NHS Dentists: South-West England

Jim Shannon Excerpts

Wednesday 24th May 2023 Westminster Hall

[Chris Loder (West Dorset) (Con)]

I beg to move,

That this House has considered the provision of NHS dentists in the South West.

It is a pleasure to serve under your chairmanship, Ms Elliott. I am grateful to colleagues from across the House for attending this very important debate. If someone living in Dorset rings their nearest NHS dentist looking for an appointment, there is a 22% chance that they will be told the practice has gone private. If someone living in Dorset rings their nearest NHS dentist, there is also a 42% chance that they will be told the practice is not taking new patients with special or additional needs. There is a 50% chance that they will be added to a waiting list that is over 12 months, so half the constituents calling today could be waiting until May or June 2024 before they are seen. Finally, if someone living in Dorset is calling to book a dental appointment for their child, there is a 77% chance that they will be told the practice is not accepting new child patients.

The reason for these unacceptable statistics is because access to NHS dentistry in the south-west has been on an alarming downward trajectory for some time. Today, rural parts of Dorset, many of which can be found in West Dorset, experience worryingly low access to vital and sometimes life-saving dental treatment on the NHS. This is no doubt a widespread issue across the country, which is plain for all to see in the recent flurry of debates and questions on this subject in the House. Following this debate, there is an Adjournment debate in the House this evening examining dental care in the north-east, which shows how this issue is affecting constituents across the country.

According to recent reports, a quarter of the adult population in England have unmet dental needs, despite there being 24,272 active NHS dentists. That is enough for one for every 539 people, but these statistics can be misleading, because, importantly, even though there has been a 2.3% increase in the number of NHS dentists this year compared with last year, productivity has slowed. As many as half of these 24,000 dentists have cut back on their NHS work, according to the British Dental Association, forcing more people to either choose to go private and shoulder the burden of these additional costs themselves, or to go without and face the risks of poor dental hygiene that that can bring, such as tooth decay and gum disease.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman and his team of MPs who come along to support one another on these issues. I am really impressed by how well they do their job. They did it yesterday, and they are doing it today; well done to them.

Across the whole of the United Kingdom of Great Britain and Northern Ireland, there are issues. The hon. Gentleman referred to the figures in his constituency; in my constituency, 100% of people cannot get an NHS dentist. Paying online for a whole year’s subscription to a dentist is not possible for many, including people who are elderly. Does he agree that the Minister should liaise with the devolved Administrations, in Northern Ireland in particular and in Scotland and Wales, on how we can better do this together? Clearly, it does not matter where we are in the United Kingdom of Great Britain and Northern Ireland—dentist appointments cannot be got for those who need them most.

[Chris Loder]

I thank the hon. Gentleman for his short and succinct intervention, as ever. He is absolutely right and confirms that this issue needs to be addressed across the United Kingdom, not just in the south-west. I am delighted that he has attended this debate on dentistry in south-west England.

The south-west region was recently rated fifth out of seven for adult NHS dental coverage, with only 35% of adults covered by access to essential dental services, which is below the national average. Dorset fares slightly better, but adults in my constituency and those immediately neighbouring it also experience below the national average coverage for an NHS dentist.

The inequality is also affecting children, whom I am particularly concerned about. Although they are faring better than adults, with a coverage rate of 46% in both Dorset and the south-west, that is still below the national average for access to NHS dental services. Without those services, almost one third of five-year-olds are suffering from tooth decay, which is the most common reason why children aged between five and nine are admitted to hospital. Tooth decay is mostly preventable, so its effects serve to demonstrate what a lack of access to NHS dentistry is doing to our children.

Why are we faced with this difficulty? Why is dentistry in England, and particularly the south-west, under such pressure? Although the answer is multifaceted, I believe the reason is primarily threefold: first, the National Health Service Act 2006 and the subsequent dental contract; secondly, the lack of institutional services and the knock-on effects; and finally, the NHS backlog following the covid-19 pandemic.

The National Health Service Act 2006 set out the provisions for agreement between NHS England and dental practices in relation to services that would be provided and the renumeration for those services. Before the Act became law, the National Audit Office and the Public Accounts Committee both produced reports to the then Government on reforming NHS dentistry, which raised concerns about the 2006 changes. Those concerns included the urgent need to change the incentive mechanism for dentists to increase their commitments to NHS dentistry, the difficulty for patients in better-off areas in accessing public health services, and the difficulty for those in more deprived areas in accessing any services at all.

The reports also raised concerns that there would be a shortage of NHS dentists, a glut of people who would be left without access to NHS dentistry, and no guarantees that the reformed contract would be enough to commit dentists to the NHS rather than private practice.

Cost of Living: Healthy Start Scheme

Jim Shannon Excerpts

Tuesday 23rd May 2023 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

We had a similar debate yesterday about poverty, the cost of living and disabled people. It was a heartfelt debate because everyone brought examples from their constituents. I congratulate the hon. Member for Stretford and Urmston (Andrew Western) on bringing forward today’s debate. It is always a pleasure to add a contribution in support of the hon. Gentleman, but I also support the thrust of what he has asked for.

I always like to give credit where credit is due. The Government and the Minister have genuinely made many efforts to address this issue. The hon. Member for Stretford and Urmston is asking for more consideration. I reiterate that, and do what I always try to do, which is to provide a Northern Ireland perspective. Yesterday’s Westminster Hall debate on the impact of the cost of living on disabled people across the UK was important, but it is also good to discuss the detrimental impact of the cost of living on families. The hon. Gentleman outlined some examples from his own constituents and the people he meets every day. I would like to do the same.

In the UK, we are very fortunate to have the Healthy Start scheme. I can very seldom stand here as a Northern Irish MP and talk about a scheme that applies to the whole United Kingdom, but that one does. It provides huge help to many lower-income families, especially at the peak of the cost of living crisis. The Healthy Start scheme, for which the Minister has responsibility and which the Government have made available, provides a pre-paid card for eligible applicants that allows them to purchase frozen fruit and veg, liquid cow’s milk, vitamins or infant milk-based formula. Some 13,500 households in Northern Ireland avail themselves of the scheme and it has been a Godsend—I use that word on purpose—for those families. It has been instrumental for many people in providing the key nutrition they need at the time they need it. I put my thanks for that on record. The scheme is not only for young children, but for expectant mothers and for new mothers who are breastfeeding.

