Health and Wellbeing Services: East of England

Jim Shannon Excerpts

Wednesday 1st March 2023 Westminster Hall

[Priti Patel]

I thank my hon. Friend for making that point. The British Dental Association has been pressing for reform probably for as long as I have been in Parliament, and I am very familiar with its case. My hon. Friend speaks very clearly about access and inflexibility. Importantly, if there is no flexibility in the system, there is no opportunity to provide services to meet local need accessibly and in a way that means people do not think they will be charged or subject to barriers to access.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Lady. She was a very effective Home Secretary and it is good to see her just as active on the Back Benches—well done. This subject does not affect me personally, but I want to ask her about a similar issue: face-to-face GP appointments. It is vital for a GP to assess what they see as well as the words they hear. My constituents wish to have face-to-face appointments, but they seem to be restricted. Is the right hon. Lady experiencing the same problems? What would she suggest should be done to solve them?

NHS Workforce Expansion

Jim Shannon Excerpts

Tuesday 28th February 2023 Commons Chamber

[Wes Streeting]

There are a couple of challenges with that approach. First—I want to be clear about this—having international students come to study at UK universities is a wonderful thing. It is wonderful for British students who mix with cohorts drawn from across the world, and it is wonderful because they contribute to the cultural and intellectual life of our universities, and of the towns and cities in which they live while studying here. It is a wonderful thing because they often return to their countries with fond memories of Britain, which is an extension of our soft power and diplomatic influence. Those are all great reasons why we should cherish, embrace and welcome international students, and it is why I hope the Home Secretary does not win the argument inside Government to restrict further access to international students. Finally, I should say that international students also pay an enormous amount to come and study here in the UK, and they subsidise home students.

I want to be clear about how much I welcome international students, but it is an absurdity that people are coming to this country to study in medical schools that have no British students. It is an absurdity, when we have a chronic shortage of doctors, nurses, midwives and allied health professionals, that we see straight-A students from our own country being turned away, while university medical schools are being told they can only recruit international students. That is the depths of stupidity that this Government are plumbing.

[Jim Shannon (Strangford) (DUP)]

I commend the shadow Minister for his thoughts. The poaching of junior doctors by Australia, for example, for better pay and working conditions, as opposed to fractured shift patterns here, is a major issue. It is not just about expanding the workforce, to which he has referred; it is also about having a careful and concerted campaign to retain staff here. Does he agree that has to be part of the thrust of this debate?

[Wes Streeting]

I wholeheartedly agree with the hon. Member. I will talk about this later in my speech, but it is why the Government have to resolve this pay dispute with existing NHS staff. The danger is not that they walk out for another day of strike action, but that they walk out of the NHS altogether for countries that treat them better. What an absurd position to be in. It is also absurd, by the way, that we still have doctors retiring early for no other reason than that the pensions rules create an active financial disincentive to work up to normal retirement age, as many of them would like to do. It is completely absurd.

Government Support for Breastfeeding and the 2023 Lancet Series

Jim Shannon Excerpts

Monday 20th February 2023 Commons Chamber

[Alison Thewliss (Glasgow Central) (SNP)]

I have repeatedly brought matters to this House concerning infant feeding. For an issue that concerns every child ever born, it generally gets remarkably little attention from Governments. Madam Deputy Speaker, I can assure you that breastfeeding is an issue of the utmost importance. According to the World Health Organisation, breastfeeding has the potential to prevent 800,000 child deaths globally each year. As The Lancet paper editorial states:

“Breastfeeding has proven health benefits across high-income and low-income settings alike: it reduces childhood infectious diseases, mortality, and malnutrition, and the risk of later obesity; mothers who breastfeed have decreased risk of breast and ovarian cancers, type 2 diabetes, and cardiovascular disease.”

Yet despite those clear health benefits, around the world and here in the UK, we see a growth and embedding of commercial milk formula in our culture.

I stress that this is not a criticism of individual parents, or a value judgment. This is not about formula versus breastfeeding; it is a structural issue, relating to recognition of the importance of breastfeeding and to the lax regulations that have allowed a commercial industry to flourish. The recently published Lancet papers tackle the structural reasons for which breastfeeding does or does not happen. Commercial milk formula is a multibillion-dollar industry which directly targets families with multifaceted and sophisticated marketing practices—practices that influence our beliefs and values, prey on our insecurities and weaknesses, and are exacerbated by the absence of comprehensive Government support for breastfeeding.

There are three Lancet papers, each highlighting the impact of several aspects of commercial milk formula marketing. The second states:

“The marketing of commercial milk formula…for use in the first 3 years of life has negatively altered the infant and young child feeding ecosystem.”

Successful breastfeeding depends on a network of policy and society responses. It is the responsibility of Government to regulate the industry, and to implement structural policies to mitigate the impact of formula marketing. Women who do breastfeed do so despite billions of pounds’ worth of marketing designed specifically to undermine them.

However, this commercialisation does not just affect breastfed babies and their families. The cost of the marketing literally adds to the price of commercial formula on supermarket shelves. Research by Leicester Mammas—presented recently to the all-party parliamentary group on infant feeding and inequalities, which I chair—shows the influence of advertising, with many parents choosing the most heavily advertised first- stage formula rather than the cheapest. All first-stage formulas are exactly the same by law.

In 2018, the APPG produced a report highlighting the significant impact of the cost of commercial milk formula on family budgets. Inflationary pressures are much worse now than they were in 2018, with profound consequences. Feed UK has highlighted the increased costs in its own more recent research, and just yesterday an article in The Guardian revealed that supermarkets such as the Co-op are now keeping formula behind the counter to prevent shoplifting. It said:

“The cost of infant formula has soared over the past year - with the price of the cheapest brand increasing by 22%. Even if a parent is able to access the cheapest brand, Aldi’s own label, the cash value of Healthy Start vouchers, £8.50 a week, is no longer enough to pay for the amount of infant formula needed to safely feed a baby in the first six months of their life.”

That is a very difficult increase for many families to bear. The Minister should be concerned about the risks of parents’ watering down formula, feeding babies under a year old cows’ milk, or thickening milk with porridge because they simply cannot keep up with the spiralling costs of infant formula. Inadequate nutrition at an early stage can have devastating long-term health and developmental impacts. I have raised this matter with Ministers before, and I encourage them to take it seriously. I am presenting the debate this evening because I feel that it is important for the Government to engage meaningfully with the findings of The Lancet report.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for initiating the debate, and for the leadership that she brings to the APPG. Her voice on behalf of breastfeeding women throughout the United Kingdom has been welcome.

In Northern Ireland, our community midwives team are extremely focused on aiding breastfeeding, yet, as the hon. Lady will know, we have the lowest breastfeeding rates in the UK. Does she agree that providing breast-milk pumps for women in low-income families who are put off by the prohibitive cost of the pumping equipment, but who need their child to be minded after the end of their all too short maternity leave, may be a useful tool to help mums to realise that “breast is best” can work in tandem with their return to work?

[Alison Thewliss]

The provision of those pumps can indeed make a huge difference to working families by giving women the flexibility to return to work. Many of them want to breastfeed, but find that returning to work presents a barrier to it. I will say a little more about the pressures from maternity leave later in my speech.

In this post-Brexit landscape, health industry professionals are making it clear that there should be no reduction in regulation on commercial milk formula. Existing regulations should be maintained as a minimum, and work should be conducted to improve on them.

Let me now take a bit of time to discuss the different angles of the three papers. The first explores the challenges of breastfeeding in a market-driven context. Many of us will be familiar with the stress of having a newborn: are they feeding enough, too much, too little? Are we getting enough sleep? Why are they still crying? Commercial milk formula companies thrive on this self-doubt. They want to exploit what are normal developmental phases and present them as problems to which only they can provide a solution. Online forums and baby clubs, apps, emails and pop-up ads are rife. They consistently undermine parents’ confidence, so that a product can be sold as the answer to their problems. When you are exhausted and your baby has been crying for hours, commercial milk formula companies are there to sell you a good night’s sleep, peace of mind, or a special type of formula to stop your baby fussing.

No one would judge parents in that position. We have all been there, and would gladly hand over all the money in our wallets to get that peace of mind. Companies have stepped into this space to offer specialist formulas in a quite unregulated way: formulas sit on the supermarket shelf offering solutions to colic and spitting up, for “hungry babies”, and to deal with allergies. The truth is, however, that there is no solution—not one that comes in a tin, anyway. Fussing and crying and disrupted sleep patterns are all extremely normal parts of human development and baby behaviour. Normal sleep patterns of babies sadly do not align with the sleep patterns of adults, no matter how they are fed. The responsibility lies on us, as policymakers, to ensure that parents are informed and helped to make the best choices for their babies. We need to ensure that any vacuum of information is not filled by aggressive marketing.

The second paper looks at the marketing playbook used by commercial milk formula companies. I should say at the outset that I am not arguing that marketing is inherently bad, or that companies should not make profits, but there is a case for an overhaul of the regulations. When marketing impacts human development and health outcomes to such an extent, Governments need to step up to the plate.

Commercial milk formula sales were worth $55.6 billion in 2019. Let me put that figure in context: it far exceeds the Scottish Government’s budget in the same year. Sales per capita have increased substantially across the world over the last decade. There are many reasons for that—poor breastfeeding support, work constraints, perceived issues with milk supply or fussiness—but the major contributor is marketing. Between $2.6 billion and $3.5 billion is spent on milk formula marketing every year, and that is likely to be the tip of the iceberg, because it does not include the costs of lobbying, social media or sponsorship of health workers, all of which are key entry points in shaping beliefs and altering consumer decisions. Industry lobby groups work to influence policy environments in favour of the milk formula industry and their shareholders.

