Brain Tumours

Julian Lewis Excerpts

Monday 18th April 2016 Westminster Hall

[Helen Jones]

Again, we were given various reasons when we took evidence, and we want the Government to consider the matter carefully. There is no doubt that if we are to improve scanning procedures, we must accept that a number of scans will come back clear. The issue is, what proportion that comes back with no tumour shown is acceptable? Surely it is better to invest in a scan than to let a tumour grow, because later treatment is much more difficult, complex and costly. We want more people to have access to scanning.

Early diagnosis is important, but it will not solve the problem without more research. Despite the excellent scientists and clinicians who gave evidence to the Committee, there is no doubt that they are working in an underfunded system. The Government response to the petition said that about 1.5% of cancer spending is devoted to brain tumours, but that includes fundamental research and non-site-specific research.

The National Cancer Research Institute told us in evidence that some non-site-specific research undoubtedly benefits brain tumour research, but it was unable to put a figure on that. We heard from Professor Tracy Warr of the brain tumour research centre at the University of Wolverhampton that brain tumours are less likely than other cancers to benefit from non-site-specific research because of their complexity and location, and the blood-brain barrier, which means that drugs that work in the bloodstream do not transfer to the brain. That is an unscientific explanation, but I am sure hon. Members will know what I mean.

We found that spending records are very unclear. The Government’s own records are not clear. The National Cancer Research Institute was unhelpful when trying to find out exactly how much of the spending benefited research into brain tumours and there is no central record of spending by people who are not partners with the National Cancer Research Institute. There is no doubt that spending is low. The only figure that we can be certain of is the 3.3% of spending on site-specific research, which is about £7.7 million a year. At that rate of progress, it is estimated that it would take 100 years for the outcome for brain tumours to be as good as for many other cancers.

[Dr Julian Lewis (New Forest East) (Con)]

Does the hon. Lady agree with the assessment of my constituent, Mrs Alison Hutchman, who has been living with what she calls “this devastating disease” for the last six years, about that estimated time of 100 years? Why is this terrible disease so low down the priority order?

I saw the recent death of my friend, Richard Webster, at the age of only 50, from a brain tumour, despite the loving care of his family and his long-term partner and later husband, Jamie Norton. I know only too well, as only someone who has seen it can know, what is entailed when this disease strikes.

[Helen Jones]

I am grateful for the right hon. Gentleman’s intervention and I agree with his constituent. Brain tumours are perceived to be rare, although my argument is that they are not as rare as we think and the number of life years lost and the burden of the disease mean they have to be tackled. We know there is a correlation between the amount of money spent and survival rates in cancer. Survival rates for those with brain tumours went up by only 7.5% between 1970 and 2015. For cancer overall, they have doubled.

Junior Doctors Contracts

Julian Lewis Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

With respect, not very far away from the hon. Lady’s constituency is the Salford Royal, whose very respected chief executive concluded that a negotiated outcome was not possible. That is why I reluctantly took the decision to proceed with the new contracts. As for the studies on mortality rates, we have had eight studies in the past six years, six of which have said that staffing levels at weekends are one of the things that need to be investigated. The clinical standards say that we need senior decision makers to check people who are admitted at the weekends, and junior doctors, when they are experienced, count as senior decision makers, which is why they have a very important role to play in delivering seven-day care.

[Dr Julian Lewis (New Forest East) (Con)]

I know that the BMA very properly balloted its members before embarking on a policy of industrial action, but has it yet balloted junior doctors on the specific question of withdrawing emergency cover?

[Mr Hunt]

No, it has not, and I think that is what is causing many junior members to pause for thought. Many people say that this escalation is something that the BMA should consults its members on, once again.

Junior Doctors: Industrial Action

Julian Lewis Excerpts

Thursday 24th March 2016 Commons Chamber

[Mr Speaker]

There is much interest. I will start by calling not a medical doctor, but a generally brainy bloke, Dr Julian Lewis.

[Dr Julian Lewis (New Forest East) (Con)]

I am greatly obliged, Mr Speaker, as always. Will the Minister tell me whether, having quite rightly balloted its members on general strike action, the BMA has balloted the junior doctors on the withdrawal of emergency care?

[Ben Gummer]

My right hon. Friend raises an important point. I believe that the legality of the action is correct and that the BMA is within its rights to do as it is doing, but that does not change whether it is right or wrong. Many junior doctors who may have supported the BMA in the withdrawal of elective care will be profoundly worried about that escalation.