I want to commend the hon. Member for Glasgow Central (Alison Thewliss), who has been a great leader on this issue through the all-party parliamentary group on infant feeding and inequalities. I am a member of that group because I support what the hon. Lady is trying to put forward. It is a very active APPG. I have spoken at a number of events in Northern Ireland and the hon. Lady has always ensured that breastfeeding is central to the debate. I have no doubt that when she speaks shortly that she will add some of the thoughts that she has expressed in APPG meetings.

In Northern Ireland, the scheme has been good for expectant mothers and new mothers who are breastfeeding. I would like to say how important it is to receive the right support at the right time. In Northern Ireland, eligibility for free school meals does not start until primary 1, the equivalent of year 1 here in England, so before children start primary school, the responsibility to provide them with nutrition is solely on mothers and families. I did not see the story on the news about people hearing their children crying for food, but the hon. Member for Stretford and Urmston told it well. I am well past the baby stage now, but I had my grandchildren at our house at the weekend. Whenever they want to be fed, they want to be fed right then, so when the hon. Gentleman tells a story about a child crying because they are hungry, I understand how important it is that we can respond.

Unfortunately, some people struggle to afford food, and the additional pressure of the cost of living has made things considerably harder for mothers and families, which highlights the importance of the wonderful Healthy Start scheme and why it is so crucial for so many parents across the whole of the United Kingdom of Great Britain and Northern Ireland. Northern Ireland statistics show that 330,000 people in Northern Ireland live in poverty. That is a massive figure out of a population of 1.95 million—almost one in five people. Sadly, it includes 110,000 children, which means that the poverty rate is highest among children. This is an issue that I deal with every day in my office, and—the hon. Member for Stretford and Urmston referred to food banks—my staff try to help people through the food bank in Newtownards, which has been used 50% more than it was last year. That gives Members an idea of what is happening. Food banks have a role to play, and they bring good people together. They bring together churches, charities and people in order to reach out and help, and they do that with a kindness and generosity that always amazes me.

The figure of 110,000 equates to one child in four—24%—living in poverty. I ask the Minister to consider extending the eligibility criteria for the Health Start scheme so that more people are included. If I had one request to the Minister, that is what I would ask for. I know the hon. Member for Stretford and Urmston referred to the issue, and I think we are all united on that. So many working individuals are already on the breadline and are unable to support their families because of the cost of living, which is something that we deal with every day in our offices and advice centres. Working families who are struggling to cope should be able, at least temporarily, to avail themselves of the perks of the Healthy Start scheme while the rise in the cost of living is proving so prevalent.

There are so many factors that sew into why so many people and their families are struggling. We are not blaming anybody, because there are circumstances beyond our control. The Ukraine war is one example, as is the cost of energy. They are the fault of nobody in this room, but they are among the factors. What we get from our Government and the Minister is compassion and understanding, and increasing or reviewing the eligibility for the Healthy Start scheme would be a massive step in the right direction. Other factors include the cost of living, the removal of the uplift in universal credit, and the basic rates of maternity and paternity pay for certain forms of employment.

My benefit adviser, who works from both of my offices in Strangford, in Newtownards and Ballynahinch, is a very busy lady and spends five days a week doing nothing but benefits, which are complex. The wonderful thing about her—I say this to her face, so I am not saying anything that I have not said before—is that she understands the benefit system. It can be complex for people to take on board, but she understands it and can offer help through it to address the cost of living, which is impacting on all sorts of people from all kinds of communities.

I have spoken numerous times in the House about the increase in food bank referrals from my office. The food bank in my town is run by the Trussell Trust and was the first one in Northern Ireland. It tells me that my office refers the most people for food bank packages. I probably see more than most people what it means to be desperate, with some being too embarrassed to ask for the help they need. I have also spoken before about the need for universal free school meals. I am not sure whether it is the Minister’s responsibility, but perhaps he could indicate whether it is possible to provide support for children, who are the future—we must not let them down. I love children; we all do. We have our own families, children and grandchildren, and we want to see them do well. However, we also see the children of people who come to see us, and the desperation in their eyes as they try to reach out and seek help. That is what we desperately want as well—to be able to respond in a positive fashion.

I ask the same for the Healthy Start scheme; we should do more to assist expectant mothers and children up to four, who also need help. It should not depend on what parents earn or how much they are struggling, there should be an acceptance that this is a hard time for everyone. We can do more to provide that extra bit of support. The hon. Member for Stretford and Urmston has asked for that. I endorse it; I support it, and I know others will as well. I also encourage greater discussion between the devolved Administrations to keep a constant eye on the situation, and to assess what more we can do in this place to support people who are struggling daily to make ends meet.

I look forward to hearing from the two shadow Ministers—the hon. Member for Glasgow Central and the hon. Member for Denton and Reddish (Andrew Gwynne). The three of us are always together in the same debates, and more often than not with the same Minister to respond. I look forward to hearing from him as well.

Recovering Access to Primary Care

Jim Shannon Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

My hon. Friend touches on an extremely important point. The measures will provide, for all Members of the House, much greater transparency on the variation between primary care settings. I am keen that we should publish much more information showing, within constituencies, the differences in the services offered by different primary care settings. We already see that between those that have digital telephony and online booking and those that do not, but we also see that in other indicators, and I am keen that he and other Members of the House get visibility of that.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement. The primary care recovery plan is very welcome, and it will be wonderful for NHS England when the goals are achieved. However, I have a very specific question about Northern Ireland. My constituents are struggling to get hold of their medical records over the phone for personal independence payment assessments and appeals. He referred in his statement to improvements in the app system. What discussions will he have with the Department of Health in Northern Ireland about introducing a similar system to enable patients in Northern Ireland to access their medical records via an NHS app?

