Unavoidably Small Hospitals

Jim Shannon Excerpts

Tuesday 6th September 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

May I say what a pleasure it is to speak in this debate? I thank the hon. Member for Isle of Wight (Bob Seely) for raising the issue for his constituents in a commendable way and with passion. He has illustrated the necessity of having a good local hospital or small hospital, as the title of the debate suggests. I share his concerns about St Mary’s Hospital in his constituency, which is completely isolated by water. It is of major importance that, for the sake of his constituency, his local hospital is funded correctly, to encourage people to use the services available there and to enhance those services, as the hon. Gentleman has suggested. I was pleased to read about recent plans to innovate and improve the service at St Mary’s; it is great to be back in Westminster Hall, in this parliamentary term, to discuss that.

May I say how pleased I am to see the Minister in her place? She has a real understanding of health issues and I am sure her response will encourage us all, and particularly the hon. Member for Isle of Wight. I am also pleased to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place and look forward to her contribution.

I always give a Northern Ireland perspective: the title of the debate is “Unavoidably Small Hospitals” and I certainly have one of those in my constituency. The importance of that hospital should never be underestimated. Back home in Northern Ireland, most of our major hospitals are in the County Antrim area, near Belfast city, where the majority of the population tends to live. In my rural constituency of Strangford we have two hospitals. The main hospital in Ulster is on the edge of my constituency. It is the biggest hospital and is very important because it provides acute services and can take in almost every emergency that comes its way. The other hospital, Ards Community Hospital, is in Newtownards, where my main office is. It used to be a major hospital, but things have changed in recent times. Hospitals have centralised their services and many services that used to be provided by Ards Community Hospital have moved to the Ulster Hospital.

My three boys—they are now young men, are married and have their own families—were all born at Ards Community Hospital, so I have a fondness for that hospital and for Adair House, as the maternity section was then. The hospital has changed—I understand why—and we now have a hospital that is not able to provide all the services that it once did. I want to put on record, as the hon. Member for Isle of Wight did in respect of his local hospital, my thanks to all the staff at Ards Community Hospital, the Ulster Hospital and elsewhere for their commendable and industrious work, their energy and passion, and their commitment to making lives better. That is something we can never fully understand, but we do understand that the part they play is so very important.

I understand the arguments about isolation, in terms of both where the hospital is situated and where my constituents live. To receive some services, my constituents are referred to the bigger hospital—the Ulster Hospital—where a significantly larger number of services are available, including a cancer centre. That is very important to us in Northern Ireland, where cancer impacts nearly one in every two people, just as it does in the rest of the UK.

For my most rural constituents, in villages such as Portaferry and Cloughey on the Ards peninsula—I live between Greyabbey and Kircubbin, but they live even further down the Ards peninsula—patients seeking medical care must have the reassurance that their nearest hospital can provide them with at least a basic assessment and service, despite the size of the population where they reside. That emphasises the importance of properly funding smaller hospitals such as Ards Community Hospital. Although I understand that our health services are devolved and therefore not the responsibility of the Minister present, the principle of health treatment is the same across the whole of the United Kingdom. Hopefully, I will be encouraged by what the Minister says and can send a copy of the debate to the Minister in the Northern Ireland Assembly to ensure that they take these matters on board.

I make a plea for the air ambulance, which I asked a question about in yesterday’s statement on urgent and emergency care. In Strangford, the air ambulance deals with life and death situations every day and is so very important for our rural community. Last year, Air Ambulance Northern Ireland had its busiest year ever.

In respect of per head services, we can never predict how serious any incident may be, but I believe that we underfund smaller and more remote hospitals because of that factor. In my constituency, we have to take into account both the fishing village of Portavogie, which is an economic and industrial centre, and the many remote places across the Ards peninsula from which it is just as critical to get to a hospital in time. There are also issues with the cost of medical services, based on the location of the hospital. That means that smaller and more isolated hospitals in certain areas face higher costs due to the decreased likelihood that a particular service may be utilised.

The community services formula, which was introduced in 2019 and to which the hon. Member for Isle of Wight referred, recognised that some rural and coastal areas tend, on average, to have an older population, which means there are higher needs for community services. In the Ards peninsula, the population of older people is growing. Many people come from other parts of the Province and move out to rural villages where houses are perhaps that wee bit cheaper so they can use the money they have to buy a house. They look on the area as a place where they will be for the rest of their lives, so the numbers of elderly people are increasing in my constituency.

The need for community services was assessed in England, and I encourage the Minister to engage with Health Minister Robin Swann back home on a similar strategy for Northern Ireland, to enable improved district healthcare for communities. I would be indebted to the Minister if she would take that forward. I will do my bit, but maybe the Minister might be able to do the same with the Minister in Northern Ireland. What I love about these debates is that we can all share things from all parts of this great United Kingdom of Great Britain and Northern Ireland, and we can use those things for the betterment of us all. Today’s debate does just that.

In the short time I have left, let me say briefly that in rural areas there tends to be less access to public transport in the evenings, which exacerbates the problems with the use of hospitals. Our own local hospital and other smaller hospitals may not even be open at certain times, and sometimes not until the early morning. It is crucial that that is taken into account in the funding of smaller hospitals.

To conclude, I echo the comments of the hon. Member for Isle of Wight, who introduced the debate, and very much look forward to the contributions of others. We must ensure that small hospitals are properly funded, for the sake of our constituents, friends, families and loved ones, and avoid the clear delays in funding opportunities. The NHS is a wonderful service. We depend on it and it must be protected. We must also give thanks and gratitude to all nurses and healthcare workers in our small hospitals who do their very best to work with what they have available and to ensure that our people—our constituents—are looked after in the healthy way that they deserve.

--- Later in debate ---

[Jim Shannon]

I thank the Minister for her answers. The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) and I both asked questions about health being devolved in Northern Ireland and in Scotland, and we are keen to ensure that some of the thoughts and ideas from the debate are shared with the devolved Administrations. Can the Minister confirm that that will happen?

[Maria Caulfield]

Absolutely. We need a collaborative approach because we all face the same challenges, whether in Scotland, Wales, Northern Ireland or England. I have been in contact with Minister Swann over recent months, and I am happy to work with him and the other devolved Administrations on these matters, because we all have a shared interest in ensuring that small hospitals are successful.

I can reassure colleagues that we want to support our smaller hospitals in future so that they are able to do more for their local communities.

Urgent and Emergency Care

Jim Shannon Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

Again, despite that colourful language, we have more doctors, more nurses and more paramedics. We are training more and meeting more demand, and significant additional funding has been applied to ambulance trusts, call handling and other parts of the system, including primary care. Part of reducing the demand on the ambulance system is related to GP capacity, which is why—to take that as an example—an additional £1.5 billion of funding has gone in.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and for his clear financial commitment to trying to address the issue of ambulance response. I also congratulate the new leader of the Conservative party. In her statement at dinnertime, the right hon. Member for South West Norfolk (Elizabeth Truss) said that the NHS is one of her main priorities.

The Secretary of State will know that this week is Air Ambulance Week, which runs from 5 September to 11 September. Today, Air Ambulance Northern Ireland stated that it has had its busiest year ever, so will the Secretary of State allocate additional funds to the devolved Administrations, particularly in Northern Ireland, to help cope with the increasing use of air ambulances due to delayed response times and extortionate waiting lists?

[Steve Barclay]

I very much agree with the hon. Gentleman on the importance of the air ambulance. As a rural MP, I know full well the importance of the service it provides across the Cambridgeshire fens, and I know that it provides an essential service for his constituents. Again, if there are any specific issues, I am happy to ensure that the Department looks at them, but he is absolutely right to draw attention to the importance of the air ambulance within the wider response.

Women’s Health Strategy for England

Jim Shannon Excerpts

Wednesday 20th July 2022 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

And finally, Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

Thank you, Madam Deputy Speaker. I have the strongest legs in the Chamber.

I very much welcome the Secretary of State’s announcement of additional moneys for women’s health training. He referred to one-stop clinics. I coincidentally spoke to a medical student who graduated in Cardiff today, who feels that more is needed for the specialty of women’s health, and specifically the menopause, which the hon. Member for Swansea East (Carolyn Harris) mentioned. What training will be extended to GPs, in the context of one-stop clinics, to ensure that each surgery has a trained GP available to advise and to help?

[Steve Barclay]

One of the key issues highlighted in the response to the call for evidence was how areas such as the menopause were being dealt with by the NHS. That is why we have a menopause taskforce looking at specific recommendations, one of which concerns the training of clinicians.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 19th July 2022 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend, who campaigns hard on this issue for Airedale Hospital. I absolutely understand the urgency around aerated concrete given the effect it is having, and of course I agree that the NHS has a vital role in supporting net zero. He will understand that I cannot commit to any one application. We are reviewing all applications and we aim to make a final decision later this year.

[Jim Shannon (Strangford) (DUP)]

Can the Minister assure me, and the House, that the money used for the purpose of achieving a net zero NHS will have no impact on, for instance, those who are on waiting lists for cataract operations, who cannot even see the environment because they have been waiting for their operations for so many years? Net zero is very important, but what is more important is getting those operations done.

