Smokefree England: Covid-19 and PHE Abolition

Jim Shannon Excerpts

Thursday 12th November 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

For the second time today, it is a pleasure to follow the hon. Member for Winchester (Steve Brine), given the knowledge he has of all the subjects we have covered in this debate and the last one. I thank him for his contribution when he was Minister, too. It is always good to see him in his place.

I congratulate the hon. Member for City of Durham (Mary Kelly Foy) on what I think may be the first debate she has led in the Chamber. If it is, I say to her, “Well done and congratulations.” We look forward to many more contributions from her in this place. I was glad to add my name to the request to the Backbench Business Committee for this debate, and to work alongside the hon. Lady to highlight some of these issues.

I believe that freeing smokers from the tyranny caused by their addiction, and the damage it causes to their health and wellbeing, is an issue not just of health but of human rights. I am my party’s spokesperson for health and human rights, and this debate covers both those issues.

This issue is close to my heart, as I know it is for speakers on both sides of the House. Public health policies, which are the responsibility of the devolved nations, have a key role to play in tackling smoking, but so do the Government in Westminster and this debate. I am pleased to see the Minister in his place. He and I have been good friends for a long time, and I look forward to his response because I know it will be positive.

I want to refer quickly, if I may, to the Northern Ireland Department of Health tobacco control strategy, which was implemented in 2012. It was clear that the Northern Ireland Assembly was trying to direct its action at children and young people, disadvantaged people, and pregnant women and their partners who smoked. A review of that strategy undertaken earlier this year found that Northern Ireland has met its target of ensuring that a minimum of 5% of the smoking population accesses smoking cessation services annually, but there is still a group of people who continue to smoke. I am conscious that people have freedom of choice, but we hope that they take note when we present them with the health issues.

That target was achieved, but we are not hitting our targets at population level. There was a target to reduce the smoking rate among manual groups from 31% to 20% by 2020. That rate still lingers around 27%, so that target has not been met. There was also a target to reduce smoking during pregnancy from 15% in 2010 to 9% by 2020. To date, however, that rate has barely declined, so we have hit problems in Northern Ireland. At the time of speaking, the rate is 14%, so we have reduced it by only one percentage point. Let us be very clear: smoking when pregnant puts babies at risk of avoidable harm, including stillbirth, premature birth and birth defects.

We seem to have done better on the target for 11 to 16-year-olds. I am really quite encouraged by that. There has been a reduction from 8% in 2010 to 4%. The target was 3%, so we are one percentage point shy of it, but what we have done there has been quite dramatic. Children who live with smokers are almost three times more likely to take up smoking than children from non-smoking households, which creates a generational cycle of inequality, with smoking locked into disadvantaged communities.

Will the Minister make contact—he probably has—with the Northern Ireland Assembly, and particularly the Health Minister, Robin Swann, to see what has happened there? I feel that we can feed off each other regionally in Administrations, to our advantage. If something is being done right in England, we want to know about it in Northern Ireland, and the same applies in Scotland and Wales.

The disadvantaged communities worst affected by smoking have also been hit hardest by the coronavirus pandemic. Smoking is a leading risk factor for all sorts of things, such as cardiovascular disease and chronic obstructive pulmonary disease, which have been identified by Public Health England as being associated with worse outcomes from coronavirus. When households stop spending money on tobacco, it can lift them out of poverty, and it increases the disposable income available to spend in local communities rather than lining the pockets of the transnational tobacco firms.

Those inequalities are a problem not just for Northern Ireland but in every part of the United Kingdom. The answer is more action at population level through Government interventions that support people, particularly in disadvantaged communities. I believe that the time is right for the Department of Health and Social Care to publish a new tobacco control plan that addresses UK-wide issues as well as those relating just to England—I believe that we should be doing this across the four regions—and provides solutions to the threats posed by Brexit as well as delivering on the opportunities.

Smoking on screen is an issue close to my heart; we have to find some way of addressing it. Smoking is rarely portrayed in an unattractive manner, or associated with negative consequences. Guidelines on smoking have been established by the communications regulator, Ofcom, but they are often not rigorously applied. The UK Government and Ofcom have committed to working with the British Board of Film Classification to ensure a consistent approach across the piece. On the tobacco control plan, I said in 2018:

“A clear causal link has been established between smoking initiation among young people and smoking on screen in the entertainment media. The impact is down to the amount of smoking that young people see, not whether it is glamorised or not.”

Young people may feel, sometimes unconsciously, that smoking is normal, and that we should all be doing it. However, its depiction is linked to greater risk of smoking uptake. In that earlier debate, I asked:

“Will the Minister ask his colleagues who are responsible for the regulation of film and TV in the Department for Digital, Culture, Media and Sport to work with the Department of Health and Social Care, and press Ofcom and the British Board of Film Classification to ensure that their codes effectively tackle the portrayal of smoking in films and television programmes that are likely to be seen by children?”—[Official Report, 19 July 2018; Vol. 645, c. 685.]

At the time, the Minister briefed that Ofcom and the BBFC were dealing with the issue; quite clearly, Minister, that has not happened to the extent that we would like.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Gentleman promised me that he would no longer address the Minister, but would take to addressing the Chair, in the way one is supposed to in this place. He speaks in this Chamber more than any other Member, and he knows that he must not address the Minister. I cannot understand why he persists in doing it.

[Jim Shannon]

Thank you, Madam Deputy Speaker. I will certainly endeavour to get that right.

In 2018, there was an explosion of new video on demand services, such as Netflix and Amazon Prime, which are particularly popular among young people. Ofcom’s on demand programme service rules, governing video on demand services such as Netflix, have no rules at all on smoking. The use of video on demand continues to grow, so this problem will only get worse. Is the Minister prepared to look at that issue and address it?

The licensing of tobacco retailers is another issue that I spoke about in 2018 that bears raising again. In Northern Ireland, since 6 April 2016, retailers have been obliged to register with the tobacco register of Northern Ireland; the deadline for doing so was 1 July 2016. It built on similar schemes in Scotland and Wales. In 2018, we implemented a track-and-trace scheme that required every retailer to have an economic operator identifier code. That system was required by the EU tobacco products directive, but the Government have confirmed that it will continue after we leave the EU. Can the Minister confirm that all nations in the UK will continue to implement a retail register scheme? Will he ensure that officials at Her Majesty’s Revenue and Customs talk to their opposite numbers in Northern Ireland, Scotland and Wales about their experience of the retail register scheme, and the lessons to be learned about it from the devolved Administrations?

Are the tobacco control regulations on e-cigarettes delivering on the twin goals of helping smokers to quit and protecting children from taking up smoking—objectives supported by all parties and all nations of the United Kingdom of Great Britain and Northern Ireland?

There is a concerning loophole in our regulations: while it is illegal for e-cigarettes to be sold to children under 18, according to advice from trading standards, it is not illegal to give them out as free samples to anyone of any age. Could the Minister give us direction on that? How can we ensure that things are done correctly? I hope the Minister is aware of the article in The Observer in October that highlighted that a supplier working on behalf of British American Tobacco was caught handing out samples from BAT’s popular e-cigarette brand to a 17-year-old without carrying out any kind of age check. That contravenes the spirit, if not the letter, of the regulations. Given the importance of balancing the needs of smokers against any impact on young people, it is vital that a review of these regulations is undertaken. Will the Minister set a timeline for just that?

Breast Cancer Diagnosis and Services: Covid-19

Jim Shannon Excerpts

Thursday 12th November 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I welcome you to your new role in Westminster Hall, Ms McVey. It is a pleasure to follow the hon. Member for Winchester (Steve Brine). He and I have sparred many times—never sparred; we have worked together, which is a better way of putting it—in many debates in Westminster Hall and the Chamber. I very much value those times, and I thank him. It is also nice to see the Minister and shadow Ministers in their places.

Every person in this place, including myself, is probably intimately acquainted with someone who has suffered from breast cancer. The statistics stick in your mind. I will focus on my own area; I know it is not the Minister’s responsibility, but I will give a few stats from Northern Ireland and my own constituency.

