Online Safety Bill

Debate between Jim Shannon and Nadine Dorries

2nd reading
Tuesday 19th April 2022 Commons Chamber

[Ms Dorries]

Sir David was a friend to all of us, and he was very much at the forefront of my mind during the redrafting of this Bill over the last few months. I give my right hon. Friend my absolute assurance on that.

[Jim Shannon (Strangford) (DUP)]

A number of constituents have contacted me over the last few months about eating disorders, particularly anorexia and bulimia, and about bullying in schools. Will the Secretary of State assure me and this House that those concerns will be addressed by this Bill so that my constituents are protected?

[Ms Dorries]

They will. Inciting people to take their own life or encouraging eating disorders in anorexia chatrooms—all these issues are covered by the Bill.

Russia’s Attack on Ukraine

Debate between Jim Shannon and Nadine Dorries

Thursday 3rd March 2022 Commons Chamber

[Ms Dorries]

Yes, I absolutely agree. That is our leadership—don’t do it, don’t promote Russia, don’t broadcast Russia. Sadly, local Russians will suffer and pay the cost as a result, but I am afraid that Putin’s actions have consequences. We are holding conversations this afternoon—we have ongoing conversations—with officials and sporting organisations to take that hard line of not broadcasting, not facilitating and not displaying Russian football, Russian goods and Russian shows—anything. We must not do it.

[Jim Shannon (Strangford) (DUP)]

I commend the Secretary of State for her statement, her resilience, her courage and her clear and strong leadership, which we all admire in this Chamber. Some say that politics and sport should never mix, but this is not about politics; it is about life and death. Every way we can, in every aspect of life, we must get the message across that we will not overlook, we will not forget and we will not accept Russia—that is the only way forward. Does she believe that in the present situation, as this House is saying clearly, the art world must consider its exhibitions? Will she allow it to make its own determinations whether those should continue, or will she issue guidance on what should and must be done?

[Ms Dorries]

The hon. Gentleman is right that sport and politics should never mix, but we are in the theatre of war and it is very different. Sport is a very useful tool in the theatre of war, particularly against someone like Putin—which is why sport and politics will very much be mixing. We are providing, we hope, the clearest leadership we can in our messages to sporting, cultural and creative institutions about what we expect of them.

Will we publish guidance? I hope that over the coming days and weeks, all those institutions will hear the message, heed the guidance that we are giving and make the right decisions themselves. A statement will be issued this afternoon as a result of the summit, and I am sure that more will be forthcoming over the coming weeks, but we hope that everyone gets the message loud and clear.

Covid: Vitamin D

Debate between Jim Shannon and Nadine Dorries

Thursday 17th June 2021 Westminster Hall

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)]

It is an absolute pleasure to serve under your chairmanship, Mrs Murray, I think for the first time. I offer my warm congratulations to the hon. Member for Strangford (Jim Shannon) on securing the debate. I am sure if he had not secured it, he would have contributed to another debate in here this afternoon. I intended to say this yesterday, but I did not get the chance: I would like to send my warm and best wishes to the hon. Gentleman’s mother. He will know why I am saying that. It is a delight to be here today to respond to him.

I will try to respond directly to all the points that were made today, if not specifically then more broadly, but I am always here if hon. Members want to ask me for more specific details. We consistently review the data and the latest information as it emerges on covid-19. Our objectives are to ensure that people are not made adversely ill by covid-19 and that as many people as possible stay out of hospital, off ventilators and improve as quickly as possible.

That includes the progress we have seen in treatments for those suffering with the virus, including longer-term preventive measures, such as our strategy to reduce obesity, which we know is one of the few modifiable factors of covid-19, and the implementation of the vaccination programme.

Some 78.9% of adults in the UK have now received the first dose of the covid-19 vaccine, and 56.6% have received the second dose. Everyone who has spoken, including the shadow Minister, the hon. Member for Nottingham North (Alex Norris), and the SNP spokesman, the hon. Member for Glasgow East (David Linden), has congratulated volunteers and those who have run and operated the vaccine programme across the UK, and I add my congratulations. It has been phenomenal, and we have much to be thankful for. I am sure that everyone will join me in acknowledging the dedication of volunteers who have answered the clarion call and turned up. I think the hon. Member for Glasgow East said—it may have been yesterday—that they have donned the vest and got out there, and they are still doing those jobs. That is just amazing.

Since the start of the pandemic, there have been reports that vitamin D may reduce the risk of coronavirus. I have to sound a note of caution here because, when looking at the data and the evidence, we cannot cherry-pick the odd report here and there. I am not accusing anyone of doing that, but we have to take a more robust view of the data and look at it in the round.

I will pick up on the points that the hon. Member for Strangford made about BAME communities. To date, the UK Biobank’s most robust data on covid, vitamin D and ethnicity has not found a link between vitamin D concentration and ethnicity that could reduce covid-19 infections. There was no link, sadly. It would really be encouraging for us if the data showed that vitamin D prevented people from catching covid—that would be quite amazing—and we are certainly working on and searching for that data, but we do not have it yet.

On 14 January, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), responded to a debate on this matter, in which the hon. Member for Strangford also participated. I welcome the opportunity to debate it further and set out the measures that we are delivering. As my hon. Friend said:

“Several nutrients are involved in the normal functioning of the immune system; however, there is currently insufficient evidence that taking vitamin D will mitigate the effects of covid-19.”—[Official Report, 14 January 2021; Vol. 687, c. 597.]

Last December, the National Institute for Health and Care Excellence, the Scientific Advisory Committee on Nutrition, and Public Health England published rapid guidance in response to the queries that the hon. Member for Strangford and others have raised on vitamin D in relation to covid-19. The data was reviewed by an expert panel and included the best available scientific evidence published to date, including both randomised controlled trials and observational studies. The expert panel supported existing Government advice and the recommendation for everyone to take 10 mcg of vitamin D supplement throughout the autumn and winter to protect their bone and muscle health. However, the panel concluded that there is currently not enough evidence available to support taking vitamin D to prevent or treat covid-19.

There are still significant gaps in the current evidence, as was the case in January. To date, studies have not reached the high level of data quality required to revise the guidance. The current evidence base is mixed and dominated by low-quality studies, with substantial concerns around bias and confounding evidence. There are lots of studies out there, but some of them do not have the quality and the robustness of data and evidence that are required.

Currently, studies are unable to demonstrate a causal relationship between vitamin D and covid-19 for anyone. That is because many of the risk factors for severe covid-19 outcomes are the same as the risk factors for low vitamin D status. Owing to the lack of reliable evidence, the NICE guidance recommends that more research be conducted on the subject. Government guidance continues to stress the use of high-quality randomised control trials in future studies.

At present, more than 90 trials that are looking at the efficacy of vitamin D as an intervention for covid-19 across all stages of the disease are either under way or due to publish, either in the UK or internationally. Given that 90 trials are currently under way, possibly—hopefully—the evidence and data that we require will come our way soon. I would be really disappointed if those 90 trials do not give us the evidence we want. Let us hope that they do.

Some of the trials are of the high quality that we require to produce the data, and will answer key questions. NICE, PHE and the Scientific Advisory Committee on Nutrition are monitoring new evidence from trials as it becomes available.

The long-standing Government advice is that, every year, between October and early March, everyone is advised to take a supplement containing 10 mcg—400 international units—of vitamin D a day. Vitamin D helps to regulate the amount of calcium and phosphate in the body and to protect bone and muscle health. In April and autumn 2020, PHE reiterated the advice and also ran a public awareness campaign throughout December 2020. That had a specific focus on BAME communities, where vitamin D supplementation is important.

