Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mr Speaker]

We are well over time, but I do not want the hon. Member for Strangford (Jim Shannon) to feel isolated or excluded. Let us hear it.

[Jim Shannon (Strangford) (DUP)]

Child suicide calls to Childline are at a record high among girls—it is at 68%. Despite that, the NHS spends only 11% of its budget on mental health issues. Will the Minister indicate what he is going to do to prevent child suicides?

[Mr Hunt]

We are very focused on reducing all suicides. As the hon. Gentleman will know, we have a plan to reduce suicide rates by 10%, and last week we announced a plan to reduce in-patient suicides to zero, which is a big aspiration to which the NHS in England is certainly committed. We are very committed to this agenda.

Neuroblastoma

Jim Shannon Excerpts

Tuesday 23rd January 2018 Commons Chamber

[Kwasi Kwarteng (Spelthorne) (Con)]

I am honoured to be called to speak in this Adjournment debate. It is a great honour, as a Member of Parliament, to be able to make representations in this House on local cases, and this particular case is something I have been very much affected by. I have met the parents of the young boy concerned, and I would be grateful if the House allowed me to explain the nature of the case I am here to plead this evening. I wanted to hold this debate on funding for the treatment of children who are diagnosed with neuroblastoma, a specific form of childhood cancer. It is very debilitating, arises in immature nerve cells and is the third most common type of childhood cancer, affecting about 100 children every year in Britain.

Members may be familiar with the case of Bradley Lowery, a young boy from Sunderland who struck up a friendship with the England footballer, Jermain Defoe, after appearing as a Sunderland mascot. Bradley suffered from neuroblastoma and his cheerfulness and great courage touched the hearts of so many people. Very sadly, Bradley passed away last year. He was only six years old, but in his short life he touched the hearts of millions.

It can be very difficult to spot the early symptoms of neuroblastoma, as they can be vague and mistaken for other childhood conditions. There are options to deal with the illness, but the case I briefly want to describe involves a young boy, Alfie Ward, who is now 15, and who lives in my constituency in Ashford. He is now battling this disease for the third time. The problem we have is that the NHS, under its current dispensation and policy, funds treatment only in the first instance. However, as Alfie started nursery, having battled the disease and survived this appalling affliction, it became apparent that it had come back.

At this point, I want to make the case for the NHS to review its policy on not funding relapses. As I understand it, about half the people who suffer from this appalling illness relapse, if they recover. It seems very harsh to adopt a policy whereby people can be funded the first time that they are affected by the illness, but not for subsequent relapses. In Alfie’s case, he has been denied treatment. As I said, this is the third time that he has had the illness. Now he, his family and his parents are under the extreme pressure of having to raise something like £600,000 so that he can get treatment.

In wrapping up my remarks, I want to say that £600,000 is a huge amount of money. It is to their eternal credit that Alfie’s parents, who I have met—

[Jim Shannon (Strangford) (DUP)]

rose—

[Kwasi Kwarteng]

I am happy to give way to the hon. Gentleman.

[Jim Shannon]

I could not let the debate go by without commenting on a young gentleman in Northern Ireland. Some things in Northern Ireland cross the barricade, and one of those was the touching story of young Oscar Knox, whose battle with neuroblastoma touched people from every part of the Province and in whose memory I stand in this House today. Does the hon. Gentleman agree that we must do more to fund the treatment of this cancer in the United Kingdom of Great Britain and Northern Ireland, instead of parents having to try to raise money to help their children? We must look towards more treatment options as well. Does he agree with that? I know the answer.

[Kwasi Kwarteng]

I am delighted that the hon. Gentleman has made representations from his part of the country. People face this problem across the country. It is not widely known, because the absolute numbers are not great, but the suffering is severe. We absolutely have to try to think of a way to reach an accommodation on funding, because £600,000 is a huge amount to raise.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

I congratulate my hon. Friend and parliamentary office neighbour, the Member for Spelthorne (Kwasi Kwarteng), on securing this debate on such an important issue.

It is a privilege to be cancer Minister—I hear some of the worst and some of the best. We know that cancer is a disease that will affect most of us, either directly or indirectly, at some point. I suspect it will affect everybody in the House tonight. That is particularly true, and somewhat inevitable, as the population ages, but it is especially heartbreaking, is it not, when cancer afflicts children and teenagers, as it has his constituent Alfie? I have young children myself, and I cannot help but think about that.

