Infant Mental Health Awareness Week

Jim Shannon Excerpts

Thursday 16th June 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate. The right hon. Member for South Northamptonshire (Dame Andrea Leadsom) deserves every credit. She and I came to this House in 2010, and she has spoken about this issue in Westminster Hall and in the main Chamber on many occasions since. She will correct me if I am wrong, but I do not think that there has been a time when I have not supported her in such debates.

I do that for a number of reasons: first, because of our friendship as MPs, but secondly, because I fully support and endorse the right hon. Lady on this issue. I am always challenged by her contributions because they are so full of detail and knowledge about the right way to do things. The input of mothers is so much greater than the input of the dad. As a father and not as a mum, I cannot take any credit for how my children turned out; it is really down to my wife. She is the lady who did all the hard work—I was very rarely there—so I recognise the role of the mother in particular is critical, and it moulds the child for the future. For that reason, I am really pleased to come along to this debate.

[Munira Wilson]

Will the hon. Gentleman join me in saying that it is a wonderful thing to see cultural change and dads taking a much more active role? My husband is the primary carer of our two children and is very much the dad at home, and he has been since they were tiny, while I have always been out there working.

[Jim Shannon]

I was reminded when the hon. Lady mentioned that that I was at a function last Friday for the centenary of the Royal Ulster Constabulary. One of the councillors of my party is a house dad and he looks after two children. I will not mention his name, but he said to me last week, “Jim, I’d rather be working.” I said, “You are working, you’re just looking after the children. It’s slightly different.” But yes, the hon. Lady is right; society is changing, and sometimes that is the way it is. I have to say that I do think the role of the mother is much more important. That is just me; maybe I am old fashioned. I just see a slightly different and more critical role for the lady.

A growing body of evidence from the fields of clinical and social science shows that the areas of the brain that control social and emotional development are most active during the first three years of a child’s life. The hon. Member for Twickenham (Munira Wilson) referred to that, and referred to three to five years as well. That is important. Careful nurturing of a child’s social and emotional health during their early years is vital to provide them with the skills necessary to form relationships and interact with society later in life. It is so critical to get that right in those first few years. The hon. Lady has always said that in debates in the Chamber and elsewhere. I am my party’s health spokesperson, so I am pleased to be here, given my personal interest in the issue and as a grandfather with five grandchildren. The sixth is on the way, so we will shortly have a sixth one to nurture and look after. It means that the Shannon name will live on, and more so when the sixth grandchild arrives.

Developments start during pregnancy, and the choices and experiences of the mother during that period can have a significant impact on maternal and infant social and emotional health. With that in mind, Northern Ireland has a dedicated mental health strategy. I know that the Minister is aware of all those things, not just because some of her ancestry comes from that part of the world, but also because she makes it her job to be aware of what is happening in the regional Administrations. Although we have a mental health strategy in place, the pressures of lockdown and covid have greatly impacted child mental health, and any strategy must take that into consideration.

I want to focus on that issue, which the right hon. Member for South Northamptonshire referred to in relation to covid. Covid has put extra pressure on what the right hon. Lady is trying to achieve, and what we are trying to achieve in this debate. We have more children than ever who, as we say in Northern Ireland, make strange with strangers. I will try to explain what that really means. The right hon. Lady referred to isolation during covid, and it is as critical and stark as that. Covid babies were literally prevented from seeing other children; that is a fact of life. “Being strange with strangers” means nothing more than not knowing how to act with wee children of their age or how to react to adults who want to be friendly and acknowledge them. Children being strange with strangers, having not seen other children and adults during formative periods of their lives, is a critical issue that needs to be addressed.

Ever mindful that health, education and so on are devolved matters—although the issue for Northern Ireland will be similar to here—I have a major ask of the Minister, which I will be happy if she can respond to. What extra assistance, help, funding or advice can be given to parents whose children were born or were between two and five during covid—those two stark years when life was so different and we could not interact? What can be done to address that issue as we come out of covid and move forward in a constructive way?

Naomi from my office—who is my speechwriter, by the way; I keep her busy and make sure that she is across all these things—and I are of a kindred mind and spirit, so it is easy for us to discuss the issues that I want to speak about, because we look at how to do things the same way. She helps with the creche and the children’s church on Sunday morning, and she has told me, based on her personal experience, that it is only after a full year of being back that some mothers can slip back into the main service without their children getting upset. Let me explain what that means, Madam Chair. In the last two years, the covid pandemic put pressures on families like never before, which meant that the children probably did not leave their mum very often. Now that the creche and the children’s church is back, the children are able to stay there and their mums are able to leave.

That wee period is an example. In Naomi’s opinion, it has taken a year for those children to feel safe, even in a safe place—wow!—if their mother is not there. My fear is for those mothers who have been unable to leave their children—those who do not attend church, do not have a creche or nursery, or do not have access to other adults who could help. The right hon. Member for South Northamptonshire said how important it was for mums to have another mum to talk to, and even that was partially lost in the pandemic. I also wonder about pre-school and nursery children.

We must consider the effect of lockdown in a very detailed way. It is a genuinely big question to ask the Minister, but I see it in my constituency, and I am sure that everyone in this debate will be on the same page. I recently read a report by the National Children’s Bureau that highlighted the post-covid position. Although support for babies and infants, and their families has always been critical, the unprecedented covid-19 pandemic has refocused efforts on prevention and early intervention to address new or increasing risks, which is what this debate is really about.

Although it will be some time before the long-term impact of the pandemic is known, evidence already suggests a number of areas for concern, including the rising cost of living. The pandemic has moved on, but other things are impacting on young children, from babies right through to five-year-olds, including the cost of living and increasing fuel poverty. These are real things that every mother and every dad has to look at every day. I am no different from anybody else in this Chamber; I think that we are all the same. We are hearing regularly from our people and our constituents about these issues, and we worry about that. Again, that is not all the Minister’s responsibility; it is just to show the impact that these things are having.

Many people and families are increasingly reliant on food banks, which comes on top of already unacceptable child poverty rates, and against the evidence about the links between poverty and adverse childhood experiences. I never fail to get quite upset when I read those stories in the press about wee children who have been abused or, in the cases that make the press unfortunately, killed. I just cannot understand how those things can happen. I cannot understand the mindset of anybody who does that, and I cannot understand how social services did not step in earlier. This is just me, speaking from the outside. I find those stories quite painful to read, Madam Chair; I think we are all the same in that regard. Sometimes, you just have to flick over the page—not that you are disregarding it, but because it is so awful that you just cannot read it all. Those are some of the things of the day, along with concerns about parental mental ill-health, which is being driven by isolation, job uncertainty or the loss of a job, the loss of loved ones, illness and anxiety, among other factors.

I will just make a couple of quick points—I am coming to the end of my remarks; time is flying on here. I am greatly encouraged by foster families. The right hon. Member for South Northamptonshire is absolutely right about that. I know foster families who do some fantastic work, and they have a love for their children. Although they are not their biological children, they are their children. Those children get the love they did not have in their own homes, for whatever the reasons were. I know some foster families who have adopted maybe 20 or 30 children—that is incredible. They give affection and love, which is so necessary for a wee baby or small child between three and five, which are such important years.

Increased pressures in the home and the rising incidence of domestic violence—which is unfortunately another issue that happens with a regularity—are putting young children at risk of witnessing or experiencing abuse, and it impacts parental wellbeing. They see their mummy or daddy—let’s be honest, more often their mum—getting beaten, and that affects the child. The right hon. Lady is right: the experience of that three to five-year-old seeing that will have an impact for years to come. That is why this debate is critical and why over the years, when she has brought us to Westminster Hall and the Chamber, I was always there. I understand—not as good as the right hon. Lady does—what she is trying to achieve.

