NHS: Staffing Levels

Jim Shannon Excerpts

Tuesday 11th December 2018 Westminster Hall

[Tracy Brabin]

I absolutely agree that training for this most lauded position should not be done at the cost of nurses themselves.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Lady agree that we must have fewer medical quangos and more medical professionals in their white doctors’ coats seeing patients; less cleaning up of paper trails and more cleaning up in wards and A&Es; and funding that is targeted at frontline staffing and reasonable rates of pay?

[Tracy Brabin]

Certainly, funding and support should be given to frontline staffing. I will go on to talk about how I see that playing out.

The Mid Yorkshire trust is a major employer of about 8,000 members of staff who operate across three hospital sites: Pinderfields Hospital, Pontefract Hospital and Dewsbury and District Hospital, which is in my constituency. Like many trusts across the country, the trust is feeling the pressure on recruitment. In the most up-to-date figures, which were given to me directly by the trust this week, there is a 10% vacancy rate. That includes 95 full-time-equivalent posts for medical staff, 209 vacancies for full-time registered nurses, and vacancies for all other posts covered by the trust. The trust tells me that its key workforce challenge remains recruiting registered nurses and junior doctors in training. Those staff shortages lead to expensive cover being required— a bill that is ultimately paid by the taxpayer.

I am pleased that the trust has taken steps to mitigate against staffing shortages, including an extensive recruitment programme where vacancies across the trust are advertised and marketed widely. It has introduced a new associate nurse role in partnership with a local university, and expanded and increased the number of apprenticeship opportunities to offer different routes into careers in the NHS. It has held open theatre days to promote particularly difficult roles to recruit for, such as operating department practitioners. Finally, it has increased the number of nurses and doctors on the local temporary staff bank, which reduces its reliance on, and the cost of, commercial agency staff. I am sure that all hon. Members agree that that is all great.

Despite that work, problems remain. I must put on record my concern that staffing shortages can lead to problems for patients. The ambulatory emergency care unit at Dewsbury and District Hospital opened in 2015 to care for patients who needed a quick diagnosis and treatment, and who could be treated without the need for admission to a hospital bed. Since July, it has been closed because of staff shortages and it will remain closed for the foreseeable future. It had also been closed from the end of December last year to early March. Patients now face the lengthy and expensive trip to Pinderfields Hospital.

In the most recent inspection at Mid Yorks, the results of which were announced last week, the safety of services was deemed to require improvement, which will cause deep concern to my constituents. We are now told that the harsh funding climate for our NHS, which has existed since 2010, is coming to an end—austerity is over.

HIV and World AIDS Day

Jim Shannon Excerpts

Thursday 29th November 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

First, may I thank the hon. Gentleman for bringing his personal story to the House today? I mean that very much. I also wish him continued good health and that he continues to prosper, as he quite clearly is doing.

I mentioned to him before the debate that I wanted to intervene, and I wish to bring to his attention the Elim church in my constituency. The church has an HIV programme in Swaziland, which has the highest levels of HIV in the world. Every year, the children from a choir group come over. Every one of them is HIV-positive, but every one of them is surviving today because of the medication that is available. If the medication is there, we can do lots of things, save lives and give opportunity. Among many churches and individuals around the world, there is a lot of good will to help.

[Lloyd Russell-Moyle]

That is quite right.

We are making progress on treatment, but when it comes to stigma we still have so much further to go. Last week, I was in Kenya with the International Development Committee and met a HIV-positive mother of eight children from the Democratic Republic of the Congo. Although she was on medication, she had suffered such abuse that she was forced to flee the DRC and now lives in a refugee camp. Because of the prejudice and violence that she faced as a result of her status, she was forced to leave without her children, and she knows not of their future.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 27th November 2018 Commons Chamber

[Steve Brine]

The hon. Lady—my shadow Minister—knows that I have a great deal of respect for her. She mentioned smoking; smoking rates in England are at their lowest ever levels. We hear spending commitment after spending commitment from the Labour Government; it is like the arsonist turning up at the scene of a fire. I will take very seriously, as I am sure will the Treasury, her bid towards the spending review discussions, but yes, prevention is better than cure and it will be at the heart of the long-term plan.

[Jim Shannon (Strangford) (DUP)]

4. What steps he is taking to support people to lead healthier lives.

[Robert Neill (Bromley and Chislehurst) (Con)]

17. What steps he is taking to ensure that people take greater personal responsibility for leading healthier lives.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Prevention is indeed better than cure. As well as having a right to expect NHS services to be free at the point of use, we all have responsibility for our own health, and to use the NHS responsibly.

[Jim Shannon]

I recently met Breast Cancer Now—the Secretary of State will be aware of it. It has 10 priorities for the NHS long-term plan. Has he made an assessment of the impact of the real-terms 5% cut in public health budgets on reducing the incidence of cancer?

[Matt Hancock]

There are many things we need to do to diagnose cancer early, and of course public health is part of that, but there is a much bigger agenda, and that includes more screening. We have seen an increase in the number of people invited to screening, but we need to get the screening right, so I have instituted a review of all our screening processes for cancer and other diseases.

Health Services: Witham

Jim Shannon Excerpts

Tuesday 13th November 2018 Commons Chamber

[Priti Patel (Witham) (Con)]

I am grateful for the opportunity to speak about this subject. This is one of many interventions I have made on the health issues that affect my constituency since being elected in 2010. I am sure the Minister will respond appropriately.

Like many other parts of the country, the Witham constituency and mid-Essex are experiencing significant demographic changes, with the proportions of people aged over 60 and over 80 increasing faster than the national average. Those demographic changes, and the population growth that is occurring, place huge new pressures and demands on our services, including our local health economy and the complex network of hospitals, health trusts, councils and providers that support it. One of the most effective ways we can improve our health economy and services is by investing in better primary and community care.