Neuroblastoma is an uncommon cancer—there are about 95 cases in the whole of the UK each year—but it has one of the lowest survival rates of all the childhood cancers, and that is why raising awareness of it is vital and why I thank my hon. Friend for bringing it to the attention of the House. As he says, it is always a privilege to speak here and to raise issues on behalf of constituents.

I will come in a minute to how we are prioritising investment, which is so important, in research and improving access to drugs for cancer, particularly those that are less survivable. First I would like to pay tribute to the Bradley Lowery Foundation—my hon. Friend mentioned Bradley—which is providing fantastic support to Alfie’s family, for which I thank it. As a football fan myself—okay, I am a Spurs fan—I saw several times how Bradley’s smile lit up many football grounds, including his own in Sunderland, before he sadly lost his own battle against neuroblastoma, as my hon. Friend said. His legacy is the tremendous awareness of this rare cancer that he raised in his short life. He encouraged a huge amount of fundraising for treatment and research that will help so many children. I often think, whether we live for 100 years or 100 minutes, we all in some way change the world we are born into, and that is certainly true of Bradley’s life.

In England, we want something that is very difficult but quite simple to convey: we want to have access to the best cancer services in the world, especially for children and young people who have to face this disease so early in their lives. That is why the Government—this Prime Minister, the previous Prime Minister, the Secretary of State and I—have prioritised cancer services. Since 2010, we have seen year-on-year increases in the number of people surviving. At the end of last year, this country had its best survival figures ever, which is of course something to be pleased about, but just one person who is battling cancer will not feel like that.

We know that there is a huge amount more to be done. NHS England is leading the health and care system in implementing every one of the 96 cancer strategy’s recommendations with the aim of achieving our ambition to save a further 30,000 lives a year by 2020—although if we can do more, we should. NHS England has committed some £600 million to support the delivery of the strategy. No one will hear me speak about cancer without mentioning early diagnosis, which is the most crucial factor that we know of in successfully treating neuroblastoma or any other cancer.

In 2016, some £200 million was made available to the new cancer alliances, challenging them to encourage innovative ways in which to diagnose cancer earlier and to improve the care for those living with cancer. That is so important. Members will have seen the television campaign by Cancer Research UK, which includes the words “A mum with cancer is still a mum.” Many people are battling cancer, but they are still living their lives. It is always important to say that. The funds are also intended to ensure that all cancer patients receive the care that is right for them, and we are rolling out one-stop shops throughout the country. We have invested some £130 million in upgrading and replacing radiotherapy equipment, to ensure that patients have the best and latest equipment regardless of where they live.

Cancer services for children and young people, including the treatment of neuroblastoma, are specially commissioned by NHS England. Neuroblastoma is often treated with radiotherapy. In 2013, a £23 million fund was used to improve access to intensity modulated radiotherapy, a precise form of radiotherapy that can be directed more accurately at cancers and allows a higher dose of radio- therapy to be given with, hopefully, fewer side effects. That is particularly important to very young children, who may have weaker immune systems and who are less resilient to more invasive treatments.

[Jim Shannon]

I thank the Minister for his endeavours. It is always a pleasure to listen to his response to any constituency issue. In England, responsibility clearly lies with him, but is there any possibility of discussions with the regional Governments with a view to joint working, whatever their role might be? I think of young Oscar Knox in Northern Ireland, and that is really my reason for making the suggestion.

[Steve Brine]

I am glad that the hon. Gentleman is here. He raised the same point last week during the Westminster Hall debate on blood cancers, to which I responded. As he had to leave before I did so, I will repeat what I said then. Obviously, once devolved government returns to Stormont and there is a Health Minister in the Northern Ireland Executive, I shall be happy to meet him or her, and I am sure that the hon. Gentleman would like to be involved in that meeting. We shall then be able to talk about some of the successes that we have had in England and some of the things that I am sure we can learn from Northern Ireland.

An even more precise form of radiotherapy that can be used in neuroblastoma treatment is proton beam therapy. It sounds like something out of the future, and in many ways it is, but the future is coming. In 2012, the Government provided some £250 million for the building of two PBT centres in England, at University College Hospital here in the capital and at the Christie cancer centre in Manchester. I had the privilege of visiting the Christie last year—I happened to be there in the autumn, for some reason—to see its new PBT facilities, which are incredible and which will be providing treatment for patients later this year. As a result, the NHS will no longer need to send young patients to the United States—which has caused great upheaval to patients and their families, has had an impact on patient outcomes and has, of course, involved huge expense to the families and the NHS—for this cutting-edge treatment.