Services are facing pressure as they seek to continue the delivery of essential support to infants, parents and their families within the constantly changing environment that they find themselves in. The environment is changing all the time, and the pressures are great. There have been delays in access to services and support during lockdown and the pandemic, particularly for isolated and vulnerable families with newborns. Sometimes mothers have difficulty dealing with their children—it happens. It is a fact of life, but having someone to speak to and to help at that early time is so important.

The hon. Member for Twickenham is absolutely right about the need to invest in our children and young people. I see it as an investment and an opportunity to get it right, so that the children of the future can grow up to be Ministers, Chairs of Committees, doctors, teachers or MPs. We should give them the opportunity to do that. Let us get things right at the early stages. Every child deserves a good start in life, as the right hon. Member for South Northamptonshire said. I agree wholeheartedly with that, and I hope the debate can in some way move us towards that.

The need is clear, and we need to be just as clear in our pathway to support and help and in how this will be funded and promoted in every area of this United Kingdom of Great Britain and Northern Ireland. I am pleased to be an MP here and part of a nation that is united across the four regions. I say that to the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—she and I are good friends. It is important that we have a strategy and a way forward for all four regions to achieve what the right hon. Member for South Northamptonshire said: giving every child a good start in life. If we could do that, we would be doing well.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 14th June 2022 Commons Chamber

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

Of course every suicide is a tragedy. We must do all we can to help to prevent suicide. In the last financial year, we provided £5.4 million to 113 voluntary, community and social enterprise organisations; we also provided £510,000 for the Samaritans helpline for people experiencing distress. That is in addition to more than £10 million we provided to voluntary and charitable mental health organisations in 2020-21.

[Jim Shannon (Strangford) (DUP)]

As IVF treatment is incredibly time sensitive, will the Secretary of State consider increasing the funding available to allow couples to make use of private facilities on the NHS, to help families have the children that they so much want?

[Maria Caulfield]

I cannot comment on health in Northern Ireland specifically as it is a devolved matter. IVF will be a significant factor in the women’s health strategy, because we recognise the disparities that exist across the country in how couples currently access IVF.

Menopause

Jim Shannon Excerpts

Thursday 9th June 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

As always, I am thankful to be able to speak on behalf of my constituents. I want to start by congratulating the hon. Member for Swansea East (Carolyn Harris). I have been fortunate in my life to have always been surrounded by powerful women. It was my mother to start with, then my wife, and in the political sphere the hon. Member for Swansea East, who is a really powerful lady. Whenever she asks me to be involved with debates, she is pushing on an open door. She knows I will be more than happy to support her—I always have been.

When the hon. Member for Swansea East started this campaign some time ago, she and I talked about it, and she was very keen to have a man on board. I am very happy to give my support, for a number of reasons. I do it because the request is right: it is about raising awareness. As a man, I do not find these subject matters particularly easy to discuss—it is probably my old-fashioned, traditional nature—but I know that these things happen. It happened to my wife, Sandra. We have been married 35 years. She is an extremely powerful lady. She is very understanding and has stuck with me for 35 years, so I think that tells you all about that lady.

I remember that when we married she had period problems. The doctor she went to see was very good and he said, “Sandra, when you have children, everything will change.” Well, it did not. We had three children fairly quickly in a period of five to six years. We both wanted children. I was very fortunate to get three boys. I think Sandra would have liked a wee girl, but it did not work out that way. Throughout her life, she always had problems with her periods—they were always very heavy—but then she came to the menopause.

I am pleased to speak in this debate and give a man’s point of view. I am giving a husband’s point of view, too, because I understood from the very beginning what the problems were for my wife. It was all the things that the hon. Members for Belfast South (Claire Hanna) and for Guildford (Angela Richardson) referred to: the night sweats, the brain fog, the pain, the agony. She just could not get settled and was always restless. I understood why that change was coming in Sandra’s life. I was not there all the time—perhaps that was better for her, actually—but whenever I was, on those three and a half days a week, I understood that she was having terrible difficulties. We are lucky that the boys have left the house, but the two cats and the dog absolutely dote on her. They do not understand what is happening, but they trot alongside her.

I tell that story because I want the ladies here—the right hon. and hon. Members—to know that I do understand, although I have not experienced it personally. The hon. Member for Belfast South asked what would happen if men could live through this. I tell you what—we would have a different attitude. I have lived through it with my wife, and I think I understand it—I hopefully understand it well.

I have been very pleased to see more businesses and people seeing the benefit of bringing menopause into the light. The civil service has launched a menopause strategy, citing that females account for 50% of the 24,000 Northern Ireland civil service workforce, and that more than 55% of the female employees are over the age of 45, so a significant number of employees are likely to be affected by the menopause. The aim of the policy is to raise awareness and understanding of menopause and outline the support available.

The hon. Member for Belfast South and I, as Northern Ireland MPs, understand this debate from a Northern Ireland perspective, but also because we are active constituency MPs. We understand the importance of having a good workforce who are able to do the work and understand when things are not right.

The hon. Member for Cities of London and Westminster (Nickie Aiken) referred to GPs. I have seen a change—I just whispered this to the hon. Member for Belfast South—in GPs and doctors in my constituency. The hon. Member for Cities of London and Westminster inadvertently, or maybe purposely, referred to her friend from Killinchy. Men have retired and ladies have taken their place, so I hope that means that there will be better understanding. Giving depression and anxiety mediation is the wrong thing to do; HRT should be given. I hope to see those changes. I see them in my doctor’s surgery and in the surgeries and clinics in Newtownards. That seems to be replicated across the whole of the constituency, and I suspect it is happening in other parts of Northern Ireland. The hon. Member for Belfast South, in conversations we have had, has said that women GPs and doctors have to take time out to look after their families. That happens at times, but I see a change coming, with a better understanding, so that in the future we will hopefully not have the problems that we once had in the past.

I referred to the strategy for the 24,000 members of the Northern Ireland civil service workforce, and that comes on the back of the first meeting of the UK-wide menopause taskforce, which has been established to strengthen co-ordination across Government and raise awareness of the impact of menopause, improving care and support for women and ending the taboos and stigmas what still surround a natural part of ageing.

I echo the request that every other Member has made. I am very pleased to see the Minister in her place. I have seen more of her this week than I have seen of my wife—she has been in this Chamber on three or four occasions to respond to debates. She said to me, “You’re back again,” to which I said, “Well, I never leave here.” I am so pleased to see her in her place. I know that she has understanding of the issue and compassion. When the hon. Member for Swansea East was introducing the debate, the Minister was cheering as much the hon. Lady was—that’s the Minister. I look forward to her response.

I am pleased that the taskforce is attempting to lead the way. While I am thankful to all the big businesses that are stepping in to acknowledge this medical issue, my mind turns to those smaller businesses that do not have a human resources department to guide them. I ask the Minister—I do not know whether this is under her control; responsibility might lie with another Minister —what support are the Government offering smaller businesses to help them understand the issues that their workforce are facing, and to support their workforce throughout their journey?

