Healthcare: East Midlands

Jim Shannon Excerpts

Tuesday 30th April 2019 Westminster Hall

[David Tredinnick (Bosworth) (Con)]

Thank you, Mr Hollobone, for allowing me to speak first. I think it is the first time I have heard a Chair say that there is no time constraint, but I will not detain the House for too long. At the risk of being called to order, I had planned to raise the work that you have done for Kettering General Hospital and your impassioned demands for improvements to it over the years, which no doubt the Minister has listened to many times. I was with some friends last week who said, “Ah, Northamptonshire. That’s the Bones—Peter and Philip—isn’t it?” Kettering General Hospital came up. At the risk of being called to order—I do not see you doing that—let me say what a good job you have done for that hospital. As was said in the Chamber this week, your whole identity in the House is linked to the work you have done there.

I congratulate the hon. Member for Lincoln (Karen Lee) on securing not just half an hour but an hour and a half in what used to be called the Grand Committee Room but is now Westminster Hall. She spoke passionately and with detailed knowledge, as a former nurse, about the problems in her area. I listened to her speech, and I have sympathy with what she said about some of the consolidation that has taken place, but inevitably there have to be some changes and rationalisations in the health service.

I will talk mainly about the changes in the great town of Hinckley, in my west Leicestershire constituency of Bosworth, which is some way from Lincoln. We were very fortunate that the Secretary of State himself—ipse—recently came to Hinckley to look at the changes that will be made thanks to the £8 million grant that has been secured for upgrading the facilities in Hinckley. Mayur Lakhani, the chair of the West Leicestershire clinical commissioning group, spoke warmly about the way the Secretary of State had responded to their bid, and the support of Hinckley and Bosworth Borough Council, which happens to be Conservative-controlled, and which I will refer to later.

I was lucky to be elected to this House a long time ago—in fact, so long ago that I sometimes forget the date. I have been a Member for more than 30 years, and the one health issue that has bedevilled my constituency above all others in that period is what to do with the Mount Road hospital—the old hospital in the middle of Hinckley. Because of the £8 million grant that the Secretary of State awarded to the clinical commissioning group, we are now able to make some substantial changes to the health improvements in Hinckley. Given your interest in Kettering General Hospital, Mr Hollobone, you will understand my joy at seeing the improvements that are about to take place—consultations are going on at the moment.

I have a letter from the West Leicestershire clinical commissioning group setting out exactly where we are now. It says that the investment supports plans to provide modern, fit-for-purpose facilities, and more services in the local community and closer to home in Hinckley. I say to the hon. Member for Lincoln that part of that will be about shutting down old facilities. One is a portakabin and another is the old hospital. In exchange, the investment will make better use of all available existing space in Hinckley Health Centre on Hill Street, not far from the old hospital, and Hinckley and Bosworth Community Hospital, which we call Sunnyside because it is on a hill and gets the sun all day long—it is a marvellous place for a hospital.

As part of the £8 million package, the Hinckley Health Centre will be refurbished to accommodate X-ray, ultrasound and physiotherapy, and to increase the number of consulting rooms, which is extremely important. Out-of-hours primary care services will be relocated from Hinckley and Bosworth Community Hospital—Sunnyside—to the newly developed urgent care hub in the Hinckley Health Centre, which will provide out-of-hours urgent care for local patients. A combined day case surgery and endoscopy unit with day case beds will be created. That will provide an increased range of day case procedures and cancer screening services for local patients. We will be removing services from the old Hinckley and District Hospital and the physiotherapy portakabin, which are unfortunately not fit for purpose, and physiotherapy services will be relocated to Hinckley Health Centre.

As I have the luxury of time, I say to people who have campaigned for years to save the old Hinckley and District Hospital that as it is such an old building, upgrading the hospital to the highest standards would require a phenomenal amount of work at a very high cost, with a low return on investment because all the special cables now have to be run with special conduits for oxygen and monitoring. It simply cannot be done efficiently in such an old structure. Although many of my constituents will have an emotional attachment to the old hospital, the decision that has been taken by the clinical commissioning group is right: it needed to close. In exchange, we are now getting an £8 million grant, which will provide much better facilities. As I mentioned earlier, some of the facilities are coming into the town from the outskirts—from Sunnyside to the health centre. It is quite an achievement.

We were lucky to get the grant of £8 million. My father always said to me that you generate your own luck in life, which is true. In this case, one of the drivers that made it possible for the Department and Secretary of State to agree to the clinical commissioning group’s bid was the extraordinary co-operation in west Leicestershire between the different service providers, particularly in Hinckley in my constituency.

At the beginning of the 2005 Parliament, I was lucky enough to get elected to the Health Committee under the new procedures. Subsequently, I chaired it for a short time. When I was elected to the Committee, I asked the then leader of the council, “Would you like me to come and talk about health on a regular basis?” It was agreed that I would, and that developed into a health and wellbeing partnership, which meets quarterly with the clinical commissioning group; the director of public health for Leicestershire County Council, Mike Sands; and senior officers at Hinckley and Bosworth Borough Council, including Bill Cullen, Simon Jones, Councillor Maureen Cook and many other excellent Conservative councillors over time. We also have doctors from the local surgeries attend.

Over a period of some years, we saw the meeting change from participants sitting with their arms folded and leaning back, to sitting up and listening attentively. We have learned to work together, and the partnership has been leakproof—there is nothing to gain from talking outside. We have had an extraordinary degree of co-operation, and I am absolutely convinced that it has improved the health services in my constituency and the county as a whole. It has reduced costs and brought up a whole a range of new ideas, some of which I shall go through today. The work of the secondary provider, Hinckley and Bosworth Borough Council, has been really remarkable and hugely encouraging, and it is something that all local people in my constituency can be proud of. Leicestershire County Council has done a good job, too, but I am particularly proud of what Hinckley and Bosworth has done through its health and wellbeing partnership—its contribution to health delivered through that partnership.

It might be instructive if I run through some of the areas that Hinckley and Bosworth Borough Council has worked on. I am pleased to see the Minister of State in his place rather than a Parliamentary Under-Secretary; he is the deputy of the Secretary of State. It illustrates how seriously the Government take the issue of health funding in the east midlands. I want to share with him what is going on in Hinckley. First, I reiterate that we have a local delivery of preventive services through co-operation. I mentioned the councils, but we also talk to the voluntary and community sector. We have patient participation groups, school participation groups and elderly patient participation groups.

The information pyramid is broad-based, and the lines of communication are fluid. Information can come from the bottom to the top very easily. From those ideas, the Conservative-controlled Hinckley and Bosworth Borough Council has produced a comprehensive prevention strategy, which sets out the work that the authority will undertake with its partners. The first objective is to prevent issues from escalating by taking action as early as possible. The second is to reduce demand for high-cost services and dependency on statutory services, thereby making spending more efficient.

