Antibiotic Resistance

Jim Shannon Excerpts

Wednesday 15th October 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Mr Chope. It is always nice to speak on health issues in this hall. It is also nice to see the Minister in her place—we seem to be here regularly discussing health issues—and I look forward to her response.

First, I thank the hon. Member for York Outer (Julian Sturdy) for bringing this issue forward for discussion and for his introduction. The issue is of the utmost importance, and, despite the warnings about it, some people still want to bury their head in the sand like the ostrich—“If you put your head in the sand, the car won’t run you down.” Antibiotic resistance is a serious issue but, for some reason, some people—perhaps many people —are under the illusion that if we do not talk about it, it will not happen. However, it is happening right now, and we should all be extremely worried about it. That is why the debate is important. Indeed, the hon. Gentleman and the hon. Member for Inverclyde (Mr McKenzie) both mentioned the example of the grazed knee—in the past, it was not an issue, but it could be in the future, and people could end up dying from it.

Antibiotic resistance is the ability of a germ to prevent an antibiotic from working against it, and it is a global problem. It is also part of the reason why, in recent years, we have been warned over and over again to take antibiotics only when absolutely necessary. That is a serious issue, which we must address. Although we cannot become resistant to antibiotics themselves, because they are designed to target germs not cells, antibiotic resistance is a major health problem, and we already face the reality of having fewer choices of effective drugs with which to treat basic illnesses.

Some 70% of the world’s bacteria have developed resistance to antibiotics. Unfortunately, we are now in the position of considering drugs of last resort. Before we are at the stage when only one antibiotic is left that can do the business, we need to think ahead. Other Members have talked about the pharmaceutical industry and the development of new drugs, and that is important. The more a drug is used to treat germs, the more resistance they develop. For example, just a few years after penicillin was developed, resistance to it was found in Staphylococcus aureus, in the skin. After years of heavy use, several species of bacteria are now resistant to penicillin. However, the biggest problem facing us is the development of multi-resistant germs, which are resistant to a large range of antibiotics. As they begin to develop, effective treatments become difficult. In that respect, I declare an interest as a type 2 diabetic. Every year, I am eligible for a flu jab to help me combat colds and flu. Some years it does, but some years it does not—I am not quite sure why—but, again, that shows there is resistance to the jab used to deal with flu and the cold bugs out there.

We have been advised to follow some simple instructions to try to prevent germs from becoming immune to our medicines. The advice includes getting antibiotics only when absolutely necessary, and it falls to our GPs to know when that is. Other advice includes washing our hands regularly, finishing a course of antibiotics as advised and ensuring that antibiotics are taken only by the person they have been prescribed for. Finally—I hope the Minister can give us some indication of what is being done on this—GPs should not prescribe antibiotics for colds and flu, because they are caused by viruses, not bacteria. Sometimes GPs need to have a better focus on what is best. Do people always need an antibiotic, or do they need something different?

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

Does my hon. Friend agree that we require an educational process—from the Government, to GPs, to pharmaceutical companies and to the wider public—to ensure that we do not face an Ebola-type position, where we are trying to play catch-up and the end result is many deaths?

[Jim Shannon]

I thank my hon. Friend for his intervention. As always, he succinctly puts the issue into perspective. We are all aware of Ebola, although we are not talking about it today. The question is how we resist such bacteria.

When it comes to viruses and bacteria, most of the pieces of advice I mentioned are simple enough for us to follow. However, the two most important, which involve access to drugs, relate to doctors, and my hon. Friend referred to that. Undoubtedly, we need to encourage greater awareness through media campaigns and posters in doctors’ surgeries, and by educating our children and young people. This is all about knowledge and awareness.

The findings from the World Health Organisation are quite disturbing. In May 2014, it warned that we should expect “many more deaths” because dishing out too many antibiotics

“will make even scratches deadly”.

That is the point many people are making. Over the years, antibiotics have been used properly to extend our lives, but now we are at grave risk of turning the clock back on medicine, with the World Health Organisation claiming that antibiotic resistance has the potential to be worse than the AIDS epidemic of the 1980s, which was responsible for 25 million deaths worldwide.

The importance of necessary prescriptions cannot be underestimated. In England last year, 41.7 million prescriptions were written out, up from 37.2 million in 2006. The World Health Organisation looked at data from 114 countries on seven major types of bacteria, and the results showed that we have reason to be most concerned about the bacteria that cause pneumonia, urinary tract infections, skin infections, diarrhoea and gonorrhoea—the hon. Member for Inverclyde referred to sexually transmitted diseases.

As people become infected by resistant superbugs, they are likely to need to remain in hospital for longer than would normally be required. That may also result in their being moved to intensive care. Both those things cost the NHS money, which is simply not an option in this economic climate.

Medicine is amazing, and we are blessed to have the NHS, which is so efficient and helpful. What has been achieved over the last 100 years is astounding. However, our generation has come to rely on tablets. We are all busy, and with work and families it is not always practical to take time off, but the convenience of taking a tablet to reduce our recovery time is beginning to have adverse effects. Unfortunately, while bacteria were getting smarter, we were loading ourselves up with antibiotics. If one did not work we got another one, and if that did not work we got yet another. Now bacteria are outsmarting us, and there are few new antibiotics in the pipeline.

Although we bear responsibility for our own health, and must ensure that when prescribed an antibiotic we take it properly, much of the responsibility lies with general practitioners. They must prescribe such drugs only when absolutely necessary, and they must prescribe broad-spectrum antibiotics suitably, making sure that the selection, dosage and duration are correct. That is a clear role for the GP to play. It is vital to review and renew our campaign to research and assess microbiological data, with the aim of preventing any more bacteria from becoming resistant to antibiotics. Perhaps in that way we will find a way to reverse their immunity, and ensure that the drugs that we are using are not those of last resort.

Foetal Alcohol Syndrome

Jim Shannon Excerpts

Tuesday 14th October 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Sefton Central (Bill Esterson) on bringing this issue forward for consideration. The debate is long overdue. Now is a good time to air this matter, and Members have done that. I am pleased to also be able to make a contribution.

Foetal alcohol exposure is the most important preventable cause of severe brain damage in babies and children. For that reason, we should debate the issue and highlight it. Drinking while pregnant can cause miscarriage, stillbirth, premature birth and low birth weight. Furthermore, children with FAS have distinct facial features as a result of their mother drinking alcohol.

FAS can result in hearing problems, mouth and teeth problems, a weak immune system, epilepsy, liver damage, kidney and heart defects, cerebral palsy and other muscular conditions, height and weight issues, and hormonal disorders. Those clear health issues are preventable, which is why the debate is important for a number of reasons. First, as all the Members who have spoken have said, we should educate people. However, there is also the saving to the NHS from promoting prevention, and I will return to that.

The effects do not stop with those I listed. The invisible effects include attention deficit, memory deficit, hyperactivity and difficulty with abstract concepts such as maths, time, and money, to name just a few. People can also experience difficulty solving problems, as well as poor judgment, immature behaviour and confused social skills. We have to question why any mother would want to drink during pregnancy if she was made aware of all those horrendous effects.

Normally, there is no way of preventing a genetic condition from passing from parents to children. This is the only disorder that can be completely prevented by the mother’s actions. We therefore have to educate mothers and ensure they are aware of the issue. Some mothers may not be fully aware of the impact of what they are doing, which is why we have to look at this much more generally.

Most women are aware that they are not advised to drink alcohol when pregnant. For example, a 2007 report by the British Medical Association—a much respected organisation—concluded that women who are pregnant or who are considering pregnancy should be advised not to consume any alcohol. However, I fear that women are not always aware why they are advised not to drink or just how serious the dangers are for the unborn baby.

The hon. Member for Huddersfield (Mr Sheerman) referred to the need for the drinks industry to take specific issues on board. He also mentioned the need for GPs to—this is not a pun—harp on more about this issue and to be more aware of it. It is important that the serious dangers for the unborn baby are underlined.

