Covid-19: Contracts and Public Inquiry

Lee Rowley Excerpts

Wednesday 7th July 2021 Commons Chamber

[Lee Rowley (North East Derbyshire) (Con)]

I am grateful for the opportunity to contribute to this debate.

I start by saying something with which I hope most Members can agree: I welcome the announcement of a public inquiry and I am glad that the Government are committed to learning the lessons from one. After the most unprecedented time of our lives, when there was no prior institutional memory of what was likely to happen and the risk calculation suggested that a pandemic based on coronavirus was extremely unlikely, we none the less need to learn lessons from what we have gone through and work out how, if there is ever a future pandemic, which I hope there never will be, we ensure that we approach it differently. We must also try to learn lessons from a wider community, society and government perspective.

If we all agree with the concept of a public inquiry, that there are lessons to be learned and reviews that need to happen, and that we need to understand how to work better in future, what do we disagree on? Why are we here, other than for another debate to push forward the suggestion of Scottish independence, in all but another name? The right hon. Member for Ross, Skye and Lochaber (Ian Blackford), who is no longer in his place, said clearly that he wishes to see a public inquiry this year; the first obvious thing on which we disagree, then, is the question of when. I acknowledge that there are arguments for both—I understand and accept that there is a logic to a quick inquiry and a logic to a longer one—but to me the basic premise is that an inquiry should have the opportunity to review what has happened calmly, and not while in the middle of or even near the challenges, or while we run the risk of those challenges coming back. That does not seem to be an inappropriate approach to take.

We have obviously made a huge amount of progress in recent months in terms of resuming normal life and hopefully being able to move back to what we did previously when we get to 19 July, but it remains the case—I presume that, when we pull back all the hyperbole and political machinations, everyone in the Chamber would accept this—that we are not necessarily absolutely and completely out of the woods yet, and throughout the winter a huge amount of work is going to have to be undertaken to make sure that we hold the line and do not go back to lockdowns and the like, to which we do not want to go back. With that in mind, I simply do not understand how we could conclude, on the balance of risk and the weight of evidence, that the inquiry should start immediately, or nearly immediately, when that would almost be guaranteed to take capacity out of our ability to prevent or reduce the chances of any problems over the coming winter. I think most average men and women on the street would accept that.

The second thing on which I fundamentally disagree—or on which those on the Government and Opposition Benches seem to disagree—is how cautious and careful we want to be about the conclusions we draw. I want to learn lessons from this pandemic; it is clear that there are lessons to be learned. I want the Government to improve and to be as effective and as efficient as they can be in terms of their procurement and processes—I say that as somebody who served on the Public Accounts Committee for 18 months in the previous Parliament and saw lots of examples of where we need to improve—but we forget the context of last year, simply to score political points, at our peril.

On procurement, the hon. Member for Inverclyde said that any junior procurement officer would understand from day one exactly how they should approach this. Well, any junior procurement officer would understand from day one that the circumstances of last March and April were entirely extraordinary and are unlikely to be repeated. The concept of procurement is to ensure a process that takes time to get a satisfactory outcome, but if we do not have that time then we have to accept that we are undertaking a prioritisation exercise that pits time against outcome.

If there are people on these Benches, including the hon. Member for Inverclyde, who genuinely think we should have gone through the process of tender, submissions, reviews, notices of publications, cool-off periods, mobilisations and all the things that so many of us who have operated either in local government or in this place for many years know about and understand—we understand the amount of time it takes to get through them—then they should come to this Chamber right now and argue that in March and April last year we should have put out a series of call to tenders for things we needed in our hospitals, our care homes and across our society. That was simply not proportionate or reasonable.

[Joanna Cherry]

I do not think anyone is suggesting that there should not have been an emergency contract tendering process. What people are suggesting is that there should not have been bias in who the contracts were awarded to. That is what the courts said.

--- Later in debate ---

[Lee Rowley]

I am so grateful for the hon. and learned Lady’s intervention. She just spent about two minutes talking to this Chamber about the difference between bias and apparent bias, and she has just conflated the two points to make a political point.