Another objective is to develop self-help approaches to enable communities to take responsibility for their own health and wellbeing, which is something that the Department of Health and Social Care worked on under the Secretary of State’s predecessor, and the Health Committee in the 2005 Parliament looked at personal budgets and how they work. It was about getting people to think about their own health. With an ageing population, that is one of the areas that really must be brought to the fore in the future. However much money we ask for the NHS, we will never have enough supply of resources to meet demand unless we encourage people to take greater care of themselves. In this respect, the initiatives that Hinckley and Bosworth Borough Council has taken are hugely important in encouraging people to do that.

I will come on to what the council has done in a moment, but the overall aim of the strategy is to ensure that, together with its key partners, the council enables communities—especially people who are most at risk—to keep safe, keep well, stay independent and enjoy life. To support those aims and achieve those objectives, the council provides integrated locality teams, which identify and support people in a more co-ordinated way, focusing on two specific areas. The first is:

“Proactive identification via risk stratification of patients (18+, frail, multiple LTCs) at risk of a hospital admission and assessing the ‘whole person’ and their needs to keep them safe and well at home where it is appropriate to do so.”

I quote from this document—“whole person”—because a key thrust of health policy in the future should be holistic healthcare, which has become slightly muddled up and seen as definitely not mainstream. Actually, it should be at the core of the mainstream, treating the patient as a whole. I will come on to long-term care and conditions when I discuss the Health Committee’s report, “Managing the care of people with long-term conditions”, which I signed off as Chairman.

In Hinckley and Bosworth, we have a council that is proactively segmenting the population to treat people who are most in need as priorities, which I absolutely applaud. It also does that through the use of health ambassadors, who are

“uniformed volunteers who support and encourage people to get more active more often. They undertake this by playing to their strengths. Some give presentations, some lead activities, some encourage and support new participants on current schemes. Some are happy to have a coffee after an activity and talk to new participants. The big thing is they are positive role models who are empathetic with people and can support them to change and be more active in a way that is natural and comfortable to them.”

The programme is particularly effective when dealing with older people. In my beautiful constituency, Desford sports centre provides classes for elderly people, to keep them active. They have a chance to talk to experts—not doctors particularly, but sports therapists. They can play table tennis, sit down and do quizzes, play tennis—there is even tennis for people who are disabled. The whole idea is to get people who are a bit tired of life, or a bit sad by themselves, to meet other people and to engage in activities, thereby making them happier and healthier, and reducing the burden on the health service.

We are trying to divert away from A&E—the Leicester Royal Infirmary has one of the highest patient inputs in the country relative to its geographical footprint. I will not talk about the royal infirmary and the wonderful work of its health workers, but when the chair of the clinical commissioning group came to see what we were doing in Desford—on another visit, without the Secretary of State—we saw the Steady Steps programme. It is a 24-week free postural and stability exercise programme for older adults, aimed at those aged 65 and over who are at risk of falling, unsteady on their feet, lacking in confidence or likely to lose their balance.

One therapy that the sports centre is not employing, but to which I should like to draw the House’s attention, is the Alexander technique, which I have used in the past. Alexander was an opera singer, and he found that he could not sing. Part of the problem was that his chest was constricted all the time, so he could not project his voice—something that politicians are also quite keen to do at time when on the soapbox, if they can ever get there. Alexander discovered that breathing was connected to posture, and most people do not stand correctly with their hips as part of their back; they tend to have a break and swivel around the second and third lumbar vertebrae. He managed to get people to stand correctly to get their weight right. With their weight right, their lungs could perform properly. Those techniques, which have been developed by experts over the years, should be looked at carefully by the Department of Health and Social Care, but I will come to ways that we can take pressure off the Department generally.

Through the Steady Steps programme, it is so exciting and empowering to see elderly people who have become immobile actually get back into the community. Some of them have mental health problems, and Hinckley and Bosworth Borough Council has an active mental health support programme with five main objectives. They are to create networks to co-ordinate comprehensive and integrated mental health services in the community; to implement activities and events for promotion and early intervention and prevention in mental health; to improve awareness of mental health issues among children and young people, so that they do not think it strange that an older person is perhaps not as with it as they were in their 20s; to improve mental health and the impacts in the workplace; and to improve the quality of life of people living with dementia, and of their families and carers.

That is not rocket science; it explains to people simple facts of life about health. The programme brings the community together—it is a project that speaks to cohesion—makes it less likely that people will be upset by the behaviour of other people, and enables instructors to identify core problems. In the Hinckley and Bosworth area, we have over 6,500 dementia friends and 40 dementia champions. That is a lot of people in a constituency of 100,000 with 70,000 electors, and a very serious intervention.

Suicide is another issue that we as MPs deal with regularly. Most colleagues will have had cases in their surgeries about which they have had to approach care agencies. Leicestershire and Hinckley and Bosworth Borough Council have taken very decisive steps, with the Start a Conversation suicide prevention campaign for Leicester, Leicestershire and Rutland. The Start a Conversation website was launched on 10 September to coincide with World Suicide Prevention Day, and aims to provide information and signposting to people who are experiencing distress, to those worried about someone else, or those bereaved by suicide. The website is still in development, but will offer support and training to professionals.

[Jim Shannon (Strangford) (DUP)]

Whether we are discussing healthcare in the east midlands or in Northern Ireland, the issue of suicide is prominent in my constituency. When I became its MP in 2010, the level of suicide among young people was at its highest. That was dealt with through the involvement of community groups and of people in the community who had lost loved ones. There was also interaction with church groups and those of faith. By coming together, we reduced the incidence of suicide, and by working alongside healthcare in Northern Ireland, which is a devolved matter, we found that together, we could address the issue. It took both the community and healthcare to make that happen.

[Mr Philip Hollobone (in the Chair)]

Before Mr Tredinnick responds, I remind the Chamber that there is half an hour of Back-Bench time left, with two other Members seeking to contribute.

Age-related Macular Degeneration: NHS Funding

Jim Shannon Excerpts

Tuesday 9th April 2019 Westminster Hall

[Bambos Charalambous]

My hon. Friend makes an excellent point; I will come to that matter later in my speech.

AMD is an ever increasing public health issue, presenting as one of the number of long-term conditions that can lead to an increased risk of morbidity in patients. AMD costs the economy an estimated £1.6 billion a year and hits the productivity of society. There is a strong correlation between AMD and decreased quality of life outcomes, including an increase in depression, impaired ability to do everyday tasks, feeling more socially isolated and being 1.7 times more likely to suffer falls. Twenty-one per cent. of the annual medical cost of falls, which is £56.5 million, is attributed to those with visual impairments. The loss of independence resulting from sight loss can also be incredibly debilitating because systems are not set up to deal with it.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing this debate, and I offer the Minister all best wishes in her new position. It is well deserved, and we look forward to working with her regularly in Westminster Hall and elsewhere.

My father suffered from AMD, although he did not know he had it until it had reached a late stage. Does the hon. Gentleman agree that early diagnosis is important for all matters of eye care that affect us, as is visiting an optician at least once if not twice a year? That is one positive thing we can do.

[Bambos Charalambous]

The hon. Gentleman makes an excellent point. Early diagnosis is so important, especially for wet AMD. The target requires people to be seen within 18 weeks of diagnosis, but that is unacceptable for people with wet AMD who should be seen within two weeks. Otherwise, their vision could suffer serious damage.