Some 129.4 people per 10,000 develop breast cancer in Strangford, compared with 165.2 right across Northern Ireland—a significantly better incidence rate in Strangford. But when we compare the stats with England, we are worse off. The incidence rates for Northern Ireland and Strangford are 62 per year, and 38 people per 10,000 die from breast cancer in Strangford, compared with a rate of 36.1 across England. We in Northern Ireland, and in my constituency in particular, have some rates that are very scary. People are also dying from secondary breast cancer. Northern Ireland has the highest mortality rate from breast cancer in the UK, compared with 33.97 in England, 34.2 in Scotland and 33.9 in Wales.

A freedom of information request by Breast Cancer Now found that 40% of hospital trusts and health boards across the UK were unable to tell how many secondary breast cancer patients were under their care, including my local South Eastern Health and Social Care Trust.

As the hon. Member for North Warwickshire (Craig Tracey) did, I want to focus on secondary breast cancer. I congratulate him on bringing the issue forward for debate. He set the scene well. Clinical trials provide a vital opportunity for patients to access potential new treatments at an early stage of their development. That is particularly important for women with secondary breast cancer, who often have limited treatment options available to them and for whom clinical trials provide precious hope to have more time with loved ones. Recruitment to the many clinical trials was paused during the pandemic. While there was relatively little disruption for breast cancer patients already on clinical trials, the pause in recruitment to many trials will have made it difficult for other patients to access them.

In March, the National Institute of Health Research suggested that many NIHR-funded or supported studies might have to be paused as healthcare professionals were asked to prioritise frontline care and make research facilities available if asked to do so by their employer. Of 92 breast cancer trials that the NIHR clinical research network was supporting in March 2020, 50% were paused for recruitment, 45% continue and 5% were closed.

Research clinical trials are so important. Of the 118 respondents to the Breast Cancer Now survey who were receiving or expecting to receive treatment as part of a clinical trial during this time, just under a quarter said they had experienced disruption. The pause in recruitment will have made it more difficult to access trials, and 59% of all respondents were concerned about it.

I know that the Minister always answers with knowledge and understanding. I ask her what lessons can be learned from the speed with which trials for coronavirus have been set up. How can we apply that to setting up clinical trials for other health conditions such as secondary breast cancer? Perhaps coronavirus gives us an opportunity to look at trials—breast cancer trials in particular—in a different way. What good can we take from all of this?

Members of the Association for Medical Research Charities account for 66% of research on cancer. Shop closures and the suspension of many fundraising activities because of covid-19 have had an immediate and severe effect on those charities’ incomes, and their investment in research will drop by £310 million. Breast Cancer Now will see a 34% drop in its income as a result of the pandemic. I support the AMRC’s call for a life sciences charity partnership fund to mitigate the impact of the pandemic and ensure the continuity of charity-funded research.

I welcome the Government’s commitment to the £750 million charity support package, but the medical research charities have not had any help. I thank the hon. Member for North Warwickshire for leading the debate and all those who contributed. I spoke at about 100 mph there.

Dementia: Covid-19

Jim Shannon Excerpts

Thursday 12th November 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Sir Graham. I am very pleased to have sponsored this debate alongside the hon. Member for Oldham East and Saddleworth (Debbie Abrahams). Everyone here has a purpose and something to say about this issue.

We know from the Northern Ireland Statistics and Research Agency that of the 475 deaths in March and April—just two months—in Northern Ireland, a third were attributed to dementia on the death certificate. The impact on those who have dementia is clearly greater than elsewhere. In addition to thousands of tragic deaths in care homes, the effects of social isolation are a big issue: 70% of care home residents have some form of dementia, and the prevention of visits to care homes is having a hugely detrimental impact on their lives.

Contact with family and friends is vital to the wellbeing of people with dementia. Some 82% of participants in an Alzheimer’s Society survey reported a deterioration in the symptoms of people with dementia. People with dementia deserve better. The contribution of loved ones to their care and wellbeing should be acknowledged by the Government and reflected in the guidance to care homes on safe visiting.

I will mention one family, whose story is very real. They wrote to me:

“Our mum sadly passed away in September. We were not with her when she died. We had not been inside her home for over six months. In all that time, we saw her through a window. She didn’t understand why we were stood outside and kept telling us to come in. We were unable to hold her hand and unable to kiss goodbye.”

I understand that advice given to the Government by the Scientific Advisory Group for Emergencies in September stated that the transmission risk from visitors was low. That SAGE advice, which says that people could visit homes and there was less chance of infection from visitors, must be implemented and released by the Government. Why not give the family and the person in the home a wee bit of compassion in their time of need? The Government do not allow for loved ones to provide the personal care that the residents so desperately need.

I urge the Minister to implement the Alzheimer’s Society’s recommendations for ensuring that care homes are safe and adequate for the needs of people with dementia. The Alzheimer’s Society study on this put forward recommendations. We should follow its knowledge and the science. There have been some innovations, for example the initiative led by HammondCare. During its pilot service, funded by Innovate UK, HammondCare recorded highly positive outcomes for people living with dementia and care teams, such as reducing certain behaviours and carer stress, building capacity in the sector and reducing the use of statutory services. Plans are being explored to offer a subscription service across the UK to support care teams. The Minister may wish to explore that. The innovation in that pilot scheme has shown a way of doing this.

I ask the Minister to outline the scope of the key worker pilot in England. How will it be rolled out, and when and how will it be evaluated? Given the updated implementation of the care partner model that we have in Northern Ireland—it is always good to learn from each other—will the Minister ensure that the emotional and physical care needs of people with dementia living in care homes will be met, and confirm that it will not be another eight months before people with dementia and their loved ones are reunited?

Dementia is a subject close to my heart. I hope the Minister will listen to the experts and the families, and do all she can better to connect people affected by dementia.

[Sir Graham Brady (in the Chair)]

Before we move on to the wind-ups, I remind hon. Members that the debate will end at 4.33 pm and we hope to give the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) a couple of minutes at the end to wind up.

Exiting the European Union (Agriculture)

Jim Shannon Excerpts

Tuesday 10th November 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his explanation of where we are. Food and feed safety is vital to Northern Ireland’s important agri-sector, and for my constituency in particular the transition in leaving the EU has to enable Northern Ireland to continue to trade without obstruction. He has confirmed that the full consultation has taken place with the Northern Ireland Executive, and I thank him for that confirmation that ministerial contact in Northern Ireland and here at Westminster has been constructive.

I have one question that I wish to ask the Minister. It relates to a technical point, but I just want this on the record, if he does not mind. I understand the technical aspect of this measure and the need to react and secure, but I must express concern that it highlights Northern Ireland as being outside the UK by using the prefix “United Kingdom (Northern Ireland)”. I need to stress that Northern Ireland lies firmly within the United Kingdom of Great Britain and Northern Ireland, and that cannot be forgotten. Perhaps the Minister could confirm that.

[Edward Argar]

I am grateful to hon. Members for a typically informed and focused debate. It is a pleasure, as always, appearing opposite the hon. Member for Ellesmere Port and Neston (Justin Madders), a different shadow Minister from my normal double act in recent weeks. He raised a number of technical points about the consultation and other aspects. I will endeavour to answer them briefly, but where I do not do so I will, of course, write to him.

I am confident that the consultation undertaken in August and September was sufficient. The hon. Gentleman highlights the smaller number of responses it received. I suggest that is due to the significant consultation undertaken two years before and the fact that in this context little in our approach has changed. Many will therefore have felt that they had had their say back then and that was reflected in the approach taken. He mentioned local councils’ capacity to deal with these regulations. Like many Members of this House, I was a councillor in a past life and I pay tribute to the work that our councils and local authorities do up and down this country. I am confident that they will be able to implement these regulations effectively. On the FSA and FSS, I am also confident that they are ready and prepared for what is coming in these regulations, which are relatively minor and technical in what they are seeking to update. I will of course go through the transcript in Hansard and write to him on anything I have missed out.

On the point made by the hon. Member for Strangford (Jim Shannon), I can reassure him that, while the wording of this statutory instrument reflects the technical legal wording to reflect the Northern Ireland protocol and the withdrawal agreement and the measures in that to help protect and secure the safety of the peace process, I am happy to be very clear with him on the record in this Chamber that, of course, Northern Ireland remains a hugely important and integral part of our United Kingdom and one that I hope to be able to visit when travel is a bit more normal. I may even visit his constituency of Strangford.

