Diabetes

Jim Shannon Excerpts

Wednesday 9th January 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

First, I thank the hon. Member for Torbay (Mr Sanders) for bringing this issue to the House. Secondly, I declare an interest, as I am a type 2 diabetic and have been for four years. It has given me a knowledge of, and an interest in, the issue, although not a total knowledge—far from it. It has also made me more aware when constituents come to me with issues relating to diabetes and has given me an interest in those issues.

The disease has completely changed my life, as it would, because it is type 2. Diabetes is a major issue in every constituency. As someone who enjoyed the sweet trolley more than anyone else—to use Northern Ireland terminology, when there was a bun-worry going on, I was at the front of the queue—the sweet stuff was something that I indulged in regularly. Along with my stress levels, that has meant that I am a diabetic today.

The statistics have been mentioned, but they bear repeating, due to the seriousness of the UK’s problem, which is etched in everyone’s minds. The UK has the fifth highest rate in the world of children with type 1 diabetes. In Northern Ireland, we have 1,040 children with type 1 diabetes, some of whom are born with the condition. I want to give a Northern Ireland perspective, but I will bring in the UK strategy, because diabetes affects the whole UK, and that is why it is important. Some 24.5 children in every 100,000 aged 14 and under are diagnosed with the condition every year in the UK. We had a reception where we met some of those young people, and if we needed a focus, the focus was there that day for those of us who attended. I think that most of the people in the Chamber were there.

The UK’s rate is about twice as high as that in Spain, where it is 13 children in every 100,000, and in France, where it is 12.2 children in every 100,000. The league table covers only the 88 countries where the incidence of type 1 diabetes is recorded. There are 1,040 children under the age of 17 with type 1 diabetes in Northern Ireland, and almost one in four of them experienced diabetic ketoacidosis before a diagnosis was made.

Diabetic ketoacidosis can develop quickly. It occurs when a severe lack of insulin upsets the body’s normal chemical balance and causes it to produce poisonous chemicals known as ketones. If undetected, the ketones can result in serious illness, coma and even death. The diabetes itself is not the killer; it is the offshoots from it, the effects on the heart, circulation, blood pressure and sight, and the possibility of strokes and amputations.

The number of people living with type 1 and type 2 diabetes has increased by 33% in Northern Ireland. In my Strangford constituency, the number has gone up by 30%, with 800 people—I am one of them, by the way—becoming diabetic in the past seven years. That compares to 25% in England, 20% in Wales and 18% in Scotland. In our small part of the United Kingdom, the total number of adults—aged 17 and over and registered with GPs—with diabetes is 75,837, and a further 1,040 young people under the age of 17 have type 1. There has been a significant rise in that number also, with the prevalence in Northern Ireland now at more than 4%. An estimated 10,000 people in Northern Ireland have diabetes and do not know that they do. They have a ticking time bomb in their bodies; they wonder why they are not well, and the cause is diabetes.

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

My hon. Friend is talking about the different prevalence of diabetes throughout the UK. Does he agree that best practice regarding early detection and the promotion of an active lifestyle could be a target for all the devolved regions across the UK and here in England? The Minister would do well to respond in relation to Ministers in the devolved regions taking on such best practice to combat diabetes.

[Jim Shannon]

Yes, I agree. When people make interventions, I always wonder whether they have read my script—preventive medication is the very next issue on it.

In my doctors surgery in Kircubbin and, indeed, across Northern Ireland preventive measures are in place. There are diabetic surgeries, and the matter is taken seriously. The UK strategy that we have had for the whole of the United Kingdom of Great Britain and Northern Ireland and that will come to a conclusion this calendar year has made significant progress towards reducing the potential numbers, but diabetes has increased over the same period. There are some 100 diabetics in my doctors surgery in Kircubbin.

[Rehman Chishti]

The hon. Gentleman talks about the United Kingdom strategy. Does he accept that certain people from different ethnic backgrounds are more likely to get diabetes? For example, according to the Wellcome Trust, 50% of people from south Asian and Afro-Caribbean backgrounds would have diabetes by the age of 80. Any UK strategy would therefore have to take ethnic composition into account, because such people are affected differently.

[Jim Shannon]

That is an excellent point, and I am sure that the Minister will address it in her response. There are groups in the whole of the United Kingdom in which diabetes is more prevalent, and we need to look at those target areas.

There are 3.7 million people in the UK diagnosed with type 2 diabetes. I was diagnosed four years ago. With me, it was down to bad eating habits, stress and the fact that there were no set hours to my job. I ate whatever was quickest, and that was Chinese, usually with two bottles of coke, five nights a week. That was why I was 17 stone. I am now down to 14 and a half stone because I no longer do that. The issue is eating and living styles—eating what is quickest rather than what is best.

Edwin Poots, the Minister at the Department of Health, Social Services and Public Safety in Northern Ireland, is very aware of the ticking time bomb that is diabetes. I am aware of the key initiatives in operation in Northern Ireland, and I know that the Minister here today has had discussions with the Minister in Northern Ireland. They are doing a great job, including setting aside funding to employ additional diabetic staff—specialists, nurses, dieticians and podiatrists. That is providing all the help that a diabetic needs, but it is still not enough.

We need a concerted effort across the United Kingdom, through the media, and even perhaps through the TV soaps. I am not a soap watcher. I could not tell anyone what happens in “Emmerdale” or “Coronation Street”, but my wife could. She knows everyone in them—what they are doing this week and what will happen to them next week. Could we not perhaps use the soaps to make people more aware of the issue? I understand that plenty of issues are brought up in them regularly, so perhaps we should try this one.

It is great that our children are taught about diabetes in school. It is surprising what a five or 10-year-old knows about food that their mum and dad do not. Who is educating the mums and dads at home who are making the dinner and buying the shopping? The hon. Member for Blaenau Gwent (Nick Smith) made a point about how the food coming into the house is controlled by the parents. Diabetes UK Northern Ireland is taking part in an organisation-wide campaign entitled “Putting Feet First” to raise awareness of amputations among people living with diabetes and to work to prevent unnecessary amputations.

The Minister might want to comment on the new medications that are available. In the press this week, there was talk about a new diabetic medication in tablet form that could replace—not totally but partially—type 1 injections. The figure used was a cost of £35 per month. It would be good if we could get some feedback about whether the new medications will be available across the United Kingdom and whether everyone will be able to take advantage of them.

In Northern Ireland last year, 199 diabetes-related amputations took place, and the “Putting Feet First” campaign highlights that an estimated 80% of lower- limb amputations are preventable. There must be a UK strategy to reduce diabetes-related amputations by 50% over the next five years. What can we put in place in this Chamber to highlight and support the campaign? How can we use our influence to see the number of cases of type 2 diabetes dropping, instead of this steady rise?

The links between type 2 diabetes and obesity are firmly established, and it is clear that, without appropriate intervention, obesity can develop into diabetes over a relatively short time. For instance, the risk of developing type 2 diabetes is about 20 times more likely in obese, compared to lean, people. A newspaper recently stated that academic sources have estimated that the predicted rise in obesity rates over the next 20 years will result in more than 1 million extra cases of type 2 diabetes, and that is really worrying. Can that go unchallenged, when it is within our power, as parliamentarians, to do something about it, at least by putting a strategy in place or by beefing up the ones that we already have? When the current UK-wide strategy ends, it will perhaps be time to do something more.

