Accident and Emergency Services: Merseyside and Cheshire

Debate between Jim Shannon and John Pugh

Tuesday 22nd November 2016 Westminster Hall

[John Pugh]

There is also a petition in Southport, and I am sure there will be petitions wherever in the country this sort of thing happens. As the hon. Gentleman suggests, the ownership of the sustainability and transformation reviews is wholly unclear. No one quite knows who writes the plans, or how they are agreed, and few democratically elected bodies or people, or patients, have any kind of input. In fact, the Liverpool local authorities wrote in some indignation to the authors of the report to ask, “How can we be involved? It alleges in your report that we are involved, but we do not appear to be.” Furthermore, no one quite knows why the hospitals have been grouped as they are.

Southport hospital is in a particularly unfortunate position, because it has changed its chair recently and suspended its chief executive over a period of a year, so it is unclear to me how Southport and Ormskirk’s views could have been represented in any review. Roadshows were organised by the clinical commissioning groups to talk about the financial plight of the local NHS and things that need to be done, and I have attended some of them, but they spend all their time talking about things such as savings on prescriptions and none on the big league stuff that is agreed and discussed in NHS boardrooms. There is absolutely no transparency, and I am sure hon. Members share in my cynicism. We await the real cost-saving proposals—or, in some cases, the empire-building proposals that are often disguised by blather about clinical efficiency and safety, which come almost after the event.

I speak with some cynicism, because I am a veteran of such carryings-on. I regret all the back-stage manoeuvres and, in particular, that no one has been around to champion my local hospital in the review. There is a good case for keeping our A&E—elderly people throughout the country are the major clients of A&E, for obvious reasons.

[Jim Shannon (Strangford) (DUP)]

The debate is clearly about Merseyside, but the issues for accident and emergency are the same everywhere in the United Kingdom, including in Northern Ireland. Does the hon. Gentleman share my concern about A&E being on the frontline of the NHS, so that is where the spend clearly needs to be? Does he also share my concern about Government policies to close some pharmacies, with their role, which will push many minor ailments to A&E, creating even more problems?

Diabetes

Debate between Jim Shannon and John Pugh

Wednesday 9th January 2013 Westminster Hall

[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—

Cancer Treatments

Debate between Jim Shannon and John Pugh

Tuesday 19th June 2012 Westminster Hall

[John Pugh]

I am glad the hon. Gentleman mentioned that, because two close friends of mine died rapidly of pancreatic cancer. One point made by the people in Liverpool to whom I spoke was that, given the almost invariably fatal outcome from this cancer, it would not be a bad idea if some of the rules regarding drugs approval were relaxed a little bit, so that people could find out what worked, because in this case there is very little to lose.

[Jim Shannon]

I thank the hon. Gentleman for that valuable contribution and agree wholeheartedly. If it comes to the stage where people’s life expectancy is minimal or reduced, I believe that they would be quite happy to take advantage of new drugs, if those were available.

All hon. Members know that finances are finite in the health budget. That being so, we are grateful for the many charities that do such magnificent work, including Cancer Research UK, Macmillan Cancer Support and Marie Curie Cancer Care. However, we must get a handle on our treatment process and outcomes, which can only come through the correct use of funding. I hope that the Minister will tell us how that will happen.

In the NHS document, “Improving outcomes: a strategy for cancer”, published in January 2011, it is clear what the Minister regarded as the way forward:

“In order to achieve these principles we must also ensure that every possible penny of money the NHS has is spent improving the quality of care and outcomes that patients experience. The Government protected the NHS in the Spending Review settlement, with cash funding growth of £10.6 billion (over 10%) by 2014/15. Compared to many other government departments, that puts us in an incredibly privileged position but this is the toughest settlement the NHS has faced in a long time.

At the same time, we need to respond to the longer term pressures the NHS faces; of an ageing population and the new demands created by new treatments and technologies. That means that, as set out in the Spending Review and the 2011/12 Operating Framework, over the next four years the NHS will need to achieve up to £20 billion of efficiency savings. These savings will be reinvested back in continuing to give patients the care that they need.”

Will the Minister say whether we are on target to make those savings? If so, when will that money go back into the system?

The document contains many examples of cost-efficient care, such as people having certain treatments as day procedures and then care at home, which makes a lot of people feel more secure as well as being cost effective. We understand the reasons and the thinking behind that: it is essential that the patient is at the heart of any decision made and any strategy must incorporate this.

I am not an argumentative person—far from it, I try to get on with most people in this world—but the hon. Member for Southport commented on the advertising campaign “Have you had a cough for three weeks or more?” We do not know how successful it was. The campaign has a role to play, and those who have had a cough for more than three weeks might well have a problem. We do not know how many people went to see their doctor and, as a result, have been made aware of problems. That is perhaps a different opinion from that expressed by the hon. Gentleman.