Since being elected, I have campaigned repeatedly for a new multi-purpose health centre in Witham town to address the growing demand in the town and our villages, and to provide more local services to increase the town’s health capacity. Whenever I hold debates on health services in Witham, I highlight the patient to GP ratio. While the national average number of patients per full-time equivalent GP is around 1,700, there are nearly 1,800 in mid-Essex and 1,900 in north-east Essex. However, the overall figure for the four GP surgeries in Witham town is a staggering 2,500, nearly 50% higher than the national average. That number has grown as patient numbers have increased and GP numbers have fallen, and it will worsen as some GPs approach retirement. As a consequence, residents in Witham struggle to get appointments. In fact, in my time as Member of Parliament, some GPs have closed their books and stopped taking on new patients.

Bringing the four GP surgeries in Witham under one roof would add much-needed capacity, integrate health services, grow and strengthen our local health economy, improve access to local services and reduce demand on hospitals. The case is compelling, and the campaign for such a centre is universally supported. Witham Town Council backs it, local politicians from all parties back it, local businesses back it, my residents absolutely back it, and Braintree District Council has backed it from day one. To its credit, the district council has put money aside from a capital receipt to support the development of the new centre. It understands the long-term benefits.

Until recently, it seemed all the plans for the health centre were on track, with GP surgeries in Witham and the clinical commissioning group supportive of it. In fact, the CCG took on a consultant to develop a business case for the centre over the past few years. Shockingly, despite all the lobbying, advocacy and business cases, it appears that either some GP surgeries are rowing back on this opportunity for Witham to join forces to deliver an outstanding health centre for my constituents, or the CCG has not been able to advance the plans.

Only last month, on 15 October, the CCG informed me that it was pleased to say that it had had a “positive response” from three of the GP surgeries. However, just last week, on 2 November, I was notified that during the latest round of discussions their reactions suddenly had been mixed. Douglas Grove surgery is still strongly supportive, but there is less enthusiasm and support from the other practices.

I will touch on many aspects of health, but the purpose of the debate really is to ask the Minister and his Department to go back to the CCG and, where they can, to GPs to ensure that we deliver a new centre for the residents of Witham town and the surrounding area. They want answers, and they deserve action and delivery.

[Jim Shannon (Strangford) (DUP)]

I have always been here to support the right hon. Lady over the years, and I am pleased to be able to do so again tonight. She mentioned action, and I want to refer to that very quickly. Given the pressure that nurses and healthcare professionals are under in every trust area—including my own, by the way—does she agree that the Government must consider a complete overhaul of the way in which things are done in the NHS? We want to see action rather than words. We do not want to see reviews or reports. We want to see action. Is that not what it is all about?

[Priti Patel]

The hon. Gentleman is absolutely right. Ultimately, we should be seeking to drive health outcomes. As I have said in the House again and again over the last eight years, we can achieve that through integration of our health services at a community level. Driving outcomes is the very purpose of the facility in Witham town. We should think about the integration of mental health services, ambulance services and all sorts of prescribing, including social prescribing, and about the future of social care and healthcare.

However, this is not just about Witham town. I represent many neighbouring villages. Tiptree, which is well known for its jams—I am sure that you have sampled some of them, Mr Deputy Speaker—has a large and growing population, but it also has just 3.28 full-time equivalent GPs to serve a population of more than 11,000. That is a patient-GP ratio of 3,400 to one, which is more than twice the national average, and it needs to be addressed. Branch surgeries have been lost in Birch and Tolleshunt D’Arcy in recent years, and there is a growing population in Stanway and Hatfield Peverel. All that places more strain on GPs, so the integration of services is vital. We are hoping to increase the GP base through a new partnership at Anglia Ruskin University, at whose new medical school the first wave of GPs will be trained.

One of those neighbouring villages, Silver End, is expanding provision but has a terrible history. I know that the Minister will be aware of Virgin Care Services, which has run the Silver End general practice since 2016. This year’s rating from the Care Quality Commission was “inadequate”. Members speak about money and funds. Interestingly enough, Virgin is paid £134.37 per patient, 60% more than the standard payment of £83.64 that other GPs receive. That is a staggering sum: it seems that Virgin is almost being rewarded for failure. Just two months ago it failed to refrigerate its flu vaccines, which meant that a batch had to be disposed of. That wasted taxpayers’ money, and also caused local problems with flu vaccinations at a critical time.

I want to touch on some wider issues affecting social care in the Essex County Council area. To its credit, the council has worked diligently to address social and winter pressures. I welcome the additional £5.9 million for the council from the £240 million that was announced last month, and, of course, the Budget funding as well, but, as the county council has said, we want to see a meaningful Green Paper when it comes to social care funding. A new Witham multi-purpose healthcare facility will make a positive difference, enabling us to integrate funds and care and drive better outcomes and performance.

That brings me to another company that is in the news. A CQC judgment on Allied Healthcare highlighted a considerable risk of service disruption to the delivery of domiciliary care services, which has caused much concern. Essex County Council is one of Allied Healthcare’s biggest clients, and has been working with the CQC and the company, but we want to be certain that the Department itself is aware of the situation and able to help to resolve it. We need clarity about some of the services that could be at risk.

There is also much more work to do in relation to social prescribing. Last week I held an advice and information fair in Witham, which focused largely on the older demographic in the constituency, but was also concerned with healthcare provision through charities and other voluntary organisations. Another issue that I think we should consider—and a new healthcare centre at Witham would help with this as well—is how patient commissioning and NHS referral systems can be improved.

