Contaminated Blood Products

Jim Shannon Excerpts

Wednesday 9th September 2015 Westminster Hall

[Ms Ritchie]

Thank you, Mr Owen.

To set the context for this debate, it is my duty and responsibility to acknowledge the very good work of the all-party group on haemophilia and contaminated blood. One of the joint chairs of the group, my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), is here today for this debate. The all-party group published its report on contaminated blood products in January and clearly outlined the requirements of Government in respect of this very vexatious issue.

I secured this debate to highlight the cause of the victims of contaminated blood and blood products, in particular my constituent, Brian Carberry, a haemophiliac from Downpatrick in South Down. Along with all the other victims, he has waited too long for truth and an acknowledgement that the Government, through the Department of Health, imported such contaminated blood products from the USA in the 1970s and 1980s. The victims have waited a long time for proper compensation and access to drugs that are currently being assessed by the National Institute for Health and Care Excellence, and they need those drugs before stage 2 of the illness, which causes liver dysfunction, sets in.

I hope the Minister can today provide a detailed outline of how she will address this issue once and for all. Two thousand people touched by this tragedy have already died, and that number is rising, as people die waiting for the Government to make a final determination. I urge the Minister today to bring this prolonged delay to an abrupt close with a programme of action, including a commencement date for the consultation, which was announced back on 17 July, and the moneys to help those who have endured endless pain, suffering and anxiety for so many years.

In the ’70s and ’80s, around 7,500 people were infected with hepatitis C or HIV as a result of treatment with blood products provided by the NHS. Many of those people were being treated for haemophilia. Those viruses did not just transform their own lives; their families’ lives were also turned upside down, and some of them, including my constituent, can no longer work.

The several thousand people treated with contaminated blood and blood products by the NHS have been denied the real financial security, and the health and social care that they need. The support currently in place is only partial and does not offer the full and final settlement that those affected and their families need to live with dignity, and it falls far below the equivalent compensation in the Republic of Ireland. The development in support, financial and otherwise, over the years has been haphazard and has been delivered much too slowly. Contaminated blood victims already face substantial financial demands because of the nature of their infections and the inadequacy of their financial compensation.

One lady suffering from the infusion of contaminated blood products told me last week that some sufferers are denied even the basic stage 1 payments, even though they have a weakened and compromised immune system, and suffer chronic fatigue, fibromyalgia, depression and unexplained rashes, with a potential link to breast cancer for women. This lady also had an ileostomy, as her bowel burst, and she had a stillborn child, with all the attendant trauma attached to such an incident. Unlike other contaminated blood patients, she has been denied stage 1 Skipton fund payments. Needless to say, she did not receive the Caxton payments either.

[Jim Shannon (Strangford) (DUP)]

Between 1970 and 1991, almost 33,000 people were infected with hepatitis C; between 1978 and 1985, 1,500 haemophiliacs were infected with HIV, and some of them were co-infected with hepatitis C as well. The issue of compensation is a big one, and I congratulate the hon. Lady on bringing it forward for consideration—the number of people here in Westminster Hall today is an indication of its importance. Does she agree that, regardless of the stage of a person’s illness, compensation should be given to them?

[Ms Ritchie]

I thank the hon. Gentleman for his very helpful intervention. That is the case that I am trying to make—that there needs to be a full and final end to this issue, with a good story for the people affected, not only through compensation, but with proper access to the right drugs that will help them and ease their journey.

In the Commons on 25 March, the Prime Minister pledged to help “these people more” after the publication of the Penrose report, promising that “it will be done” if he was re-elected. He was re-elected, but that inquiry, which scrutinised events between 1974 and 1991, has been branded as failing to get to the truth by Professor John Cash, who is a former president of the Royal College of Physicians of London and a former director of the transfusion service.

Dementia Care Services

Jim Shannon Excerpts

Wednesday 9th September 2015 Westminster Hall

[Edward Argar (Charnwood) (Con)]

I beg to move,

That this House has considered dementia care services.

It is a pleasure to lead this debate—the first in my name since my election—under your chairmanship, Mr Davies. It is also a pleasure to debate with a Minister whose commitment to this cause is well known, on a subject of such importance. Indeed, its importance grows daily.

I am particularly pleased to see my hon. Friend the Member for Wealden (Nusrat Ghani) next to me. I hope that she plans to speak in this debate, because her work in her constituency on this subject, and the depth of her knowledge, is well known and will be of great benefit to the House.

Dementia is incredibly cruel; it can take a person away from you even while they are still with you. It is estimated that there are around 850,000 people with dementia in the UK; that 21 million people have a family member or close friend with dementia; and that a third of people over 65 will develop it. The majority of those 850,000 people are over 65, but an estimated 17,000 people below that age have dementia. In my constituency of Charnwood, it is estimated that just over 1,000 people have dementia. All of this—put aside the human consequences for a moment—is estimated to cost around £23 billion per annum, with a huge proportion of that being met by families, either through care that they engage or through the free hours of care that the 670,000 voluntary carers provide. The challenge before us is huge.

Significant progress on dementia has been made in this country in recent years. However, while we as a society have made significant strides in improving our longevity and our ability to fix and patch up our physical selves through the medical profession, our understanding of and care for the mind have fallen behind somewhat. Dementia poses a massive financial challenge to our country, as people live longer—a good thing, but a partial consequence is an increase in the number of dementia cases.

The last Labour Government should be rightly proud of their work in bringing forward the first national dementia strategy, and I pay tribute to them, through the shadow Minister, for that far-sighted step. It is a baton that the current Government, and particularly this Prime Minister, have seized with vigour; there has been the Prime Minister’s challenge on dementia 2012, the G8 dementia summit, and the Prime Minister’s 2020 challenge. All this is hugely positive, and dementia is an issue on which there is considerable consensus in all parts of the House, and among all the parties represented within it. However, we must not think for one moment that we have done enough, nor lose the momentum built up thus far.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this matter to the House for consideration. A great many of us across my constituency of Strangford and the whole of the United Kingdom of Great Britain and Northern Ireland know people who suffer from dementia. Just last week, I had the opportunity to go to what is referred to as a memory café, which is organised by the Alzheimer’s Association, which is a wonderful organisation. I met some wonderful people, as well as their carers and families. Does he recognise the good work that the Alzheimer’s Association does? Does he feel that now is the time to not only raise awareness of Alzheimer’s but commend the Alzheimer’s Association for its work?

