Covid-19

Jim Shannon Excerpts

Tuesday 25th May 2021 Commons Chamber

[Nadhim Zahawi]

It is worth waiting for 14 June, when we will be saying more on this, but suffice it to say two things: first, even if someone has had two doses of either vaccine —I have had this experience in my own family—they can still contract covid and should therefore be isolating and quarantining; secondly, we are also looking at ways in which contacts of people who may have contracted covid can be regularly tested instead of isolating.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his responses so far and for the magnificent effort. I had my second vaccine yesterday, and just to show how national that was, the person who gave me the injection was a doctor from Lincolnshire. I believe that this very much shows that the United Kingdom of Great Britain and Northern Ireland works better together, and that this is a supreme example of that.

We understand that things will change depending on the circumstances and that localised lockdowns may be the way to ensure that areas with low numbers are able to allow people to live safely. Can the Minister outline what parameters will establish localised lockdowns and tell us whether the same approach will be taken UK-wide by the devolved regions?

[Nadhim Zahawi]

I am very pleased to hear that my hon. Friend has had his second dose; when people get that text message, they should please come forward and have their second dose. We are looking to ensure that the whole country comes out of this together, hence the advice being very much about exercising caution and self-responsibility. People actually get this; we see in much of the research data that they know the things that can add to the risk and that they should therefore abstain from doing those things while we vaccinate at scale to get to the place where we can all hopefully get our lives back.

A Plan for the NHS and Social Care

Jim Shannon Excerpts

Wednesday 19th May 2021 Commons Chamber

[Jonathan Ashworth]

I completely agree. I hope that Ministers on the Treasury Bench have listened carefully. If they are prepared to bring forward legislation, we would work constructively across the House to ensure its speedy passage. May I thank my hon. Friend for the reference in his amendment to the impact of alcohol abuse on children? He knows that it is a subject very close to my heart; on behalf of the children of alcoholics community, I am grateful that he referred to it in his amendment.

Although we have often said this in the House, I still think that the whole House will want to remember today the 127,691 people so far who have lost their lives to covid-19, this awful disease, including the 850 health and care workers. Although repeating the numbers has become almost routine in this House, that does not make the scale or gravity of the loss any less shocking. We grieve as a nation and we all pay tribute to our healthcare workers, our social care workers and our public sector workers.

I am sure that the whole House will want to dedicate itself in good faith to learning lessons for the future. Sadly, we are in an era when, according to the experts, pandemics are becoming more predictable and will become more regular because of climate change and biodiversity loss, so learning lessons is about preparing better for the future rather than settling scores.

We know that the B1617.2 variant is spreading. From the data that I have seen, it appears to have a growth rate advantage of about 13% over the B1117 variant. It could well become the dominant strain in the United Kingdom. Although vaccination should mean that many are much safer and ought to avoid hospitalisation, the Government still have a responsibility to do all they can to contain its spread, minimise sickness and ensure that the 21 June target is not disrupted, if at all possible.

That is why I said on Monday that we need more surge vaccination in hotspot areas. We know that with vaccination there are always pockets where rates are lower than necessary, and we need to drive those rates that up. We have seen that throughout history—with measles, for example. So we urge the Government again to do all they can to drive up vaccination rates in Bolton, Bedford, Blackburn and other areas where we know there is an issue. We also need the Government to do more to contain the virus through test, trace and isolate. We need more surge testing. We need more enhanced contact tracing locally, with local authorities given the resources to carry it out. We need sick pay and isolation support fixed as well.

For those who are going in to work, or for those who are now socialising in premises, those buildings and premises need proper air filtration systems. There are experts now who can easily fix filtration systems in buildings to make them much more covid secure, and we should be inspecting workplaces in all these areas to ensure that every workplace is covid secure.

We need transparency in decision making as well. For the first time in my life, I think, I find myself agreeing with Mr Dominic Cummings. I know the Secretary of State does not often agree with Mr Dominic Cummings, but I find myself agreeing with Mr Dominic Cummings, who tweeted yesterday:

“With something as critical as variants escaping vaccines, there is *no* justification for secrecy, public interest unarguably is *open scrutiny of the plans*”.

Mr Cummings, on this occasion, is correct. [Interruption.] A wry laugh from the Secretary of State. Mr Cummings may well have been saying something different when he was in government; I do not know, but at least his public statement yesterday is correct. That is why our amendment calls for the publication of a Government lessons-learned review; not so that we can try to undermine the Government or find some hole to use across the Dispatch Box, but so that we can learn the lessons in our efforts to contain variants, and ensure that we are better prepared for the future. I hope the Secretary of State looks sympathetically upon that request, and perhaps joins us in the Division Lobby this evening.

I now turn to the contents of the Gracious Speech more generally. This should have been the Queen’s Speech that unveiled a new NHS plan to bring down the elective waiting list, which now stands at 5 million. This should have been a Queen’s Speech that outlined proposals to tackle the backlog of 436,000 people waiting over 12 months for treatment—many of them waiting in pain and anxiety, many of them facing permanent disability as a consequence of those waits.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Gentleman give way?

[Jonathan Ashworth]

I will certainly give way to my fellow Leicester City fan.

[Jim Shannon]

The shadow Minister and I, and many others in this House, shared that wonderful victory on Saturday. After 139 years of Leicester City, we won the FA cup; it is great news.

I chair the all-party parliamentary group for respiratory health. This morning, we were given some very worrying figures. They indicated that the halting of the lung cancer screening pilots restricted access to diagnostic tests, contributing to a 75% drop in urgent lung cancer referrals. Does the shadow Minister agree with me, and share my concern, that the outcomes for patients with the fastest-progressing cancers, such as lung cancer, are indeed very worrying?

[Jonathan Ashworth]

The hon. Gentleman is spot-on. I will come on to cancer in a few moments. He is a great champion for improving cancer care, and I thank him for reminding the House that Leicester City won the FA cup on Saturday. It is a reminder that even when the odds are stacked against them, a small team can still beat a well-funded, complacent opposition.

