Cancer Strategy

Jim Cunningham Excerpts

Thursday 22nd February 2018 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I beg to move,

That this House has considered the Cancer Strategy.

Thank you, Madam Deputy Speaker, for your guidance. I will try to behave much better timewise in this debate, which it is an honour and a privilege to introduce. I pay tribute to the Backbench Business Committee for enabling the debate, to the all-party parliamentary group on cancer for its timely and extremely important report and, in particular, to the hon. Member for Basildon and Billericay (Mr Baron), who could not be with us today but deserves our thanks for the extraordinary amount of work he has done on this issue.

We in the House are all on the same side against cancer and in our ambition to achieve world-class cancer outcomes. My speech will address—briefly, according to your instructions, Madam Deputy Speaker—the recommendations of the all-party group’s recent report, “Progress of the England Cancer Strategy”. The report received more than 80 contributions from charities and bodies and truly reflects the passion in the sector, but it is also a cry for help, progress and a positive way forward. My speech will address the report’s four main areas of concern: workforce strategy, data, transparency and funding. It is open to colleagues to raise all aspects of cancer care and treatment, but, on behalf of the all-party group and the hon. Gentleman, I will stick to the recommendations in the report.

The report considers progress as we reach the halfway point of the NHS cancer strategy 2015-20 and is the result of an inquiry that the all-party group held last summer and autumn. The inquiry was formally launched at a summer reception last July and the number of written submissions was far larger than anticipated, showing the dedication of those working in the field. Many submissions came from cancer alliances and others on the frontline of the services being provided and identified many pressures and challenges. The evidence from frontline services in particular seemed to amount to a call for help. In its report, the all-party group concluded that although progress had been made since the launch of the strategy, the NHS

“will struggle to achieve the objectives set out in the Cancer Strategy unless corrective action is immediately taken.”

To this end, the all-party group has listed recommendations, a copy of which will shortly be sent to all MPs. The lack of workforce planning emerged as a key concern. The cancer workforce is constantly recognised as the biggest barrier to implementing our strategy. We are all pleased that Health Education England published its report into the cancer workforce in December 2017, but it was originally promised for December 2016. According to written evidence from Breast Cancer Now, the workforce is the greatest challenge in delivering the cancer strategy. The all-party group also heard that transformation funding is being withheld from cancer alliances because of their performance against the 62-day waiting-time target—a new conditionality of funding that emerged only after the bidding process had closed.

[Mr Jim Cunningham (Coventry South) (Lab)]

I appreciate the hon. Lady acknowledging the cancer organisations, such as Macmillan, which often rely on subscriptions. Does she agree—I am sure she does—that the public should be encouraged to give more subscriptions where possible?

[Dr Cameron]

Absolutely. The hon. Gentleman makes an excellent point. These agencies are working on the frontline with people and families at their most vulnerable and deserve all our encouragement, praise and, of course, funding.

In addition to setting out how cancer alliances are to be funded and supported for the duration of the strategy and into the future, the all-party group strongly recommends that the 62-day waiting-time target be immediately decoupled from any release of funding to the alliances. The previously mentioned issues prevent progress in improving cancer care and treatment, which is not our collective vision. The all-party group also heard that improving transparency in priorities and accountability would help to support the delivery of the strategy. At the moment, a lack of clarity and lines of communication are delaying its implementation. Publishing a detailed progress update on each of the strategy’s 96 recommendations would be a positive step forward.

It is generally accepted that the 62-day waiting-time target has been treated as a higher priority among clinical commissioning groups and cancer alliance leaders than survival or stage at diagnosis, as shown by the linkage between funding and performance against the measure. Decoupling funding from process and target performance in favour of a greater focus on outcomes would strongly be in the interests of patients, not least because, if outcomes are good and survival rates increasing, processes will also be functioning efficiently and correctly.

PACE Trial: People with ME

Jim Cunningham Excerpts

Tuesday 20th February 2018 Westminster Hall

[Mr Jim Cunningham (Coventry South) (Lab)]

I thank the hon. Lady for securing this important debate. Does she agree with me that a lot of employers do not really understand how people with ME suffer and that that can affect their employment? It can also affect housewives.

[Carol Monaghan]

Absolutely. The public perceive it as mere tiredness, but it is so much more than that. The debilitating pain that ME sufferers experience is something that we all should be aware of.

