Hepatitis C

Jim Shannon Excerpts

Tuesday 12th June 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Let me express special thanks to the hon. Member for Southend West (Sir David Amess) for setting the scene. He said that he was not the master of the debate, but he was certainly the master of delivery. He told us about all the important issues, with the help of the two learned doctors in Westminster Hall today: the hon. Members for Central Suffolk and North Ipswich (Dr Poulter) and for Central Ayrshire (Dr Whitford).

As my party’s spokesperson on health, I take an interest in all health matters in the House. Some people would say, “He takes an interest in just about everything in the House,” but that is by the bye. Health matters are my specific interest, so I am here to make a contribution in that capacity and will make a comment from a Northern Ireland perspective. Obviously, that will come into the debate.

First, I commend the all-party parliamentary group on liver health for the report that it has put forward. The hon. Member for Southend West is absolutely right: if people listen and read its recommendations, they will realise that the APPG has a really firm and dedicated interest in this matter. I am most impressed by the APPG’s recommendations and report; I am sincerely impressed by the work carried out by it. In my research for my contribution to the debate, I learned a lot from its recommendations and from the work that it does. The contents of the report are informative in the extreme. It provides lots of detail and information, which I hope will help us to contribute to the debate in a positive fashion.

I sincerely hope, too, that there will be such an opportunity for the Minister, who is always responsive and helpful. We are pleased to have a Minister who clearly has an interest in the subject matter. When he speaks, we will understand just how important that is. However, we need to implement the recommendations for so many people throughout the UK. I am also pleased to see in her place the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson). I know that she will be equally positive.

The hon. Member for Southend West referred to George Best. He was the greatest footballer this world has ever known, according to Pelé, and what better person to say that than a man who many think was the best footballer in the world, even though whenever he has been asked he has said that it was George Best.

Unfortunately, George Best had problems; that was just the fact of it. With his talent and expertise came a problem, and the problem was alcohol. For a time, he and his wife lived in my constituency, just outside Portavogie, and he was very much someone who everyone wanted to associate with and spend time with. We well remember the day that he died and his funeral at Stormont. It was unusual for someone to be given the accolade of being buried from Stormont. I remember that it was a rainy day, but the crowds came from all over the Province just to be there and be part of what was a very poignant occasion as we laid to rest one of Northern Ireland’s greatest and, indeed, one of the world’s greatest when it came to playing football. I just wanted to say that, as the hon. Member for Southend West introduced it in his comments.

My parliamentary aide first went to Africa on a humanitarian aid project. She is a member of the Elim Church in my constituency. Elim Missions Ireland does some fantastic work out in Swaziland and Zimbabwe when it comes to helping with medical and education projects, as well as general all-round giving. It takes out a number of containers every year to help with that. When she told me about the list of vaccinations she had to get, one of which was for hepatitis A and another for hepatitis B, she said, “All I am really missing is hepatitis C.” Little did we understand in the office that the hepatitis C vaccine is greatly needed not simply on the plains of Africa, but in our own country. The hon. Gentleman referred to that.

The Northern Ireland Hepatitis B & C Managed Clinical Network is a website with great information that helps us to construct our speeches. Hepatitis C is an infection of the liver caused by the hepatitis C virus, which is carried in the blood stream to the liver. We know that it can cause inflammation and swelling. It can cause fibrosis and the scarring of the liver tissue, and sometimes liver damage. It may subsequently lead to cancer of the liver and possible death. Over the years as an elected representative, I have represented quite a few people who have died of liver cancer, although that is a separate debate. I remember only one person in that time who survived liver cancer to live for a longer period.

In Northern Ireland, there are more than 2,500 people known to be infected. A large proportion of people, however, remain unaware that they have the virus. That is one of the key issues on which we look to the Minister for a response. How do we raise that awareness to address those who do not know they have it, but need to know today? We all know that we need early diagnosis. If we find out early that something is wrong, we can do something about it, but if people are carrying the virus in their system and do not know, that is a real problem.