I will now move on to elective waiting lists. Where is the plan in this Queen’s Speech to bring down the rocketing waiting lists for treatment and surgery? Where is the plan to roll out technology such as in ophthalmology, for the thousands in our constituencies awaiting cataract operations? There are already 81,762 of our constituents waiting over 12 months for orthopaedic surgery. Where is the plan to get on with the hip replacements and knee replacements that many of our constituents will be raising with us in our surgeries, and how much longer will they have to wait? Where is the plan for the 24,407 of our constituents who are now waiting over 12 months for gynaecological surgery? How much longer will they have to wait?

Everyone understands that there has been a pandemic and that that has meant a disruption in care pathways, but the NHS was forced into this unprecedented position because we went into the crisis on the back of 10 years of Tory underfunding and cutbacks. We went into this crisis on the back of a 6% reduction in bed numbers between 2010 and 2019. That is why, at the beginning of 2020 when we debated the last Gracious Speech, 4.5 million people were on the waiting list for treatment. The target of 92% of patients beginning treatment within 18 weeks of referral from their GP had not been met for five years. We need a resourced plan now because the queues are set to lengthen further, as those who may have delayed seeking treatment for fear of covid infection will begin to emerge once again. Even though the NHS is dealing with significantly fewer covid patients, it is still operating at a much-reduced capacity and is unable to treat everyone in need of care.

Infection control measures meant that the number of beds fell by 9% in the first quarter of last year. It has only partially recovered in the past three months, but the number is still 6% lower than the previous year. What that means when we look at the most recent figures is that, on average, there are almost 4,000 fewer patients in NHS general and acute beds than the equivalent pre-covid period.

The Prime Minister has delayed the review of social distancing for entirely understandable reasons, but we must have a plan to drive up this capacity in the NHS. The solution to these capacity issues in the NHS cannot be a multi-billion pound deal with the private sector. The loss of capacity in terms of beds in the NHS is actually far larger than the whole capacity offered by the private sector. In order to reopen those closed and empty general and acute beds in the NHS, we need more capital investment. This investment needs to be built up now, so that the NHS can get on with the routine surgery that it will clearly have to confront in the coming years. I am afraid that, both the Queen’s Speech and, indeed, the Budget from a few weeks ago, failed to deliver that.

Covid-19 Update

Jim Shannon Excerpts

Monday 17th May 2021 Commons Chamber

[Matt Hancock]

Yes, we are making significant progress with the onshoring of vaccine capability. It is about developing the vaccine, as the team in Oxford did brilliantly, but also about manufacturing it onshore, and boy, if there is one lesson we have learned from this whole thing, it is that we cannot just not care about where manufacturing happens. Having it onshore really, really matters, for resilience but also to ensure that it is close to the NHS so that the whole supply chain can learn and constantly improve. I am delighted that we are pushing forward with the VMIC project in the same way that we have brought onshore manufacturing supply in Teesside, in Livingston in Scotland and in the fill-and-finish plants at Wockhardt in Wrexham, at Barnard Castle and elsewhere. It is a big project and, frankly, a big opportunity for life sciences in the UK to ensure that we can do all this onshore, because in my view, the pandemic has shown that we need to.

[Jim Shannon (Strangford) (DUP) [V]]

I thank the Secretary of State for his statement and for his comprehensive answers. I know that he has regular discussions with the Northern Ireland Assembly Health Minister, Robin Swann. There has been a surge in the Indian variant in Donegal in the Republic of Ireland and in the maiden city of Londonderry in Northern Ireland. Can the Northern Ireland Assembly Health Minister call upon the UK for expertise from Westminster to assist us, which I believe will show once again that we are always better together with the United Kingdom of Great Britain and Northern Ireland?

[Matt Hancock]

I could not agree more with the hon. Gentleman. The UK fights this together. There are outbreaks also in Moray and in Glasgow, and I have been talking to the Scottish Cabinet Secretary for Health about the action that is going on to tackle the outbreaks there. I talk frequently with Robin Swann, who is doing an absolutely brilliant job with the Health portfolio in Northern Ireland. The fundamental point is that the benefits of the United Kingdom working together are once more demonstrated by our ability to work together to tackle this variant.

Alcohol Products: Labelling

Jim Shannon Excerpts

Tuesday 27th April 2021 Commons Chamber

[Dan Carden (Liverpool, Walton) (Lab)]

I am grateful to Mr Speaker for allowing me this Adjournment debate, and I am grateful to you, Madam Deputy Speaker, and to the Minister, whose reply I look forward to. Earlier this month, the details of the upcoming Government consultation on alcohol labelling—part of the obesity strategy—were leaked to the press. It is a long-overdue consultation and a welcome positive step that should lead to consumers being able to make more informed choices about their own health and wellbeing, but thanks to yet another hostile Government leak, the consultation was roundly attacked and misrepresented by tabloids and industry representatives. It sparked the usual outraged backlash against the nannying state and red tape, when that is simply not the case. I thought I would attempt to put the record straight.

To avoid confusion or misrepresentation, I whole-heartedly support our hospitality industry, and I understand the uphill battle it faces and the devastation that lockdowns and restrictions have caused. There is excitement and anticipation across the country about getting out, socialising, having a drink, seeing live music and enjoying life. We have all missed spending time with family and friends, whether that is relaxing and unwinding or going out and partying.



When we consider the role of alcohol in our society, we see that there is a balance to be struck. As with many things in life, there is the good and there is the bad, because we cannot escape the very real harm alcohol inflicts. The evidence, which I will come to, speaks for itself. Tackling alcohol harm is not about punishing drinkers or landlords, or taking the fun out of socialising. However, we have a responsibility—the Government have a responsibility—to hold the alcohol industry to account, and to ensure its fair and proper regulation.

Alcohol harm is rising, and it has been for many years, however we want to count it. Alcohol is now linked to 80 deaths a day in the UK, many of them of the young, while alcohol-specific deaths are at their highest rates since records began, and the treatment and funding for alcohol addiction are in absolute crisis, yet there appears to be no sense of urgency from Government. Alcohol is responsible for more years of working life lost than the 10 most frequent cancers combined. Before covid, alcohol took up 37% of ambulance time and a quarter of A&E time. For the police, it is even higher, with more than half of police time spent on alcohol-related incidents. All of this comes at a high financial cost, too. Alcohol harm is estimated to cost the UK taxpayer upwards of £27 billion each year.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for bringing this issue to the House. It is a massive issue in his constituency, and very much one in mine as well. Does he not agree that alcohol-specific deaths are at an all-time high owing to a perfect storm? With coronavirus, isolation and lockdown, as well as the fact that very few people use standard pub measures at home, that there are supermarket deals on bottles of alcohol and people do not have to drive to work the next day, it is imperative that we take steps to remind people of the number of units per bottle, make it clear that the glass of wine they are accustomed to at home is not the same as their local pub one, and make people aware of the need to reduce their intake.