[Jim Shannon]

I would welcome the Minister to my constituency. One of his former members of staff came from my constituency as well. It will be a double opportunity for him to visit the town of Comber and also my constituency. I would welcome seeing him there.

[Edward Argar]

I will take that as a clear invitation. Sam Beggs who was a fantastic member of staff to both the hon. Gentleman and I always sang the praises of Strangford. I need no more than the hon. Gentleman’s kind invitation to take him up on it when travel is more normal.

Question put and agreed to.

Covid-19 Vaccine

Jim Shannon Excerpts

Tuesday 10th November 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for North Herefordshire (Bill Wiggin) on setting the scene so well. I am very supportive of his comments and recognise the need to get a covid vaccine in place.

The Health Secretary announced on TV this morning that, as was rumoured last night, a vaccine has been found, but at the same time he was cautious in his assessment, stating that we should welcome what is happening but remain ever mindful of the need for medical trials, which the hon. Gentleman also referred to. We watched that unfold and then later in the day we had an opportunity in the main Chamber to ask the Health Secretary questions—I think 60 right hon. and hon. Members did just that.

I welcome the fact that there might be 10 million doses of the vaccine available by the end of this year. I am particularly happy because it is a bit of good news at long last. I am always a “glass half full” person, but in the last six months it has been very difficult to try to be positive about where we are going, because the uncertainty was unreal. So today we have some good news. I know that we are not there yet, but we are moving in the right direction.

I am very pleased that Pfizer has achieved this breakthrough. However, I have some concerns at this stage that the vaccine will only be for adults—I will comment on children in a few minutes. The fact that AstraZeneca is also involved, as are many other companies around the world, shows the need to work together. I think that the Health Secretary said, in reply to one of the questions put to him today, that we need to work on an international basis, and he is right. The hon. Member for North Herefordshire also referred to that. It is really important that we realise that we are all in this together, the world over, so it is important that we get ourselves organised.

I am a diabetic—a type 2 diabetic. It is one of those chronic diseases that means I have to get the flu vaccine every year. I was fortunate enough to get the flu vaccine way back in September, I think, when I had occasion to be in the doctor’s surgery. I am not there very often, but I was down getting a check-up and they said, “Take your flu vaccine now.” I am glad that I did, because the fact of the matter is that they have run short of flu vaccines in my constituency, and in many other parts of the United Kingdom.

My question to the Health Secretary this afternoon was about the shortage of flu vaccines, and the importance of ensuring that the covid-19 vaccine, once trials are completed, is available to those who need it, so that we do not find ourselves in the same situation as many of my constituents—of a certain age, vulnerable, and who have come to me for assistance because they cannot get the vaccine. We also want to ensure that the flu vaccine that many are waiting for is available.

School teachers and care professionals—nurses, doctors and frontline workers—must be considered priorities for the vaccine once we know it is safe. If the vaccine is offered, I intend to take it, but some of my constituents have contacted me to say that they do not wish to do so. The Minister has previously said that there will be no compulsion, but my health is not just about me: it is about you, Mr Dowd, about the shadow Minister, about hon. Members and about every one of my constituents. My duty is to everyone else.

I am conscious of the time and I will not take much longer, but I want to make a plea for something that will be possible only with the support of the pharmaceutical companies and those who understand the science. I, like you, Mr Dowd, and other Members, regularly see children at my constituency surgeries with chronic asthma and other respiratory complaints. Their parents send them to school daily in fear. The young girl who drafts my speeches and does my research has a four-year-old with chronic asthma. She had to self-isolate at home from March until the beginning of August. Members might ask whether that is possible, but it is what the doctor told her to do with her child. I hope that the trials will come up with a covid-19 vaccine that children can access to.

I support the Education Minister and my own Education Minister back home in saying that children need to be at school, but they need to be safe at school. Only yesterday my grandchild was sent home because some of the pupils and teachers in the form above her showed covid-19 symptoms. They are all self-isolating for two weeks, but the fact is that we just do not know where we are with the virus. Ever mindful of the shortage with the flu vaccine, I hope we will ensure that the covid vaccine is available.

In this morning’s debate, which was also attended by the Minister, there was mention of the black, Asian and minority ethnic community and people with obesity, who are more liable, according to the stats, to have a covid-19 diagnosis. Again, when it comes to prioritising, I hope that we may include that issue.

I want to make a plea for ethnic groups across the world, as I did in the Chamber last Thursday in a debate about vaccines across the world opened by the hon. Member for North East Fife (Wendy Chamberlain). I have a personal interest in religious minorities and different ethnic groups, and I want them to have the opportunity to have the vaccine. The hon. Member for North Herefordshire mentioned that issue, and he was right. When it comes to handing out vaccines or covid-19 help and assistance, the people at the end of the queue every time are the Christians and small minority groups in countries across the world. The Health Secretary also mentioned that in passing today in the Chamber—I am referring to him quite often, and that is because I am taking note of the points that he made in the Chamber. I want to make sure that the vaccine is available not only for us, here, but for every person in the world. That comes back to the point about needing to deal with the matter internationally, and I hope that that is where we will be going.

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd.

Yesterday the news was announced that Pfizer had a potential vaccine that was quite advanced. I do not know how it affected other hon. Members in the Chamber, but my heart skipped a beat. It was brilliant news, and it is not surprising that the attitude in the rest of the country has been exactly the same. It is also not surprising that the stock exchange has effectively gone wild in some areas. People are utterly depressed by the lockdown they are living in, and the news gave them hope that there is a real light at the end of the tunnel, towards which they could drive. Unlike the lights in most tunnels, it is not an oncoming train, but a real opportunity to get out of the situation we are in.

However, it was quite right of the Prime Minister to pull back a bit on that in his broadcast last night. A number of things need to be looked at and studied before we can really rejoice in what Pfizer has done. Most scientists, for example, anticipate that a vaccine will not be 100% effective. As my hon. Friend the Member for North Herefordshire (Bill Wiggin) said, it is only—I use the term lightly—90% effective. However, no vaccine will be 100% effective. We need to ensure that any approved vaccines are as effective as possible, so that they can have the greatest impact on the pandemic.

We have also heard that there is a robust pipeline of potential vaccines in development and that some have already advanced to phase 3. However, we cannot be certain when a vaccine will become available. That is why we cannot rely on a future vaccine to fight the pandemic. We must use all the tools we already have at our disposal, such as testing, contact tracing, physical distancing and masks. I also recommend co-trimoxazole, a drug that is being trialled in Bangladesh and India and that has also been trialled to a certain extent in the UK, which stops the inflammation of the lungs that comes with this terrible virus.

It is too early to know whether covid-19 vaccines will provide long-term protection. Additional research is needed to answer that question. However, the thing that encourages me from the data on people who recover from covid-19—I believe my hon. Friend has recovered from it—is that they develop an immune response that provides at least some protection against reinfection, although we do not know how strong that protection is and how long it lasts. However, that data gives me encouragement that a vaccine can duplicate and pick up on that—if it was not there, I would be very worried that a vaccine was not going to work.

A number of people have mentioned the need to do things on an international basis, and that is a great concern of mine. I happened to meet and have discussions with Dr David Nabarro, who is the special envoy on covid for the World Health Organisation. The Council of Europe—this is one of the great things that comes out of the Council of Europe made a discussion available to members of the social affairs committee. We had a virtual session with Dr Nabarro, who is an engaging, absolutely brilliant man who answers questions forthrightly—he will never make a good politician, but what I got out of the session was absolutely brilliant. To think that, in 2017, we put him forward to be the director general of the World Health Organisation, a proposal that was lost in the politics of the WHO. What a shame. What a difference that man would have made to the World Health Organisation.

The World Health Organisation has a number of programmes. It has a value framework for the allocation and prioritisation of covid-19 vaccinations. It has a road map for prioritising population groups for vaccines foe covid-19. The fair allocation framework aims to ensure that successful vaccines and treatments are shared equitably across all countries. The framework advises that once a covid-19 vaccine is shown to be safe and effective and is authorised for use—there is an argument, which I fully accept, that we could do more to make sure that different regulatory authorities are brought into line on this—all countries should receive doses in proportion to their population size to immunise the highest priority groups. That is just the first phase, after which the vaccine will roll out. If the World Health Organisation can continue in its role—I hope the United States backs off from deserting it and allows it to continue—it will be one of the things that helps to get the vaccine to all countries.