My hon. Friend the Member for Spelthorne spoke about guidance from the National Institute for Health and Clinical Excellence. We want the very best new innovative treatments, such as the promising antibody therapy we have heard about today, to be available on the NHS. NICE is the independent body that provides guidance on whether drugs and other treatments represent a clinically effective and cost-effective use of resources in the NHS—a publicly funded health system. I am advised that NICE is currently considering two antibody-based treatments for neuroblastoma. It is appraising Dinutuximab-beta for use in high-risk neuroblastoma, but the appraisal has been delayed as NICE awaits additional evidence from the drug company. Final guidance on the use of any drug can be issued only after careful consideration of all the available evidence and extensive engagement with stakeholders. That has to be the right approach, however frustrating it is. Another drug used in the treatment of high-risk neuroblastoma is dinutuximab or Unituxin. NICE’S appraisal of this drug, which is in the same family as Dinutuximab-beta but is distinctly different, has also been suspended as demand for the drug in the United States has exceeded expectations and is outstripping the company’s ability to meet global need.

I stress that just because drugs are not routinely available to patients on the NHS that does not preclude their use. Clinicians can make a case on a patient’s behalf for exceptional funding if they believe a particular treatment would deliver the best clinical outcomes. I understand that Alfie’s consultant is looking at doing that. Individual funding requests made by a supporting clinician are always a potential route for access to treatments that are not currently commissioned by the NHS. NHS England is not aware of any IFR in Alfie’s case, but I will be happy to make it so, working with my hon. Friend, following tonight’s debate.

Despite the strides we have made in increasing overall cancer survival rates, we recognise that there are some cancers where progress has been far too slow. That is why our focus for these cancers is on research and innovation, and ensuring that proven innovations, once they are discovered, are adopted swiftly across the health service in England. I am pleased to say that the Government are fully supportive of the Less Survivable Cancers Taskforce, which I launched last summer here in the House, specifically to address the survivability gap between the least and the most survivable cancers. I met the taskforce just before Christmas to discuss how we can work together to raise awareness of the symptoms of cancer and how we can ensure that less survivable cancers have better access to research funding. That is a promising workstream. The taskforce is a cutting-edge group and I look forward to working with it.

Cancer Research UK is also funding research to better understand childhood cancers such as neuroblastoma. In September 2016, the Government announced the largest ever investment in health research infrastructure—£816 million over five years from April 2017 for 20 National Institute for Health Research biomedical research centres in England. That was a big step, and I am sure hon. Members recall the Prime Minister’s announcement. That includes £61.5 million in the biomedical research centre at the Royal Marsden Hospital here in London and the Institute of Cancer Research. The NIHR spent £137 million on cancer research in 2016-17—an increase from just over £100 million in 2010-11. That investment in cancer research is of huge importance and constitutes the largest in a disease area.

NHS Blood Cancer Care

Jim Shannon Excerpts

Wednesday 17th January 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Crawley (Henry Smith) on securing this debate and on the hard work that he has done to promote this issue in the House and further afield. I am happy to be a member of the APPG along with others in this Chamber today and to support him in the role that he plays.

As the Democratic Unionist party spokesperson for health, I felt it necessary to make a contribution, even though the onus of where we are is probably England-based. We need to highlight some issues with regard to the NHS and blood cancer care. My father, who is dead and gone almost three years, had cancer—not blood cancer—on three occasions, but he survived those three occasions owing to the skill of the surgeon’s knife, the care of the nurses and the prayers of God’s people. Clearly, we have made great advances—some magnificent advances—in cancer care over the past few years.

May I say to the Minister, the shadow Minister and the proposer of the debate that I, along with others, have a meeting with the Prime Minister at half past three, so I need to get away for that occasion?

I was delighted to receive information on blood cancer and I take this opportunity to thank all of those who are working so hard to highlight the issue and bring about change, and who supply such enlightening and helpful information. There are almost 250,000 people living with blood cancer in the UK today. Although many forms of blood cancer are rare, as a group blood cancer is Britain’s fifth most common cancer and third biggest cancer killer, claiming more lives each year than breast or prostate cancer. Those figures surprised me. We are all grateful for the advertising that highlights breast and prostate cancer, which affects us men. Unfortunately, we are probably loth to see the doctor, but the Minister’s Department encourages us to be more active and forthcoming about the problems that we have. Advertising keeps these things fresh in our minds and educates us as to the symptoms to be aware of, but the fact is that blood cancer kills more people and we need to be mindful of that when finding additional funding. The Minister always responds in a positive fashion to the debates in Westminster Hall and tries to help.

