Irish Diaspora in Britain

Jim Shannon Excerpts

Thursday 17th March 2022 Commons Chamber

[Conor McGinn (St Helens North) (Lab)]

Tá áthas agus bród orm páirt a ghlacadh sa díospóireacht seo agus labhairt ar son pháirtí an Lucht Oibre—I am delighted to be winding up the debate on behalf of the Labour party. Normally at this time on St Patrick’s Day I would be up to my oxters in Guinness and beaten dockets, either at Cheltenham or in the Sheephaven Bay pub in Camden. None the less, it is a pleasure to be here in surroundings and company that might be seen as more eminent, but are definitely less craic.

Being Irish is something of which I am very proud and which is very important to me, and being Irish in Britain—this great country that has given me so many opportunities—adds another special and distinct layer to my identity and, I know, the identities of millions of other people. My hon. Friend the Member for Rochdale (Tony Lloyd) understands that deeply, and I thank him not just for securing this debate, but for his decades of work in supporting the Irish in Britain and furthering the cause of good relations between Britain and Ireland. I know that all the Members who have spoken today are similarly committed. Some of the members of the all-party parliamentary group on Ireland and the Irish in Britain—for instance, my hon. Friend the Member for Cardiff West (Kevin Brennan) and the hon. Member for Bolton North East (Mark Logan)—cannot be here today, but they also undertake such work.

I know that many of us will be thinking of our friend Jack Dromey today. He would be so proud that we are having this debate, and of course he would be actively participating in it by making what he would describe as “just seven brief points”. We also think today of many colleagues who took up the cause of the Irish in Britain at a time when it was certainly not politically advantageous, and on occasion was even personally dangerous. You and I, Madam Deputy Speaker, talk frequently of your great friend Sir Patrick Duffy, who was one such champion. I know that the whole House will want to send him our best wishes. He is the oldest living former Member of Parliament. At the age of 101, he is still active, and has written the story of his incredible life, from Mayo to NATO, in his autobiography.

Let me now turn to the subject of our community, its place here in Britain, and its role in strengthening relations between the Britain and Ireland. The first thing to say is, like British citizens in Ireland, the Irish in Britain have a special status. That has benefited us greatly, and although paths diverged when the UK left the EU, the maintenance of that unique arrangement is very welcome.

About half a million Irish-born people live in Britain. I use the term “Irish-born” specifically because, of course, many more people here have Irish parents and even more have Irish grandparents, as was mentioned by the hon. Members for Bury North (James Daly), for West Dunbartonshire (Martin Docherty-Hughes) and for Coatbridge, Chryston and Bellshill (Steven Bonnar). As we heard from my hon. Friend the Member for Dagenham and Rainham (Jon Cruddas) and the hon. Member for Angus (Dave Doogan), the contribution made to British life by Irish people is enormous—economically, culturally, socially, in sport and, dare I even say it, politically; and also, of course, in public service.

Perhaps the last two years have shown more than ever the role of Irish people in every part of society here as we have come through the pandemic together. I am thinking of the thousands of nurses, doctors, clinicians, porters and cleaners in our national health service. I also think of the academics who researched and created the vaccine, who included an Irishwoman, Professor Tess Lambe, and of the first person to receive it—Margaret Keenan, another Irishwoman. Then there were those in the community groups and centres, from London to Liverpool, who put their shoulder to the wheel to help those who needed that help, from providing companionship for older people to providing food parcels for families. The work of organisations such as our many Gaelic Athletic Association clubs and their volunteers was incredible, and the national charity Irish in Britain was to the fore in creating the Vaccine Le Chéile, or “Vaccine Together”, campaign to encourage take-up. I know that that community campaign was strongly supported and assisted by my hon. Friend the Member for Bristol South (Karin Smyth).

This week alone showed me the strength, diversity and extent of the Irish community. Last week the British Irish Chamber of Commerce held one of its council meetings here in Parliament. Over the weekend the Taoiseach paid a visit, and was hosted in the City of London by the Lord Mayor, Alderman Vincent Keaveney, the first Irish citizen to have that role. On Sunday, the Liverpool Irish Centre hosted a lunch for Irish pensioners—and there are quite a few of them in Ireland’s 33rd county of Merseyside, including some in my own constituency and that of my hon. Friend the Member for Liverpool, Riverside (Kim Johnson). On Monday morning I went with my right hon. Friend the Leader of the Opposition to the London Irish Centre, which provides welfare support and advice for those in our community who need its help and assistance, while the arts-related and cultural side of its work showcases the best of our music, language, drama and literature.

[Jim Shannon (Strangford) (DUP)]

I apologise, Madam Deputy Speaker, that I could not be here for this debate because I had a debate in Westminster Hall that I had sponsored. I want to add my support for the hon. Member for Rochdale (Tony Lloyd) and the others who have spoken in the debate and for what they are trying to achieve. I am pleased to be supporting it through this intervention. Could I also ask a question? Would the hon. Member for St Helens North (Conor McGinn) support the request that I and others have made for the Republic of Ireland to join the Commonwealth?

[Conor McGinn]

I have a great deal of sympathy with what the hon. Gentleman says. He tempts me to stray into policy areas that are not mine, so I will pass on his comments to the shadow Foreign Secretary and ask for a response. But it was a nice try!

The hon. Gentleman will be delighted to know that, just on Tuesday, Their Royal Highnesses the Prince of Wales and the Duchess of Cornwall, alongside my hon. Friend the Member for Hammersmith (Andy Slaughter), visited the Irish cultural centre in Hammersmith. I think they were even persuaded to take up the bodhran and play their part in an impromptu music session. Yesterday here in Parliament I was proud to co-host an event for parliamentarians with the Irish ambassador and CHAMP, the peace and reconciliation organisation. And of course today, on St Patrick’s day itself, we are having this debate.

The position and prominence of our community has arguably never been stronger, but we have come through tough times and the impact of the troubles was felt acutely by the Irish community here. As my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott) and the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) said, many were shunned and subjected to anti-Irish racism, personally and through the press. We know about the prominent miscarriages of justice, but we also remember the treatment of the wider community as a suspect community and the impact of legislation such as the Prevention of Terrorism (Temporary Provisions) Act 1974.

I am sure the hon. Member for Belfast South (Claire Hanna) would agree that, outside Northern Ireland, no group of people have benefited more from, or been more supportive of, the peace process and good relations between the UK and Ireland than the Irish in Britain. We still face challenges, however. We know that many of our fellow Irish in Britain still suffer health inequalities, for example, with higher rates of cancers and increasing mental health conditions. I know that the Minister has a keen interest in this. The Government have a duty to address that in the same way they would for other communities.

Physical Activity and Health Outcomes

Jim Shannon Excerpts

Tuesday 15th March 2022 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

I am very grateful to Mr Speaker for granting me this debate.

For many years, I have championed the issue of supporting as many people as possible to achieve a healthy weight, an important issue in health prevention which matters today more than it ever has. It is also so important to remember that even if achieving a healthy weight is a real challenge and our body mass index is not yet as we would want it, the more physical activity we can do the better. Tonight, I want to issue a call to arms on the related issue of being sufficiently physically active to help us all lead healthy lives.

I start by paying tribute to Peter Walker, a parliamentary correspondent who works in this building, for his outstanding book “The Miracle Pill”. It was published last year and it should be required reading for everyone working in health and social care, everyone who cares about the NHS, and leaders across central Government and local government, as well as in business.

Let us look at the health benefits of regular physical activity. If we could achieve those outcomes with a pill, it would indeed be the miracle pill. Regular physical activity reduces the risk of breast cancer by 20%, the risk of dementia, depression and colon cancer by 30%, the risk of cardiovascular disease by 35% and the risk of type 2 diabetes by up to 40%. Hip fractures, which are so often catastrophic in their consequences for the frail and elderly, are reduced by up to a whopping 68% by regular physical activity. Those are all NHS figures.

I am grateful for the good work of the Faculty of Sport and Exercise Medicine UK on its Moving Medicine programme, which is designed to promote a person-centred approach to physical activity in health, and its Active Hospitals programme, which focuses on delivering physical activity through secondary care. Both programmes have won awards from the Royal College of Physicians and have now been adopted in Australasia and the United States. Active Conversations is also an excellent training course to increase physical activity for all health and social care professionals, social prescribers and the fitness industry.

It is good to see that the Office for Health Improvement and Disparities, a very important new part of the Department of Health and Social Care, has a number of important online resources on physical activity and health, including on the treatment of long-term conditions. As a leading academic in the area, Ralph Paffenbarger, said, “Anything that gets worse as you grow older gets better when you exercise.” As another public health expert put it, slightly more bluntly,

“being active throughout your life is about being able to get to the loo on time in your old age”.

[Jim Shannon (Strangford) (DUP)]

I am not someone who has to get to the toilet early, but I congratulate the hon. Gentleman on securing the debate; I spoke to him beforehand.

I make a plug for children to take action early against physical and health conditions. In Northern Ireland, 20% of children are classed as overweight and 6% are classed as obese, and I understand that those figures are reflected on the mainland. The need to change our way of doing things is very clear. Targeted funding for children in schools, which has fallen by the wayside as a result of covid, must be re-established, as I think the hon. Gentleman will agree. The importance of daily mile walks must be promoted in every region of the UK. Start it early—and at a later stage, Madam Deputy Speaker, you will not have to run to the toilet.

[Andrew Selous]

The hon. Gentleman is absolutely right about the daily mile. I thank him for championing it in Northern Ireland. It will absolutely make a difference; I hope he will encourage all schools in Northern Ireland to take part.

How are we doing as a nation in achieving the necessary levels of physical activity? The answer, I am afraid, is not very well at all. According to a briefing that I have received from the Royal College of General Practitioners, 34% of men and 42% of women in the UK are not active enough for good health, and physical inactivity is responsible for one in every six UK deaths—the same proportion as is caused by smoking. Some 27% of the population are classified as inactive, meaning that they do less than 30 minutes of moderate physical activity, such as walking, each week.

It is getting worse. By 2030, we are on track to be 35% less active than we were in 1960. Most shockingly of all, a third of children do less than half the recommended physical activity for their age. The findings of the 2015 NHS health survey for children are even worse: they show that fewer than a quarter of children reach the required minimum of one hour’s moderate to vigorous physical activity every day on average. It is worth pausing to consider what to do about that. The curriculum is very full and the Department for Education is reluctant to mandate physical activity, while the Department of Health and Social Care’s remit does not extend to ordering the school day. Do we need the Cabinet Office to start taking a serious cross-Government interest in the issue for children, and indeed throughout later life?

What will happen if we continue on current trends? Justin Varney, who was formerly the head of adult wellbeing for Public Health England and is now in charge of public health in Birmingham, says that

“the whole concept of an NHS and welfare state, in whatever form we have it, is completely unsustainable if a third or more of the population remain physically inactive.” 

It is not as if we have only just realised the importance of sufficient physical activity to our health. Back in 1948, Dr Jerry Morris was appointed the first director of the Social Medicine Unit, a Government body tasked with examining the way in which health issues interacted with people’s circumstances. His major initial research involved looking into why the drivers of London’s double-decker buses had significantly higher rates of heart attacks than their conductor colleagues. His conclusion was that the only real difference between the groups, who were from identical backgrounds, was that the former spent their days sitting down, while the latter were constantly on their feet going up and down flights of stairs. The hard facts are that for many of us, the way in which we work and the way in which we travel are taking years off what should be our healthy life expectancy. This is a big issue, but it is not remotely getting the attention that it deserves.