[Dan Carden]

I am grateful to the hon. Member, and he is absolutely right.

We know that those in the most deprived communities are disproportionately affected. Despite drinking less on average, they are up to 60% more likely to die from alcohol than more affluent groups. In Liverpool—just one city—there are more than 14,000 alcohol-related hospital admissions every year, and 535 new cases of alcohol-related cancer as well. Alcohol harm and addiction are destroying lives, livelihoods, communities and families.

To return to the matter of today’s debate—alcohol labelling—I would like to ask those listening to remember the last time they looked at a bottle of orange juice. They may remember a number in red detailing the sugar content, a number for how many calories are in the drink, and a whole table with further information on nutritional content. Now picture a bottle of alcohol—wine perhaps. Do they remember seeing any such information about the ingredients, calories or nutritional values? Was there any information about the impact of alcohol on health, or any guidelines for consumption? If I can make a guess, the answer is most likely to be no, or maybe “on some bottles”. That is because none of this information is legally required on alcohol labels. Alcohol products are a conspicuous outlier among consumables. They are exempt from other food and drink labelling requirements, and the only information that is legally required is the volume of the liquid, its strength in ABV—alcohol by volume—and whether any of the 14 most common allergens are present.

In July 2020, the Government unveiled the new obesity strategy. On the subject of labelling, the Health Secretary said

“it’s only fair that you are given the right information about the food you’re eating to help people to make good decisions.”

He is absolutely right, and what he says is as true for alcoholic drinks as it is for anything else. It is surely bizarre that if we buy a bottle of juice, we get a range of calorie, ingredient and nutritional information, yet if we buy a juice and vodka ready-to-drink product, we will usually not get any of the same information. Similarly, alcohol-free beer and wine must display calorie and nutritional information, yet alcoholic beer and wine does not have to.

Covid-19 has reminded us all of the need to take seriously the impact of diet and lifestyle on our physical and mental health. As we know that alcohol damages health and causes harm, it is inexplicable that alcohol products face less regulation than fruit juices and fizzy drinks, so the Government’s consultation is timely and important.

I want to press the Minister to go further with the consultation than calories, nutritional information and ingredients; it must consider health information as well. The majority of the public agree and want to know what is in their drinks. Opinion polling conducted for the Alcohol Health Alliance shows that 74% of people want ingredients on alcohol labels, 62% want nutritional information, including calorie content, and 70% want health warnings.

There is a strong case for displaying calorie information on alcohol labels. For those who drink, alcohol accounts for nearly 10% of their daily calorie intake. Around 3.4 million adults consume an additional day’s worth of calories each week, yet 80% of the public are unaware of the calorie content of the most common alcoholic drinks.

Alcohol harm is also poorly understood by drinkers. Only one in five people know the drinking guidelines, and only one in 10 can identify cancer as a health consequence of alcohol. We have warnings on cigarettes that tobacco can cause cancer, so why is similar information missing from alcohol?

I would like to quote one person with lived experience, who described the lack of health information to me like this:

“I knew little of how many recommended units per week, I knew nothing about the nutritional value, I could tell you how many calories were in a Mars Bar but not the glass of Merlot I was drinking. I knew nothing about the long-term health implications. If I buy a pack of cigarettes I am told they are highly addictive and I am told with every pack what health implication there could be. They are now behind a shutter in the shop – but alcohol? Nothing. I near lost my life to alcohol and the lack of information and regulation makes no sense to me”.

Alcohol labels are an effective tool to change that situation. A study in Canada showed that consumers exposed to health warnings on labels were three times more likely to be aware of the drinking guidelines and were also more likely to know about the link between alcohol and cancer.

A number of alcohol products voluntarily incorporate unit alcohol content per container, a pregnancy logo or message and active signposting to drinkaware.co.uk. I am grateful to the producers who contacted me ahead of this debate to share updated labels that now include calorie and nutritional information. One of the UK’s biggest pub chains has already taken that step and is providing calorie labelling for all alcoholic drinks on their menus. I am grateful to the Minister for confirming, in answer to my written question, that alcohol sold in licensed venues will also be part of the consultation.

If someone pops into their local supermarket and takes a wander round the booze aisle, it is abundantly clear that there are huge inconsistencies in alcohol packaging. That hit-and-miss approach is just not good enough. It is time to put it right and standardise the approach, as we have done with food labelling. Even on the products that did carry chief medical officer guidelines and nutritional information, there are varying degrees of clarity and visibility.

In their report “Drinking in the dark: How alcohol labelling fails consumers”, Alcohol Change UK and the Alcohol Health Alliance recommend that:

“The UK Government and devolved administrations must give a new or existing independent agency appropriate powers to…enforce what appears on alcohol labels, working in the interests of public health and consumer rights and free from influence and interference from corporate interests.”

I support that recommendation and hope that the Minister will consider it in the consultation, when it gets under way.

Sir Ian Gilmore, a leading figure in Liverpool’s fight against alcohol harm and chair of the Alcohol Health Alliance, said:

“Alcohol labelling in this country is…not fit for purpose if we wish to build a healthier society. The public must be granted the power to make informed decisions about their health by having access to prominent health warnings and information on ingredients, nutrition and alcohol content at the point of purchase. The industry’s reluctance to include this information on their products suggests profits are being put ahead of people’s health.”

Ahead of this debate, I received a letter and information from the Portman Group, the alcohol industry-funded social responsibility body and regulator for alcohol labelling, packaging and promotion in the UK, and I am grateful for that. The Portman Group supports the consultation and its intention to provide consumers with more information on calories, the chief medical officer’s lower-risk guidance and drink-driving. It said that

“we believe this can be done most effectively on a voluntary basis”.

It is encouraging to hear some industry support for the consultation and I look forward to further discussions with it, but with alcohol-specific deaths at their highest on record, it is surely time for a proper review of how the industry is regulated and held to account.