Junior Doctors Contracts

Julian Lewis Excerpts

Thursday 11th February 2016 Commons Chamber

[Mr Hunt]

As someone who I fully concede may have more experience of industrial relation disputes than me, let me just say this: it is very clear that we are able to progress when there is give and take from both sides; when both sides are prepared to negotiate and come to a deal that is in the interests of the service and in the interests of the people working in the service. That was not possible. It is not me who is saying that; that is was what Sir David Dalton, a highly respected independent chief executive, said in the letter he wrote to me last night.

Some of the things that the BMA put out about the offer—for example, it put up on its website a pay calculator saying that junior doctors were going to have their pay cut by 30% to 50%—caused a huge amount of upset, anger and dismay, and were completely wrong. I do not think it would be very constructive for me to put in the House of Commons Library a list of all those things, when what I want to try to do is build trust and confidence. The differential between doctors and other workers in hospitals is what the BMA was seeking to protect. It still exists, but we have reduced it from what it was before because we think it is fairer that way and better for junior doctors.

[Dr Julian Lewis (New Forest East) (Con)]

May I add to what my long-time comrade, my hon. Friend the Member for Gainsborough (Sir Edward Leigh) said by delving into a bit of history? In 1977, I was knocked off a motorcycle by a careless driver on a Sunday. Because staff were not in the hospital, the wound could not be cleaned until it was x-rayed and because the wound could not be cleaned, I got an infection. This is not just about increased mortality rates; it is about the prolongation and exacerbation of small or routine episodes and injuries. Will the Secretary of State, in his calm and measured way, say again to the House that when we look back on this episode people will be very surprised that it took nearly 40 years—from my accident—to bring about this long-overdue reform?

Cities and Local Government Devolution Bill [Lords]

Julian Lewis Excerpts

Monday 7th December 2015 Commons Chamber

[Peter Heaton-Jones (North Devon) (Con)]

rose—

[Dr Julian Lewis (New Forest East) (Con)]

rose—

[Mr Speaker]

Ah, what a rich and delicious choice! I call Mr Robert Neill.

--- Later in debate ---

[Mr Betts]

I thank the Minister for his helpful comment. Perhaps more discussion could have been had before we reached this point; that might be something that everyone could learn from. The Minister’s intervention has been helpful to me and I thank him for it.

[Dr Julian Lewis]

rose—

[Peter Heaton-Jones]

rose—

--- Later in debate ---

I warmly welcome the new clause. It is also welcomed by the heads of Exmoor national park—I have spoken to them about this issue in great detail since Thursday. All other national park authority managers welcome it, and I know that they have been in conversation with the Minister. I warmly welcome that because the new clause will be good for Exmoor, and good for the rest of our national parks.

[Dr Julian Lewis]

I thank you, Mr Speaker, for drawing such attention to the fact that I “beetled” into the Chamber, as you put it, rather late, and I apologise for that. I also apologise for the fact that unfortunately I am going to beetle out of it again rather early, for the same reason that I was late, namely Defence Committee business. I am delighted to have the opportunity of this small window to try to reassure those on the Opposition Front Bench. I hope that they will take my reassurances seriously, as I was one of only three Conservative Members to vote against the scheme for privatising the forest estate, which the hon. Member for Heywood and Middleton (Liz McInnes) referred to in her remarks. I am not one to accept on trust everything about forests that the Government put forward.

Having said that, the Government deserve a big pat on the back for this measure. It is often said that the Government do not listen, but this is a classic case of their having listened. [Interruption.] I would be grateful if those on the Opposition Front Bench also listened for a moment, because I am directing my speech at them in an attempt to be helpful.

The chair of the New Forest national park authority, Mr Oliver Crosthwaite-Eyre, is a former official verderer of the New Forest and very highly thought of by all those who live and work in the forest and are concerned with its management and protection. He contacted me some time ago to ask if it would be possible to persuade the Government to include such a provision in the Bill in Committee. Sadly, that stage had just concluded, so it shows extraordinary flexibility and willingness to listen by the Government in general—and by the Under-Secretary in particular—to manage to include the provision.

I fully sympathise with the Opposition spokesmen, because new clause 7 is a lengthy provision, and it is their job to scrutinise measures, whether they are long or short, but particularly if they are long. I should therefore like to try to reassure them about new clause 7 by reading two brief extracts from a document supplied by National Parks England specifically for use in our debate. It says:

“National Parks England (the umbrella body for the NPAs) warmly welcomes the tabling of New Clause 7 by Ministers and hopes that you”—

meaning me—

“will be able to speak in support of it at the Report Stage debate of the Bill on Monday 07 December 2015.”