I live the life, as do many others, of testing my blood every day, of feeling unwell when my blood sugar is out of control and of worrying that the next visit to the doctor will bring worse news, which can be the case if we do not discipline ourselves and ensure that we do things right. That is not the life that I want to have, or the life that I want my family, friends or constituents to have. The way to take on the issue is to continue with the UK-wide strategy, with dedicated funding and with all the regions working together, which will save money in the long run and, more importantly, improve the quality of lives across the United Kingdom.

I urge the Minister to take the initiative. I believe that she will and that her response will be very positive, because she understands the issues. I urge her to work with the devolved bodies, in coming together to disarm the ticking time bomb of diabetes—the cost of which some people indicate will be £10 billion—before it explodes. Type 2 diabetes is preventable, and we must do all that we can to prevent it. Education, with attention paid by everyone in this Parliament and the regional assemblies, is the way to do that.

[John Pugh]

rose—

--- Later in debate ---

[Anna Soubry]

I am concerned about it. It is unacceptable. I have already held a meeting with my officials and they are making further inquiries. I discussed with Mr Dawson what was happening locally in CCGs, which is where this will make a difference, when we see the power of our doctors and other health professionals to commission services, and the power and influence that patients and sufferers of diabetes will have. I am told that NHS Diabetes has now identified a diabetic lead in every CCG. There is an opportunity, through the reforms, to ensure that we now deliver locally as we should. All hon. Members who have contributed to this debate have identified a failure in respect of good outcomes and good practice throughout the NHS, right through to local level. That needs to be, and is being, addressed as a matter of urgency.

I have been alerted to problems with glucose meters and pumps—various new advances in technology. Some of this excites me. However, I am still concerned if there is not the availability that there should be, right across the NHS, notably for all sufferers of diabetes 1.

[Jim Shannon]

It is not just about the provision of the insulin pumps; it is also about training. There are two facets to that.

[Anna Soubry]

Indeed. I was going to end this part of my speech by saying that my constituent, Mr Dawson, paid tribute to what he described as his brilliant diabetic nurse at the Queen’s medical centre in Nottingham. He highlighted, as the hon. Gentleman has done, that it is all well and good having wonderful, great technology, but if people have access to it they need, critically, the support to be able to use it themselves. We must ensure that they have the highest-quality support, not just from their GPs, but from diabetic nurses and others who are trained and specialise in this condition.

Diabetes is common and is increasing, as hon. Members have mentioned. It is estimated that, by 2025, 4 million people will have diabetes.

Antibiotics (Intensive Farms)

Jim Shannon Excerpts

Wednesday 9th January 2013 Westminster Hall

[Zac Goldsmith]

I thank the right hon. Gentleman for his intervention. I suspect that that is part of the problem, but as I will come to later, I think it is also the case that the agribusiness sector in this country has had a disproportionate impact on policy. That is a point that I hope to impress during the debate.

As I was saying, there has been a near clean sweep of Ministers at both Departments, so this debate provides an opportunity to clarify Government policy. The Government are right to insist on better infection control in hospitals and changes in the way that antibiotics are prescribed by doctors. However, other than the brief answer that I quoted from the former Secretary of State, there has been virtually nothing from the Government that could in any way encourage vets and farmers to be similarly prudent. Not surprisingly, therefore, there has been little progress; on the contrary, analysis by the Soil Association of the Government’s statistics indicates that the overall use of antibiotics per animal on UK farms increased by 18% between 2000 and 2010, while the farm use of third and fourth-generation cephalosporins—drugs described by the Health Protection Agency as hospital workhorses—increased by over 500%.

Furthermore, recently published data from the Veterinary Medicines Directorate show that sales of fluoroquinolone antibiotics for use in veterinary medicine over the past two years have been 70% higher than they were in 2000. It is worth noting that when fluoroquinolones were first licensed for use in poultry in the UK in 1993, there was no registered antibiotic-resistant campylobacter in people who had not been treated with the antibiotics, but by 2007, almost half—46%—the campylobacter food poisoning cases caused by the most common strain were resistant. It is worth noting also that in 2008, the European Food Safety Authority said:

“A major source of human exposure to fluoroquinolone resistance via food appears to be poultry”.

Clearly, antimicrobials should be used to treat sick animals, and I do not think anyone would argue against that.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing the debate. Does he feel that the use by the farming sectors—whether pig, poultry or beef—of antibiotics is unnecessary, because there is a blanket use, rather than reacting to disease? Does he feel that that has a direct impact on us as human beings? Many people come to me and say that the antibiotics are not working, and they are getting three doses from the doctor. Is that feeding off what is happening?

[Zac Goldsmith]

Again, I absolutely agree with the hon. Gentleman’s point, and I thank him for making it. I will come to that in more detail shortly.

There is no argument against treating sick animals with antimicrobials but, surely, not the most modern and medically important ones, especially when other antibiotics, which are not as critically important in human medicine, are available. I recognise that this topic does not lend itself easily to tabloid news, but there is a real, worrying chance that that could change. By overusing antibiotics, we risk ruining for future generations one of the great discoveries of our species. In short, we risk entering the post-antibiotics age.

My hon. Friend the Minister will know that some antibiotics have already been lost to resistance: for example, penicillin for staphylococcal wound infections, ampicillin for infections of the urinary tract and ciprofloxacin for treating gonorrhoea. Many more are under threat, and new antibiotics are increasingly hard to find and license. We are now using our reserve antibiotics, and worryingly, seeing the spread of resistance to them as well. For example, rises in resistance, such as those seen for E. coli, force doctors to use carbapenems, which were previously the reserve antibiotics for use when other treatments had completely failed. However, we are now using carbapenems much more and seeing the spread of resistance to them as well.

University of Cambridge researchers revealed the first cases in UK livestock of a new strain of the multi-resistant superbug MRSA. It is called ST398, and it has become endemic in European and north American pig populations and has spread to poultry and cattle. It is significant because, unlike most strains of staphylococcus aureus found in farm animals, it is readily able to transfer to humans. If not checked, that is likely to lead to rising community-acquired MRSA, just at the time that hospital-acquired MRSA is falling, due to sterling efforts by health professionals.

Liverpool Care Pathway

Jim Shannon Excerpts

Tuesday 8th January 2013 Westminster Hall

[Sir Tony Baldry (Banbury) (Con)]

When I first entered the House of Commons some 30 years ago, I became the founder secretary of the all-party hospice support group, and Jack Ashley was the founder chairman. I am glad to say that that group has now become the all-party parliamentary group on hospice and palliative care. During those 30 years, an enormous amount of work has been done on enhancing palliative care in hospitals. We are fortunate in this country in having an outstanding hospice movement. Part of the purpose of the Liverpool care pathway was to ensure that the good practice of palliative care, which had been developed in hospices, could be spread to other health care settings, such as hospitals and care homes. Extending it to people’s own homes was also important because if people are asked where they would like to die, most say at home. The reality for each one of us is that we will die.