[Edward Argar]

In addition to the hon. Gentleman’s many talents, which are well known in this House, he appears to be a mind-reader, as I was about to come on to that subject, having visited a similar memory café on Monday. He is absolutely right to highlight and pay tribute to the work of such places. On Monday, I went to the Syston community centre, where our local Alzheimer’s Society group was holding its regular Poppies memory café session for about 30 carers and people with dementia. As I am sure the hon. Gentleman did on his visit to his local memory café, I met some amazing people and it was a fantastic session. My memories of that session, and the lessons I learned from it, remain with me; I continue to reflect on them. However, across the UK, including in my region—the east Midlands and Leicestershire—the access to and coverage of such vital services remains patchy; that was a message I got loud and clear from the people I spoke to. As I suggested, that session left me in no doubt about the vital role of dedicated and passionate carers, including the amazing people whom the hon. Gentleman and I met, in helping people with dementia.

[Edward Argar]

Yet again, it appears that another hon. Member has the facility of reading minds and anticipating speeches, because I was about to say that there remains too little understanding of dementia in our communities, despite the progress made, and dementia-friendly communities and workplaces can play a hugely important role in supporting both those who have dementia and those who care for them.

I encourage the Minister to push all Government Departments to become dementia-friendly workplaces, and to keep talking about dementia and raising awareness of it. I also encourage her to keep the NHS talking about it. I know that other hon. Members—not least the shadow Minister, the hon. Member for Oldham East and Saddleworth, who is chair of the all-party group on dementia and possibly the only dementia champion in this House—will continue to raise these issues, as the shadow Minister has done over many years.

A recent survey showed that 25% of 18 to 25-year-olds are keen to learn and understand more about dementia, as opposed to only 15% of those aged 55-plus; that was a 2012 YouGov survey, so it is relatively recent. While it is encouraging that young people are keen to understand and learn more about dementia, those figures are still far too low.

[Jim Shannon]

One thing that I became aware of after visiting the memory café last week and speaking to some of the people there—by the way, the Big Lottery Fund was one of the funders of that café, so it is doing good work—is that the age of those being diagnosed with dementia and Alzheimer’s is starting to fall. There are some people in the 40-to-50 bracket who have dementia, which worries me. Does the hon. Gentleman feel that there is anything we can do to raise awareness of that issue?

[Edward Argar]

The hon. Gentleman makes a valid point. Just last Saturday, I was at a gala in Anstey, which is a village in my constituency, and a man came up to talk to me about this issue. He said that a lot of emphasis is put on those in their 60s or 70s who develop dementia, but he told me about a lady who had developed it very early in life, which creates a whole new set of challenges around children, paying mortgages and the support that should be in place but is not always there. I will come on to the support that is or is not in place shortly.

The second part of the picture is about diagnosis and care. Diagnosis rates have improved. In 2011-12, only 45% of people with dementia received a formal diagnosis, but Department of Health figures suggest that the figure is now up to 59%, which is real progress. I know that 66% was the target set for the end of this year, but can I encourage the Minister to go that little bit further and press for a 75% target for diagnoses by 2017? That is ambitious but achievable, and if we do not set ambitious targets we will not achieve them.

However, diagnosis is only the start. Too many people tell of being diagnosed and then receiving no information or support, or only very limited information or support. In a recent Age UK survey, 89% of those surveyed said that they did not feel they had enough information about dementia. We need to improve GPs’ understanding of dementia care; many GPs are fantastic, but that is not universal. We need to ensure that after a diagnosis, people and their families receive information on “What now?”, as well as support. What steps do the Government propose to take to create minimum mandatory standards to ensure that everyone with a diagnosis receives swift signposting and advice from dementia advisers and a proper support package for them and their carers, possibly through the NHS outcomes framework?

We all know—all the research shows this—that once someone is diagnosed with dementia, if they are to continue to lead a full life, it is best for them to be able to live independently at home with their family, but if they are to do that, we must ensure that carers are cared for and supported, and that support plans are in place—as much for the carers as for any individuals with dementia. A recent pilot in Norfolk on the use of Admiral nurses—they are the dementia equivalent of Macmillan nurses, and although they are sadly rather less well known, they do a fantastic job—saved more than £400,000 and provided a strong local support service for carers and people with dementia. What consideration have the Minister and the Department given to how that might be made more widely available? What support can be given to local authorities in that respect?

We are all aware of the funding pressures faced by local authorities—not least my own, Leicestershire. It gets one of the lowest per-head funding settlements in the country, and I hope that that can be reviewed and revisited in this Parliament, with rural councils being given a fairer share. While I would not presume to burden the Minister with responsibility for dealing with the local government finance settlement as well, what progress has been made nationally on developing integrated dementia care pathways, which can go some way to alleviating financial pressures?

While care and support to stay independent at home are key, there are times when people with dementia have cause to be admitted to hospital, and here the picture is by no means universally good. According to a recent survey, 41% of hospitals do not include dementia awareness training in staff inductions, and only 36% have a care pathway in place. Many people with dementia still have real problems when they are admitted to acute care. More research into the quality of personalised care for those with dementia, particularly in hospitals, would be immensely valuable. It is estimated that a quarter of hospital beds are occupied by people with dementia, although they might not necessarily have been admitted for dementia. On average, such people have a 20% longer hospital stay than others.

While some hospitals have made progress in having dementia-friendly wards, it simply is not enough. We should have hospitals that are dementia-friendly in their entirety. We often hear of instances of people with dementia not having that noted on their hospital records, meaning that no allowance has been made for it. We also hear of carers and partners not being allowed to stay with relatives with dementia in hospital, which often leads to acute anxiety and distress among those patients at being in an unfamiliar environment without any familiar faces around them. I hope that Simon Stevens and the NHS can look at that.

The national dementia strategy and the Prime Minister’s challenges on dementia for 2015 and 2020 set out an array of targets and objectives. The key to success, however, will be proper implementation to deliver clear and focused outcomes that are measured, monitored and reported. Will the Minister update the House on the implementation plan to achieve the objectives that we all welcome, and to ensure that dementia care gets its share of the very welcome additional funding that the Government have pledged to the NHS as a whole? Specifically, as we look at how to improve care and support, 37 NHS vanguard sites are piloting new care models, but only three make specific mention of dementia. Will she consider adding to that number? The National Institute for Health and Care Excellence is updating the 2006 clinical guidelines on dementia. That work is due to be completed in September 2017. Will she make representations to NICE on updating the dementia quality standard as part of that? It is an important tool in driving up NHS standards in this area.