[Maria Caulfield]

I think we can do both. We have already reduced emissions in the NHS by 30%, and there are a number of ways in which we can reduce them further, from changes in procurement—the NHS will no longer purchase from suppliers that are not aligned with net zero ambitions—to the delivery of estate change.

Ambulance Pressures

Jim Shannon Excerpts

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

That specific point about where risk best sits within the system was addressed in the letter from the NHS medical director on Friday. Of course, the best way of addressing that risk is to address the issue of delayed discharge. We are getting people out of hospital through initiatives such as the better care fund, the £2.6 billion of investment and the use of integrated care boards. Their use will enable us to take a more integrated approach to unblocking those who are in hospital unnecessarily, which is not only very expensive but fundamentally bad for their care. It is important that we address delayed discharge as a key priority.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State very much for his responses to the questions that have been asked. To give an example that I hope will be helpful to him—this is a devolved matter—when one of my constituents fell and badly hurt her leg last week on rocks offshore, she was able to send a photograph of her injury, and as a result an ambulance was dispatched urgently and she was rescued. My concern is about those who are not high-tech enough to send photographs of injuries to prove that they are ambulance-worthy. Can I ask the Secretary of State how it would be possible to triage calls in a way that does not put pressure on people, but addresses the potential misuse of emergency ambulance requests?

[Steve Barclay]

I am happy to look at any specific issues that flow from the hon. Gentleman’s constituency case. The more we can use tech and innovation better to address those issues at pace, the more that will ultimately lead to better patient outcomes.

NHS PPE Supply Chains: Forced Labour

Jim Shannon Excerpts

Thursday 14th July 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered forced labour and NHS PPE supply chains.

Thank you, Ms Rees, for the opportunity to lead this debate. I applied for it some time ago—long before the Health and Care Act 2022 was brought to the House—so I want to take the opportunity today to do a follow-up with the Minister. I know she is incredibly assiduous on this issue and is, like me, keen to ensure that the progress continues to be made.

I thank the hon. Member for Congleton (Fiona Bruce), who is a special envoy for international freedom of religion or belief, for co-sponsoring this debate. She told me earlier in the week that, unfortunately, she has another engagement: I understand she is a guest speaker at Chester cathedral. An apology has been sent to the Minister and the shadow Minister. I hope they have both received it, because it is disappointing that the hon. Lady cannot be here. She sends her best wishes, and I know that we would have been greatly encouraged by her presence and her contribution.

Without the hon. Lady’s tireless work on international freedom of religious belief, the world would be a much more unjust place. The international conference, which she was instrumental in bringing about, took place last week and the week before. I want to put on the record my thanks to the Minister and the Government, and also to the Prime Minister, who is still there, for his commitment to ensuring the conference took place. There were 1,000 delegates from all over the world—from probably more than 60 countries. It was a marvellous opportunity to highlight issues across the world.

I declare an interest: I am the chair of the all-party parliamentary groups for international freedom of religion or belief and for Pakistani minorities. Both issues are very close to my heart, as they are for the hon. Member for Congleton.

I thank everyone in Parliament who has faithfully championed the rights of the Uyghurs since we first learned of the horrific reports of what is happening in Xinjiang province and the atrocious scale of systematic persecution that they face. There is not one of us who is not pained in our hearts at what is taking place. We feel for those people who, like everyone else, were just trying to make a living. The Chinese Government—the Chinese Communist party—took it upon themselves to persecute them and force their religious beliefs out of their minds. I will speak about that as I work my way through my speech.

This debate is about forced labour and the NHS personal protective equipment supply chains, and it is no secret that the Uyghurs are the main group being horrifically exploited. The obscene violations of human rights that have occurred in China warrant endless debates—not just this debate, but many more. As a nation, as human beings and as beneficiaries of the many supply chains with ties to China, we must not rest while China continues its despicable practices across the world.

The House will be aware of the amendment to the Health and Care Act tabled by the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith), which obliged the Secretary of State for Health and Social Care to make provisions to ensure that the procurement of all goods and services for the NHS avoids modern slavery. I welcomed the amendment very much; I spoke about it in the Chamber and I welcomed the Government’s commitment. It is important that we do not forget why it was needed. The covid-19 pandemic was a national emergency and a time of special need—a time when the Government, the Prime Minister and the Ministers responsible had to respond urgently to the national and global emergency. There was suddenly an unprecedented need for the procurement of personal protective equipment and intense national pressure to provide it.

Reports show that shortcuts around standard procurement procedures were taken. I understand why. During that time, Her Majesty’s Government gave out PPE contracts worth £150 million to Chinese firms with links to forced labour abuses in Xinjiang. That included £122 million to Winner Medical, which uses cotton produced by forced labour, with links to the Xinjiang Production and Construction Corps, the state-backed paramilitary organisation—the very organisation responsible for running the region’s so-called re-education camps. I know the Minister understands why we feel angered and annoyed that such a thing should ever happen.

An additional £19 million was provided to China Meheco, and another £16.5 million to Sinopharm. Both companies have strong links to the Chinese Communist party’s Xinjiang labour transform programme, which relocates Uyghurs from Xinjiang as slave labourers across China. We do not see as much about that now, or perhaps there is not so much focus on it as there should be, but that is what is happening—people are being moved to other parts of China, so slave labour continues not just in Xinjiang but elsewhere.

I understand that there was a pressing need for PPE, but it is disgraceful that NHS staff had to use protective equipment made in the slave labour camps of Xinjiang, let alone that taxpayers’ money was used to purchase that equipment and therefore fund abhorrent abuse. It is even more disgraceful as the abuses were well-known during the pandemic. A report from the British Medical Association notes serious concerns about the role of Uyghur forced labour in the production of PPE. An investigation by The New York Times came to the same conclusion, as did multiple reports and briefings from the United Nations dating as far back as 2010.

This is not just something that happened in the last couple of years, during covid. It has been happening for several years. It was exacerbated during covid, and has been exacerbated even more so now. I am thankful that the Health and Care Act has made NHS procurement policy more consistent with the United Kingdom’s obligations to prevent and punish acts of genocide, and more in line with the Modern Slavery Act 2015. PPE is just the tip of the iceberg.

Since 2003, nearly 20 years ago, China has sought to eradicate Uyghur culture from China. It has been happening for more than 20 years and has been exacerbated in the last two to three years. For 20 years, a systematic approach to Uyghurs has led to mass forced labour, driven Uyghurs from their homes to abuse camps, forced detention of up to 2 million people and enacted arbitrary torture, as well as forced sterilisation, executions and even organ harvesting. There have also been reports of sexual abuse, murder and torture.

China widely denies the mass incarceration and forced labour and cites terrorism as the cause of security measures in the region. I think most of us can agree, however, that that is ridiculous and entirely insincere and untrue. There is overwhelming evidence that shows a systematic approach to destroying Uyghur culture, language, and faith.

Most recently the “Xinjiang Police Files”, released in May 2022, highlighted the internal view of China’s Communist party that Uyghur culture was incompatible with Chinese culture. Those documents include memos and speeches from President Xi Jinping and other senior leaders of the CCP, describing an active objective to rewire the thinking of the Uyghur Muslims. My goodness —to change the whole way in which people think. People have a right to express their religious view, and it is for that reason that I sought to secure this debate through the Backbench Business Committee—I thank it very much for giving me this opportunity. The Chinese Communist party’s objective was to be achieved through indoctrination and interrogation, transforming the Uyghurs into secular and loyal supporters of the party. The party takes away their right to think and believe, and make them something else.

Uyghurs and other minorities in China face intense monitoring and severe persecution, which have led to credible accusations of genocide and crimes against humanity. As China commits those crimes, it also seeks to profit from the detention of the Uyghur Muslims. As the arrests have increased, so has the economic output of the region. The Chinese Government have a group of people they detain and work long hours—to use terminology from back home, they work them to the bone. Goods produced by the forced labour of Uyghurs are not confined to PPE; they also include fashion, sugar, cosmetics and 40% of China’s coal, and organs are forcibly harvested for use in China’s organ tourism industry.

The Xinjiang region also produces 20% of global cotton production and 45% of the world supply of polysilicon—an essential material in solar panel construction. Today, it is deeply tied to global supply chains, from fashion to renewable energy, and that builds on the profits of ongoing crimes against humanity and, as this House has often claimed, genocide.

To put that in context, one in five items of clothing made with cotton has its origins in Xinjiang province. One in five suits, pairs of trousers and dresses is made with cotton hand-picked by Uyghurs detained in Xinjiang province. If we are to distance ourselves from the horrific abuse of Uyghurs, we must do more to distance ourselves from supply chains involving China.

I am always pleased to see the Minister in her place, because I know she has a deep interest in these issues, and that she will come back with the answers we are seeking. I look forward to what she and the shadow Minister will say. Perhaps the Minister will tell us what must be done next to address the issue of supply chains, which goes far beyond the NHS and into society.