On the need to be cautious and careful in the conclusions we have drawn, I just say calmy and gently to Members that there were opportunities for two approaches last year, and we should be very careful about drawing a conclusion on one that would not have put us in the best place to deal with the problems we were seeing last spring in an already very difficult circumstance.

Finally, what we clearly and obviously disagree with is the utility of the inquiry. All those who are calling for the inquiry to be brought forward and asking for additional scrutiny, as the hon. and learned Member for Edinburgh South West (Joanna Cherry) rightly went on about, do not actually seem to want to scrutinise things or to be that interested in the evidence, because they have made their decisions already. The level of hyperbole, smear, rumour, gossip and assertion in this debate, from the moment it was started in that unseemly way by the right hon. Member for Ross, Skye and Lochaber, shows that they are not interested in having a cool, calm and collected discussion about how we learn lessons, make things better and ensure the inquiry puts us in a better place if we are ever to suffer this or something similar again. They have decided what their answer is. They know what the outcome is. They know what the conclusion will be, and I certainly disagree with them on that basic premise.

Should lessons be learned? Yes, absolutely. Should an inquiry happen? Definitely. Should we do the exact opposite of what the SNP and to a lesser extent Labour have done and not seek to predetermine the outcome before we draw conclusions? I would certainly think that that was relatively sensible. Do I expect problems to be found and that things will need to be done better next time? Of course I do. That is the point of an inquiry. Will we, in a mature political democracy, acknowledge the difficulties of last spring in simply trying to ensure we had the things we needed at a time that we were never expecting and that it was never reasonable to assume would happen? Well, I certainly would, and I hope, in a cool, calm and collected way, that some of those who have engaged in hyperbole in this debate will acknowledge that too when things are not quite as political as this debate has been. Should we play political games with this? No, we should not. The one thing I agree about with the right hon. Member for Ross, Skye and Lochaber is that these are serious matters. They deserve to be treated with seriousness as a result.

Covid-Secure Borders

Lee Rowley Excerpts

Tuesday 15th June 2021 Commons Chamber

[Lee Rowley (North East Derbyshire) (Con)]

Thank you, Madam Deputy Speaker, for the opportunity to contribute to the debate this afternoon. I rise to speak not because I do not accept that coronavirus has created acute and challenging issues on the border, not because there are not difficulties and constraints for many people around the UK who either need or want to travel abroad and not because there are not real challenges for the aviation and transport sectors caught up in a maelstrom created by one of the most unprecedented times in our lives—there are and I absolutely accept those challenges and those difficulties, which I do not think anyone in this House would question. However, the question for this place today is not about that; it is about what the Government could do and what it was reasonable and proportionate for them to do.

In a year of difficult decisions, border policy is a particularly difficult one to get right. Too prescriptive and the United Kingdom runs the risk of withdrawing unnecessarily from the world and of leaving its key role as a member of the international community, all for limited to no economic, societal or health benefit and, compounding that—which then creates an effective Catch-22—the UK’s approach would in effect be determined by things that it does not have primary responsibility over. On the other hand, too laissez-faire, and we run the risk of squandering the great advantages we have built with vaccinations.

Given that tremendously nuanced and sensitive situation, one would hope that border policy could be determined and discussed with a similar level of nuance and sensitivity, but this is of course an Opposition day debate, and as has been the case for the four years I have been in this Chamber, such hopes are dashed each time. Frankly, the illogical arguments we have heard so far from the other side of the Chamber—so eloquently outlined by the hon. Member for Weaver Vale (Mike Amesbury), who is no longer in his place—are more a reflection of how this is just another political stunt than a serious attempt to scrutinise the Government, hold them to account or provide constructive attempts to improve the policy.

In the coming weeks, we are going to be one of the first large countries in the world to be pretty much as vaccinated as we can be. In time, that should, and hopefully will, open up new opportunities so that in the coming period, when we are going to need to work meaningfully to properly restart parts of life such as international travel, we should be looking at broadening the tools at our disposal, recognising new ones and accepting that we have a set of balanced judgments to make.

Knowing full well that this is the situation, what does the Labour party propose? Not nuance, sensitivity or thought, but instead, exactly the opposite: the removal of one of the tools—one of the lights of the traffic light—that allows us to take different approaches for different countries, dependent on different situations. We can debate which countries go into which traffic light colour, but surely it is reasonable that there can be more than two options for international travel in the coming months as we try to get it going again.