When a pregnant woman drinks, the alcohol travels directly across the placenta to the foetus via the bloodstream, and the physical impact is clear. The foetus’s liver is not fully formed and cannot metabolise the toxins out of its system quickly enough. That leaves the foetus with a high alcohol concentration in its body, which causes a lack of oxygen and of the nutrients needed for the brain and other organs to grow properly. Those are the medical facts about what happens. If those were known to all pregnant mothers, I believe they would take steps to ensure they did not drink.

It is clear that alcohol should not be consumed even when couples are trying to conceive—the hon. Members for Sefton Central, for Chatham and Aylesford (Tracey Crouch) and for Huddersfield all referred to this—because a woman may not be aware that she has become pregnant in the initial weeks of the pregnancy. It is in the first three months of pregnancy that drinking damages babies’ organs, and it is during the first six to nine weeks that babies’ facial features are formed, so mothers who drink in that three-week window are more likely to have babies with deformities. Again, no mother wants that to happen. The question is how we ensure these things do not happen, and I am sure the reply from the Minister, by whom I am always impressed, will help us feel a bit more reassured.

The problems I have just set out are another reason why it is vital that women do not consume any alcohol at all at any point in their pregnancy, and that includes when they are trying to get pregnant. Perhaps the saddest thing about FAS is that it is the biggest cause of non-genetic mental handicap in the western world, but it is the only one that is 100% preventable.

In response to a question in October 2013, the Minister referred to the Government’s strategy. When she replies, perhaps she can give us some indication of what point the strategy has reached. There must be a way of measuring its success. Is it measured on the figures the Minister has? I would be keen to hear her thoughts on that.

The number of diagnosed cases of FAS has tripled since records about the condition were first kept 16 years ago. In 1997-98, there were 89 cases, by comparison with 2012-13, when there were 252, so clearly there is a problem. Figures for the UK are unknown at present, but international prevalence studies in the US, Canada, Finland, Japan, Australia and Italy show that at least one in 100 children is affected. That would mean between 6,000 and 7,000 babies a year born with FASD in the UK.

It is little wonder that figures show 98% of midwives agreeing that FASD and the dangers of drinking during pregnancy are a subject that should be mandatory for all practising midwives. I agree. Some midwives feel that the subject is taboo, and that they should not mention it. According to the figures, only 59% of midwives are comfortable asking pregnant women about alcohol. They should not be uncomfortable about something they do to prevent disability in a baby. The subject should be on the table for discussion early in pregnancy, to make sure that the mother knows.

The issue is a serious one, as the figures show, where there can be serious consequences. As has been noted, FASD is the only non-genetic handicap that is completely preventable. There is no doubt in my mind that we need to raise awareness of foetal alcohol syndrome. Some UK statistics are worrying, indeed. For example, recent analysis carried out at Brighton and Sussex university hospitals showed that between 80% and 90% of women of childbearing age drink regularly; 25% of people aged 18 to 25 and 21% of those aged 26 to 44 drink more than 14 units of alcohol per week; and 15% to 20% of those continue drinking during pregnancy, even though they know it is dangerous. Those are truly shocking figures about a serious problem, but I believe they would drop if more campaigns about FAS were started. I appreciate that the economic climate is difficult, and it is not always easy to fund new campaigns, but it is estimated that it costs us £2.5 million, based on 813,000 births each year, to help those who are living with FASD. Surely any short-term costs that would help to raise awareness and drive down the number of sufferers would be a long-term benefit, both financially and socially.

Canada leads the way in treating and campaigning about the dangers of foetal alcohol syndrome. For example, it is discussed in parenting programmes for four to 11-year-olds, ensuring that the message about not drinking during pregnancy is ingrained in the minds of the new generation. Not only that, but posters about foetal alcohol syndrome are displayed in various public places, including train stations, airports, surgeries and shops. We could do that, equally. Although large sums of money are set aside by various provincial governments each year, proponents argue that preventing FASD in just 10 babies a year saves enough money to fund the services. Undoubtedly that is the way forward for us in the United Kingdom of Great Britain and Northern Ireland.

As hon. Members know, health is a devolved matter in Northern Ireland, and I want to ask the Minister whether consideration has been given to a campaign that would encompass the whole United Kingdom. We must address the issue in England, Northern Ireland, Scotland and Wales.

Community Hospitals

Jim Shannon Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to serve under your chairmanship, Mr Owen. The Minister and I have spent a bit of time together in Westminster Hall in the past couple of days, and it is nice to see him in his place. I wish him well. I congratulate the hon. Member for Dover (Charlie Elphicke) on securing this debate, which gives us all an opportunity to participate, and we thank him for that.

I have a deep interest in community hospitals and I therefore look forward to making a contribution. As the Democratic Unionist party spokesperson for health, the issue is of some interest to me. It is not often that we are the second largest party in the Chamber. [Laughter.] With my hon. Friend the Member for Upper Bann (David Simpson) and me, we have two Members, which makes us the second largest party. It is a pleasure to speak on this issue. The local hospital in my constituency of Strangford is in Newtownards. It is a community hospital, like Bangor and Downe, which are in neighbouring constituencies, and all those hospitals feed into the major hub of our hospitals, which is the Ulster hospital. I put on record, because I have to, the excellent staff we have at those hospitals. We are very much indebted to their work, the commitment they give beyond their hours and the quality of their experience.

Community hospitals have a big role to play in our society. Without them, the NHS health system would be under even greater pressure. We have one of the best, if not the best health system in the world, but being the best comes with pressures. Due to the nature of our health system, which entitles all UK residents to health care, delays and backlogs can, unfortunately, arise sometimes. In January this year, the Royal Victoria hospital in Belfast was forced to declare a major incident due to the large number of patients visiting accident and emergency. Health is a devolved matter, and although our Health Minister at home, Edwin Poots, dealt with the issue extremely well, I am under no illusion that the Belfast hospital was alone in declaring itself under extreme pressure. The nature of the NHS means that that happens sometimes, but community hospitals can come in to address that.

I am always thoroughly impressed by the work of staff in A and E departments, because they are often run off their feet, with many people coming in with a variety of problems, but community hospitals play an important role in easing their work. Often, people have injuries that need to be seen to that are not emergencies, and sometimes people have to look at how best to categorise those issues and which hospital to attend. Some people could see their GP at their local community hospital and use the out-of-hours service, rather than attending A and E departments. That is not meant as a criticism; I am always conscious that people respond in the way they see best, but sometimes we need to take a longer look at how things work. Community hospitals can play a greater role.

One thing that we need to do is raise awareness of community hospitals through this debate and look at how best the community and our constituents can respond. The role of community hospitals is to provide accessible health care and ancillary services to meet the needs of defined local populations, particularly in areas remote from district general hospitals. As an extension of primary care, they enable GPs and the primary health care teams to support patients within their own communities. Rehabilitation is a major role of community hospitals, and many offer a wide range of health promotion, diagnostic, emergency, acute and convalescent services, as well as out-of-hours treatment.

Community hospitals provide an undervalued resource, and those wishing to close such hospitals or downgrade them to no longer being community hospitals have often presented community support as irrational, but it is not irrational in my area. The community hospital in my constituency looks after the Ards peninsula. Travel from Portaferry, Portavogie or Kircubbin to the Ards hospital takes 15 to 20 minutes, but travel to the Ulster hospital would take twice as long, because of the traffic. The community hospital has a significant and important role to play, and we must look outside this place, to see what the issues are for my constituents. In the community hospital, they feel like they are treated as people, rather than numbers. That is not a criticism, but it is a reality.

Figures for Northern Ireland show that the waiting times at A and E are extremely good with just 294 out of 62,193 people waiting longer than 12 hours to be treated or discharged. That figure of 294 must also be addressed, but the numbers show the importance of the role that community hospitals play in treating non-emergency injuries, as well as the large-scale rehabilitation programmes that they offer. Community hospitals provide more convenient services, are less costly for the local population to access and are tailored to the local community’s needs. The hon. Member for Dover referred in his contribution to the significant and important role that community hospitals play in that respect. Furthermore, community hospitals provide a range of safe and appropriate services, often with considerable cost benefit to the NHS—minor injuries units being a prime example.

