Non-surgical Cosmetic Procedures: Regulation

John Howell Excerpts

Tuesday 12th February 2019 Westminster Hall

[Alberto Costa (South Leicestershire) (Con)]

I beg to move,

That this House has considered regulation of non-surgical cosmetic procedures.

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I am grateful to lead this debate on an issue that I believe affects all our constituents.

We live in a time when there is a certain desire, especially among the young and impressionable, that one must always look one’s best, or in fact look different to how we may really be. There is nothing wrong with that; we live in a country that gives all citizens the ultimate freedoms over their choices and their own bodies. However, we in Parliament have a responsibility to the people, and our responsibility includes ensuring that those who wish to change their appearance and their body have all the information they need to make a fully informed and rational decision and, importantly, are able to trust those administering treatments and to have peace of mind that those treatments will be carried out correctly, with minimal risk to their health.

[John Howell (Henley) (Con)]

Does this matter not come down to a fundamental issue, namely that if something goes wrong, who do we sue? Is that not the nub of what my hon. Friend is trying to get at?

[Alberto Costa]

I thank my hon. Friend for that intervention. Yes, that is one of the core issues that I wish to raise today. The mark of a professional in our society is somebody who is regulated, who is trained, qualified and licensed, and who has ongoing regulation and development. However, in addition to that, in the private sector they must carry professional indemnity insurance, so that people do not sue men or women of straw and so that they have someone to sue when things go wrong.

My experience of non-surgical cosmetic procedures does not extend to Instagram celebrities or Kylie Jenner. Instead, I wish to inform you, Mr Hollobone, of the case of my constituent Rachael Knappier. First, I thank Rachael, her mother and her friend, who are all attending this debate here in Parliament. I also thank Rachael for her tremendous bravery and willingness to talk openly about the terrible injury that she sustained as a result of a botched non-surgical cosmetic procedure. I think Rachael has been a role model for hundreds, if not thousands, of people across the country who have read the articles in the British media about her trauma. They responded with sympathy, but most crucially an understanding of her experience, because—sadly—experiences such as Rachael’s are not confined to the few. Many hundreds of our constituents have suffered such botched procedures.

Children with Life-limiting Conditions

John Howell Excerpts

Tuesday 29th January 2019 Westminster Hall

[John Howell (Henley) (Con)]

My hon. Friend mentions the adjustments that need to be made in people’s homes. To what extent does she think local councils are living up to expectations in that respect?

[Antoinette Sandbach]

I will come on to that point, but I know that in my area the situation is certainly not as good as it might be.

I hope that the Minister will commit to ensuring that children have a right to an integrated assessment, a plan and a personal budget to address their individual needs. Likewise, I hope that she will agree to review health and social care law, not only to strengthen the rights and entitlements for disabled children and their families, but to clarify them. That clarification would be hugely welcome, because uncertainty leads to some local authorities failing to meet their obligations. For instance, Together for Short Lives reports that 21% of local authorities are failing to meet their legal duty to commission short breaks for disabled children. That postcode lottery is deeply unsatisfactory and requires the Minister’s attention.

I was concerned to discover from December 2017 data that only one of the four Cheshire clinical commissioning groups was developing a strategy or care pathway for children with life-limiting conditions. The same data shows that although some of my area’s CCGs offer out-of-hours paediatric palliative care consultants, community children’s nurses and psychological support, others do not. Given that families have 24/7 responsibility, should not the NHS? My area is lucky to have specialist paediatric care close at hand, thanks to Alder Hey Children’s Hospital, but it is clear that even in Cheshire more must be done, which probably means that more funding must be put in place.