Secondly, if the Labour party does want a completely binary proposition for international travel, which, by default, can be only no travel or travel, perhaps it could articulate how that is sustainable over the long term and what criteria it would apply to flick the switch from “Don’t travel” to “Do travel” with nothing in between. For countries where the risk is reducing, do we keep them on the red list longer than is necessary for no advantage to our country, or do we move them to the green list in advance of us being totally comfortable with them being there?

If the amber list is going to be abolished, how do the Opposition propose to resource that? Hotel quarantine is a difficult policy and one that appears sustainable at only a relatively small scale. As places such as Australia have shown, there is challenge and unintended consequences within that—people who cannot get home, important family or medical trips that are difficult to go on, and so on. Will Labour stop British citizens coming to the UK, and could Labour Members explain how they are seeking practically to make a policy work that is already strained for a country of 20 million people with 20 million visits and which they are now apparently seeking to try to apply to a population of 70 million, with 145 million visits?

There has also been a liberal sprinkling of references to the arrival of the Indian variant in the UK, starting with the shadow Home Secretary, the right hon. Member for Torfaen (Nick Thomas-Symonds), and then the hon. Member for Weaver Vale. There have been nebulous suggestions that this could have been prevented with greater border control. That is just not correct. The Labour party appears to be arguing with science. The Indian variant was here on 22 February, a full month before even the Indian Government highlighted to the international community that there was a variant. Borders were closed 22 days before the World Health Organisation declared the strain a variant of concern. Right now, according to GISAID, on a small sampling, the variant is dominant in Russia, Canada, Indonesia, Pakistan and Malaysia, and is on its way to being dominant in the USA, Japan, Thailand, Portugal, Luxembourg, Bangladesh, South Korea, Qatar, Finland and most likely many other countries. If the Labour party has a viable proposition for international travel, I would like to hear it, because it has not been articulated yet.

Covid-19

Lee Rowley Excerpts

Tuesday 12th January 2021 Commons Chamber

[Lee Rowley (North East Derbyshire) (Con)]

It is a pleasure to be able to contribute to this debate. In doing so, I thank again everybody in North East Derbyshire for everything that they are doing. In the most difficult period of our lives, what our constituents have done, are doing and will continue to do is incredible. We will get through this together, and I thank them for everything.

Today, I want to focus on the last mile in front of us and a very vexing part of the public debate around that. It is hard to believe that only a year ago today the World Health Organisation confirmed the existence of a coronavirus in China. That year has felt like 10. The virus has turned our lives upside down repeatedly and yet, ragged, weary and older, we persist.

Even as the light draws nearer, with the vaccinations, we still have much work to do. Even with hundreds of thousands of jabs going in arms on a daily basis, suppression at this last stage remains vital. Yet every day, I am contacted by residents who remain unsure about the strategy that we are pursuing and who rightly challenge and question. They are absolutely right to do so.

Most accept the position once we discuss it.

A small number remain unsure; they want to be supportive of the Government’s actions, but they are buffeted by the continual suggestions—particularly on social media—that the virus is some kind of collective mirage. Given the siren voices on those media, I can see why the alternative view is so alluring. They suggest easy choices, benign realities and soft landings—that we are in a casedemic; that the pandemic was over in the summer. It would be fantastic if that were true, yet it is not.

This tiny, unrepresentative group, basking on past glories or extended CVs, continues to argue against reality. For a time, I thought they were valuable voices of scepticism in the debate; then, that they were just wrong. Now, I am not sure I can accord them that benign intent.

[Bob Stewart]

My hon. Friend is absolutely right. I entirely agree. It seems to me that someone does not need to go to medical school or law school or any other professional establishment to get a qualification these days; they can become a professor just by going on the internet.

[Lee Rowley]

I am grateful for that contribution from my hon. Friend. It highlights that just because somebody has a certain number of letters after their name or a title in front of it does not necessarily mean that we should not apply the same element of scepticism to what they say, particularly when they are saying things that are not accurate. This small group of people operate in a grey space, suggesting that because something is not happening right now, it is impossible for it to happen and that it cannot possibly be the case that there may be catastrophic outcomes if we are not careful.