The participants in the PACE trial received a range of different treatments, including cognitive behaviour therapy and graded exercise therapy, where patients were encouraged to become physically active and then increase the activity’s intensity. Unbelievably for a trial this large, none of the groups was given specific medical interventions. The results were published in The Lancet in 2011, with the contentious claim that CBT and GET brought 30% of patients back to normal, while 60% improved. The media reported that all ME sufferers had to do to recover was exercise. However, the report was immediately questioned by the patient community. How could exercise, the very thing that was known to worsen symptoms, actually help?

NHS Winter Crisis

Jim Cunningham Excerpts

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is an assiduous campaigner for his constituency, and he is absolutely right to highlight both the progress made and the importance of the prevention offered through the increased number of vaccinations. I hope many more people next year will continue to take up the vaccination, including Members of this House.

[Mr Jim Cunningham (Coventry South) (Lab)]

Does the Minister not realise that 14,000 beds have been taken out of the national health service on this Government’s watch? People are now being treated in ambulances, which is a disgrace. Is he not taking us back to the Major Government of the 1990s, when people were sleeping on trolleys?

[Stephen Barclay]

Again, the hon. Gentleman is ignoring the increase in the number of doctors. There are now 14,900 more doctors and 14,200 more nurses in the system. As I alluded to earlier, it is not just the number of beds; it is also how we manage those beds. It is how we manage the fact that 5% of the patient population is occupying 43% of beds that will best address bed occupancy rates.

Hospital Car Parking Charges

Jim Cunningham Excerpts

Thursday 1st February 2018 Commons Chamber

[Robert Halfon]

The right hon. Gentleman is exactly right. Too often, these charges are imposed without any consultation, or without fair consultation, and they hit the most vulnerable. He will hear later in my remarks that I completely agree with him.

[Mr Jim Cunningham (Coventry South) (Lab)]

Will the right hon. Gentleman give way?

[Robert Halfon]

I will not take too many interventions, but I would be honoured to take one from the hon. Gentleman.

[Mr Cunningham]

I agree with the right hon. Member for Kingston and Surbiton (Sir Edward Davey). A lot of the hospital charges are part of private finance initiatives, and he is right that the Secretary of State or the Minister responsible should now be looking at eliminating those charges. We could argue that they are a tax on illness.

[Robert Halfon]

That is the sad thing. Many private companies are making profits from the taxpayer and the most vulnerable people in our society. That must stop. The PFI things that have happened under Governments of both main parties have caused huge amounts of problems to many people, particularly when they park at hospitals up and down the country.

There is still a postcode lottery on car parking charges; different hospital trusts set wildly different fees. The core principle of the NHS is to provide free healthcare for all at the point of access but the charges are a stealth tax on drivers using the health service. The parking charges are the bane of people’s lives. No one goes to hospital out of choice; they go because they have to. No one chooses to be ill, and we rely on our doctors and nurses to look after us. I urge the Health Secretary and the Minister to take urgent action to end this social injustice once and for all, and to introduce substantive legislation to ensure hospitals scrap their parking charges.

Neuroblastoma

Jim Cunningham Excerpts

Tuesday 23rd January 2018 Commons Chamber

[Kwasi Kwarteng]

I am delighted that the hon. Gentleman has made representations from his part of the country. People face this problem across the country. It is not widely known, because the absolute numbers are not great, but the suffering is severe. We absolutely have to try to think of a way to reach an accommodation on funding, because £600,000 is a huge amount to raise.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate the hon. Gentleman on bringing this very serious issue to the House, and I am sure that many people in Coventry and the west midlands would support him too. It is tragic to pick up a newspaper and read about families trying to raise money for treatment abroad that they cannot get in this country. We wish him well in his endeavours to get some justice for his constituents.

[Kwasi Kwarteng]

I am touched by the hon. Gentleman’s remarks. It is delightful to see cross-party agreement on this. It is a great honour to raise this issue—it goes to the heart of what one does as a constituency MP. I have met Alfie’s parents and have been incredibly impressed by the way they have conducted themselves, and by their bravery and courage. They are totally devoid of self-pity. They have just got on with it and raised a great deal of money, and I am hopeful that they will reach their target.

In the case of relapses, however, the obligation should not fall on the shoulders of parents and friends to go through what is a very stressful experience. We have all raised money for various causes in our time, and it is a stressful and time-consuming endeavour. As a society, we have to consider ways in which the NHS or the National Institute for Health and Care Excellence can fund treatment for relapses so that the parents of young boys such as Alfie Ward do not have to go through that kind of suffering and pressure simply to give their son a fighting chance of life.

I am grateful to have secured this debate, on an issue that has been raised by other people, and it is a privilege to have raised it in this forum. I look forward to hearing what the Minister has to say.