Some have argued that legislation is already in place to prevent such goods from entering UK supply chains. It includes the Modern Slavery Act 2015, which encourages businesses to take action to eradicate modern slavery from their operations and supply chains. I believe that the Act is a nudge strategy; it does not have any teeth. It asks businesses with a turnover of more than £36 million to make statements describing the steps they are taking to address modern slavery. We need a lot more than statements; we need action.

The Act has been championed as providing measures that could help restrict imports from Xinjiang province. However, in February 2021, a review from the Business & Human Rights Resource Centre concluded that it had failed to eradicate modern slavery from UK supply chains. What is being done to ensure that words become action that makes a difference?

Companies can choose what to include in their statement. They can adopt a tick-box approach and provide only general information. They can also state that they have taken no steps at all to eradicate forced labour and still be compliant with the Act. It is not a verbal commitment that we need; it is action on the ground.

Despite that minimal approach, there has been persistent non-compliance by 40% of companies. We really need to turn the screws on them and ensure that they do more than give verbal commitments, and we also need to act upon the ones that do not. After six years of non-compliance, there has not been one injunction or penalty for any company that has failed to report, so it seems that the Act is toothless.

Clearly, more legislation or more pressure is needed to make the change. In the Queen’s Speech, Her Majesty’s Government outlined plans to increase companies’ and other organisations’ accountability for driving out modern slavery from their supply chains through a new modern slavery Bill. I hope that that Bill will strengthen existing legislation, but the Government need to lead by example. Will the Minister give us some idea of how the new legislation will make a difference?

If we are asking British companies and the NHS to take steps to ensure that procurement is free from modern slavery, we must lead and not be complacent with legislation that does not achieve what it sets out to do.

It is right to pay tribute to the many parliamentarians who have advocated and worked physically and emotionally in both Westminster Hall and the main Chamber for the Uyghurs in Xinjiang province. A great deal of parliamentary time has been given to the topic, and rightly so. I want to recognise that because I believe that the efforts of both Back and Front Benchers has made a difference. In the last few years, there have been no fewer than 16 debates and 446 written questions across both the House of Commons and the House of Lords. That gives an idea of the magnitude and significance of this issue and the strength of commitment and interest from Members. There have been multiple urgent questions on the matter, and Parliament has stated that it believes there is overwhelming evidence of genocide in Xinjiang province by the Chinese Communist party. The Foreign Affairs Committee has published two reports recommending that the Government

“accept Parliament’s view that Uyghurs and other ethnic minority groups in Xinjiang are suffering genocide and crimes against humanity, and take action to bring these crimes to an end.”

We know that Christians have suffered in China. They are persecuted, their churches are knocked down, and they are continually spied upon. Those of other faiths and ethnic groups, such as Falun Gong, are also subject to this incredible persecution by the Chinese Communist party. In short, there can be no doubt of the extent of support for more to be done to combat the practices of the Chinese Communist party.

It is worth noting that the efforts of this Parliament, our Government and our Ministers, as well as others in the international community, have borne fruit. Let us recognise some of the things that have happened and the good things that have been done. We often lament the dire situation in China and human rights violations more broadly, but we should take encouragement that not all efforts are in vain. Next week, at about this time, there will be a debate in the main Chamber on human rights across the world. I may have an opportunity to highlight this matter in a different way, along with many others.

China is changing its narrative on Xinjiang—at least outwardly. It has now acknowledged the existence of the re-education camps and claimed that students at those camps have graduated, focusing significant propaganda efforts to try to justify its policies. Those are only for the world and the media; the reality is very different. China is aware that there is growing awareness of its corruption, but further international action is essential. I am mindful that the Minister present is responsible for the NHS, not the Foreign, Commonwealth and Development Office. However, I ask her what discussions she has had with the FCDO on other steps that we can take outside her Department.

In January 2021, the Foreign, Commonwealth and Development Office announced its intention to introduce measures to ensure that

“British organisations…are not complicit in, nor profiting from, the human rights violations in Xinjiang.”

The then Foreign Secretary, the right hon. Member for Esher and Walton (Dominic Raab), stated that compliance with those measures will be mandatory for central Government and that:

“This package will help make sure that no British organisations, Government or private sector, deliberately or inadvertently, profit from or contribute to the human rights violations against the Uyghurs or other minorities in Xinjiang.”

It is now 550 days—more than a year and a half—since that announcement, and those measures have yet to be implemented in their totality. I therefore seek an assurance that that action will be taken and, if possible, a timescale for when that will happen.

The will of this Parliament is clear: action is needed, and action works. The Health and Care Act 2022 highlighted the scale of the problem of forced labour in the NHS, but that legislation impacts on just one Department. The import ban for the NHS is an encouraging step, but I am sure we all agree that no Government Department should procure goods produced by slave labour, whether that be in Xinjiang province in China, which is living off the backs of the Uyghurs, or in any other part of the world. No Government Department should allow China the opportunity to profit from the genocide, brutality and violence that it is carrying out against good, decent, ordinary people.

I am very proud of this country’s commitment to upholding human rights internationally. I am also proud to be a member of the United Kingdom of Great Britain and Northern Ireland and to be MP for Strangford. I am proud and happy to support our Minister and her Department. During the UK presidency of the G7, one focus area was addressing forced labour in global supply chains and making commitments to uphold human rights and international labour standards, but we are in danger of losing that reputation.

Since the Brexit referendum, human rights standards and obligations have been removed from negotiations and the texts of trade deals. That does not fall within the remit of the Minister’s Department, and I do not expect an answer from her—I cannot ask her to answer for Departments where she has no responsibility—but will she do me the kindness of asking that question of the correct Minister? It is important that we have an idea of what has been done to address that issue, because these standards are the norm around the world. Global Britain has much to offer the world, but that cannot be at the expense of Uyghurs in Xinjiang province or of other religious or belief minority groups around the world, whether they are in China or further afield.

Her Majesty’s Government have refused to accept Parliament’s view that it is highly likely that genocide is happening in Xinjiang province, despite reams of evidence from many people, including video evidence and personal evidence from within China. That evidence has been provided by the Uyghur tribunal, United Nations monitoring trips, the Xinjiang police files, the Foreign Affairs Committee and many more. It is time to change that and to follow the example of the United States of America in recognising what is happening to the Uyghurs and others in Xinjiang province as genocide. I wish we had done the same, and I hope it can still happen.

Just this week, the Uyghur Forced Labor Prevention Act came into force in the United States of America. The Act introduced a ban on imports from Xinjiang province following the overwhelming evidence of forced labour abuses. They had the evidence and we have access to that same evidence; we need to take the same action that they have taken. All companies have to prove they have taken due diligence of all possible steps to ensure their supply chain does not contain goods made through Uyghur forced labour.

The Act introduces penalties for companies, the ability to seize goods that originate in Xinjiang province and a testing requirement, which can include genetic testing of cotton and other goods to find out where they have come from. I hope that the Minister will ask other Departments to urgently endorse the strategy of the United States and do the same here. I am proud that the Act was drafted as a result of the G7 summit in Cornwall, in our own United Kingdom, which shows the influence we have. It is now time to follow the example of the United States. A similar ban on imports from Xinjiang province should apply not only to the NHS but to all Government Departments and further afield.

In drawing my remarks to an end, I want to highlight the next steps. First, we must ensure that the measures announced by the Foreign, Commonwealth and Development Office on 12 January 2022 are enacted swiftly. The Government have set down some policies and some ways forward, and I would like to see them happening, and happening soon. I also seek a timescale for those policies. We must ensure that these measures, existing legislation and the new modern slavery Bill are robust enough to address reports that Uyghurs are being moved out of Xinjiang province and into other parts of China. They are dispersing them throughout China and it is going to be hard to find out what is happening in other parts of China. It is wonderful how information seems to leak out. The Chinese Communist party is trying to hide the abuse across all parts of China. It is doing something absolutely despicable and dastardly.

Secondly, Her Majesty’s Government must lead by example. The Health and Care Act sets a precedent. Each Government Department should conduct an urgent review to ensure that its supply chains do not source products from Xinjiang or have links with companies that support detention camps in the region. No Government Department should allow China the opportunity to profit from a genocide that the rest of the world has recognised and that I believe we must recognise as well.

Thirdly, the Government should introduce a central list of goods and resources that have a high risk of being produced by slave labour in Xinjiang province and implement testing requirements for Government procurement contracts that involve items on that list. At a minimum, the list should include cotton and polysilicon.

Fourthly, we need to reintroduce basic human rights standards into the negotiations and the wording of post-Brexit trade deals. That is a norm in international trade deals and, if Britain is to maintain its leading role in championing democracy and human rights, as I hope it will, we cannot sever the link between trade and human rights. The central theme that came through the international conference held last week was the connection between freedom of religious belief and human rights. The two are closely linked, and cannot be severed. Nor can we sever the link between trade and human rights, especially as younger generations put greater emphasis on corporate responsibility. The parallels are evident and should be heeded. The conference made that point.