Medical professionals are targeted as well, through deliberate efforts by formula companies to encourage the diagnosis of health issues which they claim that their products can alleviate. Dr Chris van Tulleken is among several health professionals who have explained how this has led to over-diagnosis of health issues such as cows’ milk protein allergy, an activity that is being led by formula companies presenting their products as a “solution” to normal baby behaviour. He found that, astonishingly, between

“2006 and 2016, prescriptions of specialist formula milks for infants with CMPA increased by nearly 500% from 105,029 to over 600,000, while NHS spending on these products increased by nearly 700% from £8.1m to over £60m annually.”

There is little evidence to suggest that prevalence has increased, but it is clear from those figures that industry influence has. This is a cost to the NHS of which the Government should be mindful.

The report finds that the World Health Organisation’s “The International Code of Marketing of Breast-milk Substitutes” has been routinely blocked, reinterpreted, circumvented, or ignored entirely in order for companies to achieve astronomical profits. One example is the creation of follow-on milks as a response to the marketing constraints that do exist: they are completely unnecessary, and often contain additional harmful sugars. The aim is to sell them to promote first-stage formulas that cannot be advertised on television. In the UK, the existing regulations are poorly enforced, and could well end up being scrapped in the bonfire of regulation that is the Retained EU Law (Revocation and Reform) Bill. I seek an assurance from the Government that that will not happen. I also ask the Government to use their voice at the meeting of the Codex Alimentarius Commission to tighten regulations globally, instead of allowing industry to have its own way.

The third paper highlights the way in which the political economy influences breastfeeding outcomes. The paper finds that inadequate maternity rights and poor working conditions make it difficult for many mothers to breastfeed, and, as was pointed out by the hon. Member for Strangford (Jim Shannon), a rise in insecure and underpaid work has made it even more difficult. There is evidence from around the world that where Governments fail to protect maternity rights, formula companies thrive.

This paper highlights how women’s labour is systematically undervalued. If a tin of formula is purchased in a shop, that contributes to GDP figures, which the Government record as an expression of national wealth. If that same baby is breastfed, it does not count towards GDP because women’s time is just not valued the same way as a commercial product. The paper found that if we were to put a monetary value on the milk produced by breastfeeding women globally, it would amount to an astonishing $3.6 trillion. Commercial milk formula companies are aware of that, and this report exposes how their interests are aligned with poorer maternity protections. The incentives and resources are there for lobbying companies to persuade Governments to reduce workplace rights. This acts as a distortion on the labour market and needs to be actively resisted.

Scotland has legislation specifically protecting breastfeeding in public, for which I thank the former Labour MSP Elaine Smith. The SNP Scottish Government also put breastfeeding into their programme for government, with investment which led to an increase in breastfeeding rates. It is progress, but so much more needs to be done. As I hope I have outlined, this matter goes far beyond individual choice. Ultimately, a healthier population is a positive externality: it benefits everyone, saving money for the NHS through infant and maternal health, a healthier workforce and better outcomes in education. Encouraging breastfeeding and regulating formula effectively should be seen not as a drain on the public purse but as an investment for the future.

I have some asks for the Minister. Almost exactly six years ago, I published my Feeding Products for Babies and Children (Advertising and Promotion) Bill, and I would be glad to speak to the Minister further about it, because it presented the Government with credible options that could make a difference. As I mentioned earlier, we are also at an important juncture with the retained EU law Bill, which could see current infant formula regulations being scrapped. Let us not forget that these important regulations across Scotland, England, Wales, and Northern Ireland protect the health of our youngest citizens. They must be retained, but they must also be strengthened.

Prior to Brexit, when I asked about the prospect of the UK Government joining the countries that have fully implemented the World Health Organisation’s international code of marketing of breastmilk substitutes, I was told that our membership of the EU presented a barrier to doing that. That excuse has now vanished, so I would like the Minster to tell me tonight when he aims to implement the code in full.

Will the Minister meet the authors of The Lancet reports and representatives of the all-party parliamentary group on infant feeding and inequalities to discuss further what the Government intend to do in response to these findings? Will he accept that child and maternal health should come before the profits of commercial milk formula producers? Will he commit today to exploring the role of the UK Government in stopping the aggressive marketing of the formula milk industry? As The Lancet so clearly set out, superficial slogans to encourage breastfeeding are a poor substitute for addressing the sociocultural, economic and commercial determinants of infant and young child feeding. I urge the UK Government to engage with the reports and to do much better by our youngest citizens.

NHS Strikes

Jim Shannon Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

First, let me agree entirely with what the hon. Gentleman said about NHS staff and how we all owe them a debt of gratitude for the service they have given, not just to us but to all our families. Again, he may have missed it when I asked that if any Opposition Member was going to raise the same question, they might also stand up and say exactly where each block of £700 million would come from, out of my £150 billion budget. [Interruption.] The hon. Member for Brent Central (Dawn Butler) says, “Show us the books.” She knows exactly where the NHS funding goes. I want to ensure that we have an open and honest dialogue. I have been having those conversations with the unions and I have set out exactly the challenges we face. Any pay has to be affordable not just to the NHS but to the wider budget. It has to recognise and reward those who work in the NHS. Of course I want to retain and attract the very best, but it also has to be fair to taxpayers, and that is the point I think the hon. Gentleman and others are missing.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers. For nurses and many others in the NHS, striking is not what they want to do: all they want is dialogue and to try to move forward with an agreed wage structure. They have been left vulnerable by understaffing on the wards, and the pressure that adds is repugnant to them. The Government must move from their entrenched position to find a workable solution. Will the Minister commit to reopening dialogue and looking at the situation, not from the angle of enshrined principle but from a safety angle, which concerns us all?

[Will Quince]

I thank my hon. Friend for his question. We accepted in full the independent pay review body’s recommendation this year of 4.75%, which was over and above last year’s figure of 3% when the rest of the wider public sector was frozen. He asks about dialogue. Of course I am happy to have dialogue with the unions; my door has always been open and it will continue to be so. What I am not going to do is reopen this year’s pay review. We have the independent pay review body process and we accepted that recommendation in full. What I am willing and happy to do is to have that dialogue about next year’s independent pay review body recommendation. Let us not forget that it is in only two months’ time that the new financial year starts, and we have to get that right. I hope that he will encourage unions and others to take part in that process so that we can get it right, because we all want to ensure that NHS staff get the right pay rise that recognises the huge service they give.

Cystic Fibrosis: Living Costs

Jim Shannon Excerpts

Thursday 2nd February 2023 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the impact of cystic fibrosis on living costs.

It is a real pleasure to be here in Westminster Hall—a bit breathless, but we are here. This is a massive subject, and I am very pleased that many colleagues have been able to attend in support. Looking around the room, I see many Members who have personal stories to tell; they will do so, and their stories will reinforce the questions that we all wish to ask the Minister. I am very pleased to see the Minister in her place, as well as the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne). He and I seem to be in many debates together; indeed, we are a bit of a tag team. It is also a pleasure to serve under your chairship, Ms Harris.

I am the DUP spokesperson for health, so I am pleased to be able to highlight the struggles of those with cystic fibrosis and other lung conditions who have been affected by the spiralling cost of living. As the Minister knows, I will make a number of asks of her in my speech. Most Members will be aware that cystic fibrosis is a progressive, life-limiting genetic condition that primarily affects the lungs and the digestive system. The condition is due to inheriting a faulty gene from both parents that causes the lungs and the digestive system to become clogged with mucus, making it hard to breathe and to digest food—that is the graphic way of explaining what it means. It is common for those with CF to also have CF-related diabetes; I did not know that until I read the research, but I was aware that other effects include osteoporosis and being malnourished. Some 80% of people with CF are pancreatic insufficient, and therefore need a higher calorie intake to maintain a healthy weight.

Roughly 11,000 people in the UK have CF: 9,000 here on the mainland in England, 1,000 in Scotland, 500 in Wales and 500 in Northern Ireland. In 2021, the median age of people with CF who died was 38. Wow—this disease really puts life into perspective. People with CF are particularly susceptible to lung infections, and therefore cannot meet each other face to face due to the risk of cross-infection. Again, the life of someone with CF is really restricted, and is much more difficult.

That brings us to the crux of the issue: living with CF demands an incredibly high burden of treatment, taking at least two to five hours and up to 70 pills each day. People with CF have higher food bills because they need a higher calorie intake to maintain a healthy weight, and higher energy bills because they need to keep their homes warm to stave off lung infections and they may need to power an additional fridge to store sterile medications or essential medical devices such as ventilators. Life as a person with CF is so different from everybody else’s life.

People with CF living in England must pay for their NHS prescriptions, unless they are exempt. Those with CF living in England and, at least until 2024, in Northern Ireland also have to pay hospital car parking charges. The Cystic Fibrosis Trust, in conjunction with Bristol University, commissioned a report entitled “The Financial Costs of Cystic Fibrosis”. I urge the Minister to take time to process that report; if she has already done so, we thank her for that. It will give her a good perspective on my speech, and perhaps on other Members’ speeches as well.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

I congratulate the hon. Gentleman on securing another debate in Westminster Hall—he is very successful at doing so, and I thank him very much. According to research, an adult with cystic fibrosis will, on average, incur an additional £209 per month in living costs, while a parent carer of a child with the condition will incur an additional £291. Very few people on an average income have that kind of money to spare. Does the hon. Gentleman agree that dropping prescription charges for people with cystic fibrosis, as has been done in Scotland, would be one way of easing the burden on families?

