, making some interventions. I am also grateful to the Minister for Care for coming yet again to Westminster Hall, because this is not the first time that we have had a debate on dentistry in the east of England, and in East Anglia in particular. The reason for those numerous debates is the significant problem of access to NHS dentists in particular, but also to private dentists.

Peter Aldous, who I am sorry to say lost his seat at the recent election, was a doughty campaigner on the issue. I pay tribute to him for the numerous debates he brought forward. Most recently, in September, the hon. Member for Norwich South (Clive Lewis), who is not here today, held a debate on the topic. Time is short, so I will not focus on the need as much as I normally would, but the Minister has been here before and knows very well how significant the need is for increased access to NHS dentistry in East Anglia.

I will give highlights, however, because the Secretary of State for Health and Social Care has described Norfolk not only as a dental desert, but as the “Sahara of dental deserts”. The Minister—the noble Baroness, Lady Merron—confirmed in the other place on 25 November that the Norfolk and Waveney area has

“the worst ratio of NHS dentists to patients in England”.—[Official Report, House of Lords, 25 November 2024; Vol. 841, c. 479.]

In my last debate in this forum, I was shocked to report that in Norfolk and Waveney the ratio of dentists per 100,000 population was 39, when the national average was 52. Now I have to update those figures, because the Secretary of State has recently confirmed that the figure of 39 has dropped to 36 per 100,000 of population, while the national average has increased to 53. It is getting worse, not better.

The data from this month is even more concerning. The British Dental Association confirms that there are 3,194 NHS dentists in the east of England, which are the statistics we previously used. BDA’s further analysis last month reveals that that equates to just 1,096 full-time equivalent dentists in NHS roles. If those figures are run through the population, there are 17 full-time equivalent NHS dentists per 100,000 population in the east of England. Those are truly shocking figures.

The issue can be sliced and diced in another way. The amount of money that the Government spend on people’s mouths in the east of England makes for sobering reading. The national average is £66 per mouth spent on dental treatment by the NHS. In the east of England, that figure is just £39. What is it? Is it that our fillings and dental work are cheaper in the east of England, or are we doing less? It is not due to less demand; we have the greatest demand. We had more than 1,000 people presenting in the past year at NHS A&E with significant dental problems. I believe I am right in saying that dental concerns are the single biggest reason why primary school children present at hospitals.

[Jim Shannon (Strangford) (DUP)]

On that critical point, dental care must start in primary school. When I was at school—that was not yesterday, of course—they came in to check the children’s teeth. We had that the whole way through, but that process is missing today. Does the hon. Gentleman think that primary school should be the first stage of response?

[Jerome Mayhew]

This debate is about the east of England, not the east of Northern Ireland, but I will take the hon. Gentleman’s intervention anyway. He is right that we learn our oral hygiene habits as children. It is primarily the responsibility of parents to look after their children’s oral health, as well as their general health; that has always been the case, and that should always remain the case. However, we recognise, as did the last Administration, the increasing role of primary schools in reinforcing the role of parents.

Border Carbon Adjustment Tariffs and Decarbonisation

Debate between Jerome Mayhew and Jim Shannon

Wednesday 16th December 2020 Commons Chamber

[Jerome Mayhew (Broadland) (Con)]

Border carbon adjustment: it may not trip off the tongue, but this is not a dull subject. This policy is the stuff that dreams are made of.

I ask hon. Members to imagine that, as they settle down in their beds, they start to wonder how we could create the economic environment for levelling up in our manufacturing heartlands, giving them a low-carbon head start on the rest of the world. As they turn over and start to count the fluffy sheep jumping over a fence, they catch sight of a free market that naturally seeks out the most effective way to reach carbon net zero and deliver on the Prime Minister’s 10-point plan. Finally, just as they drift off to sleep, they glimpse, as in a glass darkly, a Government leading the world at COP26, achieving an international approach that brings co-operation and rapprochement with our European and American friends and allies. Could this be real, or must it evermore remain but a dream?