One concern is that the NHS has insufficient eye clinic capacity, due to delays and cancelled appointments that the British Ophthalmic Surveillance Unit has identified could lead to up to 22 patients a month losing their vision. The all-party group on eye health and visual impairment—I am pleased to see two members of the group here today—is supported by the Royal National Institute of Blind People, and in its inquiry, “See the Light”, published in June 2018, it identified 16 recommendations on which the Government should take action.

Three recommendations on which the APPG is still waiting to see progress include: the urgent need to increase the number of trainee ophthalmologists to keep pace with increasing demand; the need to ensure that sustainability and transformation partnerships—STPs—address current and future need; and the need to establish a national target to ensure that patients who require follow-up appointments are seen within a clinically appropriate time to prevent delayed and cancelled appointments.

According to statistics from the Industry Vision Group, last year three out of 44 STPs identified ophthalmology as a priority service, and only seven out of 44 met the 18-week referral target every month between January 2017 and January 2018. Early intervention for wet AMD is crucial to avoid blindness, and even the 18-week target that I mentioned to the hon. Member for Strangford (Jim Shannon) is not suitable for people with wet AMD, which requires treatment within two weeks. There is still a need to collect robust data on ophthalmology at clinical commissioning group level in order to assess performance and learn from best practice. Some of the issues relating to delay or the cancellation of appointments may be due to systems and processes, and not necessarily to funding.

Ophthalmology has the second highest outpatient attendance of any speciality, with 7.6 million appointments in England in 2017-18 accounting for 10% of all outpatient appointments. As we are all living longer, that figure is projected to increase by up to 40% over the next 20 years. The Government could do a number of things to help improve the situation for people with AMD and other sight-threatening conditions. First, we need a national eye health strategy—that point was raised by my hon. Friend the Member for Battersea (Marsha De Cordova). Unlike Scotland and Wales, England does not have a national eye health strategy, but one is needed to address workforce capacity issues and health inequalities, and to enable better care and improvements to the quality of life for those with AMD.

[Bambos Charalambous]

I am pleased to hear of the excellent work taking place in the hon. Gentleman’s constituency.

Contained within the strategy should be a minimum commitment to research similar to that given in the Government’s dementia 2020 challenge, which committed £60 million a year to dementia research, resulting in significant advances for those suffering with dementia. It is unclear how much funding has been set aside for ophthalmology from the £20 billion announced in the Government’s NHS long-term plan. I would be curious to hear from the Minister whether it is part of the plan or not.

There is also a need for the establishment of a national ophthalmology database to collect and analyse data for the purpose of improving outcomes, better decision making, and allocating resources. At present, there is fragmented data collection, such as that by the health quality improvement partnership, administered by the Royal College of Ophthalmologists, which covers only cataract surgery. A database that routinely collects information on AMD would greatly assist research and the planning of clinical care for those with AMD.

All STPs and integrated care schemes should be held accountable for developing and implanting integrated ophthalmology plans. Three years ago, the Department of Health commissioned a number of “Getting It Right First Time” reports into a series of areas, including ophthalmology. Unfortunately, that report is yet to be published, but hopefully when that happens it could inform the integrated ophthalmology plan, along with other sources such as the Royal College of Ophthalmologists’ “Way Forward” reports.

[Jim Shannon]

The hon. Gentleman is very gracious. As I should have said earlier, I declare an interest as the chair of the APPG for eye health and visual impairment. He is right that it is important to visit an optician to have a test for AMD, but such a visit can have other benefits. Through a person’s eyes, an optician can get an idea of what that person’s body is like, and can diagnose other things that are wrong. There are other benefits to visiting an optician for an early AMD test, in terms of everything that goes with it.

[Bambos Charalambous]

The hon. Gentleman makes an excellent point. We should all visit opticians on a regular basis, because they can detect a whole series of other eye conditions.

My second ask is for the publication of a workforce development plan for ophthalmology. That should also be a priority. There is already a shortage of eye care specialists who can diagnose and treat AMD. The number of ophthalmologists in the UK is the second lowest in Europe. The numbers are expected to reduce further, while the patient population is likely to increase significantly. The Department of Health and Social Care should commit to producing a workforce development plan that addresses the current situation and assesses future demand and provision need.

NHS RightCare should also develop guidance and a workstream for AMD, and data packs that can be shared as a resource and inform improvement in treatment for AMD. An IT platform that allows better integration of services is needed—for example, from primary care to hospital-based ophthalmology—so that a more joined-up approach can lead to better outcomes for patients with AMD.

Finally, it should be remembered that there is a link between sight loss and mental health, depression and frailty. The secondary effects of sight loss should also be considered when making both national and local policies on commissioning services.

--- Later in debate ---

[Seema Kennedy]

I will respond to the question that the hon. Lady raised in her intervention later on in my remarks. We know that regular sight testing can lead to early detection of these conditions. In his capacity as chair of the all-party group, the hon. Member for Strangford (Jim Shannon) referred to the importance of regular eye tests, given that, combined with early treatment, they can prevent people from losing their sight. That is why we continue to fund free sight tests for people over 60 and, alongside NHS England, are fully supporting the aims of the UK Vision Strategy to improve the eye health of people in the UK. A mark of the priority that the Department places on eye health is the inclusion in the Public Health Outcomes Framework of an indicator of the rate of avoidable blindness, both as a headline measure and by main cause, to highlight and track the direction of travel at national and local level.

The hon. Member for Enfield, Southgate has raised a number of wider important issues for the eye care sector. Many of those were highlighted in the report from the all-party parliamentary group on eye health, “See the Light”, which was published last summer. The Department welcomes this report and, along with NHS England, is carefully considering the key recommendations.

The hon. Gentleman said that eye clinic capacity was insufficient. I of course share any concerns about delays to treatment. National guidance is clear that all follow-up appointments should take place when clinically appropriate, and patients should not experience undue delay at any stage of their referral, diagnosis or treatment. To help address that issue, two key initiatives—“Getting it Right First Time”, led by NHS Improvement, and the elective care transformation programme, led by NHS England—have been set up to consider what can be done to ensure that patients do not suffer unnecessary delays in follow-up care. My Department is following that work closely.

The hon. Gentleman also asks that we establish a national target to ensure that patients requiring follow-up appointments are seen within a clinically appropriate time. As I am sure he will appreciate, the intervals for follow-up appointments will vary between different services or specialties, and between individual patients, depending on the severity of their condition. That is why all follow-up appointments should take place when clinically appropriate. For patients who require further planned stages of treatment after their “referral to treatment” waiting time clock has stopped, treatment should be undertaken without undue delay and in line with when it is clinically appropriate and convenient to the patient to do so.

The hon. Gentleman and the hon. Member for Battersea both raised the matter of a national eye health strategy. The Department takes sight loss very seriously. We are working with NHS England to ensure that the commissioning and development of eye services are of high quality and sustainable. I look forward to meeting the hon. Lady to discuss all matters relating to vision and sight loss.