Vitamin D is made in the skin when exposed to sunlight during the spring and summer months and the PHE advice to continue taking vitamin D supplements is therefore particularly important for those who were shielding, care home residents and prisoners, as well as those who choose to cover most of their skin when outdoors, as these groups are likely to have reduced sunlight exposure. Importantly, individuals with dark skin are more at risk of not having enough vitamin D and are advised to take the 10 mcg of vitamin D supplements all year round.

We have actively supported the uptake of the PHE recommendations. Over winter 2020-21, the Government provided a free four-month supply of daily vitamin D supplements to adults on the clinically extremely vulnerable list who had opted to receive the supplements, all residents in residential and nursing care homes in England, and the prison population, where Her Majesty’s Prison and Probation Service made supplements available across England and Wales.

The Government prioritised groups that were asked to stay indoors more than usual over spring and summer 2020 due to national restrictions. The supplements were provided to help support their general health and, in particular, bone and muscle health.

Recipients of the Healthy Start scheme are also offered supplements containing vitamin D by the Government. Guidance on vitamin D can be found online, and we encourage individuals to buy 10 mcg vitamin D supplements from retailers such as supermarkets, chemists and health food shops.

As research continues on the impact of vitamin D on covid-19, we will continue to monitor evidence as it is published. We have committed to keeping this under review and, as I have said, we are committed to keeping the 90 trials that are under way under review, some of which are high quality, producing robust information.

[Jim Shannon]

Does the Minister have any indication of when the trials will be completed and when the evidence will be sought and got?

--- Later in debate ---

[Jim Shannon]

I want to thank all those who took part in the debate. First, I thank the hon. Member for Glasgow East (David Linden) for his contribution. Many things that the Scottish Parliament does on health issues interest me. He knows this, because I have said it to a health spokesperson for his party. I always listen intently to everyone, but in particular to the Scottish Members about how Scotland has done things, because it has done many things that I believe we could replicate across the whole United Kingdom.

One of the great things about these debates is that we can learn from one another and then, hopefully, take some of the good things from elsewhere and bring them in where we are, in the same way as we have done in Northern Ireland. The hon. Member for Glasgow East referred to what the Scottish Parliament is doing on vitamin D and to taking it all year round. It is perhaps a step ahead of us, so I thank him for describing that.

I am very pleased, as always, to have the hon. Member for Nottingham North (Alex Norris) here. My apologies to his wife; she can have him for the rest of the day—is that the way to put it? He has responsibilities here and has done well; I thank him for that. I also thank him for making, as always, an in-depth contribution, which lets us know where the Opposition, in the form of the Labour party, are and what they are doing.

We can probably all agree—I think the Minister is absolutely right, by the way—that we are here to support each other and the Minister. She outlined a very robust strategy for health—

[Ms Dorries]

I want to let the hon. Gentleman know that I have received a response on when the trials are due to conclude. Most are due to conclude this year.

[Jim Shannon]

Now, that was a quick answer! How many people get an answer to a question they asked 15 minutes ago? That is brilliant. That reinforces my comments about the strategy that the Minister referred to—the restrictions on adverts before 9 pm, the obesity and covid-19 death connection, and all the things the Minister referred to. Hopefully, some of the 90 trials—I never realised that there were that many trials going on—will produce high-quality data, which is what the Government needs to act upon.

I am hopeful, and I thank everyone for their participation. In particular, I thank the Minister for her excellent response and for reassuring me, the shadow Minister, the hon. Member for Glasgow East and those who were not able to come today but are watching the debate and would have wished to participate. Today, we have hope for the strategy. If the high-quality data is there, this can be a reality. I genuinely believe in my heart that this can benefit people, but we need the data to prove it. Our job, and the Minister’s job, is to receive that data and work on it. We have had that commitment. If the data is correct, we will have that.

Thank you for your chairmanship, Mrs Murray, as always. We do not always say that to the Chair, but thank you for chairing the debate well, as you always do. I also thank the staff, who work away in the background behind the screens. If we did not have them, this would not work at all.

Question put and agreed to.

Resolved,

That this House has considered the value of vitamin D as a defence against covid-19 infection.

Ockenden Review

Debate between Jim Shannon and Nadine Dorries

Thursday 10th December 2020 Commons Chamber

[Ms Dorries]

I thank my hon. Friend for her pursuance, her persistence and her dedication, both to her constituents and the hospital as a trust. I would also like to mention, as my right hon. Friend the Member for South West Surrey (Jeremy Hunt) did, the parents of Kate Stanton-Davies and Pippa Griffiths, who have been instrumental in getting us along the pathway to where we are today. Yes, my right hon. Friend commissioned the report, I pushed for it to happen now, and my hon. Friend has been pushing also, but it is down to those parents and their commitment. It should not have to be like this. Parents should not have to go through what they have gone through to get to where we are today.

As my hon. Friend is aware, I have visited the trust myself and have been round the midwifery unit and the consultant-led unit, and I think there is an anomaly there. Should we have a midwifery unit and a consultants’ unit? Is that not where the problem is, with two separate disciplines not working together? Should there not be just one delivery unit? Does the culture not start there, and should we not look at how it works?

However, my hon. Friend has my absolute 100% assurance that, for as long as I am in this post, I will be driving forward the recommendations and findings of this report.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her understanding and compassion on the findings of the Ockenden report. With other right hon. and hon. Members, I wish to express my deepest sympathy to those families who have been grievously damaged by the failings of the Shrewsbury and Telford Hospital NHS Trust.

But will the Minister underline that sympathy alone is not necessarily what is required? What is required is action, and an undertaking to review procedures not only in this trust, but UK-wide, to ensure that the Ockenden report recommendations are implemented in all maternity wards. Will she give a guarantee that that will be done?

[Ms Dorries]

I thank the hon. Gentleman for his question; he is absolutely right, of course. The findings will be put in place, and in many trusts they already are. I was just looking for my data on the Morecambe Bay investigation, which I believe my right hon. Friend the Member for South West Surrey (Jeremy Hunt) also commissioned. If we look at the Morecambe Bay trust investigation, the predecessor to this, it is quite commonplace to say—I hear it all the time—“Well, we had Morecambe Bay and nothing has happened: the recommendations haven’t been implemented there.”

Actually, the Morecambe Bay investigation made 44 recommendations, 18 of which have been completed within the Morecambe Bay trust. There were 26 wider NHS learnings and recommendations, of which 14 were accepted nationally and 11 are being worked on now in the Department, to be rolled out nationally. I use that as evidence that reports such as this have consequences: actions that are implemented and make a difference in maternity units.

Eating Disorders Awareness Week

Debate between Jim Shannon and Nadine Dorries

Thursday 5th March 2020 Westminster Hall

[Ms Dorries]

My right hon. Friend makes an important point. That is why we invested £2.3 billion in mental health services, which, as I always say, is more than half the entire prison estate budget. We are focusing on young people and young women in this debate, but funding for mental health services is growing faster than the overall NHS budget. That funding and the development of community services is there to pick up exactly the cases she cites.

No mental health service, other than the very extreme, is better delivered in a hospital than in the community, whether for children, young people or adults. Despite that investment in community mental health services, our challenge is unprecedented, and our challenge is about workforce—it is about attracting people to work in this arena and to help us develop the community services that we need to provide treatment for adults and young people. That is the challenge we have taken on, and it is a challenge that we are meeting and moving forward with. It is our ambition and my absolute hope that children, young people and adults, regardless of their age—this illness is severe, whether in adults or children and young people—receive the treatment they require, when they require it.