[Jim Shannon]

I am sorry for intervening, but I am concerned that those who are in good health but who happen to have a fairly deep pocket financially may think they can access this vaccine. It is really important that the people who access the vaccine for covid-19 are those who need it right now and who perhaps do not have the finance to buy it, as others might. Does the hon. Gentleman agree?

[John Howell]

The hon. Gentleman makes a good point. The World Health Organisation’s group of experts has already provided recommendations to countries about which populations should be prioritised. They include frontline health and care workers at high risk of infection, older adults and those at high risk throughout the population—people who are suffering from conditions such as heart disease and diabetes. As the second phase rolls forward and more doses are produced, the vaccine should go to groups at less risk of being infected or suffering badly.

I will finish there. This is an exciting opportunity, which we should not let go of. We should keep on top of this. Let us all hope that maybe in a few months’ time we can all be here celebrating the distribution of at least one—and perhaps more than one—vaccine that will help us out of this situation.

Obesity: Covid-19

Jim Shannon Excerpts

Tuesday 10th November 2020 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered obesity and the covid-19 outbreak.

This issue has come to my attention so many times over the past few months—I am highly aware of it. I applied for this debate in March, but because of the covid-19 restrictions I was able only to introduce a petition. I am glad to have reached this pinnacle of opportunity to speak on the matter.

I thank colleagues who supported my application for the debate and the Backbench Business Committee, which kindly found time for us to discuss this important issue. I also thank Members for attending the debate and for emailing me to register their interest in speaking in it. I look forward to hearing from the shadow spokespersons of the SNP and Labour party, and especially from our Minister, who is always courteous to everyone, with the answers we hope to hear from her on this topic of great importance.

For the first time in many a month this nation can smile, following the news this morning that it is hoped a vaccine will be available. I do not want to pre-empt the final trials, but for once the nation smiles with hope that better days lie ahead, which must good news for us all.

Obesity is one of the country’s greatest health challenges. The UK has, unfortunately, the highest obesity rates in western Europe, and they are rising faster than those of any other developed nation. We cannot ignore that, which is why we are debating it today and why the Minister is here to respond. We are a majority-overweight nation, with more than six in 10 UK adults being overweight or living with obesity. That has a significant effect on the nation’s health, on the NHS and on the quality of life of each and every one of us living with the condition.

Obesity increases the risk of developing conditions such as type 2 diabetes, and I declare an interest as a type 2 diabetic. I was once a 17 stone, overweight person.

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

Unbelievable.

[Jim Shannon]

I was having Chinese takeaway five nights a week with two bottles of Coke. It was not the way to live life, but I had a very sweet tooth.

Until about a year before I realised I was a diabetic I did not know the symptoms. My vision was a wee bit blurred and I was drinking lots of liquids—two signs that should tell you right away that something is not right. I took a drastic decision to reduce weight and lost some 4 stone, which I have managed to keep off.

We need to look at our diet and our lifestyle. We all live under stress, and we all need a bit of stress because it keeps us sharp, but there is a point where we draw the line. I recall the day I went to the doctor and he told me, “We are going to put you on a wee blood pressure tablet.” I said: “If that is what you think, doctor, I will do what you say.” He added: “When you start it, you have to keep at it. You cannot take a blood pressure tablet today and then not take it next week, because your system will go askew.”

Obesity leads to high blood pressure and some types of cancer and is strongly associated with mental health and wellbeing, which is so important in the current crisis. There are strong links between the prevalence of obesity and social and economic deprivation. People living with obesity face extraordinary levels of stigma and abuse. We need to be careful and to be cognisant of other people’s circumstances, because they might have a genetic imbalance, which I will speak about later.

The outbreak of covid-19 makes the obesity epidemic more urgent. It is deeply concerning that obesity is a risk factor for hospitalisation, admission to intensive care and death from covid-19. The facts are real. People with a body mass index of 35 to 40 are 40% more likely to die from covid-19 than those of a healthy weight. In people with a BMI of 40-plus, it rises to 90%. That places the UK population in a very vulnerable position.

In the latest report from the Intensive Care National Audit and Research Centre, which audits intensive care units in England, Wales and Northern Ireland, almost half—47%—of patients in critical care with covid-19 since 1 September had a BMI of 30 or more. In other words, they were classified as obese. Those figures show that almost half the people in critical care had a lifestyle that they needed to address. That figure compares with the 29% of the adult population in England who have a BMI of 30 or more. People with obesity are much more likely to be admitted to critical care with coronavirus.

We also know that covid-19 has a greater impact among black, Asian and minority ethnic communities. Currently, 74% of black adults are either overweight or living with obesity. That is the highest percentage of all ethnic groups. That is a fact—an observation—not a statement against any group, but we have to look to where the problems are and see how we can reach out to help, because we need to reach those groups.

It is encouraging to see the Government setting out the steps that they will take to support people to live healthier lives and reduce obesity. Those steps will make a positive contribution to the environment we live in and will encourage people to make healthier choices, helping to prevent obesity. I will also speak about other groups, because it is sometimes those in a certain financial group who do not have the ability to buy the correct foods and are driven by the moneys that they have available.

The Government now have to implement their proposals and fund them adequately. Then they need to measure their success and to review what more can be done. Three childhood obesity strategies have been published since 2016, and the proposals have not yet been fully implemented. One reason we are here today is to see how those proposals can be implemented, and we need a timescale. I know we are on the cusp of finding a vaccine, but we also need to address the issue of obesity in the nation as a whole. Perhaps covid-19 is an opportunity to address it. We cannot afford a delay. It has to be an urgent priority for the Government and the Minister if we are to protect people from severe illness from covid-19.

Furthermore, we need to address the structural drivers of obesity. Inequality is a key element, as I mentioned a little earlier. Obesity prevalence in children is strongly linked to socioeconomic deprivation. Families with lower incomes are more likely to buy cheaper and unhealthier food because what drives them—let us be honest—is what is on offer this week and what budget is available to buy the food that is on the shelf. We do not always check the labels. Is it high in calories, sugar and salt? Those are things that we probably should check, but we do not, because the driver is money.

A report by the Food Foundation in 2018 found that the poorest 10% of households need to spend 74% of their income on food to meet its Eatwell guide costs. That is impossible for people on low incomes. When the Minister sums up, perhaps she will give us her thoughts on how we can address that issue directly.

I welcome the Prime Minister’s commitment to the support for schoolchildren and school meals. It is good news; it is good to know that the four nations in this great United Kingdom of Great Britain and Northern Ireland are united in taking action on that issue. Scotland is doing it, Northern Ireland is doing it, Wales is doing it and now England is doing it. That is good news, because by reaching out and offering those school meals we will help to address some of the issues of deprivation and how the mums and dads spend the money for food in the shop. This is a way of doing that. We all know that school meals have a balance as well, so it is really important over the coming school breaks and other times that children have the opportunity to have them. In Northern Ireland, the Education Minister set aside £1.3 million to help to provide school meals over the coming period.

The Government need to work more closely with the food and drink industry as well, to make the healthy option the easiest option. However, while we need to support healthier choices and behaviours, there is no point in seeking to make individuals’ behaviours healthier if the environment in which they live is not suited to healthy behaviour. It is okay to say these things, but how do we make them happen? We need to look further at the social factors that lead to obesity, and we need to address them to make them more conducive to healthy living. To give just two examples, eating more fruit and vegetables and walking, which gives the opportunity to be out and about, are among the things that we need to look at.

There is a long-term process, which involves planning, housing, the workplace, the food supply, communities and even the culture of life in the places that we live in. It is about the groups of people we live with and the people we have everyday contact with. Earlier, I mentioned genetics, which is also an important factor in causing obesity. Again, it is a fact of life that there are people who may carry extra weight because of their genetics. Indeed, it is suggested that between 40% and 70% of variance in body weight is due to genetic factors, with many different genes contributing to obesity. Again, I am sure the Government have done some research on that issue, working with the bodies that would have an interest and even an involvement in it. It might be helpful to hear how those people who have a genetic imbalance, for want of a better description, can address it.