[Steve Barclay]

The hon. Member is right to recognise the importance of access to medical records. It is a key part of the functionality that we are delivering through the NHS app. He is correct that that is focused on England and not on Northern Ireland, but I am very happy for us to have discussions with him and his colleagues in Northern Ireland on any shared practice.

Epidermolysis Bullosa: Drug Repurposing Trials

Jim Shannon Excerpts

Tuesday 9th May 2023 Commons Chamber

[Gareth Bacon (Orpington) (Con)]

Epidermolysis bullosa is dreadful. It is often referred to as butterfly skin. It is a little known and rare genetic skin blistering condition, which causes skin to blister and tear at the slightest touch. BE—I will be kind to myself and refer to it in the rest of my speech as BE—causes excruciating, lifelong pain, and can have a devastating impact on the physical and mental wellbeing of patients. It can also greatly affect patients’ families because of the constant treatment needed. In many cases, this means several hours of bandaging and unbandaging the most affected parts of the body daily. In its most severe form, EB also affects internal organs and eyes, causes severe problems when it comes to eating and drinking, and requires extensive healthcare—and there is no cure. It is believed that EB affects around 5,000 people in the UK, although there is limited information available from the NHS. Although that is a relatively small number, the severity of the condition is such that it has a deep impact.

I was asked to secure this Adjournment debate by some of my constituents, DEBRA, which is a UK-wide charity supporting people with EB and their care givers, healthcare professionals and researchers who work with EB. The charity exists to improve quality of life for people living with EB, and to fund pioneering research to find effective treatments. The charity works in partnership with the NHS to deliver EB healthcare services. There are four centres of excellence delivering specialist care in the UK, along with additional hospital care and clinics at other locations. The charity has a proud record of funding EB research in the UK and internationally, funding the first clinical trials in gene therapy. Its current focus is on fulfilling its mission to help people with EB live a life free of pain, a point I will return to later in my speech.

Many colleagues may be familiar with DEBRA from some of its network of more than 100 charity shops, which are the main source of the charity’s income. I was able to visit one of the DEBRA shops, located in Locksbottom in my Orpington constituency, a few months ago, and I met not only the volunteers there, but a local constituent called Wendy, who suffers with EB. This particular lady has been suffering from EB since birth, and she told me of her experience and the experience of others who have an even more severe type of the condition.

As a child and even as a young lady, Wendy did not know that she had EB because doctors had not diagnosed the condition, which, particularly in the early years, is difficult to spot. She did, however, suffer constantly from blisters on her feet and her legs. Wendy told me about how, while she was growing up in constant pain, she would try to hide her wounds from friends and classmates, and would avoid wearing skirts to avoid causing unpleasant reactions from others. Yet as terrible as this sounds, Wendy told me her case was not uncommon and not as severe as it was for other patients.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for bringing this debate forward. He raises an issue that affects not only his constituents, but mine and those of others across Northern Ireland, so I commend him. Does he not agree that this dreadful disease, which is named the butterfly disease because it is unusual, has the capacity to limit life and the quality of life, and that the funding for the treatments he refers to, which can provide relief to constituents in all of our constituencies—in his, mine and those of others in this House—is vital? Would he urge the Minister, who is a very compassionate man and understands the issue very well, to give even the smallest bit of funding towards research to try to find a cure for the disease and to help the lives of those who have it?

[Gareth Bacon]

I thank the hon. Gentleman for his kind words and the way he expressed them, and I agree entirely with those sentiments. Without giving out too many spoilers at this stage, there will be a request for a small amount of funding towards the end of my speech.

What I learned during the visit I referred to was truly moving, and I am particularly grateful to have met Wendy. I also thank DEBRA’s director of research, Dr Sagair Hussain, and the excellent staff at the charity shop in my constituency, for inviting me to visit them and learn more about how they help individuals who live with this painful condition. In the spirit of thanking people, I also thank the Minister for his interest in this subject and for being here this evening to respond to the debate, and the Minister for Social Care for recently answering a written parliamentary question that I tabled about EB.

I stress that we cannot merely wait for a cure for this condition. We need to make a difference for patients who are suffering today and those who will be living with the condition for the foreseeable future. All EB patients are crying out for better therapeutic treatments, which have the potential vastly to improve their lives. DEBRA has set an objective of securing two to three treatments from drugs that are already licensed for other conditions, to radically improve the quality of life experienced by people with EB. In reply to my recent written question, the Minister for Social Care said that medicines that are potential candidates for repurposing in this way should be put forward for consideration for support from the Medicines Repurposing Programme. I am grateful for her guidance, and officials from the MRP have been in touch with DEBRA since to talk about the programme’s work. That is excellent news.

In addition, I was delighted to hear that some innovative treatments for EB are either in trials or are being considered by the National Institute for Health and Care Excellence. Specifically, NHS England is working with NICE on the evaluation of two products for EB: birch bark extract for skin wounds, and a gene therapy with a name that I find particularly difficult to pronounce, although I will give it a shot—beremagene geperpavec. I have almost certainly mispronounced that, but it is still encouraging news. However, my understanding is that those two treatments will be available only to a fraction of the total number of people suffering from EB. That is why the repurposing process for more mainstream therapeutics is so important.

DEBRA has identified six anti-inflammatory drugs that could help with EB. Several of those are already available for people with more common skin conditions such as eczema and psoriasis, but for people with EB they could be nothing short of life-changing. They have the potential to transform thousands of lives by improving wound healing, reducing pain, and lowering the burden on the family members and carers of those with EB.

--- Later in debate ---

[Will Quince]

If I am available I would be happy to do that. I thank my hon. Friend for his support for that charity, which is based in his constituency but works nationwide. The support that constituency Members of Parliament provide to charities through this place should not be underestimated. If I am able to attend, I will.