Finally, Her Majesty’s Government should revisit the outcome of the parliamentary debate that decided that it is highly likely that genocide is happening in Xinjiang province. I know that the Minister will respond by stating that it is the long-standing policy of the British Government not to make determinations in relation to genocide and that that is instead down to a competent court or tribunal. As such, I gently remind the Minister—although I am also trying to be persuasive—that the UK’s duty under the 1948 convention on the prevention and punishment of the crime of genocide is to prevent genocide, not just to punish the perpetrators after the event. What is being done to prevent the genocide that is most likely going to occur, if it is not already happening?

There was a debate in the main Chamber earlier on Srebrenica. That offers a reminder of the many places across the world where massacres and genocide have been carried out. We always hope that each one will be the last, but unfortunately that is not the case. I am very pleased that this great United Kingdom of Great Britain and Northern Ireland is a leading voice on the international stage, well known for its advancement of human rights, particularly that of freedom of religion or belief. Let us not damage that reputation by failing to act.

At last week’s international ministerial conference on freedom of religion or belief, a quotation from Dietrich Bonhoeffer was repeated, over and over again, in different seminars and fringe events. Many will know it:

“Silence in the face of evil is itself evil. God will not hold us guiltless. Not to speak is to speak. Not to act is to act.”

Those words are as relevant today as they were many years ago.

Parliament has spoken. Her Majesty’s Government must lead by example. Will the Minister address the need that all Government Departments—she can speak for her Department and the discussions she has had with others—should not procure any goods whatsoever made in Xinjiang? What steps will Her Majesty’s Government take to reach that goal? What discussions have taken place with other countries to do the same?

I look forward to hearing from the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar). I think we are a tag team, as he is always here in Westminster Hall, as is the Labour party’s shadow Minister, the hon. Member for Hornsey and Wood Green (Catherine West).

I am pleased to see the Minister in her place, and I look forward to her response. I also look forward to the remarks of others, because they, like me, believe that what happens in Xinjiang province is unacceptable and that we have role to play in that. I am very pleased to have had the opportunity to come along and make my comments.

--- Later in debate ---

[The Minister of State, Department for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Ms Rees.

I start by congratulating the hon. Member for Strangford (Jim Shannon) on securing this debate and on all his hard work, alongside Members such as my hon. Friend the Member for Congleton (Fiona Bruce), on this significant issue. It is important to debate the supply chain for NHS PPE, to learn lessons from the past and to ensure that robust systems are in place for the future. I reassure him, and all hon. Members, that this matter is a priority for the Department and we continue to take steps to ensure that there are robust systems to safeguard against the coming into the system of supplies that may be linked to slavery or forced labour. I am pleased that this issue was debated during the passage of the Health and Care Act 2022, and further legislation will be introduced to address it.

However, I must put it on the record that our priority during the pandemic, as Members will understand, was to protect our frontline staff. This was a global crisis, in which we were competing against many countries to secure PPE for our frontline workers. Nevertheless, we had and still have a responsibility to those across the PPE supply chain to make sure that when PPE is procured, it is done responsibly and does not put people in any part of that chain at risk. It is absolutely important that we do that both globally and domestically, because although the hon. Member for Strangford rightly mentioned the Uyghurs in China, we have heard only too well this week from Mo Farah that slave labour and slavery exist in this country as well.

I take the point that the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) raised about his concerns about the Government’s approach, but I will gently say that the Herald on Sunday stated that during the pandemic, half a billion pounds-worth of procurement in Scotland did not go through the usual scrutiny process, either—and that was just one report. That reflects the fact that all countries during the pandemic had to make tough decisions to get supplies through, safeguard frontline services and ensure that those pieces of equipment were in place. Where lessons need to be learned, we absolutely will do so. Since the pandemic, almost 40 billion items of PPE have been ordered and almost 20 billion were distributed by March 2022. We are still distributing over 600 million items a month. That shows the scale of the amount of PPE that we have had to distribute. Hon. Members will be aware that covid rates are still high at the moment, so PPE is still very much needed by our frontline staff.

Global chains were used to procure many supplies, whether aprons, gloves or masks, but where possible we have tried to escalate domestic supply, because while it is not 100% failsafe against slavery, it is more likely that there are robust systems in place. To effectively distribute the supply across health and social care settings, we have built a distribution network from scratch and adopted a sophisticated sales and operations planning system to regulate supply and distribution. We have a clear understanding of where the stock has come from and the processes in place to ensure that slavery or forced labour was not used in any part of that chain. Part of the network is using technology to track and trace where that supply comes from, and if there are queries or concerns in the future, we are able to look back and see where those supplies came from. Since April 2020, over 6.9 billion PPE items have been ordered through that e-portal system.

As we move to living with covid, the decision has been made to step down some of the Department’s work on the PPE programme, and we are handing that over to the NHS supply chain more generally. Safeguards in the Act ensure that some of that work will continue to happen. Modern slavery encompasses the offences of slavery, servitude, forced and compulsory labour and human trafficking. The NHS has a significant role to play in combating modern slavery, including by taking steps to ensure that the NHS supply chains and business activities are free from labour abuses. The Government rely on their suppliers for the delivery of many important public services, and we expect high standards of business ethics from our suppliers—and their agents. They will be routinely checked for that.

The Department follows a procurement approach, as set out in the UK Government modern slavery statement, that includes a zero-tolerance approach to modern slavery and a commitment to ensure that respect for human rights is built into all our contracts, self-assessments, audits, training and capacity building. I reassure the hon. Member for Strangford that if there is a complaint or a suggestion of any supply being involved in slavery or forced labour, we can lock down that stock until an investigation is concluded. We can then unlock it if no evidence is found, but we can stop some of those contracts if there is evidence of forced labour. We look at what happens in other countries—he touched on the US—and if other countries are finding evidence of slave labour used in any part of the supply chain, investigations will start on UK stock as well.

[Jim Shannon]

I thank the Minister for her positive response. Clearly, the United States has taken a line of legislative action. Has the Minister had a chance to discuss or get ideas from what the States are doing and what drove them to do that? I posed that question and both hon. Members who spoke asked the same question. If they can do it in the States, we can do it here.

[Maria Caulfield]

Absolutely. We have secondary legislation coming forward that will enact what was agreed in the Health and Care Act 2022, which will look at some of this issue. The Procurement Bill is also passing through the House of Lords and will come to our Chamber. It will look at procurement more generally, not just NHS procurement. If he and other hon. Members with a keen interest in the subject, such as my hon. Friend the Member for Congleton, have specific questions on NHS procurement, I am happy for them to write to me and we shall see whether we can look at them as part of scrutiny of the Bill as it progresses. He is right that we want to ensure that we are learning lessons and sharing best practice across the board. I cannot speak for other Departments, but we are keen to get that right for the NHS where possible.

We are taking steps to achieve greater supply chain visibility, particularly where risks are highest, with the recognition that workers in the lower tiers of supply chains are often the most vulnerable. In line with that, we ensure that all contracts placed by the Department adhere to standard terms and conditions that include clauses requiring good industry practice to ensure that there is no slavery or human trafficking in supply chains.

Suppliers appointed to NHS supply chain frameworks must also comply with those standards or they can be removed from consideration for future opportunities. All the suppliers of PPE frameworks let in conjunction with the Department were registered and required to complete a modern slavery assessment and a labour standards assessment. Our purchase process includes safeguards to strengthen due diligence and to terminate a contract should there be substantiated allegations against a provider.

We are not content to rest on the status quo, which is why the Health and Care Act contained a regulation-making power that will come into force, designed to eradicate the use in the NHS of goods or services tainted by slavery or human trafficking. The regulations will set out the steps that the NHS should be taking to assess the level of risk associated with individual suppliers and the basis on which it should exclude them from a tendering process. Those regulations will help to ensure that the NHS, the biggest public procurer in the country, is not buying or using any goods or services produced by or involving any kind of slave labour. It represents a significant step forward in our mission to crack down on the evils of modern slavery wherever they are found. We are grateful to the work of modern slavery campaigners, who hailed the regulations as

“the most significant development in supply chain regulation since the Modern Slavery Act 2015”.

Alongside those regulations, the Health and Care Act also requires the Secretary of State to carry out a review into the risk of slavery and human trafficking taking place in NHS supply chains and to lay before Parliament a report on its outcomes. That review will focus on NHS supply chain activity, as well as supporting the NHS to identify and mitigate risks with a view to resolving issues. The review and the regulations will send a clear signal to suppliers that the NHS will not tolerate human rights abuses in its supply chain; they will create significant incentives for suppliers to review their practices; and they will block, if necessary, any suppliers that are found to be using human trafficking or slave labour.

I was moved to hear the cases of the Uyghurs that the hon. Member for Strangford raised. He is right that that goes far beyond the NHS, which is why the Procurement Bill, currently passing through the other place, is an important piece of legislation. I am sure that he and other hon. Members, such as my hon. Friends the Members for Wealden (Ms Ghani) and for Congleton, and my right hon. Friend the Member for Chingford and Woodford Green (Sir Iain Duncan Smith), who are assiduous campaigners on the issue, will take a keen interest in that.