The third and final part of tackling dementia is research. We have seen some encouraging early signs over the summer that finding a way of slowing down the progress of dementia might be that little bit closer. There is still a long road ahead for that research, but it is a reminder of the importance of a continued focus.

--- Later in debate ---

[Tom Tugendhat (Tonbridge and Malling) (Con)]

I declare an interest as a proud supporter of the Dementia Friends movement, which has done so much in my constituency. I praise in particular Mrs Christine Parker, whose work in bringing the Dementia Friends message to so many in Tonbridge has echoed across other areas. I draw inspiration from her for my remarks, which I hope I can make on her behalf as well.

The rising demand on the NHS in my community is not unlike that in others. One in three people in my constituency is over 65, so the pressure on dementia services is naturally high. Indeed, 1,600 people in my community have dementia, and in the west Kent NHS region, 322 are under 65 and therefore count as young dementia sufferers. As my hon. Friend the Member for Charnwood (Edward Argar) so eloquently put it, when we think about dementia and old people, we usually think about people for whom it is an end-of-life event, but for too many in our society it is not—it is part of life. It is something with which individuals, families and communities—indeed, our whole society—will have to live as they experience this terrible disease.

It is important that we work together, because this is not something that central Government can solve alone; nor, indeed, can the devolved Administrations or local government. It requires a fully joined up approach. The work by a lot of third-sector organisations to bring together the community at all levels has been essential. I particularly praise the organisations working in my part of Kent: Age UK, Crossroads, the Alzheimer’s Society and many care homes.

[Jim Shannon]

In his speech, the hon. Member for Charnwood (Edward Argar) mentioned the need for more research and development. There have been massive steps forward in the development of medication that can delay the onset of Alzheimer’s and dementia in some cases. Although that is a wonderful step forward, the cure is not yet here. Does the hon. Gentleman feel that, along with all the good work that the Government are doing, there should be more partnerships with the pharmaceutical industry to ensure that we can take more giant steps forward?

[Tom Tugendhat]

I can confirm that the hon. Gentleman is not reading my mind—I had not thought of those points. He makes a very important point about tying together with the pharmaceutical industry. I would also urge tying together with universities throughout the country, because many of them across the nation have done incredible work on this issue. I urge my hon. Friend the Minister to look hard at what more can be done to partner up.

Many of the issues have already been covered today so eloquently by Members, so I will just highlight one area that I feel is somewhat tragically overlooked. As we increasingly see younger people suffering from this terrible disease, we must recognise that their needs are different. We are talking about not only old people who may also suffer from other weaknesses and might not be going out as much as they once were, but younger people who rightly expect to enjoy some form of independence in their life. Indeed, through medical treatment, older people are, thank God, much stronger and fitter than they once were and rightly continue to enjoy active lives for longer and longer.

As a society, we should do more to encourage dementia-friendly transport. In my constituency, we have been working towards dementia-friendly communities, whether towns or villages, and we have had some success in different areas. In fact, some places have developed a dementia-friendly high street and various other spaces. Nevertheless, I feel we have not yet got dementia-friendly transport right. Whether we are talking about taxis, buses or trains, the ability to be able to put someone with dementia on a form of transport and know that the people on board will be aware that there might be an issue, allowing people with dementia to maintain some level of independence, is essential if we are ever to achieve the result we wish for: people with dementia living happily and comfortably as part of our society.

Finally, when I learned about dementia, what struck me most was the importance of emotion, which we too often forget when we medicalise and use too much science. When we deal with people in our communities who have dementia, it is important to remember that even if they struggle to understand who we are, the community they are in or the actions they are taking, the one thing that will stay will them, which we must really value, is the emotional response. We must remember that that will live with them for a lot longer than any confusion, and we must make sure that we play our part as individuals—not just as a society—in ensuring that that emotion is positive.

NHS Reform

Jim Shannon Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right to draw attention to the fact that our manifesto commitment was to a true seven-day service across hospitals and general practice. That is why, a few weeks ago, we announced in our new deal for general practice plans to recruit 5,000 GPs so that we can increase capacity and make sure that people can get routine appointments in the evenings and at weekends.

[Jim Shannon (Strangford) (DUP)]

I welcome the NHS Pay Review Body’s report on seven-day services. There is a compelling case for such services, but contractual barriers to reform need to be addressed. Today’s statement refers to England and Wales, and the Northern Ireland Assembly has devolved responsibility for health. Will the Secretary of State consider having contact with the other UK regions, to assist them in engaging with national bodies based here on the mainland on how this important matter can be taken forward?

[Mr Hunt]

I am very happy to do that. We can learn a lot from each other across the UK about how things are implemented. I thank the hon. Gentleman for his interest in English health matters, because there is always a good read-across.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Speaker]

Extreme brevity is now required. I call Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

A recent study suggests that the NHS is starting diabetics on insulin much later than in other countries. What will the Department do to address that issue?

[Jane Ellison]

I thank the hon. Gentleman for his interest in this important subject. As he knows, we are looking at care right across the diabetes pathway, with a view to building on the first ever at-scale national diabetes prevention programme. I will take up the issue he raises and look at it in the context of all the other aspects of diabetes care we are examining.

Fibromyalgia

Jim Shannon Excerpts

Wednesday 1st July 2015 Westminster Hall

[Alok Sharma]

Yes, of course; the hon. Gentleman is absolutely right. I shall go on to provide more details of what is going on locally and perhaps what we ought to be doing nationally.

I first learnt about the condition almost by accident a few years ago, through a chance conversation with some constituents. Since then, through the work of the excellent Reading fibromyalgia support group, which meets regularly in my constituency, I have been able to learn more about fibromyalgia and meet many of the people locally who are trying to cope with the condition, as well as medical practitioners who are focused on helping sufferers.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this issue to Westminster Hall for consideration. In my constituency, many people have come to me with disability living allowance claims, which is where my interest in and knowledge of fibromyalgia comes from. What concerns me greatly as a result of the correspondence and communication that I have had with my constituents is that GPs seem not always to be aware of the symptoms of fibromyalgia. That means that the figure for diagnosis in Northern Ireland is only 3%, yet we have a significantly larger number of people who have the disease. Does he think we need greater awareness among GPs to start with and then we can address the issue?

