Future of the NHS

Jim Shannon Excerpts

Monday 31st January 2022 Westminster Hall

[Matt Vickers]

I have shared concerns about NHS dentistry from my own part of the world, and I am fairly confident that the Minister will fill us in and give a more extensive response.

The NHS carries the weight of our country’s health problems on its shoulders, which is why I am delighted to support the Government’s ongoing commitment to it. The biggest cash boost in the history of the NHS is allowing us to put thousands more doctors and nurses into our hospitals, coupled with major capital investment programmes that have already benefited my local hospitals. I know that the Minister is only too aware of my ongoing campaign to secure more sizeable improvements at the University Hospital of North Tees. That said, I know from my constituency that there remain huge challenges for the NHS and its role in improving the health of the nation.

In 2018, Stockton was labelled England’s “most unequal town” by the BBC. It is a town where people born in one area can be expected to live 18 years fewer than those living just a few miles up the road. Such health inequalities are not acceptable in modern Britain. The NHS rightly looks to prevention as well as cures, and furthering this cause requires not just more resources and improved efficiency, but joined-up co-operation with other agencies, which lies at the heart of the reform agenda.

Putting my experiences and observations aside, the lead petitioner, Mr Hynes, and those from Unite wanted to let me know that they are fundamentally opposed to the Health and Care Bill. As part of their reasoning, petitioners cited concerns about the staffing crisis, overwhelmed human resource departments and the backlog as core reasons for their belief that the Bill should not be brought on to our statute book. Petitioners shared their concerns about staff shortages and worker fatigue in an NHS that already stretches itself to meet the needs of the UK’s ageing population and the exponential growth in the public’s health needs. They talked of how the pandemic has compounded this problem.

Moreover, the pandemic paused elective surgery, leaving the NHS to deal with backlogs and extended waiting lists. The view of the petitioners was that the NHS should be given time to stabilise and respond to those challenges before taking on the challenges of reform. On a more institutional level, Unite said that it fears that this Bill would open the NHS up to deregulation, worsening staff shortages, and create a pay-for-use system akin to America’s.

The petition states that

“The Government has no democratic mandate to privatise the NHS”.

I agree: the Government have no democratic mandate to privatise the NHS, which is why they are doing no such thing. Access to NHS services will continue to be based on clinical need, not an individual’s ability to pay.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on having secured this debate. I put to him—this is perhaps a challenge to the Minister and the Government—that we need to be careful with the NHS as it is today. We all love the NHS—we love the workers and we love what it does—but if we are not careful, it could come to a point where if a person does not have the money, they cannot pay for their care. Does the hon. Gentleman agree that if that were to happen, the whole principle of the NHS would be knocked on the head?

[Matt Vickers]

This is a debate that we have in every election campaign, and other than the issues around dentistry, which I am sure we will come to, the NHS remains free at the point of use. I will fight the corner to keep it that way, and I am sure that the hon. Gentleman will do so as well.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate. I concur with the comments of others. Like the hon. Member for Stockton South (Matt Vickers), I acknowledge the incredible work of all healthcare workers across all spheres of the health system over the past two years, through the pandemic. The commitment and dedication that they have all demonstrated throughout the public health crisis is of course not unique to the pandemic but is a defining characteristic of all the staff our wonderful national health service produces. Each one of us present is here to say thank you to them from the bottom of our heart.

I commend the NHS staff who have been working hard day in and day out to ensure that their patients are looked after in the same caring way as they are in normal times. It is important that we acknowledge the sacrifices made by the families of nurses and doctors who have been called in at short notice when wards and A&Es have been short-staffed. Many of my constituents do that every day, and have done it almost every day through the crisis. Many do so having only just left a long overnight shift, and many saw very little of their families during those times. We tend to take it for granted that our NHS staff will go above and beyond to serve the public, which should make us even more proud of them. There is an onus on us in this House, and on the Minister and the Government, to ensure that we deliver for our staff for all that they have done.

The NHS is very different in the scope of the services that it delivers from how it was at its inception on 5 July 1948. I am certain that if Florence Nightingale walked its corridors today she would be more than impressed by how far the delivery of medical services has advanced, but she would also see the familiar aspects of local doctors delivering a first-rate service in community hospitals. The building blocks remain unchanged, and as our NHS looks to the future it is vital that the foundations never change. The NHS is central to our society. We do not want it to be Americanised. We all know what that means: that we would have to pay for it, which would be wrong. We have a duty to deliver for the people we represent, without having to gauge whether their wage packet can pay for treatment, or whether their wallet is big enough.