I conclude by thanking all hon. Members for their contributions. Modern day slavery is a deplorable practice that causes irreversible harm to those affected. We all have a responsibility to call it out. As a Department, we take it extremely seriously. I hope that, by sharing what is happening, I have given hon. Members confidence that we will do all we can to root it out and take out of our supply chains any affected pieces of equipment.

--- Later in debate ---

[Jim Shannon]

I would. I shall be only two minutes. I thank the two shadow spokespeople. I thank the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) for his always helpful contributions. He and I seem to be in all the debates together. It does not lessen our interest in these issues, because pursuing them is what brings us together. He referred to the serious labour rights concerns that a compassionate Government need to respond to. We all agreed on genocide, including the shadow Minister, the hon. Member for Hornsey and Wood Green (Catherine West). She referred to the scale of the problem. It almost takes our breath away sometimes when we realise how massive the problem is. She also mentioned the trade unions, which have worked throughout the world; I recognise that. Trade unions play a critical role around the world; we thank them for all that they do.

In trade deals, human rights must be protected. I think the Government are already doing that, but it is good to call for it again. Hon. Members also mentioned cross-departmental work and the roles that must be fulfilled. In a late intervention, the hon. Member for Hornsey and Wood Green made an important point. When the Minister gets feedback from the other Departments, perhaps those who have participated today, and my hon. Friend the Member for Congleton (Fiona Bruce) and I, will take the opportunity to express our views and have a chat with the Minister.

The Minister was helpful, as she always is. I wrote down some of the things she said. The Procurement Bill is coming through and we will all be able to feed into that process. The Government have made a commitment to use the modern slavery Bill to take significant steps against human trafficking and to block activities if necessary. I like the idea that if there is an accusation, there is a block right away until the matter is checked out evidentially. If it is proven to be true, it is stopped. That is positive stuff, and I welcome that.

I also mentioned the importance of following best practice when evidence is found. I understand—I think we all do—that the Government responded to covid-19 in the way that they had to. It is not a criticism: perhaps corners were cut—but that had to be done because otherwise we would never have got things in place. Now that we have got past that stage, it is time to get procurement right. This debate has been about getting it right.

I thank everyone who participated—the hon. Members for Coatbridge, Chryston and Bellshill and for Hornsey and Wood Green, and the Minister. I also thank you, Ms Rees. You are always very gentle but firm, and I thank you for your chairmanship of all the debates. I also thank the civil servants, who make sure that the debates go smoothly and get Ministers the answers, and I thank all the staff. Thank you so much, everyone.

Question put and agreed to.

Resolved,

That this House has considered forced labour and NHS PPE supply chains.

Ambulance Services and National Heatwave Emergency

Jim Shannon Excerpts

Wednesday 13th July 2022 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

The Minister and the Government were able to respond to the covid-19 pandemic and showed that resources could be made available. Can I ask the Minister this question in a positive fashion? Is it possible to use some of the very successful covid-resourced helplines for people to contact to provide short-term advice on heat-related issues, rather than perhaps ringing, as they often do, the GP out of hours? What else can the Minister’s Department do to take pressure off A&E and out-of-hours GP surgeries?

[Maria Caulfield]

The hon. Gentleman makes a very constructive suggestion—one of the first of the afternoon, if I may say so. There were lessons during covid that are being rolled out across emergency services. We are looking at best practice in those parts of the country where response times are better to see if we can share it. I am very keen to look at any option that relieves the pressure. We are investing in 111, which enables people to have alternative ways of getting urgent care directed to them. We are looking at 111 being able to make direct referrals as well, so there are a number of options. I am happy to take suggestions from any hon. Member if they are keen to see those happening in practice.

Bereavement Charities

Jim Shannon Excerpts

Tuesday 5th July 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for North Devon (Selaine Saxby) on bringing the debate forward. The topic is something that I deal with nearly every day—bereavement charities, if not their funding. We always see the funding; we do not always see the charitable work that they do, but we see the end results. The hon. Lady outlined clearly and helpfully the importance of the funding.

In our own constituencies we have all had direct contact with bereavement charities. These last two and a bit years, where death has been much more apparent to us all, have been difficult. Across this great United Kingdom of Great Britain and Northern Ireland, 160,000 people have died due to covid-19. Just over 4,000 of them were in Northern Ireland. I have worked with some of the bereavement charities that do such fantastic work.

This is by no means an easy topic. There are often no words to describe the pain of losing a loved one. As elected representatives, we may deal with that more than most, because people come to us with their issues. We feel the pain of those who have lost loved ones. It is something that we will all experience at some time in our life. There is no rule book when it comes to coping with loss. There are no parameters, rules or ways we can follow. The one thing we always need is support from family and friends and from our elected representatives, which the hon. Member for North Devon does in spades. We are fortunate in the United Kingdom to have a long list of charities that work tirelessly to provide support for the bereaved, so it is great to encourage them all and to look to our Minister to see how we can ensure they continue their work and do it better, as the hon. Lady said.

When death comes, more often than not it is the Church—the minister, pastor or priest—who comes to offer support, and family gather round. The hon. Lady referred to the rise in suicides across the United Kingdom, which was on my mind, too. We had a spate of them in our constituency and it was very hard, because they were mostly young people. The hurt, pain and loss was perhaps greater because they were young—not that it should be any more of less for anyone, but when young life is lost, it has a big effect.

As we know too well, the covid-19 pandemic caused many people, old and young, to lose their lives. There has been an immense feeling of loss since the beginning—that resonates with us all. Members will recall only too well that I lost my mother-in-law, but I got great reassurance from my family and our local church. That does not take away the pain of the loss and the hurt, even if I know my mother-in-law is in heaven. It is fair to say that everyone copes differently. We all have different ways of responding and dealing with things.

I want to praise the work of NHS Charities Together, who have allocated £125 million to a range of projects that aim to support NHS staff, volunteers and patients who are coping with bereavement. All those wonderful people have done incredible things. The shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), is one of those NHS staff, and we thank her for her contribution, as well as the hon. Member for North Devon, who spends a few days a week working in this area. We all appreciate it.

NHS staff are among those mourning the loss of loved ones during the pandemic. The personal grief of many of them has been made all the more complex by isolation from family and friends while working in high-pressure environments during covid-19. King’s College Hospital is among those that have launched a bereavement service for NHS workers, recognising the pain, soreness and hurt among staff members and responding positively. The service also offers free telephone and face-to-face support for the relatives, partners and friends of any patient who died in the trust’s hospitals during covid-19. That is another example of people starting things that were not there before to respond and to help.

Back home, each social care trust has publicly available bereavement services. Charities such as Cruse Bereavement Care—a group with which I work regularly, as I do with Marie Curie, the Samaritans and the Compassionate Friends—have proven instrumental in providing support. Naming them all, as I have done those four, is all well and good, but we must ensure that they can carry out their services, which we may rely on one day. It is our duty to ensure that those charities are financially stable so that they can. The hon. Member for North Devon is right to bring the debate, and we look to the Minister for a response.

The stats state that, on average, 26% of people want to talk about their grief but do not know how to, or they talk to a professional. Some people out there have never been able to cope, and I believe that we must do something for them. The support is out there, and there is no stigma around it. Bereavement will not go away, but to prevent further hurt, mental-health deterioration, self-harm or even suicide, which the hon. Lady referred to, we must ensure additional funding for bereavement organisations so that people have access to the help that they need.

I call on the Government and the Minister to consider the funding of bereavement and mental health strategies. I know that the Government have committed a substantial amount of money to mental health, which I welcome. Could some of that money be made available for bereavement care? If so, we might answer the hon. Lady’s question by finding a way to help those returning to work after a bereavement with readily accessible schemes across the whole of the United Kingdom.

We all have to face bereavement someday. We will face it ourselves; we will face it for those close to us; we may face it multiple times. Bereavement charities are central to the healing process. The funding and strategy to respond are therefore critical, and that is why the debate is so vital. I congratulate the hon. Lady on securing it, and I look forward to the other contributions, especially that of the Minister.

Draft Mental Health Bill

Jim Shannon Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

We are putting in record amounts of new investment, with newer services. During the pandemic, we established for the first time a national 24/7 all-age mental health helpline. I would like to make that permanent, beyond the pandemic. When it comes to NHS talking therapies, I mentioned earlier that some 1.25 million people were seen last year. We aim to get that up to 1.9 million over the next couple of years. When it comes to waiting times, the hon. Lady is right that there is a waiting time for high-intensity mental health services, and the NHS is of course working to bring that down. For low-intensity mental health services we have managed to bring the median waiting time down to 14 days nationally.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his clear commitment to make things better. We are most grateful for that. I wholeheartedly welcome the strategy in his statement on mental health, but I am of the belief that the lockdown has impacted and exacerbated mental health issues in each corner of this great United Kingdom of Great Britain and Northern Ireland.

With that being the case, can the Secretary of State tell me what discussions have taken place with the relevant Minister in the Northern Ireland Assembly? Furthermore, the Secretary of State said that £2.3 billion had previously been allocated for this. How much will come to Northern Ireland through the Barnett consequentials, taking into account the fact that Northern Ireland has the largest percentage of mental health disorders in the United Kingdom and is in need of similar radical reform and, indeed, additional funding as well?

