Organ Donation

Jim Shannon Excerpts

Wednesday 30th November 2011 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thought that I should speak, and it is a pleasure to do so, on this matter, which is one of some importance to me. Every person in this House agrees that something must happen. It is the strategy or the policy for the way forward that is the issue. I have to say that I totally support the point of view of the hon. Member for Newport West (Paul Flynn).

I have carried a donor card—it is a bit faded, but it is still a donor card—for more than 20 years. This is the second or third one. If this body that I stand in today should be in an accident, and there is an opportunity for donations, I would like my body to be used for that purpose to give life to others. That is a personal opinion. There will be others in this House who carry donor cards, and they will be of the same opinion.

My nephew Peter is a recipient of an organ donation. He received a kidney. I can well remember the day he was born—he is a year younger than my elder son—and he was a wee boy. He was born with about half a kidney, and it was touch and go the whole way through his life. The result of it all was that he received a donor kidney, and today his whole life has changed. Today he races motor bikes—a bit of a tradition in our family—and he has a job and a full-quality and normal life. That is good news.

In my constituency of Strangford, we had the opportunity to have a memorial garden. That was an initiative that came from local people, who worked with the Ards borough council and ensured that a portion of land was set aside earlier on this year—in May or June—for a memorial garden so that those who are recipients of donor organs and those families whose loved ones have passed on have somewhere where they can go to have a moment of quietness or of contemplation.

Some eight years ago, just a mile from the location of that garden, an accident took place in which one person was killed instantly and another survived for a few days. Months afterwards, the father of one of them came to see me. He was still heartbroken, but he told me that his son had managed, as a result of his death, to pass on organ donations, and the gift of life, to five families. That is another illustration of the quality of life that can arise out of such events.

I am conscious of time, but I shall make three quick points. Just four weeks ago, I put down an early-day motion for the House to consider. Through that, I became conscious that we need to do something better, because the system we have today is not working. Organ donations are not coming through and we must do something about that. We need to think outside the box, if I may use that terminology—it is used often about many things. People of the vintage of 70 to 80 years old should not be excluded from organ donation. If their bodies or organs are healthy, why not use donations from people of that age? Perhaps the Minister can give us an idea about that in her response.

The hon. Member for Ceredigion (Mr Williams) mentioned the TV programme, which I had actually seen the night before, although it was the same one. It very clearly illustrated the highs and lows of people who are waiting on organ donation—the highs when they think it is their turn and the lows when they find out that it is not suitable. It charted the life of one person through her youth, her marriage and the countdown of days after the marriage until she was on a life-support machine and had only three days to live, and then the organ donation came through. Again, that illustrates very clearly the things that we need to do.

I have been contacted by many constituents who are aware of the issue, of the need for organ donations and of the need for that to happen quickly. My last point is in relation to those who need a transplant, but—nobody has yet mentioned this—have a rare blood group. What are the chances of someone with a rare blood group receiving an organ donation from someone of that particularly group? It is one of those 100 to one or 1,000 to one chances. We therefore have to do something different. Whether that means a pilot scheme, so that people are automatically organ donors unless they say otherwise, which is what I believe we need; I would go a stage further, although I am not sure that everyone would agree.

Unless we have a system in place that gives the individual an option and ensures that organ donations can come through, we are not serving our people or our country well. I urge hon. Members to think very honestly about the issue and to move forward in a positive fashion. We need organ donation, we need it on a different system and we need it now.

Epilepsy

Jim Shannon Excerpts

Tuesday 29th November 2011 Westminster Hall

[Steve McCabe]

I certainly agree that there have been considerable strides and we should not dismiss them, but there is an overwhelming need for further research and for improvements in specialist care and treatment. That is one of the points that I hope the Minister will comment on later this morning.

SUDEP accounts for nearly half of all epilepsy-related deaths. Research suggests that the seizure activity in the brain may sometimes cause changes in the person’s heartbeat or breathing, very occasionally causing the person to stop breathing completely. The single most important risk factor appears to be uncontrolled generalised tonic-clonic seizures, which, I understand, are the type of seizure that causes a person to lose consciousness, while their body becomes stiff and then starts to jerk. Such seizures can lead to sudden unexpected death.

It is estimated that there are about 500 cases of SUDEP every year, and a further 500 deaths every year due to other epilepsy-related causes. About 39% of adult deaths from epilepsy were considered to be potentially or probably avoidable. The main problems or deficiencies that cause these deaths include inadequate drug management; lack of appropriate investigations; inadequate recording of patients’ histories; adults with learning disabilities being lost in the transfer from child services to adult services; and one or more major clinical management errors being made. The absence of evidence of a package of care for those suffering from epilepsy is also a cause of rising concern. In primary care management, the main problems identified include sparse evidence of structured management plans, missed triggers for referral and professional communication failures.

For women with epilepsy, the risk of sudden death in pregnancy remains higher for those with other long-term conditions. The risk of maternal death is an estimated 10 times higher for women with epilepsy than for women in the general population. It is probably fair to say, however, that the risk is still low overall.

I am very grateful to Young Epilepsy, formerly known as the National Centre for Young People with Epilepsy, which works on behalf of about 112,000 children with epilepsy.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this matter to Westminster Hall for debate. I went to school with a young fellow who had epilepsy. I well recall how scary my first encounter with the condition was, because I did not know what was happening. Does the hon. Gentleman agree that there is a need for better awareness in schools? If there are pupils with epilepsy in a school, the school needs to know that, so that it can react in a positive way rather than with the fear that comes from not knowing how to deal with it.