[Jim Shannon]

When we spoke earlier, I was quite sure that the Minister is truly a compassionate man. He has given us the answers that we wish to hear, and I thank him for that. He talks about the possible cures for EB. Will that information be shared with all devolved Administrations? I think he said that it would be, but I wanted to check.

[Will Quince]

Absolutely. We work on clinical and medical research across our United Kingdom, and rightly so. We work very closely across all four nations.

I am conscious of time, and I want to pick up on the final question from my hon. Friend the Member for Orpington about generic versus branded medicine and the MRP. Branded medicines are potentially eligible for the medicines repurposing programme. I understand that the eligibility criteria state that the programme can support generic, biosimilar and branded medicine. I would be happy to look at my hon. Friend’s list.

In closing, I give my thanks again to my hon. Friend for securing today’s important debate, and to all Members who have contributed. I also pay tribute to the whole EB community and charities such DEBRA and Cure EB, which I know work tirelessly to improve the lives of people affected by the condition. They are fortunate to have my hon. Friend in this place as their champion.

Question put and agreed to.

Reforms to NHS Dentistry

Jim Shannon Excerpts

Thursday 27th April 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

May I say what a pleasure it is to speak and give a Northern Ireland perspective to this debate, as I do in every debate I attend? The Minister has no responsibility for Northern Ireland—he knows that; I know that. Nonetheless, I would like to add a Northern Ireland perspective, which will back up the comments that others have made.

This is a matter of increasing concern as more and more dentists are refusing NHS clients and leaving a wide number of people without access to basic dental care. I will give two examples. One constituent came to see me after her front teeth bridge had fallen out, and we could get her a dentist only outside of the constituency, because there are no NHS dentists prepared or able to take that work on. It took one of my staff more than an hour to find someone accepting NHS dental charges, as all dentists have switched to a pay monthly plan. It is clear that covid-19, Ukraine and the rising prices are all taking their toll as the pressure lines up against dentists as well. Another lady come to see me who was in her 80s. She told me that because she does not do online banking, she had to pay a year in advance to stay on her dentist’s books. I find that reprehensible to say the least. While that lady did have the wherewithal to do so, not everyone does. With this happening, I believe that we can see the end of free NHS dental care. It cannot be that those on a low income ignore a loose filling until they lose a tooth, and yet that is what is happening.

Having said that, I have to make it clear that I am not saying that the dental industry is greedy. I am saying that I believe the Government must step in and devise a new scheme that will adequately compensate dental practices and allow people to access the dental service they so desperately need.

I received an interesting briefing from Denplan that highlighted the fact that more than 19 million dental appointments were lost over the course of 2020. Some 70% of Denplan member dentists reported concerns about the future financial stability of their practice, while

“the pandemic also exacerbated issues with mental health and wellbeing.”

The surveys included in the briefing

“indicated that dentists believe there is a misunderstanding of the industry in general”

—this is what the industry itself is saying—

“which has manifested into a relatively poor relationship between policymakers and the dental profession over the years. Member dentists who responded to the October 2020 survey, indicated dental services are often treated as an afterthought, with the government’s communication with the sector considered to be lacking.”

If I were to take one ask from today’s debate, that would be it. I know that this is a Minister who understands: he is always easy to speak to and engage with, and he understands things very well. May I ask him now to engage with the dentistry sector to come up with some ideas about how to move forward? That is what they desperately need.

The briefing states that

“67.52% of respondents to the 2020 survey, said they ‘strongly disagreed’ with the statement ‘the government understands the dental sector’.”

It is clear that the Government do not understand it. Moreover,

“36% of respondents said the pandemic had affected their oral health—with 50% of those who had seen a decline in their oral health, saying that they had had appointments delayed, or were unable to book any dental appointments with their dentists… According to our data, the pandemic also changed…attitudes towards dental treatment, with 29% saying that following issues during Covid-19, they now value their oral health more and are more likely to visit a dentist.”

That, at least, has been a plus factor. However, the briefing continues:

“Nonetheless, existing backlogs and an exodus of staff is preventing patients from accessing the dental care they need”.

Others have mentioned that.

I am very conscious of the timescale that is expected of me, Mr Deputy Speaker, but I want to make a very quick comment. On Tuesday morning, I saw a television programme—we probably all saw it—about a lady who, because she could not access a dentist, removed 12 of her teeth. That had all sorts of impacts, affecting her social engagement and causing her anxiety. A dental charity then stepped in and restored all her teeth. Today she is engaging with people again, and is back at work.

Sometimes people resort to doing things that they really should not do, and would not normally do. According to the briefing, some 41% of people in Britain said that they

“would be willing to undertake DIY dentistry”.

That worries me as well. Among younger people the figure was 48%, and among seniors it was some 28%.

Let me end by quoting Ciara Gallagher, chair of the Northern Ireland Dental Practice Committee. She has said this:

“In the meantime, practices need help, they need hope, and they need urgent action from the department to know that they have a future. They need support so that they are not being financially starved out of the NHS.”

I join all my colleagues who are present today, on both sides of the Chamber, in asking for better liaison with the dental industry, and increased funding to shore up NHS dental access throughout this great United Kingdom of Great Britain and Northern Ireland.

Medicinal Cannabis: Economic Contribution

Jim Shannon Excerpts

Thursday 20th April 2023 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate and to serve under your chairmanship, Mr Stringer. I thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for leading the debate and for setting the scene so well and in such a balanced way. In his introduction, he said that we all have constituents who have benefited from medicinal cannabis. I have one such constituent, and I want to speak about that young girl and her family, because I have seen at first hand exactly what medicinal cannabis can do to improve health, to lift the fortunes of a family and to give them the encouragement that they need.

As the DUP spokesperson for health, these issues are very important to me. I have seen at first hand the impacts that medicinal cannabis can have on people who are ill. It is sad that it does not work for everyone, but it has certainly worked in cases that I am aware of. There are success stories, but also a large proportion of people for whom it does not work. However, for those who are fortunate enough to see results, it is a crucial treatment that can ultimately save lives. I am here today to celebrate that.

