Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 19th April 2022 Commons Chamber

[Maria Caulfield]

The Father of the House is quite right that the crux of the problem is that there is a shortage throughout the country not of dentists but of dentists taking on NHS work. The contract is the nub of the problem, which is why work is under way to reform it. We will shortly announce some short-term changes and some longer-term reforms, which will hopefully help my hon. Friend’s constituents.

[Jim Shannon (Strangford) (DUP)]

Bearing in mind that dentists are now determined to turn their practices wholly private as they cannot make ends meet with NHS prices, will the Minister pledge to review NHS payments to stop the haemorrhaging of NHS dentistry provision?

[Maria Caulfield]

The hon. Gentleman is correct that the units of dental activity payments are a perverse disincentive. Sometimes, when someone needs more extensive work, their dentist is paid the same as they would be for, say, one or two simple fillings. That is the nub of the problem and we are currently in negotiations on the matter.

Health and Care Bill

Jim Shannon Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Mr Deputy Speaker (Mr Nigel Evans)]

I intend to call the Minister at 5 o’clock to give him 10 minutes to wind up. We have not got long, so will Members please keep their contributions as short as they can?

[Jim Shannon (Strangford) (DUP)]

Thank you for calling me, Mr Deputy Speaker, to speak in this debate. I am pleased to follow the hon. Members for Sleaford and North Hykeham (Dr Johnson) and for Congleton (Fiona Bruce). I thank them both for the contributions.

It will be no surprise to the House that I am here because I abide by the absolute view that both lives matter—the unborn child and the mother. I know that many people believe that if someone is anti-abortion, they are anti-woman. I am not—I never have been, never will be and it is not the case. I believe in life and helping people. My career and all my life have been based around that, and I will continue as long as God grants me the strength to do so.

The Minister referred in his introduction to the fact that the regional devolved Administrations will make their own decisions. They can make that decision in Scotland and Wales, but we cannot make that decision in Northern Ireland, because the Government made it here. They took that decision away from us, and I am particularly concerned about that.

I have several concerns about the approach adopted during the pandemic in relation to so-called telemedicine to access abortion, which was recognised at the time as short-term. Without a face-to-face appointment, there is no confirmation of how many weeks pregnant a woman is, which makes a difference to the experience of an abortion at home. As reported in the summary of consultation responses, women who had experienced an abortion said that information should be provided on

“how inaccurate dating of pregnancy may mean increased pain and bleeding”.

A woman whose pregnancy is later than 10 weeks could find herself unexpectedly passing a mature baby at home, which could lead to significantly more complications. I understand that those advocating for the Lords amendment argue that complications have decreased since the pandemic, but I question the evidence, given that the Government and the Minister’s Department say that

“data on complications is incomplete”

and they are working on reviewing the system of recording abortion complications.

I am also persuaded by the concerns about the increased possibility of a woman finding herself pressurised at home to have an abortion that she does not want, as other hon. Members have said. There is a well-known link between abortion and domestic violence. Indeed, the BBC published a survey a few weeks ago reporting that 15% of those surveyed said they had felt pressured into ending a pregnancy. How are we protecting those women? How can doctors know that they are really speaking to a woman who is voluntarily calling about an abortion, or even that they are speaking to the right person at the other end of the phone?

There are many differing and strong views on this subject on both sides of the House, but I question whether the women who find themselves coerced into an abortion from their home, or who have found themselves bleeding unexpectedly at home or having an abortion much later in their pregnancy than they expected, would agree that telemedicine abortion is a positive step in women’s health. I doubt that they would.

I have recently been vocal regarding the need for face-to-face GP appointments. I have been inundated by constituents who simply have no confidence that a diagnosis by picture or telephone call is safe. I have constituents whose cancer has been undiagnosed because the GP was unable to see first hand what would have been clear in a face-to-face appointment. I believe that face-to-face appointments should be available.

I find it difficult to understand how pills to end life—to take away life—in a painful manner for the mother can be given without seeing someone to assess what cannot be seen on the phone. The signs and movements that an experienced GP can see that point to a deeper problem cannot be discussed in the two minutes allocated to such phone calls and I am fearful that the duty of care that we are obliged to discharge will continue to be missed. I am diametrically and honestly opposed to this legislation, because as I said at the outset, both lives matter. Lives could have been saved if abortion had not been available on demand.