[Steve McCabe]

Absolutely. Young Epilepsy is very effectively carrying out a pilot project, with more than 20 schools, to develop and test a model of best practice that can be replicated in any school. Although there might well be the usual problems of time and finance, I understand that the pilot is now at a stage where it could be rolled out across the country. That would go some way to addressing fellow pupils’ concerns and to preparing staff much better in what to do in particular situations. I am extremely grateful to Young Epilepsy for its work in that area.

The figures suggest that there has been a general increase in epilepsy, but that could be due to better diagnosis. There certainly seems to be a suggestion that greater attention to the recording and monitoring of people with the condition has been a factor, due to the GP outcomes framework and the introduction of the National Institute for Health and Clinical Excellence guidelines, and similar ones for Scotland. Misdiagnosis remains a significant problem: a rate of between 20% and 30% of people being misdiagnosed could equate to something like 138,000 people without the condition receiving anti-epilepsy drugs, at a cost of about £220 million a year.

There is evidence that epilepsy is more prevalent in the most socially deprived parts of the country than in the better-off ones. There is a particular problem, with which the Minister will be familiar, in the allocation of residential care for some people who suffer from epilepsy, with the local authority describing epilepsy as a health condition, but most other people saying that a combination of health and social factors are involved. A particular group to mention in that respect is prisoners. A number of studies have been done, not least by the all-party group, that show that the NICE guidelines are not followed in the vast majority of prisoner cases, and that there are problems with prisoners having access to the proper drugs and, significantly, with diagnosis. There also seems to be a problem with how some PCTs determine access to services, with some using referral and funding panels rather than relying solely on clinical judgment. I would have thought that that is not necessarily in people’s interests.

All of that leads to a picture of a treatment gap. About 70% of the population with epilepsy in this country could be seizure-free if they received optimal treatment, but only about 52% are seizure-free. Too few children are offered or referred early enough for surgery that could cure their epilepsy or at least significantly reduce seizures. I understand that there is a backlog of more than 2,000 children who could benefit from such surgery.

The Prime Minister himself has acknowledged that there is a need for improved services. More than 10 years have passed since the then chief medical officer, Sir Liam Donaldson, said in his annual report that epilepsy services suffered from a lack of interest compared with the management of other chronic conditions such as asthma. Although national initiatives such as the NICE guidelines and inclusion in the GP contract have raised awareness of epilepsy, and although there are patches of excellence across the country, overall service provision in most communities has not translated into sufficient effective interventions. One purpose of today’s debate is to ask the Minister to meet with some of the epilepsy organisations, particularly Epilepsy Bereaved, to discuss what else we can do to prevent avoidable deaths.

I do not want to take too long because I want to let other people speak, but I should mention that there are recurring stories about the deaths of young people. A young boy of nine who experienced frequent seizures had benefited from excellent care from his paediatricians, but he died following a transfer of care during an overnight stay in hospital when his history was not adequately updated. In another case, a young woman died suddenly in her sleep, leaving behind two sons. She had had infrequent seizures but had never been given adequate advice. Some five years ago, two famous cases, those of Erin Casey and Christina Ilia, led to a fatal accident inquiry in Scotland, with which the Minister might be familiar. In summarising, the sheriff was absolutely clear that the risk of sudden death might have been reduced by access to a night monitor or much better information about the particular risk at that point in the evening.

I will not dwell on the number of things we need to do. I take the view that there has been progress in our understanding of epilepsy and that there is probably less stigma attached to the condition these days. I think that the previous Government and the present one have made efforts to improve the quality of care, but we know that significant problems remain. We need to think about whether we can set up a dedicated research fund to look much more closely at epilepsy. General practice needs to be much clearer about risk management, about the potential benefits of technology—for example night monitors—and the need to flag up injuries, A and E visits and missed prescriptions. Good medicines management is needed because, as I said earlier, about 70% of people could be seizure-free if prescribed the right medicine. Much more active monitoring of epilepsy deaths is also needed, so that we know what is happening and can draw up plans to help people to manage the condition.

The depth of the subject tempts me speak for much longer, but as I said at the outset, my purpose is to flag up some of the central issues involved in avoidable deaths and the actions that could be taken to help people who suffer from epilepsy. I will allow sufficient time for other colleagues to contribute and for the Minister to reply to the debate.

Bowel Cancer Screening

Jim Shannon Excerpts

Wednesday 23rd November 2011 Commons Chamber

[Guy Opperman]

I do indeed. I welcome the fact that the guidelines from the National Institute for Health and Clinical Excellence have changed to allow screening to become considerably more frequent in such cases. I am sure that the Minister will comment on that.

Flexi-scope screening will undoubtedly save thousands of lives. FOB screening saved 700 to 1,000 lives a year, and flexi-scope screening will save about 3,000 lives a year. To confirm that, the Government implemented a pathfinder project in three areas. Unsurprisingly, two of those areas were in the north-east, this country’s leading medical region. The three areas were South of Tyne and Wear and Tees, along with Derby. The pathfinder findings are with the Department of Health and have not yet been published, but I can assure the House that, in broad terms, they accord with Professor Atkin’s findings. Last October, the Prime Minister announced a proposal to pilot the scheme nationally in 2012, but there are clinical and funding issues that need to be addressed.