My final point is about the delivery of mental health services. The Essex Partnership University NHS Foundation Trust has been in the news today because of a police investigation into the deaths of 25 patients who were under its care. The Department knows of a case involving one of my constituents, a mother who has been fighting for justice and accountability for years. Today we have learned that the police inquiry has concluded. What they have found might not have led to a charge of manslaughter, but there are serious problems that still need to be addressed.

There are so many health issues that obviously need to be addressed, but the purpose of this debate is to drive the change and produce the outcomes we want to see in Witham town in terms of the delivery of the new health centre. I trust that the Minister will be able to help us: that he will be able to help my constituents overcome the challenges we are now facing with the CCG and GPs in Witham town to deliver this new health service.

Healthcare in Essex

Jim Shannon Excerpts

Monday 5th November 2018 Commons Chamber

[Robert Halfon (Harlow) (Con)]

It is a pleasure to see you in the Chair, Madam Deputy Speaker. Thank you for your continued support, as my constituency neighbour, in our campaign for a new healthcare campus in Harlow. You could not have done more to support me, and I am very glad to see you here this evening.

Today, I would like to update the House on the desperate need for a new hospital in Harlow that is fit for the demands of the 21st century. This is now my third debate on the need for a long-term solution to the healthcare crisis in west Essex, and I cannot stress enough the urgency of the situation. The present site, the Princess Alexandra Hospital, serves over 350,000 people and is no longer able to cope under the pressure of an influx of patients. The new healthcare campus, as proposed by the Princess Alexandra Hospital NHS Trust, would encompass accident and emergency services, general practitioner provision, social care, physiotherapy and a new ambulance hub in state-of-the-art, purpose-built facilities.

I thank those Members, some of whom are in the Chamber this evening, who have been so instrumental in the progress of this campaign. In May, they joined me in signing a letter to the former Health Secretary to urge the Government to support the capital funding bid in place for a new hospital. They included my hon. Friends the Members for Broxbourne (Mr Walker) and for Hertford and Stortford (Mr Prisk), my right hon. Friend the Member for Epping Forest (Dame Eleanor Laing), my hon. Friends the Members for Braintree (James Cleverly) and for Saffron Walden (Mrs Badenoch), my right hon. Friend the Member for Witham (Priti Patel), my hon. Friend the Member for Brentwood and Ongar (Alex Burghart) and my hon. Friend the Member for Chelmsford (Vicky Ford), who is present and a big supporter of our new hospital proposal for Harlow.

From this, I have gone on to secure a visit to the Princess Alexandra Hospital from the new Health Secretary, who has heard the case loud and clear, and I look forward to welcoming him to Harlow to discuss the future of our healthcare provision in Essex.

As my hon. Friend the Member for Telford (Lucy Allan)—Telford is also a new town—so accurately put it in my first debate on the subject in October 2017, hospitals

“are the centre of our communities and cement our identity”.—[Official Report, 18 October 2017; Vol. 629, c. 347WH.]

The unwavering support that I have received for a new health campus, both in Parliament and locally, is a testament to its importance, not just to Harlow, but to the wider population of Essex and Hertfordshire.

In March, we received the wonderful news from the Care Quality Commission that the Princess Alexandra Hospital NHS Trust had been brought out of special measures—news on which the former Health Secretary, echoing the sentiments of the Prime Minister, congratulated the hospital in a special video message on Twitter. The chief inspector at the CQC noted that the driving force behind the 18-month turnaround was “the dedicated staff” and “outstanding leadership” team, headed by chief executive Lance McCarthy. I do not believe that enough credit can be given to the staff at the hospital.

I recently visited the Williams day unit, a specialist cancer treatment centre at Princess Alexandra Hospital, for a Macmillan coffee morning. I was struck by the staff’s compassion for their patients and their determination to ensure that, at possibly the most difficult time in a person’s life, the hospital is a happy, welcoming place to come to, to get better and to leave feeling more positive than when they came in.

From my numerous visits to the hospital, in my capacity as an MP and as a patient and visitor, I defy anyone to find better staff than at Princess Alexandra Hospital. In spite of a working environment that is literally falling down around them, thanks to the efforts of every single staff member, from the porters, cleaners and kitchen staff to the nurses, midwives and consultants, 64% of the services are on their way to a “good” or “outstanding” rating.

Special credit must be paid to the maternity unit, which the CQC deemed “outstanding” overall. The team delivers more than 4,200 babies a year, yet their rate of stillbirths is 10% lower than the national average. For those reasons, the maternity department was recently selected to feature in an ongoing documentary with TV personality and presenter of “The Voice”, Emma Willis. I encourage hon. Members to watch that programme on Monday evenings to see for themselves just how dedicated and caring the staff are.

[Jim Shannon (Strangford) (DUP)]

Will the right hon. Gentleman give way?

[Robert Halfon]

I will always give way to the hon. Gentleman.

[Jim Shannon]

I have always supported the right hon. Gentleman’s contributions in the Chamber since we both came to the House together in 2010. He has clearly outlined the case for healthcare in his constituency. The Government have set aside an ambitious £28.5 billion for healthcare. Does he hope to have some of that money for his constituency? Does he also feel that there needs to be a reduction in red tape so that professionals can use their medical expertise to their full ability? This is about the money, but it is also about reducing the red tape.

[Robert Halfon]

I hope that my hon. Friend the Health Minister knows that a new hospital in Harlow is supported not just in Essex and Hertfordshire, but in Northern Ireland. This is the second debate on the subject that the hon. Member for Strangford (Jim Shannon) has attended, and of course I agree with him.

The maternity department serves as the perfect example of how investment can transform patient care under the successful staffing that is already in place, as the labour ward benefits from nine refurbished delivery rooms and a second maternity theatre. However, it also sheds light on the fact that refurbishment is not a fix-all solution. Therefore, does the Minister agree that, were the Princess Alexandra Hospital NHS Trust to receive the capital funding that it so desperately needs to build a state-of-the-art health campus, that would allow every department to flourish, as the maternity ward has already done?