I should be clear: I do not seek to silence these people. They are free and should always be free to make their statements, whether they are correct or otherwise, but I seek to highlight that they are wrong. What they assert, they must justify, and when they cannot—as was the case when I spoke to one of them directly a few months ago about repeated assertions on the inaccuracy of the PCR tests—they should be treated with the disdain that they all treat us with by making these false assertions in the first place.

Our hospitals are full. Our death statistics are high. We can see the virus in our communities. On this last mile, please do not listen to these people. We will get there and hold on. Together, we can do this.

Covid-19

Lee Rowley Excerpts

Wednesday 11th November 2020 Commons Chamber

[Lee Rowley (North East Derbyshire) (Con)]

I am grateful for the opportunity to speak today.

It is incredible how quickly things change. The last time that I properly spoke in this Chamber about coronavirus was in September when virus rates were lower, restrictions were looser and hospitals were emptier. Covid continues to dominate us in a way that we never wanted it to do and our lives remain shaped by the battle against it. Throughout it all, however, there has been one constant: the continuing resolve of everyone to get through this.

I want to say thank you to everyone in North East Derbyshire. We know how difficult this is. We know that our ability to work, to love, to live, and to offer support are being affected every single day, and we are grateful for their forbearance at this difficult time. And in the past few days, the reason for that endurance is becoming clearer. Our job of suppressing the virus was never for nothing. All along, we have been building a bridge to a time when we have other weapons to fight this problem, and the announcements of this week may be showing that we are actually starting to get there. Light is on the horizon, yet we know that we will not get there immediately. Even if solutions are coming, we still face soul-searching questions.

The first big question remaining will be one of evidence. Every day, massive decisions are being made on our behalf and we are grappling with the foundations upon which these are made. In searching for evidence, we face a blizzard of data and hypotheses. Right now, within a few clicks, the web will tell us both that the case fatality rate is negligible and that it is substantial, that tests work and that they do not, that masks are life-savers and that they can be life-takers. Should we wish, we can literally choose our facts, even though only one set of those premises is actually true. It is no wonder that constituents are confused.

That goes to the second challenge that also bedevils us: uncertainty. Our natural instinct is to recoil from ambiguity, yet this virus forces us to deal with it. There is uncertainty about how it works and how it will act in the winter. The virus forces us to make decisions now on the basis of what might happen in 40 days’ time. It is a challenging mix, which, quite understandably, has worn people down. Yet our job is to deal with the world as it is, not how we wish it to be. For those residents who are frustrated or anxious, I say that I am, too. But if there were a quick answer, it would have been found already. If there were a single solution, it would have been used. We are here because, for now, we think that what we are doing is proportionate and the least worst option while we wait for the alternatives, and those alternatives are coming. This cannot, must not, will not last forever, but, for the first time in our history, we may actually be able to turn back a pandemic in mid-flow. If that happens, it will be the most remarkable test of our ingenuity, our resolve and our willingness to get there. I say hold on, we will get there.

Covid-19 Restrictions: South Yorkshire

Lee Rowley Excerpts

Wednesday 21st October 2020 Commons Chamber

[Edward Argar]

The hon. Gentleman knows I have huge respect for him—indeed, a huge fondness for him —but I am afraid I cannot agree with what he says. We have been working very closely in a collegiate way with local authorities. It is absolutely right that, alongside that negotiation or discussion on the package and support they need, we recognise that we have to be fair and proportionate across other regions that are in the same tier. We have to ensure that the approach we are adopting, which we are, is both fair and proportionate.

[Lee Rowley (North East Derbyshire) (Con)]

North East Derbyshire sits on the outskirts of South Yorkshire and many towns and villages, such as Dronfield, Eckington, Killamarsh and Ridgeway, look towards Sheffield for work and education. For the benefit of those residents, will the Minister confirm that there has been no change to the tier level in North East Derbyshire, that the rules remain the same unless those residents are travelling to Sheffield and that North East Derbyshire will continue to be dealt with on an independent basis, while working closely with Sheffield when we review our tier status in future?