The future of our NHS will be supported by revolutionary technology, just as revolutionary as the first penicillins when they worked what seemed to be miracles. We do not have a crystal ball, but we can be certain that increased funding will be necessary to support the radical adoption of innovative technology, to improve resources and, without question, as the hon. Member for Cynon Valley (Beth Winter) said, to pay our NHS workers a wage that reflects the work that they do, have done, and will do in future.

I will conclude, as I am conscious of the three-minute limit, Mr Gray. Today, GPs and hospitals are under severe pressure, which I believe will not ease for the next generation of GPs and NHS workers. In order to ensure that the original building blocks of the NHS that we cherish remain in place, we need, as policy makers, to build firm bridges between now and then. Most importantly, the NHS of the future must have the same ethos of care and compassion at its core in 2050, when we may not be here, as it did at the beginning in 1948, when I was not here either.

--- Later in debate ---

[Edward Argar]

I will not give way to the hon. Lady now. I have given way to her before. I will try to make progress, but if there is time I will try to give way to her.

We have seen innovative new ways of working: new teams forged, new technologies adopted and new approaches found to some old problems. There is no greater example of that than the phenomenal success of our vaccine roll-out. That would not have been possible without the staff, who are the golden thread that runs through our NHS. As we look to the future and a post-pandemic world, we know that, as the shadow Minister said, there is no shortage of challenges ahead of us: an ageing population, an increase in people with multiple health conditions and, as he rightly says, the challenge of deep-rooted inequalities in health outcomes and the need to look at the broader context. I do not know the shadow Minister as well as I knew his predecessor, but both his predecessor and I had a career in local government as councillors. I suspect that the shadow Minister may have had one too, so he may well know that I understand his point about the broader context.

[Jim Shannon]

Will the Minister give way?

[Edward Argar]

I will make a little more progress. If I can, I will then try to give way to hon. Members.

More needs to be done, and we are giving the NHS the support that it needs and has asked for. In addition to our historic settlement for the NHS in 2018, which will see its budget rise by £33.9 billion a year by 2023-24, we have pledged a record £36 billion for investment in the health and care system over the next three years. The funding will ensure that the NHS has the long-term resources that it needs to tackle the covid backlogs and build back better from the pandemic.

[Jim Shannon]

The hon. Member for Stockton South referred to recruitment within the NHS. What is the Government’s response to that, to ensure that we have the recruitment and the staff in place?

[Edward Argar]

As the hon. Gentleman will know, there are 1.2 million full-time equivalents in the NHS—a record number of staff. Take one example: our pledge for 50,000 more nurses by the time of the next scheduled general election in 2024. Last year alone, we saw the number of nurses in our NHS increase by 10,900. We have a plan in place, and we are recruiting and training more staff through increased numbers of places—at medical schools, for example.

NHS Hysteroscopy Treatment

Jim Shannon Excerpts

Monday 31st January 2022 Commons Chamber

[Ms Lyn Brown (West Ham) (Lab)]

I am, frankly, very disappointed to have to be raising this issue again in this House. This is the ninth time I have spoken about this, and it is more than eight years since my first speech on this topic. However, the problem of pain and trauma caused during hysteroscopies has not gone away. I want to pay tribute to the Campaign Against Painful Hysteroscopy, who do so much to let women know that they are not alone, that their experience has not been singular, that they were not making it up and they were not hysterical; they were experiencing great pain and discomfort. That campaign offers comfort and a productive outlet for their utterly justifiable anger. My hope is that this Minister will not only take this issue away, but will commit today to getting action at a national level, because it is a true scandal that these horrific abuses are still taking place. Let me be really clear with people. Every time I speak, I have new stories, because women hear my speech as they reel from fresh abuses and they get in touch. So all these stories that I am going to recount today have happened since my last speech on this issue.

I will start with the story of Jane, who had a hysteroscopy late last year. Jane had been warned by her excellent GP that the specialist might attempt to talk her into a hysteroscopy without anaesthetic, and that she had the right to insist on proper pain relief. After all, she has several well-recognised risk factors for pain during hysteroscopy, including endometriosis, a tilted uterus, and never having had children. Fully aware of that, Jane received a letter for an appointment about the results of an ultrasound scan she had had. The letter said nothing about a hysteroscopy, and nothing about her risks or her right to anaesthetic, so she went along expecting simply to have a discussion with a consultant about the results of the scan. But when she got there, she was informed that the consultant wanted to do a hysteroscopy there and then. She said immediately she wanted a general anaesthetic, and explained that she had had terrible pain from similar procedures in the past. Shamefully, the consultant’s response was to laugh in her face and say

“if we gave a general anaesthetic to every woman who had a hysteroscopy the queue would be a mile long”.

To laugh at a woman in distress in that position, I find abhorrent.