What can we do about it? The answer is a very great deal, if we have the political will and really value our NHS rather than just paying lip service to it, and if we follow the academic research and learn from existing best practice around the world. Making active travel possible is the single biggest health intervention that the Government could make. Walking and cycling are the easiest ways to integrate physical activity into our daily lives. Two thirds of journeys in the UK are under 5 miles and could be cycled in half an hour by those who are capable, but only 2% are cycled. E-bikes, of course, help the elderly and those in less good health, and make cycling much more inclusive. Staggeringly, 1.5 billion journeys of less than a mile are made in cars every year, so there is an enormous potential to do better. Active travel can meet 23% of the moderate-to-vigorous physical activity needs on school days for primary-age children and 36% for secondary-age children. People who cycle to work take fewer days off sick than their car-driving colleagues, so cycling is good for the economy.

Those who are not so far tempted to consider a daily commute by bicycle should read a 2017 British Medical Journal article by Carlos Celis-Morales, which used UK Biobank data to follow 250,000 people over five years. It showed that people who commuted by bicycle had a 40% lower chance of dying during the study period. I am among those who want cycling to be for the many not the brave, and we need our roads to be safe, but the statistical reality is that for many of us, it is far safer in health terms to be on a bicycle than in a car or on the sofa.

I support the work that the Department for Transport is doing to deliver the Prime Minister‘s vision in which half all journeys in towns and cities will be cycled or walked by 2030. This plan is backed by a £2 billion package of funding for active travel over five years under the inspirational leadership of Chris Boardman, the interim active travel commissioner for Active Travel England. The plan includes delivering safe routes for cycling and walking, cycle training for all children and adults who want it, and creating active travel social prescribing pilots. Employers who care about the wellbeing of their staff as well as the productivity of their businesses should be right behind that. I also look forward to the publication of the second four-year statutory cycling and walking investment strategy this spring to reflect the new policies in “Gear Change” and the multi-year funding settlement from the spending review.

This is not a pipe dream. It is happening now in Copenhagen, where 40% of commuting trips are made by bike, and I suspect that the rate is not much lower in Amsterdam. That did not happen by chance in either of those cities; it happened because of visionary leaders who cared about the wellbeing of their residents and pursued this policy over decades.

We can do more in the workplace as well. The Googleplex offices in Mountain View, California, are designed to encourage as much physical movement by staff as possible. That includes using nature between buildings as well as what happens in them. Most of the workspace is on the second storey, and all the meeting rooms and cafés, and every single toilet apart from the accessible ones, are on the ground level, connected by courtyard-style staircases.

So, what are UK businesses doing to build some mobility into what has become an excessively sedentary culture? Sitting still for too long is not good for us. I have come across one Defence Minister, one female general, one House of Commons Clerk and one Hansard recorder who conduct meetings standing up or who have a standing desk. It is the exception rather than the rule, and when I had the pleasure of discussing Peter Walker’s excellent book with him recently, I made sure we did so while walking around St James’s Park. I wonder whether the Department of Health and Social Care and the House of Commons Commission have looked at the BeUpstanding programme, a free world-leading project that improves the health and wellbeing of desk-based workers ? If not, why not?

I mentioned earlier that only between a quarter and a third of UK schoolchildren were undertaking the recommended amount of physical activity. I am a huge fan of the daily mile initiative, which the hon. Member for Strangford (Jim Shannon) referred to, where children run or walk a mile at the start of each day. There are 7,289 schools in England and 1,191 in Scotland doing this, which is commendable. I would like to see that number grow substantially, including in Wales and Northern Ireland.

There is another country in Europe, however, that is doing even better. The global report card shows that of the 49 countries covered, Slovenia has the best results for activity levels in children, with more than 80% of those aged six to 19 meeting the one-hour-a-day threshold for activity. Frankly, that puts the United Kingdom to shame, notwithstanding the tremendous daily mile initiative. Again, this did not happen by chance. It was a conscious decision that equipped every school with two gyms and an outdoor play area as well as track and field facilities, and with five sports days per year and another week off for outdoor activities.

I wonder whether we fully use the fantastic expertise of our diplomatic network to really understand the best practice in public health around the world. If the Department of Health and Social Care is unaware of the level of commuting in Copenhagen or the outstanding physical activity achievements of Slovenian children, I would urge the Minister to speak to her colleagues in the Foreign, Commonwealth and Development Office to ensure that the relevant briefings are provided to her and her officials so that we can copy what is working well elsewhere.

It is really important to emphasise that even if we cannot do our 10,000 steps every day or, as adults, 150 minutes of moderate exercise or 75 minutes of intense exercise a week, every little helps. It is also really important to understand the difference between formal activity and incidental activity. Sport is brilliant and I want to see as many people as possible of both sexes and all ages participating, but the evidence suggests that the biggest gains will be from the minor adjustments we make in our everyday lives, such as using the stairs rather than the lift, getting off the bus one stop early, finding a parking space some way away from our office or meeting, or taking up a hobby we enjoy such as dancing. One of the best things that the Whips Office has ever done for me is to put me on the fifth floor of Portcullis House, giving me the opportunity to climb the 137 steps to my office on a regular basis throughout the day. I am not sure it was meant as a favour, but I am genuinely grateful.

I implore the whole of central and local government to wake up to the importance of this issue and all of us to play our part in keeping as active as possible in every way that is open to us. With good policies and the political will, we can make the right thing to do the easy and affordable thing to do for more and more people.

Covid-19: NHS Support for Prostate Cancer Patients

Jim Shannon Excerpts

Thursday 10th March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Ms McDonagh, and to make a contribution on this issue as my party’s health spokesperson. I thank the hon. Member for Carshalton and Wallington (Elliot Colburn) for setting the scene so well, as he always does, and for being so relatable.

I did a quick head count earlier. There are nine men in this room and the fact is that one in six of us—possibly two of us—will succumb to prostate cancer. That being the case, the effect of prostate cancer really hits home. I am also pleased to see the Minister in her place and recognise her contribution not just as a Minister but in the NHS, as the hon. Gentleman referred to. I am pleased to be alongside my colleague and friend, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), who is the shadow health spokesperson for the Scottish National party. It is also nice to see the hon. Member for Enfield North (Feryal Clark) in her place, and I look forward to her contribution.

As I have mentioned many times, the pandemic has had a significant impact on all aspects of life, but undoubtedly on our health service. As my party’s health spokesperson, it is great to be here to talk about what further steps we can take to support those who suffer with prostate cancer.

I want to quickly tell a story, because nothing illustrates the case better than a story. I have a very good friend. I am not going to give his name or say where he works, but we would work closely every week of my life. I always phone him and seven or eight weeks ago, I asked him how he was and he said to me, “I just went to get a wee health check to see how I was. They tell me I’ve got prostate cancer.” I said, “I hope it all works out.” He waited for the tests to come back, and the test was positive. They did not hang about. Within two weeks he had the operation. The NHS in Northern Ireland, where it is a devolved matter, paid for his operation and he went to Dublin to get it done. He did not realise that that check to see if everything was all right would lead to a prostate cancer operation, but that early diagnosis means that he is able to have same normality of life as everybody in this Chamber.

That illustrates the issue raised by the hon. Member for Carshalton and Wallington said. We have to put in place a prostate cancer strategy or plan for, as the hon. Gentleman said, men of a certain age—and I am one of them, by the way. It is not for me to comment on people’s age, but a few others present may also qualify.

Prostate cancer is the most common cancer for men, with over 47,000 new cases every year. Even prior to the pandemic, challenges in delivering the highest quality of care for patients had increased. It was exacerbated by staff shortages, inadequate care pathways and limited access to effective diagnosis. That is what we have to address. I know the Minister recognises the need for early diagnosis on any condition, but today’s debate is about prostate cancer. One in six men in the UK will be diagnosed with prostate cancer. It accounts for 27% of all new male cancer patients in the UK. That gives Members an idea of the size of the subject matter and why it is so important to debate it.

I always want to give a Northern Ireland perspective in debates, because we are part of this great United Kingdom of Great Britain and Northern Ireland, and what happens in Northern Ireland is replicated here. Our population is only 1.8 million, but we can none the less illustrate the issue. In Northern Ireland, 1,100 men are diagnosed with prostate cancer every year, with sadly 276 of those on average losing their lives to the disease. That is a large number—26% or 27% of those with prostate cancer unfortunately do not make it. Whether this is due to late diagnosis owing to the pandemic or to men downplaying their symptoms as they feel that there are more important things to deal with, we must encourage and raise awareness of the importance of checking for prostate cancer.

Speaking as a man, I know that those watching and present in the Chamber will know that there is no cold as bad as a man’s cold. But when somebody tells us to go to the doctor, we say, “No, I won’t.” If we are asked to go to the doctor, we put it off because we do not want to bother them. We say, “It’s not that bad really. I was exaggerating a wee bit. I think I’ll be alright.” That is our attitude. How do we change that attitude? We cannot do it by raising awareness alone. Perhaps one way of addressing it is by highlighting the brutal facts of how prostate cancer is taking people out of society. Perhaps we need to shock men into responding.

I have been in contact with Prostate Cancer UK, which has highlighted the troubles faced during the pandemic. First, reduced access to MRIs as a result of covid impacted on the ability of the NHS to diagnose prostate cancer, and there has been significant variation in the provision of services. How are the Government addressing the issue of early diagnosis and of access to MRI scans and biopsies to check it out? Crucially, what impact did the “Stay at Home” message have on people in need of diagnosis?

The pandemic has had many detrimental effects on society, one of which is people getting used to not seeing others. They are not going out in the way that they did in the past. We have to address that. In particular, older men, who are in a higher risk group for covid, were less likely to visit their GP and more likely to downplay their symptoms. Could the Minister give an indication of how we can address that?

Workforce issues and staff shortages were already significant before covid, with a growing shortage of oncologists and workforce burnout exacerbating the challenges faced by healthcare professionals in providing high-quality care. NHS England has been working with cancer alliances to ensure that improvements made during the pandemic are retained and improved further. I urge the Minister to have conversations—I know that he already does this—with our counterparts in the devolved nations to ensure that no man, nobody, is left behind by health provisions across the United Kingdom.

Education also plays a crucial role in health improvement. It should provide clear and simple messaging to educate men who are at risk of prostate cancer about the potential impact of diagnosis. Do we advertise that on TV, or are there more adverts in the press? It is advertised in my surgery in Kircubbin; I suspect that the same is true of everybody’s surgery. I do not go to the doctor very often, except for my diabetes check-ups. Perhaps the messaging is not getting to the people it needs to get to. How do we do that better?

Prostate Cancer UK has shared an online 30-second risk checker, which is very helpful for men across the United Kingdom. They can enter basic details and assess the risk that they face. That involves men taking a minute out of their day, and the online tool will direct them in the right way.

I will draw to a finish, as I am conscious that others wish to speak. The pandemic has had a significant impact on all aspects of life and disrupted the provision of routine care, forcing providers and patients to postpone many services and to adopt virtual consultations. I can almost feel my blood drain when I hear the term “virtual consultations”, because people need to see their doctor face to face. This has highlighted the need for face-to-face appointments in order to embrace and enhance the services that our NHS provides.