As I have touched upon before, the dilapidation of the estate is hindering any further progress. A 2013 survey rated 56% of the hospital’s estate as unacceptable or below for its quality and physical condition. That was five years ago now and the situation is only deteriorating. With long-term under-investment, we are continuing to put the capability of the hospital to care for those in need at serious risk—just read the reports of raw sewage and rainwater flowing into the operating theatres. Given that time is of the essence, does the Minister recognise the importance of the release of capital funding to the Princess Alexandra Hospital NHS Trust this autumn?

Ovarian Cancer: Diagnosis and Treatment

Jim Shannon Excerpts

Tuesday 30th October 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for North East Derbyshire (Lee Rowley) on securing this debate. He is right that ovarian cancer does not affect us men, but it affects people we know, and that is why we are here. I thank him for his introduction and for the extensive work he has done on the issue in his role as vice chair of the all-party parliamentary group on ovarian cancer. I was particularly impressed by the group’s report, “Diagnosing ovarian cancer sooner: what more can be done?”. If hon. Members have not had a chance to read it, I suggest that they do so, because it is very helpful. It was published earlier this year and contains a number of key recommendations and findings, which I will pick up on today.

Every single year, more than 7,000 women across the United Kingdom receive the devastating news that they have ovarian cancer. The hon. Gentleman, in his examples at the end of his speech, referred to those who have survived and those who have not; it is important to realise that sometimes people do survive it. Unfortunately, in my time as an elected representative, most of the people I have known who have had it have caught it at a late stage and have not lived as long as perhaps they could have. UK survival rates are among the lowest in Europe and less than half of all women diagnosed with ovarian cancer survive five years or longer.

The fact that we are at the lower end of that league table is an indication that perhaps we need to do more. I look to the Minister, as we always do, for a positive response. We also know that the earlier a person is diagnosed, the better chance they have of beating the disease. More than a quarter of women with ovarian cancer are diagnosed through an emergency presentation, for example via accident and emergency. The hon. Gentleman referred to those who thought they had irritable bowel syndrome, had a bad stomach or were bloated, or whatever it might be, and suddenly found it was something much greater. Over 80% of women diagnosed following a GP referral will survive for a year or more. I think if an early diagnosis can be made, the figures speak for themselves. We must do more to raise awareness about the disease, something I will come on to later.

Before I continue, I would like to share a bit of welcome news for ovarian cancer patients in Northern Ireland. As colleagues may be aware, drugs approved by the National Institute for Health and Care Excellence for use through the cancer drugs fund in England are now being considered in line with the country’s existing endorsement of NICE recommendations and will be equally accessible in Northern Ireland. That has just been announced recently. In cases where a drug is yet to be fully approved by NICE, it can be made available for use under the CDF. I will mention one lady who is no longer with us, Una Crudden, who I got to know when she met us here, as someone who had had ovarian cancer. I think it was six years after her diagnosis. She was a remarkable lady and her story was a very real one: I remember it probably every day of my life.

CDF-approved drugs were previously unavailable in Northern Ireland, meaning that patients had to wait for their full approval by NICE, which can take up to two years. This change in Northern Ireland will help more people to survive, and for longer.

[David Simpson (Upper Bann) (DUP)]

Whenever ladies go through this treatment, their aftercare and companionship with other people is important. Will my hon. Friend join me in congratulating a lady in my constituency, Mrs Maureen Clarke, who set up the Angels of Hope charity some years ago? It has been a tremendous help, psychologically and in every other way, for people who suffer from ovarian cancer.

--- Later in debate ---

[Jim Shannon]

I wholeheartedly support the tremendous work of the great many people in charities and elsewhere. Una Crudden was one of those who inspired everyone around her. We think of her often.

Without CDF approval, cancer patients in Northern Ireland have been unable to access life-extending drugs that have been approved for use in England, Wales and Scotland, such as niraparib. It is a PARP inhibitor, meaning that it blocks the action of the enzymes PARP1 and PARP2, which help to repair any damaged DNA in cancer cells while they divide to make new cells. Niraparib blocks PARP enzymes, which is incredibly important, and it is good news that we will have direct access to it in Northern Ireland. When researchers trialled niraparib on women with ovarian cancer, they discovered that the women lived for longer without the disease worsening and could go significantly increased times between treatments, meaning that they had more time between chemotherapy sessions.

Almost 200 women in Northern Ireland are diagnosed with ovarian cancer every year, and more than 50% lose their battle with it. It is particularly frustrating and upsetting for patients, and their families, who did not have access to the same potentially life-changing drugs as their English, Scottish and Welsh counterparts. However, that has changed in the last month; patients in Northern Ireland are finally set to have the same access to drugs as those in the rest of the United Kingdom. According to reports, the implementation of this policy will take place at some point in this financial year. We look forward to that. I am sure that colleagues will join me and my hon. Friend the Member for Upper Bann (David Simpson) in welcoming this fantastic news.

Access to drugs is one thing, but it is reactionary, rather than preventive. Evidence, including in the APPG’s report, suggest that much more needs to be done to raise awareness about ovarian cancer, which could affect the number of people diagnosed with the disease. Early diagnoses give longer life and prevent death. Although not limited to these, the four main symptoms are abdominal pain, bloating, feeling full quickly and needing to pass water. Most concerning is that only 20% of women could correctly identify those as being symptomatic of ovarian cancer, which goes back to a point made by the hon. Member for North East Derbyshire.