Northern Ireland has an average of 123 cases of leukaemia diagnosed annually. That may not seem much, but when we take into account the small size of Northern Ireland it is clearly something that is taking its toll. It is also clear that the aftercare of those cases is essential. Although we are discussing NHS England, there is a need for devolved bodies to work together to ensure that we do not have a UK postcode lottery for the treatment of blood cancers and that an equal level of treatment is available UK-wide. Can the Minister outline whether he has had any co-operation with the Department of Health in Northern Ireland? If not, is he willing to undertake to do that?

[Mr Gregory Campbell]

On the issue of co-operation, does my hon. Friend agree with me that the excellent news of the opening in the past year of the North West Cancer Centre in Londonderry, which offers opportunities and the skills of many in the nursing profession both in Northern Ireland and in the Irish Republic, is a perfect example of that co-operation and is widely welcomed in the community? Does he agree that that is an exceptionally good development?

[Jim Shannon]

My hon. Friend has mentioned a supreme example. That is something that we all welcome in Northern Ireland, and indeed across the whole of the United Kingdom of Great Britain and Northern Ireland.

I have been contacted by Myeloma UK, which asked me to highlight its cause and needs. I am happy to do so in Westminster Hall and for the Hansard record. Some 5,500 new cases of myeloma are diagnosed in the UK every year, which equates to 15 people a day. Although myeloma is a rare cancer, it is the second most prevalent blood cancer, which has no cure as such. It is important to highlight that in Westminster Hall today and with the Minister.

In the past 10 years, with improvements in treatment and care, survival rates are increasing faster than in most other cancers, so there is some good progress, but there is a long way to go. Myeloma remains a very challenging cancer to live with and to treat. To truly get to grips with that cancer means dedicating funding to finding the cure, but also providing a quality of life for those who suffer from it.

In our debates on cancer the one thing that always comes up is early diagnosis. Whether it is prostate cancer, breast cancer, myeloma or bowel cancer, getting it early is the secret. I mentioned us menfolk earlier and how we respond to things. Maybe we need to be a bit more eager to tell our doctor when things are wrong with us. I commend the many charities and groups such as Marie Curie and Macmillan. Along with those charities we also have many church groups and organisations that help and give succour and support to families at a time when one of their loved ones is very ill.

Another issue is that of the 100-day care by NHS England after treatment, which must be reconsidered to ensure that there are no gaps in service, as has been highlighted by the Anthony Nolan trust. The Minister is nodding; I know that he and others in this Chamber are aware of that. The briefing that was provided made it clear that the steps taken by the Government have been welcome, and yet more leeway is needed to allow complete care packages to be in place. If that means going over the magic number of 100 days, there needs to be a mechanism that allows that to take place. Will the Minister fully consider that request—I know he will—and provide a detailed response outlining his decision as to whether the extension of care before transfer to local CCGs can be achieved?

I believe we can make decisions in this place, in this House, in Westminster Hall, in the House of Commons and across the whole of the United Kingdom of Great Britain and Northern Ireland that will allow blood cancer sufferers to have a better prognosis and a better treatment plan. We must do all that we can to bring that about.

Patient Transport Services: Northern Lincolnshire

Jim Shannon Excerpts

Tuesday 16th January 2018 Commons Chamber

[Andrew Percy]

Absolutely. As my hon. Friend has highlighted again in this debate, we are not talking about one or two cases: Members of Parliament across our area have multiple cases. I want to highlight another one. Another constituent of mine, this time from Burton-upon-Stather, has to attend Castle Hill Hospital for chemotherapy every single day. His experience is of ambulances frequently being late, of other patients missing their appointments and of late collection for following treatment. As he has pointed out, receiving chemotherapy means that he is already very ill and weakened, but not just once but regularly he has had to wait up to three hours for an ambulance to collect him. He has also had issues with the booking system and trying to get a place at all.