Without going into the motivations and challenges faced by people living with obesity, and particularly those living with severe obesity, it is clear that it is not always easy for them to lose weight. Let us be honest: it is not easy to lose weight. Some people say, “Well, what do you do? Do you stop eating? Do you cut back on your eating?” But if someone enjoys their food—I enjoy my food, although in smaller quantities, I have to say—and overeats, we have to address that issue as well.

We want to encourage people to improve their wellbeing and mental health and to have the willpower. There are a lot of factors that need to be part of that process. I was therefore pleased that the Government strategy sets out plans to work with the NHS to expand weight management services. Again, perhaps the Minister will give us some idea of what those services will be.

Support for people to manage their weight can range from diet and exercise advice to specialist multidisciplinary support, including on psychological and mental health aspects, and bariatric surgery. We have the National Institute for Health and Care Excellence guidance on these treatment options, which sets out who should be eligible for them, yet they are not universally commissioned, which means that many patients cannot access support even if they want to. Given the urgent need for people to reduce weight to protect themselves against covid-19, we need to make these services more accessible by increasing their availability and the information provided about them to patients and the public.

Over the years, I have had occasion to help constituents who probably had a genetic imbalance and were severely overweight. The only way forward for those people—men and women—was to have bariatric surgery. On every occasion that I am aware of involving one of my constituents, bariatric surgery was successful. It helped them to achieve the weight loss that they needed and it reduced their appetite. That made sure that their future was going to be a healthy one.

We have strict acceptance criteria in the NHS for obesity treatment that are not found with other conditions. If a person has a BMI of 50, they must follow diet and exercise advice and receive a multidisciplinary specialist report. These services are otherwise known as tier 2 and tier 3 services. We are almost sick of hearing of tiers 1, 2 and 3, but they are a fact of life for obese people before they are even eligible for surgery.

If a patient does not complete those courses, they must start again, which can make some people lose motivation. The lower levels of support are absolutely necessary and effective for the appropriate patients, but it would be better to remove the loopholes and duplications. That would allow more people to achieve the appropriate support, even before additional resource is provided.

Currently, the United Kingdom performs 5,000 bariatric surgeries every year, which represents just 0.2% of eligible patients. If more people had the opportunity to have that bariatric surgery, they would probably take it. Can the Minister indicate what intention there is to increase the opportunities for surgery? We lag behind our European counterparts when it comes to surgery for obesity, despite it showing benefits in terms of cost, safety and the ability to reverse type 2 diabetes.

Many reports in the papers in the last few months have indicated how people can reverse their type 2 diabetes and the implications of that. Talking as a type 2 diabetic, I am ever mindful that if people do those things and reduce their weight, it helps, but it may not always be the method whereby type 2 diabetes can be reversed. When I lost that weight, I found that my sugar level was starting to rise again after four years, and I moved on to tablets and medication, which controls it now. Ultimately, the control will be insulin, if the level continues to go the wrong way.

The British Obesity and Metabolic Surgery Society has recommended that the number of surgeries should increase incrementally to 20,000 a year—a massive increase from 5,000, but we believe it will heal some of the physical issues for the nation. This is a small proportion of the total number of people with obesity, but they would also benefit the most. This debate is not about highlighting the issues, but about solutions. I always believe that we should look at solutions and try to be the “glass half-full” person rather than the “glass half-empty” person, because we have to be positive in our approach.

For people who require nutritional, exercise or psychological advice, face-to-face services were closed during the first wave of the pandemic. I understand the reasons for that. While digital and remote services can provide help to vulnerable people during lockdown, these new ways of working cannot reach everyone. How do we reach out to all the people who need help? That is vital as the country moves through future stages of the pandemic. We hope we have turned the corner, but time will tell in relation to the trialling for the new vaccine. Obesity continues to be a priority, and services should remain available.

Lastly, in future, obesity services should not be cut as part of difficult funding decisions. I understand very well the conditions in the country and the responsibility that falls on the shoulders of the Health Ministers not just here in Westminster, but in Scotland, Wales and Northern Ireland. It is vital that the inequity in access to these services is corrected to ensure that people can access support, no matter where they are in the country. What discussions has the Minister had with the regional Administrations—with the Northern Ireland Assembly and particularly with the Minister, Robin Swann, and with our colleagues in Scotland and Wales? If we have a joint strategy, it will be an advantage for everyone. I would like to see the person in Belfast having the same opportunities as the person in Cardiff, Edinburgh, London and across the whole of this great nation.

I have three asks of the Minister, along with all the other questions I have asked throughout my speech—I apologise for that. Can she reassure us of the continued political prioritisation of the prevention and treatment of obesity? I call on the Government to implement, evaluate and build on strategies to reduce obesity. Can the Minister tell us how have discussions on that been undertaken with the regional Administrations across the UK? I also call on the Government to work with local NHS organisations and local authorities to ensure that services are available to our constituents who wish to manage their weight.

In summary, given the range of secondary conditions caused by obesity—this also applies to covid-19—would it not be more prudent to address their underlying cause before they occur? I always think that prevention, early diagnosis and early steps to engage are without doubt the best way forward, and it would be helpful for the nation as a whole if those things were in place. I believe that would help to reduce the impact of conditions such as type 2 diabetes, heart disease, kidney disease, high blood pressure, stroke, sleep apnoea, many types of cancer and more. The problem with covid-19 is that although our focus should rightly be on covid-19, we must not forget about all the other, normal—if that is the right word—health problems that people have, because dealing with those is very important for our nation to move forward.

The NHS currently faces huge demands, but reducing obesity now would significantly reduce demand on wider NHS services. It is a question of spending now to save later, if we are looking at the financial end of it. It is not always fair to look at the financial end, but we cannot ignore it, because there is not an infinite budget available to do the things we want to do; we have to work within what our pocket indicates. And we have to do that while also protecting people who are vulnerable to coronavirus.

I commend the Minister and our Government for their focus on obesity. I very much wish their new obesity strategy success. How it will work across the four nations is important, but we need to do more, in both the short and long term, to prevent and treat obesity, and we must do so with adequate funding, which is crucial to enable the operations, strategies, early detection and early diagnosis to be in place.

I hope that our future strategies to reduce obesity will continue to focus on how people can also be supported to live healthily. When it comes to these things, we have to be aware that it is not just one person who is living with the obesity; the family also live with it. Sometimes we forget about the impact on children, partners, wives, husbands and so on. Whenever someone sits down for a meal, is their meal the same as what the rest of the family are having? It would be better if they were all eating the same food, in terms of diet and content. I believe that if we can achieve that, we will find a way forward.

May I thank in advance all right hon. and hon. Members for taking the time to come to this Chamber and participate in the debate? Like me, they are deeply concerned about how covid-19 is affecting those with obesity issues. Today is an opportunity to address this issue, and I very much look forward to hearing other contributions; I am leaving plenty of time for everybody to speak.

[Philip Davies (in the Chair)]

It might be helpful if I say that I intend to get to the Front Benchers no later than 10.30 am. There are currently five Members on the Back Benches who want to speak, so if people could take seven minutes or so each, that would be helpful to give everyone a fair crack of the whip.

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[Jim Shannon]

I thank all hon. Members for their contribution. I thank the shadow spokesperson and I thank the Minister in particular. I love the statement of a combined national effort; I think we have all captured that as the message we want to send out. I very much support what the Minister has said in relation to advertising and further reductions, the consultation programme that is going on, preparing and cooking meals and child weight loss programmes. All those things are important, so I thank the Minister and I thank hon. Members.

Motion lapsed (Standing Order No. 10(6)).

Covid-19 Update

Jim Shannon Excerpts

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

Of course it is important that we continue to build and strengthen the contact tracing system, as we are doing. My hon. Friend mentions the uncertainties, and the issue of the virus that has spread back from mink to humans is one example of that. Of course managing a pandemic is beset by uncertainty. We still have uncertainty, for instance, over whether even the Pfizer vaccine will pass the safety hurdles that we very much hope it will in the coming weeks, but managing through that uncertainty is a critical part of getting this right.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement. Is it not good to see the nation regain at least a smile in relation to the potential for a vaccine? That has to be good news for us all. Will he outline how he intends to ensure that, unlike with the flu vaccine, where there is a shortage in the nation and in my constituency, each region will receive the necessary amount of this vaccine and that rather than using estimations, the health service will allocate on the basis of priority need and not postcode?