[Jim Shannon]

These plans will require a close working relationship between the Department of Health and Social Care and the Department for Education. I am sure that that is what the Minister refers to, but will she confirm that that is the case?

[Ms Dorries]

Absolutely, and the Green Paper, which I am sure the hon. Gentleman will be aware of, references the mental health of young people in schools. However, it is also about the trailblazer schemes, peer support workers and other people who go into schools who specialise in how to identify this and pick it up. Teachers have a huge job, and I think if we were to say that they needed to pick up when someone is suffering from an eating disorder, they would probably throw their hands up, because it requires specialised training. It is a skill, and it takes careful handling when identifying someone who is suffering from an eating disorder. So yes, of course we work across Departments, but it is those specialised and trained mental health workers in schools who will pick this up.

Historical Stillbirth Burials and Cremations

Debate between Jim Shannon and Nadine Dorries

Thursday 6th February 2020 Commons Chamber

[Ms Dorries]

I will. If my hon. Friend drops me an email at my departmental address, we will look into that, and the officials will take it away. I am grateful to him for raising that, because I was not aware of it.

I do not think I have missed out anyone who made a speech. We have heard today how important it is to many parents to find the final resting place of their stillborn children’s remains. Unfortunately, that is not always easy or possible, and I have explained that such records are not currently held by the Government. Rather, they are held by local hospitals that arranged for burials or cremations with local funeral directors or crematoriums. In some cases, records no longer exist, or they may not contain enough detail to be helpful.

Nevertheless, I reiterate that the Department of Health and Social Care expects all hospitals to provide as much information as they have available to them to any parents who inquire about what happened to their stillborn babies, no matter how long ago they died. I would like to praise the 800 parents who have attempted to find out where their babies’ remains are, because they have helped to raise the profile of this issue. As the hon. Member for Swansea East said, only by raising the profile do we manage to get something done. We need to continue to do that, because that is how we will make progress.

We have also heard today about the new regulations and systems to ensure that parents are involved, as they want to be, in the burial or cremation arrangements for their stillborn children. Parents are required by law to register a stillbirth, and once registration has been completed the registrar provides parents with all the certification they need to organise their babies’ burial or cremation, and a funeral service if they so wish. The required burial and cremation forms ensure that the wishes of parents are recorded and respected. Many NHS hospitals still do make arrangements for funeral services and support parents to consider various options and to make the decisions that are right for them. Some parents may wish to arrange a private burial or cremation with a funeral director. Most funeral directors do not charge for their services for stillborn babies. Thanks to the hon. Lady’s efforts, the new children’s funeral fund supports parents, as I said in my opening speech.

A funeral can sometimes be a catalyst for people to begin processing a deeply profound loss. At such a time, parents mourning their stillborn baby need as much emotional support, compassion and understanding as possible. However, the quality of support can vary from one maternity service to another. This is why the Government have funded Sands, the stillbirth and neonatal death charity, to work with other baby loss charities and the royal colleges to produce a national bereavement care pathway. The pathway covers a range of circumstances of baby loss, including miscarriage, stillbirth, termination of a pregnancy for medical reasons, neonatal death and sudden infant death syndrome. The NBCP is now embedded in 43 sites, and a further 59 sites have formally expressed their interest in joining the programme.

I would like to talk a little bit about mental health support. The hon. Member for Kingston upon Hull North is a campaigner on this, and she raised mental health during her speech. A couple of weeks ago, I visited nurses who are delivering perinatal mental health care support. As part of the new approach to and new funding for mental health, there are now specialist perinatal mental health community services in all 44 local NHS areas in England, and further developments are planned. Just in 2018-19, this has enabled over 13,000 additional women to receive support from specialist perinatal mental health services, against a target of 9,000.

I spoke to the nurses about the perinatal services that are being delivered, and in that particular trust they have helped 700 women who previously had no assistance whatsoever. It was incredible to hear the stories of how that assistance—the mental health support—is now being given to women. As I have said, all trusts now have in place those perinatal support services, which were never there before. Again, that is a huge step on the path towards delivering services that are focused on women and their needs.

Via maternity outreach clinics, we are also providing targeted assessment and intervention for women identified with moderate or complex mental health needs arising from or related to their maternity experience who would benefit from specialist support, but where it may not be appropriate or helpful for them to accept specialist perinatal mental health services, so we are even thinking further than that. In those services we are also assisting partners and families, so it is not just for the women, but for their partners and families.

A huge amount of work is being done in this area. I am not saying that we have finished—there is more to be done—but we are making progress. This actually fits in very well with our women’s agenda in the Department of Health and Social Care. The women’s agenda is not just about periods and menopause; it is about so many things. The particular area we are discussing today is a huge part of that.

Hon. Members present for the Baby Loss Awareness Week debate last October may recall that I undertook to write to Professor Jacqueline Dunkley-Bent, the chief midwifery officer in England, to ask if those bereaved by baby death could be included in the NHS long-term plan commitment to develop maternity outreach clinics that will integrate maternity, reproductive health and psychological therapy support for women with mental health difficulties arising from or related to the maternity experience. I am delighted to tell the House that I recently received a letter from the chief midwifery officer confirming that access to these services is available to women and their partners who are experiencing moderate or complex/severe issues, so we have listened and we have addressed that need. At this point, I should pay tribute to Professor Jacqueline Dunkley-Bent for her understanding of and support for my role in helping to deliver better services to women.

As I have said, a funeral can often be a catalyst for helping people to deal with death and stillbirth death, and I believe that that is so important today. It used to be about protecting women or just not holding them in high enough esteem to inform them about what happened, but we now know that actually the opposite is true. As my hon. Friend the Member for East Worthing and Shoreham mentioned, it is important to be involved not just in the death, but in what happened before, during and just afterwards. The question parents have at a time like this is: why? That question needs to be answered, and it does not get answered in a sentence or in a minute. Parents need to know and women need to know. They can only feel as though they have fulfilled their own responsibility to their child when they have explored every avenue and know every detail of what happened.

[Jim Shannon (Strangford) (DUP)]

This debate has been specific to England, Scotland and Wales, and not necessarily about Northern Ireland. I congratulate everyone who has made a speech on their very valuable contributions. After this debate, could the decisions, conclusions and the way forward on the strategy be conveyed to Northern Ireland, where this is a devolved matter, so that we can all work together to help everyone?

[Ms Dorries]

The hon. Member is quite right that this is a devolved matter. However, this is an issue that affects all women in the United Kingdom. He is quite right, so I will ask my officials what discussions take place with the devolved Assemblies and come back to him.

The stillbirth rate in England is falling. As I am sure the hon. Member for Swansea East knows, it was our intention to reduce the 2010 rate of stillbirths by half by 2025. I am delighted to report that we are ahead of that target: in January 2020, we were already ahead of what we are trying to achieve. Since my appointment as the Minister with responsibility for both maternity and patient safety, I have seen for myself how NHS maternity services in England are working hard to ensure that the care they provide is safe and personalised to women’s individual needs.

Many measures have been introduced in maternity services that are achieving this reduction in the rate of stillbirths, and the issues raised in debates such as this on baby loss also make a contribution. We all know that applying pressure and raising the issue pushes the agenda further along.

The efforts have resulted in a 20% decrease in the stillbirth rate between 2010 and 2018. Between 2016 and 2018, there were 760 fewer stillbirths in England than in 2015. That is an enormous achievement, and something that we should be very proud of. There are 760 fewer families who have to go through the painful experience of planning a funeral for a much-loved and wanted child. I think we all know that there is nothing more painful for a woman or a couple than to go into hospital to have their baby and to leave with empty arms and broken hearts. The fact that 760 fewer families are doing that now, as a result of the measures that have been introduced, is a huge achievement.