First, when is the Department of Health going to invite bids for the follow-on pilot process, given that that was supposed to be done in 2011 and it is now 23 November?

Secondly, clinicians raise the specific concern that the flexi-scope system is only manageable if we have a sufficiency of trained nurse endoscopists, so where are we in respect of this crucial training? Even with the most amazing piece of equipment, if we do not have the people to operate and interpret it, it is useless. Under this scheme, several hundreds of thousands of endoscopies will have to be carried out, with colonoscopies to follow in about 10% of cases. Therefore, everything will depend on training.

Thirdly, how does the Department of Health plan to assess its age groups? My understanding is that the current group of 60 to 74-year-olds will have FOB testing, and those aged 55 will have a flexi-scope. That is relatively clear, but what will happen for gentlemen and ladies in the 56-to-60 age group is not at all clear. Will they be offered the flexi-scope as well, or is that to be based solely on GP referral? Trusts need guidance on what they are to do with such a large and unknown number of people, as they need to plan budgets, staffing and much more besides.

Fourthly, we need to assess what we are going to do with those who have a flexi-scope at 55 and receive the all-clear and then reach the age of 60. Will we rescreen? Anyone who has ever worked in the health industry will know that there is “health speak”, and in this case the following question would be asked: “What is the parallel screening modality for the future?” As always, “health speak” is gibberish, but the simple question here is: are we going to rescreen people who are fine at 55?

[Jim Shannon (Strangford) (DUP)]

I have also gone through the screening process because of a family history of cancer. My GP and consultant at that time said the screening would have to be done again in a year’s time and then again a year later, in order to be absolutely sure. Has the hon. Gentleman considered whether there should be checks not just every now and again, but on a periodic basis?

[Guy Opperman]

It is ultimately up to the clinician—which it should be, frankly. The Minister must say how this policy will be implemented, but it should always be clinically driven.

Fifthly, trusts need confirmation that the pilot projects to be implemented next year will be funded from national funding.

I want to turn briefly to the financial case. The researchers behind the Atkin study suggest that the screening programme will reduce the costs associated with treating people with bowel cancer. Ministers will be aware of the Department of Health-commissioned report, as set out in the memorably named journal, Gut, in 2006, which suggested that if a screening programme based on this test was effective, it could save an average of £28 for every person screened. I urge the Minister to follow what a lot of doctors and others have recommended. We must understand why people do not take up the state’s offer to safeguard their health. If only 54% of those eligible are taking up this offer, that is a serious issue that needs to addressed.

When should we start screening? I speak as an MP whose constituency borders Scotland, and we are often told that in Scotland the health care system is much better, much more expansive and so much more free. In Scotland, FOB screening takes place at 60, not 50 as it does in this country and my understanding is that they do not intend to take up the flexi-scope screening. Personally, I am yet to be persuaded of the clinical or financial basis for screening at the age of 50 given the immense task of screening from the age of 55 onwards, with all the numbers of people who will go through the system. Although there might be pressure—obviously, the Opposition Benches are packed—to move towards such screening at 50, there is no clinical or financial basis in the current system to justify such an approach.

I want to address the possible role of private or other public organisations, suitably supervised, in this process of change. We need to explore the issue of those whom the state must look after but do not take up the offer of screening. It affects both their health and our finite budget. The state must and will always be the provider of medical services in the future—no one disputes that—but it must also enable change and encourage private or public organisations to help in health care. All acknowledge that the take-up of screening is tragically low, as 46% resist the chance to screen themselves for bowel cancer and more than 20% of women resist the chance to have cervical or breast cancer screening. Everybody must accept that there is a problem with that. How can we address that?

Only the short-sighted or extremely socialist would suggest that the state always has the answer to all those problems. What if public sector organisations were to go the extra mile and care for their employees in a different way? We should bear it in mind that the state spends a fortune training its employees to carry out their designated tasks, whether they are consultants, surgeons, endoscopists or nurses. It surely makes sense to safeguard one’s assets—that is, one’s employees. Why not use the public sector as a lead by making it either mandatory or strongly advisable that all permanent core workers should have the screening that their health deserves and that we ask of the rest of the public? I would suggest that they should lead the way. That follows on from the point that is made about flu jabs and the prevention of winter problems in hospital.

We should also consider companies; I want to finish on a localism point. We always criticise employers in this House, but let us say that we had an enlightened employer. Why could they not be allowed or even encouraged to conduct screening of their workers, in whom they invest so much? There is clearly a benefit to the worker, the employer-employee relationship would improve as the employee was valued and cared for, and the state would not necessarily have to pay for the health care screening provided to its citizens. I am talking not just about bowel cancer screening, which is quite complex. Breast cancer screening, for example, is important but not necessarily that difficult.

The cost of such privately paid screening could then be borne in the form of a reclaimable tax break to the company, such as an equivalent cut in the cost of the company’s local business taxes. That would offer localism, increased health screening and better care for employees. Although there might be some data protection issues and concerns about who would pay for the follow-up care, it would unquestionably improve the take-up of screening. I refuse to accept that there is no mileage in my suggestion, which surely brings true localism and better screening to the workplace.