The regulation of alcohol marketing in the UK is fragmented and largely self-regulating. Under the current set-up, the Advertising Standards Authority, funded by the advertising industry, Ofcom and the Portman Group, funded by the alcohol industry, all play a role in regulating marketing, from TV advertising to sponsorship deals to packaging. That is surely ripe for review, to consider how a new model and a new alcohol industry regulator could be made more accountable to the public and be fully independent of the alcohol industry.

I hope that the Minister will use her consultation as an opportunity to mandate wider health information on labels, too. This should, as a minimum, include the CMO’s guidelines, pregnancy warnings, drink-drive warnings and cancer warnings, so that we can make informed personal health choices and collectively seek to reduce alcohol harm.

I accept that alcohol labelling is only one small part of seeking to reduce alcohol harm across society. Any progress on improving labelling should be part of a broader strategy: a national, Government alcohol strategy. The last alcohol strategy was formulated in 2012, and, since then, harms have continued to rise. Over the last decade, we have learnt a lot more about the wider health impacts of alcohol, such as the link between alcohol and cancer. The World Health Organisation is clear that policies on the affordability, availability and promotion of alcohol are the most effective—policies that have also proved effective in reducing smoking.

What can really be said of attempts to reduce the increasing and worsening harms caused by alcohol misuse? Why is it that evidence-based research and policies are being ignored in this way? The Government’s addiction strategy is under way—it was promised in 2020, but we are waiting for it—and we also await the second part of the Dame Carol Black review of drugs. These are very welcome, but now is surely the time for a full-scale review of reducing alcohol harm across society. A focused alcohol strategy would allow a much broader and fuller understanding of the extent of alcohol harm and the measures needed to reduce it.

As it stands today, the UK has the highest number of alcohol-specific deaths on record. Drug and alcohol addiction services have been pushed outside the NHS into cash-strapped local authorities, decimated by funding cuts and fragmented. There are fewer addiction psychiatrists in training than ever. Alcohol is now 74% cheaper than it was in 1987, and in England there are over 300,000 children currently living with at least one adult who drinks at a high-risk level.

This current trajectory cannot continue and the urgent need for a national alcohol strategy cannot be overstated. In their approach to obesity, the Government have shown a willingness to take bold action to protect the public’s health. The same boldness is now required to tackle alcohol harm. The consultation on the labelling of alcohol products is the first step towards improving transparency and accountability across the alcohol industry, and ensuring an evidence-based approach to reducing alcohol harms. I implore the Minister to get it under way, and I look forward to her response.

--- Later in debate ---

[Dan Carden]

Will the Minister give way?

[Jim Shannon]

Will the Minister give way?

[Jo Churchill]

My goodness—stereo!

[Jo Churchill]

Now is a great time to focus on making sure that we enable people to make the healthier choice as the default choice, and that we work to ensure that people have the right information for them. All I am willing to say at this stage is that nothing is off the table. There are a lot of strategies. Rather than making any blanket statement, the important job now is to refocus and to deliver on some of the commitments that we would like to see, and to make sure that the consultation is rolled out so that we can have that dialogue and make sure that we are doing the right thing for individuals but also across the industry.

[Jim Shannon]

I thank the Minister for outlining very clearly a strategy to address the issues that the hon. Gentleman is referring to. Minister, I know that it is not technically your responsibility, but I think perhaps—

[Madam Deputy Speaker (Dame Eleanor Laing)]

No, please, the hon. Gentleman cannot disappoint me like this. He cannot say “you” to the Minister.

[Jim Shannon]

Apologies, Madam Deputy Speaker. One massive issue has been the promotion of drink at cheap prices so that people can get drunk cheaper. Would the Minister be sympathetic to discussing this issue with the industry—the Portman Group has been referred to—to try to address it?

[Jo Churchill]

I think the hon. Gentleman refers to minimum unit pricing. As I say, we are refocusing on making sure that we are having a broad range of discussions. As he pointed out at the beginning of his intervention, this is not something that sits within my responsibility. However, I have heard, and I am sure others have heard, his plea for that work, which does go on in other parts of the United Kingdom.

Alcohol labelling is one part of wide-ranging cross-Government work to address alcohol-related health harms and their impact on life chances. The Government are committed to supporting the most vulnerable at risk from alcohol misuse. We have an existing agenda on tackling alcohol-related harms, including an ambitious programme to establish specialist alcohol care teams in the worst-affected 25% of hospitals, because I do recognise some of the challenges within the workforce that the hon. Member for Liverpool, Walton mentioned. We continue to support the children of alcohol-dependent parents—a situation that wreaks such havoc.

As part of the prevention Green Paper, we are committed to increasing the general drinking population’s direction of travel towards lower-strength alternatives when they have moderate drinking habits. We are working with the industry and other stakeholders to create more consumer choice and availability in the low-alcohol and no-alcohol sector. They are often very palatable alternatives, particularly for those who are driving or who may have a reason to want a clear head the following morning. The more choice that we can give people in that area, the better.

The Government have committed to publishing a new, UK-wide cross-Government addiction strategy that considers the full range of issues, including drugs, alcohol and problem gambling. While each of those comes with its own set of issues—as the hon. Gentleman said, the second part of Dame Carol Black’s review is due shortly—there is also much common ground and many benefits to tackling addiction in a complete, comprehensive and joined-up way. The scope of the addiction strategy is still being developed, so I consider this debate and his calls most timely as we consider what more can be done to protect people from those alcohol-related harms.

I emphasise the Government’s commitment to ensuring that alcohol labels provide the information that people need to make informed choices about the products that they are purchasing. I stress, probably for my husband and children mostly, that we are not saying, “You can’t enjoy a drink.” What we are saying very clearly is that we would like to encourage the nation’s drinking to be responsible, and to help people not to be one of those statistics that wreck lives.

We believe that people have the right to accurate information to help them to make decisions about the products that they purchase, and we are committed to ensuring that the labelling on alcohol provides that. Progress has been made in relation to the UK CMO’s low-risk drinking guidelines and other information on alcohol products, but we are not complacent. We will continue to actively monitor the position and keep it under review, and ensure that we level up so that people, no matter what drink they choose, can get accurate information from the product.