In closing, I pay tribute to the initiatives that have been stimulated by Members of this House to improve support for families experiencing a stillbirth. These include the national bereavement care pathway, the children’s funeral fund and the Parental Bereavement (Leave and Pay) Act 2018, which provides for at least two weeks’ leave for employees following the loss of a child under the age of 18 or a stillbirth after 24 weeks of pregnancy.

I also pay tribute to the clinical professionals and support staff working in acute and community maternity services. They work incredibly hard. I visit these maternity units and meet amazing midwives who dedicate their lives to being in that room at that moment when a baby is born, to ensure a safe delivery. Through their efforts, many more women and babies are being supported to have a healthy pregnancy, labour and birth. They will be supported nationally by the maternity transformation programme, which will continue to oversee the implementation of maternity safety initiatives, including those published in the NHS long-term plan and the new NHS patient safety strategy, published last July.

I would like to conclude by thanking the hon. Member for Swansea East yet again—we are truly in her debt for the issues she raises in this place—and my right hon. Friend the Member for South Holland and The Deepings for supporting her, or for being her acolyte, as he described himself.

Question put and agreed to.

Resolved,

That this House has considered historical stillbirth burials and cremations.

Hernia Mesh in Men

Debate between Jim Shannon and Nadine Dorries

Thursday 5th September 2019 Westminster Hall

[Jim Shannon]

To follow on from the shadow spokesperson’s question, has it been possible within the investigation and review to understand why the vast majority of people can have the operation without any side effects, while a large number of people do? There were 400 such people in Northern Ireland. If we take that population across the whole country, that means about 24,000 people across the rest of the United Kingdom, so the figures show a large number of people who have had problems. Is it possible to say why, or to investigate and ascertain why those problems take place, as they did in Australia?

[Ms Dorries]

We will take that question away. I will come back to the hon. Gentleman, because that is a detailed question with more complexity in it than I could answer today. For those people who suffer from pain, is it alleviated by the steroid and local anaesthetic injection? Are those numbers just people who present back once with pain, or do they go on to have chronic long-term pain, and, as the hon. Member for Washington and Sunderland West says, come back three or four years later? Some drilling down into that data is needed.

Work is under way both within and independent of Government to improve safety and how we listen to patients, in order to gather the information to work with. In July, we launched the patient safety strategy, which sets out the direction of travel for future patient safety. It was developed through speaking to not just staff and senior leaders but, importantly, patients from across the country. As much as it looks at system improvements, such as digital developments and new technologies, it also looks at culture, so that the NHS becomes ever more an organisation with a just culture of openness to concerns, whether they are raised by patients, family members or staff. Concerns of all kinds should be welcomed, valued and acted on appropriately.

We are also waiting to hear back from the independent medicines and medical devices safety review, which is led by Baroness Cumberlege. The review examines how the healthcare system has responded to concerns raised by patients and families around three medical interventions, one of which is vaginal mesh. To do so, the review has focused on meetings with a broad range of stakeholder groups; I think the hon. Member for Washington and Sunderland West may have attended one of those with her mother.

I close by acknowledging just how difficult the subject matter is. No one should suffer from chronic long-term pain without every effort being made to reduce it and find out why it occurs in the first place. This is not an easy subject for men who are suffering from ongoing pain to speak about. We know that men are always very reluctant to come forward and go to the doctors about anything. I pay tribute to the many impassioned contributions of the brave men who have allowed their stories to be told, who have visited their MPs and contributed, because men are not good at sharing information when it comes to their health.

As I mentioned earlier, however, it is vital that the use of mesh to treat hernias continues. It remains the best course of action for patients where the appropriate treatment pathway leads to surgery. As with all treatment, shared decision making should be central to this process. It is vital that we continually examine the evidence together on the best means of treatment. Decisions in healthcare are often about weighing potential benefits against risks, and I thank those in our healthcare system who strive always to offer us the best treatment possible.

--- Later in debate ---

[Jim Shannon]

It was the hon. Gentleman’s quotation, so I am just quoting him again. He has personal knowledge of what has taken place. Again, to be fair, his operation has been successful. The shadow spokesperson, the hon. Member for Washington and Sunderland West, brought a lot of information to the debate. The problems are really real.

We set out two subjects in this debate: No. 1 was awareness, which is important, but No. 2 was that everyone should understand, before they have the operation, what the implications could be. That does not mean that they will not go ahead with the operation, but it ensures that they understand it. The hon. Lady referred to the “devastating” effect that this can have on lives. It is not a quick or cheap procedure, either, and patient safety is critical.

I thank the Minister for her response. She first confirmed in her contribution that we are raising awareness, and secondly referred to a safety review. I appreciate that and understand why. That does not in any way dismiss—no one can dismiss—those problems that have arisen out of the hernia mesh operations in men as not real. I ask her, if she has the opportunity, to perhaps look at the Australian investigation, although maybe she has already done so.

[Ms Dorries]

indicated assent.

[Jim Shannon]

There we are; the Minister is ahead of me there. Well done. That investigation might give us some ideas for what we could do here as well.

I also thank the hon. Member for Burton (Andrew Griffiths), as always when he turns up, for his contribution. I know many people who have had the operation successfully, but my job here is to bring to the attention of the Minister and this House the many others who live with the mental, physical and emotional problems. That is what this debate is about. I thank everyone for their contributions, and I thank you, Mr Hanson, for chairing the meeting admirably, as you always do.

Question put and agreed to.

Resolved,

That this House has considered hernia mesh in men.

Suicide Risk Assessment Tools in the NHS

Debate between Jim Shannon and Nadine Dorries

Wednesday 4th September 2019 Westminster Hall

[Ms Dorries]

I am delighted to inform the hon. Lady that just this week, NHS England has written to all mental health trusts to make clear that they should be adhering to NICE guidelines on the use of risk assessment tools. My hon. Friend the Member for Thirsk and Malton mentioned a trust that is still using the old method. As a result of this debate, we have ensured that the letter is going out to tell NHS trusts that they should not be using the tools any longer and should be implementing the NHS guidelines.

[Jim Shannon]

I congratulate the Minister on her appointment. When intervening on the hon. Member for Thirsk and Malton (Kevin Hollinrake), I referred to the 20% increase in suicides in Northern Ireland. I did so because it is factually correct, and because in Northern Ireland we have a policy and strategy in place to address those issues. Has the Minister, in her short time in her role, had the opportunity to discuss those matters with, for instance, the Northern Ireland Department of Health?

[Ms Dorries]

I am afraid I must disappoint the hon. Gentleman. This is my third day in, and I have not yet had a chance to discuss Northern Ireland in detail, but as a result of his intervention I will ensure that we do that, and it will be on tomorrow’s agenda.

The letter that NHS England sent out highlights the report from the University of Manchester on “The assessment of clinical risk in mental health services”, and asks trusts to ensure that their risk assessment policies reflect the latest evidence from the university, as well as best practice. I am pleased that NHS England and NHS Improvement have committed to working with trusts to improve risk assessment and safety planning as part of future quality and safety work on crisis care and suicide prevention.

My hon. Friend the Member for Thirsk and Malton asked specifically about the role of the Care Quality Commission in ensuring that trusts are adopting best practice in respect of risk management processes. The CQC has assured me that risk management processes are a key feature of every CQC inspection. I hope that that assurance from the CQC, along with the letter that NHS England sent out this week, will go some way to reassure my hon. Friend.

Childhood Obesity

Debate between Jim Shannon and Nadine Dorries

Tuesday 16th October 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Will the hon. Lady give way?

