Adult Social Care in Shropshire: Government Funding

Jim Shannon Excerpts

Wednesday 22nd January 2020 Westminster Hall

[Daniel Kawczynski]

I thank my hon. Friend and neighbour for that intervention. I could not agree more.

When we came into office, we of course had to rein in expenditure, and all Government Departments had to have cuts. The cuts to local government have, of course, adversely affected our council. I am pleased that the country’s annual deficit is now below £28 billion a year, down from the £152 billion a year that we inherited. However, now that we are getting the finances under control in a more sustainable way, I urge the Minister to take the message back to the Treasury that we need to increase public funding of our councils, so that they can start to meet the huge rise in demand for adult social care in our county. I will explain why Shropshire is uniquely affected.

[Jim Shannon (Strangford) (DUP)]

Although it is absolutely the case that adult social care is very important in Shropshire, and in other parts of the United Kingdom of Great Britain and Northern Ireland, does not the hon. Member agree that we need to attract more workers into adult social care, because there seems to be a dearth of them, and help them to understand how rewarding it can be to make a real difference to the life of a vulnerable person? Also, does the hon. Member believe that we can do anything in this place to encourage more adult workers to be involved?

[Daniel Kawczynski]

Yes, very much so, and I am sure that some of my colleagues from Shropshire will take up that point in interventions. However, I will make a few quick points before I take another intervention.

During the 2017 general election, we gave the impression to the electorate that somehow they would have to sell their homes in order to pay for their long-term care. I have to tell the Minister that I had never come across such levels of bewilderment, frustration and anger on the streets of Shrewsbury as I did following that announcement, and have not done so subsequently. Whoever came up with that policy for the then Conservative Government was really out of tune with the thinking of many of our natural voters.

Even my own beloved mother—this is the first time I have referenced her in 15 years—Halina, who is a staunch Conservative supporter, said to me, “I haven’t made sacrifices all of my life, I haven’t done the right thing, paid the right amount of tax and done all the right things, for you now to force me to sell my home to look after my long-term social care needs.” I think my mother exemplified the strength of feeling across the United Kingdom.

I am convinced that that policy lost us our majority at the 2017 general election; it was certainly a major contributory factor. I am therefore very pleased that the Prime Minister has indicated that in this Parliament a solution will be found. However, as my hon. Friend the Member for The Wrekin said, we need radical, innovative thinking that has the support of our voters.

Shropshire MPs meet the council on a regular basis. We Shropshire MPs work as a team and hunt as a pack, and one of our greatest strengths is the unity between us all. In fact, we are seeing our council this Friday, 24 January, which happens to be my 48th birthday. I am looking forward to a few bottles of beer from my colleagues during the meeting.

Stepping Hill Hospital

Jim Shannon Excerpts

Tuesday 21st January 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

First, may I congratulate the hon. Gentleman on what he is doing? I have read some of the background, as I have already told him, and I commend him for his energetic efforts on behalf of his constituents and the hospital. My hospital, like his, has a specialist stroke unit and we want to keep it open, too. Time is of the essence. Does he agree that the retainment and enhancement of specialist services must be a priority in the NHS, no matter what direction it takes?

[Mr Wragg]

Naturally, I agree with the hon. Gentleman and commend him for his work, particularly in maintaining the stroke services at his local hospital. Indeed, I commend the work of all those who perform such vital roles at Stepping Hill.

In other parts of the country, especially in large cities, people have a number of options for where they can receive care for a range conditions, including as a result of accidents and minor injuries. That means that emergency departments just care for the sickest patients who need resuscitation or emergency care.

Surrogacy: Government Policy

Jim Shannon Excerpts

Tuesday 21st January 2020 Westminster Hall

[Andrew Percy (Brigg and Goole) (Con)]

I beg to move,

That this House has considered Government policy on surrogacy.

It is a pleasure to serve under your chairmanship, Sir David, and a delight to see my current favourite Minister and favourite shadow Minister in their places. Having flannelled them, I am sure that the debate will receive a very successful response.

Surrogacy is an issue that I came to by accident, having watched a documentary about people who were going overseas to partake in surrogacy arrangements, and some of the problems that that was causing, particularly when it came to the welfare of some of the surrogates. From that, I started to look at the issue of surrogacy in the UK a little more closely. Having become more interested in the subject, it quickly became clear that there is urgent need in this country for reform of surrogacy law. There is also an urgent need for Government to understand and appreciate the important role that surrogacy plays in creating families in this country, whether those families are heterosexual couples, same-sex couples, or single people who wish to create a family. It is a legitimate, valued and socially acceptable means of family building.