In the minute or so I have left, I want to address the fact that this is men’s health awareness month and individual members of the public must take responsibility for their own health. All around us, perfectly sane men are sporting moustaches as “Movember” kicks into gear. For too long, men have ignored their health. It is well known that they do not have regular check ups. The reality is—I am not surprised the House is not packed this evening—men do not like to talk about the prostate or their bowel. As one of the nurses I met in hospitals put it to me: “Men and their bits—they get so precious about them! If men had to go through what women have to go through with cervical cancer screening and pregnancy they would be a great deal more healthy and self aware.”

I praise the television celebrity Chris Evans for his campaign to show that there is no shame and in fact great benefit in having bowel cancer screening. The shame in such matters exists when people ignore the signs and even die through false manliness or ignorance.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Anne Milton]

I thank my hon. Friend, and I will take this opportunity to praise again the work of midwives and the Royal College of Midwives. It was a pleasure to be at its conference only last week. I would point out that there are now more than 20,000 full-time equivalent midwives. That is an increase of 2.4% on last year. We have record numbers of midwives in training, with 2,493 this year and an increase on that next year. What matters is that we get the right services for women who are pregnant, ensure that they can exercise the choices that they need, and get the right skills mix.

[Jim Shannon (Strangford) (DUP)]

Figures today reveal that older women are being discriminated against in breast cancer treatment, with some 20% of women over 65 receiving chemotherapy compared with some 70% of women under 50. Will the Minister assure the House that those who are over 65 will receive equitable treatment, and that this discrimination will stop?

[The Minister of State, Department of Health (Paul Burstow)]

I am grateful for that question, and I assure the hon. Gentleman that the Government are determined to root out ageism wherever it might be within the NHS. That is why we have made it clear that there will be no exemptions from age discrimination legislation—and that will have to be taken into account by clinicians when they make decisions.

Obesity

Jim Shannon Excerpts

Wednesday 9th November 2011 Westminster Hall

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

It is a privilege to speak under your chairmanship, Mrs Riordan. I am delighted to have secured the debate. I have come to notice, particularly with health-related issues, that an hon. Member may think they are well informed on a topic when they succeed in securing a debate, but once they have succeeded in securing it, the administrative back-up kicks in and all the groups involved start supplying them with significant amounts of promotional material, and they are even more well informed by the time the debate arrives. I thank all the groups involved with this issue for providing me with information.

Sometimes it is wise to start a very serious debate with a slightly humorous anecdote. I am reminded of the overweight gentleman who was sent along to his local well man clinic by his wife, as men are wont to be. She instructed him to go to the well man clinic and to come back with precise instructions on what he was to do to lose weight. When he came back with a smile on his face, his wife said, “There’s something wrong here. What exactly were you told?” He said, “Well, I’m exactly the right weight—for someone who is 7 foot 8.” Unfortunately, that encapsulates part of the problem.

A sedentary lifestyle is not only costing those members of society who are overweight very dearly; it is costing all of us exceptionally dearly. From the correspondence that I have had and my own research, it appears that obesity currently costs us—depending on whom we believe—between £4 billion and £7 billion a year directly and indirectly. Whichever figure is right, the reality in 2011 is that we are talking about an exceptionally expensive but preventable series of conditions. The situation is bad at the moment, but unless we take radical steps and measures, unless we do something fundamental—I will come to that later—the rates of obesity are likely to double in the next 30 years.

Currently, almost one third of children are overweight, so obesity is not a condition that is the preserve of either the elderly or the middle-aged. All of us in society, right across the age spectrum, are being affected. Only 20 years ago, people who visited America—perhaps somewhere such as Florida—would come back here and say, “The United States has a terrible obesity problem. Thankfully we will never be like that.” But we are, and things are likely to get worse.

For example, 25 years ago, about three quarters of schoolchildren walked or cycled to school; now, less than 10% do so. When giving that figure, I take into account the fact that there have been lifestyle changes, school closures and so on, but the fact remains that there has been a significant increase in sedentary lifestyles. There has been a change in attitudes. The unfortunate reality is that more and more of us are spending more and more time at desks, in front of computers. Many people become couch potatoes—unfortunately, that analogy is all too accurate.

I will give another statistic to show how things have got considerably worse. In the early 1980s, roughly 7% of the population were classed as overweight. That ratio has trebled in the past 30 years. We can see the trend. It is likely to double again in the next 30 years. We must get to grips with a problem that, as I said, is proving exceptionally expensive for us all.

Obesity is linked to socio-economic deprivation. The figures that I have been able to establish indicate that the ratio of children in lower-income households suffering from obesity is twice that of those in higher-income households. Again, we see the repetitive nature of the problem, the cyclical response that is indicative, because many obese children are, unfortunately, the children of either one obese parent or two.

Of course, we all know of the additional and subsequent health risks associated with this condition. We are all aware that heart attacks and strokes, coronary artery disease and type 2 diabetes are much more likely among the overweight. There is an additional cost further down the line, in years to come, as people who begin to be overweight today begin to show the symptoms of those other conditions only in years to come and then of course have to be treated by the NHS.

[Jim Shannon (Strangford) (DUP)]

Type 2 diabetes is one of those hidden diseases that some people do not know they have. The indications are that there will be a 50% increase in the number of diabetics in the next couple of years. Does my hon. Friend believe that diabetes itself needs a direct Government plan in order for that issue to be addressed, because it is a hidden disease that can kill?