It then gives a long list of the reasons why it supports the extension of powers, which are similar, it points out, to powers given to many comparable bodies. It ends by referring specifically to the new clause:

“New Clause 7 follows the legislative format established for other public bodies. National Parks England supports this amendment and would encourage MPs to speak in support during the Report Stage debate on the Bill.”

I understand the difficulty in which Opposition spokesmen find themselves, given that a clause of such complexity has been tabled at short notice. I hope that I have been able to reassure them that national parks themselves warmly welcome the clause. I do not think that it is a conspiracy. I have had occasion in the past to point out conspiracies when they crop up, but I do not think that this is an occasion for concern about conspiracies—on the contrary, it is an opportunity to congratulate Ministers, including the Under-Secretary, on listening, being flexible and making a change at, indeed, the eleventh hour. That change deserves to be made if we are to show our trust in the judgment of the national park authorities themselves.

[James Wharton]

I do not intend to speak for long. I merely wish to record my thanks to hon. Members who have contributed to this debate. We began in a contentious place, but we have, I hope, moved towards consensus. I acknowledge the contributions of right hon. and hon. Members, including my right hon. Friend the Member for New Forest East (Dr Lewis), who has been vociferous in making the case and with whom I have exchanged a significant quantity of correspondence, for bringing this to the Government’s attention and suggesting that it be included in the Bill. The measure is welcomed by national parks and by many hon. and right hon. Members. I hope that it will be welcomed, too, by shadow Ministers and that we can move forward in a more consensual way in the rest of today’s debates. Regardless, I commend the changes to the House. They are welcome and they are important.

Question put, That the clause be read a Second time.

Contaminated Blood

Julian Lewis Excerpts

Monday 20th July 2015 Commons Chamber

[Ben Gummer]

I thank the hon. Lady. It is a good example of the new mode of working between our Governments that officials in the Department of Health have been working very closely with their counterparts in the Scottish Government. Of course, most of the events that the Penrose report refers to were pre-devolution. It is therefore entirely right that the recommendation is adopted across the United Kingdom, not just in Scotland. I expect that cross and close working will continue through the course of the settlement process.

[Dr Julian Lewis (New Forest East) (Con)]

My constituent Lesley Hughes was infected with hepatitis C 45 years ago, but the condition was discovered only relatively recently. Given that she is an older sufferer, the standard drugs do not agree with her or assist her to the extent that the new generation of drugs would. Is there a timescale that I can offer her to give her hope that she will be able to move from the less effective and less tolerable drugs to the new generation of drugs?

[Ben Gummer]

My right hon. Friend raises an important point. He may be aware that the Government have launched an accelerated review of hepatitis C drugs, and the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), will be updating the House as soon as he has news on that. At the moment, I am afraid all I can promise is celerity rather than certainty.

Epilepsy

Julian Lewis Excerpts

Thursday 26th February 2015 Commons Chamber

[Steve Baker]

I am extremely grateful to my right hon. Friend. I have already passed the details to the Minister. I am aware of the inquest and the NHS investigation, but I will certainly take her advice and give those other bodies the opportunity to investigate.

That brings me on to the specific issue of consent. I have spoken to Mr and Mrs Monks today and they say that at no point was it explained to them that this medication could have these side effects. Jessica was 17 when she started taking it, and I feel that that possibility really should have been explained to her parents. They should have had the opportunity to take very strong action. Of course, they did take very strong action—they took the strongest action they could—and it seems to me, without wishing to pass judgment, that the key problem was that they could not get hold of the neurologist.

[Dr Julian Lewis (New Forest East) (Con)]

I am puzzled that the instructions that came with the medication did not include a warning that if someone had those sorts of side effects, they should cease taking it.

[Steve Baker]

I am a layman, but one of the things I have learned today is that one cannot simply cease taking medication for epilepsy, so specialist advice is required.

Oesophageal Cancer

Julian Lewis Excerpts

Monday 23rd February 2015 Commons Chamber

[Mike Weatherley]

My hon. Friend makes a very important point that I was not going to cover, and I thank him immensely for doing so.

Crucially, as with many other types of cancer, the outcome of oesophageal cancer depends on how advanced it is when it is diagnosed. The reason not many people can have surgery is that by the time a difficulty in swallowing is recognised, the tumour has become fairly large and has spread. As my hon. Friend pointed out, the surgeons see most people when they are already too late for curative treatment, which makes it difficult to identify survival rates for each individual stage of the disease.

What measures would I like the Minister to consider? Let me make six points. First and, I think, most important, we should make the process of seeing the doctor much easier. No one should be put off from making an appointment at the first available opportunity. Access to evening and weekend GP clinics remains patchy at best, and, as we know, that has a knock-on effect on A and E departments.