I am very fortunate to have always had powerful women in my life. I have six ladies in my office—apart from me, it is a purely female staff. That sometimes gives me an understanding of what happens in the office among ladies. One of the lovely ladies in my office had a hysterectomy and went through her menopause in her mid-50s. The hon. Member for Cities of London and Westminster referred to the age of 51 in relation to the menopause. I do not miss too much in the office; I usually have a fairly good idea of what is cooking. One of the other girls in the office did a small thing that I think made a big difference. She bought her a wee pink fan—I use the word “wee” all the time; it is a Northern Ireland thing—that sat on her desk and made a psychological difference for her. The girls were telling her, “We know what you are going through.”

[Caroline Nokes]

The hon. Gentleman makes a brilliant point about the small pink fan. Some of the interventions, changes and support measures that employers can put in place are small, cheap, unobtrusive and not difficult.

[Jim Shannon]

The right hon. Lady is absolutely right. As with constituents, the small things that we do are big things in their lives.

At the same time that my staff member had her hysterectomy, one of the younger girls in the office—I have two girls in their early 20s in my office—was going through endometriosis treatment, and her medication pushed her into menopause. It was drastic for a such a young girl, and one who is keen to have children someday— I very often feel for her.

The issue of menopause and perimenopause affects a large amount of the working population. It is great that work has begun to recognise that, but that support should be in every avenue of work, not simply the big companies. Can the Minister therefore give us some indication of what is happening for smaller companies in that regard?

The hon. Members for Cities of London and Westminster and for Belfast South asked about HRT. We would really appreciate an update on the supply of HRT medication. When ladies present themselves to GPs, there needs to be a better understanding of how to respond. In this House we need to ask ourselves how we can come alongside the small business owner to ensure that they are aware of how the small things—as the right hon. Member for Romsey and Southampton North (Caroline Nokes) said—can make a huge difference to the quality of life of their employees, as well as to the environment and productivity in the workplace. It has been said for many years that a contented workforce is a productive workforce, and which of us does not want to understand how to get the best work out of our employees and allow them a decent quality of life?

The hon. Member for Cities of London and Westminster and I must have been speaking to the same script writer. I remember the days when people muttered under their breath, in hushed tones, that someone “must be going through the change.” People almost whispered it—“don’t say it too loudly.” Today’s debate is about saying it loudly, because it is important. That is what the hon. Member for Swansea East has done, right down the line. I admire her courage and determination to make things happen, which is infectious—I come to all her debates and support her in everything she does. I do it because I want to, but also because it is right. This is a debate that is right.

It is time for us not to be ashamed of the menopause or to try to hide it; we should accept that it is a part of life with medical implications. We need appropriate responses in the workplace and appropriate responses from the general public—from men and all those out there who do not understand it. That may be because they do not want to, or because they have a wee bit of trepidation about it. We should give those businesses the opportunity to learn more, and put in place effective policies. That is up to the Departments for Work and Pensions and for Health and Social Care, working in partnership and, respectfully, what I believe we must see.

Again, I am thankful for the opportunity to represent my constituents, and to represent my wife, obviously, since I have first-hand knowledge of how this has affected her. I have always tried very hard to be supportive and understanding. I hope that this will not be another lost opportunity, where words are spoken but no action is taken. To be fair, today’s debate is about actions, and there are people here who drive actions.

I said this in the last debate, and I will say it again:

“Eighty per cent. of women suffer from menopausal symptoms; 100% of women deserve support.”—[Official Report, 21 October 2021; Vol. 701, c. 1023.]

For me, this debate is about every one of those 80% of the ladies, and giving them my 100% support, as everyone else here today does. I look forward to hearing the Minister’s response shortly, and to the participation of my male colleague, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar).

Health and Social Care Leadership Review

Jim Shannon Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

Yes, I do.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and for the commitment to quality leadership within the NHS. As he said himself, that is so important. The review findings and recommendations are a method to deliver that improvement. Retention of staff—the consultants, the GPs, the doctors and the nurses—is core to any improvement, so what is being done to retain staff and not lose them? Is it the Secretary of State’s intention to share the findings with regional Administrations, particularly the Northern Ireland Assembly, to provide betterment across all the United Kingdom of Great Britain and Northern Ireland?

[Sajid Javid]

The hon. Gentleman will know that the review specifically looked at the NHS and care in England, but there are important lessons here that can be drawn on by, for example, the health service in Northern Ireland. On the issue of retaining staff, the NHS is undertaking many initiatives to improve that, but I hope he will agree with me that one key way to retain staff is to ensure we have good leadership and good managers.

Government Action on Suicide Prevention

Jim Shannon Excerpts

Wednesday 8th June 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

As my party’s health spokesperson, I am happy to speak in this debate and to look at how we can improve the mental health services we have in place.

I thank the hon. Member for Bristol East (Kerry McCarthy) and congratulate her on her consistent efforts in tackling issues around suicide prevention and normalising the feeling of not being okay. There is no doubt whatsoever that more needs to be done to support those feeling low and I am pleased we can discuss that today.

This is a difficult subject to address because we all know people who have passed away as a result of anxiety or depression, and whose difficulties meant ultimately they could not cope with life. The framework for the NHS five-year plan in tackling suicide was first published in 2012. It aimed to help those directly affected by suicide and recognised the lasting impacts suicide can have on family and friends. I am grateful that the Government, and the Minister in particular, have set aside £57 million in funding allocated for mental health services by 2023-24. We should welcome that because it shows that the Government and the Minister have recognised the need to do something specific. I hope that that will address issues across the whole of the United Kingdom of Great Britain and Northern Ireland, as I understand some of those moneys will come to us in Northern Ireland through the Barnett consequential.

For me personally, the subject of the debate is quite difficult. The current suicide rates back home in Northern Ireland are devastating, and I use that word on purpose, because they are. Figures indicate that suicide has increased since 2015, with levels increasing from one registered suicide in 2015 to a shocking 100 in 2019. The Northern Ireland Statistics and Research Agency has not yet provided the figures for registered suicides in Northern Ireland over the two-year period of the pandemic, but I have no doubt in my mind that, unfortunately, some may have struggled all too much over the covid period. That is not to mention that, in 2018, it was revealed that more men died by suicide in Northern Ireland than anywhere else in the United Kingdom: an average of 29.1 per 100,000.

My constituency of Strangford has unfortunately had those experiences as well. In Newtownards, the largest town that I represent, there was a period that saw a spate of suicides among young men—a group of young friends. If someone takes their life, those around them are deeply affected. What thoughts does the Minister have on how to address that issue? Every one of us here can probably confirm that that is an issue—I know that I can. It was quite difficult when some of the funerals took place: that circle of friends was decimated and devastated by what took place. In addition, data is presented in the year the suicide was registered, so as inquests are a long process, there are many still to be discovered. I see that in my own constituency.

There is more that can be done in all aspects of government. In health, education, the Department for Digital, Culture, Media and Sport, and transport, there is a lot of room for much-needed improvement in suicide prevention. There are also increased suicide rates among young children. Another thing that grieves me and, I think, others in this House is that social media is one of the most prominent confidence-killers in modern society: children being nasty to other children online. We read truly horrendous stories in the press of young boys and girls taking their lives because they feel pressurised by other children, or sometimes exploited by adults. We have a duty to ensure that, through legislation such as the Online Safety Bill, they are protected and not subject to abuse. I understand that that is not the Minister’s responsibility, but it might be helpful if she can tell us about any discussions with other Ministers on how the Government can address those issues.