For too long, cancer patients have felt let down by the prioritisation of covid. Today’s debate gives us a chance to address the issue. I thank the hon. Member for Carshalton and Wallington for securing the debate, and I look forward to the Minister’s response. I am never disappointed with her responses. I know that she understands the issues and we look forward to her answers.

Covid-19: Deteriorating Long-Term Health Conditions

Jim Shannon Excerpts

Thursday 10th March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Mrs Cummins, and I seem to be doing so regularly. I am pleased to participate in this debate. I want to thank the hon. Member for Bromley and Chislehurst (Sir Robert Neill) for bringing it forward and for setting the scene with the detail and information to help us participate. I am pleased to see the shadow spokesperson, the hon. Member for Denton and Reddish (Andrew Gwynne), and the Minister in their place.

We often parley in this Chamber. Indeed, the Minister, the two shadow spokespersons, myself and others here, including the hon. Member for York Central (Rachael Maskell), are always willing to come to these debates. I am my party’s spokesperson for health, so I am always pleased to speak in health debates. People may say that I speak in every other debate, but that is by the way. If I am spared another hour, I will speak in the next debate as well. Members of Parliament in a small party find that they have more portfolios than most. I have got a lot of issues, and that is why my participation in debates is so frequent.

During the pandemic I repeatedly spoke about the impact on schoolchildren and those who were ill. My fears have unfortunately been realised. We have children with issues catching up on basic education. We have a raft of people who are undiagnosed or misdiagnosed, and treatable conditions have escalated. As the hon. Member for Carshalton and Wallington (Elliot Colburn) has done, I want to thank all health workers—doctors, GPs, pharmacists, nurses, care workers. I also want to thank family members, who gave up a lot of time to look after family members who were unwell. Pharmacists have also been mentioned, and it is important to place on the record our thanks to them. It is because of their industrious efforts that we have all been able to get to the other side of this pandemic.

I would also like to thank the Minister and the Government for what they have done. Covid and the vaccine roll-out enabled us to move toward what I always hoped we would see, and which the Prime Minister has been keen on—a normal life, where we do not react to covid but learn to live with it. That is where I want to be, and I believe it is where the people want to be as well.

There are those who suffer from long-term deteriorating health conditions who have not received the necessary treatment and care. In some areas, people will have had a poorer quality of life because of covid.

I am always reminded of one gentleman in particular, who is a minister of the church in Newtownards—we call him Pastor Mark. He took covid early on and is very fortunate to be in this world. He was ill for a long period of time. He is a young man with a wife and a young family. He suffers from long covid, the deteriorating effects of which are very clear to him. Today he does not have the stamina and energy that he once had. He tires easily. He refers to brain fog. I am not sure what that means, but I understand when he tells me. These are some of the repercussions of the pandemic. The sad fact is that covid has robbed us of so many, and we must rebuild where we can.

Some of those with severe health problems were in a queue to receive treatment. For some, delays were part of the reason for the numbers of those who passed away. I recall with sadness people I knew who were on a list to get an operation or a treatment. They were put to the back of the queue because of covid, and they are no longer here today. That operation is lost and the opportunity for treatment was not given. I cannot say that it would have prolonged those lives, but it would have given a better quality of life and would maybe have added a few years. We must think of all those people who were not able to get the help they needed.

The hon. Member for Carshalton and Wallington spoke about dementia. We had a debate on dementia in Westminster Hall some time ago. He is right. Probably because of my length of time as an elected representative, I know lots and lots of folk who, over the last period of time, have developed dementia and Alzheimer’s. I see the detrimental effect on their wellbeing and on their families—how dementia and Alzheimer’s robs people of their quality of life and their knowledge of their family members.

A wee lady passed away just this week. Her daughter phoned me on Sunday and let me know. I have known her all my life—she was 94 or 95 when she passed away. She took dementia and she came home. Some things people do remember. One thing her daughter told me on Sunday was, “Jim, she bought the Chronicle every week”—that is our local paper—“and when she saw your picture, she knew it was you, though she might not have known that I was her daughter.” Some things rob people of the very core of their life, and that concerns me.

More than 150,000 had their lives cut short by the virus. As the Alzheimer’s Society, Macmillan, Stroke Association, Age UK and many others have highlighted, across the UK, many people with pre-existing long-term health conditions have deteriorated faster than usual since the pandemic began. The increased rate of deterioration is due to the effects of having covid-19, as well as the measures taken to contain the virus, such as lockdown to reduce social contact and the suspension of rehabilitative services.

During the first wave of the pandemic, maybe professionals who provide rehabilitation were deployed to acute services for covid-19 patients. We understand the logic behind that, but there is an impact and there are side effects, which we are pointing to. Community rehabilitative services moved to primarily offer virtual support. As a result, rehabilitation services were unable to provide the same level of support that they did pre-covid. Community services are vital in helping to support people with long-term conditions. The mental wellbeing of those undergoing treatment for cancer, MS and heart conditions, and of disabled people, was greatly impacted, which gives us some cause for anxiety and concern.

The question for the Minister today, and for my Government, is where to go next. I support the aims of the organisations that produced “Moving forward stronger” and its specific recommendations, three of which I will cover in the timescale that you have indicated, Mrs Cummins. First,

“fully fund a national two-year rehabilitation strategy that ensures people with significantly deteriorated long-term conditions get the therapeutic support they need”.

That is really important. The second is to

“appoint a national clinical lead to implement this rehabilitation strategy”

and thirdly, to

“ensure local partners—such as local authorities and Integrated Care Systems…develop and deliver their own localised rehabilitation strategy, and that each ICS has a regional rehabilitation lead.”

When the Minister responds, I have every confidence that she will be able to reassure us that the things we are asking for today—collectively, but from different parts of this great United Kingdom of Great Britain and Northern Ireland—will be addressed.

I know that the Minister has regular contact with the Minister back home—Robin Swann of the Northern Ireland Assembly. I think that is important. I am a great believer in the Union, not because I come from Northern Ireland and am a Unionist, but because I believe in the Union for England, for Wales, and—with great respect—for Scotland, with equal passion and concern. I would therefore ask the Minister what talks she has had with the Minister back at the Assembly.

I will give a quick plug for those who are waiting for cataract operations, and those who had glaucoma. Do you know what really annoys me, Mrs Cummins? It annoys me that some people have lost their eyesight because they have not had the care within the time when they should have had it. Maybe the Minister can give some reassurance on that.

I finish with this: these are things that I absolutely stand behind. I ask the Minister, to address the possible reasons why Government will not stand behind and implement the “Moving forward stronger” recommendations —although I hope that she will reassure me otherwise. We have people with a quality of life that can be improved with the right strategy, and the document lays a foundation to build on as we seek to repair that which has been decimated—through no fault of Government; it was covid-19 that did it. We are taking the approach that we must live with covid; those people have lived with the side effects it has had on their illnesses, and that cannot be allowed to continue. With that in mind, I very much look forward to the Minister’s response.

--- Later in debate ---

[The Minister for Care and Mental Health (Gillian Keegan)]

It is a real pleasure to serve under your chairmanship, Mrs Cummins, and to follow the hon. Member for Denton and Reddish (Andrew Gwynne), who showed no symptoms of brain fog in his eloquent speech. He has my personal assurance that we will definitely focus on both research into long covid and its treatment.

I thank my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) for raising this very important issue, and for his proud advocacy for patients with many different long-term conditions who rely on NHS services, particularly those who have had a stroke. I extend my best wishes to my hon. Friend’s wife, Ann-Louise, who I am sure informed much of his powerful speech. Many of the experiences we have heard about will resonate with many of us. My father had a stroke a couple of years ago, and rehabilitation has been vital to his recovery, which is a long road that he is still on.

I was deeply moved to hear of the difficulties that the pandemic has caused people with deteriorating long-term conditions, many of which have been outlined. I want to reassure all hon. Members that we remain committed to making sure that everyone has access to the care and support that they need and deserve. We know we have to catch up after the impact of the pandemic.

My hon. Friend the Member for Bromley and Chislehurst mentioned spinal cord injury. I attended the all-party parliamentary group on spinal cord injury yesterday to hear about the concerns and the impact that the pandemic has had on people with the condition, and what more we need to do to respond to it.

We know that covid has had a significant impact on the health and care system, including on rehabilitation services. It has had a real and profound impact on people with rehabilitation needs and their treatment. I am very sorry for any undue suffering that that has caused. We remain committed to making sure that everyone has access to the care and support that they need and deserve. Throughout the pandemic, we have worked to maintain access to health services in what has been an extremely challenging environment, but we recognise that getting that support at the right time is vital for people’s health. That is why we protected priority services across England during the pandemic, which included rehabilitation and post-acute services, for people who had survived a stroke, and their families and carers.

Continued service delivery was in part supported by innovative methods of care—we have talked about a few of them—throughout the pandemic. NHS England and Improvement supported people with long-term conditions by providing safe and person-centred assessments and diagnosis via remote methods, or in face-to-face consultations when appropriate. Providers innovated and rolled out remote consultations using video, telephone, email and text message services, and health services implemented new models of care with effective triage processes to make sure that patients received the care appropriate to them and in outpatient settings closer to home.

Clinical teams used and will continue to use virtual rehabilitation services alongside face-to-face contact to ensure that every patient gets the treatment and support that they need. Almost half of stroke survivors have received virtual care since the pandemic began, transforming their experience of the health system. Over 80% reported positive or very positive experiences, as my hon. Friend the Member for Bromley and Chislehurst outlined, but we know that remote consultations are not suitable for everyone or for every situation, as eloquently outlined by the hon. Member for York Central (Rachael Maskell), who has experience in this matter. We will continue working to make sure services are suitably tailored to meet patients’ often complex needs.

For example, NHSE&I has worked with memory assessment clinics to capture best practice on remote consultation and virtual diagnosis of dementia, which is vital, as mentioned by my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn), to promote its use. It has published guidance to help enhance best practice in dementia assessment and diagnosis, and to support a personalised approach with choice over the delivery of remote consultation and diagnosis.

There has been further guidance for a range of conditions to help health systems adapt to the challenges of the pandemic, including the National Institute for Health and Care Excellence guidance on chronic obstructive pulmonary disease and the Association of British Neurologists guidance to help healthcare professionals prioritise neurological services.

People with different long-term conditions may also need emotional and psychological support, as has been mentioned by many hon. Members, and that is why NHS mental health services stayed open throughout the pandemic, and why local areas continued to offer talking therapies—remotely in many cases—with a face-to-face option if appropriate. We are investing in a mental health recovery action plan, which will help us to provide more appointments, which, sadly, were missed during the pandemic. That will help us catch up.

We are committed to ensuring that those who need it are given outstanding and tailored care with choice, control and the support that they need to enable them to live independent lives, and we are committed to ensuring that people find adult social care fair and accessible. A lot of reforms are coming forward in this area. We recently introduced our strategy for the social care workforce in our “People at the Heart of Care” White Paper, which is supported by at least £500 million to develop and support the workforce over the next three years.

As highlighted by the “Moving forward stronger” report, rehabilitation services were particularly affected by the pandemic. The health system has long recognised the importance of rehabilitation. Many hon. Members mentioned how important that is to lifelong conditions and how important it is to enable people to avoid more acute illness later on, requiring more services from the health service. Specific commitments are set out in the long-term plan, which include the expansion of pulmonary rehabilitation services over 10 years from 2019, new and higher-intensity care models in respect of stroke rehabilitation, and the scaling up of cardiac rehabilitation to prevent up to 23,000 premature deaths.