The all-party parliamentary group on baby loss wrote to the Chancellor at the end of last year to ask for a guarantee of the future of the NHS England children’s hospice grant beyond March 2019; for an increase in its value to £25 million per year; for parity of funding between children’s and adult hospice and palliative care charities in England; and for a funded, cross-departmental children’s palliative strategy for England. I was pleased to see that the issue received attention in the NHS long-term plan, but I am concerned by the mismatch between NHS England’s 27 December announcement about children’s hospice funding under the plan, and what was published in the plan itself on 7 January: the announcement said that the money was for hospice funding, but the plan said that it would be for palliative services, including hospices. Will the Minister clarify whether that £25 million will be for children’s hospices only, or for a wider group of children’s palliative care services?

Likewise, will the Minister guarantee that the £11 million children’s hospice grant will be protected and increased as a result of the long-term plan? It is vital that we resolve that, because in 2006-07 the children’s hospice grant contributed 14% towards the cost of providing clinical care in children’s hospices across England, but by 2015-16, when the grant had risen to £11 million, it contributed an average of just 8%.

I hope that the Minister will offer the reassurance that so many families deserve, not just about the finances but about integration and ending the postcode lottery. I am sure all hon. Members agree that these families need support, but now we must build on that agreement and implement a sustainable, compassionate plan to support them.

Cervical Cancer Smear Tests

John Howell Excerpts

Monday 28th January 2019 Westminster Hall

[Helen Jones]

The hon. Lady makes a good point. We need people to realise that women know their own bodies and know if something is wrong, so people must listen to what they say. There are too many examples of women having to pay for a private test before finding out they have cervical cancer. If it is not diagnosed early, there is a chance it will become terminal. If it is diagnosed early, the chances of survival are much greater, so we need to ensure that people are diagnosed early.

On the question of whether the age for screening should be reduced, I am not convinced at the moment. The scientific evidence does not support it, but I hope that the Government will keep it under review. If the evidence changes, we need to change what we do. Sir Mike Richards is undertaking a review of cancer screening and is due to report by Easter. I hope he looks at the issue. Ministers must ensure that they get the best advice and they have to proceed on that advice. We have to remember that, rare as it is, in 2016, 15% of women diagnosed with cervical cancer were under 30, and last year, 12 of those who died were under 30. We can and should do much more to prevent such deaths by ensuring that women are screened where necessary, even if they are under 25. If they have indications that require them to be screened, they should be. We must ensure that we promote the HPV vaccination programme, which is one of the best things that has been done in recent years. I say to parents who worry about it, “Don’t put your daughters at risk. Get them vaccinated.” We have to do much more to convince them that vaccination is the right thing. We have to do much more to make screening accessible and easily available to women, and it must be done in a supportive environment. Let us be honest: it is a bit like a sausage machine when we go to the GP, precisely because health workers are screening all the time. To them it is not at all unusual, but it is to the people who attend; that is the difference.

[John Howell (Henley) (Con)]

I hope that, like me, the hon. Lady will support the Public Health England awareness campaign that is about to start, which will try to tackle all the misunderstandings about screenings, and to overcome the feelings of fear and embarrassment that she described so well.

[Helen Jones]

The hon. Gentleman is right, and it is not before time to have such an awareness campaign. However, it is no good having one unless we ensure that screening is easily available and that people are treated well when they go. That is vital, because one bad experience can put a woman off ever going again, which is not what any of us want.

Natasha started the petition because she wanted to raise awareness of the symptoms of cervical cancer, and to ensure that other women did not suffer as she had suffered. That was a remarkable thing to do, and I hope that today’s debate, which I know her MP, the hon. Member for Newton Abbot (Anne Marie Morris), would have liked to have attended—unfortunately, she has to be in Committee elsewhere—will go some way towards doing that. I hope the debate will open up the dialogue on how best to get women screened, and when they should be screened, and I hope that the Minister will commit to keeping the age of screening under review, so that, if the scientific evidence supports screening earlier, that is acted on.

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Sir Roger, and to follow the hon. Member for Warrington North (Helen Jones) in this important debate. I thank the petitioners, as it is good to have the opportunity to discuss such an issue in open debate. I think that all Members will get the strong impression that there is agreement across the House for what is being proposed.