I will vote against the permanent extension of this ill-advised scheme today and urge hon. Members on both sides of the Chamber to join me. It is a step backwards rather than forwards in providing adequate support and care for women, and it further normalises the practice of abortion as a phone call away rather than as a counselled decision under medical care, which is what it deserves to be. I, my constituents and my party are clear that this is a massive issue. I fully and absolutely oppose the Government in what they are putting forward today, for the safety of both mothers and the babies, because I am about saving lives, not destroying lives.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I rise to speak on the subject of the health services safety investigations body and on abortions. I begin by making a couple of declarations: I am a now non-practising doctor, my wife works as a doctor, and I am a member of the Royal College of Physicians and the Royal College of Psychiatrists.

On the HSSIB, I will keep it brief. I hugely thank the Minister for supporting the Lords amendment and ensuring that we have those safe spaces for doctors. That is critical for the body to work and for us to learn from it. Hopefully, we can undo some of the harms of previous atrocities and what has happened to previous doctors, as has been referred to.

On abortion, it is important to say that I wholeheartedly support and believe that women should have access to safe and legal abortion services, but the regulatory framework around them is complex and it is a sensitive area. As is clear from the powerful speeches that I have heard from both sides of the House, it is also sensitive for hon. Members. Many of my constituents—on both sides of the debate—care deeply and correspond regularly with me about it; I care deeply about it too. I have looked after women who are contemplating having an abortion and I have looked after women who have had abortions, so although I have never carried out one myself—I am a mental health doctor—I have seen it from both ends.

--- Later in debate ---

[Wes Streeting]

My hon. Friend is absolutely right and she will know of our party’s ambitious commitments, outlined by my hon. Friend the Member for Tooting (Dr Allin-Khan), to ensure that patients receive guaranteed mental health treatment within a month. That would be revolutionary. It will require investment and require recruiting the people we need to help provide that care, but this country is living through a mental health crisis on top of everything else. This has been a deeply difficult two years for our country during the pandemic. Many people bear not just the physical scars and ongoing physical health consequences of long covid, but the grief, the loss and the injury to their mental health and wellbeing caused by this deadly pandemic. Many of those people who are suffering mental health crises are the very people who are still turning up for their shifts in the hospitals, still turning up for their shifts in the GP surgeries, and still turning up at work to help care for others even though they are in need of care themselves.

Lords amendment 29 does not commit the Government to hire thousands more doctors and nurses, although they should. It does not commit to new funding for the NHS, although it desperately needs that. It does not even commit the Government to finally publish the workforce strategy the NHS is crying out for, despite the fact that the NHS has not had a comprehensive workforce strategy since the Labour Government’s plan was published in 2003. All we are talking about today is an independent review of how many doctors, nurses and other staff the NHS needs for the future. That is not just a view put across by Labour Members: it is supported by many Members right across the House, including the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey, who is a former Health Secretary. It is not the first time that he has helped to unite the sector, although I remember the days when it was sometimes united in opposition to, rather than in support of, his proposals.

I will say this, actually: when the right hon. Member for South West Surrey took over as Chair of the Health and Social Care Committee, I was really nervous about the prospect of a former Health Secretary effectively marking his own homework, but on this issue, he has shown a degree of honest reflection and has genuinely contributed his experience to the debate about the future of health and social care in this country. Not only has he been honest about where he fell short, and where other Conservative Ministers may have fallen short, but he is determined to make sure that we improve the quality of the health and social care debate in this House. I very much welcome his contribution to the debate about the NHS workforce challenge.

[Jim Shannon]

Will the hon. Member give way?

[Wes Streeting]

How can I resist?

[Jim Shannon]

The shadow Minister is always kind in giving way. I want to back up his comments about the right hon. Member for South West Surrey (Jeremy Hunt). On Lords amendment 29, does the shadow Minister acknowledge that Macmillan Cancer Support said that it needs an additional 3,371 cancer nurse specialists? That would double the nurses by 2030, and it gives us a reason why we need to support Lords amendment 29 and why workforce safety is critical.

[Wes Streeting]

The hon. Gentleman is absolutely right. If I am honest, I suspect that the Minister and the Secretary of State for Health and Social Care also agree that Lords amendment 29 is needed. I suspect the truth is that they are not the ones blocking it. They are in a Treasury-imposed straitjacket from the Chancellor, preventing them from doing what they know to be necessary for the NHS, because the Treasury would rather stick its head in the sand and not acknowledge the scale of the challenge or the reality of the cost. It hopes that ignorance is bliss and that we can carry on as we are, and perhaps nobody will notice—even the 6 million people on NHS waiting lists.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am surprised that the hon. Member for Strangford (Jim Shannon) does not wish to speak. [Interruption.] Oh, he does. I hope he will be brief, so that the Minister will have time to answer the debate.