Jane was scared. She shook but she felt she had no choice but to comply. She told the doctor and nurse what she had heard about the pain, but they told her not to believe everything she read. She told me that

“as soon as the speculum went in I felt immense pain that was absolutely unbearable...the doctor was having difficulty finding the opening to my cervix so twisted the speculum and dug around, which caused indescribable pain, I felt I might pass out, I had tunnel vision”—

and she was “shaking and hyperventilating.”

At that point, thank heavens, the procedure was stopped but, unbelievably, the doctor said that he simply did not understand why Jane was in so much pain and causing such a fuss, which only worried her more, because it increased her concern that she had cancer. Even after all that, the doctor was still unwilling to consider a proper anaesthetic. Instead, he prescribed a hormonal pessary and suggested that she come back for another go in a fortnight.

Jane was in a fog. She does not remember anything other than getting home and curling up on the sofa, shaking with shock. She has relived the experience over and over, unable to move on because of the threat that she would have to go through it all again without pain relief. She has had trouble sleeping and has had to take time off work because she cannot concentrate. Understandably, Jane believes that she has post-traumatic stress disorder. She told me that she was actually more afraid of having another brutal experience than she was of dealing with possible cancer. How much will the late detection of cancers resulting from this fear cost our NHS and our families? I emphasise to the Minister that this is not major surgery; it could be essentially painless if only proper anaesthetics were offered.

The last I heard, Jane will now have a hysteroscopy with a general anaesthetic. I am praying that she does not have cancer, because if she does, the months-long delay caused by her mistreatment and the callous attitude of that doctor could be deadly to her. What estimate have the Government made of the added cost of failed hysteroscopies that must then be repeated with anaesthetic? Jane is not alone in her experience and in having understandable distrust of the NHS and doctors as a result of her trauma.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady on her speech. I was there the last time that she brought this issue to the House, as I am tonight, because my wife has been through the experience that the hon. Lady referred to. As a result, I think it is important that I am here to support her not just for my wife, but for every other lady across the United Kingdom. Pain relief is a way of providing much needed reassurance for women who are having hysteroscopies. This is a potentially life-changing treatment and women must be enabled to be as comfortable as possible—I see how important that is. Some 35% of the women who undergo anaesthesia-free hysteroscopies reported severe pain. Does the hon. Lady agree that the pain medications and anaesthesia must be readily available for those who need it? No one should have to live in this day and age with severe pain that cannot be taken care of.

[Ms Brown]

I agree with the hon. Gentleman and I am grateful for his intervention. I know he has been in these debates with me, and he makes the same point: no woman should have to go through this. No woman should be held down while procedures happen because they are screaming with pain and they want the pain to stop.

Another woman who contacted me about a hysteroscopy that took place last year told me that she had never experienced so much pain—not from a hip operation, nor from having her spleen removed. As a result of her traumatic experience, she now has anxiety and has been prescribed tablets by her GP just to help her function with the day-to-day. Like Jane, she is losing sleep and no doubt her broader health has been harmed by this. She does not know whether she has cancer, but she told me that she is now too scared to go to the hospital for anything.

There are so many stories that I could have told today. I am sent so many of them, despite the fact that the issue does not get a huge amount of press. Women who experience this are seeking out me and the charity I work with to tell us about it. If there were more publicity, more women would come forward. I really hope that the Minister understands that this is an issue of patient safety, but also an issue of common decency. It is an issue of confidence in the medical professions and the NHS, and it will be costing us all, both in money and in lives, because problems simply are not being caught early enough.

Health Inequalities: Office for Health Improvement and Disparities

Jim Shannon Excerpts

Wednesday 26th January 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank the hon. Member for Bootle (Peter Dowd) for setting the scene. He is a man known for setting the scene well, and we appreciate his contribution—I think every one of us will have been heartened by what he has said today. I wish to make a contribution as my party’s health spokesperson. I am pleased to be here to discuss the evident disparities and inequalities in our health system, both on the mainland and back home in Northern Ireland. I know the Minister is not responsible for health in Northern Ireland, but I will give examples that will hopefully spur those who speak in this debate.

We must ensure that everyone has access to efficient healthcare. I will speak about three groups of people: those with mental health issues, those who are homeless and those with addictions. The Office for Health Improvement and Disparities officially launched in October 2021, as part of a restructuring of health bodies in England and throughout the UK. I am pleased that the OHID will co-ordinate local and central Government to initiate improvements in public health. The purpose of the OHID is clear. If it delivers on that purpose, everyone present will be more than pleased because many of the issues would be addressed.

