Type 2 Diabetes: Availability of Drugs

Debate between Jim Shannon and Christine Jardine

Tuesday 30th January 2024 Westminster Hall

[Christine Jardine (Edinburgh West) (LD)]

I beg to move,

That this House has considered the availability of drugs to treat type 2 diabetes.

It is a pleasure to serve under your chairmanship, Mr Pritchard.

I am grateful for the opportunity to speak about what is a vital and, I think, under-recognised issue. I wish I did not have to, and that all the necessary medicines were available for all of the serious, life-changing conditions we face, but the reality at the moment is that they are not. Specifically, I would like to talk about type 2 diabetes, which is more common than type 1 and can go undiagnosed for years.

To be clear about what we are talking about, if someone’s body does not make enough insulin or what it makes does not work properly, the result is high blood sugar levels—type 2 diabetes. If untreated, that increases the risks of serious problems with their eyes, feet, heart and nervous system. High blood sugar levels can cause serious complications, potentially at great cost to individuals, but also to the national health service. The reality is that any of us can develop type 2 diabetes, but it mostly affects people over 25, and often those who have a family history of it.

What about treatment and medication? We know there is currently no cure, but we also know that type 2 diabetes can be put into remission by losing weight. We all know that eating well and exercising are the key to a healthy lifestyle, and that is never truer than with preventing and reversing the onset of type 2 diabetes.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing the debate forward. I am a type 2 diabetic—I declare an interest as such—and when I was diagnosed some 13 or 14 years ago, I went on a weight loss course right away. The doctor told me, “You lose weight!” I lost about 4 stone, and I have kept it off, but that did not stop the diabetes in its entirety. I still have it, and I still have to be very careful about what I eat.

The point I want to make is that there are recent indications that certain diabetes treatments can also be successful for weight loss, but weight loss is really important at least for the first stage of diabetes, and priority for such treatments must be given to those with type 2 diabetes before, with respect, those who are finding success with them for weight loss. How can the Minister and our Government encourage such guidelines to be firmly set in place?

[Christine Jardine]

I thank the hon. Member for that intervention, because that point is at the heart of the matter. We have to ensure that the supply of drugs, which is short at the moment, is prioritised for those who need them for important health reasons.

A healthy weight, as the hon. Member said, and keeping active make it easier for someone’s body to manage their blood sugar levels and help prevent insulin resistance, which can lead to type 2 diabetes. Research has shown that, for some people, a combination of lifestyle changes can reduce the risk of type 2 diabetes by about 50%, but sufferers may also need to take diabetes medication such as metformin and insulin, as well as making changes to their lifestyle.

In the UK, 4.6 million people have type 2 diabetes and around 13.6 million are at risk of developing it. People often need help, such as intervention and medicines. Last year, I called on the UK Government to take action on the shortage of medicines for type 2 diabetes patients, after a constituent came to me concerned that her treatment and her health would be impacted by a shortage of the diabetes drugs she needed. They are known as GLP-1 RAs—glucagon-like peptide-1 receptor agonists—and include one of the most common drugs, semaglutide.

As for many other manufactured drugs, there is currently a supply problem with semaglutide. In this case, the problem has been made worse, as the hon. Member for Strangford (Jim Shannon) said, by the fact that the same drugs are effective for weight loss. The very thing that semaglutide does to help diabetes patients is making it difficult for them to access it.

I wrote to the Scottish Government, who told me they did not expect the supply to return to normal until mid-way through this year. I appreciate that that is not the most helpful response, but in some ways it is understandable, because medicine supply and licensing is a reserved matter. That is why I am raising it with the UK Government. We have seen issues with drug shortages beyond diabetes, and that is why I am so concerned at the slow response to the lack of medication.

Patients find themselves stuck between the proverbial rock and a hard place. In Scotland, they have the Scottish Government unable to act, and they perceive the UK Government to be very slow to act. It seems that neither Government have realised how potentially serious this situation could be for patients who use these drugs daily. For a patient to be in a position where they do not know whether they can get what they need to help them get well and keep them healthy is simply not acceptable. I have heard from people in my constituency and beyond about the impact that the situation is having on their lives.

Post Office Services: Edinburgh West

Debate between Jim Shannon and Christine Jardine

Monday 27th November 2023 Commons Chamber

[Christine Jardine (Edinburgh West) (LD)]

The subject of the debate is post office services in Edinburgh West. Although it is about my constituency, the problem could just as easily apply to many constituencies throughout the country. Indeed, I have not spoken to a single Member who has not said that their constituency faces the same problem with post office closures as we face in Edinburgh West.