The Liverpool care pathway requires staff to ensure that all decisions to continue or to stop treatment are taken in the best interests of each patient, and emphasises that patients should be involved in decisions about their care and that carers and families should always be included in the decision-making process. An evaluation in 2011 showed that in 94% of cases, there had been such involvement. The idea of documenting conversations, which the hon. Member for West Lancashire (Rosie Cooper) mentioned, is sensible. In our own professional lives, and, indeed, as Members of Parliament, we all know that people, especially family members, do not always take on board news that may be distressing. Often it is quite a shock to be told that a loved one is near to death. Very often, the instinctive reaction is to want to ensure that life can be preserved for as long as possible, but we also have a duty of care to ensure that in people’s last days and hours they die well and painlessly and with as much dignity as possible.

I was very struck by two contributions in the Library briefing. One was a brave article by a specialist registrar who herself is a terminally ill cancer patient. Of the Liverpool care pathway, she said:

“It prompts us to have open discussions with relatives, and, if possible, patients, to stop unnecessary medication, to discontinue futile medical interventions, and to shift our focus of care to symptom-control, comfort and dignity… Most patients on the LCP, in my experience, are too poorly to eat or drink, but where a patient is alert enough to swallow we certainly continue to offer them food and fluids in my hospital. They are not ‘starved to death’. The problem with intravenous fluids is that cannulae need to be inserted to administer them. This is painful, often very difficult and sometimes near impossible in patients who have been in hospital for a number of weeks.”

[Jim Shannon (Strangford) (DUP)]

Although the hon. Gentleman makes a pertinent point, surely the issue must also be about those people who are not convinced about the system and who are suspicious and worried about what they have been told. There are people who have been denied fluids, and also drink and food. Does the hon. Gentleman think that there should be some protection in the system for such families so that they can feel assured that there is care? The point I am trying to make is that this should be about care and not killing, but many of us suspect that there is more emphasis on the killing than on the care.

[Sir Tony Baldry]

Very few of us can have the confidence of Cardinal Basil Hume who, in his book “The Mystery of the Cross”, observed:

“Death is a formidable foe until we learn to make it a friend. Death is to be feared if we do not learn to welcome it. Death is the ultimate absurdity if we do not see it as fulfilment. Death haunts us when viewed as a journey into nothingness rather than a pilgrimage to a place where true happiness is found . . . Death is not the end of the road, but a gateway to a better place.”

Few of us, irrespective of our faith, have that clear courage and confidence, but we all recognise that we will die. There is nothing about 21st century medicine that is going to keep the hon. Gentleman or myself, or any of us, alive for ever. Death, and the process of death, can be extremely painful, and it is our collective duty and responsibility to try to ensure that people die as painlessly as possible and with as much dignity as possible.

I can assure the hon. Gentleman that people do not go into the medical profession to kill. My father became a doctor and my mother a nurse to ensure that they could give people the best quality of care. Although the press have published a number of stories about relatives who have expressed concern about how the local care pathway has been used, there is no systemic evidence to suggest that the policy is being abused. A consensus statement was published last year by several non-governmental organisations and charities, all of which are much respected in this House, supporting the Liverpool care pathway. They include Age UK, the Alzheimer’s Society, the British Heart Foundation, Help the Hospices, Macmillan Cancer Support, Marie Curie Cancer Care, the Royal College of General Practitioners, the Royal College of Nursing, the Multiple Sclerosis Society and the Royal College of Physicians.

[Jim Shannon]

rose—

[Sir Tony Baldry]

No, I will not give way because others want to speak. This is an important issue, but we must ensure that we put it in perspective. If we are not careful, all the work that has been done over the past 30 years by a whole number of organisations, including those that I have just mentioned, to enhance and improve palliative care could be undone. Sadly, people die every day; that is the reality. It is not a failure of the NHS that people die. It is only a failure of the NHS if people do not die well. We need to ensure that all improvements, whether they be to records or to communication with patients and their families, are undertaken, but nothing should deter us from trying to ensure that everyone in this country gets the best possible end of life and the best possible palliative care.

--- Later in debate ---

[Jim Shannon]

I congratulate the hon. Lady on the passionate way in which she has dealt with this issue. Does she agree that it is important that those who work in the Liverpool pathway are highly skilled? If such care is left in the hands of those who are less skilled, there is a possibility that what could be termed voluntary euthanasia will take place. Does she agree that only highly skilled people should be involved in the Liverpool care pathway?

[Fiona Bruce]

I do, and this is where training is so important. Without the proper application of the Liverpool care pathway, death can be hastened, and that is not the intent of the pathway. Occasionally, even with correct application, it can be the unintended consequence—for example, through the use of narcotics to alleviate severe discomfort and facilitate a more peaceful passing.

I wholeheartedly welcome the Minister’s decision to hold an independent public inquiry into the LCP. I have met him, and I thank him for his open-minded, calm and reasoned approach and for the fact that he has had ears to hear concerns about the LCP. Without wishing to prejudge the terms of the inquiry, may I make the following suggestions for it to consider?

First, a number of pressures might subvert the proper implementation of the LCP, and I am grateful to Professor David Albert Jones of Oxford, who is an authority on this topic, for highlighting them. He says they are:

“the subjective character of judgments about how soon someone is going to die…the fact that the LCP may be initiated by people who are not senior clinicians familiar with the individual patient’s case and have not consulted with palliative care physicians… the influence of managerial pressures to reduce bed occupancy …reluctance to face the difficulties of continuing care of certain difficult patients…the euthanasiast outlook of some clinicians…the possibility of doctors or nurses regarding the LCP as a set of ‘tick boxes’…rather than assessing the needs of the patient…Other NHS organizational/staffing procedures or constraints”.

He adds:

“Research shows that care of the dying is poorest in the hospital setting”

in contrast to care in hospices, which I believe we all admire.

I also urge that the inquiry consider the following measures: that no patient should be placed on the LCP unless they are imminently, irreversibly and inevitably dying, which I understand to mean perhaps within 36 hours; no one should be placed on the LCP without its being discussed with a designated relative or carer; every patient placed on the LCP must be continuously monitored and reviewed by a multi-disciplinary team; documentation must be simplified and standardised, so that those implementing the LCP can easily follow the guidelines; training and supervision should be mandatory, as well as standardised and improved; non-clinical priorities in the use of the pathway must be eradicated and every patient must be treated solely according to their needs; payment for such care must be reconsidered; and the communication to relatives should be substantially improved.

I believe that, if it is well used, the LCP can improve standards of end-of-life care, especially in hospitals. It should promote better palliative care and support the kind of good death that we would all wish for ourselves and our loved ones. I sincerely hope that the independent inquiry will be a major step in facilitating that.

NHS Funding

Jim Shannon Excerpts

Wednesday 12th December 2012 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Deputy Speaker. I have no doubt that I will finish in time.