I will start with the Public Health England campaign, which I mentioned when intervening on the hon. Lady. I agree with her that it is about time we had such a campaign, and that it will have a hard job. On the one hand, it has to tackle issues concerning the women themselves—the enormous misunderstandings about the screening process, and the fear and embarrassment that surrounds it. There is not just fear about the illness; anything to do with cancer creates fear, so there is an enormous amount to overcome.

However, I suggest that the Public Health England campaign should also look at the other side. The Minister has heard us talk strongly today about the impact on GPs, and the way in which they have to handle the issue and make facilities available. It would be very good to have something in the campaign that targets GPs, making those points to ensure that testing happens in the right place, at the right time and in the most effective manner.

The hon. Lady also mentioned inoculation against HPV, which I support. I am pleased that we are now inoculating young boys against it as well, as that makes a very big difference. Those who have talked to medical professionals in this area will have heard stories about the number of people who develop cancer as a result of HPV. It is very good to have such inoculations, and to be able to support the campaign.

Like the hon. Lady, I am not yet convinced that the age for screening should be reduced. Around the world there has seemingly been a general trend to increase the starting age of such programmes. I think the American Cancer Society recommended that the age for cervical screening go up from 18 to 21, which is interesting. The reason she and I believe that the screening age should not be reduced is the false positives that are created. No one wants to be put in the situation of having a false positive test. It is not about the waste of money, but about the concern that a false positive creates for an individual. I am not yet convinced that the age should be brought down but, like the hon. Lady, I call on the Minister to look very carefully at it, to keep it always in his mind, and to keep reviewing it.

I think that Scotland has increased the age at which women go for their first smear test from 20 to 25. That, too, is an interesting reflection of the way things are going, and builds upon the difficulties in dealing with this matter. However, I thank the hon. Lady for presenting the case, and the petitioners for bringing it, and allowing us to discuss it in the way we are doing.

Oral Answers to Questions

John Howell Excerpts

Tuesday 15th January 2019 Commons Chamber

[Jackie Doyle-Price]

I have to advise the hon. Lady that we are on course to meet the targets in the five year forward view, but she is right to raise concerns about the workforce. Frankly, that keeps me awake at night. We are investing in a significant expansion of mental health services and that requires appropriate staff to deliver them. I can assure her, however, that we are in productive discussions with clinical leads in NHS England. We need to be much more imaginative about how we deliver services, and we are seeing substantial gains and improvements in performance through the increased use of peer support workers, who provide the therapeutic care from which many can benefit. However, the hon. Lady is right to hold me to account.

[John Howell (Henley) (Con)]

12. What steps he is taking to improve the diagnosis and treatment for patients with rare diseases and cancer.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

Our much-mentioned new plan sets out the clear ambition to diagnose three quarters of all cancers at an early stage—up from half today.

[John Howell]

The blood cancer charity Bloodwise launched its “Hear our voice” report in Parliament last week. Will the Minister ensure that NHS England works with the charity to ensure that blood cancer is included in the 75% target?

[Steve Brine]

Yes, I will. I spoke at the launch of Bloodwise’s excellent report at its parliamentary reception last week. I have been clear since the new ambition was announced that the 75% target applies to all cancers, and we will not achieve it unless we focus on harder-to-diagnose cancers, such as blood cancer.

Diabetes

John Howell Excerpts

Wednesday 9th January 2019 Westminster Hall

[John Howell (Henley) (Con)]

My right hon. Friend is making a very strong case. Is he aware of the new research into the treatment of type 2 diabetes, which suggests that a change of diet can eradicate it, giving the person a clean bill of health?