Following the publication of the national stroke service model in May 2021, NHS England and NHS Improvement have committed to creating integrated stroke delivery networks across England, bringing together health and care services across the whole stroke pathway, from prevention to rehabilitation. As my hon. Friend the Member for Bromley and Chislehurst mentioned, linking those services is vital. More than 20 integrated stroke delivery networks are now operational, bringing together health and care services across the whole stroke pathway. Over £3.3 million has been dedicated to the establishment and ongoing delivery of those networks, which have already brought about some improvements to the co-ordination and direction of how the stroke care pathways across England are delivered.

The NHS is committed to delivering personalised, needs- based stroke rehabilitation to every stroke survivor who needs it, and we recognise the vital role of multidisciplinary teams, comprising occupational therapists, speech and language therapists and physiotherapists, in assessing, diagnosing and treating issues concerning different daily activities, speech and cognitive communication. Community rehabilitation services continue to benefit from extra investment, with £4.5 billion of investment in primary medical care and community health services by 2023-24 and productivity reforms set out in the long-term plan. The long-term plan committed to the rolling out by 2024 of new two-hour urgent community response and two-day reablement ambitions, which will improve the responsiveness of community health services to people’s needs across the country. We anticipate that the wider package of investment in community and intermediate healthcare will eventually free more than 1 million hospital beds, allowing health systems to better support those in need.

Underlining our commitment to improving rehabilitation services, the NHS has created the new role of national director for hospital discharge and rehabilitation, which was rightly called for. Jenny Keane, who was appointed to the post in December 2021 and started recently, will lead a team of 60 people responsible for hospital discharge and rehabilitation. Her team within NHSE is already taking forward important work in this area, including a programme to identify the optimum bed-to-home model of care for non-acute rehabilitation services. That will support the implementation of the discharge-to-assess policy, and improve the delivery of timely and high-quality care in home settings. Ultimately, that will empower more people to recover and maintain their independence following an unplanned event or a period of acute care.

The programme will estimate the capacity for bedded non-acute rehabilitation care that integrated care systems will require for their populations. Systems will be supported to shift towards new rehabilitation models through a range of guidance, frameworks and tools. I anticipate that rehabilitation will also benefit from the wider reforms set out in the Health and Care Bill, reorienting systems towards co-operation and strengthening NHS action to reduce health inequalities. Rehabilitation will also benefit from the plans that we have set out in the integration White Paper, under which patients will receive better, more joined-up care.

Looking ahead, the NHS published its delivery plan for tackling the covid-19 backlog of elective care last month. The plan sets out a clear vision for how the NHS will recover and expand elective services over the next three years, including how it will support patients. We plan to spend more than £8 billion between the next financial year and 2024-25. That is in addition to the £2 billion elective recovery fund and £700 million targeted investment fund already made available to systems this year to help to drive up and protect elective activity. However, my hon. Friend the Member for Bromley and Chislehurst is right that we must ensure that the voice of rehabilitation services does not get lost in that considerable investment.

That funding could deliver the equivalent of around 9 million more checks, scans and procedures, and it will mean that the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than it was delivering before the pandemic. A significant part of that funding will be invested in staff, in terms of both capacity and skills. The delivery plan also contains some targets to ensure that by March 2025 people will not wait longer than a year for elective care.

[Jim Shannon]

I am finding the Minister’s response very helpful and supportive of what we are trying to do, but I asked a specific question in relation to those who are waiting for eyesight-saving operations. We need to ensure that they do not lose their eyesight because of the delays. If the Minister is able to give me a response today, that will be great, but if she cannot, I am happy for all of us to receive a response by letter.

Allergy Research and Treatments: Government Support

Jim Shannon Excerpts

Wednesday 9th March 2022 Westminster Hall

[Christian Matheson]

That is an awful situation. I pay tribute to my hon. Friend’s family. That three times in three years is a shocking statistic, which we will come back to because there is a burgeoning rise in allergic disease in the UK. It is an issue of great importance to people across the country, as the recent parliamentary petition demonstrated. Indeed, I thank the Petitions Committee for incorporating that petition into the debate.

It is estimated that here in the UK one in three people are living with allergies and 3 million with food allergies. It is not only about food allergies. I was contacted today by a lady called Sue. She, her daughter and her grandson have a latex allergy. Her daughter has had to write, on behalf of her son—Sue’s grandson—to all the manufacturers of school sportswear equipment to find out whether their equipment contains latex, because of that allergy. Her daughter has lost 3½ stone in two years because of her allergies and has finally, after about two and a half to three years, got a treatment. However, it should not take that long.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing the debate. My second son was born with allergies, and has just the one now—I am thankful that he managed to grow out of some of them. Does the hon. Member agree that as one in four people suffer from some type of basic allergy, and have to live their lives with medication to deal with the symptoms, we must see extra investment into research on the varied multitude of allergies that people are suffering from throughout the UK?

[Christian Matheson]

I thank the hon. Gentleman for that intervention. I absolutely agree. Research shows that in the 20 years to 2012, there was a 615% increase in hospital admissions in the UK for anaphylaxis, a potentially life-threatening allergic reaction mainly caused by food allergies.

Members may be familiar with a tragic list of recent fatalities, mostly of young people, from anaphylaxis: Sadie Bristow, aged nine; Shanté Turay-Thomas, 18; Karanbir Cheema, 13; Ava-Grace Stevens, nine; James Atkinson, 23; Owen Carey, 18; Ellen Raffell, 16; and, of course, Natasha Ednan-Laperouse, 15. Those are just some of the entirely avoidable deaths we have witnessed in recent years.

Thankfully, because of the powerful campaign run by Nadim and Tanya Ednan-Laperouse, Natasha’s parents, we now have a new allergen and ingredient-labelling law in the UK, known as Natasha’s law. It will save lives and prevent others from suffering the terrible grief that those families will always bear. I pay tribute to the Government in this case for their swift response in ending the loophole in the law that Natasha’s death—caused by sesame seeds hidden in a baguette—exposed. I am sure that the Government’s actions on that are welcomed throughout the House.

Much more needs to be done. I will highlight two areas where I challenge Ministers, in this time of great need, to rise up and offer real hope to hundreds of thousands of families who live daily with the fear of a loved one suffering a severe—or worse, fatal—anaphylactic reaction: research and treatment. Turning to the latter, for too long allergy services have been the Cinderella services in our healthcare system. There is a national postcode lottery, and too many patients take too long to get specialist appointments, as we heard from Sue who emailed me. There are too few specialist allergy clinics, too few specialist allergy doctors and consultants and too little training for GPs. The pathway between GP and hospital allergy services is deeply disjointed. No specific treatment for allergies is readily available in the UK, and an individualised avoidance strategy with an adrenaline auto-injector is the only practical advice offered. That negatively affects quality of life.

The care that people with allergies receive is at best patchy, and at worst has led to avoidable deaths. Without greater priority given to allergies, those problems will continue and sadly more lives might be lost unnecessarily. Those are just a few of the reasons why colleagues on the all-party parliamentary group for allergy recently published their excellent report calling for the appointment of a national lead on allergy. I thank my hon. Friend the Member for Dagenham and Rainham (Jon Cruddas) for his dedicated work and leadership on the matter—he may seek to intervene later in the debate.

That is also the view of the Ednan-Laperouses’ charity, the Natasha Allergy Research Foundation, which has ran an excellent campaign calling for an allergy tsar. That was also the topic of the petition considered in this debate —someone to work across Government to tackle those issues. It is fair to say that the allergy community—patients, families, charities and the clinicians—are united as one in believing that there is an urgent need for a national lead to be appointed. I know that the Minister of State recently met members of the APPG and the national strategy group. I ask the Minister what plans the Government have on the appointment of a national lead on allergies. I hope that the Minister can provide the leadership and drive that the allergy community has called for.

Turning now to the matter of research, I urge the Minister to respond to the request from the Natasha Allergy Research Foundation for a meeting, sent in early January. There is a strong belief in the scientific community that, given the right amount of research funding, in the next couple of decades treatments can be found that could potentially eradicate allergies. I am aware that the Natasha Allergy Research Foundation intends to be a lead player in the research field and in its mission to make allergy history. I take the opportunity to thank everyone at the foundation for all the crucial work they have already done in the field. I understand that they will shortly announce their first research project, a £2.2 million study across five university hospital sites in England. That investment is roughly the same as the Government have donated as a whole to allergy research funding over the last five years.

If I may quote the Minister, on 29 October, she stated:

“Over the past five years, the Department of Health and Social Care has awarded the National Institute for Health Research over £2 million for research into food allergies.”—[Official Report, 29 October 2021; Vol. 702, c. 597.]

I am fearful that this is not sufficient. Without enough funding, there is not enough research. Without research, there is no treatment. Without treatment there is no change for the millions of people and families affected. I ask the Minister why, given the acknowledged growing epidemic of allergies in this country, research funding is not being given a significantly higher priority? Why is research into food allergic disease so underfunded compared with other diseases? Will the Minister consider other areas of allergy such as, for example, the case of latex that I mentioned earlier?

I am aware that the Food Standards Agency is undertaking a research programme into food allergy and intolerance, but it is not researching cause and prevention or developing treatments. I am also aware that the Department for Education is currently running a food standards pilot. However, flying in the face of the evidence from staff in our schools of a food allergy epidemic, it has not even bothered to include food allergy in its remit. That is another example of how individuals with food allergies are being forgotten and excluded. That is another reason why, as the petition states, we need an allergy tsar to work across all the Departments and Government agencies.

The Natasha Allergy Research Foundation is heavily leveraging the major food companies to help fund and play their part. They cannot do that work alone. I, and many others, believe that the Government now need to show direction and deliver investment into food allergy research, including cause, prevention and treatments. We need to be moving, and at pace. We should not be waiting for other young lives to be tragically lost before we step up to the mark.

Breastfeeding: Government Support

Jim Shannon Excerpts

Tuesday 8th March 2022 Westminster Hall

[Alison Thewliss (Glasgow Central) (SNP)]

I beg to move,

That this House has considered Government support for breastfeeding.

It is pleasure to see you in the Chair, Mr Efford. I thank all Members present for making it to the debate this afternoon. It feels particularly appropriate that this debate on Government support for breastfeeding is happening on International Women’s Day. It is an issue that matters to so many women, and I have had lots of people in touch about it. However, today, as with every day of late, I have thought of the women of Ukraine and their babies; I wonder how they are coping and I hope that they can get to safety soon.

I send my very best wishes to everyone who is feeding their wee one and to those who are proud of meeting their breastfeeding goals. I also send my love and thoughts to those who have struggled and felt let down, and to those who carry those feelings around with them for the rest of their lives. We all know that breastfeeding is natural, but it is certainly not easy.