We are well aware of the pressures in every area to implement Government cuts and how difficult it is to do that. Whether we are in government or in opposition, we all have a job to do in sorting out that problem. In my opinion, there is no worse place to carry out cuts than the NHS. Sick people need treatments that are often expensive and doctors are working out treatment plans and thinking about how they can keep to their budget and provide top-class care. There are pressures on the doctors in the system and they are ever mindful of the budget that they have to work to.

Everyone inside and outside the Chamber is aware of the issues and of the value of the NHS. The debate is about how we can do things better. The Opposition tabled the motion and their concerns have been well rehearsed today.

In my constituency—many hon. Members have given similar examples—a young lady had been unwell for 10 years with ulcerative colitis. She was responsive to her treatment of infliximab, and yet the doctor had to take her off it because it was too expensive and other more serious cases needed the treatment. However, once she was off the treatment she worsened, had to go on the sick and received numerous warnings from her workplace about losing her job. Where would the money truly be saved in such a scenario—stay on the treatment, stay in work, or go off the treatment, go off work?

My mother had a saying—I am sure that many hon. Members will be able to relate to this—“Your health is your wealth.” It clearly is and those of us who are in good health are fortunate.

The right hon. Member for Cynon Valley (Ann Clwyd) is no longer in her place, but she made an excellent, compassionate speech. I think that she probably told the story of this debate in the examples she gave. I told her before she left the Chamber how important it was to have those comments on the record.

It must be remembered that in its review of independent NHS trust three-year plans up until 2014-15, Monitor, the NHS’s economic regulator, warned that cuts were unlikely to be matched by any let-up in the number of patients requiring care. There is an emphasis on preventive medicine and how best to use it. I am sure that the Minister will address how we can ensure that people who are getting older do not succumb to the many diseases and other problems. Sometimes, there is nothing gracious about growing old—it is a fact of life.

The Minister will talk about efficiency savings—they can achieve much—but when I consider the great job that the Northern Ireland Minister of Health, who happens to be a colleague of mine, has done on efficiency savings, I wonder whether the further cuts to Northern Ireland’s block grant will be applied to health again over the next few years. How much more can we save through efficiency? There is a limit—a ceiling—to what efficiency savings can do without affecting health. John Appleby, the chief economist of the King’s Fund think-tank, has said that the outlook for hospitals in 2013-14 and 2014-15 is particularly severe, with anticipated cuts of about 1% when the Government’s inflation forecast is 2.5%. That is a clear difference.

Some hospitals plan to partially offset the radical drop in NHS income by expanding their private patient work, aided, as their financial plans say, by moves to restrict NHS funding for certain surgical procedures. This is expected to fuel an increase in patients funding surgery privately. That greatly undermines what the NHS is about—its very thrust—namely care, no matter the condition, provided by national insurance contributions. As has been said, if we introduce a two-tier care system to operations, how long will it take until we find ourselves providing a system similar to America’s private health care system? How ironic it is that the Americans are attempting at this time to a design a system that is in line with our own NHS. Perhaps we can take some lessons from that.

I also want to comment on the problems that arise when we cut NHS funding. The number of MRSA cases in hospitals has increased. That is not through any particular fault of the staff—I am clear about that—but it is a problem that occurs whenever cost-cutting becomes the No. 1 priority for hospitals. We have to be careful.

We have already implemented cost-saving measures, such as carrying out certain treatments as day procedures followed by care at home, which, as well as being cost-effective, makes a lot of people feel more secure. However, it is essential that the patient is at the heart of any decision made and any strategy must incorporate that. There is a fine balance between cutting costs and cutting care. My fear is that the latest cuts, which will filter through to Northern Ireland through the block grant as a matter of course, will tip the balance for many people.

Many people in my office tell me that they were brought up to respect authority and that if a doctor tells them something, they accept their word. I come across other people who challenge their doctors and push them for the experimental treatment that they know is available, although at a cost, or for a referral to the mainland for innovative treatment. It saddens me that the results differ between those two types of people. In my opinion, it puts our health care professionals in the difficult position of choosing who deserves and who does not deserve the nth degree of care.

Recently in this Chamber I questioned the Secretary of State about the shocking use by doctors of so-called death lists—I am very careful about using that terminology—for elderly people, whereby they withhold certain treatments from those who they believe will die anyway. It is a dangerous precedent to set for the NHS when that can and does happen. If one puts oneself in the doctor’s shoes and realises that the Government are putting a great emphasis on cost, one can see that they are almost forcing that choice. That makes it a little more understandable, but no more acceptable.

As an MP, I have come across many constituents who have come to the mainland to have hospital operations and examinations. We are thankful that we are able to do that, but it involves a cost.

I am not the kind of person who believes that money grows on trees. I wish that it did. I have some trees in my garden, but I cannot find any money on them. We could spend, spend, spend, but I know that we must reduce the deficit. In my opinion, there are other ways of doing so, such as adopting the proposals put forward in the debate in May on the NHS and foreign nationals. To give a brief reminder of that debate, an article in The Daily Telegraph stated that official figures suggest that

“more than £40 million is owed to NHS hospitals by foreign patients who were not eligible for free care”.

It stated that a freedom of information request showed that

“the average unpaid debt for the provision of care to foreign nationals was £230,000 in the 35 trusts which responded.”

The article went on to note that the doctors’ trade magazine Pulse claimed:

“If this figure was the same across all 168 English acute trusts, the total debt would be almost £40 million”.

Perhaps in his response the Minister could give some detail about whether that money has been collected, and if not, when it will be.

In that debate, it was suggested that there should be a £1,000 threshold. Has that been implemented yet? Have those who owe the money been chased down? Has the six-month registration period for a GP been altered? In my opinion, by acting on such matters urgently, we can save money without cutting care. Does the Secretary of State agree that such angles must be pursued if we are to stop cutting services and still save money?

Time has got the better of me, so I will end by urging the Government to look at people and not simply at numbers. If everybody does their job more effectively, we can ensure that all people have top-class care, no matter where they live, without having to pay for it. The NHS is truly a jewel in the crown of this country. Many owe their lives to it and many depend upon it. Let us retain it and build upon it to ensure that in the years to come, it will still be the jewel in the crown that all in this nation cherish, love and depend upon.

Hospital Food (Animal Welfare Standards)

Jim Shannon Excerpts

Wednesday 12th December 2012 Westminster Hall

[Neil Parish (Tiverton and Honiton) (Con)]

I am grateful for the opportunity to discuss this important issue, and I thank you, Mr Turner, for allowing me to open the debate, in which I will call for the introduction of mandatory animal welfare standards for hospital food in England. It is a pleasure to do so under your chairmanship. As many hon. Members know, I am passionate about animal welfare, and I am both a proud member of the Select Committee on Environment, Food and Rural Affairs and the chair of the associate parliamentary group for animal welfare.

It may come as a surprise to many that the food served to patients in NHS hospitals in England need not meet mandatory animal welfare standards. Currently, Government buying standards are mandatory only for central Government buying departments, the Ministry of Defence and prisons. Schools and hospitals, which are excluded from the buying standards, account for 70% of public sector spending on food, meaning that prisoners currently have a guaranteed minimum standard but patients do not.