My final example is of another constituent living just outside Burton-upon-Stather: 82 years old, suffering from Alzheimer’s, in a wheelchair and with very poor mobility, he is totally dependent on the assistance of others to get to and from hospital. Again, his experience is of frequently waiting for the service to collect him from Scunthorpe Hospital. Not so long ago, during snowy, freezing weather, he was left for over three hours in a hospital doorway, waiting for a lift. In the end, hospital staff intervened and brought him inside to warm up, but yet again the experience of the complaints process was that Thames Ambulance Service was wholly unresponsive in dealing with complaints.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing this debate. The consensus in the Chamber is clear. The current format has people waiting at home for transport to hospital—for a scan or other procedure—and then having it cancelled. Does he agree that it is not just about cancelled operations and appointments or wasted slots, but about the financial impact on the service and on the patients, who then have to go to the back of the queue, and about the trauma they go through as a result?

[Andrew Percy]

It has a whole knock-on effect, whether it be individuals having to find their own transport, missed appointments or rescheduled appointments—it is all incredibly expensive—and it is not just patients who have these terrible experiences, of course; it is also the drivers. I have had whistleblowers from the service contact my office. One said they come on duty at 12 o’clock and are expected at the same time to be at Castle Hill Hospital in Hull with patients. They have described themselves as being at their wits’ end and thoroughly stressed. One contacted me recently about a 100-year-old lady who had to wait three and a half hours to get home.

Junk Food Advertising and Childhood Obesity

Jim Shannon Excerpts

Tuesday 16th January 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate, Ms Dorries. I congratulate the hon. Member for Erewash (Maggie Throup) on setting the scene so very well and giving us the chance to participate.

As a type 2 diabetic, I have had to learn to have a new lifestyle. I used to have a takeaway almost every night, and two bottles of coke on top. Add stress to that, and all of a sudden I was 17 stone. I am pleased that I am now keeping my weight down to about 13 stone. What is important to say is that I knew there was something wrong but did not realise what. If only I had known that the symptoms were diabetes-related. When I was diagnosed some 11 years ago, food management was important but it would have been more important 10 or 15 years before that, when my lifestyle was grossly affecting my health. I say that as an adult who does not want his grandchildren, Katie and Mia, to be in the same position, with a preventable life-changing illness.

I commend my hon. Friend the Member for East Londonderry (Mr Campbell) for his Westminster Hall debate on childhood obesity way back in November 2011. Even at that stage changes were afoot. I suppose the question today, six years later is: have they made a difference? I want to give some Northern Ireland stats. The Northern Ireland Department of Health’s “Health Survey (NI): First Results 2016/17” highlighted something that was not so much a shock as a disappointment: about 75% of children aged two to 15 were classed as either normal weight or underweight. That is interesting. At the same time, 17% were classed as overweight and 8% as obese. Over the last decade, the proportions of children classed as overweight or obese have remained at similar levels. Although some might consider that a victory, I would say it is a disappointment, because we should be trying to lower the figures. To have 8% of children classified as obese does not bode well for the ticking time bomb of diabetes. More clearly needs to be done.

I will give some detail about what we are doing back home to show why it is important to be on top of the matter. I recently met constituents who were part of a pilot programme that used social media and games to address healthy eating with children and parents. There has been discussion of funding for permanent schemes since the successful pilot but, as usual, funding is hard to source. Before I left the hotel this morning, I saw on TV children exercising in a school—in London, I think—with Gabby Logan as part of the backroom team. The children did not seem to be doing a lot of exercise, but it was enough to make a difference at that age. There are a number of schemes across the United Kingdom of Great Britain and Northern Ireland, and we, in this place, must determine to have schemes like that one back home, setting aside funding to train children, and also to re-train their parents.

Schools in Northern Ireland have attempted to bite the bullet, as it were—if I may use a pun for us in Northern Ireland—with schemes that allow children to come in early and have their breakfast at a subsidised cost. They have also altered school meals so that they are healthier options and have implemented school rules under which only water and fruit are allowed at break-times. We have a scheme in Northern Ireland—my hon. Friend can probably confirm this—whereby up to 100,000 portions go out to schools. That might not seem a terrible lot, but it is when compared with the population and the number of children we have.

I congratulate the schools on attempting to do everything in their power, but the fact remains that something must be done to help parents understand how their choices affect children. If children are eating healthily—eating their wee bit of fruit—it is terrible if mum and dad, and I say this with respect, are tucking into pizza, chips and a bottle of coke. They must set an example in the home; it is not for the children alone to eat healthily. If children are asked whether they prefer a chocolate bar or a piece of fruit, the vast majority opt for the unhealthy snack. That is fine in moderation, but the fact is that people do not give their children snacks in moderation, and we need to help to change that.

