(2 weeks, 2 days ago)
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It is true that a lack of understanding among professionals about the severity of the problem contributes to the situation. To have it put down to a lack of collaboration would be infuriating for that parent, as well as truly tragic.
We know well by now that early intervention is crucial for identifying and supporting recovery in patients with eating disorders. However, as a parent of someone affected, I must say that has not been my experience on the ground. Hospital admissions for eating disorders have surged, exceeding 30,000 for the first time in 2023-24, which is a 60% increase compared with pre-pandemic levels. While the NHS struggles to meet this growing demand, private equity firms are profiting from the crisis by owning many of the in-patient units the NHS depends on.
Does my hon. Friend agree that his point highlights the urgent need for the Department to examine the influence of private equity in NHS in-patient mental health services? It is vital that private sector involvement complements the NHS’s mission to deliver high-quality patient-centred care and does not serve as a vehicle for profit-making at the expense of vulnerable patients.
My hon. Friend is entirely correct. Our experience of private equity is that it is selective in terms of the patients accepted. It profits from misery. We were put in the awful position of having to choose to send our youngest child to a hospital that had just seen the tragic death of Ruth Szymankiewicz—I take this opportunity to pay tribute to Ruth’s parents. Our second trip to a private equity-run hospital led to them forgetting to feed my daughter 11 times. My hon. Friend’s point is, unfortunately, well made.
More concerning still is that I do not believe that our approach to treatment is changing year on year to confront the heightened demand. If these admission increases were associated with a disease such as cancer, the treatment would quite rightly adapt. Our approach to mental health treatment, especially eating disorders, remains stagnant, outdated and alarmingly resistant to progress.
Another deeply concerning issue is how we respond when patients with severe anorexia refuse treatment and are subsequently diagnosed as terminally anorexic, a classification that holds precedent in UK Court of Protection rulings. In such cases, treatment may be withdrawn entirely, resulting in preventable deaths, such as that of a young patient known as BG who tragically died aged 19 in 2022. For those who may argue that treatment will be withdrawn only when a patient is terminally ill, I point to the case of Patricia, previously deemed untreatable by the Court of Protection, only to have the judgment overturned last month—August 2025. That reversal highlights not only the fallibility of such decisions but the danger in labelling eating disorder patients as beyond help.
We cannot ignore the fact that eating disorder deaths are most likely to occur due to suicide. Following an evidence session of the eating disorders all-party parliamentary group, one expert stated that their research found that anorexia sufferers are 18 times more likely and bulimia sufferers seven times more likely to die from suicide than the average patient, due to a combination of pre-existing and untreated mental health conditions, early discharge and the physical effects of eating disorder recovery triggering suicidal ideation. I do not wish to pre-empt the response from the Minister, who I know is keen to make improvements in this area, but I believe that eating disorders must be included in the suicide prevention strategy if we are to meaningfully tackle this worrying trend and stop patients from falling between the gaps in the already patchy world of child and adolescent mental health service provision.
The eating disorders APPG and campaigners from Dump the Scales are urgently calling for a confidential inquiry into avoidable deaths of eating disorder patients. Eating disorders are treatable illnesses. They are dangerous and life-threatening when untreated, under-treated or poorly treated. The risk to life is entirely preventable; deaths from eating disorders are not inevitable. With integrated, well-resourced and evidence-based treatment, recovery is possible, even in the most severe cases and after many years of suffering. Despite that, coroners, families and communities continue to see too many lives needlessly lost. That should not happen, and it does not need to be that way.
Although the facts I have set out today are difficult and harrowing, they must be heard. I also believe, however, that there are reasons to remain hopeful. I know at first hand that the Department, right up to the Secretary of State, is committed to improving outcomes and getting this right. As a Back Bencher, and more importantly as a father, I see it as my responsibility to push for this change to go further and faster.
(1 month, 3 weeks ago)
Commons ChamberLast autumn, there was not a single NHS dental practice in Derbyshire Dales accepting new adult patients other than those referred for specialist care. The lack of NHS dentistry has led many of my constituents to experience severe economic hardship, with one telling me he had to spend £100 to have a single tooth fixed and another spending £2,000 on dentures. Will the Government provide increased funding for NHS dentistry to ensure that more people in rural areas like Derbyshire Dales can access NHS dentists?
The mess we inherited from the previous Government beggars belief, with 14 million adults with an unmet dental need, while for children between five and nine years old, the most common reason for hospital admission was to have their rotten teeth removed. This Government are determined to get NHS dentistry back on its feet. We are targeting the areas most in need, including rural areas, by delivering 700,000 additional urgent dental appointments, and reforming the dental contract. Our consultation is under way, and I encourage my hon. Friend to participate.
(8 months, 1 week ago)
Public Bill CommitteesQ
Professor Linda Bauld: I think there are political aspects to that, which I will not comment on, but obviously the understanding was that it was a very comprehensive and ambitious set of measures that was introduced. Like this Bill, it was about not just the smoke-free generation but other measures as well, including, interestingly, on the density of retail outlets, which might be something for another day or another, potential future measure. A new Government came in and decided not to take it forward.