[Jim Shannon]

I thank the hon. Lady for her intervention, and I agree with her. In Northern Ireland, there are no prescription charges—there is no cost—which I believe makes a difference. That is one of my asks of the Minister; there are a lot of asks, most of which are financial, but they are very important.

To follow on from the hon. Lady’s intervention, the report also revealed that the additional cost of living due to cystic fibrosis is over £6,500 per annum. The financial burden is made up of both extra spending to keep well and the loss of income. The key findings indicate:

“Families with CF are more likely to be struggling with their finances than the public—24% of adults with CF and 35% of parents of children with CF described meeting their bills each month as a ‘constant struggle’”—

life is really hard for people with CF—

“compared to 17% of UK households overall.”

The findings continue:

“Food and rising energy bills were the biggest financial concern for people with CF and their families—both are essential to the health and quality of life of people with CF.

For the average family the combined impact of extra spending”

includes “heating, expensive dietary needs” and “attending medical appointments”—the local hospital is not always where they go to meet a consultant or specialist—and “home medical equipment”. Life for a CF patient in their home is almost like being in a hospital.

There is also the loss of income: treatment takes two to five hours every day, which means that they cannot keep down a full-time job; indeed, it would be difficult to keep down a part-time job. The extra spending and loss of income means

“they are thousands of pounds worse off than comparable families.”

The findings continue:

“Three-in-five (59%) of adults with CF had also incurred some form of income loss as a result of their condition in the last two years—for example, reducing working hours, taking unpaid leave to attend appointments or leaving work altogether”,

as many have to.

The Cystic Fibrosis Trust has seen a significant increase in the support needed, with 72%—a big figure—of helpline inquiries since October 2022 relating to financial support. Between October and December 2022, it provided cost of living fund grants to hundreds of households and increased its grants for essential household appliances and white goods. The figures are real—they are quite detrimental and very hard to comprehend.

According to the Marmot review of health inequalities,

“Those living in the poorest neighbourhoods are twice as likely to develop a lung condition, and seven times as likely to die from one than those in the richest areas.”

We have seen the pressures on those with CF, but those pressures are even greater if they live in households where money is tight, where they cannot keep a wage and where they are probably more dependent on benefits. I will talk about that in my requests to the Minister. I know that benefit payments are not the Minister’s responsibility, but they are one of the issues that come off the back of this debate.

Because poorer communities are disproportionately impacted by the cost of living crisis, many of those living with a lung condition are more likely to be struggling from the outset. Asthma and Lung UK found that almost two thirds—63%—of those surveyed with a lung condition are

“buying and eating less food.”

That is when they need food more, need the right food and need it in the right quantity. Eating less food can lower immunity and increase the risk of

“viruses that are the top trigger of asthma attacks”.

It is clear that those who suffer from cystic fibrosis, or from other lung conditions, are in grave need of help. That is my ask of the Minister today. Some of the issues will take cross-Department co-operation, but I believe the Minister is best placed to take them forward. The collective asks that I and others in this debate have are so important.

I should have said at the beginning—I apologise for not doing so—that I thank the Backbench Business Committee for agreeing to the debate. The Committee is very good when we propose debates to it, and it granted this one without any thought whatsoever. We also hoped to have the debate at this time, because it ties in nicely. There are people in the Gallery who have helped me, and probably others in this room, to prepare our contributions for today.

Ask number two, which I have raised before but will raise again, is that benefits must continue to rise in line with inflation. Some 83% of parents of children with CF are receiving one or more type of benefit, and 68% of adults with CF are claiming at least one form of benefit, according to the new report. The Office for Budget Responsibility forecasts that consumer prices index inflation for 2023 will be 7.4%. Those are the figures. If the Government—I always say these things respectfully and they are not meant critically, which is not my form, but I ask them because they need to be said—do not continue to increase benefits in line with inflation, not only those with CF but all the poorest will suffer a detrimental blow.

[Margaret Ferrier]

I thank the hon. Gentleman for giving way again; he is being very generous. Research conducted by the University of Bristol found that a surprising number of cystic fibrosis patients had applications for personal independence payment or disability living allowance rejected, and others did not apply because they did not know what support might be available. Does he have any thoughts about how the DWP could improve awareness of the condition and ensure people are getting the right support?

[Jim Shannon]

It is almost like the hon. Lady read my next point. That is one of the focuses of my request. It is my next sentence, would you believe?

We must remove unnecessary PIP reassessments for people with long-term conditions such as CF. There has to be an understanding of what CF is and how it affects people. There has to be an understanding that their lives are not like anybody else’s lives. I said earlier that the median lifespan for people with CF in the last year was 38 years. It is sad to say this, but it is a life-limiting condition.

There is a requirement for claimants to report any change in health to the Department for Work and Pensions—wow! It would be great if every person with cystic fibrosis could say, “I tell you what, I’m better today. I won’t need those 70 pills and the medication for the next wee while.” That does not happen. It would be a miracle. I believe in miracles—you know I do, Ms Harris—but they do not happen every day. The fact is that people sometimes have a sickness or a disability—this is one of them—that means they need help. I have always been a great believer that society is marked by how it helps those who need help, and that is what we need to do.

These people have a progressive lifelong condition and their health is unlikely to improve, but there is the threat of constant reassessment—my goodness, reassessment again. We know the condition is life-changing and life-limiting, and that they probably need a transplant. The hon. Member for Bristol East (Kerry McCarthy) is always here in these debates. I welcome her to her place—not that it is my job to welcome people to Westminster Hall, but I like to see her because I know she makes very helpful contributions. The reassessments provoke anxiety and are costly and unnecessary. Streamlining the assessment system would mean that those with progressive, long-term conditions such as CF do not have to undertake reassessments. That would not only remove the anxiety but provide cost savings to the DWP. We do not need to do those reassessments because it is a life-limiting disease.

I feel very frustrated—I am sure others do too—when people with life-limiting diseases have to go through reassessments for employment and support allowance, PIP or DLA. It is absolutely unbelievable that that should happen.

[Andrew Western (Stretford and Urmston) (Lab)]

The hon. Gentleman is making an excellent point about the reassessment process. Does he agree that many people with cystic fibrosis are unfortunately unable to access PIP because it is treated as an illness, rather than a disability? The assessment process assesses what people may theoretically be able to do, rather than what they can do in practice on a daily basis.

[Jim Shannon]

The hon. Gentleman has summed it up in that one sentence. I said when he made his maiden speech last week that his contributions will add much to this House. That is one of them, and I thank him for it. I wholeheartedly support him.

I again ask the Minister—she knows these requests, because I have made her Department aware of them—to remove VAT on energy bills. That is important for people with CF because, at a time when energy bills are already astronomical, the median energy bill for an adult with CF is £26 higher every month than for typical households. For parents of children with CF, the figure rises to £36, because they do more and keep more heat in the house for their children. Adults can sometimes bear with it a wee bit, but there is still a cost factor.

[Liz Twist (Blaydon) (Lab)]

The hon. Gentleman is making an excellent speech. Does he agree that it is really important that people with lung conditions have the right environment at home and the right heating? The additional costs, especially given the rising energy costs, mean that we must take care of those people who need extra heat. That applies especially to people with CF.

[Jim Shannon]

The hon. Lady is absolutely right. I thank her for her contributions on this subject. She brings much knowledge to these debates. I am pleased to be a member of the all-party parliamentary group for respiratory health with her. We work with others to ensure that we can pursue matters, and today we are pursuing this matter for our constituents.

[Kerry McCarthy (Bristol East) (Lab)]

It is good to be in a Westminster Hall debate led by the hon. Gentleman; he is often a fixture here. I thank him for his kind words about my presence in previous debates.

On the energy bill issue, is the hon. Gentleman as concerned as I am about the reports of forced prepayment meters, including for people with extreme vulnerabilities and disabilities? Often those forced prepayment meters lead to self-disconnection because they are more expensive and people cannot afford to keep them topped up. I welcome today’s announcement that there is to be a moratorium on forced prepayment, but we should not have that at all, particularly for people with conditions that require their homes to be heated.

[Jim Shannon]

I do not have that in my notes, so I thank the hon. Lady for her knowledgeable intervention. That issue is hard to comprehend. If we have a decent wage, energy is not a big problem. On the minimum wage, it becomes a problem. When someone is disabled, it becomes an even bigger problem. She is right and I thank her for that reminder. We are all making points that we look to the Minister to respond to. Those with prepayment meters are under especial pressure and we look to the Minister to respond to that.

Removing VAT from energy bills would benefit not only CF families but all of the poor, as they spend a larger percentage of their income on energy bills.

Hospitals should provide free parking. I call on NHS England hospitals to provide access to free hospital parking for people with chronic medical conditions. Most hospital car parking charges are already abolished in Wales and Scotland, and Northern Ireland is set to abolish them in 2024. For once, the mainland needs to catch up with the regions. However, there are worries about potential delays to that coming into effect, given that there is currently no sitting Northern Ireland Assembly.

The guidance from the Department of Health and Social Care for NHS trusts in England makes it mandatory for parking to be free for those with blue badges, those attending as an out-patient three times a month for at least three months, and parents of sick children staying overnight, but it is rare that those with CF meet those criteria. The hon. Member for Stretford and Urmston (Andrew Western) referred to the assessment process, and that has to be addressed.