[Sajid Javid]

Much of the work that has gone into the publication of this draft Bill, such as that carried out by Sir Simon as well as the work that went into the White Paper, would apply equally to Northern Ireland. We stand ready to work with our friends in Northern Ireland to help them if they wish to go down a similar route. I can also confirm that the Barnett consequentials for the £2.3 billion would have gone to Northern Ireland.

Heart and Circulatory Diseases (Covid-19)

Jim Shannon Excerpts

Thursday 23rd June 2022 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the impact of the covid-19 pandemic on people with heart and circulatory diseases.

May I say how pleased I am to have this debate in the main Chamber? It was originally earmarked for Westminster Hall, where most of my debates are—indeed, probably all of them—but on this occasion I have kindly been elevated to the main Chamber, and I am greatly humbled to have this opportunity. I spoke to Mr Speaker’s Office this morning to thank the staff for that. I understand the reasons for it, but the reasons do not matter: we are here, and that is the important thing. I am very pleased to be able to participate in this debate.

[Bob Blackman (Harrow East) (Con)]

I thank the hon. Gentleman for taking on the opportunity to have a debate in this Chamber; as he well knows, had he not been so flexible the House would be rising now. He has enabled the House to continue, and on behalf of the Backbench Business Committee I thank him. Of course, his season ticket is honourably renewed.

[Jim Shannon]

I thank the hon. Gentleman for his kindness. The Backbench Business Committee is kind to everyone who applies for a debate, so I am always very pleased to do so, and on a regular basis. It will not be too long before I am back looking for more debates.

On this debate, I put on the record my thanks to the Committee. I am pleased to see that Members from across the House are involved, although I am mindful that today right hon. and hon. Members have many other engagements that mean they are unable to be here, even though the debate is in the main Chamber.

It is just over two years since the start of the lockdowns, and a little more since the pandemic first arrived. Life changed for everyone—I do not think there is anyone in the United Kingdom of Great Britain and Northern Ireland who did not have a life-changing moment—and for some of us it may never be the same as it was. It will never be the same for those who have lost loved ones; that is very real for every one of us. Some of the changes that took place due to the pandemic and covid-19 were cosmetic, but others have been life changing, and it is those changes that we need to address.

I want to say a massive thank you to all the doctors, nurses, auxiliary staff and cleaning staff—there are so many to name—who have been outstanding. There is nobody in this House who does not know some of them, has not spoken to them and does not also want to put that on the record as well. I thank them at the beginning of this debate.

During lockdown, barriers and obstacles to providing care for heart patients and all patients rocketed. I know that happened across all health departments, but in particular I thank the British Heart Foundation and the Stroke Association for all the information, detail and evidence they sent to me and others for the debate. We are very pleased to have that.

Some of those efforts by doctors were heroic; I do not use that word often, but on this occasion it is a word that aptly describes their efforts. Despite those heroic efforts of doctors, nurses and other key workers in our health systems, however, we have seen cardiovascular services disrupted so greatly that people are still feeling the effects today.

I am beyond thankful for every NHS staff member who went ahead with emergency surgeries. The reality of life for elected representatives is that we do not get many people coming and saying, “Thank you very much for that.” We get the complaints, but that is what we do. We are a conduit for their complaints and concerns. Some of the people were waiting for emergency surgery were not sure whether they would pay a price for that, so again for that I sincerely say a big thank you.

We are all aware of the waiting lists, reduced access to primary care and the pressures on urgent and emergency care. They all have real consequences for people’s health. That is why hon. Members pushed for this debate and why we are so pleased to have the opportunity to hold it today in the main Chamber. I feel incredibly privileged, honoured and humbled to be able to present this case—not for me, because I am not important, but on behalf of our constituents who have experienced hardship because of those things.

Those problems have also had real consequences for families’ lives, their relationships and the happiness of their families. Very often, the issues for those who were ill reflected back on the families, who were under incredible pressure to deal with circumstances that would be difficult to deal with normally but that, with covid-19 and the pandemic, escalated even more. There are 11,000 people living with heart or circulatory diseases in my constituency. I know the Minister does not have responsibility for Northern Ireland, but I will provide examples from Northern Ireland that are relevant across the whole of the United Kingdom of Great Britain and Northern Ireland. There are 2,000 stroke survivors and 13,000 people who have been diagnosed with high blood pressure.

Long waits, difficulty accessing routine medical services and long ambulance response times make life more difficult for the 7.6 million people living with heart and circulatory diseases in the UK. I mention those issues not as a criticism, but to highlight them and raise awareness. Ambulance response times in many parts of the United Kingdom, including in my own constituency, have been difficult, as have been the waiting times outside accident and emergency departments, with ambulances in place. That is happening not just in Northern Ireland but elsewhere, as I am sure other hon. Members will confirm.

Someone in the UK dies from a heart or circulatory disease every three minutes. This debate has been going for six minutes, so that means two people will have died from heart disease since it began. By the time the debate is over—it is a stark headline, unfortunately—as many as 20 people will have passed away. That statistic reminds us of the fickleness of life. It also reminds us of what this debate is about and why we are here. Someone is admitted to hospital due to a stroke every five minutes. Indeed, someone will have been admitted to hospital since this debate began. Two thirds of patients leave hospital with a disability. Stroke as a standalone condition costs the UK economy £26 billion annually, yet it is largely preventable and recoverable.

I look forward very much to hearing the response to the debate from the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup). I know she is very committed to her job and has a deep interest in it, so I look forward to what she has to say in response to the questions we will ask her today. I also look forward to hearing from the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), who is a good friend and with whom I seem to be in debates all the time. If we were not in the Chamber today, we would be in Westminster Hall.

Northern Ireland Chest, Heart and Stroke highlights that there were 15,758 recorded deaths in 2019. That is some figure and it is worrying. The top three causes were cancer, circulatory diseases and respiratory diseases; together, those accounted for 64.3% of all deaths in Northern Ireland. That figure reminds us of just how fickle life is and that we are just a breath away from passing from this world to the next. They have been the three leading causes of deaths since 2012. Deaths due to chest, heart and stroke conditions, when combined, are the No. 1 cause of death, at 36%. As I said earlier, that reminds us why this debate is so vital and why we look to the Minister for a response that can help us, encourage us and give us some hope for the future.

These are some of the most prevalent, serious and life-altering conditions that anyone could have the misfortune to suffer from. They touch everyone’s lives, be they in Northern Ireland, where my Strangford constituency is, Scotland or Wales—or England, with whose health matters this House is primarily concerned. I also very much look forward to hearing from—I apologise; I should have said it earlier—the hon. Member for Motherwell and Wishaw (Marion Fellows) on behalf of the SNP. She has a deep interest in health, too, and I look forward very much to her contribution.

Every one of us has a neighbour, a friend or a loved one who has problems with their heart. Those problems do not halt at any border. They do not even, dare I say it—rather mischievously, perhaps—stop at the Irish sea border, which is able to prevent most things from crossing over. What prevents them from getting the care they need? The most obvious issue is undoubtedly waiting lists, which are at record levels. One of the questions I would like to ask the Minister—I always ask such questions constructively; that is my way of doing things—is: what is being done to reduce waiting lists and to provide some hope? According to NHS England, only this month the queue for NHS care stood at 6.5 million, the highest number on record ever. The number of patients waiting more than a year to be seen has increased to 323,000, which is a massive number. These are record levels as the health sector recovers from the impact of the pandemic.

Although the pandemic has hugely affected waiting lists, the issue predates the pandemic. At the start of 2020, around 30,000 people were waiting more than 18 weeks for cardiac care. This problem was not caused by covid, but it was exacerbated and worsened by covid. If it was bad before, it is much worse now.

The pandemic has had a seismic effect. In April 2022, two months ago, 170 times more people in England were waiting more than a year for heart procedures than in February 2020. I look for an indication of how we can reduce that number, and I know there is a strategy. I am putting this constructively, because I believe there are ways to do it, and the hon. Members for Denton and Reddish and for Motherwell and Wishaw, other Members and I are keen to hear what they are. Waiting lists for cardiac care have also hit record levels, rising to 319,000 people. In Northern Ireland there are 31 times as many people waiting more than six months for cardiac surgery compared with the end of 2019.

And it is not only life-saving surgery, as some of this surgery is about people’s quality of life. Waiting times for echocardiograms, a kind of heart ultrasound used to diagnose a range of conditions, have risen, too. More than 170,000 patients were waiting for an echocardiogram at the end of April 2022, with 44.6% of them—almost half—waiting more than six weeks. That is a 32% increase on the year before. The covid-19 pandemic has increased those numbers, and I am not blaming anyone for that, but we need to address these issues, both as a Government and collectively, in a way that gives succour and support to our constituents.

In Northern Ireland, the number of people waiting more than six months for a cardiac investigation or treatment reached a new record in March 2022. That is the responsibility of Robin Swann, the Health Minister in the Northern Ireland Assembly, and I know he has taken steps to try to address it, but this is a general debate about how we address heart and circulatory diseases across the whole United Kingdom of Great Britain and Northern Ireland following covid-19.