Secondly, we should make every effort to improve testing at the point of contact with GPs, and to ensure that there is rapid follow-up access to hospital diagnostic tests. Giving some GPs direct access to hospital specialist tests such as endoscopies and CT scanning would speed up the process of diagnosis.

Thirdly, we should educate patients so that they recognise the symptoms of oesophageal cancer. That will lead to earlier detection of cancer, which in turn will lead to higher survival rates. A good oesophageal awareness campaign is currently running on television.

Fourthly, 1 believe there are some “quick wins” which, if implemented, could speed up processes, remove inefficiencies and save money. For example, at the moment if someone is referred for a chest X-ray and the findings are abnormal, the results go back to the consultant or GP and the person has to have another appointment before they can be referred for an additional test, such as a CT scan. If a chest X-ray was found to be abnormal and the person was then referred straight for a CT scan, it would save on unnecessary GP or consultant appointments, and ensure that when the person is seen, their GP or consultant has all the information they need to make a diagnosis and set out next steps.

Fifthly, another factor in poor care is that it is almost invariably because of pressure on specialists due to the volume of work. When campaigns are announced by the Government, they create a surge in demand, which causes problems for medical staff because they cannot cope with the high volume of work. I would like the Minister to consider allocating extra resources for endoscopy. Targets and high outputs mean that patients are treated as statistics rather than as individuals. Take this quote, for example, from an upper-GI surgeon:

“I get lists of potential 62 day target breaches with no details of the patients themselves. We see about 20 patients in two hours in our cancer clinic on the one morning we have for these appointments—that equates to just six minutes per patient. In order to give patients dignity and respect, most doctors would need an hour per patient to talk them through their diagnosis, treatment and surgery.”

Here is a similar point direct from another specialist surgeon:

“I fully support the ‘Action Against Heartburn’ organisation emphasising the need to take seriously symptoms of persistent heartburn and dysphagia, and not having more and more medications without investigation.”

This will increase demand on endoscopy services significantly, as well as CT scanning, which of course would need extra funding to cope. However, the increased detection of early disease will enable more minimally invasive endoscopic therapy, avoiding surgery and saving money.

[Dr Julian Lewis (New Forest East) (Con)]

I recently had the advantage of an intensive briefing on oesophageal cancer from Professor Tim Underwood, a specialist at Southampton general. My hon. Friend may be interested to know that it is developing a technique that would enable the discovery of the cancer cells earlier and without an endoscopy being carried out. Research is constantly going on to try to remedy the very problem that he has identified so clearly.

[Mike Weatherley]

I thank my hon. Friend for that intervention, and my surgeons have made similar points to me. Clearly the tools are available to do that.

The sixth strategy I recommend is greater hospice care to provide end-of-life care away from hospitals that supports people and allows them to spend their final weeks and days in a place of their choice, rather than in a hospital bed.

I hope that this short Adjournment debate has two positive outcomes. The first is an increased awareness of this cancer, with many more people detecting problems earlier. If we can save lives through early detection, that has to be a good thing. The second is a commitment to additional specific resources. Of course this would mean more money being allocated, and I am well aware that there are huge conflicting demands on limited budgets, but part of this could be achieved by a quicker, more efficient diagnostic procedure. Our radiotherapy capacity is far short of what we need and access to the latest advanced techniques to spare normal tissues is limited—although I would stress again that, as my hon. Friend the Member for New Forest East (Dr Lewis) said, we do have diagnostic tools to deal with this disease and change outcomes, so it is not a huge step to save more lives.

I look forward to hearing the Minister’s comments and, hopefully, Government determination to be on the patient’s side in treating this particular cancer. We really do need to improve on just 15% of patients living longer than five years once diagnosed.

Child and Adolescent Mental Health Services

Julian Lewis Excerpts

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

I am grateful to the hon. Gentleman for his generous remarks—perhaps he ought to talk to his Front-Bench colleagues about my commitment. He is absolutely right to highlight the fact that although there is quite a mixed picture across the country, in many areas there has been disinvestment in children’s mental health services. They are local decisions, and they are not decisions that I accept. That is why I made the serious point about the absolute importance of introducing waiting time and access standards, including in children’s mental health services. We need data so that we can monitor performance against those standards, and we need a payments system that does not disadvantage mental health. I also share his view that we need to change the way services are organised and commissioned so that we focus much more on prevention.