Doctors can be summoned very rapidly to community hospitals, virtually all of which operate without resident medical staff in a satisfactory way. They have proved that they can do the job to a certain level, which is impressive and eliminates the argument that community hospitals do not provide enough of a service, forcing people to district general hospitals when injured or ill through the night. It is a fact of life that such things happen, but that does not downgrade the importance of the community hospital. It would be good, however, to see all community hospitals offering night-time services. In community hospitals, the patient is under the care of their own GP, who will continue to look after them on discharge. The community nursing teams are also able to retain closer links with the patient at community hospitals, which is vitally important for rehabilitation and is why community hospitals are so successful when it comes to patient recuperation

In conclusion—I am conscious that several other Members want to speak—the benefits of having the same doctors and nurses, who know a patient’s case and can get to know the patient, cannot be underestimated. That is why this debate is so important. I encourage the Minister to raise awareness of community hospitals’ work and to encourage people with minor injuries to use their local community hospital instead of A and E departments at district general hospitals. I congratulate the hon. Member for Dover on bringing forward this debate. I look forward to the Minister’s response and to hearing from the third party in the room today when the shadow Minister makes his comments.

Obstructive Sleep Apnoea

Jim Shannon Excerpts

Tuesday 2nd September 2014 Westminster Hall

[Julie Hilling]

Thank you, Mr Havard. I am very pleased to be serving under your chairmanship. You will not be surprised to learn that I first got interested in this subject from a road safety perspective. When a member of the Select Committee on Transport, I received an e-mail from the parents of a young woman who was killed by a lorry driver who fell asleep at the wheel, so I raised the issue on a number of occasions when we were doing different inquiries on things such as freight transportation and road safety. However, as soon as I started to talk about sleep apnoea, I discovered that it was far more common than I had thought—with a number of friends and acquaintances declaring that they had it—and that, in Bolton West, predicted rates of the condition are higher than the national average. I asked for the debate today to coincide with the launch of the British Lung Foundation’s obstructive sleep apnoea health economics report, because an estimated 1.5 million people have the condition in the UK, yet only 330,000 people are currently diagnosed and treated.

OSA affects people of all ages, including up to 4% of middle-aged men, 2% of middle-aged women and 20% of those aged over 70. Although not everyone with OSA is overweight, many are, and with an increasingly overweight and ageing population, it is anticipated that the rates of OSA will increase in the coming years.

What is obstructive sleep apnoea? It is a condition whereby the muscles in the throat relax, causing an obstruction in the airway during sleep, meaning that a person stops breathing. Some people stop breathing hundreds of times a night, and others have periods during which their breathing is restricted. Untreated OSA can have a profound impact on the quality of life of those affected and it has been proven to cause high blood pressure, as well as being associated with a host of other health conditions such as heart disease, heart failure, stroke and diabetes. The life of someone whose OSA is not treated can be dramatically shortened. Correct treatment has been shown to increase the probability of survival of OSA patients by 25%.

There is a strong link between OSA and an increased risk of road traffic accidents, with individuals who have uncontrolled OSA three to seven times more likely than the general driving population to have an accident on the road.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this issue to the House for hon. Members’ consideration. Many people will look on OSA as something that perhaps is not all that worrying, but from what the hon. Lady has said, it very much is. Does she feel that probably what we, the Minister and the devolved Administrations now need to do is to raise awareness of the condition through GP surgeries, leaflet drops and education?

Aerospace Industry

Jim Shannon Excerpts

Tuesday 2nd September 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure, Mr Hollobone, to serve under your chairmanship. It is equally a pleasure to speak in this debate, and I thank the hon. Member for Mid Worcestershire (Sir Peter Luff) for securing it. He has outlined the case brilliantly, although he did not mention Northern Ireland, so I will do that and correct the balance. That is important, because we have an industrious and successful industry in Northern Ireland that creates many jobs, and I will outline that in my contribution.

As the Democratic Unionist party spokesman for transport, this subject interests me, not only because of its magnitude, but because it creates many jobs in my constituency, both directly and indirectly. It creates jobs directly in the companies, and indirectly through sub-contracting. Many companies come into the engineering sphere because of the good work done through the aerospace industry.

We should all feel immensely proud of the UK aerospace industry, and we have every right to be proud of it. We boast the largest aerospace sector in Europe and we are second globally only to the United States. We should shout our successes, not from the rooftops, because we are not on the rooftops, but in the Chamber. The importance of the continued partnership of the Government and the industry through the aerospace growth partnership cannot be underestimated, as the latest figures from the ADS, which represents the aerospace, defence, security and space industries, suggest. As of 28 August, there was a record backlog of more than 12,000 aircraft and 21,000 commercial aircraft engines orders. With the economy still only making a slow recovery and thousands of jobs not yet secure, that is fantastic news for the aerospace industry and for the United Kingdom overall, with estimates that the backlog will be worth between £135 billion and £155 billion over the next nine years. That is not a paltry sum and it indicates how much the aerospace industry contributes to the economy of the United Kingdom of Great Britain and Northern Ireland.

The aerospace industry is extremely positive. While everything else makes slow and steady progress, the industry has been growing at a pace 10 times quicker than the rest of the economy in the last three years, outstripping many employment sectors. That is another example of the importance of the Government’s partnership with the industry. I am sure that the Minister and the shadow Minister will underline that clearly in their responses. The new orders are simply part of long-term industry growth, with estimates of demand for more than 29,000 commercial airliners between now and 2032, which is in line with the airlines’ desire to carry more passengers and expand their fleets. The future looks positive, and it is positive because of the direct attitude the Government have adopted to the industry, but—as the hon. Member for Mid Worcestershire said—other things need to be done to keep us in a prominent position.

The situation certainly looks promising, and I must admit that I was keen to contribute to today’s debate not only in my capacity as my party’s spokesperson for transport, but also because of the massive contribution that Northern Ireland makes to the industry. The main factory in Northern Ireland is located in Newtownards in my constituency. I am pleased about that, of course, and I can boast of having one of the most technologically advanced and internationally focused aerospace industries in the world right in my constituency, giving job opportunities to many young people.

The hon. Gentleman referred to apprenticeships, as did the hon. Member for Burnley (Gordon Birtwistle), who has commented on the issue before in Adjournment debates and in Westminster Hall, and I am pleased to see such opportunities coming through for people in my area. Bombardier has more than 5,000 highly skilled employees across four sites in Northern Ireland. The site in Newtownards is the biggest, but there are others in Newtownabbey and Belfast. Bombardier promotes many job opportunities, and it is important to see that happening. With first-class capabilities, the site’s operation plays a pivotal role in all of Bombardier’s families of commercial and business aircraft. It also produces and sells components for Rolls-Royce, Airbus and General Electric. Bombardier’s CSeries aircraft has significant UK content, primarily through the advanced composite wings that were designed, and are manufactured, by Bombardier Aerospace in Belfast.

[Sammy Wilson (East Antrim) (DUP)]

The hon. Member for Mid Worcestershire (Sir Peter Luff) emphasised the importance of research and development. One of the ways in which Bombardier has kept its place in the market and, in particular, kept production in Northern Ireland has been through the research and development money made available by the previous Government to ensure that the investment required in Northern Ireland to keep the competitive edge was made. Does my hon. Friend agree with the point made by the hon. Gentleman on the need to think about the long term, because the period of return is long term? It is important to think about long-term research and development incentives if the aerospace industry is to be maintained at its current standard in Northern Ireland and the United Kingdom.

[Jim Shannon]

I thank my hon. Friend for that valuable contribution. He is absolutely right. Sometimes you wonder, Mr Hollobone, whether people have looked at your notes before they make an intervention, because often they raise issues that you were going to come on to. The Northern Ireland Assembly has made a significant commitment to Bombardier—the Minister responsible for that is Arlene Foster—as have this Government and other Governments. We have a huge range of aerospace companies operating in Northern Ireland, including B/E Aerospace, Magellan Aerospace, Goodrich, RFD Beaufort and Thales, to name just a few, so it is perhaps not surprising that one in three of the world’s aircraft seats are manufactured in the village of Kilkeel in Northern Ireland. Look around the world and think of all the planes there are and remember that a third of those seats are manufactured in Kilkeel in Northern Ireland.