The so-called sugar tax has undoubtedly helped. I welcome what the Government have done and I supported the legislation as it went through Parliament but, as was mentioned in an intervention and as I have stated before, we need to address fat and salt as well. Some of my colleagues, friends and others in the House might say that the nanny state is not what we want, but I very much believe that we sometimes need it to enforce what is best for people. Chocolate bars are made smaller to keep the prices down, which is great, as the bars obviously contain fewer calories. We have implemented packaging requirements that ensure that products clearly show how much fat and calories are in them, and that is great as well. Well done to Tesco for allowing children to eat a piece of fruit as their mothers shop, but are three-for-two offers on junk food wise when someone sets out to buy only one but wants a bargain? Yes McDonald’s is fine as a treat, and well done to the company for allowing healthier options in “happy meals”, but it is not great if people have them on a regular basis.

It all comes back to the message: all things in moderation. All those initiatives are great, but they are not doing the job quickly enough. Under the smoking initiative, we have greatly monitored and lessened the amount and form of advertising, and that needs to be done for junk food with equal pursuit, zeal and enthusiasm. I am happy to swallow the accusation of a nanny state if it means that my grandchildren and other children are healthy, happy and content with their fruit at school and with their wholemeal bread and balanced diet, along with the occasional treat. We should not deprive them of their treats, but we must ensure that treats are not an everyday occurrence.

A better way of handling advertising would help parents to teach their children balance without the children feeling hard done by, or different from what they see on TV. We must do all we can—I must do all I can—for the future of our children and grandchildren in the hope that the lessons will also impact on how adults eat and live their lives. The nation as a whole will benefit. I look to the Minister for the comprehensive response we always get from him. I have already apologised to you, Mrs Dorries, the Minister and the shadow Minister, but I have to leave for a meeting with a Minister.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 19th December 2017 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend highlights one of the biggest challenges we face. There is no doubt that the rate of organ donation is much lower among black and minority ethnic populations, and yet they are more likely to suffer from diseases that require a donated organ, so we are keen to work on that. Only this week, I met organisations connected with the black and Asian community to discuss how we can communicate, getting the right messages through the right messengers, to encourage people to join the register.

[Jim Shannon (Strangford) (DUP)]

I fully support the organ donation opt-out, because it will increase the pool of organ donors. Will the Minister comment on whether the recent statistics from the Welsh Health Department show an increase in the provision of organs due to presumed consent? In other words, has it been a success so far?

[Jackie Doyle-Price]

I thank the hon. Gentleman for his support. The figures from Wales come at an early stage, but the system that we are looking to introduce has much in common with that in Spain. The issue is not so much about the register moving towards an opt-out system, but the wraparound care that goes with it, such as the specialist nurses who speak with relatives when they are going through the trauma of losing a loved one, and the public debate that raises awareness. Taken together, they are what will lead to more organs becoming available.

Mental Health Provision: Children and Young People

Jim Shannon Excerpts

Tuesday 12th December 2017 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing such an important issue to the House at this time of the day. Taking into account reports that mental health problems affect about one in 10 children and young people and that 70% of children and young people who experience a mental health problem have not had appropriate interventions at a sufficiently early stage, does she agree that it is time not for words but for action that would see the Health Department and the Department for Education working cohesively to address the issue she has put forward?

[Luciana Berger]

The hon. Gentleman makes a really important point about co-ordination between various Departments to ultimately effect change and support young people across the country, and that is what I and so many others are really looking forward to. However, I am going to set out in the rest of my remarks why I think the opportunity has been missed.

We have seen programmes such as Channel 4’s “Kids in Crisis”, which have brought many of the issues I have set out to a broader audience. That has included the scandal of too many young people having to travel hundreds of miles from their homes to receive treatment and support—and that is if they get in at all.

We know that the younger generation, coming into adulthood, are prone to a range of mental health conditions: depression, anxiety, eating disorders, self-harm, suicidal thoughts, phobias and other challenges. Those destroy confidence, blight education, training and employment opportunities, alienate young people from society, and, in some cases, drive families to tearful despair.

There is a social justice aspect to this too. Children from the poorest fifth of households in our country are four times more likely to have a mental health difficulty than those from the wealthiest fifth. Health inequalities in our country persist as strongly in mental health as in physical health.

Stroke Services

Jim Shannon Excerpts

Tuesday 5th December 2017 Commons Chamber

[Sir David Amess]

I very much welcome that news. I think that the two of us will look forward to meeting the Stroke Association and working with it to enhance the already excellent facilities at Southend Hospital.