[Sir John Hayes]

I was going to refer to the achievements of the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson), later in my speech, but my hon. Friend obliges me to highlight them earlier than I had planned. He is a model example of someone who, having contracted type 2 diabetes, adjusted their lifestyle and diet, lost large amounts of weight, and fought back against—indeed, fought off—type 2 diabetes, exactly as my hon. Friend suggests. Many other hon. Members, including some in the Chamber today, are living with diabetes. Remarkably, our Prime Minister not only manages to hold down her job with immense dedication and determination, but manages type 1 diabetes simultaneously. I spoke about every family and every constituency, but many Members of this House have personal experience of dealing with both type 1 and type 2 diabetes.

During the debate, I will focus on three areas in which we can make real progress: the human and financial cost of diabetes; how education and technology can enable self-management and improve outcomes for both type 1 and type 2; and how, in the case of type 2 diabetes, intervention on societal and individual levels can prevent the onset and mitigate the effects of such a serious problem.

To prevent just a fraction of the complications arising from diabetes would have a big impact on the national health service, generating significant savings as well as fundamentally reducing pain and distress for individuals. Every week in England, over 160 lower-limb amputations result directly from the effects of diabetes, so the ability to provide high-quality diabetic foot care is of particular concern. The recently published NHS long-term plan makes a renewed commitment to the diabetes transformation fund, and I know that that will be welcomed by the whole diabetes community.

I hope that the Minister will set out what steps the Government are taking to encourage the use of education and technology to better support people in self-managing their diabetes, as that will reduce the burden of diabetes both on the individual and on the NHS. A few years ago, a family came to my constituency surgery, with a tiny, wonderful little girl. She was just about to start school. She had already been diagnosed as a type 1 diabetic. That little girl, Faith Robinson, was wearing technology that allowed her glucose to be monitored and insulin to be administered to her—that was absolutely necessary because she was so young. The family came to me with a request, which I will pass on to the Minister so that he can work with colleagues across Government to ensure that this happens routinely for all constituents who need it. They asked that Faith receive one-to-one support at school to manage that technology. The little girl was under five, and needed people at the school she was about to attend to understand the condition and how to deal with the challenges that she faced.

I estimate that there are constituents across the country in similar circumstances, with very young sufferers who need that kind of care and support. I invite the Minister not necessarily to comment today—I do not want to catch him out; that is not my intention—but to reflect on that and to say more about what can be done for that little girl, who I was able to help in that circumstance, and for many others like her.

Mental Capacity (Amendment) Bill [Lords]

John Howell Excerpts

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Tuesday 18th December 2018 Commons Chamber

[Matt Hancock]

I have had some discussions on that subject, and I am happy for the hon. Lady to take up that point in more detail either directly with me or with the Minister for Care, or in Committee, because there are significant interlinkages between the two areas.

The Bill builds on the extensive work and recommendations of the Law Commission. It has been fully scrutinised by the Joint Committee on Human Rights and then improved by the other place, as has been discussed. I am grateful for all that work. Ultimately, it is about striking a balance between liberty and protection.

[John Howell (Henley) (Con)]

My right hon. Friend mentions the Law Commission and its suggestions. What he proposes does not quite tally with all the Law Commission’s recommendations. Where are the differences?

[Matt Hancock]

We built the Bill on the basis of the Law Commission report, but we have put some differences into the Bill. For instance, we think the principle of prioritising people over process is important, and we have strengthened that compared with the Law Commission’s recommendations. The Law Commission improves the law but does not make policy decisions. On top of the Law Commission’s work, which is incredibly helpful, we have made further policy decisions to ensure that people are put more foursquare at the heart of the process. It is true that the Bill and the Law Commission’s recommendations are not exactly aligned, but I would strongly defend our further improvements.

NHS: Staffing Levels

John Howell Excerpts

Tuesday 11th December 2018 Westminster Hall

[Tracy Brabin]

I shall go on to discuss that in more detail, but my hon. Friend and neighbour is absolutely right. We have both been in meetings with the trust where that has proved to be of great concern to it.

[John Howell (Henley) (Con)]

On a similar subject, is the hon. Lady aware that Oxford University Hospitals agreed today to fund the cost of obtaining settled status for EU nationals who work there?