[Mr Campbell]

I thank my hon. Friend for that intervention. I hope that the Minister will respond to it. I want to come on to some of the things that Health Ministers throughout the United Kingdom—in the devolved regions as well as here—can do to deal with the issue, but my hon. Friend’s point is certainly well made.

Having diagnosed the problem, as it were, I want to consider what is being done. It is not all negative. A considerable series of measures is being taken, not just nationally but locally. Various councils, various health trusts in Northern Ireland and other bodies are actively engaging in trying to come to terms with the problem. Many programmes that promote healthier food choices are being actively promoted. I am aware of the healthy eating awards, and of course we are all aware of the food labelling issues that have come to the fore in recent years. There have been other programmes aimed at reducing the salt, sugar and fat in some foods. All those things are creating greater awareness among the wider community, but we are fooling ourselves if we think that the measures currently in place will arrest the problem.

I will turn at this point to what needs to be done now and for the foreseeable future. Obviously, the fast food industry is a key player in relation to the problem. Some people in that industry are quite responsible. Some have responded to the campaigns driven locally and introduced more healthy eating options—they are to be commended for doing so—but some have not. We need to see best practice not just nationally but internationally being analysed and then promoted, so that we can see significant progress.

At the moment, there is—certainly in Northern Ireland, and I assume across the UK—a better educational approach in schools. Our young children, particularly primary school children, are now getting information that simply would not have been proper protocol 25 years ago. Many people then would not have even seen the need for primary school children to receive that type of education. That is changing, but again, more needs to be done to increase awareness. We have all seen issues where, for example, healthy eating has gone wrong. Sometimes we see photographs in newspapers that show parents queuing up to give other types of food to children because healthy eating standards have gone awry. We need to ensure that the whole educational process about healthy eating for children is properly assessed and rationally implemented.

When we ally the fast food sector—I do not want to name any of the organisations—with a sedentary lifestyle, I think we can account for 80% to 90% of the obesity problem.

[Mr Campbell]

I agree with that; I was just about to come to the issue of exercising. I love walking, and when I get the time to walk, as I try to weekly, I despair at the rarity of seeing other people walking and exercising.

[Jim Shannon]

Surely, my hon. Friend does not just walk; he marches. When someone marches, they lose more calories, and I understand that he marches often.

[Mr Campbell]

I thank my hon. Friend for bringing us back to basics with a Northern Ireland and Scotland perspective on that. That is true.

I do despair when, for example, I see very few people exercising between October and March or April, and even fewer children.

--- Later in debate ---

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am grateful for the opportunity to contribute to this debate. I will not speak for very long, but it is worth highlighting some of the issues that have been raised in a comprehensive way. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this debate.

Obesity in the UK is a growing problem. In 1993, only 13% of men and 16% of women were obese, but in 2009, 22% of men—and 24% of women—were obese, which represents almost a doubling of the number of men with obesity. I am not talking about people with a body mass index of between 25 and 30, which means that they are overweight; I am talking about obesity. Almost a quarter of the UK population is obese and I am sure that we all find that unacceptable.

How can we deal with obesity effectively, because whatever previous Governments have done, obesity has not been addressed in a way that has worked or has been effective? First, I will briefly outline how Government policy is moving towards more community-based interventions on obesity, and I will explain how that approach, through the health and wellbeing boards that will be set up under the health care reforms, will be effective and work well. Secondly, I will talk a little about nudge theory, because I am more hopeful and optimistic about it than my medical colleague, my hon. Friend the Member for Totnes (Dr Wollaston). There is good evidence elsewhere, particularly in Iceland, that it has worked, and I hope it will also work effectively in relation to obesity.

[Jim Shannon]

While the hon. Gentleman is giving us his thoughts, and given his experience in his previous job, will he comment on gastric band operations? Just two weeks ago, I had occasion to visit the Northern Ireland Health Minister, Edwin Poots, with some of my constituents. These people had tried everything to lose weight; they had tried dieting and exercise—some of them were not able to exercise, which was the other problem—but they had clear medical and health problems. As a last resort—this really is the last chance saloon, or the last chance restaurant, perhaps—should regions and Health Ministers set aside money specifically for gastric band operations?

[Dr Poulter]

We certainly have to look at how the Government can help people to take more responsibility for their own health care. That is fundamental to obesity issues, and it is a particular challenge in more deprived areas. People often require gastric bands at the point where the medical problems associated with obesity—diabetes, the risk of heart attack or stroke, or high blood pressure—pose a potentially life-threatening risk. Such people may not have that long to live if a gastric band is not put in place, so it is the only feasible mechanism for dealing with obesity in such cases. Gastric bands have been shown to be an effective mechanism for looking after that part of the population, and there is good medical evidence to support their use. There is also good evidence in terms of the health care economics, as helping people to become slimmer will lessen the burden on the NHS.