We await the consultation to ensure that we take everyone with us, because it is important that we do things in a measured but directed way in order to bring the benefits to the most people. I thank the hon. Member for Liverpool, Walton for introducing this Adjournment debate and for everything that we have discussed. Let us hope that we can get there.

Question put and agreed to.

Stroke: Aftercare

Jim Shannon Excerpts

Wednesday 21st April 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate, Sir Edward, and I congratulate the hon. Member for Bromley and Chislehurst (Sir Robert Neill) on securing it. I can remember when he requested the debate during business questions—I believe it was in January—so it is good to know that the system works. We have in place two of the participants in a Westminster Hall debate on heart valves, which I think was held on a Thursday in February. This Minister responded, and the shadow Minister also made a significant contribution. I do not want to pre-empt what the Minister will say, but I think the hon. Member for Bromley and Chislehurst will be pleased with the response, because she certainly gave me a good response to my debate on heart valves. We will take the Minister up on her invitation for the all-party parliamentary group to speak to her about these matters.

This is an issue that has become very real for me, although probably not as real as it is for the hon. Member for North Norfolk (Duncan Baker), and for people whom I know who have had a stroke. Over a period of time, I have been greatly encouraged by those who have improved. Some improve almost back to where they were—about 80% to 85%—and others not as well, which is probably to do with age and the severity of the stroke.

I want to make three quick points to the Minister, and I am quite sure that the reply will be positive and helpful. I believe there is a need to increase the availability of clot-removing treatment—thrombectomy—to enable all hospitals to carry out the procedure. We should have a target of delivering a tenfold increase in the proportion of patients who receive a clot-removing thrombectomy in order to end their strokes, so that 1,600 more people can be independent after a stroke each year. If we are to do that in reality, we have to address some of the reasons why strokes happen. Perhaps our health conditions have not been as good as they should have been, and it is about improving people’s health. Can the Minister tell us what has been done to deliver that across every region?

Back home in Northern Ireland—I presume it is the probably the same here—we have regular adverts. Chest, Heart & Stroke has an advert on UTV that tells people what to watch out for, and it is really helpful. Can the Minister confirm whether the mainland has the same number of adverts? They tell people what to look out for. To take up the point made by the hon. Member for North Norfolk, time is of the essence when someone has a stroke. It is what people do in those minutes afterwards, regardless of whether they have the qualifications or just want to do something that helps, because time is absolutely critical.

I recently watched something on TV. It was a clip of a darts match in which a player is having a stroke. His face distorts, and he loses all power in his arm. Seeing that take place in real time has shocked me, because it really brought home the issue that pertains to those who have had a stroke, as well as what can be done in that short time. We need to incorporate a greater awareness of the warning signs. Getting help quickly makes the difference between a fast recovery and a slow one. Can the Minister tell us what has been done to raise awareness among the general public?

I said that I know people who have had strokes and who have recovered quite well. Indeed, a friend of mine had one a while ago and is now back to almost 95%. It is incredible that someone can have a stroke and recover so quickly. In Northern Ireland, over a third of strokes happen to people over the age of 69, and 50% to people over the age of 60. However, it is not uncommon, unusual or unique for those under that age to have a stroke. What has been done among all those groups? Those who are most at risk must be aware of the signs and symptoms.

The hon. Member for Bromley and Chislehurst was absolutely right to refer to long-term personalised care. I am asking things that have perhaps been asked before, but I am quite sure that the Minister will be able to reiterate and to assure us on that, and on the national stroke programme and the lessons learned and the changes that can provide better protection, raise awareness and ensure that we improve health for everyone in this great United Kingdom of Great Britain and Northern Ireland. I know that the Minister has no responsibility for Northern Ireland, but I look to her, as always, for a response to the queries we have all put forward. It is important, not only for me, as my party’s spokesperson on health issues, but for all of us to know that we are improving long-term care and help following strokes for those who need it.

Elective Surgical Operations: Waiting Lists

Jim Shannon Excerpts

Tuesday 20th April 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate. I intend to make some constructive comments and look forward to the Minister’s response. I thank the hon. Member for Bootle (Peter Dowd) for setting the scene so very well and reflecting the opinion that we all have. The Minister does not have responsibility for health in Northern Ireland, but I will give him a couple of examples from Northern Ireland as they are replicated elsewhere.

As the hon. Member said, the figures, which we are all aware of, were clearly in the press last week. I had the opportunity to ask the Secretary of State about them yesterday. I did so because of the backlog of operations—I mentioned tonsillitis and children waiting for their adenoids to be removed—with waiting lists growing not just here in the mainland but indeed across the whole of the United Kingdom of Great Britain and Northern Ireland. Those who have spoken have mentioned the concerns and pressures that I have, and they will be reiterated by those who come after. The Secretary of State in replying said that £7 billion would be made available—the hon. Member for Twickenham (Munira Wilson) will be interested in that figure—and through the Barnett consequentials we in Northern Ireland will get some benefit.

The Secretary of State did acknowledge that there is an absolutely massive backlog, but I think that as we slowly get out of covid-19 through the vaccine roll-out—we put on record our thanks to the Minister and the Government for all they have done on that—we need a strategy in place that addresses the backlog of those waiting to be seen. From waiting lists to see consultants to surgery dates being pushed back, coronavirus has brought us from teetering on the brink of surgical collapse to being under the rubble. It is as serious as that, certainly in Northern Ireland, where the waiting lists are gross. The Secretary of State referred to how it is a problem not just in England but in every region in the United Kingdom. We welcome how he and the Government recognise the problems, but we look to the Minister, with no pressure whatsoever, to tell us what is going to happen and how the strategies will address the backlog.

The Secretary of State always tells me that he has regular contact with Health Ministers in the devolved Administrations. I know that he does, and I welcome that close contact, being on the phone every week—maybe two or three times a week—but I want to ensure that the strategy and the co-ordination are working across all the regions. I will give two examples to illustrate what the issues are.

One of those examples happens to be from one of my own staff, who has two wee girls. One of them is a five-year-old, Lily, who was choking on her food and her drink. After another bout, her mum looked into her throat and saw that her tonsils were the size of golf balls. Those are her words. For a wee girl of only five years old, one would panic right away. She rang the GP, was seen and got an urgent referral to ENT. She then paid to go private, which meant she had to borrow money. Not everybody can do that. She was told that the waiting list was over a year long just to get a consultation. She went to the consultant and was sent home with a sleep monitor, to see where the problems were, which would report back to the doctor. She gave back the monitor after three nights, as requested, and was contacted within two days to say that Lily needed urgent surgery, as her oxygen levels had dipped dangerously low during the night.