We have spent a lot of time discussing the pandemic and its impact on our daily lives, which is not always good—sometimes it is uplifting, but sometimes it is quite disheartening. We must not underestimate the effects of isolation on mental health. As we come out of the pandemic—in England, there are no longer requirements for isolation—people have the opportunity to seek proper face-to-face help. The issue is now whether the support is readily available and accessible for all, which is where we must step in to help with suicide prevention. We should be ever conscious of where we are and how we move forward. I know that the Minister is a lady with a deep interest in her portfolio, and that she understands the issue only too well. I am hopeful that in her response to all our requests, she will speak about what extra help there will be after the pandemic to ensure that those who face today’s complications, problems and overwhelming issues will receive the assistance that they need right now.

Suicide affects many people, and it leaves a nasty scar for friends and loved ones left behind. That is the story in my constituency, and in the cases that I have seen; there has been a spate of young lives lost. As the hon. Member for Bristol East mentioned, Mr Speaker made some powerful comments on the death of his beloved daughter. He stated:

“When it happens, you never get over it”.

How true that is for everyone. For those I know who have lost loved ones, that scar, deep pain and hurt are right in their heart. We can see it in their eyes; they do not have to say a word—look at them, and there is the story. We must learn from this and put our words into action; through legislation, through support, through normalising talking and breaking barriers, we can tackle suicide and initiate support for those who need it. Everyone here is all too aware that there is a fine line and balance between normalising talking and keeping your life, and perhaps tipping over the edge. We all have to face that line; some people have faced it and unfortunately ended their life as a result. It is about how we step in, how the Government step in and how the Minister steps in to make a difference.

Mental health has been characterised as a silent killer, but it affects us all at some stage, through our families, through our friends and through our constituencies. We all share the heartache of suicide and what it can do to families. I commend and thank the hon. Member for Bristol East for bringing forward this timely debate on such a crucial issue. As a former member of the all-party parliamentary group on suicide and self-harm prevention, I can assure her that in this House we all share the desire to do everything we can to help to address suicide prevention. We look to the Minister, as we often do, for the answers to our questions, which we seek not for ourselves, but for our constituents.

Cancer Care: Young Adults

Jim Shannon Excerpts

Wednesday 8th June 2022 Westminster Hall

[Julie Marson (Hertford and Stortford) (Con)]

I beg to move,

That this House has considered cancer care for young adults.

It is a pleasure to serve under your chairmanship, Mr Paisley. Normally I would say that it is a pleasure to be here in Westminster Hall speaking on a particular issue but, of course, it is not a pleasure today. I wish I was not here raising the issue of cancer in young adults.

It is an issue that is horrible to confront and contemplate, but what I feel is nothing compared with what Simon and Andrea Brady feel. Every day they have to confront the reality of what happened to their daughter Jessica, who tragically passed away on 20 December 2020, aged just 27. They are here today because of Jess. I am here because of Jess. My right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) is here because of Jess, and the Minister is here because of Jess—I thank them both for that.

I pay tribute to Simon and Andrea. They are utterly determined in the face of their terrible loss to effect change in Jess’s name. I hope I can do justice to them and to Jess in supporting their call for that meaningful change. We are asking for Jess’s law—a practical change designed to save lives. Jess’s law would be that after the third contact with a GP surgery about a condition or symptom, a case should be elevated for review. After five contacts, it should be red-flagged and set procedures and guidelines should be followed, including a referral to a specialist.

We are clear that this should not be a tokenistic exercise, such as a simple, inconclusive blood test with the patient given an all-clear. The investigations need to be thorough and conclusive to make a real difference and to save lives.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this debate forward. I am moved by her plea on behalf of her constituents. I thank her for her dedicated efforts and for consistently raising the importance of cancer care for young adults like her constituent Jessica, who she has spoken about on a few occasions.

In Northern Ireland, trusts that run screening tests for certain types of cancer, such as breast, cervical and bowel. Does the hon. Lady agree—indeed I think she is asking for this—that it is time to introduce early intervention blood testing for those with symptoms of cancer to ensure early detection? Doing that would mean catching these cancers earlier.

Dialysis Care Outcomes

Jim Shannon Excerpts

Thursday 19th May 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered dialysis care outcomes.

I thank you for chairing this debate, Sir George, and thank those who are here to participate—they are colleagues, but also friends. I am pleased to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place and am especially pleased to see the Minister in her place, too. I am not being condescending when I say that; I am encouraged because the Minister understands the issues very well. I look forward to her response—no pressure, Minister. We are pleased to have this opportunity.

I thank our guests in the Gallery, particularly Fiona Loud, who has been instrumental, through me, in achieving this Westminster Hall debate. I thank the Backbench Business Committee for allowing the debate. I applied for it some time ago, but the Queen’s Speech meant that those applications to the Committee fell. It was originally supposed to take place on the Thursday before recess, but we are having it at the same time, 3 o’clock, as it would have happened on that day.

Dialysis is an important issue to raise, especially at this time of rising daily costs that directly impact people who choose to receive their treatment in their own home. In a question to the Prime Minister yesterday, the right hon. and learned Member for Holborn and St Pancras (Keir Starmer) referred to Phoenix Halliwell and the cost for those receiving dialysis treatment at home. There might have been a bit of confusion around how the question was asked and how the answer came through—I know that others will speak to that—but it pinpoints a key issue for this debate, which is the impact of the cost of electric and energy on people receiving dialysis treatment at home. That is of particular concern to me and others at this time of rising costs. There are global pressures on the price of energy. This is not a debate on energy, but on what is happening to those who have dialysis treatment.

It is not just adults who are affected by this issue. Fiona and I spoke to the Minister beforehand; we appreciate that very much. It seems that not every postcode covers children. Local providers have discretion as to whether they reimburse the utility costs for children. I know that Fiona, who I spoke to beforehand, is concerned about that, and I certainly am. One person who contacted us said that her son has been on peritoneal dialysis since January. It used to cost £115 per month for combined usage, but it is now up to £350—a massive increase of 220%.

Although this debate covers a health issue, it also focuses on the predicaments of those people in the health system. We need to review that and think about it again, so that we can understand it better. It is important for those we are concerned about that we understand where the pressures are—financial pressures are coming from all sides.

Others will refer to this, but even on the warmest day of the year—we experienced the highest temperature of the year on Wednesday—a person receiving dialysis will feel cold. Cold weather puts even greater pressures on household energy costs, but people who receive dialysis at home are being very adversely affected by rising fuel and heating costs. I will refer to that later, but I wanted to put those two issues on the record. They have been brought to my attention and are of deep concern.

I know that this is not the Minister’s responsibility, but I will give some facts from Northern Ireland, where attempts are made for every patient to be given approval to receive dialysis at home at first. It does not always happen, because sometimes patients are sent to the renal department at the Ulster Hospital, which is my nearest hospital and which I have visited on a number of occasions over the years.

Analysis by the UK Renal Registry showed the rate of home dialysis in areas of deprivation at the end of 2020. Unfortunately, however, there was no data available for patients treated in Scotland. My colleagues and friends from Scotland may have some figures. Overall, the rate of home therapy was lower for patients from the more deprived areas of England, Northern Ireland and Wales. In England, 22.9% of patients in the least deprived areas were able to access home dialysis, compared with 15% in the most deprived areas. The rate of home dialysis for patients in Northern Ireland was 7.2% in the least deprived areas, whereas it was 9.8% in the most deprived areas. I am alarmed at these figures. If someone has a certain amount of income, it means that they have to pay for their energy. However, someone who is deprived is under pressure to ensure that the energy, electric and heating levels in their house are at a certain level, so the impact on those in deprived areas is much greater than it is anywhere else.