The gastric band is good for the patient, because their health improves dramatically when it is used effectively, but the challenge with obesity is to bring about long-term lifestyle change, and the question with gastric bands is whether they necessarily deal with long-term lifestyle changes. In a medical sense, there needs to be greater emphasis on the education that goes with the bigger issues around obesity and lifestyle at the same time as the gastric band is fitted. I hope that that helps to answer the hon. Gentleman’s question.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Burns]

My hon. Friend raises an important and controversial issue, as he will have heard when listening to my right hon. Friend the Secretary of State earlier and the debates that he has attended in the House on this subject. We are determined that proper facilities will be made available, based not on money but on the high quality of care, particularly for children. An independent review is being carried out by the joint committee of primary care trusts, which is expected to announce its recommendations later this year.

[Jim Shannon (Strangford) (DUP)]

Has the Minister considered exchanging expertise with the regions of Scotland, Northern Ireland and Wales? That exchange could take place without any charge.

[Mr Burns]

The hon. Gentleman raises a valid point. The NHS in England has regular contact and discussions with the NHS in other parts of the United Kingdom, and will continue to do so because both the UK and the devolved authorities can learn a considerable amount from sharing views and practice.

Ovarian Cancer

Jim Shannon Excerpts

Wednesday 12th October 2011 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. It has been a good many years since I last did so, when I was chairman of the Welsh Young Conservatives and you were chairman of the national Young Conservatives. I am grateful for the opportunity to raise this important subject. I am conscious that many hon. Members wish to contribute, many of whom have personal and constituency experience of the disease. It is important to hear from as many of them as possible, so I shall make my opening comments as brief as I can.

My personal experience of the effects of ovarian cancer occurred some 40 years ago, and it meant that I never knew my grandmother. In her 50s, she suffered from the disease, which sadly took her life in my first year of life. She was buried on my first birthday. Clearly, at that age I was too young to know, but she was, by all accounts, a truly wonderful lady and, due to the cruel nature of the disease, her death was a loss that impacted on my family for many years.

Some 40 years on, I was elected a Member of Parliament in 2010, and like all new MPs, I am sure, I felt somewhat overwhelmed when I came to this place. What staggered me more than anything was the volume of invitations that I received from many different charities. One stood out—that from Target Ovarian Cancer. It stood out because it informed me that a constituent would be attending a reception, and because of the impact that the disease had had on my family.

I worked in the charity sector for 16 years and, as I was involved in politics, I thought I knew how to get to Members of Parliament, but I realised how wrong I was when I saw the volume of correspondence that I received. I thought it clever of Target Ovarian Cancer to make its invitation personal by bringing a constituent down here. In June, I attended that reception and had the opportunity to meet my constituent, Chris Shagouri. She is one of those people with whom one instantly clicks; she is inspirational. I listened to her speak about how late diagnosis of the cancer had impacted on her, her husband and her family. She talked about her ongoing battle to keep the disease at bay, and it is clear that she has great determination, but it was easy to wonder how much easier it might have been had the diagnosis been made earlier.

As the reception continued, I heard, time and again, moving stories from other women about their experiences. That and Chris’s persuasive manner convinced me to support the all-party group on ovarian cancer, which was being set up.

Sadly, diary clashes have restricted the number of meetings that I have been able to attend, but it is impressive that they are regularly attended by women who reinforce over and again the message that early diagnosis is necessary. At the most recent meeting, we heard again from women from throughout the UK about their experiences. At the most recent reception, four women gave personal accounts of their problems, which motivated me to bid for this debate. I am grateful to have been given that opportunity.

Ovarian cancer is not rare. It is the fourth most common cause of cancer death in women after breast, lung and bowel cancers. Every year, some 6,500 women are diagnosed and, staggeringly, 4,400 die every year. Just 36% of women who are diagnosed survive for a further five years. Those figures are staggering, compared with more than 80% for those who suffer breast cancer. It is also staggering that in three quarters of women who are diagnosed, the cancer has already started to spread. Those figures are scary.

The holding of this debate prompted someone to contact me this week. They wrote:

“My mother died aged 67 in 2009 with Ovarian Cancer. By the time she was diagnosed, the cancer wasn’t in the early stages and she was given only a 2% chance of living for 5 years. She fought all the way with various treatments and lived for 7 years after diagnosis.”

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on raising the issue. As he rightly said, every one of us can relate to a constituent or family member with the disease, and most people are aware that the cancer is hereditary or genetic. Does he believe that whenever someone is diagnosed with ovarian cancer there should be immediate checks on other family members—sisters, nieces, and daughters—to ensure that the hereditary effect is not passed on? Does he believe that that should be done quickly after diagnosis?

[Stuart Andrew]

I am grateful for that intervention. I agree absolutely that anything we can do to ensure early diagnosis of conditions can only help. In the long term, it is better for the individual concerned, and certainly better for the rest of the family, who go through equal concern.

Health and Social Care (Re-committed) Bill

Jim Shannon Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

I absolutely will not.

I want to mention some of the other lies that have been printed about me. I have been accused of wanting to reduce the number of abortions by introducing the amendment. That is absolutely not the objective. However, if any individual in the street was asked about the amendment and told that it might bring down the number of abortions, would they say, “Well, that’s a good thing,” or would they say, “We’re proud of the fact that 200,000 abortions a year are performed in the UK”? That is the highest number in western Europe. Would the individual in the street say that that is a good thing? No, they would say that it probably would be a good idea if something could help to bring that number down. I do not want to restrict access to abortion. The amendment is not about restricting access. I do not want to return to the days of Vera Drake-style back-street abortionists. That is not what the amendment is about. I am pro-choice, although I am presented as pro-life in every newspaper. The pro-life organisations are in fact e-mailing pro-life MPs to tell them not to vote for the amendment. I am pro-choice. Abortion is here to stay.