Apart from investigating the situation of surrogacy overseas, the only other thing I remember about surrogacy is the debate in the 1980s, when I was a kid growing up. That was when the legislation on which UK surrogacy is presently based came into being, in response to some of the stories and concerns about surrogacy at the time. The debate in the 1980s was very different from the debate we have now. We now understand that surrogacy in this country works, and that it is a legitimate and loving way in which families are created. I thank the previous Minister, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who is in the Chamber today. She was, I think, the first British Minister to publicly state in the House of Commons the positive role that surrogacy plays in this country. Although I do not wish to embarrass her, I will repeat what she said in July 2018 when she was a Minister in the Department of Health and Social Care:

“Surrogacy has an increasingly important role to play in our society, helping to create much-wanted new families for a range of people. The UK Government recognise the value of this in the 21st century where family structures, attitudes and lifestyles are much more diverse.”—[Official Report, 19 July 2018; Vol. 645, c. 38W.]

We could not disagree with a single word of that, and we thank her on behalf of the whole surrogacy community for the positive way in which she embraced surrogacy.

We in the surrogacy community also thank my hon. Friend for the guidance that was issued by her Department during her time as Minister, including “Care in Surrogacy”, which was guidance that the Department of Health and Social Care issued to healthcare providers across the country. It had the same simple aims that all of us in the surrogacy community want to achieve: to normalise surrogacy among healthcare professionals, and to avoid the embarrassments that sometimes occur when healthcare professionals do not understand how these arrangements are come to and just how normal they are. In the past, there have been car park handovers of children because healthcare professionals on maternity wards and in hospitals have not known how the legislation and these arrangements work. We all want to avoid those situations, so I thank my hon. Friend for that guidance, which was updated at the end of November last year. I also thank my hon. Friend for addling the brass, as we say in Yorkshire, to ensure that the Law Commissions’ review into the current legislation—a joint review by the Scottish Law Commission and the Law Commission for England and Wales—was a root and branch review. We are very grateful for that.

I also want to say a big “thank you” to the Surrogacy UK working group on surrogacy law reform, which has done a brilliant job. Some of that group’s members are here today, although of course I am not allowed to refer to people in the Gallery. Particular thanks must go to my constituent, Sarah Jones, who serves as the chair of Surrogacy UK. When I got interested in this topic, I did not realise that one of my constituents was chair of Surrogacy UK; it was quite by accident. A big “thank you” is also due to Natalie Smith, and to Dr Kirsty Horsey from Kent University, who led and chaired the review working party within Surrogacy UK. We are really grateful that the funding is in place, and that this review has now happened. It is a three-year project which, if memory serves, we are about half way through.

Surrogacy in the UK has been regulated since 1985 by the Surrogacy Arrangements Act 1985, which came out of the 1984 Warnock committee report. That Act contains a number of provisions that make advertising for, or as, a surrogate illegal, criminalise for-profit surrogacy and render all surrogacy arrangements as they stand unenforceable in law. Since 1985, there has been plenty of legislation to change some of that Act’s provisions. The Human Fertilisation and Embryology Act 1990 established that in all forms of assisted reproduction, a woman who gives birth, and no other woman, is the legal mother at birth. The legal problem with the situation now is that a surrogate who is carrying a child who has no genetic link to them is, in law, the mother at birth, whereas the intended parents, who may have a 100% genetic connection to that child, are not.

The 1990 Act also determines that the partner of the surrogate is the legal father, even though he may have had absolutely no part in the surrogacy arrangements. That is why parental orders are being created that enable legal parenthood to be transferred after birth as long as certain conditions are met. However, that takes six to nine months at best, and in many cases takes much longer.

Surrogacy legislation has evolved and changed over time. Not so long ago, a remedial order was passed by Parliament in response to a human rights court case. That order now enables single individuals to take part in surrogacy, something that was previously outlawed. The key problem with the legislation, as I have highlighted, is the issue of parent orders. Despite the fact that surrogates, intended parents, and everybody involved in these arrangements have only one interest at heart, that of the child, the current legal situation sometimes works against the interest of the child. It is very rare in a surrogacy arrangement for the relationship between the surrogate and the intended parent to break down, but the current law means that if that does happen, a surrogate who, at birth, is the legal parent can prevent legal parenthood from ever transferring, even though the children could have no genetic relationship to the surrogate.