Oral Answers to Questions

Jim Cunningham Excerpts

Tuesday 19th December 2017 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

My hon. Friend asks an important question. We have just commissioned Warwick University to investigate the links between breast density and breast cancer. If the findings suggest that there should be any changes to the national breast screening programme, the UK national screening committee will of course consider that, as it does with any new evidence that helps it to target screening appropriately and make women aware of any increased risk of breast cancer. I will be watching this like a hawk.

[Mr Jim Cunningham (Coventry South) (Lab)]

T3. What assessment has the Secretary of State made of NHS funding for the 2018-19 financial year? Will it be sufficient to deliver the standards set out in the NHS constitution?

[Mr Hunt]

The NHS mandate is very clear that we expect the NHS to move towards hitting those constitution standards which we consider to be vital for patients.

Autism Community: Mental Health and Suicide

Jim Cunningham Excerpts

Thursday 30th November 2017 Commons Chamber

[Dr Cameron]

I thank the hon. Lady for her important words. The bedrock of much of the work undertaken across the UK is such small charities, often run by those who have personal experience and know what works and what needs to be done.

The level of interest in the debate shows the importance of the issue. It is important to so many across the UK, including charities such as those already mentioned. Many charities have contacted me with important recommendations, including Autistica, the National Autistic Society, the Royal College of Psychiatrists and the British Psychological Society.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate the hon. Lady on securing this debate. Will she join me in congratulating women’s organisations in Coventry that are very much involved in mental health issues among younger people and older people in particular? What help can they get? Often, women act as carers and the Government should do something about that and give proper grants to those organisations.

[Dr Cameron]

That is an extremely important point. We must bear it in mind that for young people with autistic spectrum disorder, there is often a family-systemic approach, with carers are at the forefront of providing support, and they need the best resources possible.

I also thank the many citizens from across these isles who have contacted me to give their own poignant personal accounts. These accounts have been harrowing to read—and more harrowing for them to experience—and make us realise just how absolutely vital this debate is.

I also want to extend a personal warm welcome to the youth patrons up in the Gallery today representing Ambitious About Autism. Their recent campaign and research project, “Know your normal”, has been helping many people and raising important awareness. I pay specific thanks to the hon. Member for South Cambridgeshire (Heidi Allen) and the right hon. Member for Chesham and Amersham (Mrs Gillan), who have worked tremendously hard on this debate, on behalf of people with autistic spectrum disorder, through the all-party group over many years.

As a psychologist, I know that progress has been made on autism and mental health over the many years since I started in 1990, when waiting lists were extremely long—possibly a year and more—and services were very limited. However, much more must be done across the United Kingdom.

--- Later in debate ---

[Dr Cameron]

Yes, I wholeheartedly agree with that point. I have personal clinical experience of that through working across a variety of secure hospitals and prisons in my practice with the NHS. People with autistic spectrum disorder often find themselves caught up in the criminal justice system, which has little awareness of their needs or of the support that they require. When they get caught up in the system, it is difficult for them to move on and rehabilitate because the provision simply is not there.

[Mr Jim Cunningham]

Following on from the point made by my hon. Friend the Member for Cardiff West (Kevin Brennan), there is an argument that the police lack the training to handle some of these young people because they do not understand the nature of their mental illness. Does the hon. Lady agree that something needs to be done to provide the police with the necessary training?

[Dr Cameron]

I agree. Our police are on the frontline and they deserve the utmost respect for the work they do, but yes, it is correct to say that they require further training and also further support. There requires to be a clearer pathway when people exhibit challenging behaviours in the community, from the point at which the police are put into contact with them right through to the provision of adequate support in the health system, without their being caught up in the criminal justice system in between.

--- Later in debate ---

[Dr Cameron]

I agree. That is an extremely valid point. If people arrive at A&E for crisis intervention and are admitted for a period of time, it is important that they are discharged with some follow-up. People often return to the same circumstances that led to the difficulties in the first place, and if they do not have some support to deal with those difficult circumstances, they may be in a vulnerable situation and may try to self-harm or take their own life once again.

If a person with autistic spectrum disorder feels unable to go to the GP or to reach out to services in their local community, they might try to ring a suicide helpline. However, that can be extremely difficult in itself for a person with autistic spectrum disorder who finds communication and social interaction difficult. They might be able to verbalise only some of their difficulties, and they may then find there is no follow up from that service, either. Early access points and early intervention are crucial to preventing suicide and preventing mental health problems being exacerbated. Much more has to be done at that critical early intervention stage to ensure access to services.