I thank the Government for listening and learning from the lessons of the pandemic, and that information has now been taken ultimately to improve our health service. The Minister has said that our Government have three priorities to work on. The first priority is preventing poor mental and physical health. One in four people in the UK—25% of the population—and 19% of adults in Northern Ireland suffer from poor mental health, so that should be prioritised. The second priority is addressing health inequalities. Health is devolved, but this must be a priority for the Department across the whole of the United Kingdom. The third priority is working with partners within and outside Government to respond to the wider health determinants. These partners also have a responsibility for public health outside England.

I will talk about addiction issues and why it is so important that we address them within this campaign and policy, which the Minister will reply to shortly. In Northern Ireland, and in my constituency in particular, alcohol and drug-related indicators continue to show some of the largest health inequalities monitored in Northern Ireland, with rates in the most deprived areas five times those of the least deprived areas for drug-related mortality, and four times those for alcohol-related mortality. I suspect that other hon. Members will also state those mortality figures for people with drug or alcohol addiction issues. The inequality seems to be, unfortunately, in the areas where people have a poor quality of surroundings and less money, and therefore they are the ones we need to focus on because of the high risk of mortality that is prominent.

The King’s Fund has ascertained that health inequalities are avoidable and depend on people’s access to care; the quality and experience of care; behavioural risks to health, such as smoking and drinking; and wider determinants of health, such as housing circumstances and social factors and decisions. All these things combine to put pressure on people. Crisis, an organisation that campaigns to end homelessness, has contacted me in relation to tackling the disease of disparity. That is quite a term: the disease of disparity. Yes, it is a disease and it needs to be addressed. People who are homeless face some of the poorest health outcomes in society.

Some of the statistics are as follows. People experiencing homelessness are three times more likely to be diagnosed with a severe respiratory health issue. I did not know that until I got that information from Crisis, but it is a fact. The average age of death among homeless people is 46 for men and 42 for women, as the hon. Member for Stockport (Navendu Mishra) referred to. In this day and age that is totally unacceptable. We must address that issue. At the same time, I read in the papers—I do not know whether it is true—that people are living longer. Will someone who is homeless live longer? They will not, and therefore that must be addressed. I hope the Minister can respond to that.

Finally, a recent study found that people facing homelessness in major cities, such as Belfast or London, have levels of frailty like that of a 90-year-old. Again, that is another combination of issues. The barriers blocking greater equality for our health service are just astonishing, and these have only been exacerbated by the pandemic. It is about time that we started prioritising, and that starts with everyone being given the same allowances to access our truly admirable NHS.

Lastly, it is time for the OHID to monitor the provision of commissioned services for those who are socially disadvantaged and cannot access sustainable healthcare. I urge the Minister to commit to producing guidance and support on what actually works in the provision of health and social care services. I believe our duty in this House is to speak up for those who need speaking up for. Today, I am doing just that.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate the hon. Member for Bootle (Peter Dowd) on bringing forward this extremely important debate. It has been really interesting and, with many people contributing, it has been quite rounded. The hon. Gentleman spoke passionately and knowledgeably about the issue, as did other Members. We have probably done the issue a disservice by having only an hour and a half to debate it. I look forward to further debates.

It is time to shift the centre of gravity of the health system from treating disease to building good health. To do that, we have to focus on the people and places who face the worst health outcomes. That is why on 1 October 2021, we launched the Office for Health Improvement and Disparities. The mission of OHID is to improve the health of our country so that everyone can expect to live longer in good health, and to break the link between people’s background and their prospects for a healthy life.

OHID is doing that by working with the rest of Government, the healthcare system, local government and industry, to bring together expert advice, analysis and evidence in policy development and implementation. As a number of hon. Members mentioned, covid has shone a light on the poor underlying health of certain groups in the population, the depth of health disparities and the implications for our health, economy and society.

Health disparities across the UK are stark. As the hon. Member for Bootle highlighted, in the borough of Sefton, where his constituency is located, the life expectancy deprivation gap is 11.8 years for women and 12.5 years for men. Health disparities can be driven by a range of factors, including education, income, employment and early years experiences. Therefore, OHID aims to systematically tackle the top preventable risk factors for poor health by looking actively at the evidence on health disparities and the ways in which we can go further to address them.

The new Health Promotion Taskforce, which was set up by the Prime Minister, will drive and support the whole of Government to go further in improving health and reducing disparities, because many of the factors most critical to good physical and mental health are the responsibility of partners beyond the health service. This new Cabinet Committee, now chaired by the Secretary of State for Health and Social Care, brings Departments together around the objective of reducing ill health and health disparities. It also provides a new opportunity to work together actively on the most important health issues and agree new ways to address them collectively. I hope that helps reassure colleagues that the new taskforce is at the top of Government, and is determined to bring all Departments together to tackle this agenda.