[Edward Argar]

As my hon. Friend knows, I know Dronfield having spent a very happy day there with him in the course of his successful election campaign. I can reassure him that the situation, as I stand here, remains exactly as he sets out.

Covid-19

Lee Rowley Excerpts

Monday 28th September 2020 Commons Chamber

[Lee Rowley (North East Derbyshire) (Con)]

Thank you, Mr Deputy Speaker. It is a pleasure to be able to contribute to this timely and important debate in the place where I thought I was supposed to be contributing.

I come to this debate as a self-professed libertarian Conservative, and somebody who strongly believes that states are most effective when they tend to concentrate on doing some things well, rather than lots of things badly. I want to explain why I as a libertarian can be supportive of the measures that have been taken by the Government, and I want to explain to those who share my ideological views or just those who are frustrated at the moment, whose views have come into all of our inboxes, why I think what we are doing is proportionate and appropriate.

There are two times when I think that big states and big governments are appropriate: one is in a time of war, which I hope none of us in this Chamber ever has to go through, and the second is in a public health emergency, and we are in a public health emergency. The virus exists; it is not flu, as some of my constituents seem to want to tell me. It transmits: it transmits well in social scenarios, and for a small but very important number of people, it creates very difficult outcomes and can be fatal at certain points. That is a public health emergency by any definition.

We can debate the approach, we can debate the enforcement, we can debate the scrutiny and we can debate the strategy, but I do not think we can debate those facts. We should debate the enforcement, we should debate the scrutiny and we should debate the approach, and when we are debating that, I look at it from two principles: one of liberty and one of risk. On the liberty point, I am a strong proponent of freedom and choice and bringing them to as many people and as many constituents as I possibly can. But the ability to have the freedom to do things comes with the requirement not to harm others. It is that second part of the principle of liberty that we need to ensure that people understand. There is an externality in terms of what we do on a day-to-day basis. If we do not ensure that that externality is understood and regulated, then we are not only constraining our freedom but will potentially extinguish the freedom of others.

[Mr Steve Baker]

Will my hon. Friend give way?

[Lee Rowley]

I would be very happy to give way.

[Mr Baker]

My hon. Friend’s speech is so marvellous that I am just baldly going to give him another minute.

[Lee Rowley]

I am so grateful to my hon. Friend; I did not even ask him to do that.

The second point is one of risk. I recognise that this is a nuanced and difficult discussion where there are no clear-cut answers for us all. This debate, I accept, has been unbalanced over the past few months during coronavirus. We have had a focus on some of the short-term, hugely important and hugely tragic issues—my own family have faced some of those—whereas the more hidden, longer-term consequences of similar things that we are debating and discussing are often not brought to the fore because it is more difficult to do and more difficult to articulate. It is a question of the level of risk that we as a society are willing to tolerate.

We cannot tolerate zero risk. I have zero time for the members of the Independent SAGE who populate the pages of The Guardian with the idea that zero cases is somehow achievable. It is an impossibility, and we should cease to even entertain it as a serious idea in solving the problem that is in front of us. By the same token, we cannot have complete risk. We cannot have complete freedom to do things, because of the externality that I spoke about. That means, ultimately, that we need a proportionate approach. For now, based on what we know, and understanding the challenges that we face, the Government’s strategy is proportionate. It accepts that there are challenges and problems, and it is trying to balance those.

We may find out more in the next few weeks about whether there will be changes to how the virus is moving, we may find out in the next few months whether we have a solution to this, and perhaps we will have to change strategy in the future as a consequence. But we have to be honest with people: there is no straightforward answer to this. There is no absolute science. There are no easy comparisons with other countries, and people should be very careful about making those. There is no constraint on liberty that can last for ever. Ultimately, no laws, no edicts and no enforcement can boil down to what we all need to do as individuals and citizens, which is to do our best for ourselves, our community and our society as a whole. For those who value liberty and agree to a temporary constraint for others, for community and for society, I support that, but not for one minute longer than is necessary, not for one more person than is required, and not for one more element of society that we need to change as a result.