Even more good news for Northern Ireland and UK industry was the announcement—this relates to the intervention of my hon. Friend the Member for East Antrim (Sammy Wilson)—of a £6.8 million advanced engineering competence centre in Northern Ireland. That is a commitment to the future and to research and development. The centre will be based at the Northern Ireland Advanced Composites and Engineering Centre in Belfast and will focus on developing innovative solutions in the advanced engineering sector. In other words, it will look at the long-term progression of aerospace, not just in the United Kingdom of Great Britain and Northern Ireland, but in Europe and the rest of the world.

The centre is tremendous news locally, as it will no doubt create more jobs, but it is also brilliant news for the UK aerospace industry as a whole. As opportunities in civil aerospace grow, the UK faces increasing competition from mature and emerging markets, so the new centre will, I hope, develop new approaches for advanced engineering, because being ahead of the competitive market is the only way we can ensure that we remain first in Europe and first in the world. That is the point I want to emphasise. We are aiming at short-term goals, but we are also trying to achieve a long-term strategy.

The figures I gave are testament to just how successful and important the aerospace industry is to the UK economy and our ability to compete globally. That is why I urge the Government to work alongside their partners, not just to encourage technological innovations, which are important, but to lead the way in cutting emissions, reducing fuel burning and increasing aircraft efficiency. Those are important issues that we cannot walk away from, and the aerospace industry is trying to address them. That can be done, and we must do our best in tackling them.

One thing that is close to my heart is my wish to see the Government encouraging students and young people to undertake the necessary courses at universities and technical colleges, as the hon. Member for Burnley said. We need not only aerospace engineers and technicians to replace the current generation—we have to look at that—but staff who can work with new technologies and materials. We need further education at universities and technical colleges to work alongside the industry to ensure that the bright brains of our young people are there to take on those jobs.

I am pleased to learn that almost 70% of UK aerospace companies employ apprentices and trainees. That is tremendous news. Each year we meet some of those trainees here in Westminster, as I did this summer. It was good to meet some of the young men and women who are interested in the industry and looking for opportunities. We have a commitment from Government, both here at Westminster and regionally, to ensure there are apprenticeship opportunities for both genders. This is exactly what the industry needs. Provided we continue to develop and innovate, I believe that the future of UK aerospace is very bright indeed.

[Mr Philip Hollobone (in the Chair)]

I call Sir Gerald Howarth—a qualified pilot.

--- Later in debate ---

[Mr Wright]

The hon. Gentleman is right, and that model works well for the aerospace industry. I certainly want to see that encouraged, because an oversupply of apprentices then cascaded down through the supply chain reassures the primes about quality. It can be a means by which the whole competitiveness of the sector can be maintained and something that we should certainly encourage.

[Jim Shannon]

In Northern Ireland, with Shorts aircraft fitters for example, Bombardier has been anxious and keen to secure recruitment from those in the 50-plus bracket, who perhaps went to another job, but still have the skills. They can come back to do training with Shorts Bombardier. That is an example of where in the United Kingdom that is happening for those over 50, who are not on the apprenticeship scale, but are looking for jobs and have the skills.

[Mr Wright]

The hon. Gentleman makes an important point.

Going back to what the hon. Member for Burnley (Gordon Birtwistle) asked in an earlier intervention, not only with specific regard to particular trades and fitting, but the whole education system, from primary through secondary education and on to further and higher education, the system should be geared up to say, “The aerospace industry: you could have a fantastic career if you choose it.” Going to work in a factory, in particular somewhere such as Airbus in Broughton, is certainly not a sign of failure. I would be absolutely delighted if one of my children won an Airbus apprenticeship. It is a fantastic success story, which we need to encourage. The culture of this country is that we do not make anything in Britain any more, but that is simply not true in practice. What steps are the Government taking on manufacturing in general and aerospace in particular to ensure that that is dealt with?

I mentioned the success of exports for the UK aerospace industry, with 90% of the high-value products made by the sector in Britain exported overseas. However, the industry has told me—the hon. Member for Mid Worcestershire mentioned this—that more support and co-ordination are needed for export sales campaigns. Primes and suppliers have said to me fairly consistently that they would like more advanced information and to be more closely involved when Ministers are travelling on trade missions, or when international delegations are visiting the UK. Will the Minister respond to what seems to be a constant voice?

Mitochondrial Replacement (Public Safety)

Jim Shannon Excerpts

Monday 1st September 2014 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

We have heard many stories today about the potential of mitochondrial replacement for women with mitochondrial conditions, possibly allowing them to have children without these conditions. But the hon. Member for Congleton (Fiona Bruce) and others have put forward the safety issue and the need to make sure that there has been a full investigation. This might seem like fantastic news, but just because the HFEA expert panel has not found evidence to say that mitochondrial transfer is unsafe does not amount to saying that the evidence proves it is safe either, as the potential risks of the techniques required are not yet fully understood.

The controversy surrounding genetically modified food comes to mind: it teaches us a number of important lessons. In a paper submitted to the “Science as Culture” conference in 2008, several academics asserted that

“the GM experience represents a warning, a cautionary tale of how not to assess an emerging technology and allay public concern.”

Clearly, there is some evidence to show that we need to look at this again.

The UK is the only country that is considering permitting these techniques. In the USA, the Food and Drug Administration held hearings where concerns about the safety of the techniques were explored. Some even consider the lack of international consensus as a sign that the UK is moving too quickly, and I must admit that I, along with many others, share that view.

The Government have sought to justify ignoring the clear majority against the techniques on the basis that respondents to public consultations are from self-selecting audiences, but I say to the Government, “Ignore them at your peril.” It would be foolish to dismiss responses to public consultations on any subject in such a cavalier manner, but when we are dealing with concerns regarding the public safety of what is in effect a new biotechnology, and when the memory of the GM food debacle is still fresh in the public memory, the strategy is exceptionally foolish.

It is important that we consider these matters in their full detail. It is in this regard—mindful of the need to avoid at all costs any sense of rushing and of ignoring public opinion post the GM food saga—that difficulties surrounding the approach of the Department of Health are thrown into particularly sharp relief.

According to a poll conducted by ComRes in February, 35% supported the technique and 34% were against it, but in a matter of six months those figures changed to 18% in support and 46% against. That extraordinary loss of support in a very short period highlights that the cavalier approach of the Department of Health is very risky and dangerous.

At the very least, the Government should reassure the public by making it absolutely plain that they will not rush into laying any regulations before this House or anywhere else until all the pre-clinical experiments recommended by the HFEA in its three safety reports to the Secretary of State have been concluded. Only then will we be able to move forward.

Organ Transplants

Jim Shannon Excerpts

Tuesday 8th July 2014 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I am pleased to have the opportunity to speak on this subject. We debated the organ donation register only a few weeks ago, but it is appropriate to highlight the issue in national transplant week. I believe that everyone present is committed to ensuring that organ donation increases throughout the United Kingdom.

I pay special tribute to the hon. Member for Stretford and Urmston (Kate Green), because although I am introducing the debate, I must confess that she asked me to do so. We asked the Backbench Business Committee for an opportunity for this debate, and that opportunity has come this morning. I thank the hon. Lady for giving us all the opportunity to participate, and I hope that the debate will be useful to all involved. I also thank the Backbench Business Committee for giving us the opportunity to speak on this subject in national transplant week. I am passionate about organ donation not just because of the cold facts, but because I witnessed first hand how urgent and important organ transplantation is when my nephew Peter required a kidney transplant.

I was delighted to hear that the latest figures from the British Medical Association show that the number of people who have registered to be an organ donor in Northern Ireland has reached an all-time high of just over 582,000. I checked that figure last night and again this morning because I wanted to make sure that it was right, and it is correct: 582,000 people are registered. That is fantastic news. That all-time high has no doubt been aided by the marvellous work of our Health Minister in Northern Ireland, Edwin Poots, who since 2012 has been dedicated to increasing awareness of organ donation and achieving the desired figures.