Ovarian cancer has low survival rates and, sometimes, delays in diagnosis, so we need a reinvigorated effort to ensure that the general public know what to look out for and when to see a doctor. The Be Clear on Cancer campaign was introduced in 2011, and I take this opportunity to put on the record my thanks to Public Health England for launching it. It is an excellent campaign that has undoubtedly played a vital role in improving cancer awareness more generally among the general population, which is part of the strategy’s focus.

National campaigns have been successfully run for bowel, lung, breast, bladder and kidney cancers, but only regional and local pilot campaigns have been launched for ovarian cancer. Does the Minister intend to launch a pilot campaign for ovarian cancer? A regional campaign launched in 2014 included the use of television, radio, online and face-to-face events and led to a significant improvement in women’s awareness of the symptoms of ovarian cancer and a greater inclination to visit their GP to discuss any concerns that they might have.

Raising awareness—especially about potential symptoms —is obviously important and can only be a good thing, so I will be grateful if the Minister indicates what discussions he has had with Public Health England about the possibility of running a national campaign for ovarian cancer that covers the four nations. We could work together to raise awareness at every level. I always think it is better to do things together. As you know, Mr Bone, we are better together in everything that we do, and I would like that to continue to be the case, especially for this.

Another way to improve awareness about ovarian cancer would be the introduction of a national screening programme. Screening programmes exist for breast and cervical cancer, but there is no equivalent for ovarian cancer. I understand that the UK collaborative trial of ovarian cancer screening looked at the possibility of an ovarian cancer screening programme, with a blood test to identify changes in the levels of the CA 125 protein, which is a tell-tale sign. If levels had risen, the patient would be sent for an ultrasound, so a system would be in place to offer early diagnosis, and it would be preventive as well. It is estimated that, if a national screening programme were rolled out, 12.5 million women over the age of 50 would be eligible to attend, with around 2% required to have a further ultrasound. Such a programme could take preventive help to the next stage.

I understand that, when women are contacted about making an appointment for a cervical or breast cancer screening, they are provided with informative leaflets that detail possible symptoms. Of course, although the screenings are vital, it is entirely up to the patient if they follow up and make an appointment. However, just having access to the leaflets is helpful in raising awareness. Does the Minister intend to produce a leaflet to raise awareness of ovarian cancer? Recognition of the symptoms of ovarian cancer remains low, so it would be helpful if women were provided with a similar leaflet that might help to improve awareness of this specific disease.

I understand that the cost of national screening programmes is high, but that needs to be measured against the long-term benefits. If people can be screened and ovarian cancer caught early, people have a greater chance of survival, and their long-term reliance on the NHS could well be reduced. That is ultimately cost-effective, because it reduces the amount of care that they later need.

I understand that one concern with rolling out a screening programme of that nature is the lack of sonographers, who are of course required to provide ultrasounds. Are the staff with those skills in place? I am interested to hear what consideration has been given to the use of artificial intelligence to fill the gap of highly skilled diagnosticians. Would it be possible to provide some sort of incentive for those considering postgraduate UK ultrasound qualifications? We often say this, and I know that the Minister is responsive to it, but if we set out the graduate positions that will be available in the future and encourage graduates to study towards those jobs, that will be helpful.

Prevention is vital. Approximately 15% of women with ovarian cancer develop it as a result of a mutation in the BRCA1 or BRCA2 gene. Identifying women with ovarian cancer with a BRCA mutation not only helps in designing their treatment plans; it enables family members to be tested. We sometimes look at the individual, which is important, but we should also look at the family circle—sisters and daughters and so on—and test them as well, which would allow them to make decisions about reducing their risk of developing ovarian cancer.

“Achieving world-class cancer outcomes: a strategy for England 2015-2020” calls for all women with ovarian cancer to be offered access to genetic testing at the point of diagnosis. That follows 2013 NICE guidelines that require all women with a 10% or higher risk of carrying a BRCA mutation to be offered genetic testing. However, in reality, testing varies between regions and between hospitals, because the guidelines are often interpreted differently. This clearly needs to be addressed, as the same testing should be available for all, without variation depending on postcode or because of the funding—or lack thereof—available in different genetic testing centres across the country. Obviously if eligible family members were tested to identify potential mutations, they might be able to take steps, including surgery, to ensure that ovarian cancer cannot occur.

Concerns have been raised about what genetic testing could mean for individuals with private health or life insurance. Members may not have thought of this, and the hon. Member for North East Derbyshire did not mention it, but he and others will be aware of it. For example, does a person with private health or life insurance need to declare if a genetic test has been carried out, and its results? I am interested to hear from the Minister what work the Department is doing alongside the insurance industry to address any disparity for cancer patients and their families who undergo genetic testing, which may have an impact on their private health or life insurance.

We can all agree that, while improvements have been made in the last couple of decades, survival rates for ovarian cancer continue to lag behind other cancers. We need to do more to raise awareness of ovarian cancer, to ensure that women know what to look out for and when to see their doctor—particularly those in higher risk categories, either because of family history or because of their age.

I am very pleased about the recent news for cancer patients in Northern Ireland: as is the case with genetic testing, it is unfair for patients to access different treatments, tests or drugs simply because of their postcode. I hope that the Minister will work with Public Health England and NICE to consider national campaigns, which take in all the regions, and screening programmes for ovarian cancer, as well as to ensure that guidelines are implemented and funding made available for testing.

I again thank the hon. Member for North East Derbyshire for the opportunity to speak on this subject. It is close to my heart; indeed, that can be said of all of us who are here and many who are not here because they are doing other things. Ovarian cancer is one of those diseases on which we need to give hope and support to the people affected. We all know people who are affected and we are here today to speak on their behalf.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Mr Speaker]

In calling the hon. Member for Strangford (Jim Shannon) I promise to make no reference to the result of the match last night between Arsenal and Leicester City.