[Dr Julian Lewis (New Forest East) (Con)]

Does the Minister accept that this is a matter not only of funding but of philosophy? Does he agree that part of the problem is that certain primary care trusts have adopted a philosophy of cutting in-patient beds generally? For example, adult beds have been cut by 35% in areas as far apart as my constituency and that of my hon. Friend the Member for Burton (Andrew Griffiths). Does he detect any rowing back from that rather extreme philosophy in the near future?

[Norman Lamb]

We want to try to ensure that when there is a crisis, a bed is available locally. With regard to the philosophy of seeking to reduce the tendency to have long periods of in-patient care—institutionalising people—it is absolutely right that we move away from that and focus far more on early intervention, community support and recovery. That is the general trend in progressive views within mental health. However, there must be a bed available when a crisis occurs.

Contaminated Blood

Julian Lewis Excerpts

Thursday 15th January 2015 Commons Chamber

[Dr Julian Lewis (New Forest East) (Con)]

Mr Deputy Speaker, having come late to the debate because of a clash with a meeting of a parliamentary Committee on which I serve, I am grateful for the indulgence of the Chair in allowing me to make a brief contribution.

I wish to focus on three points. The first is that people are still, even now, long after the event, being discovered to have been infected with contaminated blood; the second is that momentum for a settlement is in danger of being lost; and the third is that the best treatment is not always available for those who have been infected.

I was struck by what the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke) and others said about the debate being a chance to give a voice to individual constituents. I was also struck by the question asked on 10 December of the Deputy Prime Minister, who was standing in for the Prime Minister, by the hon. Member for Coventry North West (Mr Robinson), because he said in that question what he repeated today—that the scandal had reflected badly on successive Governments, possibly going back as far as that of Harold Wilson, if not further. In the context of momentum being lost, he said that the Prime Minister had undertaken in June to look at and rectify the situation. In fact, according to my constituent, Mrs Lesley Hughes, who only a week before he asked his question had got in touch with me about this very issue, the Prime Minister had apparently told one of his own constituents who was affected by this that he hoped to have a resolution within six months. This would have meant the end of the last calendar year.

I said that my first point was that people are still being discovered who were infected long ago, and that is Lesley Hughes’s situation. In 1970, she and her future husband were involved in a very serious road traffic accident in London, and she had to receive no fewer than 44 pints of blood. For many years she knew nothing about the fact that she had been infected, although over those years she had many visits to GPs and hospitals with numerous symptoms of illness, and considerable pain and suffering. Only last year was it finally discovered that she had been infected with hepatitis C by NHS contaminated blood. Her main concern in writing to me initially was that, given that the Prime Minister had said that he hoped to wrap the issue up himself, she was really anxious that we should not get to the general election—which is, after all, scheduled to be about five months after the deadline that the Prime Minister had set himself—without reaching a resolution.

[Mr Robinson]

I am not sure that the exact undertaking that the Prime Minister gave is recorded anywhere, but it is recorded in exactly those terms by my constituent, Joseph Peaty, as well. Does the hon. Gentleman agree, though, that the impression was left that the Prime Minister would do his very best to get a settlement by the end of the year? We are past that deadline now. Does he agree that, irrespective of the reports being compiled, we do now have the means necessary to settle the issue, and that is what the Prime Minister should try to do?

[Dr Lewis]

That is exactly my view, and for that reason I wrote to the Secretary of State for Health, drawing attention to the matter. I received a reply dated 12 January from the Minister who will reply to this debate. Of course she was sympathetic in the terms that she used, but the important part of her letter was the conclusion, which was that

“this issue is being looked at very seriously, and…an announcement will be made to affected individuals and MPs once work has been concluded.”

My simple question to the Minister is, when will that work be concluded, and will she and the Prime Minister undertake to get this work concluded, on behalf of my constituent and many others, before this Parliament comes to an end? Otherwise, we are back to square one—a cycle which I am sure has been repeated over and over again.

Finally, I said that I would mention the other point about how the best treatment is not always available. I understand from Lesley, whom I have not met yet but whom I believe to be present with her husband today, and whom I hope to meet after the debate, that there are problems with the fact that many people suffering from infection are offered the older interferon and ribavirin-based treatment, and that not everybody can tolerate that, particularly as it takes a long time to clear the system, and particularly if they are people who are at a later stage of their life.

If the Minister cannot answer today, will she perhaps write to me later about the situation of patients in that position? Kinder and more effective treatments are available, but are not always sanctioned for reasons of cost either by NICE or by individual health trusts. I wish to give others the opportunity to speak, but once again I thank my constituent for her bravery in allowing me to tell her story and attribute it to her, and I thank the House for its indulgence in allowing me to contribute to the debate at such a late stage.