I am on to ask No. 5. Some 80% of people with CF are pancreatic insufficient, meaning they require a higher calorie diet. During hospital appointments and in-patient stays, it is vital that they have access to affordable food. However, NHS England’s national standards for healthcare food and drink do not refer to a need to ensure that affordable food is available in hospital cafés and canteens. That must change because there are people who cannot afford the right sort of food, but who need it.

[Lee Anderson (Ashfield) (Con)]

The hon. Gentleman is making a passionate speech, but I want to pull him up on one point. The City Hospital in Nottingham has its own cystic fibrosis unit. The in-patients get a personal chef who cooks them whatever they want 24 hours a day. They have access to snacks, cakes and all the junk food that CF patients need, so what the hon. Gentleman says is not correct in my neck of the woods, where they have their own chef and can eat whatever they want, whenever they want.

[Jim Shannon]

I am really pleased to hear about that initiative in the hon. Gentleman’s hospital. That is a model for the rest—well done! We look forward to that scheme being taken on board by the Government.

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) made a point about ending prescription charges for people with cystic fibrosis in England. I am on my last page, Ms Harris—I am conscious that I committed to a timescale, and I will try to keep to that. I am thankful for the exemption in place in Northern Ireland, but I cannot in all conscience leave it out of any debate on this issue for my fellow British citizens. As everyone knows, I am a great supporter of the United Kingdom of Great Britain and Northern Ireland. I am pleased that my friend, the hon. Member for Linlithgow and East Falkirk (Martyn Day), who will speak shortly for the Scots Nats party, is part of this great United Kingdom as well.

The list of medical conditions that are exempt from prescription charges was written by the Government in 1968, so I think it is time to look at that again. The reality is that, at that time, children with CF were not expected to live to be adults, so CF was not included in the list. However, there are now more adults than children living with CF and it continues to be one of the few chronic, life-shortening conditions where people pay for their prescriptions. One of my asks of the Minister is for that to change.

[Lee Anderson]

I thank the hon. Gentleman for giving way; he is being very generous with his time. Is he aware that there is a loophole in the system? Although people with CF cannot get free prescriptions, if they have diabetes caused by CF, they can. It is crazy and unacceptable that they have to rely on getting another disease before they can get a free prescription.

--- Later in debate ---

[Jim Shannon]

I thank the hon. Gentleman for his intervention, which reveals another anomaly. The list of questions for the Minister is getting longer, but I know she will be able to respond.

Ending prescription charges for the estimated 2,500 people with CF who are not currently eligible for free prescriptions could cost the Exchequer as little as £270,250 per annum. That is not a big cost. The Cystic Fibrosis Trust believes that ensuring that people with CF receive free prescriptions will mean they can live better, healthier and longer lives, ultimately reducing the burden on the NHS. It is vital that there is an urgent review of the medical exemption list to ensure that people with CF across the UK have equitable access to free prescriptions.

I thank all Members for their contributions and interventions. I look forward to the contributions by the SNP spokesperson, the hon. Member for Linlithgow and East Falkirk, and the shadow Minister, the hon. Member for Denton and Reddish. I thank the Minister pre-emptively for her response, for which I have high hopes. I genuinely know that the Minister has a heart for effecting real change—and that, I believe, is what is needed today.

--- Later in debate ---

[Helen Whately]

I absolutely hear the hon. Member’s argument, and similar points were made during the debate. As the Minister with oversight of major conditions, cystic fibrosis is not the only condition about which I have received letters, parliamentary questions and lobbying in general asking for exemptions to prescription charges. We cannot just look at cystic fibrosis in isolation; a similar argument could be made in relation to a number of other conditions. As I have set out, the way the system works is specifically designed to help people on low incomes with the cost of prescriptions and make it more affordable for people who have to get a lot of prescriptions during the course of a year.

[Jim Shannon]

I want to follow on from what the hon. Member for Bristol East (Kerry McCarthy) said. I think I referred in my contribution to the 1968 legislation. The perception at the time was that children who had CF were not going to survive, and that therefore there was no need to include CF, but today there are more adults who have CF than ever. The point that I am making is that things have changed. Will the Minister convey that information to the DWP in as strong a fashion as we have in this Chamber, and ask the DWP to look at that? I know it is not the Minister’s responsibility to look at that, but if that is agreeable to her, it would be helpful.

[Helen Whately]

As ever, the hon. Member is extremely persuasive. I will be happy to take that up with ministerial colleagues who are responsible for prescription charges, but I do say that this is the case not just for cystic fibrosis. We should be aware that we would be similarly lobbied on behalf of other conditions, so we need to be aware of the breadth of the issue raised. However, I shall be happy to take up the matter with ministerial colleagues.

I want to pick up on the cost of attending medical appointments, which was also raised. To help people to get to appointments, the NHS healthcare travel costs scheme provides financial assistance to eligible patients who need assistance with their travel costs. That includes patients in receipt of a qualifying benefit and those on the NHS low-income scheme.

Another way to alleviate the cost pressures of medical appointments for people with cystic fibrosis—I stress that this is only where appropriate; I do not want to be misconstrued—is for appointments to be virtual. NHS England is supporting NHS providers to embed and spread the use video consultations innovatively, where that is the right thing for a patient, and in discussion with the patient in respect of their individual needs. For some patients, that is helpful in reducing the number of journeys they make to appointments—but I am clear, and I know very well, that some appointments should and have to be in person, particularly whenever anybody wants that.

[Jim Shannon]

I tried to illustrate this point earlier, but although I understand that, with the restructuring of hospitals, not every hospital can specifically respond to everything—hence the centralisation of medication and healthcare—when it comes to cystic fibrosis and getting an appointment with a consultant, physio or whoever it might be, one factor is the distance that a great many patients have to travel, especially those in rural areas. The Minister has said that those on benefits can qualify for travel costs, but for some people it is not the cost alone; it is the travel itself. I am sorry for going on a wee bit, Ms Harris, but as I said earlier, for most people with CF that means two to five hours every day of their lives, so the impact on them is greater. The Minister has talked about the physical and mental health aspects, but there are wider aspects, which include the long distances that people have to travel just to get the treatment they are after.

[Helen Whately]

The hon. Gentleman makes an important point about having to travel further for appointments and treatment, which affects people in rural areas generally. Those costs will clearly affect those who have to travel regularly and frequently, such as patients with cystic fibrosis who need many appointments. I am very happy to take away the point he raises and to look at whether we should do something different or specific for those living further away from wherever they need to go for treatment.

I want to pick up on the point about hospital parking, which is clearly another cost that might be affecting people. The Government committed to introducing free hospital car parking for those in great need, including frequent out-patient attenders, as part of our election manifesto. NHS trusts and NHS foundation trusts are required to comply where applicable with NHS car parking guidance, which outlines that disabled patients and visitors should receive free parking for the duration of their attendance at, or visit to, hospital. It also makes it clear that parking will be provided free to all out-patients who attend hospital for an appointment at least three times in a month and for an overall period of at least three months. Importantly for parents of children with cystic fibrosis, parents of children who are admitted as an in-patient overnight should receive free parking between the hours of 7.30 pm and 8 am while visiting their child. I was glad to hear from my hon. Friend the Member for Ashfield that, as I have heard in other places, there is indeed free parking for the patients with cystic fibrosis he mentioned and their families.

I want to mention the innovative work—which also touches on the virtual appointments that I mentioned a moment ago—that Royal Brompton and Harefield NHS Foundation Trust is doing in partnership with NuvoAir, whereby patients use spirometer devices at home to measure lung function and access the results on their phones or tablets via Bluetooth. The results can be shared with a specialist cystic fibrosis clinical team at the Royal Brompton Hospital during virtual consultations, saving the patients time and money while ensuring effective monitoring by the clinical team. There is a balance here, because although the many appointments mean extra journeys, we are doing things to improve the lives of people with cystic fibrosis and to help with the practicalities of the necessary extra treatment and care.

This debate has powerfully brought to life the extra challenges facing people living with cystic fibrosis and their families. It has been helpful to air the issues relating to extra costs and anxiety and the practical difficulties of living with the condition. I pay tribute to all those involved in supporting people with cystic fibrosis and all those living with it. The drive and determination to improve things is inspirational, and I hope that I have reassured everybody about the Government’s commitment to supporting patients with cystic fibrosis and their families.

[Jim Shannon]

I thank all Members for their contributions. I thank the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) for her interventions on costs, benefits, and employment issues; she is always very wise. I thank the hon. Member for Blaydon (Liz Twist) for bringing her knowledge about lungs and asthma, which are part of this subject matter, from the APPG for respiratory health. I thank the hon. Member for Bristol East (Kerry McCarthy) for her efforts over the years. She referred to mental health, because physical ailments sometimes spill over into mental health issues.

We are all indebted to the hon. Member for Ashfield (Lee Anderson) for his personal story, because he described what it is like to live with extreme CF. We thank him for that story and for what he does for his wife—I know she appreciates it greatly, particularly with her diabetes. We also appreciate the other personal story about Amelia; I never realised that people so young could be affected.

The hon. Member for Stretford and Urmston (Andrew Western) referred to his constituent Penny Mitchell and her daughter Eva, to DLA and PIPs, to the extra water and food that people may need, and to the problems that some experience in securing employment. My friend the hon. Member for Linlithgow and East Falkirk (Martyn Day) emphasised how CF sufferers can pay £6,500 a year and referred to how CF patients have to prioritise aspects of their lives, to acceptable levels of benefits, and to energy costs.