CCGs are responsible for commissioning all secondary care ophthalmology services, and are also available to commission primary care services such as minor eye services and monitoring, in the community, to meet identified need. It is therefore right that the planning and commissioning of high-quality eye care services that meet the needs of the local population should happen locally, not at a national level.

The hon. Member for Enfield, Southgate, also referred to the national ophthalmology database, and asked that it be expanded to collect data on AMD. Data is currently collected on cataracts as part of a five-year programme funded by NHS England. I understand that at an earlier stage the programme funding panel considered expanding the focus, but decided that the focus should remain on cataracts in that time-limited audit.

I recognise the hon. Gentleman’s concerns and thank him for raising the matter. We are working incredibly hard, alongside NHS England, Public Health England and other partners, to ensure that eye care policy is focused both on preventing disease and, where disease develops, on ensuring that there are high-quality, sustainable eye care services for people across the country. I hope that the significant focus on effective treatment, prevention and AMD research that I have outlined means that he can reassure his constituents that we take AMD incredibly seriously. Maintaining good vision throughout life is of the utmost importance, especially as we grow older.

[Jim Shannon]

It might be helpful to give the Minister the report of the inquiry by the all-party parliamentary group on eye health and visual impairment. Perhaps she would agree to meet the officers of the all-party group, so that they can advance that case.

[Seema Kennedy]

I very much look forward to reading the report of the APPG that the hon. Gentleman chairs, and to sitting down with him in due course.

My Department remains committed to preventing sight loss and to ensuring that anyone and everyone living with AMD has access to the very best treatment and support.

Question put and agreed to.

Mental Health Support: Young People

Jim Shannon Excerpts

Tuesday 9th April 2019 Commons Chamber

[Ruth George]

I absolutely agree with my hon. Friend. There are so many areas of children’s mental health where support is needed, but with ASD a diagnosis is needed as well, which can delay the support they so desperately need.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way. I did seek her permission to do so beforehand. I congratulate her on bringing this issue to the House today for an Adjournment debate. It is a critical issue and we are all very aware of it. Does she agree that the world young people face today, in which they have little privacy and so much exposure, is just so difficult? There is no place to go to get out of the reach of bullies or social media. This pressure sees so many young people struggling with self-esteem and self-worth. There must be more early intervention support for these young people to provide affirmation and tools for parents to help at an early stage and not let self-harming or suicidal thoughts begin.

[Ruth George]

I absolutely agree with the hon. Gentleman. I will come on to some of the additional stresses that young people are facing at the moment.

--- Later in debate ---

[Ruth George]

Absolutely. I pay tribute to my hon. Friend for his work on the matter. I hope that the Government will take up the recommendations in the report that the all-party group on social media and young people’s mental health and wellbeing, which he chairs, has produced.

We are seeing not just online but physical bullying, and rising violent crime, especially among young people. I spoke to teenagers at a college yesterday who told me that they are actually scared of the gangs of 13 and 14-year-olds who roam the streets in my area. Of course, young people are more likely to be victims of violent crime than anyone else.

Even in quiet rural areas such as mine, county lines gangs put pressure on more and more teenagers to become involved in crime. When I visited my local youth centre and talked to teenagers there, they said that, for one night a week, it is the one place they can go to escape the gangs and their peers who put pressure on them to get involved in drugs, aged just 13 and 14.

[Jim Shannon]

Will the hon. Lady give way?

[Ruth George]

I really need to make progress—I am sorry.

At the same time, more parents are working longer hours and spending more time travelling to work. We have the longest commuting times in Europe. Those parents have less time to spend with their children. There are more demands for flexibility from employers, especially at weekends, in the evenings and in school holidays—the times that parents most need to spend with their children.

There are new demands from the state for parents to be in full-time work, whether to access free childcare places from age three or through the demands of universal credit from age 12. At the same time as parents are working harder and longer, there is an increase in child and family poverty. Increasing numbers of parents face money worries and debt and have to visit food banks—strains that their children all too often see.

Alongside all those pressures on families and our young people, the number of professionals who are there to support them is reducing. Class sizes in schools are increasing and there are fewer teaching assistants, so school staff have less time for each child and growing pressures to prove academic achievement. Our schools do a fantastic job and I pay tribute to the staff who go above and beyond to support the young people in their care, but they cannot help with the sustained, one-to-one counselling and professional support that is so often needed. On top of that, child and adolescent mental health services have huge waiting lists and are still underfunded.

Our clinical commissioning groups spend 14% of their budget on mental health, but just 0.9% on children’s mental health. Even when the Government put additional funding into CCGs, it was not ring-fenced and, too often, not spent. Although an extra £250 million a year was allocated to CAMHS, in the first year only 36% of CCGs increased their spending by as much as that allocation. In the following year, 2016-17, only half of them did so, and last year, 2017-18, the spending stayed roughly the same. In 2018-19, it increased by just £50 million. Only a small fraction of the £1.25 billion that the Government had invested in children’s mental health services and CAMHS actually reached the front line.

CCGs are under huge pressures. Derbyshire’s CCGs have had to cut their spending by £51 million this year, and, despite the promised extra £20 billion for the NHS, they face further spending cuts of £270 million over the next four years. Mental health services are on the target list. The number of psychiatrists working in CAMHS at all levels fell by 3.7% between 2011 and 2018, although the number of referrals has almost doubled, as has the number of children admitted to A&E with mental health problems. At the same time, councils are cutting their spending.

School nurses spend a great deal of time supporting families and young people on the CAMHS waiting list who are going through the agonising wait of 12 to 18 months while experiencing suicidal thoughts, but they too are being subjected to cuts because of cuts in public health spending. We are losing half our school nurses in Derbyshire. As for “early help” support for families, 200 staff are being made redundant, and there is nowhere for families to turn for support. At all levels, support services are being underfunded. The Government have made a commitment to providing more counsellors in schools, which is often the right place for them, as children may need access to support. However, the target of extra provision in just a quarter of schools in five years’ time is not good enough. Our children are being failed, and their families are being failed.

Investment in mental health support for young people would actually save the Government money—not just in the health service, which would be able to nip mental health problems in the bud, but in the education, social services and criminal justice sectors. Our young people are crying out for help. The Government have some laudable aims in the 10-year plan, but they have not enough concrete plans to implement those aims, to fund CCGs to deliver them, or to invest in the training of the staff who will be on the front line.

The huge number of people who have contacted Parliament, and me personally, about this debate shows how much concern exists out there about the terrible cases of young people who are driven past the point of despair and the families whose lives are turned upside down. This is a cry for help on behalf of all of them. I ask the Minister please to listen, and to tell us how the Government will act.

--- Later in debate ---

[Jackie Doyle-Price]

My hon. Friend makes a good point. Transition is clearly an area that we need to address, and she is right to highlight the importance of this in universities.

The hon. Member for High Peak made a number of points in her speech. She referred to people with ADHD and ASD, and I could not agree with her more that there is a real issue with the failure to diagnose people with those conditions early enough. We know that those people are more likely to suffer from mental ill health, so early diagnosis is absolutely crucial if we are to equip those young people with the tools to look after themselves. I am pleased that that has been a target in the forward plan that we will roll out. The hon. Lady also rightly highlighted the issues surrounding county lines and knife crime, and there is no doubt that the increased incidence of trauma in communities will bring with it more demand for mental health services. That is something that we are very much tackling as part of the Prime Minister’s summit, which took place just last week.