By their very nature, issues such as this can sometimes be contentious. The right hon. Gentleman set the scene well and got the balance right. I congratulate him on that because he presented the issue well. This subject sometimes sparks debate, but we would try anything if it gave someone a better chance at life.

There is never a debate on this topic in which I do not highlight the benefit of regulated medicinal cannabis prescription by talking about lovely Sophia Gibson. She is a young girl who, at about six or seven years old, was having epileptic fits every day of her life. In my office, I have a photograph of her from when she was smaller. She is the daughter of Danielle and Darren and has Dravet syndrome, which is incurable, and she will continue to have seizures until her wee body can no longer cope.

Medicinal cannabis is not the cure for Sophia—there is no cure—but that young girl’s quality of life has changed dramatically. I can remember when the epileptic fits were of such ferocity and in such numbers that it was impossible for that young girl to have a normal life, but today her life has changed. The prescription from the health board changed not only her life but the lives of her distraught parents. She was in hospital every month and was missing months of schooling at a time, but Sophia’s THC prescription has enabled her to attend school, because the intensity and number of her epileptic seizures has drastically reduced.

I recall the meeting that I had in this House with the then Minister, Mark Field, and Sophia’s mother, Danielle. I have said it before in this House and I will say it again: the Minister was such a help to Danielle, young Sophia and the whole family in moving forward. Ultimately, through Mark Field’s help, the assistance of the health board back home and the Department here, Sophia was able to receive medicinal cannabis and her life changed. That is what I see: I see a real difference in a young girl who was potentially looking at a life that was going to get worse and worse.

I have a wee nephew. I often say this, and I say it with regret because medicinal cannabis was neither available at that time nor did I have knowledge of it. My sister, Joy, has one child. He has epileptic fits. I often wonder whether, if he had had access to medicinal cannabis, it would have been possible to have changed his life. I am not saying that would have been the case, but now it is too late, because he has had so many years with the condition that it is impossible to put his life back.

Sophia still needs 24-hour care, but she can also live a life with her family. It did my heart glad to see her travel, as she did just last year with her family to Disneyland Paris. The family always bring their pictures in to encourage me; it is good to see her progress through the pictures. I saw a picture of Princess Belle dancing with Sophia. That would not have been possible without the blood, sweat and tears, the dedication and commitment, of her mum and dad, who did not cease until their daughter got the medication—they would do anything for their child, as parents do; and how right they are—or without the Health Minister at the time, Mark Field. Nor would it have been possible without the will of this House to take steps to provide for the safe classification of this drug for medicinal purposes.

While I celebrate Sophia’s victory, I also support my colleagues in trying to secure access for more children like her. That is why I am here today. When I saw the title of the debate, I automatically said to Naomi, my speechwriter, “I’ve got to be here for this debate—it’s important to me.” I have seen first hand the improvement to Sophia’s quality of life, and I want more people to be able to access this treatment for that purpose. I want to clarify: I am not looking for a free-for-all—and I do not think the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale is either, by the way. I want a process that allocates the drug in specific circumstances, as directed by the Health Department. I do not think we are currently there.

There are so many companies that are investing in cannabis plant products for healthcare, because the benefits for those it works for are incredible. We know that the UK is the world’s biggest producer and exporter of legal cannabis for medical and scientific purposes. Globally, there is a rising trend in the legal production and use of cannabis for medicinal and scientific purposes. Jazz Pharmaceuticals has offices in Oxford, Cambridge and London, and manufactures the products Epidyolex and Sativex, and Target Healthcare makes certain bedrocan cannabis oils in the UK. In 2019, a major US cannabis company set up its European headquarters in—guess where?—Belfast. Colorado-based Mile High Labs, which is the largest extractor of cannabidiol isolate in the world, established its base on the Boucher Road in Belfast, so we have moved forward.

The benefit of medicinal cannabis to individuals and their families, as well as the economic benefit that is starting to arise from it, is reason enough to review the approach. That is what the right hon. Member is asking for, and I support his request. We are talking about allowing wider production and delivery within—ever mindful of what I said earlier—the strictest of frameworks. I will be clear again: I am not in favour of legalised cannabis in any other capacity than GP or consultant-led, and within the strictest medical protocols. But I believe that we can and should provide a safe and effective product to help those who need it for specific reasons within the pro forma.

I again thank the right hon. Member for introducing the debate. Sophia is my example of a young girl who has progressed to the point where she can attend school regularly. I met her at one of the fun days down on the West Winds estate in Newtownards last year. What a difference I can see in that wee girl. The wee girl in the photograph in my office was, at the time, having fits every half an hour or 45 minutes. Today, her and her parents’ lives have changed. In Sophia’s case, medical cannabis gave her a chance to live her best life with a debilitating condition. That is vitally important. I know each one of us in the Chamber wholeheartedly supports that. Can we make someone’s life better? I think we can. Sometimes when we do so, it is such a magnificent occurrence that it leaves a lasting effect on us.

NHS Strikes

Jim Shannon Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

I do share my hon. Friend’s concern. Full Fact has shown that the figure is inaccurate. It disregards higher pay later in the evenings and at weekends. It ignores the 20% that goes into pensions and that junior doctors, probably more than any other profession, have very quick pay and career progression. That is why, as part of our listening exercise, we made changes to pensions in the Budget. That was a reflection of the fact that senior doctors have often accumulated those pension pots, which is one of the other challenges we are dealing with. It is an indication of the career and pay progression that many junior doctors will see later in their careers.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State very much for his endeavours to find a pay settlement, ever mindful that it is more than pay that some NHS staff wish to see. To give an example of that, I recently sat listening to one of my constituents who is in foundation year 1. She was brought to tears by the stress and pressure on her young shoulders. When she finally finishes shifts, she lies awake going over the decisions made. In her view, she would keep her pay the same to have more qualified staff available. How will the Secretary of State’s proposals make adequate support on the wards possible?