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

I congratulate my hon. Friend the Member for Reading West (Alok Sharma) on securing a debate on this important issue. In his constituency, he has shown great support for his local fibromyalgia patient group by advocating on its behalf, raising money and raising the profile of the disease, which is so debilitating for its sufferers. He has helped the group to continue its important work of improving awareness of the condition and providing advice to patients and their families. I pay tribute to the work of FMA UK, other fibromyalgia charities and the many patient support groups around the country who work tirelessly to raise the profile of the disease and support those who are affected by it. I welcome today’s merger of FMA UK and FibroAction, which will help to give a stronger patient voice to those who are affected.

Fibromyalgia is an incurable musculoskeletal condition of unknown cause that can have a debilitating impact on those who are affected. Although no exact figures are available, research suggests that fibromyalgia affects around 2.5 million patients in the UK, the majority of whom are women over the age of 40. Fibromyalgia symptoms affect the soft tissues, muscles, tendons and ligaments of the body and result in widespread and variable pain throughout the body. Poor-quality, non-refreshing sleep contributes to an ongoing cycle of chronic pain and fatigue, and, in some cases, poor concentration and short-term memory problems. Irritable bowel syndrome, restless legs, head and neck pain and sensitivity to temperature change are also associated symptoms of fibromyalgia. The symptoms and their severity differ from patient to patient.

Diagnosing the symptoms of fibromyalgia can be challenging for GPs. Some 20% of the general population consult their GP about a musculoskeletal problem each year, which amounts to more than 100,000 consultations a day. The symptoms of fibromyalgia are common to other conditions such as rheumatoid arthritis, lupus and chronic fatigue syndrome. In addition, patients with fibromyalgia can often visibly appear well, despite their symptoms. GPs face a further obstacle because there is no diagnostic test that accurately identifies the condition. A diagnosis is usually made via a process of diagnostic investigation to exclude other potential causes of the patient’s ill health. It is, therefore, important that clinicians have the training, tools and resources to help them identify fibromyalgia symptoms when a patient presents.

Musculoskeletal conditions are a key part of the generalist undergraduate MBBS medical curriculum. The General Medical Council requires that the MBBS curriculum provide enough structured clinical placements to enable students to demonstrate the outcomes for graduates across a range of clinical specialties, including musculoskeletal health. Musculoskeletal health is also a key component of GP training, and the Royal College of General Practitioners’ curriculum statement on musculoskeletal conditions sets it out that GPs should be able to diagnose and manage common regional pain syndromes such as fibromyalgia.

In addition to clinical training and experience, GPs have at their disposal a number of tools and resources. They include: the Map of Medicine, an online evidence-based guide and clinical decision support tool available to GPs and other healthcare professionals in the NHS, which has a fibromyalgia and chronic pain pathway, and helps clinicians to identify the symptoms and make the right referral; a free e-learning course on musculoskeletal care, including fibromyalgia, developed by the RCGP and Arthritis Research UK, which aims to improve skills in diagnosing and managing musculoskeletal conditions; NHS evidence services, which provide access to a vast online repository of clinical knowledge and guidance covering a wide range of conditions, including fibromyalgia; and a fibromyalgia medical guide for health professionals developed by FMA UK.

Once a patient is diagnosed with fibromyalgia, a number of treatment options are available to them. In the absence of a cure, relieving pain and restoring quality of life are the primary clinical goals. Treatment options include pain relieving medication, physiotherapy, dietary and exercise advice, counselling or cognitive behavioural therapy, and self-management programmes to give patients the skills and confidence to manage their condition. The routine assessment and management of pain is a required competency of all health professionals. Many patients can have their fibromyalgia successfully managed through routine access to locally commissioned services via GPs, and community and secondary care services. I will turn to my hon. Friend’s point about specialist clinics in a moment.

[Jim Shannon]

The hon. Member for Reading West (Alok Sharma) and I asked how we can raise awareness within the GP profession to ensure that GPs understand the symptoms of fibromyalgia and diagnose it earlier. As I pointed out in my intervention, only 3% of people in Northern Ireland have been diagnosed with the condition, but the number of people who suffer from it is far larger. There seems to be a gap between those who have been diagnosed and those who have not. Is that because GPs are not really aware of the condition? How can we make them more aware?

[George Freeman]

The hon. Gentleman makes an excellent point, and he is helping to raise awareness today. I will pass on the points made today to the team at NHS England with responsibility for this issue. The answer to the question on awareness is to support debates such as this, and to promote the work of the charity and the patient advocacy groups.

The routine assessment of pain is a required competency for all healthcare professionals. However, patients who remain in high levels of pain after conventional approaches to treatment have failed are able to access specialised pain services, which are nationally commissioned by NHS England. Patients referred to such services receive multidisciplinary team care from clinicians with expertise in pain management.

Operational Productivity in NHS Providers

Jim Shannon Excerpts

Wednesday 1st July 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Pritchard. I apologise for having had to step out of the Chamber for a minute or two. I expected the speech of the hon. Member for Bristol South (Karin Smyth) to be a wee bit longer. It is always a pleasure to speak on these issues, and I thank the hon. Member for Hendon (Dr Offord) for bringing this subject to the House for our consideration.

The Carter report is important. Members will know that health is a devolved matter in Northern Ireland, and the responsibility for health falls clearly on the Northern Ireland Assembly and my party colleague Simon Hamilton, but it is important that we consider the issues and the recommendations in the report. I will speak to that in a few minutes, but first I pay tribute to all those who, despite the numerous difficulties facing us, make our NHS one of the premier care services in the world.

The tireless work of the doctors, nurses, surgeons, technicians, pharmacists, auxiliaries, cleaners, cooks, porters and those who work in admin behind the scenes has not gone unnoticed. I am sure everyone here would start by thanking them for their contributions, their efforts and the exhausting work they do. I thank them for their smiles to the patients and families, sometimes when the workers are so exhausted they can barely stand. I thank them for staying those extra 10 and 15 minutes beyond what they are paid for to make a patient comfortable. I thank them for choosing to come to work and sometimes having to face abuse from tired and perhaps frightened people. I thank them for retaining their dignity and helpful nature. In this debate, we do not stand in judgment on the NHS or the workers; rather, we look at the procedures in place and how we as Members of Parliament can help to make the NHS, which we are fortunate to have across all the regions, more effective for everyone.

[Mr Jim Cunningham]

The hon. Gentleman mentioned long hours. Some of the young trainee doctors are doing a 12-hour day, seven days a week. That can go on for months. That is not exactly conducive to good morale in the national health service, is it?

[Jim Shannon]

None of us here said that it was. It is important that our doctors and the staff are not over-tired.