[Matt Hancock]

Yes, absolutely; this is a UK programme and I have been working closely with my Northern Ireland counterpart, Robin Swann, who is doing a brilliant job in Northern Ireland, to make sure that we get this roll-out as effective as possible right across the whole United Kingdom.

Baby Loss: Covid-19

Jim Shannon Excerpts

Thursday 5th November 2020 Westminster Hall

[Cherilyn Mackrory]

This is now the fifth year the House has marked Baby Loss Awareness Week—as with many things, covid-19 caused some delay, as Baby Loss Awareness Week took place a month ago—and I am pleased and grateful that we are here today. It is extremely encouraging and moving that right hon. and hon. Members have ensured that this important issue has been debated often in recent years, helping to deliver an unmistakable message outside this place about its importance in Parliament, the Department of Health and Social Care and the national health service. Most importantly, that sends a message to bereaved families, letting them know that there are people in this place who truly understand how it feels.

Please forgive me for telling my story today, in as much detail as I dare. It is important to me that my baby’s short story helps to shine a light on what is a really dark situation for many people. “I can see straightaway that something isn’t right”—those are the words that broke my heart and changed my life forever. It was 3 January 2019, and my husband and I were at the routine 20-week scan for our second baby. My first pregnancy had been healthy and straightforward and resulted in our fabulous daughter. At age 42, I had been slightly anxious about my 12-week scan, but happily all tests had come back clear. My midwife encouraged me to birth again at our midwife-led centre, and I was keen to stay healthy in order to do just that.

We had celebrated a low-key but cosy Christmas and new year with family and friends. I felt content and reassured by my kicking baby and wondered what the following year would bring. Three days later, we went for our 20-week scan and would receive the terrible news from the sonographer that our baby had an extremely severe form of spina bifida. I lay on the couch and grabbed my husband’s hand tightly. Tears stung my eyes—not unlike now. When I glanced at him, his eyes were watering, too. We did not dare believe what had just happened.

Just over an hour later, we were sitting in the office at our main hospital, the Royal Cornwall Hospital in Truro, with a wonderful consultant and an incredibly kind bereavement midwife. We were met at reception and taken to a small room and brought some tea. I just knew this was not going to end well, but I did not know what to expect. I was checked again, and any hope we had was extinguished by a slow and silent shake of the head. But my baby was still kicking. So started the most traumatic weekend of my life to date.

We had no idea what would happen next. Our world had started to swim and spiral away, and neither of us knew what questions we should ask.

[Jim Shannon (Strangford) (DUP)]

I will try not to get emotional myself. I understand the hon. Lady’s grief—we all do. We understand how important it is for parents to come through this terrible time. We have had similar things in my own family, so I understand exactly how she feels. I was trying to give her a bit of time, and what do I do? I start to blubber as well. I apologise for that. I just want to say that I really feel her pain.

[Cherilyn Mackrory]

I am most grateful to the hon. Gentleman for his intervention, which has succeeded.

I must say that we were looked after with extreme kindness by everyone at the RCHT. Not a day goes by when I do not think of them and thank them silently. On that day, we were barely left alone. We were provided with lots of information and given lots of time to process. I want to emphasise that, because what comes next feels pretty brutal. However, the staff make it all as bearable as they can, but it is shocking when it happens, and I want to convey that.

We were talked through what I am going to call the process. Before we left that day, I had signed a form to consent to infanticide—the termination of our much-wanted baby’s life. This is a decision that the mother must make, as the baby still belongs to her body. I could have chosen not to do this, but at nearly 21 weeks gestation my baby had no rights of its own. To be born before dying, a midwife would stay with the baby until it passes away. I am told that this is much more traumatic for the baby.

The next day we returned and endured the procedure. I have never felt so helpless. I was voluntarily allowing somebody to inject a long needle through my skin, into my womb and into my baby’s heart, so that they could inject some potassium to end that little life. Our baby was very strong, and it took longer than it usually does. I hung on to my husband and let him be strong for me, not that he felt that he was. I felt my baby kicking until the very end.

Two days later we returned to the RCHT. It was a Sunday morning, and we had been told to go to the Daisy suite. That is where women birth if their baby is going to be stillborn. It means they do not have to interact with other pregnant women or newborns while labouring. However, when we got there, it was being used by another woman who was there with her dad. She had been brought in as an emergency the night before, and her baby had stopped moving at 38 weeks. I felt that she needed the space more than I did.

I was induced and endured an eight and a half hour labour, which was much longer and far more intense than with my first baby. Finally, I delivered. I had not planned to look at my baby. To be honest, I was scared of what I might see. The midwife said to me, “You have the most beautiful baby girl.” And there she was, a perfect, beautiful, sleeping girl. She was tiny. She looked just like her big sister. I held her, I kissed her and I told her how much she was loved, and then I let her go. We named her Lily Wren Mackrory—Lily for peace, Wren because she is our smallest little girl, Mackrory.

Baby loss is far more widespread than I ever realised before it happened to my family. Many people are bearing this grief, often silently. Pregnancy and childbirth have always been perilous for women. Even now, in 2020, with all our medical advances, there are so many babies we simply cannot save. Miscarriage, stillbirth and the death of a newborn are all too common. Thousands of parents experience pregnancy or baby loss every year. It is estimated that one in four pregnancies ends in miscarriage, and 14 babies are stillborn or die shortly after birth every day in the UK.

I do not want to be completely self-indulgent during my speech today, but I do not know how else to relay how raw that feels for those parents and how important it is that we talk about it. I have one word to describe the grief I felt following the loss of Lily—primal. I just wanted to bring my baby home. I wanted her to be healthy. It dominated my entire being. I wanted to watch her kicking feet and to feel the grip of her tiny fingers on mine.

Weirdly, I gained an understanding about why some species, particularly penguins, steal each other’s babies when their own eggs do not make it. It is a physical ache down the arms and in the stomach. What had I got wrong? What had I eaten or not eaten that had made her so poorly? Was it because I was too old? Since I already had one healthy, amazing child, perhaps I had simply pushed my luck. Of course, none of that is true.

Having our then four-year-old meant that a daily routine had to continue, thank goodness. My husband and I were alarmed by the statistic we read that 50% of couples who experience baby loss end up splitting up. We were determined not to be one of them. We vowed to let each other grieve at our own individual pace and not to expect too much of each other. One would take the load when the other felt overwhelmed, angry or helpless. We allowed family and trusted friends to help us as a couple, as well as separately, but during the worst days I thought I would never recover. People do, of course, but they are changed. That was how 2019 began for me, and it ended with me coming into this place.

The experience I have just described is fairly shocking when it happens, but sadly it is not unusual. This year, Baby Loss Awareness Week focused on highlighting baby loss during the covid pandemic. From start to finish, I simply could not have got through that horrendous weekend without my husband at my side, yet we have been expecting women to do that since covid hit our shores earlier this year. As co-chair of the all-party parliamentary group on baby loss, I have had the privilege of listening to many experiences and testimonies and learning what baby loss charities and the APPG have achieved so far. Despite my position in this, I am still fairly new to the experience.

Last year, during Baby Loss Awareness Week, before I became a Member of Parliament, I attended a service in Truro with my husband as a member of the public and a bereaved parent. I looked at the book of remembrance, at Lily’s date, and there was her name in full. It was the first time I had seen it written anywhere, apart from in a small memorial that we had placed on my grandmother’s grave. There was another name there: a little boy named Isaac. I realised straightaway that he was the baby boy who had been born on the Daisy suite on the same day as Lily.

In August 2020, the APPG held a virtual meeting—my first as co-chair—focused on the impact of covid-19 on pregnancy and baby loss. We heard evidence from organisations that support women and partners who experience loss at any stage. The evidence was stark. Covid-19 has exacerbated existing challenges and has had a negative impact on the experience of women and their partners and families at the worst possible time of their lives. Hospital trusts that had traditionally been struggling in this area appear to be the most vulnerable.