[Steve Barclay]

The hon. Gentleman raises an important issue, and there is a lot more we can do around the skills mix in the NHS and ensuring that people operate at what is referred to as the top of their licence and make the maximum of the training they have. Often there are restrictions in place. We are looking at physician associates and medical examiners and at the role of pharmacists within primary care, as well as at how we get the right continuing professional development to train people, so that we get more of the career ladder from different roles.

There is a lot that we are looking at, in the context of the workforce plan, around the right skills mix, the right training and job evaluation. That was one of the issues in my discussions with the staff council—for example, there was a particular focus on apprenticeships. Sometimes people take a pay hit when they go into an apprenticeship if they were at the top of their previous band. That is one of the things we agreed to work on with the staff council. Again, I am sure that an area of consensus in the House will be that apprenticeships offer great opportunities for people to progress, and we should not have a financial penalty when people pursue them.

Junior Doctors’ Strikes

Jim Shannon Excerpts

Thursday 30th March 2023 Commons Chamber

[Steve Barclay]

There are two different things there—one on which the hon. Gentleman is correct and one on which he is not. He is correct that we have said that a precondition for meaningful and constructive talks is that the trade union suspends strikes. That is a precondition that the other trade unions were more than willing to accept, and it is applied in other sectors such as education. We have been clear on that.

The hon. Gentleman is not correct on my point about militancy, which referred to the junior doctors committee specifically. We stand ready and recognise the real pressure that many within the junior doctors community have faced. The NHS has been under significant pressure coming out of the pandemic. We recognise that there are issues on which we want to work and have constructive engagement with them. It is just regrettable that some in the junior doctors committee of the BMA want, as they have said in media interviews, to take a more overt political agenda, rather than work with us to focus on the real issues that many junior doctors are concerned about.

[Jim Shannon (Strangford) (DUP)]

I note that the Secretary of State is trying extremely hard to try to find settlements. The settlement with the Royal College of Nursing and the nurses is an example of just that, although it took a bit of time—I would have liked to see it happen sooner. Will the Secretary of State outline what support is available for junior doctors who need greater support from registrars and consultants to restore confidence—that is the whole point of the F1 and F2 process—so that they are not left to drown under the pressure of handling entire wards on the worst shift patterns possible, wondering, when they go home, whether the decisions that they have made are the wrong ones? Will the Secretary of State ensure that financial and wage negotiations will be constructive, as he did when it came to the RCN and the nurses?

[Steve Barclay]

I am very happy to give the hon. Gentleman reassurance about our desire to have that constructive engagement, exactly as we had with colleagues on the NHS staff council. There are a number of issues on which we are keen to work with junior doctors: rostering; which he mentioned; holidays, which are sometimes cancelled at short notice—a range of issues have been raised with me. When I go on visits to hospitals, as I do frequently, staff raise a range of issues, and I am very keen to work through them with junior doctors. I think that people can see from the approach that we took not just with “Agenda for Change”, but with the pension changes that were announced in the Budget, that the Government are working constructively with the NHS to address those issues. We stand ready to have exactly that meaningful and constructive engagement with junior doctors.

Medical Technology Regulations and the NHS

Jim Shannon Excerpts

Tuesday 28th March 2023 Westminster Hall

[Dame Caroline Dinenage (Gosport) (Con)]

I beg to move,

That this House has considered medical technology regulations and the NHS.

It is a great pleasure to serve under your chairmanship, Sir Gary, and to talk about the importance of medical innovation and medical technology in our NHS. We know that the NHS faces significant challenges, but medical technology—or health tech, as it is often called—holds many of the solutions that are necessary to achieve things such as delivering improved patient outcomes and facilitating the transition to more sustainable models of health and care delivery. It also has massive potential to drive economic growth.

Health tech includes everything from laboratory tests to wound care dressings, mental health apps, implantable defibrillators and critical technology—everything that is absolutely fundamental to the diagnosis and treatment of health conditions. Life-saving and life-enhancing health technologies, such as cardiac pacemakers and artificial knees and hips, are already highly regulated products. While we were part of the EU, UK-based health tech was subject to CE marking, but now there is a need to develop sovereign regulatory arrangements that provide equal levels of patient safety while protecting timely access to global life-saving and life-enhancing health technologies.

The Medicines and Healthcare products Regulatory Agency is solely responsible for regulating the UK’s medical devices market and is mandated to ensure that patient safety is protected, irrespective of where a product is manufactured. The MHRA has a huge responsibility on its shoulders, and it is for that reason that I welcome the Chancellor’s commitment in the spring Budget to reform regulations around medicines and medical technologies. In fact, that was the thrust of why I asked for this debate, so it is lovely to be able to welcome that announcement rather than to be pushing for it. It is a much more comfortable position for me to be in.

The Chancellor confirmed that the MHRA will receive £10 million of extra funding over two years to maximise its use of Brexit freedoms and accelerate patient access to treatments. He also confirmed that the MHRA is moving to a new model, which will allow near automatic sign-off for medicines and technologies that have already been approved by trusted international partners in places such as the USA, Japan and Europe. That is important, because the US Food and Drug Administration—the FDA—is recognised as delivering high-quality, innovative health tech to its citizens in a timely manner while maintaining high standards of patient safety. Those product regulation-equivalent routes, which recognise the decisions of trusted jurisdictions that have already looked at medicines and technologies very carefully, can protect NHS patients’ access to high-quality products and allow our own regulator to focus resources on where they can make the most impact.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this issue forward, and I apologise to her and others for not being able to stay—I have another meeting at 5 o’clock, as I mentioned to you, Sir Gary.

I am my party’s health spokesperson, so I am very aware that regulation is essential to our health service. I strongly believe that regulation and demand should go hand in hand on health. Regulating the use of apparatus, instruments, tools, scanners, drugs and monitors is one thing, but does the hon. Lady agree that accessing them is another? It is imperative that we ensure that patients can make use of life-saving treatments. Aspiration is good, but delivery is better.

[Dame Caroline Dinenage]

It is always a great pleasure to see the hon. Gentleman, who always make very sensible interventions on these issues. He is absolutely right: we need the right regulation in place, but we also need to have the facilities to make sure that, once technology and treatments have been approved, they are easily and quickly accessible to those who most need them.