[Jim Shannon]

I certainly will make my points quickly. My first is on the organ transplant amendment, to which the Minister referred. I fully support the measure and have been asking for it for a number of years in the House, so I am pleased to see it moved tonight. Secondly, I am not sure whether the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) is going to push his amendment to a vote—[Interruption.] He is not, but if he did, he would have my support and probably that of my party, too.

Thirdly, I am pleased to lend my support to Lords amendment 29. It would create a national independent view of how many health, social care and public health staff are needed to keep pace with projected patient demand over the next five, 10 and 20 years. I wholeheartedly agree with Macmillan Cancer Support that the Bill will fail to address the biggest challenge facing the NHS and social care right now: staffing shortages and pressures. The Government need to take Lords amendment 29 seriously. The hon. Member for Ellesmere Port and Neston (Justin Madders) referred to it, too. We recognise that we need to address staff shortages as soon as possible. I have referred to Macmillan and their request for an additional 3,371 cancer nurse specialists to help address that issue.

I will conclude with this point. I understand that the Government may come back with all the justifications as to why this is not the right amendment—the Minister is a real good man; we all know that, and he responds well to all our requests—but I am content that it would begin to address the issue that our NHS workforce is disintegrating. One of my constituents is in a prestigious medical school here on the mainland. She went to do her rotation with a GP as part of the work she does. He told her, “Do any job but this.” I thought that was disappointing. He said, “It will consume your life. You will work long hospital shifts and you will not have a personal life.” This is a seasoned GP who simply cannot cope, so we must do something, and this amendment is a way forward. I therefore will support it whenever it comes to a vote.

Ockenden Report

Jim Shannon Excerpts

Wednesday 30th March 2022 Commons Chamber

[Sajid Javid]

Yes, I can give my hon. Friend that reassurance. I can add that Donna Ockenden, in doing her work, looked at cases from Wales as well. The issue that my hon. Friend has raised has also been raised by my hon. Friend the Member for Montgomeryshire (Craig Williams), and I can give them both that assurance.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement, for the obvious compassion that he has for all those involved, and for his support of the Ockenden report. I want to place on record my sympathy with all those parents who still grieve their loss, and for whom no report will never, ever soothe the pain. Will the Secretary of State confirm that the report into this dreadful spate of deaths will be made available to all hospital trusts across the United Kingdom, including Northern Ireland, to ensure that lessons are learned and that the 84 recommendations of the Ockenden report and any mechanisms of prevention can be understood and put in place UK-wide?

[Sajid Javid]

Yes, I can give the hon. Gentleman that assurance. We are more than happy to reach out to the Northern Ireland health service and to work proactively with it on improving maternity services in Northern Ireland.

Civil Proceedings

Jim Shannon Excerpts

Tuesday 29th March 2022 Commons Chamber

[Maggie Throup]

The right hon. Gentleman makes a very good point. We know that the pandemic has had a mental health impact not just on children and young people, but on people of all ages. That is why it is important that we are now living with covid and getting our lives back to normal, which is one way of helping restore that normality that we are so desperate to get back to.

The Government helped businesses at a time when many faced disruption, including through the coronavirus job retention scheme. We have also supported the self-employment income support scheme, which paid out more than £28 billion to nearly 3 million self-employed people and was one of the most generous schemes for the self-employed in the world.

[Jim Shannon (Strangford) (DUP)]

The legislation covers England, Wales and Northern Ireland. Will the Minister reassure me that full consultation has taken place with the Health Minister and the Economy Minister in Northern Ireland to ensure that what she is mentioning is endorsed by the Northern Ireland Assembly?

[Maggie Throup]

I shall come shortly to the specific parts of the extension that are relevant to Northern Ireland. I am sure that the hon. Gentleman will appreciate that we have had ongoing conversations with the devolved Administrations throughout the whole two years.

The Coronavirus Act 2020 also helped to ease the burden on frontline staff in our critical public services. For example, provisions in the Act have helped the courts and tribunal system to keep functioning throughout the pandemic by allowing thousands of hearings to take place remotely.