I will summarise what the APPG found. Partners have been excluded from appointments and scans, and often have not even been able to join the consultation by video or speaker phone. That has led to women receiving bad news or making decisions alone. In a neonatal setting, mothers and partners had visiting rights severely restricted. Those factors all increased the sense of isolation experienced by bereaved women and their families. Thanks to a successful campaign led by my hon. Friend the Member for Rutland and Melton (Alicia Kearns), many trusts have reversed the decision to prevent partners from being present at scans and births. However, many still cannot or will not.

Women have reported restrictions on the way that they can access health services relating to their pregnancy. They often find that accident and emergency is the only route available. Scans have been cancelled, and mothers with concerns about their baby’s movement have reported being sent away from hospitals. Some key staff, such as health visitors, have been redeployed during the pandemic, which means that women cannot access the services they need. After receiving bad news, information on options and choices has not been forthcoming. For example, women report a lack of information about pain, bleeding and what to do with pregnancy remains after experiencing a miscarriage.

In maternity and neonatal settings, a lack of time and available space has impacted on whether staff can provide opportunities for memory-making after a stillbirth or a neonatal death. That is massively important for grief and recovery. In some cases, women chose not to access health services, taking the important “stay at home” message of the Government’s campaign to heart. In the early stages of the covid pandemic, in some hospital settings, personal protective equipment was a barrier to delivery of compassionate bereavement care, and staff struggled to communicate in the way they would prefer. Hospitals reported shortages of face-to-face interpreters to help communicate with women who do not speak English. After a stillbirth, neonatal death or sudden infant death, some families whose baby had a post-mortem had the results communicated by post or email, which is not appropriate.

Although some new ways of communicating began during lockdown, such as virtual antenatal appointments, they are not accessible to all and do not always provide the same reassurance as an in-person scan or consultation. I even heard the tragic story via one of our bereavement charities of a woman who had given birth to a stillborn baby, and because the mother had tested positive for covid, her baby was simply zipped in a body bag and taken away. I must add that that was at the height of the pandemic in April.

The APPG found that lockdown had exacerbated risk factors for some types of baby loss—particularly involving deprivation and domestic violence. After a loss, the isolation of lockdown contributed to negative impacts on women’s and partners’ mental health and their ability to access support from friends, family, psychological professionals and community outreach services.

In response, the APPG called on NHS England to initiate a minimum acceptable standard for involving partners when pregnancy or baby loss is anticipated or occurs, whether in relation to attendance at scans or appointments, or parental access to neonatal units. There is too much variation between hospitals at present, which must be addressed with national guidance. I know that that has already begun. I also ask for the swift reinstatement of the provision of choices for women facing pregnancy or baby loss in respect of the mental health impacts of covid-19 on those bereaved through pregnancy and baby loss, in order to plan services for that group in the future.

I thank the Department of Health and Social Care; health professionals; baby loss charities such as Sands, The Lullaby Trust, Aching Arms, and particularly Cradle in Cornwall and a lovely lady there named Emma Pearce—there are so many to mention; Members of this place, past and present; and, most of all, bereaved families for their co-operation on the work to date in this vitally important APPG. I hope that, while in post, my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and I can continue their important work and bring solace to families in their darkest time, as well as trying to prevent more losses in the first place. I look forward to working with colleagues, including the Minister, to achieve that.

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[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for applying for the debate, and everyone who has made a significant contribution. They have all been personal and heartfelt. I have spoken numerous times on this issue.

[Ian Paisley]

I thank my hon. Friend for giving way. One issue that this debate helps to address is the impact on the expectant father, as well as the mother, which is sometimes forgotten. I know the impact it has from my own experience 18 years ago. Thankfully, men are now more willing to speak about these issues, which is a good thing, but we must dwell on ensuring that the services that are provided are all encompassing and address the needs of men, as well as the most important needs—those of the mother of the unborn child.

[Jim Shannon]

I thank my hon. Friend for intervening. I have made it my business to speak in every debate on this issue. I have looked at some recent facts. In 2018, each day in the UK there were 2,060 babies born alive, 515 babies were miscarried, 144 babies were born pre-term and eight babies were stillborn. The reason I stand here today is to pay tribute to the thousands of heartbroken mothers and fathers.

As my hon. Friend the Member for North Antrim (Ian Paisley) said, that emptiness cannot be explained unless it is experienced. I have not personally experienced it myself in my own family, but my mother did. I remember very well that my mother had five miscarriages. That was in the 1960s and 1970s. It was a totally different time. When someone had a miscarriage, people did not talk about it. They would say, “I’m sorry to hear of your loss, but you can always try again.” Two days later, they would be back at work. My sister had three miscarriages and one wee boy who is disabled. That loss is real for her. My private secretary, Naomi, who writes all my speeches and prepares my business for me—a very busy wee girl, by the way—had two miscarriages. I lived through that experience with her, not personally, but as an employer who understood what that heartache and pain was like.

Since the last debate on this issue, so many people contacted me—not because of me, because I am just nobody—to say, “Thank you for speaking up for us,” including people whose partner had carried their baby to full term knowing that baby was neither going to live or breathe beyond two hours. The hon. Member for Truro and Falmouth told the story in her introduction. That is a real story for some of my constituents. That is why I am here today.

I have two asks of the Minister, if I may. The Minister knows I am very fond of her. I look forward to her response, because I know she has a compassionate heart and understands what all hon. Members have said on behalf of their constituents and themselves.

More testing must be available on the NHS for those who lose two babies in a row rather than three, as is the case currently. I am very close to a young lady who lost two wee babies in a row. She went to her appointment at the Ulster Hospital—my local hospital in Northern Ireland—early pregnancy unit to confirm that all of the baby had come away. The midwife—the hon. Member for Sheffield, Hallam (Olivia Blake) referred to the midwives—compassionately advised her and her husband to look at private options when they talked about their despair. It was terrible that they had to go elsewhere to get that help, but they paid for the private consultation and private tests, and found that something as simple as taking an aspirin daily could possibly address the blood clotting issue that had caused the loss of her little loved ones. For the life of me, I cannot understand why we traumatise women by making them go through a third loss before they can get the help that they need. That is my number one request to the Minister and my Government.

I sincerely urge the Minister to take this back to Government and press the case for at least rudimentary tests to be carried out. I have been contacted by a nurse in my constituency begging me to address the lack of support under pregnancy during the coronavirus. The hon. Member for Sheffield, Hallam and others spoke of that. I want to read from her email:

“It was a terrifying, lonely experience made worse by the fact that when I attended the Ulster hospital on Monday morning to have the assessment and scan to confirm if I was indeed miscarrying, I had to do so alone while my husband waited in the car due to the policy of only admitting the patient to the appointment”.

My heart aches for that separation, of which the hon. Member for Sheffield, Hallam and others spoke. It is a real trauma for those involved, including the nurse and the midwives, and those who have to advise because of the special times we live in.

I understand the difficult times, but the fact is that a woman needs the support of her partner and her partner must be allowed to give that support. The Prime Minister’s reply—he has been quite good with his replies—said that fast and efficient tests will be made available, but we want to see that in place right now. We need to allow support partners to have tests immediately to allow them to attend appointments with their expecting loved ones. Again, I look to the Minister to assure me and others that such people will be on the priority list for a fast test.

Miscarriage is so devastating to families. The effects are felt for years. I remember one of the first cases I heard as a Member of the Legislative Assembly in Northern Ireland of a constituent who lost her baby in the ’60s. She told me that she was never allowed to talk about it and mourn. Sixty years later, she still thinks about that. It does not matter how long ago it was; it is still real every day in life.

We must do better for these families, and offer hope, testing and support in taking steps to allow their loved one to be with them every step of the journey. I simply do not want to have to read again of the devastation that my constituent described:

“As a result of this policy my husband learnt of the loss of our baby in the car park of the Ulster hospital, hardly a suitable or private place for a sensitive and emotional conversation. His role as parent was completely undermined and dismissed by this policy”.

To conclude, the journey is that of a family, and the family must be allowed to provide whatever support and love they can give in the face of a devastating loss. To those who have lost a baby I say, “The loss of your baby is important. Your pain is real and you have the right to grieve the loss of the future that you had planned together. It is my honest belief as a Christian and a man of faith that your wee one is safe in the arms of Jesus until you can be with them again.”