Like so many unseen diseases, the problem lies in the fact that many people do not realise they have been infected with the virus, because they have not had any symptoms or they may have flu-like symptoms that can easily be mistaken for another illness. I declare an interest as a type 2 diabetic, which is a chronic disease. Every year, I get that flu jab to try to stop flu and colds. By and large it works—it has for the last few years, anyway. People who get colds and flu regularly might wonder whether it is just a cold or flu, or something more. That is the question we are all asking.

With the pressure the NHS is under, as we all know, there are few of us who would not struggle through the winter with a perpetual cold or flu, thinking we were simply run down. Few people would bother their doctor with a cold, yet for some that prevents treatment from being started when it would be most effective.

This is Men’s Health Week. Those of us who fit into that category know that we need to look at our health more seriously. In Men’s Health Week, we need to say, “If you have a problem, go to your doctor.” People say that man flu is one of the worst things to have, but us men, unfortunately, do not respond to our health issues as strongly as we should. We should be going to our GP.

I have learned that there are six types of hepatitis C virus, which all have different genes, which are called genotypes and numbered 1 to 6. Almost all people in the UK who have hepatitis C have genotype 1, 2 or 3. It is important to know which type a patient has, as different types respond differently to treatment. It is possible to be infected with more than one type of hepatitis C at the same time. I remember an awareness event in the House of Commons not too long ago—it may have been last year—on hepatitis C. That day aimed to highlight the issue and make us more informed of the problems.

Hepatitis C is a blood-borne virus and there is some stigma attached, because it can be transmitted sexually or through sharing needles. That is certainly true, but it needs to be publicised that the virus can also be shared through an unsterilized needle in a tattoo parlour or something as innocuous as sharing a toothbrush, a razor or other personal items, because the blood can survive outside the body. An old toothbrush, therefore, can bring about a whole mess of issues. One person in four will clear the virus, but it is possible to catch it more than once.

The APPG’s positive recommendations on how hepatitis C could be eradicated should be central to our thoughts on where we go. All the issues I have mentioned are reasons we are not finding it easy to meet our own target of eradication by 2025 and the World Health Organisation target of world eradication by 2030. People may not be fully aware. Will the Minister confirm what has been done to meet those targets? Can the targets be met? What is new in the way that we address or respond to these things?

We need to ensure that those who present symptoms are tested and those with a history are re-tested. Someone who has had the virus before can have it again, and they might not know. With new drug combinations, it is anticipated that it will be possible to cure approximately 90% of persons with the HCV infection. Those new combinations are effective against the infection in patient groups that were previously described as difficult to treat. We need to focus on those difficult-to-treat areas.

I agree in totality with the recommendation of the APPG on liver health regarding the fact that NHS England has recently entered negotiations with industry to develop a new funding model for hepatitis C, which is expected to guarantee access to treatment without restriction. That is good news. I agree that the resulting deal should include effective mechanisms to ensure that funds are distributed equitably across different geographies and patient populations, so that no one is left behind. I will go further: Northern Ireland must be a key part of the distribution list, not simply the mainland of England, if we are to eradicate hepatitis C and address the issues, whatever they may be.

The hon. Member for Central Ayrshire, who is the Scottish National party spokesperson, will give us not only a Scotland perspective, but a United Kingdom of Great Britain and Northern Ireland perspective. We need to look at how we can do this with the Welsh Assembly, the Scottish Parliament and the Northern Ireland Assembly, despite the limbo land that it is in, through the permanent secretary. Any new funding must be accompanied by a comprehensive and strategic plan to ensure that it is implemented effectively.

To conclude, there is a way forward with hepatitis C. It is treatable. Let us put this in perspective: it can be done. All we need is the will and the strategy to make it happen. People need to be aware that they have hepatitis C in the first place, but other work needs to be done too.