It is absolutely ridiculous that the amendment has been portrayed as something that would restrict access to abortion. The amendment is about medical practitioners making to a woman who presents at their surgery or organisation an offer of independent counselling, not compulsory counselling. Every single day I have read a headline stating that the amendment is intended to drive women into the arms of religious fundamentalists via compulsory counselling. That is absolutely not true. Any Member who rose and claimed that the amendment would make counselling compulsory would be being untruthful. It is nothing more than an offer. It is an offer made to some women who, when presenting at a GP’s practice, may have doubts, may be confused and may feel that they would like to accept. That is all it is—an offer. I find it very difficult to understand how anyone can object to a vulnerable woman being made an offer of counselling when she is suffering from a crisis pregnancy.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way, and I commend her courage and perseverance. Does she share the concern of many in this House and outside about the businesslike and commercial decisions that are taken in relation to abortion and feel that, because one hour of counselling a week for everyone is not enough, it is wrong that a commercial industry has been made out of abortion? Does she agree that when abortion becomes a business, the feelings of people have been lost?

[Nadine Dorries]

The hon. Gentleman makes a pertinent point about the relationship between financial incentive and abortion counselling, which I will talk about in a moment to make it quite clear how the amendment relates to the issue.

--- Later in debate ---

[Nadine Dorries]

As I said, I do not want to look as if I am knocking abortion providers. As a nurse, I assisted with many terminations. I do not want to look as if I feel that there is no place for abortion provision. I am pro-choice and do not want to return to those other days.

[Jim Shannon]

rose—

[Mr Umunna]

rose—

[Nadine Dorries]

I give way.

[Jim Shannon]

rose—

[Mr Umunna]

rose—

--- Later in debate ---

[Nadine Dorries]

No.

I do not want to ban abortion—I want it to continue—but should we not be taking better care of our young girls and women? Should we not be offering them something better? How do women get to the position of suffering mental health problems as a result of abortion?

[Jim Shannon]

The hon. Lady will be aware of facts and figures that indicate that a number of people who have had abortions regret it afterwards. Does she feel that if the consultation process is done correctly and the information is shown to the person who wishes to have the abortion, they would perhaps then decide that the child they are carrying could develop into a young lady and have life? Does she feel that the consultation process is clearly where the issue has to be addressed and that the emphasis has to be on the counselling, not on the abortion?

[Nadine Dorries]

The hon. Gentleman makes a point that is pertinent to his own beliefs. What I believe about counselling is that no advice should be given, that there should be no direction, and that it should be completely impartial. It should be an influence-free zone—a bubble—where a woman can sit and talk through the issues with somebody who is not guiding her. That is what counselling should be.

Every single day I receive e-mails from women who do not want other women to experience what they have experienced—who do not want their daughters to go through what they have gone through. I receive e-mails from staff who are working in, or have worked in, abortion clinics. I am in dialogue with some very senior members of staff of a number of organisations and abortion clinics across the UK—

Health and Social Care (Re-committed) Bill

Jim Shannon Excerpts

Tuesday 6th September 2011 Commons Chamber

[Grahame M. Morris]

I am grateful for my hon. Friend’s contribution, as that is an excellent point. If hon. Members will bear with me, I shall discuss new clause 6 and what I believe the implications of the Government’s proposal would be for the Bill and for health inequalities. I was intrigued by the Secretary of State’s assurances in his opening statement about the responsibilities being conferred on him in the Bill that did not apply when Labour was in power. I believe he said that those powers were devolved to primary care trusts, but if PCTs are disappearing or clustering and strategic health authorities are disappearing over time or being clustered, surely it is right that the Secretary of State, as an accountable politician, should have these powers clearly defined in the Bill. I did not mean to digress, Mr Deputy Speaker. Those remarks related to clause 1 and I shall confine myself to the provisions before us.

As I have said, many concerns have been raised about the approach being taken to this cherished institution, not least those set out by my right hon. Friend the Member for Holborn and St Pancras about patient perception.

[Jim Shannon (Strangford) (DUP)]

Is the hon. Gentleman aware of the survey carried out among the 50,000 members of the Chartered Society of Physiotherapy? It indicated that 81% do not agree with the proposals for NHS reform—that touches on the issue that he just raised. It also indicated that 89%—almost nine out of 10 of those who work in the health service—believe that patient care will suffer and that 84% do not believe that the Government have considered these changes. Does he believe that the level of concern among those workers in the health service, and among the general public, means that whenever the vote takes place tonight hon. Members should be very careful and should oppose the Bill?

[Grahame M. Morris]

I am grateful for that information. I know that other hon. Members have spent a day with the health service and I am sure that Ministers take soundings, but I can honestly say that what the hon. Gentleman describes is the feedback I have received from talking to health professionals, patients and so on. I recognise that the Secretary of State has said on numerous occasions that a substantial body of GPs support this approach. When I tuned in to this morning’s “BBC Breakfast” I saw Professor Chris Ham of the King’s Fund being interviewed. He is an eminent and respected commentator on health service issues who has given evidence to the Public Bill Committee and the Health Committee. He gave his view that it was a small cohort of GPs who were signed up and committed to these reforms. I agree with his assessment.