[Ms Dorries]

When I have ever not given way to the hon. Gentleman—and when has he ever not intervened?

[Jim Shannon]

I congratulate the hon. Lady on securing this debate about something that is a massive issue in my constituency. I am a type 2 diabetic—it is interesting that she has referred to that—and I became a type 2 diabetic because of the horrendous food I ate and the lifestyle I had as a young person, until I became a diabetic. It is essential that we address with young people the age-old principle of all things in moderation. I supported the sugar tax and changes to the way in which nutritional information is displayed. Does the hon. Lady agree that while large steps have been taken, there is more to be done to tackle this? Funding must be allocated to allow charities and Sure Start to run programmes on nutrition to teach people cheap and efficient ways of healthy eating.

[Ms Dorries]

The hon. Gentleman nearly got a speech in there. As I said, I will go on to address funding issues.

The parents on whom this issue impacts the most, and who are most likely to be affected, are those who make the poorest nutritional choices. They do not take The Times, or spend time on the internet reading the news or visiting any other sites where information about the effects of obesity on their children is likely to be repeated. They are also the parents who live in areas of higher deprivation. The fast-food, junk-food giants place more of their outlets in such areas than in areas of affluence, which makes the temptation easier and the consequences more impactful.

What can we as a Government do? I want to praise the headteacher and staff at Shillington Lower School in my constituency. Every morning after assembly, every child joins in with 15 minutes of vigorous exercise. Some are outdoors, running around the field perimeter, while others are in the hall doing boot camp with the cyber coach. That is in addition to their normal PE lessons and physical activities. The school actively encourages walking to school, and I have to say that Shillington Lower School’s efforts are there to be seen, but that is one approach, in one school in one village.

I am doing my little bit by embarking on a tour of schools in my constituency, and I am speaking to public health officers at Central Bedfordshire Council to find out how much more we can do locally in my Mid Bedfordshire constituency. However, this piecemeal approach is part of the problem. We have local council initiatives, as well as individual schools, teachers, parents, elected Mayors, public health officers, social workers and health visitors all doing their own little bit, and while that is all incredibly worth while, no one knows what the other is doing. The approach is taken on the basis of good intentions, but it is far from being an effective plan to deliver any measurable results.

This issue should be a governmental and departmental priority, regardless of Brexit and the noises off. This crisis has nothing to do with Brexit and everything to do with the lives of our children, yet there is no plan that co-ordinates a national strategy to make dealing with this issue a priority, and there is zero leadership from the top—I am very sad to say that. A national crisis requires leadership and a holistic, co-ordinated headline plan. Tackling this problem needs to be one of the Government’s top five priorities, and that needs to include funding.

The Minister is very much doing his bit, in line with the Government’s obesity plan. That is a great achievement, but sadly it is nowhere near enough to tackle the problem. The Minister is a good, conscientious and pragmatic man, and the father of healthy and very beautiful young children. I know that he personally is as worried about this as anyone else, but he is just one Minister in one Department, although I accept that his is the Department that should be leading on this, in accordance with the Government’s aims and objectives in this area. However, if we had some high-level leadership and direction, we could have all the Departments working together towards one strategy and working together as one taskforce to establish our short, medium and long-term goals to reduce the weight of the nation and in particular of our children.

In fact, the Minister is the only person who is accountable for tackling this national crisis. As “Off the Scales” highlights, there is little or no direct accountability among Departments for the childhood obesity plan, other than the Department of Health and Social Care and a small requirement on the Department for Education. What about the Ministry of Housing, Communities and Local Government? What about the Department for Digital, Culture, Media and Sport, given that sport is one of the biggest players in the fight against obesity? What about the Department for Environment, Food and Rural Affairs, the Department for Transport and the Treasury? We know that the Treasury is the place where all good ideas go to die, regardless of which party is in power, and it is not giving this national crisis serious consideration. So many people—from the wonderful staff at Shillington Lower School all the way up to the Department of Health and Social Care—are doing their own thing, but, sadly, none of this can be monitored or measured, because it is all entirely disjointed and unconnected.

The NHS has recently enjoyed a £20 billion cash injection. At present, only 0.2% of the NHS budget is allocated to Public Health England to deal with obesity and to put in place preventive strategies with regard to childhood obesity, yet the Government’s plan places huge responsibility on Public Health England to tackle this issue.

Taxes on Small Businesses

Debate between Jim Shannon and Nadine Dorries

Wednesday 18th October 2017 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

This is a very complex matter. I was doing some research on it and found that 59% of homes now own a tablet, 71% of UK adults have a smartphone and 97% of small and medium-sized businesses have access to online services. I make a plea to the Minister on behalf of craftspeople—people who know nothing about computers but everything about their hands. The person who has a computer in their house is probably a 13-year-old—

[Ms Nadine Dorries (in the Chair)]

Order. Mr Shannon, please keep it to an intervention, not a speech.

[Jim Shannon]

Does the hon. Gentleman agree that that point is not fully taken into consideration when it comes to the digitalisation of everything?

[Derek Thomas]

If the hon. Gentleman is happy to wait, I will be pleased to address that issue later.

I will move on to business rates, which have been quite a contentious and well-documented issue in recent months. There is no doubt in my mind that if the Treasury were inventing a taxation system from scratch today, the current business rate system would not feature in its proposals. The Government should scrap the current system of business rates and develop a fresh solution, injecting fairness into the tax system for small businesses and taking into account the growth of online shopping and supermarket home delivery services.

Structurally, there are many things wrong with business rates. The tax bears little or no relation to the success or activity of a business. The method used to calculate it is arbitrary. Colleagues will be aware that rates are calculated by multiplying the rateable value, based on the assumed rental value of the property, by a multiplier set by Government. Almost in recognition of that, and in an attempt to spare small businesses the business rate burden, the 2010 Conservative-led coalition and the two successive Conservative Governments have sought to address the problems associated with business rates. As a result, some businesses are eligible for rate relief, with many paying no rates at all. Others, for reasons that are beyond the understanding of most lay people, find they are charged 100% business rates, with many in my constituency experiencing considerable increases following the revaluations earlier this year.

The owner of a small independent delicatessen in Helston, where rents are relatively lower, approached me for help in March. Her current rateable value stands at an extortionate £17,750 per year. To rub salt into the wound, her rates are calculated as £149 per square metre, which is the second highest on the street. A chain bakery operating next door pays just £101 per square metre—32% less—and a national clothing chain on the other side of the street pays just £66 per square metre, which is over 56% less. If she enjoyed the same rate per square metre, she would be liable for no rates whatsoever. Because of her business rate charge, she is not sure that she can afford to stay in business.

The current business rate calculations unfairly discriminate even between businesses in the same part of the high street and do not enable businesses to operate on a level playing field. The great tragedy is that that example is not unique. There are similar cases of an independent photography shop in Penzance and a car paint-spraying business that is run by two youngsters who find that their business rate charge bears no comparison to similar units on the same industrial estate. In both instances, there is little hope for the businesses unless the Government act quickly.

Furthermore, in this age of online shopping and supermarket home delivery services, there are businesses essential to the health of the high street that find competing in today’s world nigh on impossible, despite their so-called privileged position on the high street. Historically, a place on the high street gave an advantage to the shop owner, and consequently the business rate levy reflected that. The ability of supermarkets to provide a delivery service direct to the door has undermined that advantage, and in many cases, despite the modern reach of supermarkets as a result of home delivery services, the supermarket pays relatively less in business rates than the high street shopkeeper. In fact, in St Ives, business rates for some supermarkets reduced this April.