Nearly three quarters of people in Northern Ireland waiting for an echocardiogram have waited longer than the recommended clinical maximum. A number of worried, heartbroken family members have come to my office to say that covid is killing their loved ones, even though they did not have covid themselves. The delays were and continue to be a threat to life. Covid-19 does not seem to result in the number of hospital cases that it once did, which is good news.

Although an echocardiogram is not open-heart surgery, delays still cause increased anxiety for patients and delay the treatment they need. Taken as a whole, cancelled operations risk a rise in avoidable deaths and disability, and they cause anxiety and put physical pressure on people with heart problems.

What can we do about this? The British Heart Foundation is watching this debate, and I thank it for giving me most of my information. I also have a staff member who is qualified in this, and she has given me some information, too. I am proud to work with the British Heart Foundation, which has welcomed the additional funding for the NHS and the announcement that 95% of patients who need diagnostic tests will receive them within six weeks by 2025. It is good news that we have a target but, with respect, that target is a few years away. We need to consider how we address the situation over the intervening three years. The foundation has also pushed for an accompanying Government strategy for cardiovascular disease to take us beyond recovery and address the problems that existed before the pandemic.

With all that in mind, we need to think about how we can do better and support those who need help today. The NHS long-term plan identifies cardiovascular disease as

“the single biggest area where the NHS can save lives over the next 10 years.”

If there is one issue I would love us to tackle, it is how we can save lives. I am ever mindful of the statistic I cited earlier that every three minutes someone dies as a result of heart problems. If we can save lives, that is what we want to be doing. We know that the NHS is doing all it can to deliver cardiovascular services, but without a properly funded cardiovascular disease strategy, it cannot meet its targets and deliver adequate care. When will a strategy be put in place to address the issues in the short term?

What else would such a strategy address? Cardiovascular diseases have many and varied impacts on patients, who need different forms of care as a result. Access to primary care is integral to the identification and management of heart conditions. When people cannot access primary care, opportunities to prevent heart attacks and strokes are lost, and more problems are caused for those who are already under pressure. How do we address that issue?

A 2021 survey of 3,000 heart patients found that 12% had a routine medication or condition review cancelled or rescheduled in the first year of the pandemic. I understand that the pandemic was not the Government’s fault; the Government are to be complimented and thanked for how they responded to it, because we are all beneficiaries of the vaccination programme and it is probably why some of us are alive today. However, the cancellation or rescheduling of routine medication or condition reviews explains the longer waiting lists. Four patients in 10 have had appointments cancelled or rescheduled more than once. I know people back home who have actually fasted for an operation and then been told that it would not go ahead, which has caused anxiety and worry.

Health Foundation analysis shows that 31 million fewer primary care appointments were booked between April 2020 and March 2021 than in the previous 12 months. The pandemic has also had an impact on how patients with heart and circulatory disease interact with primary care. Some people say that there are lies, damned lies and statistics, but statistics prove a point: there were 5 million fewer face-to-face GP appointments in 2020 and in 2021 than in 2019. We understand the reasons why, but we have had a lot of debates in this Chamber and in Westminster Hall about GP appointments, and there is not one of us who would not wish for the number of appointments that we once had. My constituents tell me that, and I am anxious and keen for appointments to return.

Many people welcome the flexibility and safety that remote appointments bring, but they can mean that healthcare professionals lose the opportunity to collect information that they usually gain through physical examination. Constituents have told me that their ailments and problems would be better assessed physically. The quicker we move back to physical assessments, the better. Someone cannot really be diagnosed at the other end of a Zoom call; they can say what their issues are, and by and large the doctor may get a fair idea, but in many cases it takes a physical examination. The situation is no one’s fault, but it may lead to a delayed or even missed diagnosis of a condition such as high blood pressure. I take a Losartan tablet for my blood pressure every day; I was told by my doctor not to worry about it, but after he told me I would have to take it every day, he said, “By the way, you can’t stop it.” At that stage, I realised that it is necessary to keep me on the straight and narrow and keep me breathing, so perhaps in a small way I understand the need to control blood pressure.

We do not know for sure how many missed diagnoses there have been but we do know that the NHS issued 470,000 fewer prescriptions for preventive cardiovascular drugs between March and October 2020 than in the same period of the previous year. The Institute for Public Policy Research forecasts that if those missing people with high-risk cardiovascular conditions do not commence treatment there will be an additional 12,000 heart attacks and strokes in the next five years. I ask the Minister what is being done to find those who have not been prescribed these preventive drugs over the last period of time, mindful that the unfortunate end result of that is more heart attacks.

This is a ticking time bomb, and we need to defuse it if we are to meet NHS long-term plan aspirations to prevent 150,000 heart attacks, strokes and dementia cases by 2028-29 and, more importantly, if we are to be able to look those families in the face. Behind every person who dies of a heart attack there is a grieving family; we know that probably personally and certainly from constituent cases. As the Good Book says, we have threescore years and 10; we might get less than that or we might get more, but one thing we do know is that our time will pass. We must address the issue of preventing heart attacks, strokes and dementia.

At least half of the 15 million adults in the UK who have high blood pressure are undiagnosed. We all need a bit of stress; it is part of life, and I thrive on a bit of stress, but we can only take so much and it is important to find the right balance. Many of those with high blood pressure are not receiving effective treatment. It is vital to find people early and support them to manage cardiovascular risk factors such as atrial fibrillation. The Automated External Defibrillators (Public Access) Bill was introduced in the House not long ago, with support from all parties; I hope the Government will support its progress so its measures can be introduced in health and education settings. Finding the people with conditions early is vital; we must try to help people manage conditions such as raised cholesterol and hypertension so they can longer and healthier lives.

However, we cannot do that if we do not know who they are, which shows that data is important; it comes up in almost every health debate I participate in. To be fair, the Government and the Minister understand this, as data helps to focus on the right strategy and develop it in a constructive way based on evidence. I ask the Minister to put on the record where we currently are in relation to the collection of data, as it will point the way forward.

Some patients do not need to be found, however, as they or a loved one call 999 because of a medical emergency. For cardiovascular conditions, that normally means they have had a heart attack or stroke. A fast response that gets the right person to the right hospital department at the right time in an ambulance can be the difference between life and death. The newspapers often present examples of ambulances not arriving in time for whatever reason and people passing away. Unfortunately, in England the average response time in May for a category 2 emergency such as a heart attack or stroke was almost 40 minutes; we must do better. The target is 18 minutes; it is not being met.

I did not manage to source the corresponding data for Northern Ireland, but I know personally of one 70-year-old lady who had called believing her husband was having a stroke. She was told to give him an aspirin to chew and that the ambulance was delayed. She was then told in another phone call, which was fairly frantic, that if possible she should bring him herself to hospital, so she dragged him to the car—he is a fairly big man—and arrived at the hospital crying and begging passers-by to help. This man was diagnosed with some form of hernia which presented like a heart attack, and I thank God for that because he could have died waiting on the ambulance and then waiting on his elderly wife to trail him to a car and on to a hospital; that is simply not good enough.

Owing to the scale of current ambulance and A&E delays, we will see more disability and deaths from heart and circulatory disease that could otherwise have been avoided, but if we can avoid them—if we can do things better—the debate will have achieved its goal. This is happening despite NHS workers and paramedics going above and beyond the call of duty to help those in need. I used the word “heroic” earlier, and I use it again now. It is not a word that is taken out of context when I apply it to those workers. Ambulance delays are the symptom of a system that is under immense pressure at every level. Problems in one part of the NHS affect other parts. Problems with accessing primary care lead to more emergencies, which means that, again, there is a greater demand for ambulances.

[Margaret Greenwood (Wirral West) (Lab)]

The hon. Gentleman is making an excellent speech, and I commend him for securing the debate. He mentioned the waiting times for category 2 emergencies. A constituent of mine lost her mother because the ambulance took more than an hour to arrive. This is a heartbreaking situation, and no family should have to go through it. Does the hon. Gentleman agree that we need urgent action to improve ambulance attendance times?

[Jim Shannon]

I certainly do, and I am sorry to hear of the passing of the mother of the hon. Lady’s constituent. If the ambulance had arrived earlier, perhaps she would be alive today. That example is probably replicated throughout the United Kingdom of Great Britain and Northern Ireland; I know that it is in my constituency, and indeed elsewhere. Perhaps when the Minister responds to the debate, we will hear some indication of how this could change.

A holistic response is needed. The NHS cannot begin to address this crisis, the very crisis to which the hon. Lady has just referred, without significant help from the Government—again, I look to the Minister—in the form of a cardiovascular strategy covering the whole patient pathway, as has been called for by the British Heart Foundation, which is also calling for a similar strategy in Northern Ireland. While the BHF wants the strategy in England, of which the Minister will be aware, to be replicated in Northern Ireland, I suspect that the same applies to Scotland and Wales.