The relationship breaks down only in a very small number of cases. Most surrogates go into this for entirely altruistic reasons, and the relationships between the surrogate, the parents and the child are normally very strong and often life-enduring. However, when such a breakdown happens, as in the well-known case of Re AB (Surrogacy: Consent), it can result in legal parenthood never being transferred, resulting in a situation where the parent in law will always be different to the parents in reality. That is not in the best interest of the child, which is why we in the surrogacy community welcome the Law Commissions’ proposals on this issue. By outlawing the enforceability of surrogacy arrangements, the current situation is one in which people want to properly formalise an arrangement, but cannot then rely on that arrangement later on in law.

Most of us involved in the surrogacy debate would say that what does work in the current UK legislation is the principle of altruism.

[Jim Shannon (Strangford) (DUP)]

This is a complex issue, and the hon. Gentleman is setting the scene very well. However, does he agree that in all these things, sensitivity must be key? Does he also agree that we perhaps need to look to our neighbours across the pond in the United States of America, for instance, where large numbers of surrogacies are carried out, to see how their policies and guidelines have made the process safe for parents and surrogates alike?

[Andrew Percy]

I thank my hon. Friend for that intervention, and will come on to the issue of surrogacy arrangements in the United States. Nobody would question that surrogacy arrangements in that country operate in the best interest of the child, but they operate on a wholly different basis to surrogacy arrangements in the UK: they operate on a commercial basis, which many of us would not want to see here. It is fair to say that in this country, surrogacy arrangements work. There is no doubt that the welfare of the child is at the heart of surrogacy arrangements, and at the heart of the courts in this country. However, as the debate progresses, we can of course take examples of best practice from other jurisdictions, whether through legally enforceable surrogacy arrangements or whatever else.

[Andrew Percy]

I entirely agree. I will say more later, but there is a debate in the surrogacy community about the nature of payments and whether its basis should be altruistic or commercial. Throughout the process, the view of the all-party parliamentary group on surrogacy, which I formed with other hon. Members, has been that we must maintain the altruistic basis of surrogacy in the UK. There are others in the community who take a different view; I will say more about that in a moment.

The all-party parliamentary group undertook a number of hearings in response to the Law Commissions’ proposals. The principal purpose of the debate is to explain where we agree with them and where we do not, and I thank the Law Commissions for the way they have engaged with us. They have been proactive and positive in coming to APPG meetings and some of the hearings, and they have been open throughout the process. That view is shared by everybody across the surrogacy community.

We took evidence from a number of interested parties. We heard from surrogates, intended parents, parents who have created their families through surrogacy, and the legal community. We even took evidence from Tom Daley who, with his partner, chose to undertake their surrogacy arrangement in the UK, not in the United States, precisely because there are some big reasons why the US is not as attractive a jurisdiction—although it is perfectly safe—for such arrangements. Those sessions were really interesting and valuable. In response to the Law Commissions’ initial consultation, we have some clear views on what we would like to see.

[Jim Shannon]

There is something at the back of my mind, which I want to put on the record and get the hon. Gentleman’s thoughts on. With the rise of celebrities openly discussing their surrogacy journeys—he has mentioned one—does he agree that we need a clearly defined strategy to address the rise in the number of surrogacies and the complexity of the issue, which is difficult for people to understand without clear guidelines?

[Andrew Percy]

It is absolutely the case that we need updated legislation. We welcome the arrangement of Tom Daley and his partner, Dustin Lance Black—I have just remembered his name; I am not very good at remembering actors’ names—because they are two loving parents who have created a loving family. They are a good example, because they demonstrate better than anyone, or as well as anyone, how loving families can be created in a range of ways—through surrogacy, IVF, adoption or marriage—in the UK in 2020.

Dustin Lance Black also undertook an interesting set of radio programmes, one of which, following surrogacy arrangements in the US, explained why they chose the UK and felt that the system here was better. The hon. Member for Strangford (Jim Shannon) is spot on, however, that we need a well-regulated and updated framework for surrogacy in the United Kingdom.

We as an all-party parliamentary group are positive and pleased by the Law Commissions’ proposals. We recognise how progressive many of them are, and that they balance most of the concerns about safeguards, ethical surrogacy and the welfare of children—of course—that were raised by stakeholders throughout the process. We also welcome the fact that, unlike in previous reports, the lived experience is front and centre of all the proposals. We believe that the commissions have engaged positively with the whole surrogacy community and interested parties.