To add insult to injury, rents in St Ives town are being pushed up by the perceived popularity of this iconic place. This year, because rate charges relate to rental values, independent business owners have seen their business rate charge rocket. Traditional retailers, such as bakers, butchers and grocers, face the risk of closing after decades of trading. High street chains move in, and ironically the very thing that drives visitors to St Ives is being lost, partly because of what I believe is a flawed business rate system.

Could it be that the cost of running a high street business, including a business rate charge, means that a greengrocer can no longer compete with a supermarket 20 miles away, now that it can deliver groceries to the family living in the flat above? Surely a modern-day business tax should recognise such changes in consumer behaviour. Furthermore, business rate charges take no account of external factors such as high parking charges, poor upkeep of the local area, closure of local public toilets, or a downturn in the economy, most of which have been experienced in Cornwall in recent years.

I have worked hard with a number of business owners who have found the business rate system profoundly challenging. That group includes a local pub owner, who came to the trade recently, full of enthusiasm. The pub employs 14 locals and is a focal point for the community. A rate review means that the pub now faces a 280% increase in business rates, which equates to an extra £13,000 a year. I recognise that the Government have done some work, and Cornwall Council is also doing some work, to help with that, but the fact remains that that rural pub owner’s rates have increased by 280%. As rural pubs close around us and communities are losing their rural services, issues such as this are hardly encouraging to new entrants.

Another major drawback is that business rates hinder aspiration. Should a small business benefiting from full rate relief wish to take on a second property, expanding both the business and the workforce, it will lose its rate relief and pay rates on both the new and the existing outlet. That step change discourages growth and innovation, and stifles all the benefits that growth brings, including job opportunities, staff training and career progression. That is hardly the intention of what I believe is a small business-friendly Conservative Government.

Before moving on, I want to stress the potentially unique role that traditional independent retailers such as bakers, butchers and grocers have in looking out for vulnerable people in the community—for example, the elderly. That is reason indeed to consider the potentially devastating impact of an outdated business rate system.

Finally, I would like to address the Government’s Making Tax Digital plan. I am in favour of moving across to digital tax reporting and I recognise the Government’s ambition to move to a fully digital tax system during the next few years. Will the Minister ensure that SMEs, including sole traders, have easy access to reliable software and training? Have the Government considered that for some businesses, a transition to digital-only tax will present a further serious administrative and financial burden? Strange as it may seem, there are still significant numbers of traders who are not naturally acquainted with online activity. I am reluctant to single out individuals, but I have met a number of sole traders who are not tech savvy, and the idea of making tax digital fills them with dread.

At present, I can see that there may be a benefit to Her Majesty’s Revenue and Customs in making tax digital, and I know that the Government are making allowances for areas of poor digital connectivity and plan to exempt some on very low self-employed incomes. Can the Minister please ensure that those exceptions are properly supported by accurate data, so that those who are not yet in a position to take part in the brave new world of digital tax reporting will not be unfairly penalised or discriminated against?

In conclusion, I believe that the Government could send a clear message that Brexit does not mean that important domestic priorities are being left on the back burner. The Government can do that by ensuring that small business growth is not stifled by out-of-date and grossly unfair tax systems. Taxation must promote growth so that, as a nation and within our communities, we can maximise all the benefits that a vibrant economy brings. As changes in consumer behaviour and better digital services lead consumers to gravitate towards online shopping and supermarket home delivery, we must ensure that the Government have a fair system of taxation and make changes to unlock the potential of our country’s entrepreneurial small businesses.

The Government must recognise that the negative impact of business rates and the profit hit from VAT registration often go hand in hand. Both taxes kick in at the crucial point when an enterprise is on the cusp of growing to a size at which it can be of useful benefit to the local economy and community. Will the Government please consider scrapping business rates once and for all, in favour of a tax that reflects the economic activity of all businesses concerned? Will the Government explore opportunities to raise the VAT threshold in coastal and rural tourist areas, and will the Government continue to listen carefully to those who recognise the move towards digital tax reporting but ask that we approach it with caution and understanding?

[Ms Nadine Dorries (in the Chair)]

I call Jim Shannon.

[Jim Shannon]

Ms Dorries, I withdrew my name this morning.

[Ms Nadine Dorries (in the Chair)]

Well, it is still on my list. We will go to Robert Jenrick.

DWP Estate

Debate between Jim Shannon and Nadine Dorries

Wednesday 18th January 2017 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under you today, Madam Chair.

First of all, I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on presenting her case so very well. When I saw the title of this debate, I felt that I had to come along and make a comment, primarily because the future changes to the Department for Work and Pensions estate will affect my constituency. The changes are a devolved matter and I will explain some of the issues for us in relation to it. Perhaps the Minister will find herself with a direct role in this if things do not go according to plan in the elections.

I remember my time as a councillor and as a Member of the Legislative Assembly in Northern Ireland, when the idea of a private finance initiative was first brought to my attention, with regard to building a new hospital at the Ulster hospital site. It must be the Ulster Scots in me, but I just could not bring myself to see how that could be value for money and I opposed it on that ground, and on the ground that it was putting local people out of work. I have a great problem with PFI. The fact is that we are scrambling to find people now that the contract has finished, and we cannot do anything because we do not own anything. Of course, as you will point out, Madam Chair, PFI is not directly the issue that we are considering today, but it is one that we cannot ignore and I wanted to make a point about it on the record.

I know that, on paper, the people to office ratio may allow for an office to close, but we do not live on paper; we live in the real world, where transport systems, and rural and urban issues, come into play. Let me give a Northern Ireland perspective. I say again that the Minister’s responsibility is clearly to the mainland of the United Kingdom, but if the elections in Northern Ireland in two to six weeks do not deliver the democratic process that we wish to have, direct rule will become a reality. If that is the case, responsibility for this issue will fall upon the Minister’s shoulders.

Ballynahinch social security office is out to consultation, with a view to the closure of the premises. The office is long overdue an upgrade, to both its interior and exterior, but it seems that the Department responsible simply cannot afford it, or at least that is what it is telling us. It is impractical to expect or insist that all claimants who use the Ballynahinch office should instead use the Lisburn office or the Downpatrick office, which on paper are less than 20 miles away. That does not seem far, but in reality it is a journey that many find difficult to make. In addition, both those offices are already oversubscribed and fully utilised.

The public transport links to Downpatrick or Lisburn already have problems, and for many people on benefits making such a journey would be another cost and another outgoing that they do not need. Some of those who attend Ballynahinch have severe mobility and access issues, and it would be harmful to their needs if the Ballynahinch office closed.

Let us look at some of the finer detail of the Ballynahinch SSO. Last year, it had 6,172 referrals for jobseeker’s allowance not including phone call inquiries, which could easily double that number. There were also 7,406 jobcentre referrals, and it is imperative that that figure is highlighted in the consultation process. Very often people say that a jobcentre only provides benefits, but it does more than that: it is training people for jobs, as a number of hon. Members have already said.

All those who have an interest in this service must take the time to do their part, in order to see the retention of this office in Ballynahinch. In the four months prior to the start of the consultation, JSA inquiries were as follows: in May 2016, there were nearly 500; in June 2016, 596; in July 2016, 448; and in August 2016, 550. All those cases were dealt with by the Ballynahinch jobseeker’s allowance staff alone.

The jobcentres in my area also have close contact with three local high schools. The point about schools is an important one; it has already been made by others and I make it in relation to my area. Those schools will be affected by any potential closures of jobcentres.