The welfare standard provided for animals reared for food is undoubtedly important, especially for animals reared for food bought by the taxpayer and served in public institutions such as hospitals. The animal welfare quality of food bought by hospitals in England varies widely, yet patients throughout the country deserve to eat food produced to the same high standards. We need a consistent approach to tackle the situation.

Animal welfare standards for hospital meat, dairy and eggs are subject to a postcode lottery. The programme for Government stated that the coalition Government would promote high standards of farm animal welfare, and it is important that public bodies set an appropriate example by ensuring that their purchasing policies are in line with that objective. Unfortunately, research published by the Campaign for Better Hospital Food and the Royal Society for the Prevention of Cruelty to Animals reveals big regional differences in animal welfare standards for hospital food in England.

The research discovered a number of shocking findings: 71% of eggs bought by hospitals in England are laid by caged hens, and only 39% of eggs bought by hospitals in the south of England are cage-free. Only one in four eggs in the north of England, and only one in every six in the midlands and east of England, are cage-free. We can see how much it varies in the postcode lottery. The report also revealed that 86% of chicken and 80% of pork bought by hospitals is not certified to meet RSPCA welfare standards. The figures paint a sad and regrettable picture of the welfare standards for animals reared to provide food for our hospitals. Chicken, pork and eggs that have not been produced to RSPCA welfare standards are likely to come from animals that have not had a good quality of life. Government attempts to set animal welfare standards using voluntary measures have failed, which is why I am calling for a statutory solution.

Concerns about the quality of hospital food, including its animal welfare standard, are not new. A report by Sustain, the alliance for better food and farming, estimates that in the last 20 years, the Government have spent more than £54 million of taxpayers’ money on issuing guidance to hospitals encouraging them to improve the quality of the food that they serve, including the animal welfare standard of its production, yet the research by the RSPCA and the Campaign for Better Hospital Food shows that the guidance has had a disappointingly weak effect.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing the issue to the House. Although it is important to improve animal welfare standards not only in England and Wales but in Northern Ireland and Scotland, he will be aware of the oft-stated comments about hospital food by patients and people who visit hospitals. Does he feel that improving animal welfare standards will also improve the quality of hospital food? That must be a good step.

[Neil Parish]

The reason why I talk about England is that the food served in hospitals is a devolved matter. However, it is still important for Northern Ireland. I am keen to get good animal welfare standards, and I believe that that will help with the quality of meat and eggs served to patients. The two are linked. I believe that most production in the UK and Northern Ireland meets high standards, and I want to ensure as far as is practical that that is the sort of food served in hospitals not only in Northern Ireland but across England as well.

NHS Commissioning Board (Mandate)

Jim Shannon Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

The outcome that we want is for more patients to live longer and more healthily than ever before. The right thing for me to specify in the mandate is that we want the NHS to deliver improved patient outcomes. Sometimes that will involve using the independent sector and the voluntary sector, but in the vast majority of cases it will mean working within the traditional NHS. If we deliver those improved outcomes, we will be doing the right thing by patients throughout the country.

[Jim Shannon (Strangford) (DUP)]

Minister, may I thank you for your statement on the mandate and in particular your reference to the armed forces covenant? Mental health has been the poor relation for too long. The statement says that mental health will be elevated to parity with physical health. Can the Minister explain how those who have fought in the wars in Iraq and Afghanistan in particular and who have seen the awfulness and the brutality of war will be helped through the mandate?

[Mr Speaker]

Order. I always listen extremely carefully to the hon. Gentleman, who has asked a very serious question. I hope he will take it in the right spirit if I say that my medium-term ambition is to persuade him to cease to use the word “you” in asking questions in the House. But his question has been heard and it will now be answered.

Regional Pay (NHS)

Jim Shannon Excerpts

Wednesday 7th November 2012 Commons Chamber

[Guto Bebb (Aberconwy) (Con)]

It is a pleasure to follow the hon. Member for Hartlepool (Mr Wright), although I am concerned about his claim that regional pay is being introduced by the back door. The Government have made no change to the legislation, so I suspect that the change taking place is a result of policies and Bills passed by the previous Administration.

I speak in this debate as a Welsh MP—perhaps my red plaster cast gives that away, although I stress that I have it because the plaster technician at my local hospital wanted to give a Conservative MP a red cast in which to go to the House of Commons and make an impression.

I must take issue with the right hon. Member for Leigh (Andy Burnham), who stated that he was responsible for the national health service in England. I accept that devolution has changed and complicated the situation, but when my constituents in north Wales think of the national health service, they do not think about what happens in Wales and what happens in England, because that is not how it works. The health service in north Wales is regularly dependent on specialist services offered in north-west England, and when we think of the health service, we think of it as one body.

There is no doubt, however, that the differences between what is happening in England and in Wales should be taken into account. It is all well and good to carp that figures suggest that spending on the health service in England is more or less flat in real terms—that was the claim made by the right hon. Member for Leigh—but that should be contrasted with actual and significant cash cuts to the health service in Wales that are being implemented by the Labour Administration as a choice. Those cash cuts would have been implemented in England too if the right hon. Gentleman and his party had won the last election.

When trying to ensure best value for money within the NHS, it is crucial to take into account that the health service in England is facing real challenges while maintaining a position that takes inflation into account. In Wales, however, the hospital staff who serve me, my family and my constituents are facing significant cuts as a result of decisions by the Welsh Assembly Government. That is the context and it is important to make that point.

The hon. Member for South Down (Ms Ritchie) made the important point that public sector workers have recently been facing difficult situations due to a pay freeze and increases in pension contributions. Those two provisions, however, were implemented in an equitable manner throughout the United Kingdom. People may disagree with the changes to pension contributions in the public sector, but there is no doubt that workers in Wales, Northern Ireland and south-east England have been treated in the same way. People might complain about the freezing of public sector pay, but that too has been done in an equitable manner throughout the United Kingdom.

There is real concern in constituencies such as mine that a change to regional pay—which is not being implemented by the coalition Government, merely consulted on—would be inequitable. Somebody in my constituency would be paid at a different rate from someone doing exactly the same job 40 miles down the road in Chester, for example. That is the difference between the pay freezes in the public sector and the pensions changes—those were difficult choices but were implemented in an equitable manner throughout the United Kingdom—and moving forward with regional pay, which would be damaging.

[Jim Shannon (Strangford) (DUP)]

I appreciate this opportunity to make a quick intervention. As the hon. Gentleman rightly said, the four regions of the United Kingdom have parity and equity. Will he explain what will happen when it comes to retrospective payments? In Northern Ireland, a number of retrospective payments have had to be made. Are the same retrospective payments applicable in Wales as in Northern Ireland, for those who have been upgraded and should therefore get more money?

[Guto Bebb]

I am not sure whether I am qualified to answer that question in detail, but perhaps the Minister will respond from the Dispatch Box in due course.

The changes in the south-west are taking place under current legislation and without any changes to the law, and we must be careful. We are proud to have a national health service and national public services that we take seriously. Although sacrifices are asked of people in the public sector, it is important that they are requested on the basis of equality throughout the United Kingdom. Ultimately, I am concerned that we are discussing a Labour motion that contradicts a lot of what has happened over the past few years.