That said, much more needs to be done. The UK has one of the lowest rates of organ donor registration in Europe, with 96% of the population supporting the principle of organ donation yet only 30% actually being registered. More than anything else, those low numbers are because the UK population is unaware of and often misinformed about organ donation, how to register, the process involved and how vital transplants are. Many campaigns are under way. I do not often read The Sun, but it is running a campaign on transplants. It pursues many issues, and today it is trying to encourage more people to sign up to the organ transplant list.

Currently, 7,000 people are waiting for an organ transplant, and three people die each week while waiting for organs. That is three people too many: three families left heartbroken by the loss of a loved one who could have been treated if more people were on the list to donate. Just one person can save up to nine lives, so the Government must encourage as many people as possible to sign the register. I know that the Minister is committed and that her response will be positive. With this debate, we want to encourage our nations, collectively, to get involved and sign up.

A third of families refuse to give consent for their loved one’s organs to be donated because they are unaware of their loved one’s wishes. That is just one reason why the Government must consider legislating on the introduction of a “soft” presumed consent system, wherein the families of the deceased can object to donation if the deceased dies without expressly electing whether or not to donate their organs. I strongly believe that people should be on the list as an organ donor unless they opt out. That is very much the soft option. Such a system would undoubtedly increase the number of organs available for transplantation and reduce the number of people dying while on waiting lists.

In 2013, the Public Health Agency in Northern Ireland carried out a survey in an attempt to gauge public opinion about organ donation and came up with some interesting figures. It found that 56% were in favour of presumed consent, just 18% were against it, 8% wanted more information and 18% did not know. A further 62% said that they would not opt out if a soft system was introduced. I believe that there is movement among the people of the United Kingdom of Great Britain and Northern Ireland towards the soft option, which we should consider.

The NHS “Taking Organ Transplantation to 2020” strategy seeks to increase donor rates by 80%, but it does not include or discuss the option of a soft opt-out system. Perhaps the Minister could share her thoughts on that in her response. The lack of mention of a soft opt-out is unfortunate, as the strategy refers positively to the evidence from countries such as Belgium, Croatia and Norway showing

“an increase in donation rates following a move to an opt-out system together with investment in infrastructure and raising public awareness of organ donation.”

It is clear that other nations have made the move and seen the benefits; it is time that our nation moved in the same direction.

The 2013 survey also found that 84% of respondents in Northern Ireland supported the idea of transplantation, but only 32% were on the register. Worryingly, more than a third of respondents were not aware that the organ donor register existed, with that lack of awareness being lowest among 16 to 29-year-olds and people over the age of 65. Perhaps we need to do more to encourage people in those two age categories.

[Ms Margaret Ritchie (South Down) (SDLP)]

The hon. Gentleman is making a compelling argument about the need for organ transplants and has addressed the opt-out system that has only recently been introduced in Northern Ireland. Does he have any suggestions as to the possible reasons why many people do not offer to give their organs for donation?

[Jim Shannon]

I thank the hon. Lady for that intervention. I will come on to address that issue later in my speech, but we can do a number of things. In Northern Ireland, when people apply for a driving licence they must decide whether they want to be on the organ donation list. There is no dispute: they have to answer yes or no. If they answer yes, they are on it; if they answer no, they are not. It is as simple as that. I think that that is one reason why 582,000 people are on the donation list in Northern Ireland. Perhaps the Government here on the mainland can take that approach as well.

I want to highlight a couple of other important points about the 2013 survey. Many of the respondents were wrongly informed on the subject of organ donation—for example, one in five wrongly thought that it was possible for a brain-dead person to recover from their injuries and that only the organs of young people were good for transplants. That shows the need for better understanding of the system, and we should look at how we can educate people through campaigns in schools, TV adverts and in GP surgeries. Maybe we MPs can post on our Facebook pages or websites—not maybe; yes we can. We must encourage people to sign up to the organ donation list.

In Northern Ireland, 78% of people surveyed said that they would accept an organ if they needed one. Some 96% of families claim that if they knew their loved one’s wishes, they would agree to the donation. That shows how important it is for families and friends to discuss organ donation. It should be a subject for consideration. Perhaps a media campaign could be organised and the issue written into the storylines of some of the soaps. That might make it an essential subject matter for discussion around the dinner table.

Several charities have backed this debate, and I would like to mention a few shocking statistics that they have kindly supplied me with. I want to focus on cystic fibrosis; I know that other Members will focus on other things. The chief executive of the Cystic Fibrosis Trust, Ed Owen, said:

“We are delighted to lend our support for National Transplant Week. For many with the life-shortening condition of cystic fibrosis, a lung transplant is the only way to prolong life. Yet it is a tragedy that one in three on the transplant list will die waiting for new organs.

It is vital that more lungs are made available for transplantation. So we strongly support measures to encourage more people to donate their organs in the event of their death—and we continue to support a change in the law to a system of presumed consent to help ensure more people have that vital discussion with their loved ones about their wishes.

Alongside this, more effective action is taken to ensure that a greater number of donated organs are used for transplant with a new national lung allocation scheme and greater use of extended criteria lungs. Our report, ‘Hope for More’, published earlier this year, set out a series of recommendations”.

I want some of those recommendations to be looked at.

Last Saturday, I was judging horses. I do not know very much about horses, but I was lucky; they said to me, “Pick the one that looks the best to you,” which was dead easy. It may not have been the horse the experts thought was the right one, but it was the one that I thought was the right one. At that event, I met a constituent, a gentleman with cystic fibrosis. I remembered him as a healthy, active person, but when I met him on Saturday, he told me that his condition had worsened. I am ever conscious of him and of many other constituents affected by this issue.

In March 2014, the Cystic Fibrosis Trust published the report “Hope for More”, which contained 12 recommendations for increasing the number of successful transplants. Key among them was a call for a national lung allocation system similar to the UK urgent heart system. We have a system in place that works; why can we not extend it to lungs? Regular audits have been key to the success of the urgent heart system. Surely a similar system could be introduced in relation to lung transplants.

In Germany and America, the introduction of a lung allocation system has led to a significant increase in lung transplants and huge decreases in waiting lists. I presume that we could do the same here; there is no reason why we cannot. The current system certainly seems flawed. If a patient in the south of England needs a lung transplant, they must wait for one to become available in their area rather than receiving a lung from the midlands or the north of England. We need some kind of scoring system so that those who are most desperate for a transplant receive one first, and people are ordered from those most at risk to those least at risk.

The Cystic Fibrosis Trust has come up with more ways in which the number of organ donors and therefore transplants could be increased. Although time does not permit me to go into great detail—I am conscious that other Members want to contribute—I believe that those suggestions warrant a committee to consider and delve into the issue. I hope that the Minister will indicate in her response whether she feels that a committee would be helpful in moving the campaign and this debate further on.

Existing lung donor criteria were originally drawn up over 30 years ago. Although they were reviewed in 2001, they have changed little. The criteria place limits on donors according to age, previous health complications and a number of other clinical measures. Although it is important to ensure that only viable lungs are transplanted, those limiting rules mean that lungs from fewer than 25% of brain-dead donors are used in clinical lung transplantation. There are clinically viable lungs among the remaining 75%, and we need to maximise their use. I suggest that we look into that.

On lung resizing, data on organs exported overseas suggest that many lungs from larger donors are not used due to size mismatch. The technology exists to resize organs, and it must be made more widely available. People with cystic fibrosis have smaller than average bodies due to difficulties absorbing nutrients from food.

Extracorporeal membrane oxygenation techniques, which artificially preserve critically ill lung transplant patients and allow them extended time to receive donor lungs, have been developed to prevent death. ECMO is available at eight designated centres in the UK, but guidance is lacking on its appropriate use in lung transplants, where it has been shown to work as a bridge between respiratory failure and transplantation. It is feared that without clear guidance, ECMO will not be used appropriately in such circumstances, leading to adverse outcomes for patients.

The NHS Blood and Transplant 2020 strategy commits to providing

“guidance on levels of acceptable risk in relation to offered organs, particularly from extended criteria donors”.