The new personal independence payment system is coming in. Staff need to be trained to use that system, and the increase in workload is quite phenomenal. I cannot speak for others, but I can speak for my own office and its staff—the number of PIP referrals that the office is getting is incredible. The staff’s workload has probably doubled as a result, and I cannot say any more than that. People applying for PIP need to speak to staff who understand their problems, and who have both compassion and a good knowledge of the system. We also have to address the issue of those people who may not have educational achievements or the ability who come to the office. There is also the issue of the reduction in footfall for local businesses; there is a knock-on effect for them as well.

The hon. Member for Glasgow East (Natalie McGarry) referred to the equality impact assessment and I will, too. Thought must be given to the equality impact assessment, as the rural town of Ballynahinch cannot afford to have the local jobcentre moved. That cannot be considered as “rural proofing”.

On paper, this decision about my jobcentre may be a no-brainer, but in reality we will leave hundreds of people without the support they need to find a job or to access other help, or to get advice about benefits. I am sure that this case is replicated in many ways in other hon. Members’ constituencies, which shows that, while we must cut outgoings, in doing so we cannot and must not cut people off from the help and support they need.

Again, I thank the hon. Member for Rutherglen and Hamilton West for raising this issue, and I ask the Minister for a reasoned opinion on what is being proposed for the DWP estate, and to ensure that, when it comes to making these decisions, we are there for the people who need us most.

[Nadine Dorries (in the Chair)]

I call Chris Stephens to speak. Mr Stephens, you can have an extra minute or so.

ESA and Personal Independence Payments

Debate between Jim Shannon and Nadine Dorries

Wednesday 30th November 2016 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I did indeed, Ms Dorries. Absolutely. I am more than happy to be called—I am just surprised to be called right away.

[Nadine Dorries (in the Chair)]

You are first on the list today; I know it is unusual.

[Jim Shannon]

The first shall be last and the last shall be first. Whenever it happens, it is always good to be called. Thank you very much, Ms Dorries—I actually thought that the hon. Member for North Swindon (Justin Tomlinson) might have been asked, so I was looking at him, but no doubt he will participate at some stage.

I thank the hon. Member for Lanark and Hamilton East (Angela Crawley) for setting the scene well. We are back to discuss this matter again in Westminster Hall, and it would be remiss of me not to give a Northern Ireland perspective on where we are. I am grateful that the Minister is in her place and all of us in the House appreciate it when she responds. I will give my opinion today—and others will give examples—of where the system is falling down. I have to highlight those key issues because my staff and I deal with them every day of the week. We see people across the table from us with angst and anxiety and all the associated issues of stress, and we say, “How can we help them and do things better?” I will speak about some of those things today.

I have recently spoken about the changes to the employment and support allowance work-related activity group and what that means for people. The biggest issue is that the Government need to understand the difference between “ill” and “unable to work”. That, in a nutshell, is what the debate is about—the interpretation by the Department for Work and Pensions of what it means to be ill and what it means to those people who sit across the table from me every day and tell me they cannot work. The hon. Member for Lanark and Hamilton East referred to people being pasty, sweaty and anxious, and my staff and I see those things every day of the week.

In the last month, we have seen in my office a former ward sister, a former construction business owner and a social worker, all of whom are now on ESA. Let me be clear: I do not believe for a second that those people are choosing not to work out of laziness. Who would want to go from earning £500 a week down to £75? People do not, but that is what happens.

The inference from the Government in this whole policy is insulting—I say that with respect—and more importantly, is based on a false premise that cannot be allowed to stand. I have to challenge that in the House, respectfully and kindly, and say it to the Minister and Government directly. As hon. Members know, I do not criticise—I do not feel that that is necessarily what I do—but I need to highlight the issues and ask nicely for genuine compassion and understanding.

The rationale seems to apply to PIP applicants as well. PIP is supposed to be for the help that people need to work. Apparently, the PIP assessment is intended to provide

“a more holistic assessment of the impact of a health condition…on an individual’s ability to participate”

in everyday life. It covers sensory impairments, development needs, cognitive impairments and mental conditions, as well as physical disabilities. Those five categories cover everything—medically, physically, healthwise——that there can be. The assessment looks at the extent to which the individual is capable of undertaking various activities. For some activities, someone can score points to help to meet the threshold for PIP if they can undertake that activity only by using an “aid or appliance”. That could include such things as artificial limbs, colostomy bags, walking sticks and non-specialist aids such as electric tin openers and long-handled sponges.

I want to highlight two cases, one of which involves a young lady who has ulcerative colitis. My age is such that I can probably remember the day she was born. I have got to know her very well over the years due to her diagnosis with this unseen disease, and how it has affected her and other people in my constituency. She worked in the civil service but was granted medical retirement before 30 because her employer could no longer facilitate her working. A Government employer could not accommodate her ability to work one day and not the next, as her illness dictated.

I understand the reasons why the Government and the civil service had to take a decision and say, “Look, we are going to have to terminate your employment.” However, that is where the problem started, and I cannot understand how they expect someone else to employ her when they let her go. It should be understood why this lady is no longer able to work and why her employer, the civil service—she was Government-employed—had to let her go. Why is this young lady in this conflicted position? She is asked, in respect of PIPs, “What job can you do? Where can we find you some work?” Let us be honest: that wee lassie would love to work if only she had the opportunity, but she cannot because of her disability. She is on ESA and is dealing with the stress of the proposed changes. We should never underestimate the impact of the stress of this position. I stress that as strongly as I can, because I see that all the time. She rang to make an appointment for her PIP form to be filled out. How will she be assessed? That is the question I am asking. She is currently on the higher-rate DLA—deservedly so, by the way. Will that be taken away from her? Ministers would say no, but the experience we have had so far in my office is raising fear in our mind and the minds of constituents. I see that all the time.

The young lady’s condition has not improved one iota since her last DLA application. If anything, I would suggest that it has worsened, and there is real concern that the PIP changes will not help. The stress makes her even more ill. It is a vicious cycle that is repeated over and over again. The PIP is for people who need help for hygienic purposes and for safety issues, but the problem is that that is not being translated into the new proposals. I genuinely hold the Minister in the highest esteem. From her response, we need to understand how the system works and how it can help the people on whose behalf we are here to make a plea, so that we can take away the stress and hassle.

On 11 March, it was announced that the number of points awarded in the PIP assessment would be halved for aids and appliances for “dressing and undressing” and “managing toilet needs”. Why would the Government reduce the points for things that are needed? I cannot understand that. As a result, 290,000 claimants will no longer receive the daily living component, and a further 80,000 will receive the standard, rather than the enhanced, daily living component. Budget 2016 estimated additional savings of £1.3 billion a year by 2019-20. That is great but where does it leave my constituent, who needs help during the night?

[Nadine Dorries (in the Chair)]

Order. Mr Shannon, lots of people wish to speak. Would you try to keep your speech to about nine minutes so everybody has an equal amount of time? Thank you.

[Jim Shannon]

I did not realise that. I will try to go at my Northern Ireland speed, which is very fast. The young lady I was talking about needs her sheets changed at night, and often replaced entirely, as well as someone to come in and take care of her during her bad periods. Her DLA paid for a carer to help her. Will PIP do the same? The answer should certainly be yes, but the points system is not set up for illnesses such as ulcerative colitis and Crohn’s disease. The Crohn’s and Colitis UK website contains a link to a PDF offering help and advice on the PIP for sufferers. The PDF is 70 pages long—that is how complex the system is and how much help people need to fill out the application. If that does not put off someone who is seriously ill, I do not know what would.

Is this what was intended by the Government’s welfare reform? Did they intend to make it so complex and intricate that many people will give up and live in sub-standard conditions, rather than get the help they need to live with their illness? We should be concerned about people retreating inwards, their lack of confidence and the problems they face.