I will be the first to admit that I was not the biggest advocate of Brexit. However, the freedoms afforded by Brexit allow us the opportunity to recognise approvals from any jurisdiction that we deem appropriate. Of course, any products that enter the UK market via regulatory equivalence routes from trusted international jurisdictions will need to be approved by the MHRA and to be subject to strict vigilance and post-market surveillance requirements, so a number of checks and balances are in place for British patients. However, this new system post Brexit gives the UK more control to determine what products can be placed on the market.

As the hon. Member for Strangford (Jim Shannon) said, we must ensure that the regulatory system is robust but also prevent the UK from becoming a secondary market, where patients and clinicians have less access to technologies. The right system not only increases the UK’s access to the newest innovations but increases patient safety by maintaining access to the widest possible range of thoroughly regulated and already available health technology from around the world.

Therefore, my first question to my hon. Friend the Minister—I should warn him I have two or three—is whether he can confirm the timescales for the new model to ensure continued patient access to health tech and whether there will be a sense of urgency about this. The Minister and you, Sir Gary, will know that the pandemic, through the early innovation of the vaccines and the remarkable work done by British scientists, demonstrated the UK’s ability to be a real science and technology superpower. However, there is an urgent need for action to ensure that we do not lose the opportunity to impact patients’ lives and effectively deliver on this ambition and this ability.

We have the potential to make the United Kingdom the most attractive place in the world for innovation and, in particular, medical innovation. We know that medical technology helps to deliver better patient outcomes, improves care pathways, drives cost savings in the NHS, reduces the burden on the workforce and, critically, can help to reduce the backlogs. This matters to people’s lives. In the Hampshire and Isle of Wight integrated care board area, more than 54,000 people are waiting to start treatment. The average time people are waiting in my local area to start their treatment is 16.9 weeks, with 47% of patients waiting more than 18 weeks. That is why we need to capture the potential of every way possible of ensuring that people get access to treatments as effectively and quickly as possible.

In Gosport, 1,500 people have a dementia diagnosis. Dementia is one of the biggest healthcare challenges facing us as a nation, but there are some exciting and innovative developments there too. The EDoN—Early Detection of Neurodegenerative diseases—project will use wearable tech to detect signs of dementia even 10 to 15 years before symptoms appear. Too often, a dementia diagnosis comes far too late—once symptoms are already well advanced. This technology could be game changing by allowing people to make advance lifestyle interventions that might minimise the impact of the condition. However, it will also enable scientists to make a huge contribution to research and clinical trials of drugs and interventions that will work, inevitably in the long term, through to treatments and cures.

This is also an area where we need to see the rapid approval of new treatments as they become available. In January, the FDA—the US regulator—approved the first treatment shown to slow degeneration in dementia. Two drugs are currently on trial in the UK, and the people conducting the trials expect to publish their findings later this year. Neither drug has an easy name to pronounce: donanemab and lecanemab. Can the Minister please assure me that the MHRA stands ready to accelerate the approval of these schemes as soon as they become available—it sounds as though one is imminent; it may be in the next couple of months—so they can start supporting patients at the earliest opportunity?

If I may just flag one issue with the Minister, one obstacle to these drugs being available on the NHS is the National Institute for Health and Care Excellence guidelines, which often approve medicines based on their cost-effectiveness. In this case, it will be remaining years of healthy lifespan versus the cost to the NHS. The cost of dementia is of course largely not borne by the NHS—the cost to it is only about £1.5 billion a year, compared with the £26 billion borne by the adult social care system and the informal care sector.

Will the Minister kindly agree to meet Alzheimer’s Research UK to discuss how we can best ensure that UK patients get swift access to the best possible dementia drugs as soon as they are available and that the systems designed to offer checks and balances, such as NICE, do not prove to be an obstacle to that?

Will the Minister assure us that every effort will be made to engage with the global health tech industry to ensure that the UK proactively seeks innovations for the benefit of UK patients while encouraging UK-based innovation? There is a lot of innovative practice going on right under our noses. Health tech will play such a key role in driving not only UK national economic growth but great amounts of regional growth. There is an organisation called SIGHT, or Supporting Innovation and Growth in Healthcare Technologies, which is a business support programme developed by the University of Portsmouth to provide help and guidance to small and medium-sized businesses in the healthcare technology sector. In the Wessex region, which is where Gosport sits, 10% of the workforce is employed in the health economy, and more than 300 health and life sciences companies are focused on medical technological innovation. The SIGHT process will provide an important boost to the regional economy through its support for the sector. What steps is the Minister taking to encourage local innovation and entrepreneurship in the medical technology sector, and how can he enable the implementation of innovation in the local care system, which can sometimes be quite risk averse?

To maintain the NHS’s access to the 600,000 currently available CE-marked products, it will be important not to add unnecessary burdens on to manufacturers that already supply a relatively small market, so transitional arrangements provide for a dual regulatory regime, with the unilateral recognition of CE marking in place until July 2024, subject to legislative approval. That recognition could be continued and expanded for the benefit of the NHS and patients across the country. Perhaps the Minister could talk a bit about that.

We need to act fast. A recent survey by the Association of British HealthTech Industries—the ABHI—shows that one in five products is expected to be removed from the market over the next five years, and one in 10 companies is halting all innovation activity. That has been driven by persistent uncertainty, constrained capacity in the system and increasing costs. The ABHI survey also highlighted that 67% of the health tech industry expect a delay in bringing innovation to the UK, and the figure rises to 86% for those manufacturing in vitro diagnostic medical services.

The right kind of regulation will be key in setting the standard as to whether the UK is an attractive place to do business and promote innovation. It will ensure that UK patients continue to receive world-class technologies such as surgical robots and digitally enabled remote care, and it will protect our ability to react swiftly and effectively to any further pandemics by developing the latest diagnostic tests.