Covid-19

Lee Rowley Excerpts

Tuesday 12th May 2020 Commons Chamber

[Lee Rowley (North East Derbyshire) (Con)]

I am grateful for the opportunity to contribute to this debate. Like so many Members who have spoken in the Chamber and by video link, I want to start by paying tribute to all the work that has been done in my constituency over the last few difficult months. In particular, I want to put on record my thanks to everybody at Chesterfield Royal Hospital who has dealt so brilliantly with such a challenging time, to the healthcare workers in the community, to the people working in our GP surgeries across the towns and villages of North East Derbyshire, to the pharmacists who have been in touch and are working hard, and to everybody working in our care homes and social care settings across north Derbyshire. My thanks go out to all those who are working so hard at this incredibly difficult time.

And it goes beyond that. I also want to thank the people working in our jobcentres in Chesterfield and Staveley, those who are helping in our schools to allow the sons and daughters of keyworkers to continue, and our local councils. Derbyshire County Council has been ensuring that the people who need to shield—of whom there are 1 million across the country—by staying out of the community for their own safety get the medicines and food that they need. North East Derbyshire District Council has done some wonderful work over the last few weeks, contacting those who are self-isolating to make sure that they get the support and help they need and to check up on people where necessary. I am incredibly grateful for all the work that has been done.

The little acts of kindness are particularly important, and I want to mention a few that have come through my inbox in the last few days alone—the PPE that is being created by Dronfield Henry Fanshawe School and St Mary’s at the moment; the pupils of New Whittington Community Primary School who have done a video to say thank you to their teachers; Mrs Shelagh Cheetham and her friends, who have made thousands of pieces of PPE for local hospitals and healthcare settings; and James Cutts from Wingerworth, who goes on his daily run around the village not in normal running wear but in a Batman or Superman suit, to cheer up local children when he goes past their windows. I am grateful for all that they are doing, and I hope that they continue.

In the time I have left, I want to spend a few moments looking at the broader challenge that we face. Members have raised many different questions today. Some are fair questions. Some, in my view, are unfair questions, but I understand why they are being asked. A series of broader truths has come forward over the past few weeks. We live in unprecedented times. There is no absolute certainty in decisions, and fundamentally, it reminds us all of the frailty of humanity. We think that we control our environment. Actually, our environment controls us. However brilliant our science, however able our politics and however fantastic our communities, ultimately, decisions are sometimes beyond us.

We have done so much over the past couple of months to get on top of this virus, and I am confident that we will do more in the coming days, weeks and months. This is the first pandemic in a century that we have had to deal with, and it is the first pandemic in a globalised world. We are seeking to do something that has never been done in the history of humanity: to turn back the tide of a pandemic and stop it overwhelming us. We have made huge progress, and I am grateful to everybody for the work they have done. Together, we will continue to do that work, and together, we will get through this, to a better world at the end.

NHS Funding Bill

Lee Rowley Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Laura Trott (Sevenoaks) (Con)]

Members across the House have spoken about the importance of unanimity of purpose on mental health and maternity, but I want to speak against amendments 2 and 5, for the simple reason that this funding, although so welcome and necessary in my constituency—and those of Members across the House—will be useless to my constituents unless it results in improved outcomes. Rather than talking about ring-fencing funding for specific things, we should be talking about outcomes—what they mean for our constituents, and how we make their healthcare better.

My hon. Friends the Members for Newton Abbot (Anne Marie Morris) and for Hitchin and Harpenden (Bim Afolami) raised similar points. The hon. Member for Ellesmere Port and Neston (Justin Madders) rightly drew attention to the ambitious targets in the NHS long term plan. Those are the targets that we should be tracking ourselves against. Those are the targets that we should be talking about, and we should monitor whether the improved funding has enabled us to make progress against them. We should not just talk about whether to put a certain amount of money into a certain pot; on its own, it makes no sense and will not make anyone’s life better. The main point I want to make is that we should focus on outcomes rather than forever tracking inputs that do not improve our constituents’ lives.

The NHS long term plan has some very ambitious targets for maternity and mental health. I shall dwell on the target to achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury by 2025. It is incredibly important, and it is crucial that the House is updated on our progress against it. We shall do that, yes, through funding, but funding linked with policies that will drive that outcome and drive improvements.