[Tracy Brabin]

That is something that we have discussed with our trust. The cost should not necessarily fall on the shoulders of the people we want to employ, so that seems like a good thing.

Nursing: Higher Education Investment

John Howell Excerpts

Wednesday 21st November 2018 Westminster Hall

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Davies. It is also a pleasure to follow the hon. Member for Wolverhampton South West (Eleanor Smith), especially because she was a nurse. Incidentally, on her point that nurses are more popular than politicians, when the Houses of Parliament burnt down in the 1830s, the cheers could be heard from Westminster Bridge, where people took out their frustration with politicians.

It is wrong to approach this debate in an aggressive “them and us” spirit. We all aim to increase the funding for nurses to an appropriate and proper level. I agree that nurses do a fantastic job, but we should acknowledge those nurses who are involved in end-of-life care—in my hospital, they work closely with social care staff.

However, before addressing that, I should say that, only last week, I visited my hospital in Henley—Townlands Memorial Hospital—with the previous Minister for Health. I extend an invitation to the current Minister to visit the hospital, which has a unique way of doing business. We and the NHS see it as an exemplar in the country. We spoke to a number of nurses about the services they provide, particularly in relation to the rapid access care unit, which looks after people above a certain age very well—they typically seek treatment there. I pay tribute to those nurses.

In our conversation with the nurses, we raised the point about funding for their education. We had a very mature discussion about the lack of bursaries following Government action. As a result, there was a general agreement that the situation that existed with the bursaries was not particularly helpful to nurses seeking to become part of the nursing profession—the NHS effectively generated a cap on the number of people who applied—and that we need a system that encourages people to become nurses as well as go into other professions. We pointed out that, under the bursary system, 30,000 people who applied to become nurses were rejected, which is not a good situation.

We went on to discuss other things in relation to the nursing profession. In particular, the one thing they saw as inhibiting people from becoming a nurse was the price of housing, which is astronomical in the Henley constituency. We need a tremendous amount of affordable housing, to help people to get a start on the housing ladder, and to provide them with rented accommodation where possible.

In addition to visiting the hospital, I have worked with parish councils to encourage them to provide much smaller buses on much tighter routes to give people the ability to travel from their home to their job.

I have been told that the shortage of staff was due to EU nationals leaving, but when I raised that issue with the matron, it emerged that that was not the case at all—the shortage was due to operational reasons.

Prevention of Ill Health: Government Vision

John Howell Excerpts

Monday 5th November 2018 Commons Chamber

[Matt Hancock]

I have of course looked at that report. It is important, and it is important that we get the answers to it right.

[John Howell (Henley) (Con)]

Will the Secretary of State agree that more education should be spent on understanding the total role of sugars in combating diabetes, to go with the success that he has had with regards to the direct focus on sugars in drinks and food?

[Matt Hancock]

My hon. Friend is absolutely right; I strongly agree. Reformulation is critical. However, it is crucial to look not just at sugar, but at calorie count. Replacing sugars with higher calorie products is not necessarily the right way forward.

Hospice Funding and the NHS Pay Award

John Howell Excerpts

Wednesday 31st October 2018 Westminster Hall

[Liz McInnes]

My hon. Friend highlights the problems that hospices up and down the country are experiencing with the recruitment and retention of staff. I will explore those issues further in my speech.

[John Howell (Henley) (Con)]

Maybe the hon. Lady will come on to this in her speech, but has she looked at the different effects that the pay rise has on hospices for adults and hospices for children, and whether there is effectively a two-tier system in the way that those services are delivered?

[Liz McInnes]

That is an interesting question. In terms of hospice funding, children’s palliative care tends to receive less NHS funding, so I would imagine the problem is exacerbated for children’s hospices, because they will have to find proportionally more money to fund the pay award than adult hospices. It is an important point, and I hope the Minister will be able to shed some light on those issues when she sums up at the end.