[Jim Shannon]

In my contribution, I referred to the contact that I have had with Crisis on homelessness. Will the contact that the Minister has referred to include those groups? They have the facts. She will have heard what I said about the disparities between those who, like us, live in a well-off area, and those who do not and have not got a home. Homelessness is deadly.

[Maggie Throup]

I reassure the hon. Gentleman that tackling homelessness is a high priority for this Government.

As hon. Members have mentioned, the Government will shortly publish a landmark levelling-up White Paper that will set out bold new policy interventions to improve livelihoods and opportunities in all parts of the UK, and to reduce the disparities between different parts of the UK. Poor health is stopping people accessing quality education and jobs with good career prospects, limiting their career progress, and undermining local prosperity and the general wellbeing of communities across the UK. Of course, it would be wrong of me to pre-announce the contents of that important White Paper.

Tackling health disparities promotes economic prosperity by increasing productivity and reducing strain on public services, including the economic cost of preventable ill health to the NHS and the welfare system. To address those issues, we are investing in tackling the key contributors, such as obesity and smoking. We are also investing £500 million to transform Start4Life and family health services.

Skin Conditions and Mental Health

Jim Shannon Excerpts

Tuesday 25th January 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate. I want to focus on that issue of major importance to which he referred: mental health. As my party’s health spokesperson, I am keen that these issues are addressed. Skin is always completely visual. For young people in particular, looks can seem like the most important thing, which is why it is crucial that we recognise skin conditions that are normal and those that are not. We have 4,000 skin cancer deaths annually in the UK.

The reason I am interested in this subject is that my second son was born with psoriasis. He had to have cream three times a day. The doctor told us that although he would grow out of the psoriasis—and he did—he would then develop asthma. He did develop asthma, but he is now married to Ashleigh, and they have two boys, Austin and Max—life has changed for him. I remember that when he was at school it was terrible for him; all over his skin was a rash. My wife was the person who looked after him, but that is what happened.

In Northern Ireland, in my constituency alone, we have 2,713 people who suffer from inflammatory skin disease. It is really important that the issues are taken onboard. Some 4,351 people develop skin cancer each year, and around 300 of those cases involve malignant melanomas. It is crucial that there is special psychological care to deal with the impact of skin problems, to help people to cope and to ensure that the condition does not worsen. The right hon. Member for Gainsborough referred to the fact that 18% of people suffering with skin conditions have received some form of psychological support—that is really important. They have to learn how to live with it, as well as learning how to deal with it. As I have said before, young people are growing up in a world where looks seem like everything, and we must do more for them.

Mental Health Act 1983: Detention of People with Autism and other Lifelong Conditions

Jim Shannon Excerpts

Thursday 20th January 2022 Commons Chamber

[Sir Robert Buckland (South Swindon) (Con)]

It is a pleasure to address the House in a debate on an issue that has great resonance with and importance to many people and families across the country—the continued detention of autistic people and people with learning disabilities under the civil provisions of the Mental Health Act 1983. I am grateful to the National Autistic Society and Mencap for working with me in the run-up to the debate.

Remember, these are people who have committed no offence. They are not even alleged to have committed offences. They have been detained for what is still defined as a mental disorder. They have done nothing wrong. Here are some bald statistics relating to the use of powers under the 1983 Act. At the end of November 2021, there were 2,085 people with autism or a learning disability in in-patient units; 1,234 of them were autistic people, 200 of whom were under 18—they were children. The average length of detention is 5.4 years, some people having been detained for more than 20 years. In September 2021 there were 3,620 reported instances of restrictive interventions, and 595 of them involved children. Those interventions involved physical and, very often, chemical restraint. Those are not the complete figures, because there was data for only 31 out of 55 NHS providers and four of 16 private providers, so the real figure will be higher.

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. and learned Gentleman on bringing forward this debate on an issue that is massive in his constituency and mine. The number of detentions under the 1983 Act seems to decline with age, but there seem to be significantly higher numbers of cases among children and young adults. Does he agree that there is a better chance of rehabilitation and wellness when mental health issues are dealt with properly from as young an age as possible than when there is long-term detention with no counselling or rehabilitation?

[Sir Robert Buckland]

I am grateful to the hon. Gentleman for his intervention. He has a long-standing interest in autism issues, in Northern Ireland in particular. He is right that if there is early intervention, more can be done to prevent a lifelong condition such as autism becoming a co-morbid mental health condition. I will explain that in a little while.

Behind the statistics are real-life stories of people whose lifelong conditions have led to the system, however well-intentioned it might be, ascribing a lower value to their quality of life. That implicit judgment, I believe, runs through everything from the continued lumping together of autism and learning disabilities with mental health conditions, which in many cases is wholly out of date and inappropriate, to the discriminatory and unjust application of “do not resuscitate” guidance to people with these conditions. Those are abuses in plain sight.