Those from lower socioeconomic backgrounds are affected by renal failure in the same way as anybody else, but they do not have equal access to home dialysis and the freedom that that choice offers. I look to the Minister, as I always do, for a positive response on how we can take things forward constructively in a way that can deliver for dialysis treatment patients across this great United Kingdom. We need to address this issue on a UK-wide basis, and greater equality must be achieved. I am my party’s health spokesperson, so it is always a pleasure to speak in these debates and to highlight issues that are brought to my attention by people such as my friend Fiona Loud from Kidney Care UK.

Kidney disease costs the NHS more than breast, lung, colon and skin cancer combined. It has a greater financial impact. It is estimated to cost £1.4 billion a year—equivalent to £1 in every £77 of NHS expenditure. That is a massive figure and a significant expense, with 21 people developing kidney failure every day and almost 30,000 people on dialysis in the UK. Unfortunately, it shows no signs of slowing.

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

Acute kidney injuries usually come about as a complication from another illness, and they are more deadly than a heart attack. As the hon. Gentleman said, research indicates that about 30% of acute kidney injury deaths could be prevented with better care or treatment. Does he agree that this is an area that requires urgent attention, looking at kidney disease outcomes in the round?

[Jim Shannon]

I thank the hon. Lady for those wise words, and I absolutely agree with her. She is right. We should never be guided entirely by finance, but we cannot ignore the financial implications. If we—by which I mean the NHS—could better use the moneys for early intervention, early diagnosis and early medical action, and reduce the cost, that would be beneficial to the NHS.

The clinical and cost benefits of home dialysis are well established, but despite 17 years having passed since the National Institute for Health and Care Excellence first highlighted its ambition for just 15% of patients to take advantage of home haemodialysis, as many as eight out of 10 dialysis patients are still treated in centre. That is a big challenge, but it is something I believe in, and I am confident that the Minister can embrace that challenge and give us some idea of how we can move forward in a positive fashion to deliver even better.

Some of those people will have successful transplants, although a transplant is only a form of treatment, not a cure. I have a particular interest in this matter because I have a nephew called Peter Shannon, born with a kidney the size of a peanut, or the wee nail on my finger. I remember when my boys were running about—obviously, young boys or young girls are always full of life, but he never had the energy. He was always a terrible colour—yellow, the colour of a bowl of custard—and he never really moved forward physically until he had a transplant at the age of 16. When he had that transport, his life transformed; if only that were possible for everybody, but it is not. I have been a great supporter of organ transplants all my life, and I am very pleased that the Government accepted the legislative change to make everybody a donor unless they opt out. I was always in favour of that legislation. In Northern Ireland, my party —the Democratic Unionist party—had perhaps not truly embraced it in the past, but it has now. I cannot say I am a pioneer in the party, but I am pleased that that legislation has also been endorsed by the Northern Ireland Assembly.

Many other dialysis patients will have no choice but to dialyse to replace their kidney function and to stay alive. The majority will do so three times a week at a hospital or clinic, every week for the rest of their lives, because once a patient starts dialysis, they are on it forever unless they receive a transplant. Across this United Kingdom there are nearly 30,000 people, from young to old, on dialysis. They come from all walks of life and are united by a remarkable strength and resilience to continue with this long-term, gruelling, life-saving medical treatment.

When dialysis is needed, in an ideal world the patient and their care team will consider and decide together whether to dialyse at home or in-centre. There are two forms of home dialysis therapy, with haemodialysis being the most common. Tubes are attached to needles in the arm or via a line to the neck, with blood passing through an external machine that filters the toxins and water from the blood before returning it to the body—it is almost like a cleansing process, but medically. Suitable patients can safely undertake that procedure themselves at home, carrying out sessions that meet their clinical needs to a routine that fits their lifestyle, including overnight while they sleep. In peritoneal dialysis, which is the other form of therapy, a catheter is placed into part of the abdomen via a surgical procedure.

Since its introduction in the 1960s, most dialysis care is delivered in-centre, with patients required to travel to a hospital three times a week for four hours of treatment. Many patients who dialyse in-centre benefit from the care of the UK’s excellent nephrologists, nurses and support staff, and from a sense of community with others receiving dialysis. However, that treatment is more intense over a shorter period of time, which might not suit everybody. It can be extremely draining, and it often leaves patients feeling physically exhausted as the body is pushed so hard during those treatments, and their toxin and fluid levels build up again immediately while they face a long wait until their next dialysis session. As a result, those patients must adhere to strict fluid and diet restrictions, and they must also travel to and from their dialysis centre, which is a time-consuming and often exhausting experience.

I visited the dialysis renal unit at Ulster Hospital in Dundonald some time ago. It is a new centre, and I met many of the people there. I knew two of those people personally. One was Billy McIlroy, who passed a few years ago. He went there for his dialysis treatment three days a week, which I know kept him alive. Another guy called David Johnson also attended that dialysis unit. He got a kidney transplant eventually, so his life changed greatly. I had already been given the details of what happens in dialysis, but actually seeing it showed the reality—it gave a physical understanding—of what those people were going through three times a week. For them, travelling from home and going home again was six hours of their day.

[Margaret Ferrier]

On that point, the impact of kidney disease and treatment on patients’ mental health is huge. Good mental wellbeing can make a big difference to a patient’s recovery and ability to withstand difficult treatment. Does the hon. Gentleman agree that ensuring patients have access to mental health support is paramount to improving outcomes, and that the NHS must be better resourced to provide that?

[Jim Shannon]

I thank the hon. Lady for reminding us all of that. We often focus on the physical aspects of this condition, as we should, but we must also remember the mental health and anxiety issues that come alongside it. Patients suffer with uncertainty about how they are going to feel the next day, uncertainty about their future health, and uncertainty about their personal and financial issues and their family. The hon. Lady is right to remind us of that point.

By comparison, home dialysis therapies offer flexibility and have been shown to have a positive effect on a patient’s health. When patients dialyse more regularly, they are more effectively replicating the natural function of the kidneys. Studies have shown that longer, more frequent dialysis sessions, undertaken at a schedule of the patient’s own choosing, achieve better results than a thrice-weekly in-centre schedule. People doing alternate-day dialysis have been shown to experience fewer symptoms, such as shortness of breath, high blood pressure and left ventricular heart damage. People on home haemo- dialysis have an up to 13% lower risk of death than those on in-centre haemodialysis. That shows that if people can do more home treatment, we can improve their longevity. NHS England has acknowledged the limitations of standard in-centre haemodialysis, and in particular the increased risk of hospitalisation or death after the weekly two-day break between in-centre sessions.

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) is right about the importance of mental health. Depression is the most prevalent psychiatric illness in patients with end-stage kidney disease, and she made that point powerfully. One study shows that rates within the dialysis population vary from 22.8% to 39.3%. Wow—those are big figures, and they show what the condition does. Studies have also shown that depression is a significant predictor of mortality in dialysis patients. That is particularly important for younger people on dialysis, who report a lower quality of life than young adults in general.

People who have the choice of dialysing for as long as they need and at a time of their choice have freedom and control. They can also better respond to their body’s reaction at that time, in the comfort of their home and with the reassurance of their family around them. Home treatment probably addresses some of the issues of depression and mental health issues as well. It enables patients to have a life outside their dialysis schedule and hold down a job. It allows them to have a normal life and pursue the dreams and ambitions that should be the right of any person, young or old. I can attest to that through my nephew, Peter Shannon, who has had an organ transplant. I have seen his life change. He bought his first house just last week, incidentally, at probably the highest time for house prices in the whole United Kingdom.