Where do we agree? As I said, we are happy that a full root and branch review is taking place. We are also pleased that there is no move towards allowing the commercial surrogacy that we see in the United States, because it would then become the preserve of the wealthy. That is not the case with the altruistic nature of the current system, although it is not without expense or challenge. We have a situation in the United States where some families are now going out of the United States to undertake surrogacy because they cannot afford it there.

Health and Social Care

Jim Shannon Excerpts

Thursday 16th January 2020 Commons Chamber

[James Brokenshire (Old Bexley and Sidcup) (Con)]

It is good to see you restored your place, Mr Deputy Speaker, and a particular privilege to take part in today’s debate on the Gracious Speech, with a particular focus on our precious NHS. It is also good to see the emphasis in the Government’s programme on funding, innovative medicines, safety and mental health, so that we can improve the services that our NHS delivers and improve the lives of those who needs its care.

The timing of today’s debate has some particular poignancy for me. I was struck by the comments of my right hon. Friend the Member for South West Surrey (Jeremy Hunt) about the ups and downs of politics. It is almost exactly two years to the day that I had surgery to remove the top part of my right lung and the cancerous tumour contained within it, but I am pleased to say that, in the immortal lyrics of Sir Elton John, “I’m still standing.” [Hon. Members: “Hear, hear.”] I count my blessings each day, and today provides me with a further opportunity to pay tribute to the incredible people in our NHS who saved my life and continue to save the lives of countless people up and down the country every single day.

I have learned so much over the past two years, and I am determined to use my experiences to act as an advocate for change, especially for less survivable cancers such as lung cancer. I have been heartened by the encouragement of colleagues across the House—even the colleague who upon my return to the Members’ Tea Room after surgery said, “Didn’t expect to see you back.” To this day, I am quite sure that the omission of the words “so speedily” was simply an unconscious oversight.

Over half of us will get cancer at some stage in our lives. That is why we need to be more open about and change the nature of the conversation around the disease. For many people, cancer is becoming the treatment of a chronic condition, and more and more people are living well with or beyond cancer.

[Jim Shannon (Strangford) (DUP)]

I thank the right hon. Gentleman for giving way. I was pleased to see him back after his operation, and he is making a clear case on cancer-related issues. Just this week, I met representatives from the Teenage Cancer Trust who indicated that, for young people and teenagers, cancer is not just about the operation and other physical activities, but mental anxiety, too. The Government have set aside money to ensure that that anxiety is addressed, but only 61% of such services are taken up in hospitals and just 40% of the available assistance and help is taken up afterwards. I am sure that the Government response will be positive, but does he agree that now is the time to address those shortcomings for those who experience mental health anxiety due to cancer?

[James Brokenshire]

I commend the hon. Gentleman for his point about mental health issues and some of the stresses and strains, and there is a need for greater focus and attention on teenage cancer patients. That leads me on to my next point, which is about the need to overcome the fear that a diagnosis can bring. I know what that can feel like. Early diagnosis and speedier treatment are key, not least to reduce the worry and sleepless nights that result from knowing something is wrong by getting something done about it. It is great that the NHS long-term plan recognises that. By 2028, the plan commits to improving cancer survival dramatically, increasing the proportion of cancers diagnosed early from a half to three quarters. That is why the NHS Funding Bill, with its commitment to an extra £33.9 billion a year for the NHS, is especially important.

There is, however, a question around how we turn the increased investment and that intent into the reality of improved outcomes. That is why we need to focus on what I term the “SAS”: better screening for the disease, greater awareness of the disease, and a breaking of the stigma attached to the disease. By doing that, we can make a real step change. I welcome the introduction of the targeted lung cancer screening programme, which I championed, and which is being rolled out as we speak. I commend the charities and the regular campaign events to highlight the symptoms and, yes, the importance of getting things checked out—especially for us blokes, who can be pretty rubbish at actually going to the doctors and doing something about it. The stigmas are linked to that, and we need to talk about the big C, because it is the disease that dare not speak its name. False judgments can be made, especially with something like lung cancer, because people may make wrongful assumptions that it must be perhaps the sufferer’s fault as they must have smoked. However, as one leading clinician said so effectively and succinctly at a recent conference I attended, “If you have got lungs, you can get lung cancer.”