When I was thinking about the debate, I wondered what the answer might be if I asked any of the children in my constituency what a post office was and what they used it for. I also thought they might look at me with astonishment if I told them that what they now regard as part of the local shop was once the organisation that provided everything from our telephone services at home, our mail and all sorts of Government forms, to pensions and stamps.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this matter forward. Last week, the parliamentary group of the Democratic Unionist party met the Northern Ireland sub-postmasters association. Every one of those issues that she mentions were discussed with us. We were told that those opportunities were no longer available in the post office, by which I mean MOTs, car tax renewals, and passport renewals. The post office was also used as a community hub. All of those things highlight how important post offices were. I know that the hon. Lady has said all of that, so I hope that, in his response, the Minister can give us some succour and respite in relation to what the post offices can and should do.

[Christine Jardine]

The hon. Member makes a very good point. These were all vital services. Not so very long ago, post offices were central to communities up and down the country. They also provided some of the most spectacular examples of architecture, and they dominated our town centres. The local post office was where I applied for my first driving licence. I opened my first savings account there and queued for what seemed like hours every Christmas to make sure that the family’s cards and presents went off safely to various parts of Australia and Canada—but not any more. The Post Office I grew up with in the 1960s had 25,000 branches. In 2021, that figure had more than halved to 11,415, with more than half of those listed as vulnerable. The organisation itself lost £597 million in the same year.

In Scotland we have the biggest problem in the UK, having lost more than 6% of our post offices in the past two years alone. In Edinburgh West, two have closed and one has been relocated to a different area in the past year. As I said earlier, this problem is not isolated to Scotland or to Edinburgh West. One third of rural post offices are now offered as part-time outreach services.

Sub-postmasters and Sub-postmistresses: Remuneration

Debate between Jim Shannon and Christine Jardine

Tuesday 23rd May 2023 Westminster Hall

[Christine Jardine (Edinburgh West) (LD)]

rose—

[Jim Shannon (Strangford) (DUP)]

rose—

Domestic Abuse Bill

Debate between Jim Shannon and Christine Jardine

Consideration of Lords amendments
Monday 26th April 2021 Commons Chamber

[Christine Jardine (Edinburgh West) (LD) [V]]

I share what I believe was possibly the frustration of many other speakers tonight that we are so close to achieving what we want the Bill to achieve, yet we seem unable to cross that final line. I appreciate the efforts made by the Government and everyone else, and by the Minister in particular, but I still have reservations about the Bill—particularly about the vulnerability of migrant women, and specifically about amendment 40B. The amendment in lieu laid down by the Minister is a start, but it still does not go far enough and it fails to capture the one key thing that all our amendments and speeches have said, and everything we have heard this evening: waiting for a stalker or serial domestic abuser to get a conviction for 12 months before considering them for this is way too late.

We know that most stalking victims do not go to the police. This is about cumulative obsessive behaviour. Well-intentioned though the legislation is, we simply do not feel it is going far enough. Between 15 March and 19 April, another 16 women have been murdered—that is between the Report stage in the Lords and ping-pong last week. The Government’s inaction has to end. We have to address this issue now. We have to ensure that the Domestic Abuse Bill that so many people in this place have worked so hard for over the past four years is achieved by the end of this week.

The same recommendations have been made over the years and the same reviews have been repeated over and over, yet nothing is changing. Rarely are the recommendations put into place and we have seen systemic failures over many years, with widespread misogyny, institutionalised sexism and a gender bias. No amount of guidance or training has changed that across the past two decades. In fact, matters are getting worse. That is why we need this to be in the legislation.

Many Members have mentioned the overwhelmingly depressing statistics about one woman being murdered every three days by a man, and a woman being murdered every four days by an ex or a current partner. It is simply not acceptable. We are all agreed, but we must find a solution. I appreciate the steps that the Government have taken so far to compromise to meet people halfway, but I still think that this will take another step. That is why I, like the Liberal Democrats, will be rejecting the Government’s amendment in lieu this evening.

[Jim Shannon (Strangford) (DUP)]

Briefly, I wish to highlight my concerns on the issue of the identification, monitoring and management of serial domestic abuse and stalking perpetrators, and the provisions that refer to that. I base most of the comments I make in this Chamber on personal experience—on the people I meet in my constituency office and have helped and tried to help over the years.