These provisions deal with the role of Monitor, the relevant implications and changes to the failure regime. A “Panorama” documentary on the BBC featured Sir Gerry Robinson, who has some standing in the business community and for previous journalistic investigations into the NHS. The conclusion of his report was that he thought that these reforms could mean

“the end of the NHS.”

That is his conclusion. Even after meeting the Secretary of State he remained unconvinced of the value of the reforms.

The Secretary of State has failed to persuade the public and he has failed to persuade NHS staff of his approach. That has been illustrated by various surveys, through the British Medical Association, by personal contacts and in other ways. Even elements of the business community recognise the level of public opposition and concern. It seems that the principal backers are overseas US-style private health groups, whose interest is not philanthropic. They see the prospect of substantial profits and unprecedented access to billions of pounds soon to be available from NHS coffers. We hear Ministers and Government Members saying that the NHS was open to private sector providers under the previous Administration, and a very small figure—5% or so—was cited in the Public Bill Committee proceedings.

Care (Older People)

Jim Shannon Excerpts

Tuesday 6th September 2011 Westminster Hall

[Tracey Crouch]

Indeed. This issue is about using resources wisely. However, it is very well discussing how resources are used now, but the problem lies in the future. At the moment, one in six people are over 65, but by 2050 one in four people will be over 65, and resources will only be able to stretch so far.

We spend a lot of time—rightly so—talking about financial education for young people, but I am enormously sympathetic to the suggestion that we should consider providing free financial health checks for people in their 50s and early 60s, possibly funded by using unclaimed assets in banks and insurance companies, and possibly delivered by financial advisers, charities or through the new money advice service. The provision of good quality care is an emotive matter for all involved. Standards of care, and indeed of care homes, differ dramatically, not just across the country but across constituencies. I recently visited Amherst Court in Chatham, a purpose-built Avante Care and Support home that supports residents with dementia. I was really impressed with what it offered and could tell that a lot of thought had gone into the building and the care provision. Such quality, however, has to be paid for, and unfortunately not all residential homes offer the same standards. When homes close, sometimes because the buildings are no longer fit for purpose, there can be uncertainty for residents and their families. It is that postcode lottery of care that we need to mitigate as best we can through the consideration of our long-term care requirements, which is why one policy that we need to get absolutely right for the benefit of our elders is the one on building more homes.

We have a massive housing shortage in the UK, but it is the older generation who have the least choice as to where they live. If they decide to downsize from their family home, they find that there are few bungalows or smaller houses being built. There are not many purpose-built retirement complexes, whether flats or houses, and any new development with social housing rarely, in my view, considers the needs of the elderly.

[Jim Shannon (Strangford) (DUP)]

There is a great focus on residential homes, but does the hon. Lady feel, as I do, that there should be a greater focus on letting people stay in their own home? They feel more confident there, and it is cheaper. I think that if they had a choice, a great many people would rather be in their own home than in residential care.

[Tracey Crouch]

That is precisely my point, and I hope that it will be the key theme to emerge from my speech. Homes must provide good-quality care for people who have to go into residential care, but we need to try to keep people in their own home for as long as possible. My late grandmother certainly believed, as do I, that if good-quality services can be provided people will have to rely less on expensive residential care, and we should therefore provide a greater choice of available private homes. Not many bungalows are being built, because their capital value is not that of a seven-storey apartment block on the same land, which poses a problem for our older people, who then have the choice of staying in their family home, which is incredibly expensive to heat and often impractical, or of moving into residential care.

We want to rely less on the state to fund our residential care, and it seems logical to put greater emphasis on ensuring that new developments have as much of a duty to provide for older people as for other younger sectors of society. The issue of choice extends into the social housing sector too. In my constituency, a few areas of social housing are allocated to the over-55s, but there is a huge difference in the lifestyles of 55-year-olds and 75-year-olds, which often leads to antisocial behaviour problems. I doubt that many people would consider 55 to be old, and therefore we perhaps ought to consider revising the age allocation up, to the over-65s.

I am pleased to say that Kent Housing Group, which is a partnership of developers and local authorities across the county, is looking precisely at housing for older people, and I look forward to seeing the outcomes of that work soon. However, I fundamentally believe that there is a role for the new homes bonus, which could incentivise authorities to build bungalows or complexes for older people and lead to much more housing choice for those who wish to stay out of residential care. That could be one policy that would have a positive impact on the welfare of older people, and it would also benefit the Treasury by keeping people out of the more expensive residential system.

The funding of social care might be the hardest single problem to overcome in this policy area, but we often forget that the services side is equally, if not more, important. Good delivery of services can prevent people from needing to enter residential care, or from staying in hospital longer than the average patient. We have some excellent charities and volunteers who provide an essential community service, and they can be vital to the health and well-being of the people they look after. As brilliant as individual schemes are, however, our overall community service for the elderly needs to be much better. I heard a heartbreaking story from the WRVS about a lady whose light bulbs broke. She was unable to fix them herself, and so for a month she sat in the dark. As she used her television for light, the electricity company noticed that her bills were unusually high, contacted her and discovered what the problem was. A WRVS buddy was sorted out, and her light bulbs were changed, but it took a month and a concerned utility worker to alert others before she was helped. In these modern days of instant connectivity, I find such isolation utterly unforgivable.