The Carter report sets out how efficiencies can be delivered. The hon. Member for Angus (Mike Weir) who spoke before me clearly outlined the issues. The title of the debate refers to Lord Carter’s review of productivity in hospitals, and the interim report of that review, “Review of operational productivity in NHS providers”, which was published on 11 June. We all know that Lord Carter of Coles was appointed by the Health Secretary to chair the NHS procurement and efficiency board in June 2014, to review the operational productivity of NHS hospitals and to establish the opportunities for efficiency savings across the NHS. To do that, Lord Carter and the review board worked with a group of 22 NHS providers across England, and I think that what they have found in England will be replicated for us in Northern Ireland and for our colleagues in Scotland and Wales. There are lessons to learn, so we should take note of what the report says.

As I said, an interim report was published on 11 June outlining the work that has been carried out and the interim recommendations and next steps. The full report is to come in the autumn, and I look forward to seeing what it says. Back home, people are sick to death of the term “efficiency savings”, the idiotic behaviour of Sinn Féin and the Social Democratic and Labour party and others and the funding penalties we are facing. Our NHS is being asked to do the impossible and be more efficient than it is, but when I look at the findings of the interim report, I see things that may extend to our running of the NHS in Northern Ireland. That is what the Carter report is about, and I am sure the Minister will give his thoughts on that shortly. The report sets out ways we could ease the pressure off front-line services and enable the functioning of our country while we wait for action to cease the penalties and see Northern Ireland receiving what she is entitled to—what we would be getting, were it not for the inability of Sinn Féin to do what its Members were elected to do and work for the people. That, however, is a different debate for another day, and I accept that.

The interim report suggests that the NHS in England could look to make savings of some £5 billion per annum by 2019-20 and reports three major areas of opportunity. The first is hospitals getting a stronger grip on the utilisation of resources, particularly in four areas: workforce, hospital pharmacy and medicines, estates management and procurement. The second is achieving greater productivity in hospital workflow—how patients move through the system—and the subsequent use of assets such as operating theatres. I have always felt we could look at that, and the Carter report has examined it and offered some ideas on how it could work. The final area is gaining a better understanding of the need for hospitals to develop sub-acute services, either on their own or in collaboration with others, to facilitate the discharge of patients. It is about making it work better together.

We need a way of ensuring the highest quality of patient care, delivered at the lowest price possible to ensure that more funding can be diverted to cancer drugs. Members will know that I have advocated ensuring the availability of cancer drugs across the whole United Kingdom, rather than that being down to postcode. In Northern Ireland, we would like to use prescription charges to put some money towards cancer drugs. I know that the Government have given a commitment and that there is some help for the devolved Administrations when it comes to cancer drugs, but not to the extent that we would like. We also need more funding diverted to research and other areas.

I was surprised to see in the report that one hospital could save up to £750,000 a year by improving the way it deals with staff rosters, annual leave, sickness and flexible working. That was just one example, which would regain the £10,000 a month the hospital was losing due to people claiming too much annual leave. That is an easy way of getting money back into hospitals. Ensuring every hospital pays the best price for medicines and supplies would save money that could be invested in front-line care. One hospital with 23 operating theatres improved the way it tracks the products used during surgery and saved £230,000 in the first year alone. I am not saying that every hospital could do that, but it is an example of what can be done, and it would be unwise to ignore it.

When the Hansard report of this debate becomes available, I will send a copy to my colleague, the Health Minister in Northern Ireland, Simon Hamilton, to make him aware of the Carter report and this debate. Helpful lessons may emerge that we could use. For example, a hospital was using the soluble version of a steroid for multiple illnesses and paying £1.50 a tablet when the solid version costs just 2p a tablet. Using the soluble version only for children and patients who have trouble swallowing saved £40,000 every year. Those may be small examples, but they collectively show how something could happen. I have some concerns. Cheap is not always best, and we have many examples of the copying of tablets in China and elsewhere. Those tablets are not as effective and may be harmful, so we have to monitor how we best ensure that cheaper drugs are effective and tackle the diseases they are designed to tackle.

We must take these issues in hand if we are to see the best possible use of funding. With the publication of the full report in the autumn, we will have a better idea of where we are. I hope that that report will be seen not as a stick to beat the NHS with—if it is, that will be for the wrong reasons—but as a ray of light that will help make things better. I very much look forward to seeing what it says about how we can improve things here in England, because we will then, I hope, be able to use that example to improve things across the water in Northern Ireland and perhaps in Scotland, for my colleague and friend, the hon. Member for Angus.

--- Later in debate ---

[Ben Gummer]

I do not want to ruin the hon. Lady’s nascent reputation by agreeing with her again—happily, there are very few Opposition Members present to notice, although that is not an implied criticism—but she is absolutely right. We are lucky that nursing places are quite significantly over-subscribed. The position is popular, but she is absolutely right that we need to not only make far greater use of apprenticeships but widen the skills base in nursing full stop. We are actively working on that in the Department—I have spent much of the day on it, and I am sure there will be more to come.

To help chief executives in this interim period, we have forced all agencies that want to offer their services to ensure that they are doing so through framework contracts, and we are ensuring that there is an hourly cap on the rate that can be charged. We have also taken additional measures on managerial salaries, along with a few other measures, to ensure that managers have the opportunity to be able to manage costs as they wish. We understand, however, that this is the first stage of a much deeper programme of reform that is needed. Lord Carter’s report points in that direction by suggesting that we use our existing workforce far better, so that people are doing the job that they are suited to and qualified for and that their time is not wasted. That is the great win, not only for efficiency and patient care, but for staff enjoyment of their jobs.

The hon. Member for Coventry South (Mr Cunningham) made some helpful interventions about NHS workers’ quality of life. It has been a sad but persistent truth of the NHS for many years—decades, in fact—that staff-reported incidents of harassment and bullying have been higher than the national average and that workforce stress and illness is higher than average. Some of that is to be expected—parts of the NHS are extremely stressful working environments—but we can do much more. Part of that is about ensuring, when people turn up to work, that they are doing the job they wanted to do, with a suitable but not excessive degree of pressure, and that the system is not wasting their time. If we make them happier in their jobs, their patient care will improve and their commitment to the service will be even greater. I am therefore aware of the prize, not just in pounds, shillings and pence, but in an improvement to staff morale and therefore patient care.