The learning that we need to take from that, from my understanding and from speaking to colleagues there, goes back to the CMOs’ evidence about the lobbying that is going to occur. The tobacco industry and partners around the industry are very powerful, so persuading colleagues that this is undermining choice and that it will be a burden in terms of regulation, cost to retailers and so on—those were the arguments that were used in New Zealand.
We need to keep a watchful eye, as we think ahead to the regulations and the next steps for the legislation, that we do not open that door too widely and allow those arguments to become too powerful. As you heard earlier, that industry is continually looking for new recruits to replenish those it loses through morbidity and mortality, and that will happen in the UK as well unless we get this right.
Q
Professor Linda Bauld: This is quite a comprehensive piece of legislation, with lots of different pieces, so I will give a couple of examples. One area we looked at was protecting more places from second-hand smoke, and the health benefits of that to people who are vulnerable—people with asthma, respiratory conditions and cardiovascular disease—are very immediate. When the smoking ban came in in England in 2007, I did a study looking at admissions to hospital from myocardial infarction after the legislation was introduced, and in the first year we saw substantial reductions in admissions to hospital for heart attacks. So I think some things will be quite quick.
In terms of the pregnancy question, if a woman is not smoking during pregnancy—some of the measures encourage that—the health benefits to the mum and the baby are immediate and long lasting. I also mentioned the modelling statistics on driving down prevalence, which is obviously going to take more time. There are then the regulations to protect young people from vaping, some of which will, I think, have quite a big effect if they prevent somebody from taking up vaping at all, and some will take a bit longer in terms of driving down the rates. It is a balance.
The final thing I would say is—this is my opportunity to make this point, as you would expect—please, let us make sure that we do the research. We must support the academic community to do the research to monitor how the Bill is implemented, so that we can provide evidence that what colleagues have put forward and decided to do actually makes a difference. Other countries will then be able to look at that evidence and make up their own minds.
Q
Secondly, linking to the economic argument you made earlier, you are right that deprivation is key. There is more smoking in deprived communities. I have asked all the witnesses this question. Is there a concern that because of the concurrency of people vaping and smoking, the people who are doing both will move to an economically cheaper option—that is, pick up smoking again because vapes might become more expensive because of other measures that are introduced? Has that concern been raised in academia?
Professor Linda Bauld: Let me start with the first part of your question. Those data come from the Action on Smoking and Health survey covering Great Britain, which was funded by Cancer Research UK and conducted by YouGov for ASH. Those harm perceptions are really concerning to me because we do not want people who have never smoked or young people to be vaping but, from the evidence I have seen, if more of those 6 million smokers could switch to vaping, we would see health benefits. I think those misconceptions are largely driven by the media and some of the myths—the really harmful stories that get the front page. We need to deal with that and make sure that health professionals and others are empowered to give accurate advice about vaping. We have got a distance to run on that, and anything that the Bill can do to assist that would be welcome.
On whether people who are dual using, which is a significant proportion of smokers, are more likely to switch to smoking if we take action on, for example, removing point-of-sale displays or take other measures on vaping, I am actually not sure about that. The key point is that we need to continue to make smoking more expensive than vaping and to make sure that we address the availability of tobacco in our environment and in different settings. If we can keep that balance to show that vaping is a good option for cessation and is more affordable than cessation, while we keep doing the research on it, I would be optimistic that we are not going to see masses of smokers who are currently vaping to cut down just switch back to smoking in its entirety—hopefully.
Q
Inga Becker-Hansen: I think the key would be guidance for retailers on implementation and how the measures will be carried out. Again, there is the idea of encouraging a consumer-facing public awareness campaign that highlights the new restrictions and the safeguards for shop and retail workers so that, when the new regulations go through, the public are aware of the changes.
In any new secondary legislation, we would encourage alignment within the regulations themselves and across the devolved nations so that it is clear and consistent.
We can squeeze one more in if anybody wants to ask a question. I thank the witness for giving evidence.
Examination of Witness
Matthew Shanks gave evidence.
Q
Professor Steve Turner: The children who are exposed to second-hand smoke in the home are over-represented among children with respiratory symptoms. Parents do not want their children to smoke, so they feel torn. They are conflicted: they are addicted to nicotine, but they do not want their children to smoke, and having a smoke-free generation will address that almost impossible parental conflict.
Q
Professor Steve Turner: I support the Bill as it stands. I think that the onus has to be on the vendor not to sell, not on criminalising the customer or the child.
Q
I am particularly thinking about vaping here, given that I think there is pretty unanimous agreement on the tobacco side. Therefore, just on vaping, is there any more that you think the Bill could do, not necessarily in terms of vaping as a cessation tool to support the transition from smoking, but in terms of preventing people—obviously children, but even just adults—from beginning that journey and vaping in the first place?
Professor Sanjay Agrawal: From my standpoint, there are the online harms—for example, through social media, gaming and music videos. It is a wild west out there—regarding both tobacco and vapes, actually—and there are lots of depictions that lure people in. There is a lot of advertising and promotion of both tobacco and vaping products. I think that that online and social media area is the one area that we could do much more with. That would strengthen the Bill further.