I genuinely always love the contributions of the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), because they are full of detail and evidence-based knowledge and propose many good ideas. He referred to people choosing between putting food on the table or heating their home, to how the condition affects multiple body parts, to its unpredictability—people do not know what the next day will be like—and to welfare support and the DWP.

I am pleased that the Minister showed her heart in how she responded to our requests. I welcome what the Government are trying to do with the steps they are taking. The Minister has heard our stories both individually and collectively on the behalf of our constituents. We want the benefits to be reviewed, and I am pleased that the Minister is prepared to take that to the DWP. Adults with CF today need the system to change. While every person with CF would love to be able to work, the reality is that they cannot.

I thank the Minister for her response and thank everybody else for their contributions. I hope that on the behalf of those in the Gallery today representing people with CF, we can do better collectively. That is what this is about, and I am sure that the Minister will be as energetic as we are in making that happen.

Question put and agreed to.

Resolved,

That this House has considered the impact of cystic fibrosis on living costs.

Urgent and Emergency Care Recovery Plan

Jim Shannon Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

I commend my hon. Friend for her assiduous campaigning on behalf of her constituents in Southend, through which she played a key role in securing the extra £8 million of funding. She is right that that will make a material difference not only to flow and capacity within the hospital but through that to the overall standard of patient care.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his clear commitment to extra funding for the urgent and emergency care recovery plan. Will he outline whether he is prepared to make additional funding available to meet the needs on maternity wards, which midwives feel are teetering on the brink? In reality, that means it is an issue of life and death, due to staffing levels. Will the Secretary of State ensure that additional funding makes its way to each devolved nation under the Barnett consequentials, to be used before the scheduled new financial year ends?

[Steve Barclay]

As the hon. Gentleman will know, the additional funding that the Chancellor announced in the autumn statement will lead to an uplift in health funding for Northern Ireland through the Barnett consequentials. On the flexibility within that, the hon. Gentleman will know that I agreed flexibility when I was Chief Secretary; it will of course be for Treasury colleagues to look at the requirements for ongoing flexibility within Barnett consequentials.

Draft Mental Health Bill 2022

Jim Shannon Excerpts

Thursday 26th January 2023 Commons Chamber

[Dr Poulter]

The Committee was very lucky that we had the professional expertise of my hon. Friend, the hon. Member for Tooting (Dr Allin-Khan), a former president of the Royal College of Psychiatrists and some distinguished lawyers. I know that my hon. Friend has taken a great interest in this issue for many years, and he is right: this is the beginning of a process, not an end in itself. The Committee recognised that much needed to be done by a future Government to bring fusion between mental capacity law and mental health law, of which I know he was a great advocate throughout our work.

[Jim Shannon (Strangford) (DUP)]

I thank the Committee for its recommendations and the hon. Gentleman for his presentation of this report. Each and every one of us recognises the importance of these recommendations, which are for both patients and staff, and they should be commended to all the devolved Administrations—in particular the Northern Ireland Assembly, as health is devolved. Will that happen, and if not, could he make sure that it does?

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 24th January 2023 Commons Chamber

[Janet Daby (Lewisham East) (Lab)]

2. If he will bring forward a plan to increase (a) retention and (b) recruitment of NHS staff.

[Jim Shannon (Strangford) (DUP)]

6. What steps he is taking to ensure that gaps in the NHS workforce are filled.

[Karl MᶜCartney (Lincoln) (Con)]

21. What progress he has made on increasing the number of doctors and nurses in the NHS.

--- Later in debate ---

[Steve Barclay]

We see a considerable number of applications for medical undergraduate places, far in excess of the number of places available. We have boosted the number of places—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from the Opposition Front Bench, but when I was last in the Department and the Chancellor had my role, we increased the number of medical undergraduate places by 25%. Indeed, we have more doctors and nurses than we had last year, and 3.5% more full-time equivalent staff: we have over 42,000 more people working in the NHS than we had last year.

[Jim Shannon]

The British Heart Foundation has reported that by the end of August 2022 a record 346,000 people were waiting for heart care. Despite the best efforts of NHS staff, workforce shortages are affecting primary and secondary care services. Can the Secretary of State explain how the Government’s comprehensive NHS workforce plan will address specific gaps in the workforce, especially those in cardiology services?

[Steve Barclay]

The hon. Gentleman has raised an important issue. I think that, in particular, we should look at our approach to major conditions, and I will say more about our thinking in that regard at the start of topical questions. I also think that we need to look at the issue of heart conditions in the context of the wider debate about excess deaths; we know that there is a particular issue in the 50 to 64-year-old cohort. As well as providing those extra doctors and clinicians—and from next autumn we will also have the additional medical doctor degree apprenticeship route—we need to look at methods of upstream testing, particularly in respect of heart conditions.

--- Later in debate ---

[Neil O’Brien]

Absolutely; we are looking at that issue. We have already brought in a new minimum UDA value, and we would like to deliver more. We will look at measures to encourage people to work in areas with the greatest shortages.

[Jim Shannon (Strangford) (DUP)]

T8.   On World Cancer Day 2022, the then Secretary of State for Health and Social Care, the right hon. Member for Bromsgrove (Sajid Javid), announced a 10-year cancer plan to make us a world leader. Today, cancer services are buckling under immense pressure. Can the Minister confirm that the strategy will be fully resourced and will she commit to working with cancer charities to ensure that it is delivered?

[The Minister of State, Department of Health and Social Care (Helen Whately)]

Right now, we are seeing more people come forward for cancer diagnosis or to be given the all-clear. We are supporting services with an extra £8 billion for elective recovery. Cancer is an important part of our major conditions strategy, which the Secretary of State just announced, because we are determined to include patients’ cancer outcomes.

NHS Winter Pressures

Jim Shannon Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

As befits the leader of his own county council, my hon. Friend rightly recognises the importance of the integration of health and care. I have pointed to examples where that is already being done extremely effectively in an integrated way. As I recognised in my remarks, the medical director of NHS England has said that helping people to leave hospital with the right support when they are ready to do so is not just clinically the best option for those individuals, but one of the safest options for expanding capacity for everyone who needs care. It is the right thing to do clinically, but his point—one that we are extremely focused on—is about how we then ensure that wraparound service for patients who are released into residential care so that they can move into domiciliary care.

[Jim Shannon (Strangford) (DUP)]

I know that the Secretary of State appreciates that the winter pressures are only exacerbated by the looming strikes. I joined the picket line at Newtownards hospital back in early December. Just before Christmas, I had the opportunity to meet Pat Cullen, the leader of the nurses’ union at St Thomas’s Hospital, just across Westminster bridge, as the protest was ongoing, and we heard in the news that she referred to a glimmer of hope over today’s talks between the Government and nurses. Does the Secretary of State believe that there can be real engagement with not only nurses and midwives, but junior doctors, who are also threatening strikes? Does he agree that it is about not just a pay increase, but an increase in the numbers of staff to secure safety and accountability on shifts in hospitals tonight and every night from today on?

[Steve Barclay]

I agree that a combination of pay and wider conditions have an impact on recruitment and retention. That is why we have been keen to engage constructively with the trade unions; we had a good discussion earlier today. We recognise that there is a range of factors. To take the example of paramedics, the feedback from my discussions with a number of paramedics was that their frustration about handover times and the delays that they were experiencing was more important to them than pay. It is important to have discussions through the independent pay review bodies about pay, what is affordable and what is the right balance, but a range of non-pay factors are also extremely important to staff.

Eye Health

Jim Shannon Excerpts

Thursday 15th December 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered a blueprint for eye health in England and the devolved nations.

I thank the Backbench Business Committee for scheduling this debate. The hon. Member for Battersea (Marsha De Cordova) was going to be here, but she has a funeral to attend. As she is the chair of the all-party parliamentary group on eye health and visual impairment, her contribution would be significant. The funeral was at half-past twelve, so it is probably ending about now, and she said she would try to get here. Her contribution to this debate would be of significance to all of us here, particularly the Minister.

I also thank the Eyes Have It partnership, which includes the Royal College of Ophthalmologists, the Macular Society, the Royal National Institute of Blind People, the Association of Optometrists, Fight for Sight and Roche, for its support. The name of the group is my favourite of all the names. The work that the group does is incredible. What could be better for a Westminster Hall debate in the House of Commons than the Eyes Have It? When the ayes have it, that means we are on the right road. I am pleased to see the Minister in his place. My staff have been in touch with him, so he will have a fair idea of what we are trying to achieve.

I am also pleased to see the Labour spokesperson, the hon. Member for Tooting (Dr Allin-Khan), who brings much knowledge from her own personal job to the debate. I look forward to her contribution. I also welcome the hon. Member for Motherwell and Wishaw (Marion Fellows) from the Scots Nats. We speak in all these debates, and it is hard to find a margin of difference between the two of us when it comes to our proposals—indeed, between the three of us.

I thank the Minister for his presence. I know the issues raised will be heard and acted on, which is what we want in these debates—a responsive Minster with a good ear to listen and to grasp the issues, which I know he does, and build on what we say. I am ever mindful that health is a devolved matter, so my contribution to a blueprint for eye health in England and the devolved nations will be from a Northern Ireland perspective. I know the Minister will respond specifically to what we have here on the mainland. The spokesperson for the Scots Nats will add her knowledge from Scotland. I like to hear the contributions from our Scottish colleagues because they have a health system and an eye care system that might be the envy of many of us.

Today’s debate seeks to build on the previous debate, held in January 2022, on eye health and macular disease. It was a Tuesday morning debate, so probably more amenable to those who wanted to attend. Sometimes on a Thursday afternoon, when there are difficulties with trains and suchlike, the people who could be here are not. Since the debate in January 2022, some good things have happened. NHS England has appointed its first national clinical director for eye care. At the same time, England has established integrated care systems, which empower local areas to increasingly shape their healthcare provision. What has been done therefore has a local, community impact.