I have been very pleased to work with the hon. Member for Ogmore (Chris Elmore) on this, and I welcome his all-party parliamentary group’s report on the impact of social media. The impact of social media brings with it a whole new set of pressures on children’s and young people’s mental health. It brings greater intensity to relationships, for example. We think our children are safe in their bedrooms, but they are not necessarily, and we need to be vigilant about how we hold social media and internet providers accountable for the content that they host on their sites.

[Jim Shannon]

The Childline charity has reported a 30% increase in referrals in the past year. That is an indication of the pressure being put on our children. Has the Minister had an opportunity to speak to Childline?

[Jackie Doyle-Price]

I have not had that opportunity yet, but I am sure I will.

I could say an awful lot more, but I do not have much time remaining. It is clear from hon. Members’ contributions to the debate that we all recognise that this is perhaps one of the biggest challenges facing our young people right now. It is heartening to see that so many people are really seizing those challenges, whether by demanding better services or by asking for changes to Government policy to deal with some of the threats. That is all very welcome, and I have no doubt that all Members will continue to challenge me on this important issue.

Question put and agreed to.

Infant First Aid Training for Parents

Jim Shannon Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Sarah Newton]

The hon. Lady makes a very good point. I hope that in our small way—as a result of this debate, the people watching it from outside the Chamber and the media coverage we secure—we will encourage people to take up that opportunity. That is a really good idea.

I have been listening very much to healthcare professionals in my constituency. Dr Simon Robertson, a consultant paediatrician at the Royal Cornwall Hospitals NHS Trust, told me:

“I have been a consultant general paediatrician for the last 12 years. I see children referred into hospital from their GPs, and the emergency department.

From the view of a general paediatrician a child illness and resuscitation course for all parents makes practical sense for the families and NHS services.

Parents are expected to make important decisions about their children’s health and about seeking medical advice. But we know they find it difficult to work out if their child just has a minor viral illness, or something more serious. Unfortunately not all parents are educationally equipped to read instructions from their red book, NHS Choices or health advice apps like the ‘HandiApp’. For them, we know they really need time and practice in a supportive environment to learn these decision making skills. We repeatedly see this in the families we teach resuscitation to on the wards.

What is needed in my opinion, is a course for all parents and those in child care on how to manage the common emergency problems like choking, diarrhoea and vomiting, a seizure, recognising sepsis, managing a head injury, or in preventing accidents, drowning or cot death. These learnt skills could help keep children safe and healthy, so should be the skills highly valued by families. Vitally, early action may help prevent some medical emergencies deteriorating to life threatening illness.

This can only be good for the health of children, and for children’s acute NHS services.”

I completely agree.

In 2013, the Department for Education undertook a confidential inquiry into maternal and child health in England. It conducted a meticulous audit of deaths of babies and children, and reported identifiable failures in children’s direct care in just over a quarter of deaths, and potentially avoidable factors in a further 43% of deaths. The University of Northampton’s 2017 report “Before Arrival at Hospital: Factors affecting timing of admission to hospital for children with serious infectious illness” stated that parents often find it difficult to access relevant health information or to interpret symptoms, and that it can even be difficult for GPs to determine how serious a case is in the early stages.

I have been working with Cornwall Resus, which was established in 2012 by two paediatric nurses to give parents and carers the necessary skills to empower them to recognise when their baby or child is unwell and to respond appropriately. It runs courses for parents in community centres around Cornwall. Those courses last two to two and a half hours and include practical training on choking and resuscitation using lifelike dummies, with lots of time for questions and discussion at the end. I know that I would not be happy to undertake those actions unless I had practised them on a dummy first; having just looked at instructions or a diagram, I would still be very nervous about the amount of pressure to apply, so using dummies and having practical sessions and reassurance is really important.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this subject forward for consideration, and I commend her for the work she did as a Minister. I am very pleased to see her active on the Back Benches with the rest of us. I became a grandfather for the third time just before Christmas, when my grandson Austin—I already had two granddaughters—was born. I am very mindful that parents are immensely stressed after the birth of their baby, given the care babies require. For each parent to have just a bit of knowledge about these things at that time can be the difference between life and death. Does the hon. Lady agree that there is an opportunity, through the antenatal classes that mothers do with their local trust and GP, to instil in parents the basic skills she refers to?

[Sarah Newton]

I thank the hon. Gentleman for his contribution. I will come on to what I would like the Government to consider doing. I do not think we should be prescriptive about how this training is enabled. Lots of organisations provide such training—Kernow Resus is one such organisation, but we have also heard about the Red Cross, St John Ambulance and Millie’s Trust—and of course there is the NHS workforce themselves: maternity nurses, and healthcare professionals who visit families at home. We should not be at all prescriptive about how we might enable this training, but it is important that all parents have the opportunity to participate.

Most courses cost around £30, which will seem to most of us like a very modest investment, but not every parent will be able to afford that. That will be a real barrier for some families. That is why I would like the Government to enable universal access to high-quality, evidence-based training delivered by fully qualified providers. That would give us the opportunity to reduce morbidity and mortality and, importantly, family distress. It would also help tackle the associated costs of treatment, hospital admissions and even possible litigation. We have seen huge improvements in child and infant health in our country. The number of deaths of babies and small children has fallen significantly, but it is still far too high, so I really hope that the Minister will consider seriously how we might take forward this relatively modest, straightforward intervention.

The NHS is rightly focused on preventing ill health and injury, and I am delighted that the Government are investing so much in it. I am sure everybody in the Chamber is fully supportive of that investment. It would require only modest investment to pilot this training in a couple of geographical areas and work with a couple of local commissioning groups to see how they might go about delivering it. We have heard about a range of options they might pursue. By giving commissioning groups responsibility to see how they might go about that, we could collect proper evidence about not only the impact on families and the reduction of deaths and harm to children, but the impact on acute trusts and primary care in an area if, as a result of being more confident, parents do not engage with the NHS quite so much.

This would be a small but vital step. It would be such a positive contribution. We would have more Rowenas, and far fewer families would have to cope with the dreadful grief of losing a loved one.

--- Later in debate ---

[Douglas Ross]

I fully endorse what the hon. Lady said. If there is not time or there are other constraints that mean a first aid element cannot be included in an antenatal class, perhaps there should be a signpost saying, “This is something you can consider. Here are some of the organisations who could do this,” just to put it on people’s radar. They are very excited about the birth of their child and fascinated by the birth process, which they have gone along to learn about, so just mentioning that may be a trigger that would make some parents consider, “Actually it is important to go to that organisation, or another, to get that training.”

[Jim Shannon]

I congratulate the hon. Gentleman on the birth of his son, which I would have done anyway. Will he be a footballer or a referee—who knows?