I recently took part in a television debate on regional pay in Wales with a Labour Member who said that the changes to HM Courts Service pay rates were not about regional pay but about zonal pay. As it happens, zonal pay in Wales is lower than in other parts of the United Kingdom. I am sure that workers in Wales were cheered that they were subject not to regional pay in that context, but zonal pay, which made it all right.

There is a degree of opportunism from the Opposition Benches in initiating this debate at this time, and there is no recognition that many of the issues that have given rise to concern are a direct result of policy changes that the Labour party implemented when in power. I accept, however, the need to ensure we get the best possible value for money for the taxpayer from public services, and it is important to look at the degree to which we can be flexible in the way we deliver public services, whether in England or Wales. My view is that a person should not be discriminated against in pay if they are doing a similar job in the same manner as someone within 40 miles of them. The Government should take that extremely seriously.

The economic argument for regional pay is difficult to make by a party that claims to believe in the Union. One advantage that a rural, low-pay area such as mine derives from the relationship with the UK is the transfer of money from richer to poorer parts of the country. We could argue for a stronger regional policy and that we need to do more in that respect, but it would be difficult for me, as someone who believes that the Union brings a great deal of benefit, to argue that workers in my part of the world should be given a different degree of support from the state from workers doing exactly the same job in other parts of the country.

I find it difficult to disagree significantly with the motion, but I welcome the Government amendment. The one thing we can say about the coalition Government is that they are willing to throw difficult, controversial matters out into the open—that often creates problems for MPs because we need to sell those policies on the doorstep. I feel comfortable with the amendment. Ultimately, when Members are elected, they have a responsibility to look into issues carefully, to read around them and take on board the evidence. The amendment states:

“there will be no change unless there is strong evidence and a rational case for proceeding”.

I can live with that—it is great deal better than the Labour motion. Labour Members are basically hiding behind a discussion in the coalition. The fact is that the changes are happening as a result of legislation they proposed and voted for, and now regret.

Polycystic Kidneys

Jim Shannon Excerpts

Tuesday 6th November 2012 Commons Chamber

[Mrs Moon]

The hon. Lady is absolutely correct. This is a little-known condition, and the horrific nature and impediments caused by the condition as it progresses are little known and little appreciated. Often, people can look quite normal but be suffering tremendously. I commend her work in trying to raise awareness.

For individuals with ADPKD, it is a truly disabling, painful and limiting condition. Kidneys become enlarged, leaving patients disfigured and appearing prematurely pregnant. The kidneys continue to function normally, but eating, sleeping and even breathing can be difficult because of the size of the kidney and the pain experienced. The liver can be affected, too, and many patients are often diagnosed with PKD and liver disease. Besides the effects on the kidneys and the liver, there is a range of other complications: heart disease, bowel problems, hernias, infections and a high risk of intracranial aneurysms.

The kidneys can weigh up to 17 lb—upwards of 10% of a person’s body weight—and in one case a patient was recorded as having kidneys weighing 48 lb. An affected liver can grow more quickly than the kidneys, effectively squashing them. PKD affects people of working age and is characterised by premature mortality. Tragically, end-stage kidney failure is common at an average age of 55—within working age, as the hon. Member for Chatham and Aylesford (Tracey Crouch) mentioned.

PKD affects an estimated 12.5 million people around the world and is the fourth most common cause of kidney failure. It is more common than sickle-cell anaemia, cystic fibrosis, autonomic dystrophy and Down’s syndrome combined. We simply do not know how many people are affected by PKD in the UK. On the one hand is the answer to my parliamentary question in July. The Department of Health said that a total of 1,100 hospital admissions in 2010-11 were identified as resulting from PKD, although I was informed that that might include repeat visits by the same individuals. On the other hand, PKD Charity’s own figures suggest that the number is far higher. On the basis of the number of people requiring a kidney transplant and dialysis as a result of PKD, it estimates that as many as 60,000 to 70,000 people could have the condition in the UK.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this matter to the Floor of the House. My nephew, Peter Shannon, was born with posterior urethral valves, which meant a kidney transplant for him. Had he not had one, he would be dead. Does she agree that we need a bigger push to get people to sign on to the organ transplant donor list in the interest of those with kidney diseases, and those with PKD specifically, who are currently being kept alive by dialysis treatment? Transplants are important. If Members have not signed up, they should do so and encourage others in their constituency to do the same.

[Mrs Moon]

I completely endorse the hon. Gentleman’s comments. It is imperative that kidneys be available for these transplant patients. It is the most generous commitment that anyone can make.

I am particularly grateful to Sandra Buckland and her husband for allowing me to quote directly from her remarks at the kidney group meeting. She bravely shared with us her experience of PKD, and I would like to share them with the House. Sandra’s powerful remarks underscore many of the points I want to make about what needs to be put in place to tackle this condition. Sandra was particularly brave in doing so, because she had also recently lost her sister, who died from PKD. She said:

“I suffer from polycystic kidney and liver disease. I am married with two sons, both with polycystic kidney disease and the youngest with polycystic kidney and liver disease. My elder son has an eight-year-old daughter with PKD and my younger son, a four-year-old son with both polycystic kidney and liver disease. My father died at age 39 with heart failure due to side effects of PKD.”

She left the group with the following question:

“Why, when I lost my own father at 17 to this dreadful disease, are lives still being lost and progress appears to be at a standstill? If more successful research could be performed, halting the genes that allow PKD to continue, it would remove the stress, heartache and trauma for many families.”

Sandra Buckland clearly demonstrates the cost of PKD to an individual and her family. It is a long-term, devastating diagnosis. At a national level the costs to the NHS are unknown, although an estimate is possible. The PKD charity believes the annual cost is £330 million. As I said in my opening remarks, PKD is currently incurable and can be managed only with dialysis and transplants, combined with monitoring, all of which are expensive. It was only in 1994 and 1996 that the two ADPKD genes were discovered. The ARPKD gene was characterised only in 2002.

Funding for research is limited. In the US, $360 million has been invested in research over the past 15 years —$45 million in 2009 alone. The House will be shocked to learn that the total investment in research in the UK and the European Union is zero. The PKD charity recently funded a small biobank of PKD kidney cells at the UCL-Royal Free, and together with the US PKD foundation, it has funded one small laboratory study in Sheffield. This funding is all reliant on donations. It is telling that in the past 12 years there has been no improvement in the life expectancy or average age of renal replacement therapy of 55 years for someone diagnosed with ADPKD.

It cannot be acceptable for PKD to remain a neglected condition in terms of research and the development of treatments. Transplants and dialysis are costly. Developing treatments would not only improve the quality of life for patients, but reduce the cost to the NHS. The PKD charity has recently begun work with the UK renal registry to develop an analysis of PKD patients on renal replacement therapy. Would the Minister consider supporting the extension of this work to include pre-dialysis patients by asking the Renal Association to develop quality standards relating to ADPKD? Would she also support changes to governance requirements that would enable the UK renal registry to collect the data, and provide the necessary funding of £500,000 for the analysis and publication of these data?