[Jim Shannon (Strangford) (DUP)]

Mr Speaker, you had a broader smile on your face this morning than my friend the hon. Member for Scunthorpe (Nic Dakin) and I. We still support Leicester and hope we will pay you back some day.

An important aspect of diagnosing cancer is to find the drugs that address it. What has been done to ensure the partnerships between universities and the NHS can continue, so that they can find new drugs and therefore address cancers at a very early stage?

[Matt Hancock]

There are deepening relationships between universities and the NHS right across the country, especially in this field of the combination of diagnosis and early treatment. Some of the most advanced technology and research in the world is happening in universities in the UK in order to save lives, which is such an important issue here.

Paediatric Cancers of the Central Nervous System

Jim Shannon Excerpts

Monday 22nd October 2018 Commons Chamber

[Chris Elmore]

I entirely agree with my hon. Friend. I pay tribute to him for the bravery that he and his wife, Rebecca, have shown over William. I am so pleased to see pictures of him now looking so well and on the road to recovery.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing forward such an important issue as an Adjournment debate. We have some three hours to complete the debate, so he has tons of time. About 400 children are diagnosed with a central nervous system tumour in the UK each year, accounting for a quarter of all childhood cancer cases. Like the hon. Gentleman, I salute the doctors, nurses and carers for all the work that they do in looking after these children. Survival rates for other cancers have significantly increased in the past 50 years, but the same cannot be said for brain tumours. Many charities and research groups are working in collaboration to find a cure. Does the hon. Gentleman agree that more needs to be done to raise awareness, find a cure and ensure that parents are fully aware of the key signs and symptoms in babies and young children?

[Chris Elmore]

I agree entirely with the hon. Gentleman. I hope my speech will go some way to highlighting that more work is needed, and to paying tribute to parents and families who have lost children through this horrendous condition.

Cian was first diagnosed with an atypical teratoid/rhabdoid tumour in 2015, when he was four years old. This type of tumour, often called an AT/RT, is a very rare and rapidly growing tumour of the central nervous system. Cian’s primary tumour was found on his spine, with seeds of the cancer also found in his brain. In the majority of cases, AT/RT is associated with a specific genetic mutation, INI1, which can occur spontaneously or be inherited. However, genetic testing in Cian’s instance did not indicate that he had this specific mutation. Cian’s tumour was located on his spine. AT/RTs are generally located anywhere in the brain, but are most commonly found in the cerebellum—the base of the brain—and in the brain stem, which is the part of the brain that controls basic body functions. The fact that Cian’s tumour bucked this trend made a difficult medical situation even more complex. AT/RT was previously thought to have been a type of medulloblastoma. However, it is now known that this is a totally different type of cancer and cannot therefore be treated via the same methods.

Mercifully, childhood cancer is rare in itself. The majority of children who are sadly subjected to this disease are diagnosed with a form of leukaemia. Brain tumours are much more rare, and AT/RTs make up only between 1% and 2% of these cases. I hope this illustrates just how tragic it was that Cian contracted not just cancer, but a cancer of the rarest of forms. This, however, is exactly why we have to do something. We have to do something to remember Cian and ensure that his legacy is that other families may be prevented from suffering a similar fate.

Breast Cancer

Jim Shannon Excerpts

Thursday 18th October 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak in any health debates—as my party’s health spokesperson, I am interested in them—but it is particularly pleasing to speak in this debate. I thank the hon. Member for Crewe and Nantwich (Laura Smith) for presenting the case so well and, through having secured the debate, giving us other MPs the opportunity to make a contribution. It is also always a pleasure to follow the hon. Member for Lincoln (Karen Lee). All of us in the Chamber today, or who were in the main Chamber when she spoke on this topic some time ago, will remember her contributions. I thank her for them.

I am pleased that we again have an opportunity to highlight breast cancer issues while we have the Minister’s attention. We all know he is deeply interested in this subject, and we look forward to his response. I also look forward to the contribution by the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), because I know she has an interest in the subject, too. There may be few of us here, but I know everyone’s contribution will be significant.

Some 55,000 people in the UK are diagnosed with breast cancer every year. Breast Cancer Now’s new 55000Reasons campaign calls for investment in breast cancer to feature in the NHS’s long-term plan. That beseechment is worthy of the Minister’s attention. Some 11,500 women and 80 men in the UK still lose their lives to breast cancer every year. I know men are a smaller proportion of sufferers, but we sometimes forget that they can be susceptible to breast cancer; I was given a salient reminder of that while researching for the debate. We sometimes do not think about that, but we should be aware of it.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Does the hon. Gentleman recognise that although far fewer men suffer from breast cancer, because services—particularly support services—are designed for women, men often delay coming forward with concerns and find it difficult to access support? Because they still see breast cancer as a women’s issue, they are almost afraid to be open about it.

[Jim Shannon]

As always, the hon. Lady makes an intelligent contribution; I do not mean to say that nobody else does, but she always brings her knowledge of her subject to our debates. I told her beforehand that I looked forward to her contribution, because, as always, it will be full of information we can learn from.

The hon. Lady is right: as the men present will know, we hide our health problems. We do not go to the doctor as often as we should. We just grin and bear it—except in the case of man flu, when we are probably dying almost before it starts. I should not be facetious—that is not right. I am just saying we do not react in the way we should. As the hon. Lady said, when we do go to the health service, the services are not there. We need to address that.

Between 2012 and 2016, an average of 66 women a year were diagnosed with breast cancer in the Strangford constituency. On average, 20 of those women—almost 30%—lost their battle with breast cancer in each of those years. As the MP for Strangford, that puts the issue into perspective for me, but it also tells me that the survival rate is not as good as we would like. The hon. Member for Bexhill and Battle (Huw Merriman) referred to early diagnosis, which I will come to. That statistic represents 20 homes deprived of a mother, a daughter, a sister, an aunt or a friend.