Furthermore, the profound sense that the system is, in effect, making assumptions about the life of people with learning disabilities in particular has been exacerbated by the use of DNRs during the covid pandemic. Not only do we need to stop new orders being issued inappropriately to people with learning difficulties, but existing inappropriate DNRs need to be retracted. I ask the Minister: when will the Government act on the Care Quality Commission review recommendations about better staff training and family involvement in decision making about care and treatment?

It is no longer good enough for people with learning disabilities to be discharged from hospital with a form in the bottom of their bag, effectively having signed away their rights about the end of their own life. That is what we are talking about; I cannot put it more bluntly than that.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 18th January 2022 Commons Chamber

[Maggie Throup]

My hon. Friend makes a good point. The most vulnerable people are being prioritised. The UK Health Security Agency and NHS Test and Trace currently deliver an average of more than 70,000 PCR kits and 970,000 LFD kits a week to adult social care settings. In recent weeks, as demand has increased due to the omicron wave, Dudley, like other local authorities, has provided tests to key workers to enable them to keep working.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her response. The Government have recently announced that self-isolation will be cut to five days, given a negative lateral flow test. Has the Minister come to an assessment on the impact that will have on demand for lateral flow tests, given the struggle many have faced trying to obtain a box of them in recent weeks?

[Maggie Throup]

As we look at policy and amend it like we did last week, it is right that we make sure that we can fill those requirements. I reassure the hon. Gentleman that we can, and we have increased the procurement of lateral flow devices. This month, we will get another 750 million lateral flow devices into the UK for January and February.

Midwives in the NHS

Jim Shannon Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie (Stroud) (Con)]

In late November, midwives, doulas, families and healthcare professionals across the country marched in their thousands. They powerfully set out their concerns about the issues they face, and 100,000 people signed a petition to ensure their voices are heard. It is both a privilege and a daunting prospect to be standing here to try to represent their views.

Before I continue, I declare an interest. I am pregnant and, although I was hoping people would think I had eaten too much Christmas trifle, I realise I am now struggling to hide the bump. God willing, there will be a summer bundle of joy to give me additional sleepless nights over and above the ones that are normal for an MP. This makes me a current case study for maternity services, with literal skin, blood and placenta in the game.

So far, I am one of the lucky ones. The service I received from the Stroud and Gloucestershire midwifery teams during my first pregnancy was world class. It is testament to Gloucestershire’s commitment to local expectant mothers that I not only received consistent care during my first pregnancy but I have the same midwife again. I thank them all, and Jan Partridge in particular. Her name should be enshrined in Hansard, as she is a legend not only in my household but in many others around my community. I know parents across the country feel the same about their own midwifery teams for their help during one of the most frightening, painful but special moments of life.

I stood on a manifesto promising to make the UK the best place in the world to give birth, with personal, high-quality support. I sincerely hope that we can make that a reality. The March with Midwives manifesto sets out demands, which include: listen—they seek an urgent consultation to understand the steps required to address the immediate crisis; fund—an immediate appropriate restorative pay rise for midwives and financial support for student midwives; enable—to make it possible for self-employed midwives to work, thus putting 250 experienced midwives immediately back into the workforce and providing flexibility; and reduce—provide a £5 million crisis fund to charitable organisations for the provision of breastfeeding support and antenatal education, to reduce the pressure on midwifery staff.

The manifesto is wide-ranging, but it does highlight a number of important concerns. All the briefings that I have been sent and everything I have read indicate that many things lead back to staffing levels.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate; the number of MPs here is an indication of its importance.

In the Royal College of Midwives annual survey, over half the midwives surveyed said they were considering leaving their jobs. Fifty per cent. said they would leave the NHS next year. Of those who were leaving, eight out of 10 said that they were concerned about staffing levels—the very thing that the hon. Lady has referred to—and that they were not satisfied with the quality of care that they were delivering.

Does the hon. Lady agree that urgent action must be taken today to support those midwives considering leaving the NHS, so that they feel able to do their jobs to the best of their ability?

[Siobhan Baillie]

I thank the hon. Gentleman for his intervention. Staffing issues are absolutely crucial and I want to pose a number of questions about them.

Vaccination Strategy

Jim Shannon Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

Those who are clinically extremely vulnerable or immunosuppressed have already been offered a booster, so they have already received four doses. As I said earlier, at the end of last week the JCVI determined that at this stage it was not appropriate for others to have a booster or a fourth dose.