I appreciate that £500,000 may appear a large sum, but compared with the long-term savings, it is a small investment for a huge return. Funding the registry would overcome a major barrier to understanding ADPKD, support care planning and counselling, and provide cohorts for clinical studies. The information is not available at present, so there is no foundation in place on which to build a meaningful research programme.

New drug treatments are being developed, but getting access to them is not without its challenges. One PKD patient with polycystic liver disease contacted me to describe how she self-funded her involvement in a drugs trial in Italy over three years, travelling back and forth to Italy monthly for three years at her own cost. During the trial, her symptoms improved considerably. The trial has finished and her condition is rapidly deteriorating. Her local PCT refused to fund ongoing treatment. Her long-term survival is being determined by finances.

Last December the Prime Minister announced a package of support for the life science sector, which included an early access scheme for seriously ill patients with limited treatment options to receive promising new drugs in clinical trials. This accurately describes PKD patients. Will the Minister take steps to ensure, as a matter of priority, that PKD patients are included in access to drugs in clinical trials?

Last weekend a drugs trial in the Netherlands reported positive results in altering the progression of ADPKD. The drug will now be presented to the European Medicines Agency for licensing—

--- Later in debate ---

[Anna Soubry]

I absolutely agree with everything that my hon. Friend says. I was horrified to discover in a recent meeting that unfortunately in England we are not making the progress on organ donation that we should. It is a serious problem. We know that so many lives can be saved or seriously improved if people are good enough to indicate that they are willing, on their death, for their organs to be donated.

Let me go further and say this: of course I understand why, when somebody dies, the family struggle in their bereavement to give permission to allow the loved one’s organs to be donated. However, I urge people to do so, even in those very difficult situations. It is a most wonderful way to create a real legacy by enabling somebody literally to live on through someone else. If more people could, in those dark moments, see that, it would make a profound difference to improving, and indeed prolonging, lives.

[Jim Shannon]

I thank the Minister for her pertinent words about transplants. I understand that when people renew their driving licence there is a box they can tick if they want to be on a donor register for the rest of their life. It is a painless exercise that commits them for ever and provides the authority for all their bodily items to be transplanted. Given that it is so easy to tick that box, perhaps more of those who are renewing their licence should do so to say, “Yes, I want to be a donor.”

[Anna Soubry]

The ability to do that is a golden opportunity for people, and I wish they would take it. One of the problems, though, is that someone applying for a licence will think, “Well, I’m applying for a driving licence and I can’t deal with all that now; I’ll come back to it another day”, and unfortunately they do not return to it having got their driving licence.

I would very much welcome a serious look at how we can solve this problem by campaigning harder to ask people to tick the box, make their views known, and speak to their families. Each and every one of us should talk among our families about the things that we want on our death. I know that these are difficult subjects, but this is, as we all know, a wonderful legacy that people can leave which makes a huge difference to the quality and length of the lives that people could lead.

As provision could be improved with the introduction of evidence-based best practice guidance both at diagnosis and for the management of people with polycystic kidney disease, I will ask my officials to raise this with the appropriate agencies to see what further actions can be taken.

I pay tribute to the hon. Lady and all those who have contributed to this debate, and thank them for drawing attention to this specific and important disease area. I also congratulate those at PKD Charity on all their hard work. I look forward to meeting them and the hon. Lady to make sure that we raise the profile of polycystic kidney disease.

Question put and agreed to.

Nursery Milk Scheme

Jim Shannon Excerpts

Monday 5th November 2012 Commons Chamber

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I want to start by saying how important the nursery milk scheme is. All children under five years old in a day-care or early years setting for two or more hours a day are eligible to receive a free daily drink of milk. Milk is full of important nutrients for children. Their free third of a pint portion contains calcium for strong bones and teeth, protein for growth and development, vitamins such as B2, B6, B12 and folate, and the minerals iodine, phosphorus, potassium and zinc.

The Education Act 1944 provided free milk—a third of a pint a day—in schools to all children under the age of 18. I have some personal recollections from the 1950s of the milk in one-third pint bottles left in the sun all day and served in such a way that I am still not very good about drinking my milk, which may be why my bones are a bit fragile. In 1968 Harold Wilson’s Labour Government withdrew free milk from secondary schools, and of course it is well known that in 1971 Margaret Thatcher withdrew free school milk from children over seven.

I saw first-hand the benefits of free school milk for under-fives on my visit to Hayeswood first school in Colehill in my constituency on world school milk day. It was interesting to go to a school, because we have to appreciate that now that children are starting school when they are four, they are accessing the milk at school. I was impressed with the numbers and the uptake at that school, and also with the fact that, through the particular scheme that was operating, older children could have the milk purchased for them at £15 per term.

[Jim Shannon (Strangford) (DUP)]

World school milk day came to my area too. Castle Garden primary school participated and more than 100 young children were present. The important aspect of that visit was that young children who had not taken milk regularly said that they were encouraged by those who were there to participate in taking milk rather than fizzy drinks. Did the same thing happen in the school that the hon. Lady visited?

[Annette Brooke]

Absolutely. Indeed, I was talking to one of my local nurseries—a nursery that is registered for milk. The owner of the nursery had discussed with parents whether they wanted the milk or not. Parents had voiced concerns about participating because their children would not drink milk at home, but they said, “Well, we’ll give it a try,” and to their surprise, every child in the nursery drinks their milk in the group setting.

However, in the past few years the costs of the scheme have been rising. In 2007-08 it cost the Government £27 million, but by 2010-11 the amount had risen to £53 million. Increased costs could be due to greater uptake, growth in the number of under-fives in day care settings or increases in the price of milk. The Department of Health has predicted that costs could rise as high as £76 million by 2016 and so recently set up “Next Steps for Nursery Milk”, a consultation to review the current system and consult on how to make efficiencies.

A significant number of day-care providers are effectively paying over 90p a pint for school milk. I know that we must ensure that the scheme can operate as efficiently as possible while ensuring the greatest access for entitled children. There is clearly also a need to add as little as possible to the burden of bureaucracy on child-care providers and schools. I want to take this opportunity to say how pleased I am that the Department has stated its commitment to this universal benefit for under-fives and that it is fully committed to keeping it as such. The options offered in the consultation are: to leave the scheme as it is; to cap the price that can be claimed for milk; to issue e-voucher cards with economy incentives; or for day-care providers and schools to arrange the direct supply of milk themselves.

There are a number of important aspects to consider when thinking about changing the current scheme. First, it is important that as many eligible children as possible receive their allocation of milk. The Department’s own figures show that roughly 40% of the total number of under-fives currently receive milk at their day-care setting. Whatever system is put in place must be easy to use for day-care providers so that as many as possible take part in the scheme. Given the percentage of children who currently do not receive milk, I ask the Minister to look at how the Government can increase the number of children receiving the milk to which they are entitled. I appreciate that that might be counter to the idea of reducing the costs of the scheme, but I was personally rather disturbed that perhaps only 40% of eligible children access the milk.

--- Later in debate ---

[Jim Shannon]

The debate so far has been about the price of a pint of milk. My recollection, like that of the hon. Member for Mid Dorset and North Poole (Annette Brooke), is of a third of a pint of milk. If we reduce the quantity of milk for a small child, would that not reduce the price? Is that too simplistic?