There is another option: the health visitor calls to check on the child and the mother, and there is a follow-up after birth. There are many ways other than statutory ways of doing this.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this important debate. She has been a champion of raising awareness to reduce avoidable deaths through working with the UK Sepsis Trust—sepsis is also a major killer of adults and children—and I am delighted that she has now lent her voice to the cause of infant first aid training for parents. As a paediatric consultant, this is an issue close to my heart.

My hon. Friend highlighted the alarmingly high number of cases where something could have been done to prevent a child’s death: 21% according to the Royal College of Paediatrics and Child Health. I should declare my membership of that organisation. Working on a children’s ward for the last 15 years, sadly I have seen far too many of those 21%. However, I have also seen children whose lives were saved by passing members of the public, as was described earlier in the case of Rowena, by doctors or health professionals, or by visiting family members who just happened to spot something and were able to help.

My hon. Friend the Member for Truro and Falmouth powerfully described a case of a child choking. As we approach Easter and then summer, mini-eggs and grapes are particular culprits. Advice should include how to manage a choking child, as well as simple measures to prevent choking. Chopping up grapes into little pieces, sitting down while eating and not running about with things in the mouth are helpful in preventing choking, but it can still happen to anybody, young or old, at any time. We should all know some of the manoeuvres that can help, such as the one my hon. Friend described in the case of the baby choking. The baby should be held face down across the adult’s legs, so that the baby’s head is lower than the adult’s knee, and blows should be applied to the baby’s back, between the shoulder blades.

That sort of information does not take long to learn, but can have a huge impact and can be responsible for saving somebody’s life. The information is already provided to a number of parents. I have delivered infant first aid to parents whose children have been in hospital. Each of the neonatal units that I worked on in the midlands provided first aid training to parents before they left hospital, in part because pre-term babies are more vulnerable when they have just left hospital and in part to provide parents with the confidence to manage very small babies when they go home, as was described by my hon. Friend the Member for Moray (Douglas Ross). Training is also provided routinely to parents who have had a child die in the past, but obviously we want to look at prevention.

The hon. Member for Belfast South (Emma Little Pengelly) talked about contact with health visitors and midwives. Evidence shows that parents are particularly receptive to messages about healthcare and first aid when they have just had their baby or when they are expecting their baby, as my hon. Friend the Member for Moray mentioned. That is a time before life becomes really busy, when one can reflect on the joy that is to come and be well prepared for it.

There are lots of opportunities for first aid training to be provided. There are antenatal classes, where training can be signposted or provided, as well as nurseries. I strongly believe that the practical advice should not just include what to do when things have gone wrong, but how to stop them going wrong in the first place. My hon. Friend the Member for Moray mentioned burns. I remember the case of a child who walked past a lit candle; it caught her dress and she got severe burns to her whole front. In that case her mum knew what to do—drop her to the floor, roll her over and stop the burning—and treated the situation appropriately, but even so the injury was severe and could have been prevented if the candle had not been left on such a low table.

Using seatbelts and car seats are among other simple measures that we know we should to do. One major cause of preventable deaths in children is drowning, so there should be simple advice about making sure that children are not left unsupervised around open water. I have seen this particularly in situations where there has been open water and a group of people, often at a big family event, where everybody is looking after the child but there is not one specific person watching to see that they do not end up in the water. At one of my children’s christenings, I was upstairs in a bedroom on the other side of the house when I saw from the window that a friend’s little boy had gone towards the small pond we had in the garden and that he was on his own. I ran downstairs and was fortunate that he had not gone into the pond by the time I got there. My husband was out with a digger the following day getting rid of the pond. It was not worth the risk, but if people have such ponds they need to be carefully managed. I have certainly seen children drown in those situations.

[Jim Shannon]

One thing that can be neglected in homes is fluids in cupboards. Years ago, when we were younger, fluids were kept in lemonade bottles and similar containers, and children did not realise that. I well remember when my second boy was very young—he was the one who everything seemed to happen to—he managed to get a gulp or two of Brasso. He had the shiniest backside that any child ever had, but that is by the way. It can easily happen that a fluid can be drunk or absorbed by a youngster. We need to take steps in our own homes to ensure that all fluids are under lock and key, wherever they may be.

[Dr Johnson]

I take the hon. Gentleman’s point about fluids. I noticed when I bought some washing detergent last week that the lids now have a clasp that is especially difficult to open, so children cannot consume those little bubbles. No one is ever perfect; I know that if I looked for hazards to my three children in my own home they would be there. So far, thank God, I have been lucky and I hope that will continue, but we can all do things to reduce risk.

I am glad that the Government are committed to ensuring that all early learning staff have first aid training, but it is time that they did the same for parents. Since 2016, all newly qualified level 2 and 3 early years staff must hold a current paediatric first aid or emergency paediatric first aid certificate. The Millie’s Mark quality scheme, which was commended by my hon. Friend the Member for Cheadle (Mary Robinson), was also launched in 2016. It requires childcare providers to train 100% of their staff in paediatric first aid, not just to have one trained person on site at any one time. The 300th nursery gained Millie’s Mark last summer, which was a cause for celebration, and I am proud those nurseries include Dappledown House Nursery and Appletree Corner Daycare in my constituency. My son’s nursery has offered parents first aid training in the last couple of months, so the message is getting out there and that needs to continue.

The efforts to provide safety in schools should now be matched to provide safety in the home. The time and financial investment needed to provide that is small. It costs £30 for two and a half hours of invaluable training on some of the most common causes of avoidable death, including choking, and ways of providing resuscitation. Providing preventive medicine is one of the best investments we can make. As well as avoiding tragedy, it takes pressure off our NHS services, which are facing ever-increasing demand. It is the right thing to do for both our children and our country, and I am glad to lend my support to this cause today.

Pancreatic Cancer

Jim Shannon Excerpts

Tuesday 2nd April 2019 Westminster Hall

[Nic Dakin]

My hon. Friend is right: speed of treatment after diagnosis is an issue, and I will emphasise that in my speech.

Pancreatic cancer is the quickest-killing cancer: only one in four people survive a year and fewer than 7% of those affected in England will survive for five years or more. Those are appalling statistics, and they have not improved in this country in decades.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman, who has been a spokesman for pancreatic cancer treatment and many other things in this House. I always look to him personally for his lead in these things. In the background reading I did before the debate, I saw that the latest findings showed that overweight 50-year-olds have a 25% higher chance of having pancreatic cancer. I never knew that before. That not only shows the need for people to be aware of how their weight affects their long-term health, but is a red flag that the number of pancreatic cancer patients could rise. If being overweight can lead to pancreatic cancer, we must ensure that appropriate treatment is available for that rising number,.

[Nic Dakin]

The hon. Gentleman is exactly right; the more we learn about this disease, the more we can try to do things to prevent it and to support people so that they can get early diagnosis and treatment. The chances of survival for Kevin, the husband of my constituent Maggie Watts, were no better than those of his mother, who died of the same disease 40 years earlier. Yet other countries are doing much better; Belgium and the USA have double the survival rates of the UK. We need the Government to work with the fantastic pancreatic cancer charities—Pancreatic Cancer UK, Pancreatic Cancer Action, Pancreatic Cancer Scotland and the Pancreatic Cancer Research Fund—as well as other stakeholders to deliver a step change in outcomes for pancreatic cancer.