Lateral Flow Tests in Healthcare Settings

Jim Shannon Excerpts

Monday 28th March 2022 Commons Chamber

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I am delighted to have secured tonight’s Adjournment debate on an important topic for my constituents and people across the country. I feel driven to raise this point again because I do not believe that the Government are adequately considering the most vulnerable. Two weeks ago, I wrote to the Secretary of State on behalf of more than 50 hon. Members of this place and others. We were of all parties—this is not a party political issue but one of fairness and justice—and we were of one mind: that the charge for lateral flow tests would exclude many from a proper part of life in this country.

It is clear to everyone that the fight against covid-19 is not over. The rise of new variants and strains will continue. Researchers and healthcare professionals will develop and deploy new and more effective vaccinations and therapies. I think the Minister will agree that we have to learn to live with covid and that we will not eliminate it tomorrow, but living with it is a death sentence for many. Millions across the UK are clinically extremely vulnerable or have CEV relatives and friends in care homes and medical settings.

Protecting the most vulnerable has been a key aim of public health policy for two years, and that is right.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing forward the debate. I agree with him entirely. Does he agree that it is essential for testing to remain widely accessible for those who are face to face with the most vulnerable in society: the carers, who have been at the forefront of protecting all of us across the United Kingdom of Great Britain and Northern Ireland over the last two years? Lateral flow tests are still worth the cost, and they must continue to be available free for all vulnerable people and their carers.

[Mr Sharma]

I thank the hon. Member for that important intervention. I am sure that the Minister took note of his concerns.

We all know that we are experiencing and facing an increasing cost of living crisis, and earlier this month the Foreign Secretary agreed that the escalating crisis in Ukraine will only drive inflation higher, so in the midst of the most serious cost of living crisis for a generation, with a national insurance tax rise and with covid remaining a global threat, it would be wrong to add a further burden on to families wanting to stay safe from covid and visit friends and families in care settings. The introduction of charges for lateral flow tests risks introducing a serious cost on many for visiting their closest family when those visits mean so much to visitor and host.

Covid-19: Impact on Social Work

Jim Shannon Excerpts

Wednesday 23rd March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Lancaster and Fleetwood (Cat Smith) for raising such an important issue. I had hoped that we would have more people here today to participate because there is not one MP who does not have regular contact with their social workers on behalf of constituents; it happens in my office every week. I want to mention some of the issues and care packages in place, and I will mention some figures for my constituency.

I am pleased to see the Minister in her place. I always look forward to her response—not just because she is a good friend, but because she always answers with knowledge and help, which I think we all wish to see. That is exactly what the hon. Member for Lancaster and Fleetwood is seeking with the debate. I am also pleased to see the shadow Minister, the hon. Member for Bristol South (Karin Smyth), in her place—I look forward to her contribution—and my good friend the hon. Member for Linlithgow and East Falkirk (Martyn Day), who speaks on behalf of the Scottish National party. We are pleased to participate in this debate on such an important issue.

It is not the fault of anyone in this room, but the outbreak of the pandemic has cruelly exacerbated the social work situation. How we respond is the subject of the debate and the Minister’s responsibility. There is no doubt those in the profession have faced unprecedented challenges, and it is great to be here today to illustrate some of them and to discuss how we can support our brilliant social workers.

We have mentioned the NHS and many of those who kept the wheels turning and the shelves filled, who visited people and who made everything happen through a pandemic of unprecedented ferocity. All of society gelled together as a team to make that happen. I meet people every week in my constituency of Strangford who make the lives of the vulnerable and those in need better. That is their responsibility, and I have that responsibility on their behalf.

We are sometimes confronted with incredibly difficult cases. I am no different from anybody else, so I suspect that my response is the same as everyone else’s. Social workers are involved in some awful cases: the lives that people are confronted with, probably through no fault of their own, and the impact on children. I have a special place in my heart for children, because I am not only a father, but a grandfather; it is a great stage. Those of us in the Chamber who are grandparents will know that it is a wonderful experience. The great thing, Mr Robertson, is that we can give our grandchildren back at 7 o’clock at night! Whenever they get tantrummy and want to go to bed, or do not want to go to bed—it depends what mood they are in—we can always phone up their mum and dad to say, “By the way, the kids are ready to collect.” We can enjoy all the fun, but for others on the frontline, I am afraid that there are real problems.