I recall sitting in my office looking at the face of a victim, sometimes sitting beside the perpetrator, and feeling helpless and hopeless. I could see what was going on. I could also understand that my words could make the situation more difficult for the victim. So I found myself on some occasions just being silent and listening, when everything within me cried out to speak, act and help. That is what I wanted to do, but I felt that sensitivity was more important. All too often, I have tried to distract a partner while the staff attempted to assure the victim that they were here to help wherever they needed and in confidence. All too often, I have offered help, only to hear a victim say, “No one would believe me because he is a pillar of society.” That proves that, irrespective of position, those in the highest positions and the lowest positions of the land can abuse ladies.

The Lords amendment on this brings clarity on repeated offences, broadening things to include serious harm, sexual violence and stalking, among other specifications. It makes it crystal clear and a little easier to help those victims. It offers them greater scope and, with that, greater support. It makes it clear that the offences clearly listed will never be acceptable. It makes it clear that all those listed offences are taken seriously and that a strategy to deal with this must be a Government priority.

This clarity is welcome. This House must send a unified message on this Bill today. I believe that the Minister is very much committed to making the changes that are necessary to pull all of the concerns and thoughts of Members together, and provide reassurance that when we pass the Bill it is not simply the best we can do, but the best possible—not that we offer help, support and recognition to as many victims as possible, but that we have left no victim alone without legislation to protect them.

It is my desire, when I am faced with cases of domestic abuse—unfortunately, my staff and I have been faced with such cases—to have the confidence to be able to tell the victim, “All the elements, from the Police Service of Northern Ireland to the courts, are designed with your needs in mind. You do not have to do this alone. The police and the courts will walk alongside you, and give you the protection you want.” I long to send that message. I look again to the Minister for clarity that this is what we are saying tonight in this Chamber.

Assisted Dying Law

Debate between Jim Shannon and Christine Jardine

Thursday 23rd January 2020 Westminster Hall

[Christine Jardine]

I agree that better mental health care should be available at all points in our lives. For every decision that we have to make, we should have support. If we are allowed to look again at the current law and the blanket ban, the question of what mental support exists is the sort of thing we should look at.

As I said, I am grateful to the constituent I mentioned, because that example highlights the invidious position in which everyone is put by the current law and its blanket ban. That includes the patient who knows they are going to die, and who simply wants help to ease their way through it; the medical staff who must not help; and the families who are powerless to support their loved ones, because the law threatens them with criminal procedures.

A recent policy paper considered by the homicide committee of the National Police Chiefs’ Council showed that investigators are frustrated with the current legislation, and that families whose loved ones have had assisted deaths are losing confidence in the police and criminal justice system. Families such as the Whaleys and Ecclestons, who suffered the ordeal of court cases, are perhaps the highest profile examples of how the law fails those who are facing their final days, and fails their loved ones. Sadly, they represent merely the tip of the iceberg.

Dignity in Dying has calculated that every eight days, someone from the United Kingdom travels to Switzerland for an assisted death, with their grieving families often treated as criminals once they return. Every year in England and Wales alone, an estimated 300 people take their own lives because they are faced with a terminal diagnosis and it seems their only option. A great many more are beyond the reach of palliative care, which, sadly, needs more investment, and they die in agony. Perhaps the cruellest thing of all is that this can all be avoided if people can afford it.

The law has created a two-tier system. If someone has more than £10,000, they can travel to Switzerland or elsewhere for the end-of-life care of their choice. It is time to look at whether and how our law can be improved. There is ample evidence that the majority of the public would support a change. According to the most recent surveys, 84% would like to see a change. They want a very narrow and specific change—perhaps that addresses some of the points that have been made—for those in the final stages of a terminal illness who are mentally capable of making a decision, but they do want a change.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way. We had a discussion today, and we have very different opinions; clearly, I do not agree with what she is saying. The answer is not legalising assisted suicide. The answer is to help, to support and to be compassionate towards families. Does she acknowledge the good work that is done by many charities, particularly Macmillan, whose compassion and love make the unimaginable a little bit more bearable?

[Christine Jardine]

I absolutely agree with the hon. Gentleman that Marie Curie, Macmillan and other charities do outstanding work. The people who work in hospices up and down the country, and those who provide palliative care in our hospitals, perform an unenviable role and they are beyond reproach. However, it is not my view that people should have only that choice. For me, this is about being able to decide either to have palliative care—it should be there, and it should provide support—or to make another choice. That should be up to the individual, and the law should support them in that. As I said, 84% of people, according to the most recent surveys, would support a change.