In the last 18 months, covid-19 has exaggerated the negative impact of differences in dialysis care, and heightened the need radically to increase home therapy provision. Analysis from the UK Renal Registry has demonstrated that the relative risk of death associated with covid-19 among in-centre dialysis patients was much higher than that of the general population in England, especially among those of a younger age.

The UK kidney community has been calling for patients to be provided with greater choice in their dialysis care, recognising the need for increased awareness and education around home therapies and greater equity of access across the country. In the UK, however, the overall percentage of dialysis patients receiving home therapies has increased only from 3.4% in 2011 to 7% in 2022. Although that has doubled, it is a long way off the figure of 15%. It needs to double again, and I think, respectfully, that the Government should set a higher target.

In 2021, the NHS’s Getting It Right First Time programme recommended that a minimum of 20% of patients in every dialysis centre should be on home dialysis. It set that target, and NHS England’s Renal Services Transformation Programme is working to increase the provision of and access to home therapies, in line with recommendations made by Getting It Right First Time.

Although there are dialysis centres exceeding the target, which we welcome—it is not all negative; many are trying to achieve those targets and goals—GIRFT’s own report highlighted that 33 out of 52 centres in England have not yet met the target. Again, I respectfully ask the Minister—she knows I do this constructively; I just want to get the stats so that we can understand the problems and how to do things better—to tell us what has been done to increase the number of those 33 out of 52 centres that have not yet reached the target. The Getting It Right First Time target of a 20% prevalence rate for home dialysis compared to in-centre care could be transformative for patients, and could deliver considerable cost savings for the NHS at a time when they are desperately needed. We can do the treatment better, deliver the medication and dialysis better, and we can do it for a better price. That seems to me to be good value.

To address adequately the low uptake of home care, a review of dialysis reimbursement should take place to ensure that training and educational needs can be met, and to incentivise higher frequency dialysis at home, such as alternate day treatments to support all dialysis centres to meet the 20% target. What steps are the Government taking to reach that 20% target? It is essential that clinicians are offered the tools needed for them to meet the GIRFT targets in an effective manner, such as providing staff and patients with detailed, unbiased education to empower them to make informed decisions about their dialysis. I see it—as I often do—as a partnership, with clinicians working alongside Government policy and patients to do better.

One of the most pressing issues facing people who receive treatment at home rather than in hospital is the rising cost of fuel and energy. I referred to that at the beginning, and there are three points that I wanted to make. People receiving dialysis at home are at particular risk from rising energy costs. The figures that I cited, and the question asked by the Leader of the Opposition at yesterday’s PMQs, gives an indication of the issue. There seems to be an uncertainty, and perhaps a postcode lottery, as to where there is help for energy costs, but the figure that I gave of £118 per month for a child, or whatever it is, but that now costs £350, indicates that there is a way to go yet. Dialysis machines, with their high energy consumption, keep people alive. Dialysis treatment at home adds between £593 and £1,454 to utility costs per year, and that is before this year’s 54% energy bill rise.

One effect of dialysis treatment is that many patients frequently feel cold due to the associated anaemia and the process of dialysis, so they need to heat their homes more often and for longer during the year. When we feel warm, they feel cold. When we feel exceedingly warm, they might feel normal. There are not many times in the year in this great United Kingdom of Great Britain and Northern Ireland when we have Mediterranean heatwaves, so for the dialysis patient, feeling cold is almost an everyday occurrence. We do not want people to have to decide between giving up the freedom and independence that home dialysis gives them, and going into a hospital setting just to save costs. Again, I ask the Minister urgently to address that matter, because the barriers to employment for people on dialysis, posed by frequency and length of treatment, and the physical toll and intense fatigue, already compound financial insecurity for home dialysis patients.

The NHS service specification advises that NHS trusts reimburse the additional costs of home dialysis, but reimbursement is inconsistent across the country, and many patients receive no or very little financial support to pay for the additional costs of treatment. For most home dialysis patients, the £200 repayable relief on energy bills and council tax deduction will simply not be enough, and a special, specific provision is needed. It is regrettable that the spring statement was a missed opportunity for the UK dialysis community. Consistent reimbursement, longer-term capped tariffs for vulnerable groups and immediate financial support are urgently needed. Again, I look to the Health Minister and the discussions that she has with her Secretary of State for Health, and ultimately with the Chancellor, to ensure that we can deliver extra, specific financial help for those on dialysis treatment.

Many in the kidney community feel that their voices have been unheard in Westminster for too long, and when a friend from the kidney charity asked me to secure this debate, I was very pleased to do so. I think that today’s debate does two things. It raises awareness—that is No. 1—but it also directly asks the Minister to become involved and address some of the anomalies. I welcome the re-establishment of the all-party kidney group. Its work, led by the hon. Member for Bassetlaw (Brendan Clarke-Smith), aims to promote improvements in the health and care services that are available to improve the health of people with renal failure.

I call on the Minister to respond to calls from voices in the renal community to support them, and ensure that a straightforward, accessible system is in place to enable people on home dialysis to be reimbursed for the additional cost of utilities, as set out in the UK Kidney Association guidance. Would the Minister perhaps be agreeable to that request? If I may, I would ask for a meeting on behalf of the APPG—perhaps the chair of the APPG, our friend and colleague, would do that—because then we could look at some of those issues. Those who are involved in this debate might wish to attend that meeting as well. NHS tariff payments for home dialysis must be sufficient to cover all associated costs, including reimbursement for additional utilities usage that should and must reflect current price increases. Again, I look to the Minister to pledge to work with energy companies, and the Chancellor to develop capped tariffs for people on medical treatments at home, such as dialysis.

Renal units should proactively offer support to all patients undergoing dialysis, to build their confidence and ensure that they are dialysing in the right way for them at the time. Again, Minister, we need to address the low uptake of home dialysis by implementing a review of the dialysis reimbursement tariff—I think we referred to that in the discussion that we had outside the Chamber, and I look forward very much to the Minister’s response. We must also ensure that training and educational needs can be met, and incentivise higher-frequency dialysis at home, such as alternate-day treatments, to support all dialysis centres to meet the 20% target. Let us meet that target. Let us do it here and back home as well, and achieve the significant cost savings that home dialysis can bring.

I will close with this comment: it is vital that all renal unit staff receive updated training to build their home dialysis knowledge, in order to help find solutions to the issues facing patients, and so that information for patients about transitioning to home therapies is standardised and includes details on the practical and financial support available. I place on the record my thanks to all renal staff. They do magnificent work; they are saving lives and they are keeping people alive. It is wonderful, and we thank them for it. The support available should also include a consistent approach to utility bill contributions from the NHS, in order to ensure equality for every renal dialysis patient across this great United Kingdom of Great Britain and Northern Ireland. The Government must ensure that educational resources are also provided to local authorities and trusts, enabling them to respond appropriately to the needs of people in their area who want to choose home therapies.

Thank you very much, Sir George, for the chance to raise the issue of dialysis treatment and bring it to Westminster Hall in a way that, I hope, both raises awareness and lets people out there on dialysis treatment know that we in this House care for them—I believe we do—and that we are seeking change. I look forward very much to other contributions in the Chamber today, but I look forward particularly to the response from the Minister.

--- Later in debate ---

[Jim Shannon]

I thank all hon. Members who have spoken, and I thank the kidney charities that the Minister and everybody else referred to very much for what they have done.