It notes:

“Clinicians…will use their judgment, based on the current national and international evidence, to draw up criteria for non-acceptance”

and that

“there is variation in acceptance practices throughout the UK.”

Further, the strategy lays out actions

“to improve certainty about organ function”,

including investment in research to identify better biomarkers associated with good or poor function.

The Cystic Fibrosis Trust believes that it is the responsibility of NHSBT to publish guidance that brings together current national and international evidence to provide an up-to-date framework to support and guide clinicians’ judgment. It is a weakness of the NHSBT 2020 strategy that there is no commitment to providing clinicians with such a resource. Since the introduction of a German surgeon, André Simon, as head of transplant at Harefield, transplants have increased by 50%, while outcomes have remained every bit as good. It is ascribed to the culture difference in Germany. André Simon, having transferred that willingness to use extended criteria lungs at Harefield, has had an impact on the transplant programme there.

The 2020 strategy mentions the need for NHS hospitals and staff to be better supported to meet demands. That is welcome, but no mention is made of lung downsizing, and very little is made of extended criteria organs. Elsewhere in Europe, donor lung resizing is commonplace and outcomes are equitable with those of lungs that are not resized. Only three doctors in the UK can resize lungs, so it is a lottery as to whether they may happen to be around when needed. That is not disrespectful to anybody; it is a fact of life. Methods such as those, which involve controlled and safe innovation, are key to improving the likelihood of a lung transplant and go hand in hand with the NHSBT’s aim to

“ensure that transplant centres have the capacity and surgical expertise and other clinical skills to meet the demands for transplantation”.

Innovation has not been addressed in detail in the strategy, but it has been identified as an area on which commissioners must focus in order to make it a reality. Although the NHSBT strategy expresses a desire for a 5% increase in the number of hearts and lungs transplanted from donors after brain death, it is unclear how that will be achieved. We believe that there must be a renewed focus on understanding which lungs are suitable for transplant. There is strong evidence indicating that a new approach is increasing the rates of successful lung transplant elsewhere in the world.

Recent scientific guidance suggests that extended criteria lungs are key to progress in increasing lung transplant rates. Research published over the past 10 years by a range of international centres such as the university of Toronto, Hannover medical school, University Hospital Zurich and the Royal Brompton and Harefield Trust suggests that the use of selected extended criteria lungs may safely expand the donor pool without adverse consequences for lung transplantation. Many lungs designated as marginal by the International Society for Heart and Lung Transplantation criteria are now perceived by experts to be as clinically effective as standard criteria lungs.

Things are changing. Scientific evidence and research shows that more lungs are suitable, and we should be using them. Although the medical evidence is continually evolving, public perceptions are falling behind. We must address the issue of education and perception in the general public. We as MPs, this Government and the House can collectively ensure that that happens.

The charity Anthony Nolan seeks to help people with blood cancer or rare blood disorders who require blood stem cell or bone marrow transplants. The charity has said that despite the fact that there are more than 553,000 donors on the register, there are still not matches for every patient in need of life-saving transplants. Once again, more donors from black and minority ethnic communities are needed, as the only chances of finding a match are among those of similar ethnicity.

The average number of donors per constituency is 796, which is encouraging, but more are desperately needed. In my constituency of Strangford, we have a lot to do, with just 381 donors. I intend to use my opportunities as an MP through Facebook, my website, this debate and the local press to encourage more people to sign up and show the importance of organ donation and transplantation back home, but we must encourage Government to consider new ways of campaigning and raising awareness and new approaches, such as a soft opt-out system and a national lung allocation system.

I have had other correspondence from other bodies relating to organ transplants and blood safety. There are certain risks to organ donors, but they can be monitored in such a way as to reduce safety concerns. Maybe we need to raise the level of awareness and education, so that donors know they are in safe hands. We need to ensure that blood donors and organ transplant patients receiving blood transfusions are as well educated and informed on blood safety issues as they can be.

I am very aware that other Members want to speak and I will give them that opportunity; I also want to give the shadow Minister, the hon. Member for Liverpool, Wavertree (Luciana Berger), and the Minister the opportunity to conclude the debate. I will just give a few figures to put matters into perspective. Since 1 April, 309 people have donated organs; an additional 563 people have donated corneas; 824 people have received the gift of sight; and 804 people have received transplants. However, there are still 6,966 people waiting for the gift of a long and healthy life. Ultimately, choosing whether or not to donate organs will always remain the individual’s right, which is good and proper, but we in this place have a responsibility to ensure that the individual is well-versed in the matter and that the choice they make is an informed one. In organ transplant week, we need to focus on the legislative change that can and will put more people on the organ donor list, so that we can save even more lives. The first stage of that campaign is today in Westminster Hall, and we ask the Minister to respond appropriately.

--- Later in debate ---

[Glyn Davies (Montgomeryshire) (Con)]

I am sorry that I did not give you prior notice that I wanted to speak, Mrs Osborne. Although this is an important issue to me, I did not realise that it was on the agenda and I am grateful for the opportunity to speak. I congratulate the hon. Member for Strangford (Jim Shannon) on introducing the debate. I agreed with a substantial part of his speech, although not all of it. I will come to that point later.

Organ donation and transplantation is one of the most important developments in modern medical science, enabling treatment of patients with failing and damaged organs. Huge advances in transplant surgery and immunosuppression have enabled great advances to be made. Hearts, kidneys, livers, lungs, pancreases, and other organs, are successfully transplanted, but the demand continues to grow. Medical science is enabling more transplantation and we are living longer, but still about 500 people die every year while waiting. We always have to be looking for ways of increasing the levels of donation and transplantation.

My interest in the subject stems from a friend of mine receiving one of the early heart and lung transplants at Papworth, probably about 25 years ago. It was phenomenal at the time, but since then it has become much more common and is more accepted. I have had an interest since that time and that has developed in terms of promoting support for those suffering from kidney disease in my constituency, for example, with the development of a dialysis unit, and it continues here. I am also a trustee of Kidney Foundation Wales, a wonderful organisation promoting transplantation in Wales, although I disagree with it about presumed consent. I have always been disappointed in that regard and somehow feel isolated, because all the other trustees of Kidney Foundation Wales favour a change to presumed consent, which is now a new Welsh law. However, I am implacably opposed to it, because I just do not believe it will work. I will come to that point later, as one of the two points that I want to make today.

We all want to increase the level of organ donation—that is, all those in favour of presumed consent and all those in favour of continuing with informed consent. Providing new life to a fellow citizen is undoubtedly the greatest gift that any of us can give. I have spoken on this issue several times before, but there are two new issues to consider that I want to mention.

First, I emphasise how much amazing success we have had in promoting organ donation. We all owe a debt to the right hon. Member for Kirkcaldy and Cowdenbeath (Mr Brown), who established the organ donation taskforce—in 2005, I think—under the chairmanship of Elisabeth Buggins, an outstanding leader in this debate. That taskforce produced a report in 2008, with a target of increasing organ donation by 50% over five years. That target was met last year. However, it does not stop there. The latest figures show that, after six years, there has been a 63% increase, and it is still rising. We have seen a phenomenal increase as a result of the organ donation taskforce’s recommendations, which did not include presumed consent; in fact, it said that that was not a recommendation. It recommended an increase in the number of intensive care beds and specialist nurses, copying what had happened in Spain, which had delivered great success there in increasing organ donation. It is important to recognise that we can continue to build on the great success that we have achieved.

Secondly, I am disappointed that the British Medical Association takes a different view from me, supporting the introduction of presumed consent. However, it decided to do that on the basis of a show of hands at a conference meeting, and it was the quality of the speakers in the debate that led to that decision. Its decision was not based on a comprehensive report, like that of the organ donation taskforce; it was just a show of hands.

The point that I really wanted to make in contributing to this debate, because it is important and supports my view that no self-respecting surgeon would remove a patient’s organs without the support of their next of kin, is that the Royal College of Surgeons has in recent weeks withdrawn its support for the BMA’s position. The Royal College of Surgeons said:

“Evidence from these countries demonstrates that investment in public awareness campaigns and infrastructure that supports transplantation services, such as the availability of intensive care beds and number of specialist nurses in organ donation, can substantially increase organ donation.”