At present, every nation of the United Kingdom except England has some form of eye care plan, whether it is self-contained or part of a wider strategy. I am sure that the Minister will give us his thoughts on that. However, the content and focus of the plans vary significantly, as I am sure we will hear from the shadow Minister, the hon. Member for Tooting. Additionally, policy progress has often been fragmented, and what planning guidance there is for services in England does not contain longer-term ambitions or measures for improvement. I hope that the debate will perhaps outline another, stronger direction. If we can do that, the debate will have highlighted what we want it to highlight.

A plan for England would empower the NCD by providing a framework that enables effective oversight of ICSs without undermining local autonomy. It would create a shared long-term vision that encompasses primary, secondary and community care, and that future-proofs services. If we can achieve that, we will have done well. At the same time, it could provide a basis for increased alignment between nations, and I hope that the Minister will give us some pointers on how to address this issue better together. The fact that I always make this point does not weaken it: we can learn how to do better from all the regions. By doing better for one—England, for example—we can improve the situation for Northern Ireland, Scotland and Wales. If we can do that, that would be good news.

Over 2 million people in the United Kingdom are living with a condition that can cause sight loss, such as glaucoma, cataracts, macular disease or diabetic retinopathy. Some 340,000 people in the United Kingdom are registered as blind or partially sighted, and 50% of UK sight loss is thought to be preventable. I say this honestly and with deep respect to everyone here, including the Minister: if we can prevent sight loss by doing early checks in opticians and GPs’ surgeries, that would be good. If we cannot, we will leave people with sight loss for the rest of their lives.

I often think that, of all our senses, eyesight would be the hardest to lose. If I did not have the ability to hear, at least I would have vision, which colours everyday life as it goes by; losing eyesight becomes more and more difficult to handle. If 50% of UK sight loss is thought to be preventable, what is being done to prevent it? Members will know that sight loss affects people in many ways, but it is clear to everyone here that the impact of sight loss is profound for individuals, as well as their friends and families.

The Royal National Institute of Blind People once asked me to do a walk around Holywood with guide dogs, which I was more than glad to do. That gave me a better understanding of what it means to have sight loss. I put a black mask over my eyes; I could see no light whatsoever. I had a guide dog that I had never met, and the guide dog did not know me. That guide dog stayed at my right knee, and guided me up the Holywood street, which was full of shoppers, and I got a perspective on having sight loss. The dog took me where it wanted me. It stopped on the footpath before crossing the road. That left an indelible impression of what it means to be blind and what we must do to help. I thank Guide Dogs for all that it does. We all respond to the adverts on TV, and many of us in this debate, and outside of this House, probably contribute to the charity, so that someone else can have a dog as their companion and guide.

Choices made about the provision of eye care can change the trajectory of a person’s life. The experience of sight loss can often be similar to bereavement, inspiring feelings of denial, anger and fear. The impact of sight loss is also felt beyond individuals and their families. In England, the data is most readily available; it is always good to have the data, because it gives us the possibility of establishing a strategy and a way forward. In England, ophthalmology is the single biggest out-patient speciality, with over 7.5 million attendances at ophthalmology out-patient services in 2021.

Recent calculations show that eye conditions cost the UK economy some £25.2 billion per year, a figure expected to rise to £33.5 billion per year by 2050, and 84% of the economic costs of sight loss lie outside the health and social care system. Again, Minister, how best can we draw sight loss within the health and social care system, to ensure that the delivery of treatment for people with sight loss is achieved in a positive fashion?

A range of pressures contribute to what is now a capacity crisis in eye care. Over recent years, demand for eye care services has increased, driven by an ageing population, with people rightly concerned about losing their sight; if we can prevent that, then we will have achieved much. However, such concern can lead to unnecessary referrals, increasing pressure on services. A recent Moorfields study found that 52% of patients referred for specialist assessment did not need specialist treatment.

There are also significant workforce pressures. In 2018, the Royal College of Ophthalmologists identified a shortfall of 230 consultants and 204 staff and associate specialist ophthalmologists. That situation is predicted to get worse, so again I ask the Minister: what can be done to retain the number of staff, and indeed increase their number?

These structural factors have been combined with severe disruption to services due to the pandemic, making it harder for services to implement innovations that could mitigate growing demand. As a result, there are significant ophthalmology backlogs across the United Kingdom and indeed in Northern Ireland as well. Some patients are now waiting six months or longer to access eye care services. With great respect, I believe that situation really needs to improve. Eyesight can be saved if waiting times for appointments are shortened. Back home, I am aware of some people whose appointments were delayed and unfortunately in that short time they lost their sight.

In England, 641,000 people were waiting for specialist eye treatment as of October 2022, accounting for some 9.2% of the NHS waiting list and 1.1% of the entire population of England. In Scotland, ophthalmology accounts for 12.2% of waiting lists; in Wales, the figure is 11.9%; and in Northern Ireland it is 9.9%.

In my constituency of Strangford, the local health and social care trust is the South Eastern Health and Social Care Trust. As of 30 June 2022, 49% of patients waiting for ophthalmology out-patient treatment in the South Eastern HSCT have been waiting longer than 18 weeks. We need to shorten that and I have been in touch with the Minister back home—Robin Swann, who by the way is a very responsive Minister—to see how we can cut down that waiting period of 18 weeks.

According to figures for Northern Ireland from the Office for National Statistics, almost 18,000 patients were waiting for ophthalmology services. Of those, over 9,000 ophthalmology patients—about 55%—were waiting more than 52 weeks for a first consultant-led out-patient appointment. That situation is the reason why people have lost their sight and it really has to be improved. In total, 82% were waiting over nine weeks. Again, it is very clear that something has to be done. It is not the Minister’s responsibility—I know that—but I am just putting the facts on the record in Hansard because I think that there are many issues for us to address, including back home.

Evidence suggests that the mega-clinics are making some progress on cataract surgery waiting times. My own mother is 91 and she has had one of her cataracts done. She was treated on Tuesday and she made the appointment for the second cataract. This treatment will definitely improve my mum’s vision greatly, as well as her participation in life. She may be 91, but she is still a formidable lady. She has a deep interest in all that happens in the world, including in the political things that happen here; no doubt, she will want to watch this debate as well to find out what has been said.

The figures for cataract surgery waiting times are deeply troubling, and the impact on patients’ lives, including their physical, psychological and emotional wellbeing, continues to be significant. It is my belief that the next Assembly or Executive should prioritise addressing waiting times for treatment in Northern Ireland by investing in and expanding the use of timely, targeted interventions, such as mega-clinics and community-based care and support. A greater use should be made of accessible patient communication to address waiting times and treatment delays.

Treatment delays can have a significant impact. Up to 22 people per month experience severe or permanent sight loss due to delays to follow-up care. A national plan for eye care is needed to address the capacity crisis and ensure everybody can access the care they need at the right time and in the right place. Ultimately, that would prevent avoidable sight loss, which would be a massive step forward.

Scotland, Wales and Northern Ireland have some form of eye care plan, but they vary in scope, focus and content. The Eyes Have It identified four key areas that the national plan should address. The workforce should be expanded to ensure the NHS has the skills it needs now and in the future. Ophthalmology training should be expanded, and optometrists and multi-disciplinary eye care teams should be enabled to work at the top of their licences. In other words, there should be a focus on them.

New technologies, such as digital remote monitoring and remote triage, should be used to ensure the care delivered is efficient, prioritises those with the greatest needs and fits around patients’ lives. If we can do that, we will have achieved much.

There should be research into the future of treatment to better understand sight loss, and that should be translated into innovative treatments that enable more people to keep their sight. That has to be a central goal of what we are trying to achieve. The uptake of innovative treatments will improve patient outcomes, prevent the deterioration of sight and reduce the burden of care on the families impacted. We need to address them, too.

The national plan can support systems to ensure that patients access the right care at the right time. That would reduce unnecessary referrals and, ultimately, the pressure on NHS eye care services. A national plan would also help to improve the integration of all levels of community and hospital eye services. It is important that community and hospital eye services are married as one so they can do better. That would enable new integrated care systems to deliver care that is joined up, works for patients and local communities, and supports national oversight. In other words, the strategy starts here and works its way down to communities, councils and all the other systems.

It is of course right that the nations of the United Kingdom of Great Britain and Northern Ireland can develop healthcare services that meet the needs of their own populations. I understand that, but a well-designed plan for one nation can provide a valuable blueprint for others, supporting all nations to improve their eye care services and prevent more avoidable sight loss.

I am my party’s health spokesperson, which is why I am involved in all health debates and why I secured this debate, along with the hon. Member for Battersea. The cancer strategy in England provides a helpful guide for the structure of a well-built, potentially successful national plan. NHS England’s national cancer transformation board publishes an implementation plan for the strategy, and there is a commitment to a £200 million cancer transformation fund.

There are yearly progress updates from NHS England. Alongside its principles, the strategy for cancer details the current landscape in cancer care and sets out ambitions and performance metrics, rather than measuring progress. At the end, it sets out practical recommendations for transformation: improving the experiences of care, treatment and support, improving the efficiency of delivery, and driving implementation and cost savings. Costs are a part of no matter what we do nowadays, and we should make cost savings as long as there is no detriment to the service. Those will be key components of a national eye care plan that tackles the big issues while proposing specific metrics and making recommendations for policymakers.