[Jim Shannon (Strangford) (DUP)]

The Titanic Exhibition Centre, which is the largest vaccination centre in Northern Ireland, is to close on Sunday 16 January. Has the Minister made an assessment, in her Department, of the impact that the closure of mass vaccination centres will have on the booster process throughout the United Kingdom of Great Britain and Northern Ireland?

[Maggie Throup]

As I understand it, the location of vaccination sites in the devolved nations is the responsibility of those nations. I can only speak for England in that regard, so the hon. Gentleman may wish to take the matter up with the Minister of Health in Northern Ireland.

Access to GP Appointments

Jim Shannon Excerpts

Wednesday 12th January 2022 Westminster Hall

[Theresa Villiers (Chipping Barnet) (Con)]

I beg to move,

That this House has considered access to GP appointments.

It is a pleasure to serve under your chairmanship, Mr Robertson.

GPs are at the heart of our health service and our communities, and I thank them all for their dedicated work. They have been at the frontline of one of the most successful vaccination programmes in the world, thanks to which we have some of the lightest covid restrictions and one of the most open economies. Family doctors have also delivered an incredibly rapid adoption of new digital means to interact with patients when lockdown meant that it was vital to be able to give health advice without vulnerable patients having to visit a surgery. This is quite a switch for a health service that just a few years ago was still using about 9,000 fax machines.

Phone or digital consultations are here to stay, and for many they are a great way to get help from their GP, but not for everyone. In particular, many elderly people, people with learning disabilities or other cognitive impairments and those with language barriers may not be able to cope easily with digital communication. They may find anything other than a face-to-face meeting difficult. It is vital that these vulnerable people can still see their doctor, and there has been some real progress in recent months. There are now more appointments in general practice than there were before the pandemic, and, judging by the latest figures, about 65% of those were face to face.

[Jim Shannon (Strangford) (DUP)]

I was interested when I saw this issue on the agenda for Westminster Hall. I am interested in lots of things that are debated in Westminster Hall, but this is one in which I have a particular interest. Does the right hon. Lady agree that for many people who are not comfortable about describing their symptoms over the phone, or eloquent enough to do so, it is essential that they can request to see their GP without having to prove to the receptionist the reason why they need to?

[Theresa Villiers]

That is of course correct. Phone calls are important in triaging and assessing the extent to which a face-to-face meeting with a doctor is appropriate, but it is essential that those who need face-to-face appointments are given them.

We are seeing some progress, and this has been delivered at the same time as millions of booster jabs. I give credit to GPs, NHS England and Ministers for that recovery in general practice, but it remains the case that many of us will have heard from constituents about problems in getting in to see their GP. I thank the 19,302 people who signed the online petition on Parliament’s website expressing concern about this.

Access to Radiotherapy

Jim Shannon Excerpts

Wednesday 12th January 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate, Mr Davies, and also a pleasure to follow the hon. Member for Rhondda (Chris Bryant). We in this House are very blessed that he is here today because he had early treatment and was able to respond to it. I spoke to him personally at the time, and I know that others did. We are very thankful to God that he is here today and able to participate in this and many other debates in the House on a regular basis. We thank him for that.

I also thank the hon. Member for Easington (Grahame Morris) for setting the scene. We are greatly indebted to him for his leadership, for his interest in this subject matter and for every occasion on which he comes forward. We are also indebted to the hon. Member for Westmorland and Lonsdale (Tim Farron) as well. We are all on the all-party parliamentary group on cancer together, so we have regular contact with one another and with others as well. I give credit to both hon. Gentlemen for their leadership and contributions, and to others on the APPG for bringing this forward.

It is nice to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place. I always look forward to the Minister’s contribution. I believe that we will get a response that helps us to address the issues that we are raising today. I believe that we are greatly blessed to have the Minister in her place; she has a particular interest in this subject matter and is eager to secure change.

The debate today is about change; it is about making sure that we can move forward. I probably cannot even quantify—the hon. Member for Easington might be able to—the number of times we have asked about radiotherapy services. We have asked about these services before, met the Minister before and sent letters before, but we do not seem to be getting to where we want to be. That is what the hon. Gentleman said in his introduction. That is where we are.

There is a staggering backlog of an estimated 47,000 people missing a cancer diagnosis in the UK, and Macmillan estimates that the backlog of those waiting for a first treatment stands at 32,000 in England alone. Only last week in my constituency—this is not the Minister’s responsibility, to be fair, as it is a devolved matter—I met someone who was eagerly seeking an early meeting with a consultant and doctor about cancer. It is so important that she gets that; she is very worried about her circumstances. When I became aware of them, I was also concerned. We need to address that issue.