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) made some very pertinent points about depression, mental health and the psychological impact that dialysis treatment has on people. The Minister very kindly referred to that in her response, and she outlined the case.

The hon. Member for East Lothian (Kenny MacAskill) referred to the travel costs of taking children to the few centres, and he talked about the impact that has on families. He said that dialysis patients have higher levels of treatment. He also referred to prepayment meters, which can prevent people from accessing home dialysis treatment to start with. I know that is not the Minister’s responsibility, but the hon. Gentleman highlights an issue. We all know the Minister is very thorough, and that she will pass on the issues that have been brought up but are not her responsibility to the relevant Departments.

The shadow Minister referred to the two kidney patients she met yesterday. She also thanked the charities and referred to the 3.1 million people living with kidney disease in the United Kingdom. As we all did, she underlined the need for equal treatment, access and cost reimbursement across the whole of the United Kingdom.

I thank the Minister very much for her comprehensive, detailed response to the issues. She referred to the 11 renal networks and the regional care systems that feed into the transformation programme recommendations.

All hon. Members referred to rising costs. Energy tariffs are not the Minister’s responsivity, but perhaps she will be able to refer that to the right person, whoever it may be. Hon. Members also referred to proactivity and the need to reimburse people. As we were sitting here, Fiona Loud, who is in the Public Gallery, sent me a wee note that said that at least some of the people are getting their money. Perhaps people are taking note of the fact that this Westminster Hall debate is happening, because people are getting their money out—there is a commitment.

All NHS trusts must act and respond better. We need to address the reimbursement of moneys as soon as possible. The shadow Minister referred to that. It is great that the Minister and the Government are setting a target of 20% for home dialysis. We want to see that target achieved.

I welcome the chance to communicate with the Minister outside with the kidney charities, to understand better what the real problems are. We have to thank the charities for their campaigns. The reason I have knowledge is half the time because of them. Without them, none of us would be able to deliver the details, as the hon. Member for Rutherglen and Hamilton West has done.

I always look forward to the future. We bring forward issues to the Minister, and then we look forward to the response. The response we have listened to today sets out a programme of events, strategies and visions for the future. We want to see things improve. We will probably regularly come back to the Minister—I hope we do not have to, but we may have to. If we do, we will do that collectively in a positive fashion. In my life, I always try to do things positively. We bring things to the Minister and say, “Here’s where the shortfalls are. Here’s where we can do better.” What we heard today from the Minister has given us some heart, hope and confidence for the future. On behalf of all kidney charities, on behalf of the patients out there and on behalf of us all, we thank the Minister. I thank you, Sir George, as always, for the excellent way you chair these debates. I appreciate it very much.

[Sir George Howarth (in the Chair)]

I thank the Front Benchers and the Back Benchers for the constructive and consensual way in which this debate has been conducted. It is a model of how we should conduct all our debates.

Question put and agreed to.

Resolved,

That this House has considered dialysis care outcomes.

Smokefree 2030

Jim Shannon Excerpts

Tuesday 26th April 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

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

I thank the hon. Members for Harrow East (Bob Blackman) and for City of Durham (Mary Kelly Foy) for securing this important debate. I well remember, as the hon. Lady will remember, that she had this debate in the main Chamber under the covid regulations. I was happy to assist in supporting her at that time, and my support is the same now.

As we turn our attention to the rebuilding of public health following the covid-19 pandemic, tackling smoking must be among our top priorities. Smoking is the leading cause of premature death, killing some 2,300 people in Northern Ireland each year—it is a devolved matter, but I think these figures are quite shocking—with 30 times as many suffering serious diseases and disabilities caused by smoking.

Ms Nokes, I have never had a wish to smoke. I can well recall the first time that I did, with my grandfather, back in the ’60s. He smoked Gallahers; there were no filters on them. I always admired my grandfather, and I said to him one day, “Granda, can I have a smoke of that cigarette?” I pestered and pestered him, and then, one day, he says, “Now, take one, and take a deep breath,” and I did. As a wee six-year-old, I was violently sick. I was green at the gills. In those days, we had—if I can say it—a po under the bed. I was sick into that, and I never had any wish, ever, to pursue the smoking of a cigarette ever since. It left a lasting impression. Maybe that is what we need to do for the young people of today. It is a bit drastic, perhaps, but none the less, it had a very sobering effect on me.

Achieving a smokefree 2030 would reduce the pressure on NHS services at a time when they are under the most severe strain in living memory. However, analysis by Cancer Research UK shows that at current rates of decline, Northern Ireland will not achieve the smokefree ambition of smoking rates of 5% or less until a decade after England—not until the late 2040s—with our most deprived populations not being smokefree until after 2050. We have really big issues to sort out in Northern Ireland regarding that.

While Northern Ireland and the devolved nations hold responsibility for our own public policies, the Government in Westminster maintain responsibility for important UK-wide policies. I therefore ask the Minister—as others have in relation to Wales—what discussions have taken place with the Northern Ireland Assembly and the Minister, Robin Swann?

There is substantial research supporting the implementation of health warnings on cigarettes and cigarette papers, and that is clearly under consideration in Canada, Australia and Scotland. Such warnings could be implemented by a simple amendment to the Standardised Packaging of Tobacco Products Regulations 2015. Tobacco manufacturers already apply print to cigarette papers, so that would be cheap and easy to implement.

Health warnings, such as “Smoking kills”, have been shown to be effective on billboards and tobacco packs, so why would they not be as effective on cigarette sticks too? Adding warnings to cigarette sticks is important because young people in particular are likely to initiate smoking with individual cigarettes rather than packs. Is that something that the Minister and the Government would be prepared to look at?

Cigarette pack inserts providing health information are not a new idea; they have been required in Canada since 2000. The health messages are effective, and research has been carried out in the UK which supports their use here too. The Government have already acknowledged in the prevention Green Paper that,

“there could be a positive role for inserts in tobacco products giving quitting advice”,

so, again, I look to the Minister for her thoughts on that.

All those measures would be cheap and easy to implement and would benefit all the UK nations. They would also support and reinforce the impact of other measures that require significant investment, such as behaviour change campaigns and stop smoking services. Although the Government opposed the introduction of the measures as amendments to the Health and Care Bill, they did leave the door open—I believe—to considering them when developing the next tobacco control plan. Does the Minister—or the Government—intend to do just that?

I have spoken before in this House about the use of licensing for tobacco retailers. In Northern Ireland, since 6 April 2016, retailers have been obliged to register with the tobacco register of Northern Ireland, with a final deadline of 1 July 2016. That built on a similar scheme already in place in Scotland, and a scheme that was due for implementation in Wales.

Since 2018, we have seen the implementation of a tracking and tracing scheme, which requires every retailer to have an economic operator identifier code. Since leaving the EU—as the hon. Member for Harrow East mentioned—the UK has established and launched its own system, with Northern Ireland operating in the UK and EU systems. That makes it easy for all nations in the UK, including England, to not just implement a retail register scheme, but go further and implement a comprehensive retail licensing scheme. If the Minister can give us some thoughts on that, I would be very pleased.

Retail licensing is the obvious back-up to the tracking and tracing of cigarettes and would help tackle the illicit trade that gives smokers access to cheap tobacco. Those who sell illegal tobacco have no compunction about selling it to children too, so the illegal trade makes it not just less likely that smokers will quit, but more likely that children will start smoking. My hon. Friend the Member for East Londonderry (Mr Campbell), who is no longer in his place, mentioned that in his intervention on the hon. Member for Harrow East.