Ms Dorries, you have given me a time limit. I just have two more paragraphs to get through very quickly. I wholeheartedly believe that the new system is failing people. I had a doctor on the phone to say that his patient’s decision was made without the assessor taking the time to request any information about the patient from the surgery. The doctor said, “Jim, if he doesn’t get this help he will have to go to a nursing home at 46 years of age.” The care packages that health trusts put in place are not sufficient to handle people who are not able to pay privately for the additional support they require. On their behalf, I again ask the Minister, most sincerely, kindly and humbly: please look at this benefit, remember why it was set up and understand that, for many, it is the difference between having support to live and simply being able to exist. Do not continue to push these ill people, many of whom suffer from mental health problems due to the stress and strain of long-term illness. In this House, MPs are called to protect and help the vulnerable, but that is not what this new ESA and PIP system does.

Secondary Breast Cancer

Debate between Jim Shannon and Nadine Dorries

Wednesday 21st October 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Thank you for giving me the chance to speak in this debate, Ms Dorries. I congratulate the hon. Member for North Warwickshire (Craig Tracey) on bringing this matter to the House for consideration. This is an opportunity for all of us to participate and throw in our knowledge. We are all fond of the Minister and we know that her replies will be positive because of her knowledge of this subject, which we have discussed on many occasions. I look forward to her response.

This issue is of the utmost importance. I am my party’s health spokesperson at Westminster, so I am well aware of these issues back home, which come much too close to many of us and indeed our constituents.

In yesterday’s debate on the availability of cancer drugs, we discussed many issues. Today we are specifically discussing breast cancer and the hon. Member for North Warwickshire is right that we should take an interest in it. Almost 80 MPs attended the breast cancer function just over a month ago.

I would like to focus specifically on Northern Ireland. The Minister will know that health is a devolved matter, but I want to give some statistical evidence on how important it is to us in Northern Ireland and how much help we need for it in Northern Ireland and on the mainland. According to the Northern Ireland Executive, breast cancer is the most common form of cancer among Northern Irish women, excluding non-melanoma skin cancer. I am sure that Members will agree that the figures are worrying: some 1,200 women are diagnosed with breast cancer in Northern Ireland each year and one in nine is expected to develop the disease at some stage in their life.

We all know about the high-profile cases in the press every week—Angelina Jolie is one and Kylie Minogue is another. We think of them because they are household names, but, by speaking about their personal circumstances, they have raised the profile of this disease. In some cases, surgical operations have been done before the disease comes. When we hear about that sort of step, we know that we are talking about something most serious.

There have been welcome developments in breast cancer treatment and care in the Province, including free breast cancer screening for 50 to 70-year-olds every three years. That new initiative, announced by my colleague, Simon Hamilton, illustrates the need for specific action on diagnosis, and early diagnosis in particular, as the hon. Member for North Warwickshire mentioned. We need to step up to the plate and instigate action wherever we can.

Breast cancer screening is an effective way to detect cancer in its early stages. Early detection is essential to increase survival rates. Just yesterday I tabled a question, asking “what steps” the Minister’s Department

“has taken to ensure that people diagnosed with cancer are (a) diagnosed early and (b) treated immediately.”

Early diagnosis and the availability of treatment are important issues. As the hon. Member for North Warwickshire outlined in his speech, there is a period of time in between them, but we need early diagnosis and early treatment—let us have the two of them together.

Complications arise and treatment is made more difficult when the primary cancer spreads to another part of the body. It is the secondary cancer that we are here—

[Nadine Dorries (in the Chair)]

Order. More speakers have requested to speak in the debate than we realised at the beginning. Therefore, accounting for the winding-up speeches, the time available has narrowed considerably to just over five minutes each. I have to push you, Mr Shannon. Having now spoken for four and a half minutes, could you begin to wind up so that we can get everyone in? That would be fantastic. Thank you.

[Jim Shannon]

I appreciate that. I spoke to you earlier, Ms Dorries, and looked at the figures. I was not aware that we would be down to five minutes, so let me focus on these points.

It is estimated that over a third of those diagnosed with primary breast cancer will develop a secondary cancer within 10 years of their first diagnosis. Again, early detection is the issue. Advancing new treatments and improving those in existence is of the utmost importance, but we must also publicise and promote research and findings on what can be done to prevent both primary and secondary breast cancer and to reduce the risks of them developing.

I see that the hon. Member for Central Ayrshire (Dr Whitford) from the Scottish National party is here to make a contribution. I know of her interest in this issue from her previous job, so I look forward to hearing what she and her party have been able to do in Scotland. That is important for the debate.

We should also look at partnerships between Governments, universities and the pharmaceutical companies. In the Minister’s response, will she say what steps will be taken to review the NICE criteria? It seems that some new drugs on the market that could be used to reduce deaths from breast cancer are held up by those criteria. Will she look at that?

I do not believe that we can put a price on life and, when it comes to these issues, we cannot make decisions based on anything other than genuine human compassion and empathy. I hope that the debate will raise awareness for those with breast cancer.

The Minister always responds in a positive fashion. We need to look at the availability of drugs, early diagnosis and early provision of medicine and medical help. We also need to raise this issue with the pharmaceutical companies and review the NICE regulations, because, by doing so, I think we will get more drugs available.

Engineering Careers

Debate between Jim Shannon and Nadine Dorries

Wednesday 13th February 2013 Westminster Hall

[Nadine Dorries]

I will certainly take that point on board and feed it back to Andy Robinson.

I am impressed by how Autotech has tackled the problem itself, by setting up its own Autotech academy, its own apprenticeship scheme within the business, its own school within the business. It has been reaching out to schools and advertising the academy as a way to bring young people in and start doing that work—the very things that we are talking about—but it still finds attracting young people incredibly difficult.

Our country has a rich heritage in this area. When I was a girl—I am quite old now—[Hon. Members: “No!”] I am afraid I am. In Liverpool when I was a girl growing up, careers in engineering—electrical engineering, mechanical engineering and civil engineering—were very attractive to people I was at school with. In fact, those were the kinds of career that boys in particular wanted to go into.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for bringing this very important issue to the House. Shorts Bombardier in my constituency offers many people great opportunities for apprenticeships in aeronautical engineering and a career for the rest of their lives. That is similar to what happens at the company to which she has referred. One thing that disappoints me is that only one in 10 girls pursue a career in engineering. Does the hon. Lady believe that we could do more to encourage young girls to make the same choice of career?

[Nadine Dorries]

I was coming to that point. Engineering was a career choice for boys when I was at school. It was not one that girls were ever interested in, but when I was at Autotech, I realised that such a high-tech form of engineering could be quite attractive to girls. There are so many more opportunities open to both genders now. I know that some girls are involved, but I cannot imagine that we would see many girls wanting to get involved—I do not know what form of engineering the hon. Member for Newcastle upon Tyne Central (Chi Onwurah) did—in mechanical engineering. We just do not go into garages and see girls with oily rags.

Health and Social Care (Re-committed) Bill

Debate between Jim Shannon and Nadine Dorries

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

I absolutely will not.

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

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

[Jim Shannon (Strangford) (DUP)]

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

[Nadine Dorries]

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

--- Later in debate ---

[Nadine Dorries]

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

[Jim Shannon]

rose—

[Mr Umunna]

rose—

[Nadine Dorries]

I give way.

[Jim Shannon]

rose—

--- Later in debate ---

[Nadine Dorries]

No.

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

[Jim Shannon]

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

[Nadine Dorries]

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

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