[John Pugh]

I said that all those things need to be reviewed in the light of evidence, that there were good campaigns and bad campaigns, and that evidence decided which category they fell into.

Religious Education

Debate between Jim Shannon and John Pugh

Tuesday 17th May 2011 Westminster Hall

[John Pugh (Southport) (LD)]

I congratulate the hon. Member for Congleton (Fiona Bruce) on her debate. Obviously, hon. Members are speaking with considerable passion. I acknowledge that, of a number of things I have done in life for which I am barely qualified and have no genuine talent, one has been teaching RE. I taught it for quite a long time to bright adolescent boys, so I know a little about the matter.

Religious education is not an attempt to make people religious, and that must be clearly stated. It is not an attempt to instruct people on what they should believe. Religious education and religion are misunderstood and widely misrepresented.

It seems to me that a person adopts a religion because that provides a framework within which they try to understand their existence; they abandon that religion if and when it fails to provide that meaningful framework. A religion or faith is tested as one’s existence is played out day by day—religion is caught, not taught. Some people get by without using any traditional religious concepts to clarify their life and existence, and such people are called secularists. Most hon. Members present in the Chamber appear to be religious, but in general, people who are not religious are frankly indifferent to those who are. There are, however, an increasing number of angry and aggressive secularists who are filled with what can be described only as missionary zeal to ensure that people are as unreligious as possible. Some people make no attempt to apply a framework to their existence and live an unreflective life.

Within our existence we do a range of things—we study science and history, make moral decisions, listen to music. We join political parties, fall in and out of love, make speeches in Westminster Hall, get ourselves elected and so on. Those things are part of our existence, but they do not entail a particular view of what existence is about. We struggle; we sometimes wonder what we are all doing here. Happily or unhappily, most cultures have a particular view of how we should understand our existence. We call those views religions, and in a sense they come from the groundwork carried out by our forebears. The merits, strength and weaknesses of religions are discovered by those who adopt and try to live out such explanations for their existence.

We cannot teach a religion in a classroom, but we can teach about it and that is what religious education involves. RE may include a number of elements such as the history of religion to explain what people of a particular religion have done, how that religion began, how it spread and so on. The sociology behind religion may be taught to identify a religion’s social effects and the factors that influenced its growth. There may be elements of psychology in identifying traits that may—or may not—incline one towards a particular religion, and the effects of religious belief on a person. RE is not philosophy; its principal job is to clarify how religions, which exist all around us, endeavour to explain our existence and how adherents of a religion live their lives and are likely to act.

Religious education has historically been taught in a narrow way that simply explained the Christian framework. More recently we have had more of a Cook’s tour approach—I am sure that would disgust the hon. Member for Gainsborough (Mr Leigh)—and a whole range of religions are covered with a fairly light-touch approach. It is a hard subject to teach in a totally fair and scrupulous way.

Only once we understand how people view their lives will we know how to engage with them properly, which, I suggest, is what life is about. Therefore, understanding people’s religions is at least as important as understanding their history or geography. Arguably, it is more important than knowing about one’s own past or locale, although there is considerable benefit in understanding one’s culture, background and habitation. History, geography and religious education are all equally important subjects, and there is no convincing case for excluding one and including the others in the English baccalaureate. The reason given by the Secretary of State is that RE is a compulsory subject under law, but the grounds for that curious legal status are obscure and not explained. It is not clear—it seems a straight non-sequitur—why making a subject compulsory in the syllabus means that it does not need to be optional and given more intensive study in the baccalaureate. The blessings of compulsory status are mixed. In the average British school, subjects with compulsory status are often ignored or not explained, and even good schools feel licensed to provide minimal or poor-quality teaching, simply to comply with the law. The compulsory status of RE in this country has done little to stimulate genuine religious belief or interest. In the United States, where teaching religion in schools is absolutely forbidden, church attendance is higher and there are greater levels of belief.

[Jim Shannon (Strangford) (DUP)]

Given the decline in attendance at church services across the United Kingdom and particularly in England, is there not a greater need for religious education and study in schools, so that the benefits of that will be felt by those families who do not have the chance to attend church on Sunday?

[John Pugh]

Given that people do not necessarily have an adequate understanding of what religions represent and involve, there is a case for teaching more about them in schools. I will go that far, but one cannot argue that it is the job of schools to make the nation religious. RE was made compulsory in schools due to a Victorian belief that an irreligious proletariat would be difficult to handle.

Whether or not RE is legally compulsory should not affect its inclusion as a humanities subject in the baccalaureate. The most interesting thing about humanity—we are discussing humanities—is not that we live, breathe, procreate and die, but that we seek to grasp what our existence is about and live accordingly. We are all religious in some sense or other. To make RE a statutory obligation risks diminishing its status, narrowing its scope and lessening its quality. It is a poor argument to suggest that, just because a subject is compulsory in one context, it cannot be optional in another.