In addition, I understand that the Government are already committed to a medical device information system. That will collect key details of the implementation of all devices, which will be linked to a specific register to research and audit patient outcomes. That will deliver a system that allows the UK to record and access device safety and patient outcomes. That medical device roadmap lays out an ambitious vision for how the UK can become world leading in this space and a real global superpower in digitally enabled health tech. Will the Minister assure us that its delivery will be prioritised to ensure that we build on the positive reaction to its publication?

There are concerns that existing capacity constraints may impact the MHRA’s ability to deliver and most effectively use the additional funding that the Chancellor has made available. Making the most of expertise and capabilities across the ecosystem will be crucial. As well as the development of more product regulation equivalence routes to allow for the recognition of approvals in other trusted jurisdictions, we must explore all other options to ensure the expansion of existing capacity, including by reviewing the role that the MHRA can take in direct regulation, providing it with both the resource and political impetus to increase UK regulatory ambition, and enabling the development of recognition and innovation systems.

The recent commitment by the Chancellor and the Prime Minister is welcome, and it indicates that the Government truly recognise the need to ensure that there is appropriate focus and support for the ambitious innovation programme that supports clinical and patient need, availability, and choice. It is by investing in developing the skills required that we can ensure that the UK continues to be a leader in regulating the technologies of the future.

The freedoms afforded by Brexit allow us to seize the once-in-a-generation opportunity to deliver a best-in-class regulatory system and enable the health tech industry to support the drive for the UK to become, and continue to be, a global science and technology superpower.

Car Parking: Care Workers

Jim Shannon Excerpts

Thursday 16th March 2023 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Southport (Damien Moore) for setting the scene so well. I always try to contribute in debates on health issues, as Members know. Here we are again: the hardy annuals are back. The Minister, the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne) and others are here to contribute.

I am an advocate for care in the community. I feel strongly about the problems the hon. Member for Southport outlined.

I know the Minister has responsibility only for the mainland, but I always try to give a Northern Ireland perspective to any debate. It will be not just a Northern Ireland perspective, but a personal one, as it relates to my brother. He had a very severe motorbike accident when he was 39 years of age, some 18 years ago now. They said he would never be independent again and would never be able to do the things he once did. And he cannot, because he has been left with some fairly severe brain injuries.

Although our Keith cannot multitask, he can still have a life—but it is restricted and he is dependent on others. My mother is 91 years of age. I refer to her as a spitfire, because she is a lady who pushes and pushes. She pushed for Keith because she wanted him to return home and have a life, even though it would be with care attendants for a time. She pushed him into rehabilitation. He was determined, but she also made sure that the carers and the health system pushed for him. She pushed the workers in the care homes to keep driving him further. She pushed the trust to provide the care for him. Keith has been living at the bottom of my lane—I live on a farm and the house he lives in is a house that I built—and he gets picked up by the bus drivers outside the house. There is no bus stop. They drop him into Ards and he goes to the centre where he learns further rehabilitation and engages with others who have similar disabilities. It gives him the chance to have as normal a life as possible.

His care workers come in four times a day and help him get up. He has a brilliant life even with all his limitations. It is clear that Keith would have been in a care home under supervision and without care in the community had it not been for the pushing of my mother and others who wanted to give him a good level of care. I have no shame in saying that care workers are not paid enough. We need to right that wrong. We will all say that here, because we all believe it. It is a truth. The debate allows us to go beyond just a clap, which is commendable, and to send the message that we applaud their work and will make changes to support them further.

While Keith has a driveway that the workers park in, many town centre homes do not have parking. To park on the street will mean a ticket from the ever-present, sometimes overzealous, traffic warden. Currently, staff pay the minimum amount for an hour’s parking, even though the call will last only 15 minutes, and they cannot claim for that. It presents a problem, which the hon. Member for Southport has outlined very well. To me it is very clear: all staff should have a parking charge exemption permit issued by local authorities that entitles them to an hour’s free parking either on the street, as long as no obstruction is caused, or in a local car park where feasible. Those are not big things to ask for, but they would change the lives of care workers where we are.

It is right and proper that in Northern Ireland health trusts car parking is set to become free next year. I know that is not the Minister’s responsibility, but I wanted to mention it. I have grave concerns when I read articles such as that on the BBC 12 hours ago that cited the massive overspend of £500 million and the fact that:

“The Department of Health has said there are channels to generate income, such as continued car parking charges…prescription charges…and charging for domiciliary care...It’s thought that each £15m generated would enable about 30,000 assessments, diagnostic tests or procedures for patients with cancer or time-critical conditions.”

That is a matter for another debate, but I wanted to make the point that there are always things we can do financially. It would be a massive slap in the face for our care workers to continue to pay for parking, and we should do our best to help them.

The facts are clear. Care workers, district nurses and all of those in care in the community simply are not remunerated to the level they should be. If a call lasts longer, they do not get overtime. It comes out of their own time. I have a good relationship with a district nurse in Strangford who makes her patient tea and toast even if that means that she cannot take her tea and toast at lunchtime, and that is her contribution to the person she looks after. I do not think that any MP, including yourself, Sir Robert, who would be unable to give an example of that very thing happening with the care workers in their constituencies—those good people. She sacrifices her time for her patients’ comfort and, to add to that, she has to pay for the parking to do so.

The request is clear, and the hon. Member for Southport has outlined it. There is something wrong with the picture, which is why I wholeheartedly support him. More than that, as I always do, I look to the Minister—who, I believe, clearly understands our requests—to make representations to other Cabinet colleagues to ensure that additional discussions take place to enable care workers to get the help they need. If the Minister is of a mind to do so, I ask her to have some discussions with Northern Ireland officials to ensure that we are encouraged to do something similar back home through the Northern Ireland Assembly.

We have drained our health workers of good will, expecting more and more and sometimes, unfortunately, granting less and less. We need to start working on rebuilding trust and good faith, and this is a great step in that journey. I am encouraged by today’s good news that we seem to be moving closer to a wage settlement. Let us welcome that good news, but let us also try to welcome more good news for care workers when it comes to giving them the help with car parking that they need so much.