As of 2021, 105,000 people were employed as social workers for children, the elderly, and those who are vulnerable and in need. I am not asking the Minister to answer for Northern Ireland as that is not her responsibility, but I want to sew the Northern Ireland perspective into this debate because it echoes what the hon. Member for Lancaster and Fleetwood said in her introduction. The Minister always gives me some succour and encouragement in her response, and that is important.

There is predicted to be a mismatch between the supply and demand of social care professionals, with 1 million workers needed by 2025, which is not that far away. We seem to be having anniversaries regularly—whatever they may be for—and I look back and think, “That can’t have been four or five years ago”, but it was. Three years will pass quickly, and it is predicted that there will be a 35% shortfall in social workers. Will the Minister tell us from a UK perspective what has been done to recruit and train social workers, and to have the support at every level that is critical to a good response?

[Mr Gregory Campbell (East Londonderry) (DUP)]

My hon. Friend is outlining the extent of the problem and the imminent mismatch between supply and demand, which is just two and a half years away. Does he agree that what we need to see and hear from Government, both centrally and throughout the devolved regions of the UK, is an acknowledgement and admission of an impending problem? Action needs to be taken now, so that social workers and others in the care sector can see that our Governments are looking ahead, planning and preparing for the problems that we will all face.

[Jim Shannon]

My hon. Friend has summed up in a few seconds exactly what the debate is about, whereas I will take 10 or 12 paragraphs to explain it. His point is that we have to be strategic and visionary, and have a plan of action. Today is all about what that plan of action is.

[David Linden]

I visit schools in my constituency and speak to some of the kids about what they want to be when they grow up—although I am probably not grown up yet and do not know what I want to be—and it strikes me that we have to look at this issue in the context of schooling, which I accept is devolved in Scotland. We need to encourage young people to think about careers in social work. Looking around the Chamber, I was probably the one in school most recently, but I do not recall being encouraged to look at social work, when we were told in the traditional way, “Here are careers you can do.” Does the hon. Gentleman agree that we can do more to encourage young people to consider a career in social work, and would he be willing to promote that in Northern Ireland?

[Jim Shannon]

The hon. Gentleman is absolutely right. Many social workers I deal with are probably of a certain generation. He makes the point that we need to be preparing, and that goes back to my question to the Minister about having a strategy and plan in place.

I understand that many young people do come into social work, because I have met some, but—I say this very gently, and it is not in any way meant to be critical—they need to have experienced social workers to work alongside and gain their knowledge. Young people will sometimes be confronted with cases that they might not have the life experiences to deal with. That is not a criticism; experience is gained over many years. I have been confronted by such cases on behalf of constituents, and I feel that decisions are not always made—in my opinion, as someone who is not a social worker—as they could or should have been.

[David Simmonds]

I entirely agree with the hon. Member’s point. Does he agree that programmes such as the fast-track ones bring the opportunity, in particular for young social workers who might be graduates straight out of university, to work with people who may have been in the profession for 20 or 30 years? Young social workers would have the chance to learn from experienced people and to see how they dealt with cases with which I, as a lead council member, was sadly familiar—for example, sometimes, the sexual abuse of children committed by professionals who were meant to be caring for them, or elderly people suffering complex financial abuse within a family. It is important that the Department of Health and Social Care and the Department for Education continue to support that type of professional development, so that we can grow our own highly professional social workers in the future.

[Jim Shannon]

As my friend, the hon. Member for Glasgow East (David Linden), said—and as I am trying to say, in my broken words—people have to start somewhere in life; they have to start their job somewhere and learn about their role.

Social care organisations have revealed that 75% of social workers feel more negative about their work life in 2021 compared with in the first year of the pandemic. People come to us all the time with problems, and I like that because it is my job. Many people say, “I don’t know how you do your job, listening to people’s complaints and always solving their problems, and so on”, but I reply, “That’s what life is about. Life is about making lives better.” We need to be aware that social workers sometimes deal with complex and difficult issues. My question to the Minister is, has any assessment been done of the impact of the pandemic on social workers? If the figures are right—I understand that they are—that 75% of social workers feel more negative about their work life in 2021, we have a potential problem. I hope we do not, but we must at least consider that and respond.

This situation is down to the increasing pressures and challenges that the social work sector has faced. Referrals of children to social services in Northern Ireland have increased every month since February 2020. The highest figure was in April 2021, with 3,616 children being referred. That clearly indicates that parents are struggling to cope, and is a clear sign of the increasing pressure on our social workers, which the hon. Member for Lancaster and Fleetwood illustrated very well in her contribution, and as other Members have reported.

