Incontinence

Jim Shannon Excerpts

Tuesday 5th September 2017 Commons Chamber

[Mrs Moon]

I thank my hon. Friend for her work in this area. That most certainly would help, and it is so simple; it is not a huge thing to do. Another example is simply having a shelf in toilets where someone with a colostomy or ileostomy can place the clean bag, so it is readily available while they remove the full bag. That would make things so much easier and healthier, by ensuring there is no cross-infection. Instead, people often have to scrabble on dirty toilet floors, trying to access what they need.

All the figures I have to hand today are estimates—as one patient group pointed out to me, the collection of statistics in this field is patchy at best, and putting a true figure on the scale of the problem is very difficult—but we will not tackle taboos until we start talking about them: we must destigmatise the subject so that no one faces humiliation if they admit to a problem. We need to bring this issue out into the open once and for all, so that people no longer suffer in silence and we can reduce the long-term health implications and additional costs for the NHS.

An analysis of calls to the Bladder and Bowel Foundation’s helpline in 2015 suggested that half the people with a continence problem had never spoken to a healthcare professional. Another study found that only one in three families seek help for children and young people with a continence problem. Imagine the long-term impact on a child’s health of having to try to manage such a problem at school, with all the stigma of being the smelly kid and all the fear of having an accident during a lesson.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this subject forward; it needs to be aired and she is doing that very well today. I thank her for that. Does she agree that young people suffering from ulcerative colitis, Crohn’s disease and other inflammatory bowel diseases need more help and support to deal with the lifestyle changes that these illnesses can bring? The latest statistics show that 75% of those young people say that they cannot have an active social life because of their condition, and I believe that restaurants, shops and councils have a responsibility to do more to help them to lead as normal a life as possible.

[Mrs Moon]

I would ask every Member to consider the impact on their life of suddenly having a desperate, urgent need to access a toilet while at work or walking down the street, and there not being one available. Of course we must do more; no one can assume that incontinence is not coming their way or coming to a member of their family. As a society, we have to take responsibility for ensuring that people can access toilet facilities wherever they are and whenever they need them.

--- Later in debate ---

[Mrs Moon]

We need to reconsider the issue of VAT on a whole range of sanitary and continence products. As a society, we need to take responsibility for the facts of our daily life. For a person on any sort of restricted income, such as those on benefits, the costs even of simple laundry are huge when dealing with incontinence.

Some families are spending up to £100 a week buying incontinence products. It is ludicrous if they are not able to access those products through the health service or joint stores with local authorities. It is a postcode lottery whether or not a person can access the help and support they need, which is shocking. Think of the savings in sickness pay, in hours of work lost and in mental health and wellbeing if we started to tackle this problem.

It is time to raise a number of issues, including what happens when things go wrong.

[Jim Shannon]

The hon. Lady has referred to people being caught short and, from my knowledge of people who have come to me with their problems, there is a lack of understanding from employers towards employees who have these problems, with people losing their jobs. Does she agree with me and other Members that there has to be a better understanding from employers of employees who have this problem?

[Mrs Moon]

I recently had a meeting with employers in Bridgend, and the chief executive of CGI was present. That company is proactive in asking its employees what problems they have so that it can support, rather than punish, when those problems affect people’s working situation. People with incontinence should feel confident that they will not lose their job if they say, “Actually, I have this problem. I am going to have to go to the toilet.” Shockingly, I found another employer in my constituency that was making deductions from employees’ wages every time they left the floor to go to the toilet because it was time away from their telephone response service. Yes, we need to consider the whole issue of employment practice in relation to incontinence.

Between 2007 and 2015, 92,000 women in England are thought to have had vaginal mesh implants as a treatment for incontinence. As many as one in 15 women have gone on to have those removed because of complications. The individual testimonies of those affected are dreadful, and while dealing with the wider issue of incontinence we must not forget their plight. I commend the work of my hon. Friend the Member for Pontypridd (Owen Smith), who has brought this issue to the attention of the House, but it is also important that the Government carry out a full audit, establish a registry to determine how many women have been affected, suspend this treatment and look at how we can make sure that the damage and destruction of people’s lives does not continue.

I know you have been generous with our time, Madam Deputy Speaker, as the House has concluded its other business so early, but I hope that the need for action on this has become obvious. First and foremost, we need to work collectively to raise the profile of incontinence as a public health issue, not as a personal failing—that is how it is seen. If I have an incontinence problem, it is seen not as my having a medical problem but as there being something wrong with me. That view needs to be turned around. People need to be able to talk to their GP. If we go into any pharmacy, we see a sign saying. “If you’ve got a cough and it persists, see your GP.” There are signs saying, “If your mole is changing size, talk to your GP.” We need to have something that says, “Suffering incontinence? Well don’t suffer in silence, talk to your GP. You will be able to access help and support.” We need to stop assuming that this is something that affects older people and to engage schools in understanding how it affects young people. We need to educate young people on bowel and bladder health. Why on earth do we not talk about this? Are we really so hung up that we cannot talk to young people about the fact that at some point in their life they may have a problem, tell them what they do about it and say what sort of help they can get?

Will the Minister give us an idea of what his Department plans to do to tackle the huge hidden problem of incontinence in this country? Will he agree to talk to the devolved Administrations so that we do not just set something up for England, but we all take responsibility for this? I am sure that the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Newport East (Jessica Morden) would agree that we must get this sorted once and for all.

When people seek help they need to feel that health professionals will be equipped to help them. It is also important that doctors are trained in this; it needs to be part of the core training of all nurses and doctors. It should also be there for those who are training to be nursery nurses. We need to build that conversation and to do it soon. It is important that the General Medical Council takes responsibility for moving this forward. I am aware that in England the NHS published “Excellence in continence care” in November 2015, which sought to define what best practice should be and to make recommendations. The document was very welcome, but implementation has been slow. The executive summary even commented on that, saying:

“Over the years, some excellent research and guidelines have been produced for best practice continence care but this work has often stalled as it has not translated into a clear commissioning plan for a local continence pathway.”

Will the Minister ensure that every local authority and every health authority has a clear continence pathway? That is not a big ask; they should be doing it already. Can we make sure that such pathways are now in place?

Continence services in the UK vary in quantity and availability, with a report in 2010 concluding that patients were faced with a “life sentence” of suffering due to non-existent or poor diagnosis, a lack of treatment plans and poorly co-ordinated care. Earlier this year, a Paediatric Continence Forum audit established that only 41% of clinical commissioning groups and health boards provide all four main continence services and product provision. That is absolutely shocking.

I hope I have convinced the Minister that he should take the opportunity to make a change in the quality of life for far too many people in this country. This is a problem area that we have neglected for too long.