That is key. It continued:

“It is therefore of profound importance that investment in these areas is increased to support organ donation.”

It also said that

“we believe that there is insufficient evidence that an opt-in or opt-out system increases rates of organ donation. We consider the issue to be a matter for personal ethical and philosophical deliberation. We believe that to improve organ donation rates it is vital that investment in public awareness campaigns and infrastructure that supports transplantation services is increased.”

That is the key point on which I want to finish. There is no evidence that moving to an opt-out or presumed consent system will deliver any more organs. The Welsh Government incessantly repeat that it will, which is why popular support is seen when people are asked about the system. Clearly, if people are told again and again by the Government that the system will increase the number of organs, they will say that they support it. If I believed that it would increase the number of organs, I would support it, but I do not, because it simply will not do that. An important point to remember is that we need to invest in those things that work.

[Jim Shannon]

In my introduction, I referred to three countries that have shown that the soft opt-out option was successful: Belgium, Croatia and Norway. There is evidence and, with respect, the hon. Gentleman cannot deny that.

[Glyn Davies]

I have not studied the situation in Norway, but for many years the example in this debate was always Spain. Spain was the great success story, and it is indeed the best performer in the world. The Welsh Government have recently claimed Spain to be a presumed consent country. The reality is that the law was passed in 1979 and was effectively not followed. It was abandoned in 1980 and remains on the statute book, but it has never been activated. Ten years later, Spain introduced the changes recommended by the organ donation taskforce and had spectacular success. As a nation—I hope the Minister will say that we will carry on doing this—we need to continue doing what we have done, which has produced success: focusing on intensive care beds, specialist nurses and the example that the hon. Member for Bristol East (Kerry McCarthy) mentioned of people telling their next of kin. If all families knew, we could raise the consent rate, perhaps by 20%, to the levels that Spain sees, and we would deliver all the organs we need. The key is people telling their next of kin, so that their next of kin know what they desire. Far more transplants would be carried out and more people suffering would live.

Learning Disabilities (Care in the Community)

Jim Shannon Excerpts

Tuesday 8th July 2014 Westminster Hall

[Norman Lamb]

I am very grateful to my hon. Friend for that intervention. I would be interested to hear further information about the organisation to which she refers. It is clear that sometimes a leap of faith is required to give a person the chance of a better life outside, and the system is horribly risk averse. We know that the main cause of decisions to keep people in assessment and treatment centres is the clinical judgment that the person needs to stay there, so that needs to be challenged. I want to give people the right to a second opinion and I am in discussions with Simon Stevens, the chief executive of NHS England, to give people that right, because we have to find ways of giving a voice to people who hitherto have felt that they are ignored and not listened to and that nothing ever changes.

I pay tribute to the two organisations mentioned by the right hon. Member for Coatbridge, Chryston and Bellshill: Mencap and the Challenging Behaviour Foundation, which have continued to make the case on behalf of people with learning disabilities.

Winterbourne View and the appalling abuse of people there reminded us that there is still a massively long way to go to ensure that people are safe and get the right support—the support that they need. The Government’s review following the Winterbourne View case looked at the systemic issues facing people with learning disabilities and their families. At the end of the review, we published the concordat—the right hon. Gentleman referred to that—bringing together all the national organisations to commit to change. In a way, the most distressing thing is that I felt that organisations committing to the concordat and the change set out in it were doing that with a seriousness of intent that they would deliver on. The lack of change that there has been since then is really shocking, given that they committed to achieving that change. Eighteen months on, we all need to remind ourselves that progress so far has not been nearly good enough and that we all need to continue to work in partnership to deliver on the commitments solemnly made at the start of all this.

I have said recently, and the information that we have shows, that far too many people with learning disabilities are still stuck in hospitals, often hundreds of miles from home and in many cases for years, with serious questions about whether they are getting the right care and support.

I have also met Mike Richards, the chief inspector of hospitals, and Paul Lelliott, the deputy chief inspector for mental health, to ensure that the Care Quality Commission challenges organisations. If someone is living in an assessment and treatment centre, which is there for assessment and treatment, not for long-term living, surely it is not delivering the right model of care. That needs to be challenged by the Care Quality Commission and not simply accepted and tolerated.

Collectively, we need to be honest and say that the system has so far completely failed to deliver on the commitment made in the concordat significantly to reduce the number of people with learning disabilities who are in effect living in hospitals—for whom hospital is their home.

[Jim Shannon (Strangford) (DUP)]

Will the Minister give way?

[Norman Lamb]

I will very quickly; I am conscious of the time.

[Jim Shannon]

I want to say just one thing. Is the Minister saying that this Government are committed to partnership relationships with housing groups and those who are committed to facilitating supported living for people outside these homes? I think that, if he is, he will find that many outside bodies are prepared to take him up on that.

[Norman Lamb]

I very much agree and I am grateful to the hon. Gentleman for that intervention. Providers of supported living care need to be much more central to the task of changing this culture. Indeed, I have asked for a meeting to be arranged that will bring in some of those providers, with Simon Stevens and the chief nursing officer, Jane Cummings, who I am pleased is now in charge of this programme, to demonstrate how they can play a part in effecting change.

I also want to acknowledge the work that has been done from the concordat and what has been achieved by NHS England and other delivery partners.

It is appropriate for us to start by looking at the people who were in Winterbourne View before it closed. I am pleased to report that NHS England’s Improving Lives team, who include senior clinicians, social care staff, third sector partners and family members of people with learning disabilities, have now reviewed the care of all but one of the 47 people who were in Winterbourne View, and the care of the one remaining individual will be reviewed by the end of this week. Those reviews have resulted in some people moving out of hospital into circumstances that are more appropriate for them as individuals.

The Government have provided funding so that the people who were in Winterbourne View can have additional trauma assessments where the need has been identified and they have consented to those assessments. We are providing additional funding to support families through a telephone helpline, regular telephone counselling and family support days. The funding will also support other people with learning disabilities—including the 17-year-old girl whom I visited a fortnight ago—who have experienced institutional abuse, and help their families.

Involving people with learning disabilities and their families is key to ensuring that the work that we are doing means that they have a better experience and better outcomes. We have provided funding to organisations to allow people with learning disabilities and their families to share their views with us, so that we can listen to them and respond to the concerns that they raise.

We have also made progress on other Winterbourne View concordat commitments. For example, guidance has been developed on commissioning advocacy for people with learning disabilities so that, again, they get a voice and they get access to information, advice and support when necessary. It is vital that local commissioners ensure that people have proper access to high-quality advocacy where they need it.

Meningitis B Vaccinations

Jim Shannon Excerpts

Monday 7th July 2014 Commons Chamber

[Geoffrey Clifton-Brown (The Cotswolds) (Con)]

Thank you, Mr Speaker, for giving me the opportunity to raise the important matter of meningococcal B—or MenB—vaccines in this short debate. I also thank the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), for kindly responding on behalf of the Government. I appreciate that I have dragged her to these green Benches at a time when she might well be negotiating with the drugs companies and it might be difficult for her to respond to every one of my points. Nevertheless, she will understand that I must make them on behalf of my constituents and other members of the public.

There will be a number of hon. Members in this House with constituents whose lives have been affected by meningitis B. I have constituents who have had to deal with the suffering and loss caused by meningitis B, which is why I am here today further to raise the need for a national roll-out of the vaccination. My constituents, Dr and Mrs Turner, who are here today, tragically lost their 19-year-old granddaughter on new year’s day this year. As you are aware, Mr Speaker, their granddaughter, Emily, and her parents are constituents of yours. Emily’s uncle is a constituent of my hon. Friend the Member for North Wiltshire (Mr Gray).

Meningitis B is a comparatively rare disease, with about 1,800 cases in the UK each year. According to the charity Meningitis UK, however, many thousands of people die as a result of contracting the illness. The infection progresses rapidly and can lead to permanent disability or death within 24 hours of the symptoms becoming evident. That is sadly what happened to Emily. One in 10 people who contract the infection will tragically die despite the treatment that is available today. Of those who survive, one in five will have devastating life-long disability such as brain damage, hearing loss or limb damage.