We must not forget the impact that the covid outbreak has had on the social sector in relation not just to children, but to the elderly and the vulnerable. The hon. Member for Ruislip, Northwood and Pinner (David Simmonds) rightly referred to an issue that is on my mind as well: people who depend on family members to look after their financial affairs. I have dealt with a few of those cases, which are always difficult because there are often two sets of family members saying two different things—but there is a person in the middle who is losing out.

The BBC revealed in mid-2021 that almost 2,000 people in Northern Ireland are waiting for care packages, so that they can be supported to live in their own homes. Just this week, a very lovely man who I have known all my life—he is well into his 80s now—has been ill and had to go to hospital. Although he wants to come home, and would be able to, he needs a care package in place before he can come home because, due to the nature of his disability, his wife would be unable to provide the physical care that he needs. That is not the Minister’s responsibility; I am just illustrating the issue.

The wait for care packages could mean an increase of patients to residential care. My constituency of Strangford takes in the South Eastern Health and Social Care Trust, which has reported that 282 people were waiting from the end of August 2021. Social workers are a key part of making that a success story. The provision of home care is crucial in taking the additional pressure off of hospitals and care homes. We must ensure that our social workers have the capacity to deal with the increasing amount of care packages needed. I have never seen anything quite like it. I know that we are getting older—we are living longer and our bodies are breaking down, meaning that more people need care packages—but there has to be a strategy and a vision for how we deal with that, as has been pointed out in other contributions.

There is an increased risk of covid infection for those who work in the social work industry, as we have seen happen over and over. That is nobody’s fault; it is the nature of life. It cannot be helped when tests are positive and people must take time off work. However, that is where we can step in to ensure that there is a sustainable number of social workers to cope with the level of care needed by children, the elderly, the vulnerable and the disabled.

We must also take into consideration the impact of the pandemic on our social workers’ mental health. Some 55% of respondents to a survey said that they felt increased anxiety—in an already difficult job—given the risk that they posed to the vulnerable by potentially carrying covid. I am keen to hear the Minister’s thoughts on how we can better deal with that. One way would be to have extra staffing, as the hon. Member for Lancaster and Fleetwood mentioned earlier. Social workers are as prepared as they can be in terms of personal protective equipment, as the Government and the Minister have done extremely well in responding to that need, but the Government must step in when it comes to staffing and workload. Many social workers have stated that their casework load has increased by as much as 40% over the pandemic. They are working longer hours—I know that, because they tell me that and I see it—and those longer hours are probably for the same money. Overtime rates will never compensate for the loss of physical wellbeing and mental health.

The Department of Health and Social Care must have provisions in place to ensure that our social workers are not under the most extreme pressure. I very much look forward to the Minister’s response and the encouragement that she will give us. I urge her and her Department to consider the impact of that pressure not only in England, where her responsibility lies, but across the United Kingdom. I know that the Minister, like those in other Departments, regularly contacts her equivalent Minister in the devolved Administrations, be that in Scotland, Wales or, in my case, Northern Ireland, so I know that there is continuity between those Administrations. I say very gently to my two friends, the hon. Member for Glasgow East and the hon. Member for Linlithgow and East Falkirk, that I very much think that within this great United Kingdom of Great Britain and Northern Ireland, we are always better together; we can work together and exchange ideas, and we can all benefit from that. I say that gently to my friends in the SNP, because I know that they really do agree with me that we are better together.

[Mr Laurence Robertson (in the Chair)]

I call Martyn Day.

Irish Diaspora in Britain

Jim Shannon Excerpts

Thursday 17th March 2022 Commons Chamber

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

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

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

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

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

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

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

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

[Jim Shannon (Strangford) (DUP)]

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

[Conor McGinn]

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

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

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

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

Physical Activity and Health Outcomes

Jim Shannon Excerpts

Tuesday 15th March 2022 Commons Chamber

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

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

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

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

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

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

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

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

[Jim Shannon (Strangford) (DUP)]

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

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

[Andrew Selous]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Covid-19: Deteriorating Long-Term Health Conditions

Jim Shannon Excerpts

Thursday 10th March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

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

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

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

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

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

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

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

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

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

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

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

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

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

That is really important. The second is to

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

and thirdly, to

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

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

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

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

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

--- Later in debate ---

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Jim Shannon]

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

Covid-19: NHS Support for Prostate Cancer Patients

Jim Shannon Excerpts

Thursday 10th March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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