In this debate, I want to talk about the wider context for supporting breastfeeding, because it does not happen on its own. It takes a range of support, across Government, in employment law, equalities legislation and financial support for the maternity, health visiting, peer support and tongue-tie services that are so necessary. I know that Scotland is not perfect, but we have placed breastfeeding support in our programme for Government and engaged positively in the “Becoming Breastfeeding Friendly” international programme. Our investment is paying off, with the data showing an increase in breastfeeding rates. Almost two thirds—66%—of babies born in Scotland in 2020-21 were breastfed for at least some time after their birth. More than half of babies—55%—were being breastfed at 10 to 14 days of age in 2020-21. That has increased from 44% in 2002-03, so it shows what a difference that investment can make. I was also glad to see in the Scottish data that 21% of toddlers were receiving some form of breastmilk. We know that because Scotland has invested in that data, whereas the English infant feeding study was cancelled some years ago. It needs to be reinstated so that that can be tracked.

I was really glad that the UK Government announced a £50 million investment in breastfeeding, but I would be grateful if the Minister could share some more detail on how exactly that will be spent, and how the spend will be monitored. There are many fears that, although it sounds like an awful lot of money, and in some ways it is, it could be spread too thinly across services across England. We also need to regulate the factors that can dissuade and diminish breastfeeding, such as aggressive marketing of infant formula—a global issue, but one on which the UK Government can play a leading role.

I thank Parliament’s digital engagement team for its support in putting out a survey for the debate. It had a whopping 2,618 responses in the very short time that the survey was running, so I thank each and every person who responded for doing so, and for helping to inform the debate. I also thank those who contacted me directly. I hope that I will be able to fit in all the concerns that they raised. Following that social media request, in response to the question “What policies would have encouraged or supported you, your family or friends in breastfeeding?” respondents came back with a number of remarks and policy suggestions around several key themes. The first was better information and guidance through classes and healthcare professionals. Lauren responded to say:

“Covid meant there were no antenatal classes available, however midwives did not discuss breastfeeding other than asking if I intended to do it. There was no feeding support offered in hospital and no information about what feeding support is available. If literature had been available as to what support is available and how to access this, including infant feeding teams and information around tongue-tie, this would be helpful.”

That lack of information, particularly around the time of covid, has been felt by many people who responded to the survey, and indeed people in my own family. It is still going on, with mums from Newham complaining about not being able to be with their babies, and restrictions being unfairly put in place. That continues to this day. Others pointed out the importance of the provision of lactation consultants, with Georgie saying:

“I had access to a lactation consultant because I’m lucky enough to have that privilege but for my friend who did take the ill advice of her midwives, she was misdirected and her breastfeeding journey ended after four weeks.”

There are too many whose journeys finish too soon.

Workplace support is also vital to support women on their breastfeeding journey. Katie said:

“Women need to be supported so that when they return to work they have a dedicated space that they can pump and store milk so that they continue to breastfeed.”

Billie-Jean said:

“Too many workplaces don’t have suitable rooms so women have to choose between returning to work or not working to be able to keep providing breast milk for their children.”

Looking more widely at public education, Susannah said:

“Policies within education in schools—lessons around conception/fertility—breastfeeding should be learnt about accurately from a scientific view so children learn its value and importance and it is normalised.”

I know that the breastfeeding network in Ayrshire does a huge amount of work to ensure that it gets into schools to tell young people about breastfeeding.

To move to the global context on breastfeeding, the international code of marketing of breastmilk substitutes is 41 this year. It was written in response to the aggressive marketing of infant formula, which is of course to the detriment of breastfeeding. I know that it can be a really sensitive issue, so I would like to be absolutely clear that I believe that formula is an essential item that must be available to those who need it. People using formula deserve to receive impartial support and advice, not marketing and advertising.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing forward this debate. She has certainly been a champion on this issue—that word is used often in this House, but it is applicable to her. Following on from my work with her in the all-party parliamentary group on infant feeding and inequalities, I met a lady called Claire Flynn—a Breastival board member from Belfast—who I think the hon. Lady knows. She said that breastfeeding strategies and plans vary across Scotland, Wales, England and Northern Ireland. Does the hon. Lady agree that there is a real need to reinstate the infant feeding survey? We understand that work on that is under way at Public Health England. Northern Ireland must be included and funding must be made available to enable that. Through the hon. Lady, I ask the Minister to consider a UK-wide approach.

[Clive Efford (in the Chair)]

Order. For those who missed the start of the debate, and so that people do not miss out on their time—we are tight for time—let me just say that we had planned to give Alison four to five minutes, and she has that now. Then the SNP spokesperson will have three to four minutes, Back Benchers two to three minutes and the Minister 10 minutes. I thought it would be worth intervening with that so that Members could work out the timing of their speeches.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

Thank you for giving me the chance to speak, Mr Efford. I congratulate the hon. Member for Glasgow Central (Alison Thewliss) on securing the debate and thank her for setting the scene. Some people might think that it is unusual for a man to speak on this issue, but the hon. Lady brought it to my attention some time ago, when she first set up the all-party parliamentary group on infant feeding and inequalities, and since then I have always been very pleased to support her endeavours to highlight these issues and make them more acceptable across society, where sometimes people might have some questions.

The hon. Member for Glasgow Central, though the APPG and through the opportunities I have had to help others, was introduced to some of the people from Belfast who work on this. I have attended a number of their events, which I always think is very important, because if there is any taboo about breastfeeding, in public or wherever it may be, I feel that society has to be more sympathetic and understanding. The hon. Lady has done that from the very beginning, and I have been very pleased to support her.

One of my favourite TV programmes is “Call the Midwife”—I don’t know about other Members, but I never miss it—and these are the sorts of important issues it tries to address. My wife and I sit down and are engrossed in that programme. It addresses the issue of mothers being unable to breastfeed, for whatever reason, such as the physical or health circumstances that the hon. Member for Glasgow Central referred to, and it does so in a very sympathetic and kindly way. The wonderful thing about “Call the Midwife” is that, more often than not, things always turn out right, and that gives me a wee bit of a lift on a Sunday night—I wish life was like that all the time. I can think of only one exception, but otherwise the stories always end well.

I was contacted by Claire Flynn, a Breastival board member, who I met at a local breastfeeding event in Belfast to highlight some of the issues—I have been to three or four of those events. Looking at breastfeeding support across the UK, there are huge gaps in provision. Scotland and England have made significant investments in breastfeeding support—the hon. Member for Glasgow Central has driven that, by the way—but unfortunately in Northern Ireland we have not gone so far, although we do have Breastival and other things we have been doing. We have not seen the same investment, despite having further to go.

The covid pandemic has eroded many of the community supports in place and increased new mothers’ isolation, so it is important that we reach out and help. Urgent action that recognises that breastfeeding is foundational for lifelong health is needed to rebuild and strengthen protection and support for the crucial early years of a child’s life.

As I said in my intervention, there is a real need to reinstate the infant feeding survey—the Minister nodded when I said that, presumably to say that it is a good idea or to confirm that she will answer that question. We understand that work on that is under way with Public Health England. Northern Ireland must be included and funding must be made available to enable that. I ask the Minister to consider a UK-wide approach, if possible, with discussions with the devolved Administrations and the devolved Health Ministers.

The Minister will know the importance of reinstating the infant feeding survey across the UK to provide better estimates on the incidence, prevalence and duration of breastfeeding and other feeding practices adopted by mothers in the first eight to 10 months after their baby is born. We need data and statistics to direct strategy. That is hugely important information for anyone developing policies or researching infant feeding in the UK, and it would provide an update on how policies and the state of the UK are impacting on infant feeding.

I am sad to say that the Western Trust milk bank in County Fermanagh is the only milk bank in Northern Ireland, and indeed the Republic of Ireland does not have its own milk bank at all. Therefore, cross-border, that milk bank has helped hundreds of neonatal babies since 2000. It is vital that the human milk bank in Fermanagh, and milk banks across the UK, are supported. The hon. Member for Glasgow Central has done that actively—verbally and physically.

In Northern Ireland, there have been massive steps to try to normalise breastfeeding, including the Public Health Agency’s “Breastfeeding Welcome Here” scheme, as well as the growth of online support groups and Breastival, which is a unique, award-winning festival that aims to support, normalise and celebrate breastfeeding as a part of everyday life in Northern Ireland and across Ireland. I have attended it on numerous occasions to highlight the fact that men need to be involved in this discussion.

We must open our minds, open the conversation and open the coffers, and introduce into this conversation some positivity. My mother informs me—I know nothing about it—that I was breastfed as a child, so I am happy to join this debate.

Prison-based Addiction Treatment Pathways

Jim Shannon Excerpts

Wednesday 2nd March 2022 Westminster Hall

[Dan Carden (Liverpool, Walton) (Lab)]

I beg to move,

That this House has considered prison-based addiction treatment pathways.

It is a pleasure to serve under your chairmanship, Dr Huq. Too many people with drug dependency

“are cycling in and out of prison. Rarely are prison sentences a restorative experience. Our prisons are overcrowded, with limited meaningful activity, drugs easily available, and insufficient treatment. Discharge brings little hope of an alternative…life. Diversions from prison, and meaningful aftercare, have both been severely diminished and this trend must be reversed to break the costly cycle of addiction and offending.”

Those are the words of Dame Carol Black in her groundbreaking independent review of drugs—a damning observation.

The treatment system and effective recovery pathways from addiction in prisons are in desperate need of repair, yet the effectiveness of evidence-based, well-delivered treatment for drug and alcohol dependence is well established. When it is properly funded, it works: it cuts the level of drug use, reoffending, overdose risk and the spread of blood-borne viruses.

Analysis of Her Majesty’s inspectorate of prisons data from 2019 reveals that 48% of men surveyed by the inspectorate who reported having a drug problem said that it was easy to get drugs. The proportion of prisoners who said that they developed a drug problem while in custody more than doubled between 2015 and 2020.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. This is not the responsibility of the Minister, but in the papers last week it was reported that the drug uptake in prisons in Northern Ireland has risen to an astronomical height. It is therefore clear that what the hon. Gentleman is saying about the UK mainland also applies to us back home. Does he agree that the premise of prison is to rehabilitate and that addiction pathways are the absolute foundation for the rehabilitation that he and I want to see and that, to be fair, I think the Minister wants to see too? That can work only if funding is sourced and allocated UK-wide to make sure that it happens.

[Dan Carden]

The hon. Gentleman is spot on. I will come on to the function of prisons. Modern, progressive society should aspire to something more than having prisons there for punishment. The function of prison should be to rehabilitate, reduce reoffending and help those in prison to build productive and meaningful lives. I think the Minister will agree that without tackling drug dependence, that function cannot be fulfilled.

Part 2 of Dame Carol’s review calls for improved

“transparency and accountability of the commissioning and delivery of substance misuse services in prisons, including through publishing how much money is spent each year on these services”,

and ensuring that

“everyone leaving prison has identification and a bank account and that those who cannot claim benefits online get the opportunity, from the day of release, to access DWP’s telephony service.”

It calls for ending Friday release dates and for making sure that

“prisoners with drug dependence can access and receive drug treatment in the community as soon as possible after release.”

It also calls for additional prison staff to ensure that prisoners’ experience is improved, and for

“earlier interventions for offenders to divert them away from the criminal justice system, particularly prison.”

I am pleased that the majority of Dame Carol’s observations and recommendations have been embraced by the Government in the form of the 10-year drug strategy, “From harm to hope”, and the prisons strategy White Paper. Diversionary schemes are rightly encouraged by Dame Carol and endorsed by the drug strategy and the White Paper, despite the Government’s heavy “tough on drugs” messaging, because we cannot simply arrest our way out of the country’s addiction crisis, we cannot punish the already marginalised into recovery and we cannot end the pointless cycle of harm without evidence-based policy.