Well, this is no dream, and we can turn it into reality with a border carbon adjustment. We know we need to reduce carbon to net zero by 2050, and centuries of experience have taught us that the free market is without equal in being able to solve challenging economic problems such as this. Yet, right now, our free market stands helplessly by, its creativity and innovation useless.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman on bringing this matter forward. He is right about the Prime Minister’s statement on environmental issues. Does he agree that we now have the potential to make a real and lasting change for the better by implementing environmental changes, but that we must also be aware that the pressure on businesses must allow them to continue to operate and not put them out of business? There is a balance to be got, I believe, and we have an obligation not only to the industry, but to the environment to get it right.

[Jerome Mayhew]

The hon. Gentleman is entirely right. That is one of the great benefits of a border adjustment: it allows us to raise domestic costs without being unfairly undercut by international imports coming in. We can square the circle. We can support the environment by setting a carbon price that is sufficient to change people’s behaviour, to make lower-carbon products more attractive in the economy than higher-carbon products, while at the same time facilitating our domestic industry to remain competitive.

It is because we cannot price carbon emissions that our market is currently floundering. The reason is that they are an externality. When I produce a piece of paper, I take account of the cost of the ingredients for the paper, the energy I will use, my overheads, my marketing spend, my transport and distribution costs, and my profit. However, in the free market exchange with my purchaser, the cost to society of the emission of carbon through that manufacturing process is not currently accounted for, because it is dissipated into the environment and we cannot put a price on it. That is why we have market failure on the price of carbon.

So what do the Government do to try to deal with that market failure?  They are left in a very difficult position. They try to change behaviour by announcing a reduction in targets, making piecemeal regulations as and when they become available, and picking innovation winners—we have a list, most recently hydrogen and modular new nuclear, to name but two. I very much hope the Government have got those expensive choices right. Based on the available evidence I believe that they have, but that is the point: only a properly functioning market finds the best way to allocate capital, with its invisible use of the combined knowledge of the sum of all the participants in that market. No Government can match that combined wisdom.

Our current approach to carbon pricing simply does not work. If we raise the cost of energy with our higher cost of carbon, our industry simply becomes uncompetitive, as the hon. Member for Strangford (Jim Shannon) pointed out a moment ago. Manufacturing simply moves abroad, or it goes bust and its place is taken by the raft of imports from higher-carbon countries—in addition to the very high cost of carbon in the import process and transport—like China. The result is damaging to jobs. It is, of course, damaging to our business. It is very damaging to our balance of trade. It is very damaging to our tax base and it is damaging to the climate. All in all, it is a damaging disaster.

Border carbon adjustment can transform that process: charge imports from a high- carbon economy the same carbon cost as we impose on our domestic industry via a BCA and the problem is solved. There would be no incentive for our manufacturers to base production abroad, since the costs would be equalised. Foreign companies would no longer have an unfair trade advantage. In fact, it would provide them with a direct incentive to reduce carbon usage in their domestic environment to avoid corrective tariffs. From a policy perspective—I am using China as an example—the Chinese Government would have a choice: either their exports pay a carbon price at our border and the money goes to our Exchequer; or they create a carbon price in their domestic market and they get to keep the money themselves. There is, therefore, a really positive incentive internationally for carbon reduction and the benefits to be spread. After all, climate change knows no borders. Better still, using the same calculation for border carbon adjustment but this time in reverse, our own factories would get the benefit of a carbon cost rebate at the border when they export, making their exports both cheaper and more profitable, increasing our competitiveness already on the international market.

There are many ways that you can skin this particular cat, Madam Deputy Speaker. We can either design a system whereby all products coming in or out of the United Kingdom have their carbon contribution assessed, or, if that is considered to be too complex, we can take baby steps. We can start off by applying a BCA towards the five or six most carbon-intensive industries and then take it from there. We would start with steel, fertiliser, petrochemicals, aluminium and energy. I will take two examples from that list by way of explanation.

First of all, with steel, an independent research project has been undertaken to assess the impact of a border adjustment tariff on the steel industry. Its conclusions were that were we to implement a BCA in the United Kingdom, it would increase the competitiveness of UK steel against many of its international competitors, at the same time as raising for the Treasury a tax windfall of between £270 million and £850 million if that carbon price was set at between £50 and £75 per tonne.