Infants under the age of one year are disproportionately affected by meningitis B, with the number of cases peaking at the age of about five to six months. However, there is unfortunately another peak during late adolescence when students mix at university. Those are the two age groups that are most likely to contract meningitis B and the fact that there is another peak later in life highlights the need for a vaccine during infancy to protect people from lifelong suffering from this potentially devastating disease.

Parents up and down the country were given a sense of hope when in January 2013 a vaccine was licensed in the UK as well as in Europe and the US. The Bexsero vaccine was developed by the drug company Novartis and protects against approximately 73% of the different strains of meningitis B with apparently limited side effects. That was obviously very welcome, but there have been extremely long and costly delays in implementing any vaccination programme. The vaccine was turned down by the NHS after being considered by the Joint Committee on Vaccination and Immunisation.

The passion felt by many members of the public that the vaccination should have been implemented straightaway has resulted in various petitions urging the Government to do so. The charity Meningitis Now, which I heartily and sincerely congratulate on its constant campaigning, delivered a petition of 36,000 signatures to Downing street. My constituents organised a petition of around 5,000 signatures and I had great pleasure in presenting that petition to Parliament earlier this evening.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for giving way and for bringing this matter forward for consideration. Meningitis B numbers have halved in the past 25 years, but there is no room for complacency. Some of my constituents have experienced devastating effects from meningitis, so, as the MP for Strangford, my issue is whether the hon. Gentleman feels that the vaccine, when it becomes available, should be available to the whole of the United Kingdom of Great Britain and Northern Ireland.

[Geoffrey Clifton-Brown]

I am grateful to the hon. Gentleman for his intervention. As I shall discuss later, this is obviously a big and costly undertaking for the NHS. As I am sure the Minister will mention later, there are delicate negotiations to be had, but if we start with babies—preferably babies under the age of 12 months—and then roll it out to students, the whole population will eventually have been vaccinated. Perhaps that will take too long, and once we have vaccinated those cohorts of the population, we might be able to find the money later to vaccinate other cohorts, but let us start, for goodness’ sake. In particular, vaccinating young babies would be an important start.

In my view, and in the view of many others, the Bexsero vaccine should have been rolled out immediately. Doing so could have prevented around 600 cases of meningitis B, and the associated 200 deaths between January 2013 and now. Although there have been delays in rolling out this vaccine on a national scale in the UK, it has been available privately since December 2013 for parents able to pay the high price, and it has been used across several university campuses in the United States. I am sure the House would agree that it is unsatisfactory that where a vaccine has been licensed and is available for use, only those who can afford to pay can get it.

Head and Neck Cancer

Jim Shannon Excerpts

Tuesday 1st July 2014 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

I thank my hon. Friend the Minister for coming. She is smiling slightly, because we have had this discussion on a number of occasions and it will continue, at least until I get my way, if that is at all possible over the coming years.

I must begin by declaring a short list of potential interests. I am still a part-time practising dentist—very part-time. I am also chairman of the all-party parliamentary group on dentistry and the APPG on skin, which has a link to this debate.

In an earlier debate, I focused on oral cancer and, in particular, on the causative role of the human papillomavirus. I have been trying to persuade the Minister to encourage the Joint Committee on Vaccination and Immunisation, or JCVI for short—don’t the medicos always do that?—to broaden its horizons beyond the inoculation of teenage girls against cervical cancer. The results in relation to cervical cancer are very encouraging, but the virus is key to the cause of many other cancers, and that applies predominantly to two variations of it.

In a previous debate, the Minister was very nice, and explained sweetly that I must rely on the advice of the JCVI—or, at least, that she must do so. She explained that the committee was expanding its sights. Although it was enlightening to hear that it would be examining the HPV-related effects of men having sex with men, it did not help me very much because I am looking beyond that. I think that the committee should be looking above the waist, and, more specifically, looking at the trauma of pain, suffering and death—a very horrible death—as well as at the financial costs to the NHS of the existence of the virus elsewhere in the human body. I am aware that the virus plays a part in skin cancer, but I have decided to concentrate on the head and neck.

A quick cruise through the latest papers on head and neck cancer makes for frightening reading. Despite the reduction in smoking, the number of head and neck cancer cases is rising steadily and rapidly. The stark reality is that the number of new cases is growing year on year, at a much higher rate than the experts expected. Some are talking of an epidemic. The problem is now so acute that one form of cancer which falls into the “head and neck” category, oropharyngeal cancer, is the fastest-growing cancer in Scotland, and is a significant and growing problem in the rest of the United Kingdom.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising this subject. In the past year in Northern Ireland, 1,218 people have been diagnosed with head and neck cancers, and 64 people die of such cancers every year. Does he think that that is because this is seen as a lesser cancer—if that is the right way in which to put it—than others which seem to catch the eye of the public? If so, does more need to be done to increase the focus on head and neck cancer?

[Sir Paul Beresford]

I am focusing on it, because worldwide it constitutes about 5% of cancers and causes 6% of the deaths, and because, as I think is generally accepted, in a large proportion of cases HPV is a causative agent, or the root cause. There is a way of dealing with that and I think that we ought to adopt it.

In the United Kingdom, the latest findings put the incidence of HPV at 23.5% for oral cancer, 35.6% for oropharyngeal cancer, and 24% for laryngeal squamous cell carcinomas. I have no data for skin cancer, but obviously it applies to head and neck skin. On a personal note, my brother-in-law recently died from a squamous cell carcinoma on his head, which was undiagnosed and untreated, and when it was found it was too late. Head and neck cancers are fifth in the global rankings of cancer incidence, and sixth in the global rankings of cancer deaths.

The cost of oropharyngeal cancer to our health services is enormous. A new report is due to be published following extensive research on the economic cost of head and neck cancer. The findings of the research suggest that the official estimate of the burden placed on the national health service is significantly less than the actual total. The data I have seen of the report that is coming out soon conclude that the cost of oropharyngeal cancer was approximately £115 million at 2011 prices, laryngeal cancer £96 million and oral cavity cancer £98 million. The total at 2011 costs is just under £310 million. We must add that that is almost certainly low because of under-reporting, that we have three years of inflation and, worst of all, three years of increasing numbers of cases. I am not sure, but I suspect that that does not include peripheral rehabilitation costs such as physiotherapy and speech therapy and some cosmetic dentistry in appropriate cases, nor does it cover the unquantifiable cost to quality of life, with the pain and disfigurement that much head and neck cancers produce, and the treatment that is required peripherally for patients.

Perhaps what is most surprising—I have only just discovered this—is that these cancers are more prevalent in men than women at a ratio of approximately two to one. It is common knowledge that the NHS is under immense financial pressure. In fact, demand for access to the NHS is at unprecedented levels. The Government have taken commendable steps towards ensuring that the health service is protected from spending cuts, which have been necessary in so many other areas, but that does not mean budgets have not come under pressure and resources have not been stretched. It is therefore a matter of the very gravest concern that the full economic burden of head and neck cancer, and by extension HPV, is not taken into account. It should be. The whole of the problem of HPV and the way it infects different parts of the body should be addressed by the Joint Committee on Vaccination and Immunisation.

Australia has a policy of vaccination of both males and females. That is producing what is called a herd immunity. Although I am specifically looking at head and neck, with the role of the HPV virus, it is quite clear that there could be a dramatic reduction in a number of cancers, including head and neck cancer, over time with gender-neutral vaccination. Clearly, men currently face a significantly greater, and rising, risk of HPV-associated head and neck cancers.

I therefore again put it to the Minister that it is not fair, ethical or socially responsible to have a public health policy that leaves 50% of the population vulnerable to infection. Such vaccination, combined with early detection and action on smoking and heavy drinking of alcohol, could save a huge number of lives just as we are facing a dramatic increase in head and neck cancer. I hope that the Minister will be able to persuade the JCVI to broaden its horizons and to look at the human suffering, as well as the total costs of HPV to our national health service.