Exiting the European Union

Jim Shannon Excerpts

Wednesday 4th November 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Deputy Speaker, for the opportunity to ask some questions on this matter. I would like first to put on the record my thanks to the Minister for the opportunity, which he gives equally to every Member of this House, to bring to him our questions or concerns. He was very kind to do the same for me, and I appreciate it.

I am a great supporter of organ transplants—that has always been one of my goals. I supported in this House the legislation that made them easier. I have also replied to a consultation in Northern Ireland to ensure that similar legislation can be introduced there. I have done that for a number of reasons. First, I believe that it is really important. Secondly, it is personal for my family, because my nephew Peter is a recipient of a kidney transplant. Without that transplant, that wee boy would never have progressed to become the man he is today, and all because someone gave him the gift of life.

I have spoken at length during the pandemic to highlight the importance of organ transplants continuing. Some 3 million people in the UK have chronic kidney disease, including 1,000 children—my nephew would have been one of them all those years ago—and about 65,000 people are being treated for kidney failure by dialysis or transplant. In the UK, 6,044 people are on the transplant list, and 4,737 are awaiting kidneys.

Interestingly, during the covid-19 crisis, more transplants took place in Northern Ireland than on the mainland, which shows why it is so important to have transplant organs going from the mainland to Northern Ireland, and from Northern Ireland to the mainland. The indication from the Minister is that that will happen, which is good news.

At least one person a day will die because they have had to wait too long, and eight out of 10 people waiting are hoping for a kidney. NHS Blood and Transplant has estimated that this change in the law has the potential to lead to 700 more transplants each year by 2030. That might have to be extended by a year because of the pandemic. I hope that the pandemic will not prevent those who need a transplant from getting that opportunity.

I am keen to get confirmation from the Minister in relation to the tissues regulation, which is a very technical matter. I have taken the opportunity to give him a copy of this, and I hope my description of it is appropriate and correct. Many constituents and people in Northern Ireland have raised this concern with me, so I just want to put it on the record, and perhaps he can provide an answer. I would like something clarified regarding the use of “aborted babies and their tissue”, as it is termed. If one reviews the instruments themselves, the word “aborted” is not referenced. The Minister and I have talked about that, and I understand that. However, in this instrument, it would be implied or covered under the broader term “tissue”, which is defined as

“all constituent parts of the human body formed by cells”,

but that does not include

“gametes…embryos outside the human body, or…organs or parts of organs if it is their function to be used for the same purpose as the entire organ in the human body.”

Does the Minister know whether the Human Tissue (Quality and Safety for Human Application) (Amendment) (EU Exit) Regulations 2020 address the concerns about the use of tissues or organs from aborted babies, and if so, how is the issue of consent dealt with? My constituents have asked me to ask that question and I want to put it on the record in Hansard tonight, and I know that he will do his best to answer it. I would appreciate it if he could outline that. I am being very honest with you, Mr Deputy Speaker, about where I am coming from, because every cell of that little one is precious and must be used with consent and appropriately, just as is the case with those incredibly brave men and women who chose to donate the organs of their lost loved ones in order to save others.

I am always reminded—I will conclude with this thought—of a person who tragically died as a result of an accident in Newtownards. A few months later his father came to tell me that his son had been able to give seven parts of his body to organ donor recipients. That changed the lives of seven people. I am ever mindful of how important that is. I believe it is a worthy decision, and my family are beyond grateful for those who did this for us. However, we must always ensure that there is dialogue with the family, and this issue must be highlighted at every stage.

Covid-19

Jim Shannon Excerpts

Monday 2nd November 2020 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to follow the hon. Member for Guildford (Angela Richardson); I thank her for her speech.

I, as much as anyone here, know at first hand that there is no way of understanding this virus—how it takes one and leaves another, or how it spreads in one room in 15 minutes, yet in other rooms people sit for hours with no transmission. I recognise, as others do, the incomprehensible aspect of this disease, so I also recognise that it is difficult to strategise. Looking forward, what should our next steps be? We have the benefit in this second wave of not being as unsure as we were. Our NHS has equipment and more medical knowledge. There are plasma trials, which appear to make a difference. We know which interventions are the better ones. I am pleased that we have the Nightingale hospitals.

I was also pleased to hear the Prime Minister and the NHS reiterating the need for people to attend appointments if they need screenings and tests, because my abiding concern has been and will be whether we are saving people from covid at the expense of allowing people to die from cancer—a point that other Members have mentioned. One of my constituents said to me, “Is my husband’s death meaningless because it was cancer and not covid that took him?” It is imperative that we protect the NHS by doing the right thing, and the NHS has to be open for day-to-day business; it is so important to ensure that that happens.

If hon. Members look at my head, they will know that I do not go to a barber very often. I just use a shammy; I do not even use a comb. But that is by the by. I say that in jest, but I do want to make a plea for barbers and hairdressers, who have got the R rate to 0.02. I ask myself, why on earth are they subject to rules and regulations when their R rate is the one that the whole nation wants to get to? We want to get it to 1; they have got it to 0.02. Those people could end up having had six months of reduced wages. Just how can we let them down? Those people have bought houses and have been buying gifts on the high street—it just so happens that Newtownards High Street in my constituency is the Northern Ireland high street of the year. How do we let those retailers down?

Simon Hamilton, the chief executive officer of Belfast Chamber of Trade and Commerce, has said:

“COVID-19 has created an interlinked health and economic emergency. This pandemic has cost lives and already has driven numerous businesses to closure causing a huge number of job losses which are reflected in the latest labour market statistics which show the second highest number of redundancies ever during a period when the furlough scheme was meant to protect jobs… Businesses have invested millions of pounds in making their stores, their restaurants, their pubs, their hotels and their factories safe for staff and safe for customers.”

Without the willing co-operation of those businesses, where would we be? He continued:

“It has been an unprecedented period of uncertainty and challenge. After finding the fortitude to keep going after months of lockdown, restrictions and closure earlier this year, many believed that they were starting to see light at the end of the tunnel only for that to now be extinguished.”

That is what really worries me about where we are. It is about finding a balance for health and for business.

The Minister is not here, but there is a good understudy—the Lord Commissioner of Her Majesty’s Treasury, the hon. Member for Castle Point (Rebecca Harris)—in her place taking notes. I ask the Government to reconsider the closure of churches. My email inbox has been full of requests on their behalf. Our lockdown in Northern Ireland has been successful and we have been able to give people a place to go once a week to meet in unity and pray for the future of this nation—to seek God for strength, peace, comfort, hope, wisdom, forgiveness and even joy at this difficult time.

[Jonathan Ashworth]

I am sure that the hon. Gentleman is as pleased as I am that Leicester are winning 2-0 against Leeds.

On the hon. Gentleman’s point about places of worship, a lot of my own constituents have got in touch about our gurdwaras, temples, mosques and churches, and are deeply concerned about this. I hope that before the vote on Wednesday—we will be supporting the lockdown regulations—Ministers can come to the Dispatch Box and give us some reassurances around places of worship. It is a very important issue and I am pleased that the hon. Gentleman has raised it.

[Jim Shannon]

I thank the hon. Gentleman for that. I already knew the score because my hon. Friend the Member for North Antrim (Ian Paisley) had told me. I said, “I am pleased we are winning 2-0, but there’s still 70 minutes to go.” I really want Leicester to win, as my wife supports Leeds United and it is really important we win tonight.

I tabled an early-day motion asking for a National Day of Prayer. It states:

“That this House notes the unprecedented position that the covid-19 pandemic has brought the nation to; further notes that in this time of economic and societal uncertainty the country should follow the lead of Her Majesty Queen Elizabeth II and recognise the importance of prayer when Her Majesty said in her 2013 address that prayer helps us to renew ourselves; and calls on the Prime Minister to initiate a National Day of Prayer to enable those for whom this is important to seek God”.

We need wisdom, and the call for a National Day of Prayer is for those of Christian faith and others to unite together and pray for the help we so desperately need. We need support for the NHS, businesses and the vulnerable, but we also need to humble ourselves and ask God to make the path straight as we work together to come through this covid winter ahead of us. We must trust God and we must pray for the help we need. I think every one of us here should adhere to that.