The costs of stroke to the NHS and social care are about £1.7 billion a year, which is a huge amount. If I may be biased for a moment, let me say to the Minister that since 2013, the Government whom I support have contributed to significant advances in the treatment of stroke victims all over the country. The percentage of patients scanned within one hour of arrival in hospital has risen from 42% in 2013 to 51% last year, and the figure for those scanned within 12 hours has increased from 85% to 94%. I think the whole House will welcome that improvement, and I am grateful to Members on both sides of the House who are in the Chamber to listen to this Adjournment debate. I hope that their constituents will recognise the fact that they have stayed here.

[Jim Shannon (Strangford) (DUP)]

I sought the hon. Gentleman’s permission to intervene before this debate, Madam Deputy Speaker.

Right across the UK there are many problems in relation to stroke services. Some 4,000 people in Northern Ireland have had a stroke in the past year, and 36,000 people in Northern Ireland are living with the effects of a stroke. What consideration has the hon. Gentleman given to people having a normal life after stroke through the provision of rehabilitation, and of occupational and cognitive therapies, and through the way in which the NHS handles aftercare, especially for the growing number of younger people who have strokes? This is not just about people in their 70s; it is sometimes about those in their 30s, 40s and 50s.

[Sir David Amess]

If I did not know better, I would have assumed that the hon. Gentleman had read my speech, because I was just about to say that in the past three years there has been a rise in compliance with standards for physiotherapy from 53% to 79%, and from 24% to 47% for speech and language therapy. I know that similar progress has been made in Scotland. With all that in mind, it is essential that the NHS continues to lead from the front. We must utilise some of the newest technologies to improve the effectiveness of stroke treatment, to allow patients to live fuller lives, and to decrease the burden of ill health after someone has suffered a stroke.

Two out of three stroke survivors currently leave hospital with a long-term disability at a cost of £1.7 billion, as I said. The provision of healthcare to people who have had a stroke accounts for approximately 3% to 5% of all healthcare expenditure, which is a vast amount. The cost of stroke treatment will rise to £43 billion in 2025 and £75 billion in 2035. If I remember rightly, I think the husband of the hon. Member for North Down (Lady Hermon) suffered strokes during his illness.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

What a pleasure it is to see you, Madam Deputy Speaker; it has been a while. I knew that my hon. Friend the Member for Southend West (Sir David Amess) would get in a mention of Southend becoming a city. I was only disappointed that it did not happen earlier in his speech, but he managed it in the very last line. I will show great diplomacy and leave that matter to the Ministers responsible. I congratulate him on securing another Adjournment debate—we have done this before—which is on stroke services this time. As ever, he set out his case brilliantly and with such passion. He gives newer parliamentarians a real lesson in how to handle debates in this House.

As my hon. Friend said and as so many of us know, stroke is a devastating disease for patients and their families. He is right that there are currently 1.2 million stroke survivors in the UK, with more than 1,350 in my hon. Friend’s constituency alone. The hon. Member for Strangford (Jim Shannon), who is in his place as always at these debates, is absolutely right that stroke is predominantly a condition that affects older people. But it does affect younger people. I have met people of my age and younger who have been affected by stroke. Obviously, it is clinically debilitating, but it also comes as a great shock to their friends and families, who are taken aback by this happening to young people.

So many NHS staff work in multidisciplinary teams on stroke, and I pay tribute to them. There are nurses, consultants and speech and language therapists—the speechies, one of whom I am married to, so I will get brownie points for this—as well as physios, occupational therapists and specialist nurses, who all do so much when somebody suffers a stroke. The Stroke Association, which has already been mentioned, is an absolutely first-rate charity and a real partner for the Government. I also commend my hon. Friend the Member for Southend West for his strong work in driving improvements to stroke services both nationally and within his constituency. I know that he has taken a long interest in health matters, including stroke, as an MP. I reiterate his comments about the high-quality service provided by Southend stroke unit—more on that in a moment.

My hon. Friend will no doubt agree—he said this of course—that, in general, stroke services across the country are performing really well. Let me just reiterate some of the figures. Thirty-day mortality has dropped from 30% in 1998 to just over 13% in 2015-16—a huge improvement. The percentage of patients scanned within one hour of arriving at hospital, which is so critical, has increased from 42% in 2013-14 to over 51% in just three years, and the percentage scanned within 12 hours has increased from 85% to 94% in the same period.