Outcomes vary tremendously among clinical commissioning groups. We continue to lag behind other European countries, such as Sweden, Portugal, Malta, Germany and France, on breast cancer survival. Projections indicate that if current trends continue and we do not address the increase in the number of people diagnosed with the disease, the number of breast cancer deaths will begin to increase within four years. I know the Minister has a cancer strategy in place and is addressing these issues, but perhaps he will indicate what is happening.

Those projections are shocking when we consider how far cancer diagnostics and treatment have progressed. My colleague the hon. Member for North Down (Lady Hermon) told me this week that a good friend of hers—a 42-year-old—has just died from cancer. Again, the reality is pertinent for us all.

I said to the hon. Member for Crewe and Nantwich that these debates always seem to come at the time when we can relate to them best. A very good friend of our family was diagnosed with breast cancer and is going through all the radiotherapy treatment. She has lost all her hair, as so often happens, and wears a scarf. The treatment is quite harsh. She is a friend of my son and the wife, and she works just down the road from us. Her employers have been good with her—they have ensured that she can at least do some part-time work. It is important for people to have something to focus their mind on when things are difficult.

Breast cancer is no respecter of the person. The large number of people affected by it means that even seemingly incremental changes have a huge potential to save more lives. Before I highlight some of the Breast Cancer Now recommendations, let me thank the Library for its work on the excellent briefing for the debate, which outlines the things we need, including public awareness and screening. It states:

“On 2 May 2018 the Secretary of State for Health and Social Care reported to Parliament a serious failure in the national breast screening programme in England and announced an independent review to investigate.”

Again, perhaps the Minister will indicate where we are with that review.

I underline the need for access to breast cancer drugs for people who are going through the most difficult times. We all know it is not just the patient who suffers—their family suffer, too. The hon. Member for Lincoln referred to that in a very personal way, which we all understand. The cancer care strategy refers to earlier diagnosis. One of its priorities is:

“A shift towards faster testing and responding more quickly to patients who present with symptoms. A target that by 2020, 95% of patients referred by a GP will be definitively diagnosed and receive test results within four weeks.”

If we reach that wonderful target, we will certainly be going the right way.

I often say to the hon. Member for Central Ayrshire, (Dr Whitford) who speaks for the Scottish National party, that she genuinely—she knows I mean this—brings a wealth of knowledge to our debates. I also tell her that, in many cases, Scotland leads the way with some of its health strategies and plans. We should look at its cancer strategy, which was published in 2016 and deals with prevention, detection, diagnosis and treatment—and aftercare, too, which is so important.

People who suffer from breast cancer often worry about financial issues, because they have a mortgage to pay and a family to look after, and sometimes the lady is the breadwinner. We must have all those things in place, so I encourage the Minister to look at Scotland’s cancer strategy, which I know the hon. Lady will refer to, probably in some detail. We look forward to that.

The excellent Breast Cancer Now recommendations include: specific lifestyle interventions; optimising the screening programme through increased uptake; strengthening the workforce; introducing new technologies; developing a screening programme tailored to an individual’s risk so cancers may be detected earlier; and reducing variation by reinforcing the position and ambition of cancer alliances. We will do this better if we do it together—I often say we are better together in everything. We can certainly learn from one another.

We should provide long-term funding and look at funding specific CNS posts to support secondary breast cancer patients in trusts where there is not a dedicated secondary CNS. We should ensure access to clinically effective drugs at a price that is affordable for the NHS. Let us have a price system. The Minister knows about the issues with the price structure for some drugs, and I know he is pursuing that matter so we get good drugs at a fair price.

I will take the time to list Breast Cancer Now’s recommendations. Its first priority is to fund

“specific interventions to prevent the 23% of breast cancer cases that are attributable to lifestyle factors in England every year.”

We should address the avoidable cancers.

The second priority is:

“Prevent over 1,200 breast cancer deaths by increasing breast screening uptake from the current decade low of 71.1% to the 80% standard set for breast screening units.”

It is so important to have that in place.

The third priority is:

“Urgently invest £39 million in recruitment to the breast imaging and diagnostic workforce to enable breast services to cope with increasing demand over the next ten years.”

I welcome, as we all should, the Government’s commitment to spend an extra £20 billion on health; it is a step in the right direction and it is quite a commitment.

The fourth priority is:

“Adopt new technologies, such as tomosynthesis and Artificial Intelligence, into the breast screening and symptomatic services as soon as proven effective.”

The fifth priority is:

“Transform breast screening to risk stratified screening to spearhead the prevention and earlier diagnosis of breast cancer over the next ten years based on evidence as it emerges.”

As evidence indicates the trends and how to respond to them, we should make the changes to make that happen.

The sixth priority is:

“Ensure that innovative, clinically effective cancer treatments are quickly available to NHS patients at a price that is fair and affordable, including by reviewing the NICE appraisal methodology.”

The seventh priority is:

“Introduce a Catalyst Fund worth £3 million to incentivise generic manufacturers to make it quicker and easier for patients to routinely access cheap, off-patent drugs found to be effective in new uses.”

The eighth priority is:

“Fund new Clinical Nurse Specialist posts to support secondary breast cancer patients in over 120 Hospital Trusts without a dedicated post.”

Those things can make a difference.

[Dr Whitford]

The hon. Gentleman talks about having a separate secondary breast cancer nurse as opposed to the breast cancer nurses who are involved in the initial treatment, but that is a discussion about local set-up. The hardest thing is to tell a patient, “It’s back.” To have a nurse to support her, who she knows from five or three years ago, is a big contribution. At our hospital, there was a conscious decision not to have a separate nurse—if a patient got sent to her, that would be a bad sign—but to have the nurse they already knew.