[Jim Shannon]

One of the things that concerns me from a Northern Ireland perspective—this has also been raised in discussions with other Members in the Chamber today and outside—is that the NHS greatly relies on, in our case, Filipino workers, which is an immigration issue. Has the Minister had any discussions with the Minister for Immigration, the right hon. Member for Old Bexley and Sidcup (James Brokenshire), to ensure that there will be no shortfall when the gaps left by those who are here on work visas need to be filled and that the quality service in the NHS will not be lost? The hon. Member for Bristol South (Karin Smyth) referred to training people to ensure that keen, interested and able replacements are available. Has the Minister given any thought to that?

[Ben Gummer]

I was going to come on to that, so I shall do so now that the hon. Gentleman has prompted me. There have been long and deep discussions about this. Our estimate is that no more than 700 nurses will be affected by the time the new rules are in place, which is a different number from that given by the Royal College of Nursing, whose number we do not recognise. It is small challenge given the scale of the workforce and one that we will surmount at the time, but we must see it within the broader policy of reducing immigration to this country from the hundreds of thousands to the tens of thousands—a policy that has broad support across the House and certainly in the country at large. It would be wrong for the largest employer in the country—one of the largest employers in the world—to exempt itself from that overall ambition.

In the end, we will achieve a sustainable workforce in this country only if we do all we can to ensure that those who are British and have grown up here and want to work in the NHS have the opportunity to do so. That is why it is important that we widen and open the avenues into working in the NHS, as the hon. Member for Bristol South suggested, over the next few years, in order to meet the challenge to which the hon. Member for Strangford alluded.

I want to quickly run through the other issues raised by my hon. Friend the Member for Hendon. On master vendors, he has a specific issue regarding some constituents with whom he has been dealing, but I understand that master vendors are managed under a series of arrangements with the Crown Commercial Service. Officials will meet with that organisation soon to discuss the overall issues around master vendors. It is for individual trusts to make such purchasing decisions, but I understand the issue he has raised and the terms in which he put it, and I will ensure that it is investigated properly.

My hon. Friend identified two areas involving agencies and fraud. Fraud is of course unacceptable, and the NHS has quite good systems for identifying it. Given the scale of the NHS, I find it surprising—it is entirely to the credit of those who work in the NHS—that fraud makes up such a tiny proportion of the excessive costs in the NHS.

On the revalidation of locum doctors, for which the General Medical Council is responsible, some doctors find it difficult to gather all the required supporting information needed for revalidation due to the peripatetic nature of the work. To help with that, specific guidance is available for both the doctors and their employers via NHS England and NHS Employers. Locum doctors are part of a larger issue about agency spend and foreign workers working in the NHS. I imagine that the three organisations will come together in the next few years to produce a more stable situation.

[Mr James Gray in the Chair]

Let me turn to the remaining points of the hon. Member for Bristol South. On the stability of the system, I hope and anticipate that one product of the general election is that the system will be broadly stable over the next five years. We intend to continue with the current structure of the NHS. There will be some small changes, such as that identified by my right hon. Friend the Secretary of State last week concerning the NHS Trust Development Authority and Monitor, but we are broadly content with how the system is set up. We must now proceed to ensure that it works.

The shadow Minister made a point about structures and fragmentation. There will always be a genuine dilemma here, because one can approach any system and say that change can be achieved by altering structures, but changing structures can lead to the same outcome. That has been the story of the NHS since its inception. It would be a mistake to think—the hon. Member for Bristol South and the shadow Minister were not suggesting this—that a structural change would somehow produce the outcomes that we all want. The priority is to ensure that the system’s wiring works correctly—that everyone’s interests are aligned and that the incentives are correct—so that people want to sit around the table and come to a considered decision, which can too often not be the case when there is an adversarial relationship between providers, producers and purchasers. That is why I hope that the system’s stability over the next five years will allow us to focus on the significant challenges mentioned by the shadow Minister.

Post Office Horizon System

Jim Shannon Excerpts

Monday 29th June 2015 Commons Chamber

[Andrew Bridgen (North West Leicestershire) (Con)]

I pay tribute to the work carried out on this issue by James Arbuthnot, the former Member for North East Hampshire, and Mike Wood, the former Member for Batley and Spen, both of whom I worked with for more than two years in a working party in search of a fair settlement on this matter. Unfortunately, throughout the process we all lost faith and trust in the Post Office’s willingness to investigate the issue properly and thoroughly.

To give some background on how the Post Office has let down sub-postmasters and Members of this House throughout this process, let us consider how it has dealt with the matter from the outset. The Horizon accounting system used by sub-postmasters was introduced some 15 years ago. Almost immediately, a spate of discrepancies began to appear as sub-postmasters attempted to balance their accounts at the end of the day. From that time forward, there has been failing after failing on the part of the Post Office.

The Post Office has finally acknowledged that its help system for the Horizon software was completely inadequate, but even with that admission the Post Office continues in its failure to demonstrate any appetite to deal with issues arising from the Horizon system in a fair and transparent way.

[Jim Shannon (Strangford) (DUP)]

Is there not something disgraceful in the fact that criminal charges were pressed against these sub-postmasters and sub-postmistresses when the fault lay with the Post Office, yet nearly two years after the investigations those charges have not been lifted? The shadow hanging over their heads has not been lifted either. Does the hon. Gentleman not feel that it is time to bring that to an end?

[Andrew Bridgen]

The hon. Gentleman tells a tale which has been told too long to the working group. We need to bring matters to a head and I hope the debate tonight will give us an opportunity to do so.

The mediation scheme that was set up to handle disputes about the software system has not delivered what Members of this House had understood was agreed at its inception. It was flawed in a number of ways, the most significant being that it excluded those who had pleaded guilty.

Drugs: Ultra-rare Diseases

Jim Shannon Excerpts

Tuesday 16th June 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

First, I congratulate the hon. Member for Leeds North West (Greg Mulholland) on bringing this matter to Westminster Hall for consideration. Westminster Hall is well filled today because we all have constituents who are suffering and do not have access to the drugs needed to combat these rare diseases. I also congratulate the hon. Gentleman on his hard work on this issue, for which he is well renowned; we have all said that, but it is the truth, and we all want him to know that we know it.

I am glad this debate has occurred, because it is on a subject that affects many people in my constituency. We have heard some stories and we will hear more before this debate is over.

The diseases we are considering may be rare, but collectively they affect the lives of 3 million people across the United Kingdom. That emphasises that everything must be done to create a comprehensive initiative for providing care to those affected by these difficult and challenging diseases.