There are many public health campaigns that we remember throughout the years, but the Act FAST campaign that public health campaigners and the Stroke Association have done is something we see and do not forget, and that, of course, was the intention.

Excellent progress has been made in the treatment of stroke over recent years. It is important that this programme continues and that the gains are built on, especially given the demographic changes we know are coming down the track with our much talked off and much publicised obesity challenge and our ageing population. That is why we published the cardiovascular disease outcomes strategy in 2013.

There is ongoing work in virtually all parts of the country to organise acute stroke care to ensure that all stroke patients have access to high-quality specialist care, regardless of where they live or what time of day or week they have their event. Although the national stroke strategy comes to an end shortly, as my hon. Friend said, NHS England continues to lead an effective programme of work on prevention and treatment. We are continuing to work closely together to improve acute treatment through the centralisation of care in centres that can provide the highest level of care and treatment at all times of the day and night.

Decisions on whether the strategy should be renewed are, of course, a matter for NHS England, but in liaison with Ministers. My understanding is that NHS England does not have current plans to renew it in the same form, but it is a subject that I, as the relatively new Minister, encouraged, of course, by my hon. Friend’s debate, plan to discuss with NHS England early in the new year. I would welcome my hon. Friend’s involvement —and that of other Members—if he wishes to feed into that.

[Jim Shannon]

I thank the Minister for his comprehensive response. One thing that is sometimes overlooked is research and development—the work that is done by universities in conjunction with health groups to try to find better ways of caring for people with strokes. Does he have any information on how critical that is to the whole care package that is given to those who have had strokes?

[Steve Brine]

I echo the hon. Gentleman’s sentiment that that work is critical. I mentioned the Act FAST campaign, which was a heavily evidenced public health campaign showing that the quicker we act after the event, the better the outcome, so he is absolutely right to highlight that issue. However, I am conscious of time, so I am going to press on.

My hon. Friend rightly spoke about mechanical thrombectomy, which he called a game-changer, and he is absolutely right. To continue and build on our stroke service success and to address the costs associated with stroke in England, which was one of my hon. Friend’s first asks, it is imperative that we keep identifying and developing innovative treatments and cutting-edge procedures.

In mechanical thrombectomy, or MT as we shall know it, we have an innovation that we believe can significantly improve patient outcomes, and my hon. Friend spoke about that. In April this year, NHS England announced that it will commission mechanical thrombectomy so that it can become more widely available for patients who have certain types of acute ischaemic stroke, which is a severe form of the condition. My understanding is that work by NHS England is now under way to assess the readiness of 24 neuroscience centres across the country. It is expected that the treatment will start to be phased in later this year and early next year, with an estimated 1,000 patients set to benefit across the first year of introduction. Overall, this will benefit an estimated 8,000 stroke patients a year and save millions of pounds in long-term health and social care costs—my hon. Friend was absolutely right to point out the rising costs to NHS England around this condition.

As the clinical director for stroke at NHS England has said, we are committed to fast-tracking new and effective treatments that will deliver long-term benefits for patients. For me, this treatment is just one example of many that we believe have the potential to tangibly improve patient care and to address rising costs.

Maternity Safety Strategy

Jim Shannon Excerpts

Tuesday 28th November 2017 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and personal commitment. It is much appreciated. Will he confirm that part of the safety strategy includes ensuring that midwives on labour wards can take their breaks and rest periods and that midwife staffing levels on labour wards and post-section wards are checked, monitored and increased?

[Mr Hunt]

I agree that that is extremely important. I also extend through the hon. Gentleman a similar offer to the one I made to the hon. Member for Central Ayrshire (Dr Whitford), who speaks for the SNP: I am happy to pursue any collaboration possible between the Northern Irish and English healthcare systems to share best practice.

NHS Continuing Care

Jim Shannon Excerpts

Monday 27th November 2017 Commons Chamber

[Norman Lamb]

The hon. Lady might well be right. That does not justify the variations, but it is a possible explanation for part of the problem.

Secondly, the number of people nationally who are found to be eligible is falling. The National Audit Office found that the proportion of people assessed as eligible for standard continuing healthcare by CCGs reduced from 34% in 2011-12 to 29% in 2015-16.

[Jim Shannon (Strangford) (DUP)]

Does the right hon. Gentleman agree that home care packages must be better funded so that people can live independently at home, while still being cleaned and cared for, but that that is extremely difficult due to the finance available?