Lily’s mother rang the hospital and was told she would have to have surgery in the first urgent slot in April. We are more than two weeks in from the beginning of April, and it has not happened. Lily is still waiting for her surgery and her mother has installed a baby monitor, which speaks, with an on-and-off movement. What a way to live a life, heart in mouth, on eggshells over a five-year-old, listening to the baby monitor all through the night, almost afraid to sleep in case of missing something.

The stress to the family resonates across every one of them. Simple surgery would rectify that. Despite being first on the urgent list, Lily is still waiting. I know the Minister is not responsible for that. The hon. Member for Bootle, who set the scene and had lots of examples, did not go into them all. I suspect that he would have examples very similar to the one I am referring to. Lily’s mother has sleep-interrupted nights to ensure that her child is breathing. A simple procedure would be the solution but, for some unknown reason, the year has passed and we do not seem to be any further ahead.

My second example is a 42-year-old market trader who has worn kneecaps. His business employs 13 local people. He has told me that unless he gets his operation, he will have to close one of his shops, as he cannot physically load and unload the vehicles, and he is losing business. The impact of not getting an operation in time not only affects children but those involved in industry and the economy.

The hon. Member for Twickenham referred to cancer diagnosis. I know of people who had cancer in the past year and, unfortunately, because they did not have their operations, they are no longer here. That is a fact. When the hon Lady mentioned that, I could relate to it and understand, because I know people who are not here today because they were unable to get an operation. I understand that the Government have a responsibility to look after the covid situation, but the time is coming when we need to look beyond that. We need to have a strategy in place, and I look to the Minister for a response on that.

With regard to knee replacements, that 42-year-old market trader is an example of those who need it right now, not years in the future. I also make that point for cataract surgery. Lots of people are not just waiting for the surgery, they are waiting for the appointment to diagnose when it can be done, knowing that they are going blind. Simple cataract surgery can change their lives with real, dramatic and positive effect. We need to be on the ball with these things.

I understand the reference the hon. Member for Twickenham made to mental health. I have seen in my constituency the effect on the mental health of children, some as young as primary age. Schools are suffering tremendous mental health problems. This problem does not only affect Northern Ireland. Just under 4.7 million patients are waiting for hospital treatment in England, as of February 2021. That is the highest number since the referral for treatment data series started in 2007. Although a relatively sharp decrease in numbers waiting was observed from April to June 2020, the numbers have since increased to that record level of 4.7 million in February 2021. It seems likely that the dip from April to June 2020 was due to limited new referrals during the first wave of the coronavirus pandemic.

I always try to be positive when I come to debates. We get the background and examples to set the scene and show what the problems are, but everyone who has spoken so far has very honestly and admirably put forward solutions. I think we are all in the business of solutions. It is about the glass half full rather than half empty.

We need investment. We also need access to private clinics—at some time we will have to look to them—and facilities, and we need action now. With every day that passes, more people are in need; more are in pain and more are in fear, and we must get a hold on the situation. The lists continue to grow as more people’s names are added.

We need a clear strategy that prioritises the backlog of elective surgery. We need the £7 billion that the Secretary of State referred to in the Chamber, which is extra money for this particular purpose. We want to see how that pans out. We need to employ more staff, and extra surgeons as well. What do we have to do to do it? There must be a plan. We have a responsibility. As my party’s health spokesperson, I am very keen to see these matters addressed. I know the Government can do it. If they put their minds to the issue, they can make it happen, but each and every one of us in the House wants to see it sooner rather than later.

Covid-19 Update

Jim Shannon Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

I am delighted that my hon. Friend, along with my hon. Friend the Member for Harrow East (Bob Blackman), is among the 10 million who have had their second jab; that is really good to see. The hope and cheer that the vaccine brings links to the second part of her question, about the speed of the road map. The reason for the timing set out in the road map is that we want to see the impact of one step before we take the next step. We are but one week on since we took step 2. That is a significant reopening, as we have no doubt all seen in our constituencies and around the country. We want to see the impact of that on the data before taking the next step, so we can have confidence that this is an irreversible path—a one-way street, as I put it. That is the reason for the way that we have set this out, and that is how we are planning to proceed.

[Jim Shannon (Strangford) (DUP)]

Along with others, I welcome the roll-out of the vaccine, as that is very important, but few would deny that it is now time to look at waiting lists, and I shall put one on record. What steps have been taken to get routine operations such as hip replacements and tonsil operations back on the table to address the eye-wateringly long waiting lists? That is vastly concerning, especially when we hear, for instance, of children who were on waiting lists for tonsils and adenoids to be removed last year; due to dips in oxygen levels they were considered urgent at that time, but that now appears to be okay. That is very worrying.

[Matt Hancock]

The hon. Gentleman raises a very important point. The waiting list issue is very significant; it has built up because of covid, but we must tackle it and we are absolutely determined to do so. He, like me, will have seen the figures last week on the increase in the waiting list in England, but the waiting list has increased in all parts of the UK. We have put in extra funding, an extra £7 billion in total for next year in England and, through the Barnett consequentials, to the three devolved Administrations. That is there to make sure we can get through this backlog while also of course dealing with covid and the infection prevention and control needed to tackle covid. This is a vital task, the hon. Gentleman is right to raise it, and we are working very hard to address it.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 13th April 2021 Commons Chamber

[Jo Churchill]

I agree wholeheartedly that we should encourage all children to make sure that they can take part in sports and enjoy the outdoors. Regular physical exercise is important for the health and wellbeing of young people, and the local community has an important role to play in developing facilities. That is why the Government launched a £150 million community ownership fund, to ensure that communities across the UK can benefit from the local facilities and amenities that are most important to them. That includes community-owned sports clubs and sporting and leisure facilities that are at risk of being lost without community intervention, and I urge my hon. Friend to work with his community to ensure that he has those facilities locally.

[Jim Shannon (Strangford) (DUP)]

What plans the Government have to ensure an adequate number of nurses in the cancer workforce to deliver the targets for cancer set out in the NHS long-term plan.