I await with interest Javed Khan OBE’s independent review, which is due to be published shortly. I hope it will address this important issue. England remains an outlier on that important measure, which could help tackle illicit trade and protect children from tobacco. We can and must address these issues collectively, bringing knowledge from the nations we represent. I am happy to support the Minister here at Westminster in taking this matter forward and, from a Northern Ireland point of view, it is important that we address these issues together. If we do so, I am confident that we will then deliver a policy that helps not only us, but the constituents we serve.

--- Later in debate ---

[Maggie Throup]

If I may, I will come to that later in my speech, but the hon. Lady makes a very good point.

On top of the measures, the NHS has renewed its commitment to tobacco treatment through the NHS long-term plan, delivering NHS-funded tobacco treatment services to all in-patients, pregnant women and people accessing long-term mental health and learning disability services until 2024. The Government also continue to explore ways to move smokers away from smoking and towards alternative nicotine products such as vapes, as highlighted by the hon. Member for North Tyneside (Mary Glindon). We know that the best thing a smoker can do for their health is to quit smoking altogether, but we also know how hard that can be. It remains the Government’s goal to maximise the public health opportunities presented by vapes while ensuring that such products are not appealing to young people and non-smokers. The hon. Member for Denton and Reddish made a very good point on this issue in his speech, and it requires balanced and proportionate regulation.

Despite the progress made so far, the Government acknowledge that we need to go further to achieve our ambition to be smokefree by 2030, which is why the Secretary of State for Health and Social Care asked Javed Khan OBE to lead an independent review into tobacco control in January this year. The Khan review is expected to be published next month and will make a set of recommendations to the Government. The review has two objectives. The first is to identify the most impactful interventions to reduce the uptake of smoking, particularly among young people. The second is to identify how best to support smokers to quit, especially in deprived communities and among priority groups.

Mr Khan has met hon. Members from both the all-party parliamentary group on smoking and health and the all-party parliamentary group for vaping, and he has carefully considered their views and proposals. Quite a number of members of those APPGs have expressed their approval of that route and how Javed Khan is getting into the depth of everything. Once the review is published next month, the Government will consider its recommendations, which will help inform both the upcoming health disparities White Paper and the new tobacco control plan, to be published later this year.

[Jim Shannon]

I thank the Minister for her response to this issue, and what she is saying is very positive. I am ever mindful that Northern Ireland has the highest rate of deaths due to smoking. Health is a devolved matter, and we are 10 years behind the rest of the UK on achieving our goals. What discussions could the Minister have with the Northern Ireland Assembly, and particularly with the Health Minister, Robin Swann, to enable us to catch up and achieve the goals and targets that the Minister has referred to?

[Maggie Throup]

The hon. Gentleman makes a very good point. The hon. Member for Arfon (Hywel Williams) also mentioned discussions with the devolved nations, and I am very happy to have discussions with my counterparts in the devolved health authorities.

As we have heard from my hon. Friend the Member for Harrow East and others, many in this room are supportive of a “polluter pays” levy. As they will be aware, tobacco taxation is a matter for Her Majesty’s Treasury, and the tobacco industry is already required to make a significant contribution to public finances through tobacco duty, VAT and corporation tax. As part of the development of the tobacco control plan, the Department will also continue to explore and review with the Treasury the evidence base on the best options to raise funding in support of the Government’s ambition to be smokefree by 2030. As a number of Members asked, I am happy to meet the APPG to discuss funding matters and the levy in detail, while the Khan report is being published. I have met the APPG before and am happy to continue having those meetings.

Childhood Cancer Outcomes

Jim Shannon Excerpts

Tuesday 26th April 2022 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

First, let me thank the hon. Member for Gosport (Dame Caroline Dinenage) for setting the scene so very well, and all right hon. and hon. Members who have made fantastic contributions here today. I share her concerns, as we all do. I am the father of three strapping boys and I have five grandchildren, and our worst fear is that something like this may come along. As politicians in this House, we have a duty to put in place a system that can ensure a quick diagnosis; the availability of testing; the availability of treatment and staff; and the best possible set-up to aid the child in their fight against cancer. I commend all the charities in this area, particularly CLIC Sargent, which does tremendous work in my constituency. I am ever minded of the survey carried out by the all-party group on children, teenagers, and young adults with cancer. It surveyed young people, parents and healthcare professionals, with 56% suggesting that better training for GPs on cancer in children and young people would make the biggest single improvement. I would like to hear the Minister’s thoughts on that. Research has also referred to clinical depression and anxiety among young people, with those with multiple GP consultations before diagnosis becoming clinically anxious. Again, I would like to hear the Minister’s thoughts on that and how we can deal with it more quickly. Having functioning GP services as the first line of defence in health is essential for outcomes in childhood cancer.

I agree with the Teenage Cancer Trust’s recommendation that the 10-year cancer plan should also commit to achieving access rates to clinical trials of 50% by 2025, as has been highlighted by others. The plan should look further than 2025—it should also look towards 2032. Again, I would like to hear the Minister’s thoughts on how we can achieve that. Clinical trials can significantly improve cancer outcomes for teenagers and young adults, but young people with cancer are currently not getting an equal opportunity to participate in and benefit from them. A recent trial for patients with acute lymphoblastic leukaemia showed that young people’s survival rates improved by 18% through involvement in this clinical trial. Given that success in clinical trials, perhaps we should give more opportunity to young people to participate in them. Trial availability is the major determinant of participation. If there are no trials available or existing for young cancer patients, there is no possibility of inclusion. Where trials do exist, there are often barriers to accessing them, such as arbitrary age eligibility criteria. What can be done to ensure that those who can and wish to be part of those trials can be part of them? There is also no data publicly available to show progress towards the commitment of the 50% by 2025, and again I look to the Minister for help on that.

The issue is clear: we need more support and more access to clinical trials if we are to win this battle against childhood cancer. There is no more worthy battle that we must fight and must win, and we look forward very much to the Minister’s response.

Health and Care Bill

Jim Shannon Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Edward Argar]

I paid tribute to my right hon. Friend the Member for Chingford and Woodford Green, but my hon. Friend the Member for Wealden (Ms Ghani) has also taken a keen interest in this issue. The Secretary of State and I will continue to work closely with others across Government to ensure that our measures to eradicate modern slavery in NHS supply chains are effective and targeted, and reflect best practice.

On Lords amendment 29B, the Government are committed to improving workforce planning and are already taking the steps needed to ensure that we have record numbers of staff working in the NHS. In July 2021, the Department commissioned Health Education England to work with partners on reviewing the long-term strategic trends for the health and regulated social care workforce over the next 15 years. We anticipate the publication of that work in the coming weeks.

[Jim Shannon (Strangford) (DUP)]

Will the Minister give way?

[Edward Argar]

Very briefly, as I am conscious that we have limited time.

[Jim Shannon]

If the right hon. Member for South West Surrey (Jeremy Hunt) were to pursue the matter, my party and I would be minded to support him. Although I understand from the figures in the press today that there are significant numbers of new nurses coming into the NHS, there is still a large shortfall. Will the Minister confirm for Hansard in the Chamber today that every step is being taken to recruit the nurses needed to address the issue of workforce safety?

[Edward Argar]

The hon. Gentleman is right to highlight the work we are already doing, which I will address in a moment, and the number of nurses we have recruited. I believe we have now recruited 29,000 or so en route to our target of 50,000 more nurses by the end of this Parliament.