Rare diseases tend to be life-threatening or chronically debilitating. There are between 6,000 and 8,000 rare diseases. Each one affects less than 0.1% of the UK’s population, but Rare Disease UK calculates that 75% of these illnesses affect children.

We are here today on behalf of our constituents, but we are also focusing very much on young people across the United Kingdom of Great Britain and Northern Ireland who have these problems.

The ultra-rare diseases that have been mentioned include Morquio disease, Duchenne muscular dystrophy and tuberous sclerosis. I would also add Prader-Willi syndrome, which some of my constituents suffer from.

The chance of improving people’s quality of life depends very much on a narrow timescale. It requires quick diagnosis, treatment and drug provision, so that drugs can be accessed when they are proven to be most effective. In other words, as every Member who has spoken has said, time is of the essence—the people who are suffering need help now, not in six or 12 months. It is our duty to make that timeline as transparent and effective as possible within the finite resources we have, and I understand the problems the Minister has. There must be adequate assistance for practitioners, to allow for timely diagnosis and the timely provision of drugs and treatment.

[Mr Anderson]

The hon. Gentleman has been very consistent on this issue, and he is right: as those of us in the all-party group on muscular dystrophy have found, one of the main reasons for delays is that clinicians—particularly GPs—do not see these diseases very often, and when they do, they are sometimes lost as to where to go. Once a disease is diagnosed, the people suffering from it should have no worse access to treatment than people with much more common diseases—surely that is the issue that has to be addressed. Once a disease is identified, we have to get to grips with it, and people have to get the medication and the support they need, so that they can get on and live the best life they can.

[Jim Shannon]

I agree wholeheartedly. I am sure the Minister has heard us all say that time is of the essence and that we should strike right away. That is what we are about.

The health and social care professionals involved in the diagnosis, treatment and care of these patients face difficult tasks. As I was saying, there must be adequate assistance for them, to allow for timely diagnosis and the timely provision of drugs and treatment. There also needs to be sufficient funding UK-wide.

In Adjournment debates and other debates about these issues, I have always referred to Queen’s University in Belfast and to the importance of research and development. Queen’s University is one of the universities that do research, and it works in conjunction with the Health Department. Perhaps the Minister could therefore give us some idea what the Government are doing on research and development to ensure that new drugs are found.

[David Simpson (Upper Bann) (DUP)]

My hon. Friend mentions research. As he will know, I am involved in a campaign in Northern Ireland and across the United Kingdom on complex regional pain syndrome. The condition affects children, but it mostly affects adults from the age of 50 onwards, and people can lose limbs to it. One in every 3,000 people is affected, and many lives have been destroyed. We need more research to find a drug to cure this condition, and research funding needs to be put in place so that that research can be done.

[Jim Shannon]

I thank my hon. Friend for his intervention. That is a message that I, too, believe in, and I am sure the Minister will respond positively.

Leaving aside all the statistics we have heard today, we need to imagine the emotional strain these things put on people and their families, and we have had examples of that. Only 35% of patients are aware of a licensed treatment for their condition. There is something wrong when that is the case. How come only 35% of people know there is something there for them? How are the Government addressing that? I am not attacking the Minister—that is not how I work—but how do we move things forward in a positive fashion? Of that 35%, 89% are able to access the treatment, but 11% are not. Therefore, 65% of people are not aware of the drugs, and of the 35% who are, a proportion are not able to get them.

Like others, I want now to touch on Duchenne muscular dystrophy. If Translarna is given at the correct time, we can prolong the sufferer’s mobility. My constituents deserve to have access to that drug as soon as possible, and that is what I would like to see happen. The effects of long waiting times and uncertainty are widespread, and although ultra-rare diseases affect the few, their effects for those who suffer from them are an inescapable reality and should be treated with the utmost seriousness.

Families deserve a solution to the continual failure to establish a lawful, robust and transparent commissioning service that enables the rare disease community to access new drugs in an equitable and timely manner and to avoid situations such as those we have spoken about, where crucial windows of opportunity pass by. This is a crisis—it cannot be described as anything else. People are in trouble, and they need our help now.

Let me quickly pay tribute to the lady who looks after the Northern Ireland Rare Disease Partnership, Christine Collins. Last year, we met the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), to discuss these matters. We were clearly moving forward, and the Minister was very responsive. The background information for the debate says that, in November 2013, the UK Department of Health and the devolved Governments published the UK strategy for rare diseases. In June 2014, the Northern Ireland Assembly endorsed it and gave a commitment to publish an implementation plan, and last year’s meeting provided an opportunity to underline the need for that to happen. Perhaps the Minister can give us some idea today of what discussions he has had with his fellow Minister to move things forward so that we can deliver on that commitment.

The debate has dealt with access to drugs. It has also given us an opportunity to bring out the gaps in the patient experience. Let us remember the patients, the families, the children and all those who suffer. They require a co-ordinated response from not only the health service and the social services, but research bodies and the relevant charities. I hope that the common experiences we have described signal the urgent need for access to these vital treatments. I remind all those in a position to have a tangible impact on drug access that while we are debating these issues, somebody else is falling into the trap and will, unfortunately, be unable to access the necessary drugs. I urge the Minister to respond positively, and I thank the hon. Member for Leeds North West again for giving us all a chance to speak about this issue.

[Several hon. Members]

rose—

--- Later in debate ---

[Dr Whitford]

Obviously, devolution gave us the power to do things differently, but I do not think that we should re-invent the wheel. Often, we will accept work done by NICE or re-evaluate it quickly, to see whether things should be applied differently, but we do not just go back to the beginning. However, I am sure that ideas can be shared in both directions.

It seems that certain drugs were left as orphans when the system changed. We know that patients with the brain tumour form of tuberous sclerosis, which the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) mentioned, can access the drug through the cancer drugs fund, but if they have a kidney tumour and are treated by urologists they are not part of that system and simply will not be aware of it. Such random unfairness exists.

[Jim Shannon]

There is a forum and association, driven by the Health Minister, that discusses matters together with the three regions. A UK-wide strategy is already in place. The process is allowing that to happen already. However, it is delayed and has not happened yet; that is why we are concerned.

[Dr Whitford]

I think it is a matter of what ideas go on the table and what is being discussed in the meetings. Good ideas are going ahead. I commend the idea of including patients and clinicians in evaluations, because the numerical data from trials will often be small due to the nature of the diseases in question, and we will have to look wider. The problem for children is that if these drugs are to prevent deformity, they have to be got in early. People with Morquio already have the changes. We do not know yet how much change could be prevented, or how much saving there could be on a person’s disability in the long term if metastatic breast cancer treatments, which eventually become adjuvant treatments, are given earlier.