[The Minister for Care (Helen Whately)]

Cancer diagnosis and treatment is a priority for this Government. I am working with the Minister for prevention and public health—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill)—to ensure that we have the necessary workforce to deliver improved cancer care. Overall, we are increasing the number of nurses in the NHS, with over 10,000 more nurses in the NHS this January than a year ago. We are training 250 more cancer nurses and 100 more specialist chemotherapy nurses.

[Jim Shannon]

I thank the Minister for that encouraging response, but will she outline what steps have been taken to ensure that Northern Ireland students educated in UK mainland nursing schemes can easily transition to fill the needs in our cancer wards both in the UK mainland and in Northern Ireland?

[Helen Whately]

I thank the hon. Gentleman for his question, and if he will allow me, I will look into that and write to him.

Cardiopulmonary Resuscitation in the Pandemic

Jim Shannon Excerpts

Tuesday 13th April 2021 Commons Chamber

[Danny Kruger (Devizes) (Con)]

I rise to speak about the use of “Do not attempt cardiopulmonary resuscitation” notices during the pandemic. Last year, the health service was hit by the worst crisis in its history. The whole country was told to stay at home for one simple reason: to save the NHS. That meant not overwhelming the system with too much demand—too many people needing care. We faced a real nightmare scenario of the NHS not being able to treat people who were sick and dying. The horrific idea emerged of doctors or local health managers or the NHS itself having to play God to decide who should live and who should die by deciding who should get treatment and who should not. Thankfully, the NHS was not overwhelmed. This, of course, was mostly due to the heroic work of frontline staff. It is also because every measure possible was put in place to reduce pressure on hospitals. That included people staying at home, building new hospitals at record speed and getting people out of hospital as fast as possible, including to care homes. This is where the occasion for the DNACPR notices came about.

Care homes found themselves under enormous pressure, too. Stories emerged last spring of blanket DNACPR policies being put in place in care settings. They were for people with certain characteristics—people with learning disabilities, people with certain complex needs, and people with life-limiting illnesses. This was done, the report said, without consultation with patients themselves or with families. All this was quite wrong and against all the guidance. Indeed, in April last year, the Care Quality Commission issued a joint statement with the British Medical Association, the Care Provider Alliance and the Royal College of GPs, reminding all providers that it is unacceptable for advanced care plans with or without DNAR notices to be applied to groups of people of any description. I am pleased that they did it. I am particularly pleased that the Department of Health and Social Care— I understand that the Minister herself was responsible—asked the CQC to investigate these reports and to review how DNAR orders were used during the pandemic. I will come to its findings in a moment.

I want to make it clear that DNACPR orders are an appropriate part of our health and care system and can be a right and proper part of an individual’s care plan. We need to distinguish between what might be called beneficial and futile uses of CPR. An obvious example of beneficial CPR is for young people with neuro-degenerative conditions. Respiratory arrest is common for these patients, but with CPR they have an almost 100% survival rate. For them, it is essential and necessary. If a patient’s other vital organs are shutting down—if they are dying—CPR can do little.

[Jim Shannon (Strangford) (DUP)]

The hon. Gentleman and I share a very common cause, and I appreciate him bringing this debate forward. Does he not agree that for families such as mine who, last year, lost a loved one—my mother-in-law—we would like to believe that any and every measure was taken to save life. The stories that we have heard and that he has referred to are certainly heartbreaking. I very much share his concern.

NHS Pay

Jim Shannon Excerpts

Wednesday 24th March 2021 Westminster Hall

[Paula Barker (Liverpool, Wavertree) (Lab)]

I beg to move,

That this House has considered NHS pay.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring this debate. I am pleased to have been allocated such a generous amount of time for the debate. That is entirely justified given the importance of the subject at hand—NHS pay.

I thank all those who have taken the time to sign the following petitions: e-petition 300073, signed by more than 170,000 people and titled “Increase pay for NHS healthcare workers and recognise their work”; e-petition 316307, titled “Award all Nursing Staff in the NHS a pay rise of 10% backdated to 1 April 2020” and signed by more than 140,000 people; and e-petition 560253, which is titled “Recognise all members of NHS nursing profession by giving them a 12.5% pay rise”, has been signed by more than 19,000 people and does not close until 7 June.

[Jim Shannon (Strangford) (DUP)]

I sought before the debate the hon. Lady’s permission and your permission, Mr Hosie, to intervene. The petitions before us are an indication of the numbers of people across the whole United Kingdom who feel strongly about this issue. The people emailing me are not just NHS workers. They are families; they are people who have been recipients of the goodness of NHS workers. I believe that there is a moral obligation on us—I have said this to Government as well—to deliver a satisfactory pay increase for nurses. We need to give them a rose of appreciation in the springtime, not a dandelion.

[Paula Barker]

I completely concur with what the hon. Gentleman has said.

The figures that I have given lay bare the strength of feeling that people in our communities have for our incredible NHS staff as a whole. People who know me and have listened to any of my previous contributions on the public sector will know that I like to set the historical context, that context being the last decade and the political decisions taken by the Conservative party in office during that time, especially on matters of public spending and public sector pay—matters that are very close to my heart. During debates such as this, the Government may like to pretend that the pre-pandemic world does not exist. According to them, decisions that they take during the current economic crisis should be taken in the context of spiralling debt and deficits, as well as the looming prospect of inflation. But we have been here before, have we not, especially given that the last economic crisis was not too long ago? The Government are starting to sound like a broken record stuck on repeat, using the same smokescreens that they used in the early part of the last decade, which laid the pretext for an outright assault on public sector pay.

Public sector workers, and not least the brave women and men who staff our national health service, have long memories. What is it that I am referring to that existed at the front and centre of the NHS worker psyche going into this pandemic? It is the fact that nurses’ pay is down £840 in real terms since 2010. Further to that, the likes of the Health Foundation have stated that at the start of the pandemic, NHS wages were £600 lower per employee in real terms than in 2011-12. It is the fact that staff morale is at rock bottom, with many leaving certain NHS professions and the Government failing most spectacularly to fill the gap in staff shortages—nearly 50,000 combined vacancies exist across doctor and nursing professions. It is the fact that workers have had to endure rising demands on their work with less reward.