One in four people are placed in prison for committing an offence relating to their drug use. They are often given short custodial sentences of up to six months, most commonly serving as little as six weeks behind bars. Those on short-term sentences are the least likely to have access to drug and alcohol treatment, and prisoners serving seven-day sentences almost always pass through the system without support.

There are many innovative diversionary schemes and community sentences in use in different parts of the country. They reduce prison numbers, focus on treatment, recovery and rehabilitation, and stop small-time offenders losing access to housing, employment and family ties, which too often push them only further down the path of addiction, reoffending and homelessness, and exacerbate that vicious cycle of harm. I hope the Minister will touch on that in her reply.

For those who do reach the threshold of a custodial sentence and enter prison, the only answer to deliver change and break the cycle is to ensure there is access to treatment services within prison and on release. Sadly, the sharp decline in recovery services, particularly in prisons, mirrors the sharp decline in recovery services in the community. That has been further exacerbated by the pandemic, where prison regimes have entered strict lockdowns.

One practical challenge is that efforts to tackle drug use in prison are often undermined by the widespread availability of drugs across prison estates. Time, energy and resources end up being consumed by cracking down on the illicit supply. How can policy deal with that challenge, while also dealing with the demand for these substances and the root cause of that? Security can do only so much without a parallel commitment to reducing demand. The Government should ensure that they are committed to acting on both.

I am yet to meet anyone in addiction and recovery who has not experienced trauma. For those fortunate enough to have no personal experience of addiction, it is difficult to comprehend that the drug of choice is, at first, a solution, before it becomes a problem. Prisoners with drug and alcohol problems tend to have high rates of trauma, and trauma begets trauma.

Trauma has been shown to impact on cognitive functioning and on an individual’s ability to build and maintain social relationships. To be drug or alcohol dependent is a harrowing and hopeless ordeal; it is not a choice. To quote Dame Carol, a

“widespread sense of boredom, hopelessness and lack of purposeful activity in custody”,

coupled with little access to meaningful support in prison, is perhaps the worst possible environment the state could create to deal with this growing problem.

We know that, with access to properly resourced, person-centred, trauma-informed care, people can and do make positive changes to their lives. For prisoners, that care cannot stop when they walk from the prison gates. Many prisoners with drug problems are still being released on Friday afternoons, with nowhere to stay, no access to appointments at probation or drug services, no Naloxone and nothing but £46 in their pocket, with predictable results.

Transition between prison and the community must be prioritised to ensure a significant increase in engagement and community treatment on release. Every person in recovery is proof of the transformational change that is possible. For those who doubt whether someone in prison can address their addiction and make positive changes, I recommend taking the time to look at the fantastic “More Than My Past” campaign by the Forward Trust.

The sad reality is that the UK was once a leader in offering accredited addiction and recovery programmes in prisons. At the beginning of the last decade, there were over 100 programmes in England and Wales in prison settings, with over 10,000 prisoners participating. Today, access to accredited addiction and recovery programmes is a prison postcode lottery. There is no national standard, and the latest figures suggest that the number of people participating in accredited services in prisons is below 200 per year.

In 2012, the Rehabilitation for Addicted Prisoners Trust—now the Forward Trust—managed 14 intensive accredited addiction and recovery programmes in prisons across England, serving around 1,200 people per year. Independent evaluations showed that those programmes helped thousands of people into recovery from addiction, and that prisoners who completed those programmes were 49% less likely to be reconvicted compared with those who completed other programmes. By 2020, most of those programmes had closed due to lack of funding, and only around 300 people were able to access them. As it stands today, after two years of covid restrictions, only four programmes of this kind are still running, with only one currently operational. Despite the evidence, access is sparse, and prisoners have to transfer in order to access such services.

The Health and Social Care Act 2012 transferred responsibility for commissioning health services in custody from Her Majesty’s Prison and Probation Service to NHS England. Funding for prison healthcare and substance misuse services fared well compared with the local authority funded services in the community, but there have been other consequences. Physical healthcare services in prisons have improved, but as Dame Carol pointed out, the arm’s length approach to commissioning substance misuse services in prisons has been widely criticised. Contracts are often placed with general healthcare providers, then further subcontracted out, and the system becomes fragmented and unaccountable.

Since that transfer, there has been an alarming reduction in the range of provision in prisons, particularly in recovery-oriented services. Fewer than 200 prisoners are accessing accredited, structured addiction and recovery programmes, and in its “Alcohol and drug treatment in secure settings” report, the Office for Health Improvement and Disparities showed that there were 43,255 adults in alcohol and drug treatment in prisons and secure settings between April 2020 and March 2021—a drop of around 3,000 from the previous year. However, that figure of 43,255 prisoners accessing the treatment system does not tell us anything about how many were accessing recovery-oriented services. Can the Minister tell me what that treatment consists of, considering that accredited addiction and recovery course attendance has plummeted so drastically? With this new strategy, will the Minister also commit to restoring accredited addiction and recovery programmes to former levels and making them available in every prison?

When discussing addiction treatment pathways in community and secure settings, there is an unproductive and recurring debate: harm reduction versus abstinence. Each has its own set of benefits, yet they represent completely different approaches to recovery. Both approaches to treatment have their perceived pros and cons, but there is no right choice or correct pathway; after all, addiction has many causes, and recovery can be supported in a number of ways. Opiate substitute treatment, needle exchange, and the life-saving naloxone are important interventions—harm reduction saves lives, but so does recovery. It is time to take seriously the challenge of turning people away from drugs and crime.

I understand that the Secretary of State for Justice’s promotion of abstinence-based programmes in the prisons White Paper has caused confusion and some upset. Some believe that his approach goes against evidence-based research and the Government’s own 2017 “Drug misuse and dependence: UK guidelines on clinical management” document. The guidance is clear:

“any plan for reduction and cessation of OST should be based on the clinical judgement of the prescriber in collaboration with the prisoner and the wider team. Reduction and cessation should not be on an arbitrary or mandatory basis but rather requires careful clinical assessment and review…There should not normally be mandatory opioid reduction regimes for dependence…The purpose of healthcare in prison, including care for drug and alcohol problems, is to provide an excellent, safe and effective service to all prisoners, equivalent to that of the community.”

This should not be an either/or. When we think about recovery from any other health condition, that way of thinking would not be accepted. Clinicians would be focused on combinations that give people the best possible chance to make a full recovery. The Government say in their drugs strategy:

“We will treat addiction as a chronic health condition”.

I welcome that. As with many other health conditions, there needs to be a wide range of interventions and services that provide those in need with real choice.

For many people, harm reduction is the start of the recovery journey, but recovery is much more than, “Are you clean or not?” Recovery is not binary, recovery is not linear, but recovery is possible. To support it, there needs to be greater allocation of physical space on the prison estate to carry out therapeutic interventions that all people can access. That must include space for psychosocial, not just clinical, interventions. Well-designed recovery wings create a much less violent and more co-operative population who are focused on rehabilitation. Every prison should have recovery-focused wings. I wonder if the Minister is considering that possibility.

I welcome the commitment from the Ministry of Justice to expanding the use of recovery-focused areas in prison, which pointed to Her Majesty’s Prison Holme House as an example of good practice. The early outcomes from recovery wings have identified a reduction in violence and substance use, and a link to increased employment opportunities on release. Despite the support from addiction treatment charities for recovery wings, and despite their inclusion in the prisons White Paper, I have been made aware of a growing sense of open resistance in the Department of Health and Social Care to the expansion of recovery wings in prisons.

I would be grateful if the Minister could shed some light on those worrying reports. Is that the case, and if so, will she put a stop to it? Will her Department deliver on the reforms set out in the drugs strategy and the prisons White paper to improve addiction treatment in prisons and not stand in their way? Will the Minister tell us how the new spending allocation will reflect the priorities set out in both papers?

To conclude, I will quote Charlie Taylor, Her Majesty’s chief inspector of prisons:

“To lead successful, crime-free lives when leaving custody, prisoners must change the way they feel about themselves and develop a belief that they can take control of their future.”

I hope that officials in the Department of Health and Social Care take heed of the chief inspector’s words as the final decisions are made on what has the potential to be positive progress under this Government’s reforms. Lives depend on it.

Vaccine Damage Payments Act 1979

Jim Shannon Excerpts

Wednesday 2nd March 2022 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

I thank Mr Speaker for granting this debate, which is the first such debate on the Vaccine Damage Payments Act 1979 since 24 March 2015.

Vaccines have been our major public health defence against covid-19. This debate is not about all those millions who have benefited from vaccination; it is about the tens of thousands who did the right thing, were vaccinated but then, as a result, suffered death, serious injury or other life-changing adverse consequences. The vaccine damage payment scheme was extended to cover covid-19 vaccinations in recognition of the potential importance of this issue.

I am delighted that the Prime Minister also clearly believes that this is an important issue. On 11 August last year, he wrote to Kate Scott, whose husband Jamie, a fit 44-year-old software engineer, spent 124 days in hospital following severe brain injury caused by the vaccine. The Prime Minister said, referring to Kate’s husband Jamie and his family from Warwickshire,

“you’re not a statistic and must not be ignored”.

The Prime Minister went on to thank Kate Scott for her suggested changes to the vaccine damage payment scheme and promised that the Government would consider the case for reform.

Why, then, is there no tangible evidence of the Government having done anything in the six months since the Prime Minister said those words? The Government have repeatedly blocked my Covid-19 Vaccine Damage Bill, which was briefly debated in this House on 10 September. Why have they not even uprated the £120,000 payment under the scheme to take account of inflation since 2007, when it was last reviewed? On this basis, the maximum should now be over £177,000. Why have no payments yet been made under the scheme, even where a full inquest has established that the vaccine was the cause of death?

That, sadly, is the situation of Lisa Shaw’s family. The 44-year-old BBC Radio Newcastle presenter died from a brain haemorrhage confirmed by a coroner in August as having been caused by the AstraZeneca vaccine, as reported in The Sunday Telegraph on 5 December 2021. Another case about which somebody has written to me arose from a decision by the Westminster coroner who recorded the AstraZeneca vaccine as the cause of death on her mother’s death certificate. Neither of those families is yet to receive any acknowledgement that they qualify under the VDPS, let alone that they will be compensated. Are the Government disputing these coroners’ verdicts? I sincerely hope not, and perhaps the Minister can confirm that in her response.

The Sunday Times reported on 27 February this year that 920 coronavirus vaccination injury claims had been registered, but none has been accepted or been the subject of any payment. That article referred to Zion Spit, described as “a ridiculously healthy” 48-year-old antique dealer from Cumbria, whose death was confirmed as having been caused by the vaccine. His partner of 21 years and fiancée, Vikki Spit, has been in touch with me to express her solidarity with my efforts to obtain redress from the Government and her frustration at the Government’s refusal to engage with victims and their families.

Will the Minister please tell us now when the first payments will be made under the VDPS, and why, despite having told me that 26 staff are now processing claims—11 more than in December—no payments have yet been made? Will she also say how many medical assessors are currently reviewing outstanding cases, and when the backlog will be cleared?