As highlighted by Professor Kathryn Saunders, the division head of optometry in Ulster University back home, a blueprint for each nation would need to address eye health inequalities, and not just those of a geographical nature. We must ensure that there is more equitable access to eye care among the different communities and populations that are at a significantly increased risk of having a sight problem but may not be accessing NHS sight tests, such as people who are homeless, people with dementia—I make a special plea for them—and children and adults with learning disabilities.

The charity SeeAbility has highlighted the wonderful work of Professor Saunders and the issue of eye care inequality. Some people in the Gallery today are directly involved, and I am pleased to see them here. I am also very pleased that they passed information through to us. Professor Saunders has said:

“I’m sorry to say that not enough action on these inequalities is happening. I’m even sorrier to say that even a service currently offered in special schools appears under threat.”

We need to marry things up better. She continued:

“NHS England will not say what happens after 31 March 2023 to the NHS Special Schools Eye Care Service. It started last year and has reached 83 special schools so far supporting over 9000 children.”

I commend the pilot scheme promoted by the Government and the NHS. It has done much—it is a success story—but I seek assurance that the special schools eye care service will continue beyond March 2023. That evidence-based, inclusive service was celebrated globally last year on World Sight Day, and it was a first for the UK, with Northern Ireland, Wales and Scotland watching closely. It was established by the NHS on the premise that children with learning disabilities are 28 times more likely to have a sight problem but struggle to access sight tests or glasses.

The evidence is compelling. Half of children in special schools have a sight problem, yet only four in 10 have ever had a sight test. What can we do to improve that? I would be pleased if the Minister gave us some indication of what could be done, ever mindful that two Departments probably need to be approached to ensure that it takes place. I am pleased that research from Ulster University has provided evidence to support the benefits of in-school eye care for this vulnerable group. We are moving towards that strategy for Northern Ireland, which is positive, demonstrating that that model of eye care has educational benefits as well as positive impacts on vision.

If the service is to be scaled back or abandoned, what will happen to the 9,000 children in a few months’ time? I do not think that we can ignore the good work that has been achieved. Surely the intention is not for them to return to overstretched hospital clinics. We must do better. If there was ever an example of the need for joined-up strategic thinking on eye care, surely this is it. I ask the Minister the question that Professor Saunders asked me to pose: will he take action to ensure that NHS England does not close the service without proper consultation? There is real good here, and it is important that we have the opportunity to see it continue.

This is a slightly different point, but it is related to eye care in England and the devolved nations. The Older Drivers Task Force sent me some information and was keen to feed into the process, so it is important that we record that. Only the UK uses the ability to read a vehicle number plate at a set distance—20 metres—to assess someone’s visual fitness to drive at their first licence application, with no further requirement for visual assessments. The UK’s reliance on the number plate test has been widely criticised as not fit for purpose. Not only is it a crude measure of visual acuity, but, according to the Driver and Vehicle Licensing Agency in 2021, many motorists are unaware of that requirement for driving.

There have been recent calls for vision checks, such as evidence of a recent sight test, to be introduced at licence application and renewal every 10 years. Those calls are in accordance with the Department for Transport’s “Road Safety Statement 2019”, which stated that consideration was being given to having a mandatory sight test at age 70 and at three-year intervals thereafter, to coincide with licence renewal. The covid pandemic has slowed things up, and we have lost two or three years of progress in the NHS and many spheres of life, but I am keen to hear the Minister’s thoughts on this issue. There is evidence of strong support from older drivers—those aged 60 and over—for compulsory eyesight testing when renewing a licence. The over-60s are entitled to free sight tests, so such a requirement would be at no cost to those drivers. If there is no cost, it seems to be a win-win, so let us do that.

The Older Drivers Task Force recommended the introduction of mandatory eyesight testing, with an optometrist or an ophthalmic or medical practitioner providing an “MOT” of a driver’s eyesight at licence renewal at the age of 70, and at subsequent renewals. Should that be implemented, the NHS contract for free eyesight tests would need to be amended so that drivers aged 70 and above could have a more detailed “MOT” sight test. That is the request of the Older Drivers Task Force, and I believe it would benefit those in that age group who drive and everyone on the road.

The covid pandemic has had a very negative effect on the visual health of the nation. In September 2020, the Eyecare Trust announced that an estimated 5 million routine eye tests had been missed. With subsequent lockdowns and restrictions, the situation has since worsened, which raises serious concerns for road safety, as the UK licensing system relies on drivers being responsible for ensuring that they meet the visual standards for driving. The pandemic has led to long waiting times for patients referred for assessment and treatment of DVLA-notifiable sight conditions. While they wait, they may continue to drive even though their condition may be deteriorating, jeopardising both their safety and that of other road users, so there is a practical reason for this request.

Delays to cataract surgery—my mum, who has been on the waiting list for three years, had her first cataract surgery some three months ago, with the second to come shortly—have been identified as a particular concern. It is difficult to quantify the crash risk of visually impaired drivers, as data is not routinely collected. However, according to the College of Optometrists, a recent analysis of contributing factors recorded in STATS19 showed an association between visual impairment and injury collisions for drivers aged 60 and over. An earlier study by the Road Safety Authority estimated that some 2,000 drivers in the UK were involved in accidents in 2013 due to poor vision, causing nearly 3,000 casualties.

The recommendations made by the Older Drivers Task Force are quite simple, but I believe that they are very practical and helpful. It calls for a change in the way that visual standards for fitness to drive are assessed and monitored for all drivers, but particularly for those aged 60 and over. It recommends that the number plate test should be replaced with a standardised measure of visual acuity plus an assessment of visual fields, contrast sensitivity and twilight vision. In other words, we should test both night and day driving; I think that is important for licence renewals. The Older Drivers Task Force also repeats its recommendation to introduce mandatory eyesight testing and to provide an “MOT” of driver eyesight at licence renewal at the age of 70, and at subsequent renewals.

I will conclude by giving a couple of examples of the importance of people visiting their optician regularly. I know of two people in my constituency who have been affected by this issue. One lady was having headaches and went to see her optician, who checked her and found a growth, which turned out to be a tumour. He sent her to the Ulster Hospital, which is just up the road from Newtownards in my constituency. Ultimately, the lady was hospitalised and had an operation. Opticians, and regular attendance, can save people’s lives.

A good friend of mine had not been feeling well for some time. He came in on a Monday to see me in the office before I came over here for work. He said, “I haven’t been well.” I looked at him and said, “You look very pale and have lost a bit of weight.” He replied, “Jim, I’ve had sore heads for almost three weeks.” He was going to see his optician that day. As a result of the eye test, the optician diagnosed a tumour or growth. My friend was told to go to the Ulster Hospital immediately and, within two days, he had an operation to remove a tumour the size of a tennis ball. It is hard to comprehend such things. I tell those two stories because they are examples of how regular check-ups with opticians save people’s lives.

In conclusion—I have said that already, but I really will conclude with this—eye care services across the whole United Kingdom of Great Britain and Northern Ireland are facing significant pressures, with implications for individuals, the NHS and the wider economy. Developing a national plan for eye care will help tackle the capacity crisis in eye care in England and provide a blueprint to share good practice across the United Kingdom, including Scotland, Wales and Northern Ireland.

I thank you, Mr Sharma, and I thank the Minister for his time. I also thank the two shadow Ministers, who will speak shortly. I have not read their speeches, but I suspect that we will all be on the same page, asking for the same thing. We look to the Minister to respond in a positive fashion.

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[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important debate. He has been a strong advocate for eye health for a long time. He speaks from huge knowledge and personal experience, and I listened to his speech with great interest. Given that health is a devolved matter, a lot of my response will focus on England, as he suggested. I understand that the devolved nations are facing similar challenges. We are always interested in sharing ideas and working with our counterparts, in answer to the question asked by the hon. Member for Motherwell and Wishaw (Marion Fellows).

There are 2 million people living with sight loss, and that is predicted to double to 4 million by 2050 as a result of an ageing society. Sight loss is often preventable, and that is why prevention and early detection, along with access to diagnosis and timely treatment, are key. One of the best ways to protect our sight is to have regular sight tests. The hon. Member for Strangford rightly underlined why that is so important with his powerful story about the tennis ball-sized tumour that his constituent had taken out.

When combined with early treatment, sight tests can prevent people from losing their sight. That is why we continue to fund free NHS sight tests for many, including those on income-related benefits, those aged 60 and over, and those at risk of glaucoma and diabetic retinopathy —two of the main causes of preventable sight loss. More than 12 million NHS sight tests were provided to eligible groups in 2021-22. We also provide help with the cost of glasses and contact lenses through NHS optical vouchers. Eligible groups include children and those on income-related benefits. The NHS invests over £500 million annually to provide sight tests and optical vouchers.

The risk factors for sight loss include ageing, medical conditions such as diabetes, and lifestyle factors such as smoking and obesity. We are taking action to reduce obesity and smoking. Smoking rates in England are already the lowest in history, and we remain committed to going further to be smoke free by 2030. We are working to drive down the number of people who take up smoking, and we are supporting those who wish to quit. We are also working with the food industry to ensure that it is easier for people to make healthy choices, and we are supporting adults and children living with obesity to achieve and maintain a healthier weight.

Turning to the medical conditions that lead to sight loss, diabetic retinopathy—a common complication of diabetes—is a potentially sight-threatening condition. The diabetic retinopathy screening programme now provides screening to over 80% of those living with diabetes annually. Between 2010 and 2019-20, the number of adults aged between 16 and 64 who are registered annually as visually impaired due to diabetic retinopathy has fallen by 20%, meaning that it is no longer the main cause of sight loss in adults of working age. The screening programme has played a major role in that.