That is what NHS workers, who make up 4% of our entire labour market staff, have had to suck up since 2010 in order to pay for an economic crisis—a crisis in the casino economy that they had no part in creating. According to research delivered by London Economics for NHS trade unions, pay levels at every single Agenda for Change spine point have lagged behind inflation since 2010-11, resulting in a significant decline in total pay in real terms. Most spine points have exhibited a decline in excess of 10%, and total pay on the Agenda for Change spine point with the highest incidence of staff, at the top of band five, has declined by 15%. That is three times the decline in median earnings experienced by full-time private sector employees across the UK over the same timeframe.

Let all of us here today contextualise the debate by reflecting on the picture faced by our brilliant NHS staff before and going into the pandemic. They have had their pay cut, their spending power slashed, their living standards squeezed, and their morale smashed. That is the so-called old world that the new kids on the block—the Prime Minister and the Chancellor—would rather us all forget, one built by their predecessors. However, no amount of rebranding will disguise the fact that the current Government intend to continue the same legacy of making public sector workers pick up the tab for a crisis they had no part in creating. Indeed, this time it is even worse than that. They are paying for a crisis that they have ensured we have, and will, overcome. Some thanks, I say, and shame on this Government.

In this new decade, the message being received by NHS workers from the Government is this: brace yourself for more of the same. Staff in our NHS have had to endure all of that, and then 12 months ago were asked to once again go above and beyond, to gravely enter the unknown, risking their mental and physical health. They have sacrificed their family and personal lives. Some have paid the ultimate sacrifice of their own lives in the line of service, duty and compassion.

Let us cast our minds back to how terrifying the news headlines, the newspaper stories and social media chatter were when the virus first emerged on these shores. The virus was the absolutely terrifying unknown for all our people, except for our NHS workers who were not afforded the luxury of watching this public health crisis unfold from the sidelines as passive observers; they were the frontline against the great unknown.

To this day, their unrelenting commitment to the public service still moves me, as it should all people here today in Westminster Hall. I am not one to often quote Winston Churchill, or indeed make wartime references, but never was so much owed by so many to so few. If any of this brave few were able to come up for breath for just a moment, maybe because of their shift patterns, and sit in front of a TV screen on a Thursday evening last year, they would have seen many ordinary folk applauding their efforts. They would also have witnessed the galling sight of the occupiers of No.10 and No.11 clapping for the photo op, with little intention of rewarding them for their work, their sacrifice or their trauma.

Appreciation of NHS workers is not about rhetoric, warm words and pats on the head. Let me be absolutely clear. Claps and smiles do not pay the bills. It is about deeds and actions, and when it comes to NHS pay, the only deeds and actions made by the Government have been a fresh round of insulting pay offers, or, in real terms, pay cuts.

The Prime Minister recently told the House of Commons that the Government have delivered a 12.8% increase in the starting salary of nurses. It may well be true to say that some—but not all—nurses have received a pay rise of more than 12% since 2017-18. However, that is in cash terms, not in real terms, and it does not account for the fact that inflation erodes the spending power of workers’ wages over time. It is a flattering figure in other ways: it applies only to one group of nurses rather than reflecting the experiences of all NHS workers in England, and it does not take into account the years of austerity that defined the years prior to 2017-18. The Government cannot spin an assertion that they are awarding pay rises when millions of NHS workers know the exact opposite is true.

All we ever hear from the penny-pinchers that occupy the Government Benches is that we cannot afford this or that—basically, anything of social value or any moral good. The old mantra that public sector equals bad and private sector equals good is making a return. This tired politics draws the economic orthodoxy to the conclusion that suppressing public sector pay is of economic benefit in times of crisis, rather than the opportunity to grow the economy that it represents. It is almost as if a decision has been taken according to the same logic that public wages are a drain on the public purse and therefore a resource to be tapped into in order to control public finances when it suits.

It is sound economics to deliver a just and fair pay rise for NHS staff and a decent pay rise is affordable. Currently, just over 1 million nurses, midwives, allied health professionals and NHS support staff are covered by the Agenda for Change pay framework in England. The same aforementioned research conducted by London Economics concluded that a 10% increase to the NHS England pay bill amounting to £3.4 billion would result in the net expenditure of only £0.66 billion when including factors that are offset against the original figure.

Such offsets include increased tax receipts, because public sector workers pay taxes, and increases in direct, indirect and induced tax receipts, because public sector workers spend money in their local areas that helps to grow local economies and support communities. A pro-public sector agenda is a pro-business agenda. It is a miracle that public and private sector workers exhibit similar economic behaviours—who knew?

There would also be savings in recruitment and retention, because better paid staff are happier staff. There is even an extra £130 million in savings from the lower student debt write-offs for nursing students. This is the sort of sensible, moral and longer-term economic thinking the Government are totally incapable of. Instead, we have crumbs for midwives and support staff; their dignity, livelihoods and take-home pay is unaffordable, according to this Government, but not lucrative, publicly funded contracts for the friends of Tory Ministers to deliver personal protective equipment shortages and botched public health projects to the tune of billions of pounds. Apparently, that sort of spending is every bit affordable: in fact, we are told, it should be celebrated. Not only do we have a Government guilty of cronyism, but of skewed priorities. We see that only too well today when not a single Conservative Member apart from the Minister is here for this debate.

Government policy on the NHS tells us everything that we need to know. Nurses, midwives and support staff are left neglected, their immense contributions disregarded, forgotten by a Government and party intent on reverting to type. There is no policy impact assessment, as the real burden for public sector pay restraint will once again fall on the shoulders of women who make up so much of the public sector, especially our NHS. There is no regional impact assessment on areas more reliant on public sector spending, such as my city of Liverpool—so much for the levelling-up agenda.

To round up, the public overwhelmingly support a pay rise for NHS staff because they, like me, understand and appreciate their service each and every day; in times long before covid, during it and long after. They are out on the frontline, as I speak here today, delivering vaccine shots in the arms of millions of people, as well as catching up on the huge backlog of urgent elective care procedures while the Government parade around this place telling us that the economics will not permit just recognition and reward. If any group of workers in our National Health Service collectively decide that enough is enough and they embark on a course of industrial action, they will have unwavering solidarity. I appeal to the Government to change their course, walk the walk on NHS pay and give the NHS staff the pay rise that they so deeply deserve.