[Jim Shannon (Strangford) (DUP)]

First, I congratulate the hon. Gentleman on bringing forward this debate. He has been a doughty campaigner on this issue, and we all recognise that and wish him well. Does he not agree that while it is right and proper that we have confidence in the vaccine—including those of us who have taken the vaccine; the two doses and then the extra one—there are undoubtedly occasions where things go wrong, as he has outlined, and on those occasions there should be appropriate compensation? The Government and the Minister have a duty of care, and indeed a moral obligation to stand up for those people, and when it comes to being appropriately compensated, that must move in line with the times and reflect not just the loss alone, but dealing with the consequences.

[Sir Christopher Chope]

I agree absolutely with the hon. Gentleman. I describe him as a veteran of this issue, because he was one of the Members who participated in the 2015 debate to which I referred.

Many of those who have written to me have indicated that even a payment of £177,000 would be totally inadequate for the injuries and financial losses that they have suffered, including loss of earnings and the cost of care. The range of adverse conditions caused by the vaccines is extensive. By way of example, Mr Julian Gooddy of Henley has given me permission to disclose his circumstances because of his frustration at the lack of understanding by the Government.

Two weeks after his vaccine, Mr Gooddy experienced acute pain throughout his body. He developed Bell’s palsy, required treatment for his left eye, which would not close, and suffered bowel incontinence and severe fatigue. Peripheral numbness and pain in his upper legs, feet, neck and hands then developed. He was in and out of the accident and emergency department at the John Radcliffe Hospital for two weeks, being prescribed steroids, pain killers and undertaking multiple MRI and CT scans, electromyographs and nerve conduction studies. He then collapsed at home in pain and was admitted as an in-patient for five days of intravenous immunoglobulin in an effort to halt the continuing nerve damage caused by the autoimmune response to the vaccine. He was then diagnosed with Guillain-Barré syndrome, which is an autoimmune disease in which the body attacks its own myelin sheath.

Does my hon. Friend the Minister, having listened to the circumstances of Mr Gooddy, believe that his case meets the 60% disablement threshold? I have received so many other reports of complicated symptoms, which have been a real nightmare for our hard-working NHS to address and for which there are, in many cases, no cure.

--- Later in debate ---

[Maria Caulfield]

If my hon. Friend contacts me after the debate I will be happy to find out what specific help is available for her constituent in the local area. But we do have a robust safety mechanism in place, dealing with not just covid vaccines but all medicines, and the VDPS was established in 1979 as a one-off, tax-free payment, with the aim of easing the financial burden on individuals when, on very rare occasions, vaccination has caused severe disablement.

For the specific groups of vaccines that are covid-related, the Prime Minister announced on 21 September 2021 that responsibility for the operation of the VDPS would transfer from the Department for Work and Pensions to us in the Department of Health and Social Care on 1 November 2021. We are picking up that mantle and are working at pace to address the many issues my hon. Friend the Member for Christchurch has raised.

[Jim Shannon]

Will the compensation scheme to which the Minister referred apply across the whole of the United Kingdom of Great Britain and Northern Ireland—will people in Northern Ireland, Scotland and Wales qualify if they have ailments such as those to which the hon. Member for Rutland and Melton (Alicia Kearns) referred?

[Maria Caulfield]

My understanding is that it does, but I will clarify that for the hon. Gentleman as I do not want to inadvertently mislead the House if I have got it wrong.

The NHS Business Services Authority has taken over the process and is looking to improve the claimant journey on the scheme through increasing personalised engagement and reducing response times, which was one of the points made today. A difficulty we have with the covid-19 vaccines is that they are new; we are still learning about them and the scientific evidence on potential causal links between the vaccine and instances of disablement is still developing. That is part of the reason for the delay in claims being addressed.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 1st March 2022 Commons Chamber

[Maria Caulfield]

I absolutely agree; my hon. Friend hits the nail on the head of why we are seeing such problems in dentistry. We have started negotiations on the dental contract and are working with the British Dental Association. The UDA has to be reformed as part of that: it is a perverse disincentive that turns dentists away from providing NHS services. I will keep her updated on our progress.

[Jim Shannon (Strangford) (DUP)]

I thank all the Ministers for their responses. What steps have been taken to work with the Education Secretary to provide a higher number of places for medical students containing a golden handshake that allows for no student loan repayment or fees on condition that they stay in the NHS for a set time?

[Sajid Javid]

It is an important question on the workforce. The hon. Gentleman will know that over the last two years we have removed the cap on medical places and we have the highest number of doctors and dentists in training ever. It is right to think about what more we can do, however, and we are having active discussions with the Secretary of State for Education to see what can be done.

Organ Donation and Transplantation Strategy

Jim Shannon Excerpts

Wednesday 23rd February 2022 Westminster Hall

[Anthony Mangnall (Totnes) (Con)]

I beg to move,

That this House has considered the organ donation and transplantation strategy.

It is a pleasure to serve under your chairmanship, Ms McVey. I thank the Backbench Business Committee for granting the opportunity to debate the important topic of the organ donation and transplantation strategy. I also thank the Minister and her departmental team for their responses to my inquiries about organ donation on behalf of my constituents. Their answers have been detailed, helpful and reassuring.

In the time I have been in this place, I have learned that Westminster Hall debates are not always used to be helpful to the Government and are often used to point out their flaws and failings. I may be guilty of having done that once or twice myself, but I want to use this debate to do three things. First, I want to congratulate the Government on the steps they have taken thus far, most notably with the Organ Donation (Deemed Consent) Act 2019. Secondly, I want to encourage further education and awareness around organ donation. Thirdly, I want to explore future steps that the Government can take in relation to organ donation and transplantation strategy.

In May 2020, the law around organ donation in England was changed to allow more people to save more lives. The Organ Donation (Deemed Consent) Act, which many hon. Members present supported, changed the law to mean that an individual agrees to become an organ donor when they die if they are over 18, have not opted out and are not in an excluded group. The Government’s legislation brought us more into line with other countries but, more importantly, the number of available organ donors increased dramatically, while the number of people opting out of the opting-in initiative only slightly increased. Pre opt-out—before 5 May 2020—the UK had 26,037,200 registrations, whereas the total UK opt-in registration was 27,594,279 on 13 February 2020. By comparison, fewer than 1.5 million people opted out before 5 May 2020, with the total number now standing at 2.3 million. These numbers show that in less than two years, we have had a sizeable increase in the number of potential organ donors, while only a small percentage of the population have chosen to opt out of the initiative.

NHS Blood and Transplant launched a public awareness campaign in April 2019 to inform the public about the prospective law change and the choices available to them. An evaluation of that campaign found that over 75% of adults in England were aware of the new system of consent. The third year of the campaign, which I believe comes to an end in March 2022, looks to encourage people to talk to their families and loved ones about organ donation and their organ donation decisions. With consent rates currently at 68% across the UK and 78.8% in the south-west, it is particularly welcome to see the Government state their ambition to increase consent levels to 80%. A 12% increase is likely to result in approximately 700 more transplants per year and countless lives saved.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing the debate. The hon. Member for Barnsley Central (Dan Jarvis), who is present, the former MP Geoffrey Robinson and I were part of the team that worked to get the organ transplant legislation changed. As a member of the Democratic Unionist party, I was always in favour of the opt-out. I am very pleased to say that my party saw the light and supported that line of thought. With Northern Ireland and other countries in the UK having passed legislation to adopt the choice to opt out of organ donations, does the hon. Gentleman agree that now is the time for a UK-wide strategy to ensure that no organ is lost because the system does not efficiently make the most of the connectivity between each region of the United Kingdom of Great Britain and Northern Ireland?

[Anthony Mangnall]

I am always delighted to take questions from the hon. Gentleman. I absolutely agree that if there is parity in all four corners of the United Kingdom, there is an opportunity to ensure that all citizens can get the organs they need; that they can get on to the register where possible; and that there is a developed and comprehensive transplantation strategy across the country. I understand that the hon. Gentleman went further than his party and was by far one of the earliest supporters of the opt-out initiative. I know to my heart that he was a pioneer in leading his party and getting them to where they needed to be to see the changes in Northern Ireland. I am grateful for his question.

As I was saying, the Government and the NHS should be proud of the campaign that they have run to date, and the undeniable progress that it has delivered. That brings me to my second point: the organ donor register. I am sure that all colleagues here today will agree that it is essential that we encourage as many people as possible to sign up to the organ donor register. As of 31 March 2021, 38% of the population had joined the register, while 3% had opted out. Initiatives are already in place to increase registration, with a number of routes available, whether through the Driver and Vehicle Licensing Agency, the NHS app, applying for a Boots advantage card, or even through the NHS Blood and Transplant organ donation website, which, just for clarity, is at www.organdonation.nhs.uk.

It is vital that we continue to keep as many avenues open as possible, and that the campaign continues to be fully supported and championed by the Government. With that in mind, I ask the Minister what plans are in place to continue to raise awareness of the organ donor register and to encourage continued conversation and education around organ donation. Secondly, would the Minister consider extending the scheme to include other official forms? That might include, but not be limited to, those signing up to the electoral roll or giving blood.

The organ donor register moves an individual’s organ donation from a passive decision to an active one. For every individual that decides to sign up to the organ donation website, they are providing a record of their consent to help save lives should the unimaginable happen to them. Importantly, by signing that register, individuals are providing an affirmation of their desire to be an organ donor, which I hope that their family members and loved ones will honour—I will touch on that again shortly.

As of 13 February 2022, there are 6,157 people waiting for an organ transplant in the UK. Even the large numbers that I have buried the House in thus far hide the fact that there is a shortage of donors in the UK. Between April 2020 and March 2021, in the UK, there were a total of 1,180 deceased donors and 444 living donors, which resulted in 3,391 lives being either saved or dramatically improved by an organ transplant. However, 474 people died while on the active waiting list and a further 693 were removed, primarily because of deteriorating health. Of course, I accept the varied reasons why people come off the list, but the numbers provide an indication that while the situation is improving, there is still work to be done.

The NHS Blood and Transplant strategy, “Organ Donation and Transplantation 2030: Meeting the Need”, published on 1 June, calls for a highly public campaign broadening the settings in which people might find information around organ donation. It also includes six key points: making living and deceased donation an expected part of care; developing and pioneering new technologies and techniques; ensuring recipient outcomes are the best in the world; ensuring that people of all backgrounds and circumstances have timely access to the organs they need; maintaining a sustainable service across the UK; and building a pioneering culture of research and innovation in donation and transplantation in the UK. I ask the Minister how those six action points are being monitored, and how often they will be reviewed. Furthermore, does she feel that anything should be added to those points since the introduction of the 2019 Act?

Although I promised to be positive and congratulatory about the Government’s action on this matter, I am aware of a few areas relating to organ donation that are causing some concern. As mentioned already, under the 2019 Act, and specifically the opt-out system, all over-18s—albeit with a few caveats—are considered to become organ donors when they die unless they opt out. An individual can also actively register, as I have mentioned already, through the organ donor register. However, a family member or loved one can—and often does—overrule the donation of an organ in both instances. As mentioned already, the consent rate for eligible donors was 68% between April 2020 and March 2021, meaning that loved ones, for various reasons, refused to support 32% of potential donations. That equates to 695 donors.