If a person with autistic spectrum disorder reaches a health professional, they often find that their mental health problems are overlooked or misdiagnosed, which might be because they present an extremely complex case. They might also have concomitant learning difficulties, and they might not present the symptomatology that would usually be expected for anxiety or depression per se because their symptoms are complicated by their autistic spectrum disorder. It is extremely important that mental health practitioners have training in autistic spectrum disorder, in the types of presentation that they might need to identify and, particularly, in risk issues.

Diagnosis is still a postcode lottery. I hope to continue working with the Minister on that issue, because we need an understanding of who is appropriately trained in diagnosis of autistic spectrum disorder and what level of specialty we have in different professions. What is the workforce plan to ensure that this very great need is addressed across our society? This is so important. People with autistic spectrum disorder say they do not know where to go locally. As a member of the Select Committee on Health, I have asked services about that, and they say, “We don’t really have a map of who can diagnose and who can provide specialist intervention in a given area of NHS England.” Streamlined services would make it so much easier for people to gain that initial access.

I do not want to take up the whole debate, so I will provide a brief overview before letting others speak. Many Members want to contribute to this important debate, but I wish to touch on a few other important issues.

I request that the Minister look at what mental health therapies work specifically for people with autistic spectrum disorder who have concomitant mental health difficulties. There is no adequate research base yet, but we know it is critical—it is lifesaving—so we need to prioritise funding. Traditional mental health therapies might not work in the same way for people with autistic spectrum disorder. If one of us presented at a GP surgery, we might be offered cognitive behavioural therapy, but we do not know whether that is the best option for a person with autistic spectrum disorder, or whether some kind of adapted therapy would be more appropriate. That important work should be undertaken, and undertaken quickly, to engage people in appropriate therapies and save lives.

I have been contacted by a couple of individuals whose poignant accounts have struck me. One is an individual from my constituency who says that she has continually tried to access CAMHS for her daughter, who has been repeatedly self-harming. It has placed the family in such a stressful situation over a lengthy period that the family, including the mother and carers, now feel that their own mental health is under stress.

It is extremely important that we ensure not just that individuals can access the system but that we preserve family life, that we support carers and families, and that we do not place an additional burden on the NHS and other services. Families and parents may go on to develop their own depression and anxiety when dealing with an intractable situation because they do not know how to cope. If we do not address the problem at its root, we will multiply the problem for services across the UK.

[Mr Jim Cunningham]

I met a number of carers some months ago, and one thing that struck me was that from time to time they were extremely distressed. Some of them could not afford a holiday and they do not get very much help, to say the least,—they are not even paid as carers—so there is an effect on the mental health of the carers sometimes as well.

Mental Health Units (Use of Force) Bill

Jim Cunningham Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Mr Reed]

I very much agree with my hon. Friend. The Government are commissioning a much wider review of mental health services. I hope it will encompass the points he raises, but that would be for the Minister to clarify.

The Bill will make sure that every mental health provider has a policy in place governing the use of force, including a clear deliverable plan for reducing its use, and ensuring that staff are properly trained in equalities and the de-escalation techniques needed to avoid the use of force. It will speed up justice and allow learning to take place by making sure that any non-natural death in a mental health unit automatically triggers an independent investigation, and making sure that recommendations from investigations and inquests are taken into account when improving mental health services in ways that currently do not happen.

The Bill is a significant step forward for our mental health services, moving them from the containment of patients to the care of patients. It will make sure that people with mental ill health are treated with compassion, not cruelty. There is overwhelming support for the Bill across the mental health sector. I am grateful for the practical support I have received from INQUEST, in particular its director Deborah Coles, and from Raju Bhatt, the widely respected solicitor who has represented so many bereaved families following deaths in custody. I am grateful to YoungMinds UK, Mind, Rethink Mental Illness, Agenda, the Labour Campaign for Mental Health, my hardworking staff and the Croydon North Ethnic Communities Forum. Also, 38 Degrees hosted an online petition that has been signed by over 60,000 people to demand this change.

[Mr Jim Cunningham (Coventry South) (Lab)]

More broadly, having watched documentaries on this issue, does my hon. Friend agree that there is an argument for providing the police with better training, so that they understand the difficulties facing people with mental health issues?

[Mr Reed]

I absolutely agree with my hon. Friend. Unfortunately, that is outside the scope of the Bill, but I very much hope it will be in the scope of the wider review the Government are commissioning.