The UK strategy, at its core, needs to address the issue of the workforce. Just as workforce shortages are key to issues involving waiting lists, access to primary care and ambulance delays; solving those shortages must be key to the response. I know from statements that Ministers have made, both in the Chamber and in Westminster Hall, that they are committed to increasing the number of nurses, doctors and other staff in the NHS, and the figures are certainly very encouraging. We have not yet reached the targets of 50,000 nurses and 20,000 GPs, but the Minister may be able to give us some timescales and some idea of when the Government hope to achieve those targets.

People who are at risk of cardiovascular diseases, and those already living with them, are supported by a diverse range of health professionals—paramedics, cardiographers, and specialist cardiac nurses—but the 2021 “Getting It Right First Time” cardiology report estimates that the NHS is short of nearly 100 consultant cardiologists; there are currently about 1,700. Perhaps the Minister will be able to tell us when those 100 vacancies will be filled. I ask these questions with the aim of being constructive and ensuring that our constituents throughout this great nation have a better idea of what is going to happen. It is said that we also need 760 new cardiac physiologists to meet the demand over the next decade. Is there a strategy and a recruitment plan? If there is, we will be greatly encouraged. I look forward to the Minister’s response.

[Margaret Greenwood]

I thank the hon. Gentleman for being so generous with his time. He has talked about shortages, and how we should plan for the future. A number of my constituents have written to me about the financial difficulties experienced by medical students, particularly during the final two years of their training. Does the hon. Gentleman agree that the Government really need to come up with a plan to protect and support student doctors, so that we can have the workforce that we need for the future, and ensure that people from all backgrounds can have a career in medicine?

[Jim Shannon]

I thank the hon. Lady for that helpful intervention. I am glad that she mentioned that: it should have been in my notes and she has reminded me. We do need to have a plan to help those students who wish to pursue a future vocation as consultant cardiologists. If we can recruit them now, it will take three, four or even five years before they are ready. I am not sure whether it is the Minister’s responsibility, but perhaps she could give us some idea of whether there is a plan to give students some financial assistance. I have asked the question before, and the answer would be very interesting. If people make a commitment to staying in the NHS for that period of time, perhaps the Government can make a financial commitment to them.

[Mrs Flick Drummond (Meon Valley) (Con)]

The hon. Gentleman is making an excellent speech and I am listening to it carefully. Doctors take between 10 and 15 years to become consultants once they have graduated, and they stay in the NHS for two years for the foundation levels. Many GPs are doing face-to-face appointments, and some departments are doing amazing work, such as St George’s Hospital in Tooting which is looking after a huge number of my family who have Brugada syndrome, a sudden death syndrome that affects the heart. I thank the hon. Gentleman for raising awareness of the issue: there are some very good things going on in the NHS at the moment.

--- Later in debate ---

[Jim Shannon]

The hon. Lady is right. There are some remarkable consultants, and we should be greatly encouraged by that, but I want to highlight some of the shortfalls and look to the Minister and the Government for how we can take that forward. I mentioned a timescale of three, four or five years, but I accept that 10 or 15 years is more realistic.

We greatly underestimate the number of heart failure specialist nurses required to deliver the NHS long-term plan. The recommendations do not consider the full extent of covid-19 backlogs and national recovery targets, meaning the shortages are likely to be even more pronounced now than they would have been before.

More generally, the number of full-time, fully qualified GPs in England decreased by about 6% in the five years between 2016 and 2021. Full-time equivalent district nurses have reduced by 45% between 2010 and 2021. Seven out of 10 practice nurses work less than full time, and around a third are aged over 55.

I accept that the Government have committed to recruitment, but the issue is how the shortfall can be made up. Without a workforce capable of meeting demand, heart patients are at risk across the entire patient pathway, from the moment they dial 999 to when they find themselves in limbo waiting for specialist treatment. The NHS is publishing its long-term workforce plan in the autumn, and that must address shortages at specialty level. We need to know where the gaps in the cardiac workforce are so that we can address them. Perhaps the Minister can give us some idea of where we are in relation to that.

I am also interested, as a Northern Ireland MP who is principally based in this House, in the discussions that take place with the regional Administrations. The shadow Minister from the SNP will speak shortly and I am sure she will give us—as she always does—good information and the evidential base for what is happening in Scotland. I am always keen that all the Administrations come together with their knowledge and information, whether from Scotland, Wales, Northern Ireland or England, so that we can swap ideas on how to do things better. I am keen to hear what is happening in that regard.

We also need to know where the gaps are regionally. While one postcode area may be exceptional, others may not be. While there might be a shortfall in England, we need to know what is happening in Northern Ireland, Scotland and Wales. The number and type of cardiac health workers is not spread evenly across the UK. The greatest number and range of workers is concentrated in large urban areas in England, meaning that many rural areas find themselves at a disadvantage. I hope the Minister can give us some idea of what can be done to improve the situation. The areas with the most workers are not necessarily the areas with the highest rate of cardiovascular diseases, or the poorest outcomes. We need to reappraise how that is done.

The British Heart Foundation is conducting a research project designed to further pinpoint gaps in the cardiac workforce and predict where they may come in future. I wish the BHF all the best as it carries out this vital informative work. That research project might be helpful to the Department; I hope the Minister will be able to tell us what discussions she has had with the BHF on that.

If we address the issue of workforce, we can start addressing waiting lists, primary care and ambulances, and start saving more lives. Let us not forget that the NHS long-term plan identified cardiovascular disease as the single biggest area in which the NHS can save lives over the next decade. We all want to save lives and if there is a way of doing so, the Government need to grasp that. This House and our constituents need to see a clear plan.

So there we have it—I have encapsulated the debate over a bit longer time than I thought I might, but it is an important issue. We need a UK Government strategy specific to cardiovascular disease that addresses the cardiac workforce crisis, the disparity across the United Kingdom and provides sufficient resources for the delivery of cardiac services.

Cardiac care cannot wait, because those suffering from cardiovascular diseases deserve better. In this place, every one of us can be a part of life-changing post-covid changes for the better. I hope that today’s debate is another step in that programme to change things. I look forward to the contributions from other Members. I thank those who have already intervened. I look forward to the responses from the shadow Ministers and especially to that from the Minister.

[Madam Deputy Speaker (Dame Rosie Winterton)]

We come to the SNP spokesperson, Marion Fellows.

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[Maggie Throup]

I think that question should be directed at the Treasury, not the Department of Health and Social Care.

If I may continue to address questions raised, I am pleased to say that our target of 50,000 more nurses is on track for 2024. My hon. Friend the Member for Meon Valley (Mrs Drummond) made the very good point that it takes quite some time to train our amazing healthcare professionals, particularly those who are highly specialised, such as in cardiology. She also highlighted the disparity in waiting times. In England, 11.6% of the population is on a waiting list, but in Labour-run Wales, as she rightly said, the figure is 21%. We have to be careful when we make comparisons and try to criticise one nation over another. Everybody is trying their utmost to get things back on track in whatever way they can, because we know that the population’s health is a priority.

[Jim Shannon]

One of the questions I asked, in a constructive manner, was about the shortage of 100 consultant cardiologists. I am mindful—this was referred to by another hon. Member—that that training can take 10 to 15 years. If the Minister does not have the answer today, I am happy for her to write to let us know.

[Maggie Throup]

The hon. Gentleman asks a specific question, so if I may, I will get back to him.

In conclusion, I hope today I have demonstrated the Government’s commitment to improve the lives of people living with heart and circulatory disease. Our commitment is there. If we can continue to make an impact on the lives of people with these conditions with better prevention, diagnostics and treatment, it will bring significant benefits to the NHS and better health outcomes for those affected. We can all agree that that really matters. Once again, I thank the hon. Member for Strangford for bringing this very important issue to the House for debate today.

[Jim Shannon]

I thank all Members who contributed to the debate, in particular the hon. Member for Motherwell and Wishaw (Marion Fellows) for giving us the Scottish perspective. I always wish to hear, as we all do, what the Scottish Parliament is doing on health. SNP Members often give us examples of how we can do things, which is why I talked earlier about exchanging viewpoints.

The hon. Member for Denton and Reddish (Andrew Gwynne), the shadow Minister, is indeed a good friend. Both he and the hon. Member for Motherwell and Wishaw talked about health prevention. That is clearly what I would like to see, too. We all, including the shadow Minister and the hon. Member for Wirral West (Margaret Greenwood), referred to the ambulance shortfall. The Minister gave us some encouragement, which I appreciate, with £2.3 billion in the next three years on diagnostic activity, earlier intervention for cardiac, and a lifetime offer of virtual or face-to-face rehabilitation. On ambulance times, there was additional funding also to the auxiliary ambulance service—I think the figure was £30 million. And we are looking towards the 2024 target for 50,000 nurses.

With that in mind, I thank the Minister most gratefully for her response. I will be happy to take some of the other singular issues in a written reply, whenever she has that opportunity. Again, I thank everyone who participated. I thank you, too, Madam Deputy Speaker. It is not often said, but thank you so much for what you do.

[Hon. Members]

Hear, hear!

Question put and agreed to.

Resolved,

That this House has considered the impact of the covid-19 pandemic on people with heart and circulatory diseases.