Mental Capacity (Amendment) Bill [Lords]

Jim Shannon Excerpts

Ping Pong: House of Commons
Tuesday 2nd April 2019 Commons Chamber

[Kevin Foster]

My hon. Friend makes a strong point. We should not just assume that once a DoLS is in place it will be there for life. For some people, it may apply during a particular period of treatment or time, and things will fluctuate for some people if they recover to a point at which a DoLS is no longer appropriate because they are able to make their own decisions. As he says, the appropriate records must be kept to ensure that that is properly reviewed and borne in mind, so that a decision cannot be made that someone should be subject to this forever. There should be a rolling review, to ensure that those in charge of caring for a person and those overseeing the care are satisfied that it is still the appropriate measure, given its impact on the person’s life.

I do not wish to prolong the debate, given that there is consensus across the House, which is welcome. The Bill will be better for having these substitute amendments, inspired by the Lords amendments, and on that basis, I hope the House will endorse them.

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to follow the hon. Member for Torbay (Kevin Foster), as I do on many occasions. I agree with what he said. First, I thank the Minister for her commitment, for our comprehensive discussions and for making herself available for each and every person who wished to have input into this process, and hopefully the changes that the Government want to see will be passed.

The Government have gone to some lengths to ensure that this Bill replaces and improves existing legislation surrounding the deprivation of liberty as a matter of pressing urgency. The current system is not fit for purpose—many people in this Chamber and outside it feel that—and this legislative change by the Government is what we want to see.

The Bill implements the Law Commission’s recommendations, introducing a new system for people who lack capacity and need to be confined for care and treatment, ensuring that the system protects vulnerable people, is person-centred and includes a strong role for carers and families. I have had a chat with the Minister about this, and the Bill will also ensure that supported people and their families are supported and included throughout the process. That is very positive.

The supported person will be afforded their rights throughout the process by an appropriate person. The appropriate person will normally be a family member. Carers and families will be given a stronger role, with an explicit duty to consult them and the supported person. As someone who cares, along with my mother and son and others, for my brother Keith, who was in a motorbike accident some 15 years ago, I know the importance of the carer’s role across the whole process.

[Mr Jim Cunningham (Coventry South) (Lab)]

The hon. Gentleman makes an important point. For far too long, families have been left out of the equation when they should have been involved. There is an argument for looking at carers’ training and their suitability, perhaps through certification, because there have been lots of cases of abuse in the past. It has gone on for years, and we have to pay particular attention to that. The Care Quality Commission should be improved; it does not have the numbers to do the job. I often follow its reports in Coventry, so I have a good idea of its needs. Does he agree that those areas could be looked at?

[Jim Shannon]

I certainly do. The Minister has responded to the concerns of the hon. Gentleman, myself and others in a spirit of generosity, and perhaps this legislative change does that.

I welcome moves taken to make the definition of deprivation of liberty as strong as possible. What the Government have done is clear. It is vital that the definition links back to the European convention on human rights and provides a sturdy basis to protect vulnerable people. That is good news.

Members have referred to the 125,000 people who are currently deprived of their liberty without the necessary protections in place. Through this legislative change—which will not be opposed; a very helpful attitude has been adopted in the House of Lords and on both sides of this House—can the Minister indicate what will be done to reduce the backlog?

The Government have been lobbied and have consulted the Local Government Association, charitable bodies and other interested people and groups. As a result, we have a vital opportunity for long-awaited reform, and the Bill needs to be passed.

Mr Deputy Speaker, I gave you my commitment that this would be a short contribution, and I intend to keep to that. I want to finish with two quick questions to the Minister. Can she explain how the role of an appropriate person will support and protect vulnerable people in the proposed new system? Secondly, will she confirm that the needs of the supported person and their families will be put first?

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Just to help, the Minister would need leave to respond to those questions, so the hon. Gentleman is putting pressure on for something that is not available at the moment.

[Jim Shannon]

I would never put pressure on the Minister—not in a million years; I know my place. I suggest gently to her that those two things could be looked at.

NHS Pension Scheme: Tapered Annual Allowance

Jim Shannon Excerpts

Tuesday 2nd April 2019 Westminster Hall

[Paul Masterton (East Renfrewshire) (Con)]

I beg to move,

That this House has considered the effect of the tapered annual allowance on NHS pension scheme members.

I have been aware of this issue for some time, as a local MP and as a former pensions law practitioner. Primarily through the work of the journalist Josephine Cumbo at the Financial Times, it has come to light that it is significantly more widespread and has much more serious implications for the NHS than I had originally understood.

I do not want to take up too much time on what the annual allowance taper is and how it works, partly because it is boring and incredibly complex, but a small amount of background is needed before explaining why it is an issue in the NHS and the consequences that seem to be flowing from it.

The tapered annual allowance was introduced from 6 April 2016. In short, it meant that from the 2016-17 tax year, a reduced annual allowance may apply to all pension savings by or on behalf of a member, depending on the level of taxable income within the tax year. It applies to individuals with a threshold income of more than £110,000 and an adjusted income of more than £150,000. For every £2 that an individual’s adjusted income goes over £150,000, their annual allowance for that year reduces by £1. The minimum reduced annual allowance someone can have is £10,000.

It will not be a surprise that the calculations of threshold and adjusted incomes are not simple in the least. They are massively confusing and make it very difficult to predict what tax bill will be incurred. As it cuts the annual allowance for the current year, an individual has no idea how much pension saving they can make.

[Jim Shannon (Strangford) (DUP)]

The Financial Times reported that some doctors, GPs and dentists will receive a potential tax bill of £80,000. Does the hon. Gentleman agree that we and this Government have a duty to ensure that NHS staff have all the information so that no one faces unexpected tax bills?

[Paul Masterton]

The hon. Gentleman is absolutely right. One of the key issues is that because it reduces the tax allowance in the current year of work, it is impossible to work out what the annual allowance will reduce to, and people cannot plan. I will go on to raise some examples from my own constituents, as I am sure other hon. Members will want to do.

Bereavement Counselling

Jim Shannon Excerpts

Tuesday 26th March 2019 Commons Chamber

[Matt Warman]

I thank my hon. Friend for that intervention, and that is why in some ways I am calling on the Government to have ongoing support for those who are recently bereaved and an open-ended offer of counselling on the NHS which can be accessed when they are ready, not at the easiest point for the NHS.

[Jim Shannon (Strangford) (DUP)]

I also commend the hon. Gentleman on securing this debate and telling his own personal story. Across the United Kingdom of Great Britain and Northern Ireland one in four people suffers from mental health issues, and many of them are a result of the grief from someone close to them leaving, especially when that is sudden. Early intervention is key, and I would like the Minister to respond on that. Does the hon. Member for Boston and Skegness (Matt Warman) agree that we should have early intervention through the use of Cruse and perhaps other groups—I am thinking of church groups and ministers who are on call if needed?

[Matt Warman]

I thank the hon. Gentleman for his intervention, and I agree with him and will mention that issue in a few moments.