There are myriad reasons why consent for deceased donors might not be given: the patient expressing a desire not to donate, but not opting out; a lack of desire for further surgery on a body; a feeling that the patient had suffered enough; the fact that the process takes too long; or the fact that the donation was against religious beliefs. Of course we must respect the decisions and views of family members and loved ones; staggeringly, however, 10.2% of those 32% of organ donations were refused because family members were unsure about whether the patient would have wanted to donate. Surely that clearly shows the continuing need to have a conversation and actively encourage greater sign-up to the organ donation register. In actual numbers, that 10.2% equates to 71 individuals whose organs might have helped to save a great number of lives. Of course, I make no judgment about those families and the decisions that they take in incredibly difficult circumstances, but there is an opportunity for us to go that little bit further and help save those extra few lives.

With that in mind, what progress has been made with the Leave Them Certain campaign mentioned in the NHS Blood and Transplant strategic plan, which I referenced earlier? I understand that the Human Tissue Authority guidance specifically states that families will always be consulted and that scrutiny is needed in the process. However, where possible we should be trying to eliminate the second-guessing and possibility of going against the deceased’s final wishes.

I asked for this debate because among the regular correspondence that I have had with constituents on the matter of organ donation, I have had the incredible good fortune of having been introduced to Sarah Meredith and her family. Sarah is a 29-year-old constituent who lives with cystic fibrosis. Thanks to the approval of the drug Kaftrio, Sarah and thousands of others living with cystic fibrosis can look ahead with an improved degree of certainty and a greater quality of life. However, that wonder drug does not solve all the difficulties of living with that disease; Sarah needs a liver transplant.

Over the course of the last two years, I have met Sarah’s mother Cathy and sister Jessica to hear first hand about the ailments from which Sarah suffers and some of the problems that they have identified within our transplant system and the wider regional disparity when it comes to healthcare services. I have already highlighted some of the concerns around organ donation, but I would like to add a few words about healthcare infrastructure. The organ utilisation group, chaired by Professor Stephen Powis, was established by the then Health Secretary, my right hon. Friend the Member for West Suffolk (Matt Hancock), to provide recommendations that would deliver improvements in the number of organs accepted and successfully transplanted; to optimise the use of existing skilled workforce investment in infrastructure; to support innovation in the field of organ transplantation; to standardise practices across the country—a point made by the hon. Member for Strangford (Jim Shannon); and to provide equity of access and patient outcomes. I look forward to seeing the recommendations, the report when it is published—in March, I believe—and the Government’s response.

Will the Minister come before the House when the report is published to take questions from Members interested in this topic? Although the south-west can boast a high consent rate—it is only slightly off the Government’s 80% target—we are at something of a disadvantage when it comes to liver transplant units across the region. There are just eight such units in the UK, including one in a children’s hospital. The liver transplant centres nearest my constituency of Totnes in south Devon are in either London or Birmingham.

I have heard anecdotal and first-hand accounts about ill patients who have been asked to make the journey to London from south Devon for a transplant, only to arrive and discover that the organ they were expecting has deteriorated and is no longer suitable for transplantation. One can only imagine how awful that journey is in both directions in that situation. I understand that there is a new national programme to expand the number of living transplant centres across the UK and that the north-west and south-west are two priority areas due to a lack of existing transplant infrastructure. Will the Minister reassure me and all those across the south-west who are hoping for an improved service that this new programme will be rolled out at pace? It is clear that many cannot wait.

[Anthony Mangnall]

I thank the hon. and gallant—and mayoral—Member for his intervention. He has been an extraordinary champion on this matter; a significant amount of my research has been on the back of his words in this place to help to get that legislation to where it needs to be. On his point about education, I think he is absolutely correct. We need a combination of education and funding across all our hospitals, GP surgeries and other available forums to promote this issue so that we can bring down that five-year high and help to get as many people as possible off the transplant list, as quickly as possible.

[Jim Shannon]

I want to say for the record that my nephew—my brother’s son—had a kidney transplant; he was born as a wee child with a kidney the size of my thumbnail. He had to wait until he was almost 16 before he got a transplant, but he got it, and today that young man has a full life because of that. If anyone ever needs evidence—I know we all have some—of what a transplant can do, I can speak personally to that.

[Anthony Mangnall]

As ever, I thank the hon. Gentleman for his powerful intervention. He uses personal experience to lend great weight to a very serious topic, and that has certainly been registered by me and by the House. As we develop more and more strategies, as I hope we will, to encourage more and more to sign up on the organ donor register, people will hear his words, among those of others.

We are often quick to say that other countries have it better than us. While I am not suggesting that that is the case—especially thanks to the remarkable improvements that have been made over a short period of time—I will ask the Minister a final two questions. First, what engagement and consideration has the Department of Health and Social Care given to other countries’ organ donation and transplant strategies? Spain is often mentioned, and I would be interested to hear whether there is any consideration of that model and whether we can learn anything from it.

Secondly, the transplant benefit score also determines the position in which a patient might sit in relation to receiving an organ. How is that position altered when a new drug is used on a patient, presumably—one hopes—improving their situation? It would be interesting to understand whether the transplant benefit score is quick enough to determine where they are on that list.

The Meredith family are a fantastic group of campaigners for organ donation, and they are the reason why this debate is happening. I hope that their efforts in pushing me and others will result in renewed campaigns to make people aware of the organ donation register and to improve access to transplant facilities in the south-west. I very much look forward to hearing the Minister’s response.

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

It is a pleasure to serve under your chairmanship, Ms McVey. I thank my hon. Friend the Member for Totnes (Anthony Mangnall) for securing this debate and for being such a passionate champion for organ donation and transplantation. Having helped the hon. Member for Barnsley Central (Dan Jarvis) with the legislation, my hon. Friend is not just sitting on his laurels, but continuing with the campaign, because, as has been said, the legislation on its own is not enough to make a difference.

I also thank all those donors and their families who, at a very difficult time in their lives, have to make incredibly tough decisions. Even with the changes in legislation, it is an incredibly difficult time for them. Hon. Members will know that the 6,000 patients across the UK who are today waiting for lifesaving transplants are incredibly grateful for those who donate. The estimate is that every donor can save around nine lives, so it really does make a difference. More than one person a day sadly dies on the waiting list, so it is crucial that organ donation continues to be a high-profile issue.

It is nearly two years since the introduction of deemed consent for organ and tissue donation, known as Max and Keira’s law. All donors are now considered potential organ and tissue donors after death unless they make a decision that they do not want to donate. As my hon. Friend has said, among all the families approached since May 2020, the consent rate is about 66%. It could be higher. It is a good figure—much better than where we were—but there is still a lot of room for improvement. However, it has led to 296 organ donors and resulted in 714 organs being transplanted: we cannot overestimate the difference that has made to the individuals who received those organs and to their families.

If people wish to opt out, they can do so: currently, 27 million people have opted into the UK organ donor register and 2 million have opted out, so there is flexibility there. However, for many people, there is still a lack of awareness that a register exists, and very often they have not had those conversations with family members. Should the time come when, unfortunately, an incident happens and organ donation needs to be considered, families play a crucial role throughout the donation process, both helping NHS staff understand the wishes of the deceased and ensuring their organs are suitable for transplantation. As my hon. Friend the Member for Totnes has pointed out, it is really important that we continue to have national conversations about organ donation, so that if the time comes, the family of the deceased person are aware of what the issues are. Even with an opt-in and opt-out system, that conversation should take place well in advance.

At difficult moments, both families and NHS staff who may be working in A&E or in different clinical units may not feel comfortable having that conversation. When the family are struggling to come to terms with the fact that their loved one is on the register, but they are not happy about that, those are very delicate conversations to have, and it is important that staff are supported as well. The views of the family will always be taken into account: even though they cannot revoke legally valid consent, they will have an influence; as we heard from my hon. Friend, that is having an impact and meaning that some donations are not happening.

The role of the specialist nurse in discussing the matter sensitively and helping to understand some of the family’s concerns is important and that role needs to be facilitated wherever possible, because that can make the crucial difference between the family accepting the decision of their loved one and not coming to terms with it. We need to make that conversation routine and build awareness, because a 32% impact on the loss of organs into the system for donation is a very high figure.

NHS Blood and Transplant, which is responsible for organ and tissue donation across the UK, has launched the new UK-wide organ donation strategy, the main aim of which is simply to increase organ donation and transplantation. My hon. Friend the Member for Totnes asked what work is being done to raise awareness: we have organ donation week in September, and last September that led to the Leave Them Certain campaign. That campaign aimed to reinforce the role of the family and normalise people sharing their organ donation decision with family members so that, if that discussion needs to happen, it does not come as a shock. We are also introducing organ donation and transplantation into the school curriculum, because it is important to start that conversation early on, and aiming to promote awareness in young people about not just their own decision, but that of their other family members.

There was a multimedia campaign on Valentine’s day this year—my hon. Friend might have been busy on Valentine’s day; I do not know—to encourage families to have a heart-to-heart discussion about organ donation. There were 300 people waiting for a heart transplant on Valentine’s day, including more than 40 children, so it was thought crucial to raise awareness on that day, but we can all do our bit when it comes to promoting the need for organ donation. World Kidney Day is 11 March, which will provide us with another opportunity, but I am very happy if my hon. Friend wants to apply for another debate this coming September to hold our feet to the fire in making sure that we are driving up organ donation numbers.

I want to touch on health disparities, because some communities are struggling more than most when it comes to organ donation. Black and Asian communities face significant shortages and significantly longer waits—around 10 months longer than the general population—and much of that disparity is due to the lack of donation in those communities. There is a whole host of reasons why that is and, as my hon. Friend the Member for Totnes has said, this is not about judging those who do not donate: it is about increasing awareness of the difference that organ donation can make to people’s lives. Alongside other stakeholders, such as the National Black, Asian and Minority Ethnic Transplant Alliance and all the main faith organisations in England, we are actively trying to tackle some of the concerns of particular groups and communities around organ donation. We are raising awareness and promoting the work that can be done.

I am particularly concerned about the point that my hon. Friend mentioned about provision for living donations in the south-west, and the logistics that sometimes lead to donations and transplantations failing. If someone is willing to donate an organ, we should make every effort to ensure that it becomes a successful transplant. I will take away his point and look at some of the factors that might be influencing that situation.

Covid has had an impact on the service. As we heard from the hon. Member for Barnsley Central, the waiting list is higher than it has been in past, but I am pleased to say that organ donation and transplantation has now mostly returned to pre-pandemic levels, although there is a backlog of people to get through.

[Jim Shannon]

In my intervention, I referred to the need for co-ordination between the four regions, so that no organ could or would be lost. There was some discussion in the newspapers, although I am not sure of the evidential basis for it, that said that some organs had been lost during the covid pandemic. Let us make sure that does not happen.

[Maria Caulfield]

The hon. Gentleman is absolutely right. We need to ensure that we tackle any practical or logistical issues; I am happy to look at that. If there are particular regions where the centres are difficult to access because of the distances involved, then we absolutely need to consider that.

I take on board the points made by my hon. Friend the Member for Totnes about improving the ability of people to sign up for the register, whether through the electoral roll or through other mechanisms; we want to make that as easy as possible. I am convinced that there are groups of people who would be very happy to donate, but we need to make it as easy as possible for them to do so.

I will look at international comparisons. If there are lessons to be learned from other countries, let us not reinvent the wheel but gain some knowledge from them.

I thank all hon. Members for taking part today, particularly my hon. Friend the Member for Totnes, and I thank the Meredith family, who are driving this campaign forward and are the reason for the debate today. We are making huge progress. The legislation has made a big difference, but there is lots more we can do to ensure that people are not waiting on the transplant list any longer than they need to.

Question put and agreed to.