I commend the system I have talked about. I know it is difficult and challenging, but it is clearly fair, with an interim period for compassionate reasons, and people know where their voice should be heard.

Health Services in Staffordshire

Jim Shannon Excerpts

Wednesday 3rd June 2015 Commons Chamber

[Jeremy Lefroy]

I entirely agree with my hon. Friend and reiterate his remarks about the excellent work done in my constituency by staff at the County hospital to recover the situation, which a few years ago was extremely difficult, to one where the quality of care offered is of a very high standard.

To return to cancer and end-of-life services, the real concern has been over the method being used. To quote Macmillan:

“We think a procurement process is the best way to integrate the fragmented cancer and end of life services we have in Staffordshire. A procurement process is needed because at the moment there is no one organisation with overall control of cancer or end of life services.”

My argument has always been: in that case, what are CCGs for? They are there to commission, so why can they not commission? In the last Parliament, we gave them the ability to work together to procure services, so why cannot the four CCGs involved, together with Macmillan, simply make that happen? The answer I was given at the time was that the constraints on CCGs’ own administration costs—a reducing amount of funding per head—meant that it was impossible. Sometimes I am puzzled. We see this all over Government and have done for many years and across many Departments: we constrain spending on so-called bureaucracy and then, in order to get necessary things done, pay large sums of money to consultants to do precisely the kind of bureaucratic work that we forbid the experts from doing—in this case the CCGs—but, because it is called consultancy or programme work rather than overheads, it is allowed. There is a problem that needs to be solved—I do not deny that—and it affects the lives of my constituents and those of other Members, so it must be solved.

Macmillan says about the first two years of the contract:

“The main responsibility of the integrator will be to address the current inadequate data about pathway activity and the real cost of this activity. Much increased investment over the last decade has arguably been wasted by poor contract accountability and a lack of reliable data and analytics.”

That is important, but it is a research and advisory role. I have no problem with the CCGs calling in experts to offer them such research and advice, whether it is a private company, university or, indeed, another arm of the NHS. A fee will be paid for that work. Again, I have no problem with that, but I would like the Minister to say how much it is likely to be. As local MPs, we have a right to know, on behalf of our constituents, or at least have a rough idea.

According to Macmillan, after 18 months the integrator —I would say consultant—will be expected to

“present a more detailed strategy as to how they expect to achieve improved service outcomes. If the evidence is robust, arrangements will be made for all contracts to be transferred to the Service Integrator from the beginning of year 3. If not, the contract with the Integrator could be terminated and the Service integrator will be required to repay all (or a significant part) of their fee to date.”

That is where I do not see the logic. What makes an organisation that is good at research and advice the right body to run cancer services for our constituents? Why can it not simply be thanked for its advice and that advice, if it is good, be followed by the CCGs, working in co-operation with the providers? The risk is that the vital work that patients, the CCGs and Macmillan have done, with the very best of intentions, will be damaged by contractual arrangements that do not make sense and may put a private organisation with a somewhat different ethos in charge of commissioning NHS providers for services, rather than the other way round.

I have no problem at all with a private organisation producing a much better plan for cancer and end-of-life services, nor do I have a problem with social enterprises or private providers being involved in delivering certain elements of that plan, as they do now and have done under Labour, coalition and Conservative Governments. However, I do not see the logic in the organisation producing that plan becoming another bureaucratic tier between the CCGs, providers and patients. I therefore ask the Minister to take up the proposed contract with the CCGs.

The state of general practice is gradually becoming critical in our area. Many GPs are retiring or approaching retirement. I welcome the Government’s plans to train more GPs, but we will also have to train more medical students or rely on recruiting from overseas.

[Jim Shannon (Strangford) (DUP)]

In Health questions this week, an issue close to my heart was raised about GP numbers and how many doctors are choosing to become GPs. We have similar issues in Northern Ireland. The difficulties in Staffordshire have been outlined, but they are mirrored across the whole of the United Kingdom, and particularly in Northern Ireland. Could any steps be taken to encourage more doctors to become GPs, thus dealing with the problem of the massive number of patients that each doctor has, because we are getting to the stage where doctors will not be able to cope?

[Jeremy Lefroy]

I am grateful to the hon. Gentleman, who hits the nail on the head. It is vital to increase the number of medical students and those training as GPs. I know that the Government want to do that and are committed to it, but I believe they need to expand the number of medical school places.

What plans do the Government have for expanding the number of medical school places and ensuring that those trained stay and work in the NHS, particularly in those areas that are running short of GPs? A seven-day personalised service is an ideal, but those GPs who take the care of their patients extremely seriously—and that is the vast majority of them—are already working extraordinarily hard. The European working time directive most certainly does not apply to GPs, even if it does to the rest of the NHS, and if it were to apply, our family doctor service would fall apart.

Finally, I wish to address the financing of the NHS in Staffordshire. All parts of it are under strain. The KPMG report showed, although some of its solutions have rightly not been accepted, that there is a serious problem. The answer is not to be found in short-term fixes, whether they be in Staffordshire or elsewhere. The NHS England 2020 plan—tough though it is—gives us the opportunity to think long term. Yesterday, I argued in this place for a cross-party commission, including the medical professions, on the future of health and social care and its provision and financing for the 20 or 30 years beyond 2020. I repeat that call today, and I urge the Minister and his colleagues to take up the challenge.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

We will absolutely remember them. That is why it is so important to embrace new technology. Sometimes people who have to travel long distances are able to use such things as Skype or to make a phone call to receive important advice. This is a big priority for us.

[Jim Shannon (Strangford) (DUP)]

With almost 82,000 people living with diabetes in Northern Ireland over the age of 17, does the Minister agree that this ticking time bomb needs more research into better treatments? One way of doing that would be to ensure that there is sufficient funding for Queen’s University in Belfast, in the hope of providing a superior treatment for the many who are affected and living with that disease.

[Jane Ellison]

The hon. Gentleman is right to draw attention to the important role of research. We will leave no stone unturned in looking at all aspects of the treatment or prevention of diabetes. The issue of research is something I recently discussed with the chief medical officer. I will draw to her attention the point he makes. As he knows, although health is a devolved matter we always make a point of sharing all research right across our United Kingdom.