There should be a dedicated mental health helpline provided through the NHS, which under the long-term plan will be accessed via 111. It is important that there is an understanding within that that bereavement for a long time is an exacerbating factor in loneliness, suicide and more; it is a red flag that should be recorded for a long time.

The importance of such ongoing support cannot be overstated. We have spoken in this House many times about the tragedy of the rise in male suicide; while things are improving there is still a huge stigma around men feeling unable to open up and show their emotions—although I am hopefully doing all right today.

This is why it is particularly important to normalise the support around bereavement, and we must not leave it solely to those affected to reach out to organisations such as the Samaritans or Cruse. That registrar who I spoke to 10 years ago should have been trained to offer a signpost—although I confess that if he was or if he did I was in no state to listen—and the NHS and our volunteering strategy should include better plans to encourage more people to train as volunteer bereavement friends and counsellors, as in the hugely valuable work we see with Dementia Friends, or, as Sue Ryder has called them, the bereavement “first aiders”.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 26th March 2019 Commons Chamber

[Matt Hancock]

I am happy to look at all approaches to how we can reduce the overuse of antibiotics to preserve them so that they work effectively where they are needed. Of course GPs have a role to play in that, and the number of antibiotics prescribed by GPs has fallen in recent years, but again there is much more work to do.

[Jim Shannon (Strangford) (DUP)]

Will the Minister outline whether his Department is willing to enter into an agreement with medical students to wipe out their student loans if they contract to carry out five years of GP service?

[Matt Hancock]

That is an interesting proposition and I would be happy to talk to the hon. Gentleman more about the idea. I was in Northern Ireland last week looking at medical services there and at what we can learn, and that might be another idea.

NICE Appraisals: Rare Diseases Treatments

Jim Shannon Excerpts

Thursday 21st March 2019 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to follow the hon. Member for South Shields (Mrs Lewell-Buck), with her passion for the subject matter and on behalf of her constituents, so well done to her. I thank the Backbench Business Committee for enabling this debate to take place. I was very pleased to go along to it with the hon. Members for Blaydon (Liz Twist) and for North Tyneside (Mary Glindon)—two formidable, diligent ladies who have put down their marker on this subject matter. I was very pleased to be the third in the trio involved, and well done to them for giving us the opportunity, on behalf of our constituents, to express our concerns today.

I am sure that, like me, most Members in the Chamber have been inundated with emails from people begging to be helped, and begging for the drug that they need to be made available. Every one of them has said that, and I do not believe that anyone can ignore it. It is not only in the emails, but in the interaction we have with our constituents when we hear their stories face to face.

I want to start with a good story and to say what happened—not, I have to say, through this Minister, but through the Home Office. I fought very hard to see medicinal cannabis legalised for my beautiful young constituent Sophia Gibson, and what a difference that has made in her life, as it has to the lives of others. Her parents had no option other than to uproot their family and move to Holland to get the treatment that Sophia needed. At the same time, they were respectfully knocking on doors and following the system through to a Home Office Minister, the Minister for Policing and the Fire Service, and getting clinical assistance in order to bring about a change. Eight months later, their daughter has been at school more than ever before in her whole lifetime. She has had substantially fewer admissions to hospital, and has attended school parties that were impossible—they were too much for her—without this medication. She is a very different young girl today because her parents, Darren and Danielle, fought the battle in the right way and in the right place. Today, we have all presented our cases for the right battle, in the right place, at the right time and with the right request.

Since that time, I have had many other parents coming to me and asking me to help secure the drug that their child needs. A mother in my constituency has an absolutely gorgeous two-year-old son—Lorcán they call him—whom Orkambi would help. Orkambi is a second precision medicine, which targets the root cause of the disease, and it would benefit about half the people with cystic fibrosis in the United Kingdom of Great Britain and Northern Ireland. Cystic fibrosis is a terrible illness that affects the lungs and digestive system of people with the condition, who have a median life expectancy of just 31 years old.

I say this very respectfully, and I hope it will be taken into account: Vertex Pharmaceuticals, NICE and NHS England must end the protracted negotiations for the drugs Orkambi and Symkevi. We must break the stalemate between the three parties and provide access to these drugs, which could so vastly improve the quality of life of my constituents and those of everybody here, as they deserve. They want and need that drug desperately.

I have often spoken about the need to allow people to access Orkambi on prescription, and I have often been beyond frustrated with the lack of movement between the drug company and NICE. There must be—indeed, there has to be—something that can be done to find a way forward, and I believe that it must be done in this House. Today, we look to our Minister and our Government to give us answers and, respectfully, the answers that we need. We must instruct the Department to negotiate a way forward to ensure that my young constituent and so many others like him can live a better life.

I was contacted by the Muscular Dystrophy Association regarding spinal muscular atrophy—other hon. Members have spoken about that condition on behalf of their constituents, and I will do the same. SMA is a rare inherited neuromuscular condition that affects lower motor neurons in the spinal cord. It leads to the gradual loss of someone’s ability to walk, crawl, move, breathe and swallow, and it requires complex medical support. About 100 children are born with the condition each year, and around 2,000 children and adults in the United Kingdom are living with SMA. Spinraza is the first and only treatment for patients with spinal muscular atrophy. It is meant to increase the body’s ability to produce a protein called survival motor neuron, which is essential for motor neuron health. The treatment is administered through an injection into the spinal canal. It is never an easy treatment, but if it provides an opportunity for better health, people should take it.

For children with SMA type 1, life expectancy is rarely longer than two years. Some children who have received Spinraza have seen their muscle strength improve, and have lived long enough to crawl and even walk. For those children, Spinraza has been a lifeline—perhaps I should say that Spinraza has been life itself, as that is the level we are talking about. Spinraza proved so effective in clinical trials for children with SMA type 1 —the most severe form of the condition—that the trial was stopped early so that all children affected by it could potentially access that treatment.

The Spinraza appraisal took almost 14 months, and currently 25 European countries—including Scotland in the United Kingdom of Great Britain and Northern Ireland—have already made it available, nearly two years after the European Medicines Agency granted it a licence. Although Translarna was eventually approved by NICE in July 2016, that was more than two years after the European Medicines Agency gave it a licence. Such lengthy delays to a process that could and should be significantly shorter have resulted in frustration and anxiety for many families who see a life-changing treatment within touching distance. They can almost reach out for it, but they can never get it, and that is where frustration creeps in. That group of people see a better life but are prevented from accessing it. There must be a better way of dealing with these issues, and we must find it or instruct the Department to find it.

My heart aches as a father and grandfather who would do anything for his children and grandchildren, and other right hon. and hon. Members would do the same for theirs. The block on life-changing drugs affects not only the child but the entire family. If a child or adult has a physical disability, their family also feel that and live with it every day. Many families in the UK do not have access to life-changing medication, and I wholeheartedly and sincerely urge the Minister and his Department to enter into talks, find a way forward, and do better so that people can live better. The Government have set aside £40 billion for extra health support. I welcome that, as do all hon. Members, and I gently suggest that some of that money should be set aside for life-saving drugs.