Oral Answers to Questions

Jim Cunningham Excerpts

Tuesday 10th October 2017 Commons Chamber

[Steve Brine]

I am always happy to meet Members, including the hon. Lady in order to talk about York. As the shadow Secretary of State said, the STP proposals are not about Tory cuts; they are about redesigning services in the local area. So I am happy to meet her to talk about her area.

[Mr Jim Cunningham (Coventry South) (Lab)]

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

[The Secretary of State for Health (Mr Jeremy Hunt)]

This week is Baby Loss Awareness Week, and the whole House will want to mark the tragedy faced by too many parents every year by redoubling our efforts to reduce avoidable baby death and harm. I am pleased to tell the House that to mark World Mental Health Day today the entire Cabinet was this morning briefed by two of the country’s leading mental health experts, Poppy Jaman and Professor Sir Simon Wessely, on our plans announced today to roll out mental health first aid to 1 million people in England.

[Mr Cunningham]

Can the Secretary of State tell us what progress has been made regarding an inquiry into the contaminated blood scandal?

[Mr Hunt]

I can absolutely tell the hon. Gentleman the answer to that: we have been making very important progress with families over the summer; and we have decided the shape of the inquiry and the leadership of the inquiry and all the factors around the terms of reference need to be decided in close consultation with the affected families. So we are keen to get on as quickly as possible, but we have made some progress in understanding their wishes.

NHS Pay

Jim Cunningham Excerpts

Wednesday 13th September 2017 Commons Chamber

[Jonathan Ashworth]

Perhaps we really should, but I think the hon. Gentleman, who is an enthusiastic supporter of his Front-Bench team, is quoting selectively from the report, which I will move on to in a few moments.

Today’s motion is not just about doing what is right for NHS staff; it is about doing what is right for patients, too. I remind the House that we are significantly short of GPs and that we are short of 3,500 midwives. According to the Royal College of Nursing, we are also short of 40,000 nurses, with one in 10 nursing posts remaining vacant. Nearly 40% of the full-time vacancies advertised on NHS Jobs earlier this year were in nursing, and the Opposition know that Brexit is having an impact through nurses leaving the UK. The Nursing and Midwifery Council shows an increase in the numbers of nurses and midwives leaving its register. The average midwife has seen the value of their pay drop by over £6,000 since 2010, and we are significantly short of numbers, with 80% of midwives intending to leave the profession in the next two years as a result of the pay cap.

[Mr Jim Cunningham (Coventry South) (Lab)]

Will my hon. Friend give way?

[Jonathan Ashworth]

May I make a little progress?

The hon. Member for Croydon South said that pay does not affect retention and recruitment, but the Opposition say that the pay cap is at the heart of the retention and recruitment crisis. Earlier this year, NHS Providers, which represents hospital trusts, warned that low pay is causing staff to leave the NHS to stack shelves in supermarkets. Chris Hopson said:

“Years of pay restraint and stressful working conditions are taking their toll. Pay is becoming uncompetitive. Significant numbers of trusts say lower paid staff are leaving to stack shelves in supermarkets rather than carry on working in the NHS.”

--- Later in debate ---

[Jonathan Ashworth]

My hon. Friend is right. A popular, successful walk-in centre in her constituency has had to close to shift the staff to fill vacancies at the local A&E at Arrowe Park hospital, because the pay cap and other Government decisions have led to a staffing crisis in the wider NHS.

[Mr Jim Cunningham]

rose—

[Jonathan Ashworth]

I did promise my hon. Friend that I would give way, but I will take no more interventions afterwards.

[Mr Cunningham]

Has my hon. Friend noticed that the Government do not necessarily have to abide by the pay reviews? In other words, they could give an increase that goes further than what the pay review body recommends. The Tories are wrecking the national health service. They should put their money where their mouth is. If they really appreciate NHS and its staff, they should vote with us tonight.

[Jonathan Ashworth]

My hon. Friend is absolutely right. The Tories have been running the NHS for seven years now. It is going through the biggest financial squeeze in its history and we have some of the worst waiting times on record.

The hon. Member for Croydon South should note that the NHS Pay Review Body’s March report said that

“public sector pay policy is coming under stress. There are significant supply shortages in a number of staff groups and geographical areas. There are widespread concerns about recruitment, retention and motivation that are shared by employers and staff side alike.”

Again, NHS Providers said that

“seven years of NHS pay restraint is now preventing them from recruiting and retaining the staff they need to provide safe, high-quality patient care. The NHS can’t carry on failing to reflect the contribution of our staff through fair and competitive pay for five more years.”

We agree. Addressing NHS pay and lifting the pay cap are crucial to addressing the retention and recruitment crisis now facing the NHS.