[Jim Shannon]

The hon. Lady is right and I accept that we should look at what is being done in Scotland. If there is a better of way of doing something, let us do it that way.

The ninth priority is:

“Improve the Cancer Dashboard by including more detailed data on performance across Cancer Alliance geographies to identify inequalities within and between Alliances.”

The tenth priority is:

“Provide multi-year funding for Cancer Alliances, to increase confidence and encourage long-term thinking to drive investment in innovation, including a dedicated fund to address pathway variation.”

It would be remiss of us all not to thank the charities, which work so hard. We all know them and I will mention just a few I am aware of: Cancer Focus Northern Ireland; CancerCare; and Marie Curie—I met a Marie Curie lady at the Northern Ireland Affairs Committee yesterday. I know Marie Curie’s work because some of my constituents have been referred there in the last month. Its end-of-life care is incredible, as is that of Macmillan Cancer Support.

We need a plan of action and we must have the funding for that plan of action to be put into place. I support so fervently the English reforms that the Minister will put forward, in the hope that the ethos and the funding for my constituents will follow. We are in a different place in Northern Ireland; health is a devolved matter and the responsibility falls under the Northern Ireland Assembly, but it is not functioning correctly at this moment. Men and women need to know that there is a way forward, to ensure that no one dies of breast cancer anywhere in the UK in the not-so-distant future.

Childhood Obesity

Jim Shannon Excerpts

Tuesday 16th October 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Will the hon. Lady give way?

[Ms Dorries]

When I have ever not given way to the hon. Gentleman—and when has he ever not intervened?

[Jim Shannon]

I congratulate the hon. Lady on securing this debate about something that is a massive issue in my constituency. I am a type 2 diabetic—it is interesting that she has referred to that—and I became a type 2 diabetic because of the horrendous food I ate and the lifestyle I had as a young person, until I became a diabetic. It is essential that we address with young people the age-old principle of all things in moderation. I supported the sugar tax and changes to the way in which nutritional information is displayed. Does the hon. Lady agree that while large steps have been taken, there is more to be done to tackle this? Funding must be allocated to allow charities and Sure Start to run programmes on nutrition to teach people cheap and efficient ways of healthy eating.

[Ms Dorries]

The hon. Gentleman nearly got a speech in there. As I said, I will go on to address funding issues.

The parents on whom this issue impacts the most, and who are most likely to be affected, are those who make the poorest nutritional choices. They do not take The Times, or spend time on the internet reading the news or visiting any other sites where information about the effects of obesity on their children is likely to be repeated. They are also the parents who live in areas of higher deprivation. The fast-food, junk-food giants place more of their outlets in such areas than in areas of affluence, which makes the temptation easier and the consequences more impactful.

What can we as a Government do? I want to praise the headteacher and staff at Shillington Lower School in my constituency. Every morning after assembly, every child joins in with 15 minutes of vigorous exercise. Some are outdoors, running around the field perimeter, while others are in the hall doing boot camp with the cyber coach. That is in addition to their normal PE lessons and physical activities. The school actively encourages walking to school, and I have to say that Shillington Lower School’s efforts are there to be seen, but that is one approach, in one school in one village.

I am doing my little bit by embarking on a tour of schools in my constituency, and I am speaking to public health officers at Central Bedfordshire Council to find out how much more we can do locally in my Mid Bedfordshire constituency. However, this piecemeal approach is part of the problem. We have local council initiatives, as well as individual schools, teachers, parents, elected Mayors, public health officers, social workers and health visitors all doing their own little bit, and while that is all incredibly worth while, no one knows what the other is doing. The approach is taken on the basis of good intentions, but it is far from being an effective plan to deliver any measurable results.

This issue should be a governmental and departmental priority, regardless of Brexit and the noises off. This crisis has nothing to do with Brexit and everything to do with the lives of our children, yet there is no plan that co-ordinates a national strategy to make dealing with this issue a priority, and there is zero leadership from the top—I am very sad to say that. A national crisis requires leadership and a holistic, co-ordinated headline plan. Tackling this problem needs to be one of the Government’s top five priorities, and that needs to include funding.

The Minister is very much doing his bit, in line with the Government’s obesity plan. That is a great achievement, but sadly it is nowhere near enough to tackle the problem. The Minister is a good, conscientious and pragmatic man, and the father of healthy and very beautiful young children. I know that he personally is as worried about this as anyone else, but he is just one Minister in one Department, although I accept that his is the Department that should be leading on this, in accordance with the Government’s aims and objectives in this area. However, if we had some high-level leadership and direction, we could have all the Departments working together towards one strategy and working together as one taskforce to establish our short, medium and long-term goals to reduce the weight of the nation and in particular of our children.

In fact, the Minister is the only person who is accountable for tackling this national crisis. As “Off the Scales” highlights, there is little or no direct accountability among Departments for the childhood obesity plan, other than the Department of Health and Social Care and a small requirement on the Department for Education. What about the Ministry of Housing, Communities and Local Government? What about the Department for Digital, Culture, Media and Sport, given that sport is one of the biggest players in the fight against obesity? What about the Department for Environment, Food and Rural Affairs, the Department for Transport and the Treasury? We know that the Treasury is the place where all good ideas go to die, regardless of which party is in power, and it is not giving this national crisis serious consideration. So many people—from the wonderful staff at Shillington Lower School all the way up to the Department of Health and Social Care—are doing their own thing, but, sadly, none of this can be monitored or measured, because it is all entirely disjointed and unconnected.

The NHS has recently enjoyed a £20 billion cash injection. At present, only 0.2% of the NHS budget is allocated to Public Health England to deal with obesity and to put in place preventive strategies with regard to childhood obesity, yet the Government’s plan places huge responsibility on Public Health England to tackle this issue.