[Jim Shannon]

I thank the Minister for his helpful response. The target of providing retinopathy screening to 80% of those living with diabetes has been achieved. Are there any plans to try to reach the other 20%? I am diabetic. I had my retinopathy test about four weeks ago; I get it every year. I know the encouragement and confidence that testing gives people once they know they are okay. Are there any ideas for how we can get to the other 20%?

[Neil O'Brien]

Absolutely. As the hon. Gentleman says, we are keen to constantly drive that rate up, and we can talk more offline about the different things that we can potentially do to drive it up even further. The healthy child programme recommends eye examinations at birth, six weeks and age two, and school vision screening is also recommended for reception-age children.

The hon. Member for Strangford raised a question about a special school, which I will address specifically. The NHS long-term plan made a commitment to ensure that children and young people with a learning disability, autism or both who are in special residential schools have access to sight tests. NHS England’s proof of concept programme has been testing an NHS sight-testing model in both day and residential schools, and it is currently evaluating its proof of concept as part of programme development, which we expect to conclude towards the start of 2023. The evaluation will then inform decisions about the scope, funding and delivery of any future sight-testing model. I reassure the hon. Gentleman that, at present, absolutely no decisions have been made; we are waiting for the evidence that that programme is generating.

I turn to secondary care. Once an issue with eye health is detected, it is vital that individuals have access to timely diagnosis and any necessary treatment. The NHS continued to prioritise those with urgent eye care needs throughout covid-19. However, we acknowledge the impact that the pandemic has had on our ophthalmology services, as it has had on other care pathways. Our fantastic NHS eye care teams are working hard to increase capacity and provide care as quickly as possible. We have set ambitious targets to recover services through the elective recovery plan, supported by more than £8 billion over the next two years, in addition to the £2 billion elective recovery fund and the £700 million targeted investment fund announced last year.

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[Neil O'Brien]

I am grateful for the hon. Lady’s intervention, and I will be happy to meet her. It sounds like there is an important connection between where she has just been and this debate. I am extremely happy to meet her to talk about that.

I will continue setting out our strategy. I have already talked about screening in primary care, and I was setting out the sums of money that we are investing—the £8 billion plus the £2 billion—in elective recovery following the pandemic. NHS England has been supporting NHS trusts to increase capacity in surgical hubs, and the independent sector has also been used to increase the delivery of cataract surgery, in particular. In 2021-22, nearly half a million cataract procedures were provided on the NHS, which is actually more than before the pandemic, so that is recovering.

Beyond recovering from the pandemic and looking to the future, hospital eye care services are facing increasing demand. As a number of hon. Members have pointed out, ophthalmology is already the busiest out-patient speciality, and the predictions are that the demand for services will increase by 30% to 40% over the next 20 years as the result of an ageing society.

To help address these challenges, NHS England’s transformation programme is looking at how technology could allow more patients to be managed in the community and supported virtually through image sharing with specialists in NHS trusts. Current pilots for cataracts and glaucoma are allowing primary care practices to care for these patients and refer only those who need to be seen by specialists. The learning from these pilots will feed into any possible future service model. That could allow us to use the primary care workforce to alleviate some of the secondary care pressures.

I am delighted that the NHSE has appointed the first national clinical director for eye care, Louisa Wickham, who will oversee this work programme. I am aware that the APPG on eye health and visual impairment has called for there to be one Minister responsible for primary and secondary care services. I can confirm that my portfolio covers both those areas, so I will be taking an active interest in the development of that transformation programme and strategy.

A number of hon. Members have raised questions about the workforce, and we acknowledge that there are challenges across the system, including in ophthalmology. NHS England is developing a long-term workforce plan that will consider the number of staff and roles required and will set out the actions and reforms needed to improve workforce supply and retention. We have already invested in growing the ophthalmology workforce with more training places in 2022, but there is more to do. We are also improving training for existing staff so that they can work at the top of their licence.

Research is an area that the hon. Member for Strangford is interested in, and I was extremely sorry to hear from the hon. Member for Tooting (Dr Allin-Khan) about her keratoconus. That is one area where, fortunately, research and new treatments are coming online, so research is hugely important. While we have effective treatments, particularly for macular disease, we absolutely cannot rest on our laurels because medicine continues to evolve. We recognise that research and innovation are crucial to driving improvements in clinical care and improved outcomes for people living with sight-threatening conditions. The £5 billion investment in health-related research and development announced in the 2021 spending review reflects the Government’s commitment to supporting research into the most pressing challenges of our time, including sight loss.

Over the past five financial years, the National Institute for Health and Care Research has invested more than £100 million in funding and support for eye conditions research, and many of the studies focus specifically on sight loss. The NIHR Moorfields Biomedical Research Centre has recently been awarded £20 million from the NIHR for another five years of vision research, allowing it to continue its mission of preserving sight and driving equity through innovation. Through the NIHR, England, Scotland, Wales and Northern Ireland work together on a range of research topics, and the devolved Administrations co-fund several research programmes.

To assess how well interventions are achieving their intended aims, it is important that we track their impact, which hon. Members have mentioned. The public health outcomes framework’s preventable sight loss indicator tracks the rate of sight loss per 100,000 population for three of the most common causes of preventable sight loss: age-related macular degeneration, glaucoma and diabetic retinopathy.

We are making progress. The indicator shows the impact that the new treatments have had on the rate of sight loss due to age-related macular degeneration. Despite an ageing population, the rate of sight loss in 2019-20 was 105.4 cases per 100,000, down from 114 per 100,000 in 2015-16, so there has been an improvement on macular degeneration. The open availability of this data provides a valuable resource for integrated care boards to draw on in identifying what is needed in their areas and for local democratic accountability for any variation in performance against public health outcomes.

[Jim Shannon]

The answers are very helpful. One thing that all three Members referred to was the waiting list, and those who lose their eyesight just because they have been on a waiting list for diagnosis, examination and investigation. I know the pandemic created lots of problems in relation to the waiting list. Does the Department intend to have a strategy that will reduce the number of people on waiting lists to ensure that those waiting for a diagnosis retain their eyesight?

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[Jim Shannon]

I thank the hon. Members who spoke in the debate. The hon. Member for Motherwell and Wishaw (Marion Fellows) brought a breadth of knowledge to it, and we thank her for that. As I said earlier, I always like to hear what the other devolved nations are doing, and she outlined very well what Scotland is doing. With the See Hear provision, Scotland is expanding its eyesight services, with regular checks and free examinations every two years. She referred to her personal circumstances—it is always good to bring a personal story—of having had cataracts in both eyes. She does not miss too much, so I think we can be pretty sure that her eyesight has greatly improved. She also referred to improving people’s quality of life with eyesight care, and she referred to smoking, drinking and diet and the need to address those three things.

Every one of the things that the hon. Member for Motherwell and Wishaw referred to was also referred to by the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan). She referred to the need for a plan, and to people waiting for six years at the Western Health and Social Care Trust in Northern Ireland. My goodness—that is unbelievable. My mum waited three years for a cataracts operation. She was not desperate for it, so she did not mind waiting for three years, but in the last six months it was coming to the stage where she was unable to drive, which was a problem.

The hon. Member for Tooting said that patients deserve better, and she referred to the staff shortages—I think the Minister heard about that very clearly—and the integration of services. She gave Wales as an example. We hear much about Wales in a negative fashion; today, she introduced a positive. It is evidentially-based as well, which means that it is absolutely on the button. Again, we thank her for that. She also referred to the new IT system in Wales, and the fact that patients cannot wait any longer.

I gave an apology for the circumstances of my friend, the hon. Member for Battersea (Marsha De Cordova), which we understand, and I spoke to you personally beforehand, Mr Sharma, so you know the reason for it. We really missed her contribution to the debate because she brings a wealth and a breadth of knowledge. I commend her for being the chair of the APPG on eye health and visual impairment. She was able to make an intervention that was as good as a speech, so well done to her.

I thank the Minister, as always. He comes with a positive attitude, which we are all very pleased to see. He is committed to sharing ideas with the regions. I want to see that. The hon. Members for Motherwell and Wishaw, for Tooting and for Battersea want to see that as well. The Minister referred to the 12 million eye tests in 2021-22. That is an achievement. We cannot deny the positive things that he referred to. He also referred to ageing, diabetes, childcare and the healthy child programme, learning disabilities and, in answer to my question, the steps that have been taken to address eye tests for children who are disabled and educationally challenged. I think that is good. Those are some of the things that the hon. Member for Battersea and all of us present are very keen to see.

The Minister was also very positive in relation to primary and secondary care combined under his ministership. He confirmed that one of things that we asked for has happened, which is good news. He also referred to the workforce, which we have some concerns about; I think the shadow Minister referred to them, and I know that I did. It is important that we have strategy to fill those vacancies.

Lastly, research has moved on fantastically. I went to an event in Portcullis House yesterday on some of the medical research that has been done. The advances in medicine are incredible. We can never fail to be moved or encouraged by what we see. The investment and research that the Minister referred to is good. On the waiting lists issue for reversible sight loss and elective recovery, the moneys are there to make that happen.

In introducing the debate, I referred to the lovely terminology that we use for all the different groups that come together: The Eyes Have It. Well, today, the ayes have it. The Minister has given us a very positive response, and we thank him for it.

Question put and agreed to.

Resolved,

That this House has considered a blueprint for eye health in England and the devolved nations.