[Dr Poulter]

We will see what the consultation says. One option, which I have outlined, takes into account the bureaucratic burden of the cost on schools. We value the scheme and want to keep it—that is implicit—but at the same time, we recognise that going through a bureaucratic process to claim for milk could increase the cost to nurseries and other child care settings. The third option in the consultation is therefore for direct procurement from the Department of Health. That would help to reduce the bureaucracy in the scheme, although the hon. Gentleman will be aware that there is an allied, parallel scheme in Northern Ireland that operates in a similar way to the schemes in England, Scotland and Wales.

The National Farmers Union values the nursery milk scheme as a well established and highly regarded programme that plays an intrinsic role in society, supporting our dairy farmers as a key part of the supply chain. At the same time, the NFU believes that every attempt must be made to ensure a fair return to the whole dairy supply chain, including the primary dairy farmer. We must not lose sight of that. When the intermediaries are making huge profits, the farm-gate price—the price paid to farmers, who we value, particularly in rural communities—must be recognised in how the scheme operates. For the NFU and all those concerned about the impact of the proposed changes on the dairy market, let me explain that, according to Dairy UK estimates, milk supplied under the nursery milk scheme represents less than 1% of the total value of the UK dairy market; nevertheless, it is an important part of that market.

We are consulting on the scheme. The consultation closed at the end of last month, and we will be considering the representations made. To conclude, I repeat that the nursery milk scheme will continue as a universal benefit. It has huge health benefits for young children, and all eligible children in the care of child-care providers will continue to receive their free milk. We need to establish a system, however, that makes the nursery milk scheme fit for purpose and makes it adapt to recognise the important role that farmers play in the supply of milk—

Induced Abortion

Jim Shannon Excerpts

Wednesday 31st October 2012 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Mid Bedfordshire (Nadine Dorries) on securing the debate. I am pleased to speak in this debate, and my position will become very clear. I believe in human rights. I believe in the most basic of human rights, the right to life, so I am against abortion. I believe that the strong have a duty to protect the weak and the vulnerable. It is that protection that I seek to uphold, and that is why I am here to speak on this matter.

I begin by stating clearly that I am against abortion, except in the extreme case in which it is done to save the life of the mother. Statistics show that Northern Ireland, which has a restrictive abortion law, has the lowest maternal death rate in the whole of the United Kingdom. That is backed up by the fact that the Republic of Ireland has almost the lowest maternal death rate in Europe, and has no legislation that allows abortion. The UK mainland, with its more liberal abortion law, has a higher rate of maternal deaths. That speaks volumes, and it is clear that restricted abortion to save the mother’s life, which we have in Northern Ireland, works well to save both mother and child.

If there was the option of bringing in Northern Ireland’s abortion laws, I would be pleading with everyone in this House to do just that. I have been contacted by the Christian Medical Fellowship, which states things clearly. Today’s debate is calling for a small reduction in the upper time limit for legal abortions. That will affect approximately 2,000 abortions that are carried out for social reasons—I use the phrase “social reasons”, because that is why they are happening—out of a total of nearly 200,000 abortions per year. It will not prevent the abortion of babies with foetal abnormality up to term.

This issue is emotive. A large number of people have contacted me and asked me to watch the scans of a 20-week-old baby to remind me of the humanity behind our decisions. When I look at a baby at 20 weeks’ gestation sucking its thumb, having the hiccups, crying and blinking, it is beyond me how anyone in good conscience, in this House or outside, could say that it is fine to rip away life at this stage. It is not fine. It is never going to be fine. A 2008 study by University college London found that survival rates were more than 70% for babies born between 22 and 25 weeks when high-quality care was available.

[Kate Green]

It is really important that we are accurate about these figures. At 24 and 25 weeks, survival rates improve a lot, but at 20 to 24 weeks, survival rates are very low: zero at 20 weeks; 1% at 22 weeks; and 11% at 23 weeks. It is wrong to imply that at under 24 weeks, we have survival rates of 75%.

[Jim Shannon]

I thank the hon. Lady for her intervention, but life is life as far as I am concerned; that is where I am coming from.

The survival of more than 70% of babies born between 22 and 25 weeks when high-quality care is available blows away the argument that a baby can be aborted until it is viable at 24 weeks. Recently, in America, a baby of 21 weeks responded to stimulus, crying and smiling, so there is evidence that shows clearly that it can happen. All the things that we associate with life are in evidence before the time of so-called viability.

I will give the example of a young girl from my constituency. A friend of mine had a grandchild who, they were warned, would not survive as she was so premature. The family prayed hard, and asked for all possible treatment to sustain the baby’s life. Today, Zoe-Lee is 13 years of age and is the light of her parents’ life. It is scary to think that if an abortion had been allowed at that time, that young girl would not be here today.

The question that has been posed to me by members of the medical fraternity is: how much longer can we justify doctors desperately—the hon. Member for Mid Bedfordshire referred to this as well—trying to save premature babies born at 23 weeks, while down the corridor in the same hospital, another doctor is aborting a 23-week baby, which is perfectly healthy, for social reasons?

A 24-week upper limit in the UK is outdated and out of line with other EU countries. In 2008, our 24-week upper limit was double the 12-week limit for most EU countries. Some 16 out of 27 other European countries had a gestational limit of 12 weeks or less, so if we want to be in line with other countries that have high standards, then let us do that.

Ask any woman who has miscarried a baby in early term—at, say, at 12 weeks—and she will tell you that she saw its perfectly formed fingers and toes, its spine and head, and that wee face. For me, it is almost unimaginable to take it from the womb at this stage, never mind any later, and to ask any general practitioner to do this is grossly unfair. I am no man’s judge, and I feel for those women who have felt that they had no other option than to take this step.

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

Does my hon. Friend agree—he seems to be coming to this point—that we need to try to develop a caring, compassionate approach to women who find themselves in the circumstances that he is outlining, but feel that there is no alternative to an abortion? We need to offer them another viable alternative.

[Jim Shannon]

I thank my hon. Friend for his intervention, because that is exactly the point I was coming to. For the reason I mentioned, I supported the calls by my colleague, the hon. Member for Mid Bedfordshire, to have better counselling in place for women considering abortion. Will the Minister update hon. Members on when new counselling will come into play, and on what has been done thus far?

[Mr Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)]

I am listening carefully to the hon. Gentleman. Would he not agree that, given all the arguments he has given, perhaps 20 weeks is still too high, and that it should be 12 weeks or lower?

[Jim Shannon]

Yes, I agree. Ask the women who have had abortions and live with the guilt and despair every day of their lives, and who try for children and are faced with more difficulties than those who have not had abortions. Abortion should not be the choice for social reasons; it should be a last resort for medical reasons. Although I cannot today change the law in England and Wales, I speak for those babies who feel the pain of being ripped from their mother’s womb. This must stop today. This House should deal with this matter and make it clear that late-term abortions are unacceptable, apart from in limited and specialised cases. We must make it clear that we will not allow hon. Members in this House, and people outside it, to weave a web of inaccuracies that would make wrong seem right, make lies seem to be truth and seek to justify that which is unjustifiable.