Radiotherapy in particular is one of the mainstays of cancer treatment. Modelling suggests that between 40% and 50% of people diagnosed with cancer should receive radiotherapy as part of their treatment. If it is part of their treatment and they cannot get it, we have a severe problem. The difficulty lies in workforce shortages, to which the hon. Member for Easington referred. They remain the biggest challenge facing the NHS and access to radiotherapy today. The Chancellor’s October Budget, unfortunately, missed a key opportunity to tackle this issue. Can the Minister give us some indication of the discussions that she has had with the Chancellor about what can be done to address the shortfall?

Macmillan Cancer Support says:

“The pandemic has both laid bare and exacerbated the terrible strain the cancer workforce has been under for many years.”

I know that the pandemic has exacerbated that incredibly. It is frustrating to know that the waiting lists that we had in 2019 are the waiting lists of 2021—and now 2022. It is essential that the budget for Health Education England is confirmed immediately, ensuring an increase in funding to train the cancer workforce that the NHS desperately needs.

Too few cancer patients have full access to a cancer nurse specialist, which is crucial in reducing costs and improving patient outcomes. It is very clear that in the reform of the NHS priority must be given to training these nurse specialists and ensuring that the funding is there to pay them for the extra responsibility that they take on and for the workload that they take off their colleagues, the doctors. Perhaps the Minister could give us some idea of what is going to happen in relation to that issue in the reform of the NHS.

Again, I am deeply grateful to Macmillan Cancer Support for the information that it has sent me. It estimates that in order to help meet the Government’s NHS long term plan, we need an additional 3,371 cancer nurse specialists, which means doubling the number of cancer nurses by 2030. In introducing the debate, the hon. Member for Easington mentioned that issue and I mention it again now, not simply to repeat it but to underline gently the importance of having those nurses in place. It is a major ask but not an impossible one, or at least it should not be impossible.

How do we get those nurses? First, we get the finance in place. An estimated total of £124 million is needed to train the next generation of cancer nurses by 2030. Again, what has happened in the discussions that the Minister has hopefully already had, or will be able to have, with the Chancellor? That process must begin with bursaries, which give the incentive and encouragement, if it is needed, to enable not just young students but mature students—those with mortgages and debts to pay, and perhaps children to care for as well—to be able to take the step into nursing. I make that comment because of a particular example that I know of. The dream of one of my constituents was to go into nursing. She worked in a shoe shop and her husband worked in landscaping; both of them had low-paid jobs. When she made the decision to follow her dream and go into nursing, she simply could not make ends meet, which is why bursaries are important.

I know this girl personally, so I know that she has endless compassion. She worked to become an intensive care nurse. She is a clever lady who wanted to make a difference in this world, but simply could not do so. She went into care work during covid and is making a difference in a nursing home, but will she ever become an ICU nurse, as she wanted? She thinks not, but I would like to think that the differences we make in this place and the decisions that we take will enable people such as Sarah to do the good that they want to do in the world, because there are many people out there who just love to help other people. We in this House—you, Mr Davies, and the rest of us here—are MPs who wish to help people; indeed, that is our job.

In 2020, the all-party parliamentary group for radiotherapy reported that a fifth of radiotherapy machines were older than their recommended lifespan of 10 years. NHS England must ensure a sustainable future so that machines are upgraded on a rolling basis and when they need to be. That process must be continuous, so we need an action plan to make it happen. Again, I ask the Minister a question: what has been done to address the need for that additional investment? Unfortunately, it is a fact that this comes down to finance.

Additional investment in radiotherapy would be best spent on upgrading existing machines and software rather than on increasing the overall number of radiotherapy machines or centres. Cancer Research UK has said that even if new centres were built, it would be very difficult to find the staff to run them. We need a co-ordinated and strategic plan that considers all the potential issues for the future, especially in rural areas such as the one that the hon. Member for Westmorland and Lonsdale represents. As he often says, in rural areas staff shortages are often the most severe that they are anywhere.

In the long term, consideration must be given to introducing innovative technology to transform care. For example, there are a limited number of magnetic resonance linear accelerators, or MR linacs for short, in the UK. They significantly increase the precision of analysis and therefore the effectiveness of treatment, which is really important. The Government must consider how to manage funding over a long term, to expand access to MR linacs and other cutting-edge technologies. That also includes purchasing new radiotherapy technology to evaluate its efficacy as a cancer treatment.

I will finish with this comment: the fact is that much greater investment is needed. We should remember that radiotherapy is used for half of cancer treatments, so it is critical for addressing cancer. Cancer affects many people and we need to give radiotherapy the priority that it deserves, getting the nurses and the equipment in place urgently. Unfortunately, there are literally millions of people whom radiotherapy can save and thereby extend their life. It seems to be agreed by all those who have spoken in this debate, and I believe that it will also be agreed by all those who will speak after me, that we must do all that is possible to do in this place in that regard.