All this needs to be looked at in context. We need the right workforce in place with the right equipment and the right systems and processes to back it all up. I welcome the Government’s commitment to increased investment in CT scanners and to increasing the overall number of nurses, but we need to recognise the particular role of specialist nurses and the incredible difference that they make. I look forward to the publication of Baroness Harding’s workforce planning review, and I hope that it sees this special group of nurses strengthened and supported and that their numbers will be increased.

There can be no doubt about the pressures that exist within the system and the increasing demands that our NHS has to meet, but the overwhelming experience of most people who use and rely on our NHS is positive, with a real appreciation of just how special it is. We need to continue to stand up for it, to champion it and to be positive about what more it can achieve. I have every confidence that we will and, in doing so, that we will help improve the lives of the people it serves and the people we are privileged to serve as Members of this House.

Ockenden Review of Maternity Care: Shrewsbury and Telford

Jim Shannon Excerpts

Wednesday 15th January 2020 Commons Chamber

[Lucy Allan]

My right hon. Friend makes an important point—I was going to come to it in my speech, so I will bring it in now. The Morecambe Bay inquiry was led by Dr Bill Kirkup, who said of the recent findings at Shrewsbury and Telford Hospital NHS Trust that

“two clinical organisational failures are not two one offs”,

and that that points to an “underlying systemic problem” that may exist in other hospitals. My right hon. Friend is right to make that point, and I thank him for his kind comments.

The interim findings in the Ockenden review were not published, and I understand that the hospital trust has not been told about them. The families were certainly not told about them, and neither were MPs. There has been no statement to the House, and we do not know what action is being taken to ensure the safety of women and babies at Shrewsbury and Telford Hospital NHS Trust.

[Jim Shannon (Strangford) (DUP)]

I am an avid watcher of that Sunday night programme, “Call the Midwife”—I am not sure whether you watch it, Mr Speaker—where everything seems to work out at the end of the day. The hon. Lady is outlining something that does not work out at the end of the day. She mentioned families. Does she agree that the care of mother and baby must be a priority, and that more support for mothers who have had several children must be considered, to ensure that they are coping and not expected simply to carry on because they already know what to expect? Every life is precious and adds more pressures to families, particularly mothers.

[Lucy Allan]

I very much appreciate the hon. Gentleman’s intervention. As always, he makes an excellent point, and I am grateful to him for his many interventions in many debates I have secured.

I am concerned that the NHS can choose to sit on this information, and that Ministers can say, “Well, we don’t comment on leaks”. This is about the safety of women and babies, and the adequacy of the maternity care they receive in our hospitals today. Women were repeatedly told that their case was a one-off tragedy, that there will always be risks to childbirth, and that such risks cannot be completely mitigated. Failings seem somehow to have been normalised, and at the time many women accepted that, rather than question or challenge the care they received. People trust the medical profession, which is why openness and transparency are so crucial.

When people raised concerns they were dismissed as being difficult—no one listened. There was a “we know best” attitude, and complaints about poor practice were treated as women making a fuss about a perfectly natural event that occasionally would have a negative outcome. As Health Secretary, my right hon. Friend spoke about “never events”, and I suggest that those must include an avoidable death. A baby dying in childbirth should therefore be a “never event”, yet it seems that that is not the way the deaths in this case were treated—they were treated as something that could be a result of childbirth. The trust even boasted of having the lowest number of caesarean deliveries in the country, so there seems to have been an unwillingness to intervene when there were complications in a delivery. In my view, an intervention during a difficult birth must be a good thing: that is what the clinicians and medical professionals are there to do. I am concerned about the way this trust appears to have treated women and about its attitude towards women, which seems to have been dismissive. And that is something we have seen from the top.

What adds insult to injury in this particular case is that the trust commissioned a report in 2013 that appeared to find that all was well. We now know, because of the leaked report, that that was in fact a whitewash. The trust was exonerated by what was a perfunctory bare minimum desk-top review. This allowed poor practice to continue unchecked. If it had been identified at the time, the more recent cases of malpractice, which are still coming forward and include death and injury, could have been avoided. We still do not know how many women and babies have been affected, but we do know that £50 million in compensation has been paid out already. However, with hundreds more women coming forward, the cases in which a financial settlement has already been reached are clearly the tip of the iceberg.

The question we have to ask, and must go on asking, is whether that poor care, and the normalisation and denial of it, is a systemic problem within the complex bureaucracy that is the NHS.