I want to focus on midwives and maternity care. Under the coalition Government, a commitment was made to give each mother a named midwife. That is obviously extremely important, both for the mental health of the mother and for her care, because it means that there is someone who, throughout, is observing how that woman is doing—understanding how she has changed from one appointment to the next. It is not just a tick-box exercise, with a person who has never met the mother before looking at a list and saying, “Have you actually done this? Then you must be fine.” It is a person looking at the woman and thinking, “Actually, is this someone who needs a bit of help—whose mental health has deteriorated since the last appointment, who is looking a little bit more anxious?” Ring-fencing the funding is not enough in itself.

In addition, the long term plan talks about the shortage of neonatal capacity. As someone who has had the misfortune to have to use a neonatal unit recently, I know the tragic and immense strain that the movement of babies can put on parents who have to use neonatal units. We absolutely must put this money into expanding capacity in our neonatal units, and try to ensure that parents are assured that when they move into high-dependency units, they will never be downgraded because of capacity. That is incredibly important.

My hon. Friend the Member for Telford (Lucy Allan) spoke very movingly about the issues that she had in her trust. Moving forward with policies such as these will prevent any repeat of such issues.

On a linked issue, it is important that we look at outcomes for multiple births. Neonatal capacity is part of that, but in addition the Twins Trust has been doing fantastic work in terms of a maternity checklist, which has been piloted by a number of trusts but not yet all. We can look at funnelling some of the money into increasing those trials. That will drive outcomes, which is what we are all here to ensure.

Finally, I want to mention money for anaesthetists. We talk about mental health outcomes for mothers. Part of the problem has been that, according to frightening reports, women who are in terrible need of pain relief during childbirth have not been able to get it. That is a cultural issue in some trusts. They seem to view childbirth as different from having an operation on one’s leg. I would like to see anyone who would undergo an operation on any other part of their body without pain relief, but that seems to be something that some trusts believe women are able to do, and it is wrong. Investment in anaesthetists, and funnelling money into that area of the NHS, is incredibly important.

To summarise: outcomes, please, not just pots of money. That will make everyone’s constituents’ lives better.

[Lee Rowley (North East Derbyshire) (Con)]

It is a pleasure to follow my hon. Friend the Member for Sevenoaks (Laura Trott), not least because her last sentence is what the next 10 minutes of my speech are about. [Interruption.] I am sure many Members probably want me to sit down now, but I will continue none the less.

Artificial Intelligence in Healthcare

Lee Rowley Excerpts

Thursday 5th September 2019 Westminster Hall

[Lee Rowley (North East Derbyshire) (Con)]

It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate my hon. Friend the Member for Crawley (Henry Smith) on securing the debate. He is a doughty champion and campaigner for this area of public health policy. It is great to have the opportunity to talk about it and the innovations and where it can go in the long term.

I congratulate the all-party parliamentary group on data analytics for its sterling work on this important report, which brings together a substantial amount of work and demonstrates the possibilities for the country and the sector to make progress in the coming years. I also welcome the Minister to her new role and I look forward to the work that she will be doing in this and many other areas—hopefully for longer than the coming days. I hope to see her in her place for many years to come.

I welcome the debate because it is a massively important subject for our country and the health of our citizens. It is a pleasure to follow the hon. Member for Cambridge (Daniel Zeichner), who highlighted some of the work that I have been involved in, in a tiny way, over the last few months. I thank the APPG for its kindness in allowing me and the hon. Member for Bristol North West (Darren Jones) to do that. The commission that we co-chair, which looked into the importance of ethics in the aggregation of data and the use of technology, brought it home to me that we need to have more discussions such as this and that it is important for public policy to focus on these things.

I also welcome the debate because, for once, we are not talking about Brexit. It is a fantastic opportunity not to do that. I slightly regret bringing it up, but I will do it anyway. For me, this is the kind of debate that will be transformative for the people in our society and communities over the next 30 years. It will transform the royal hospital that serves my constituents in north-east Derbyshire and the hospitals in Sheffield, in the same way that automation, artificial intelligence, big data and machine learning will transform my local economy and the skills we need to teach in my local schools. If there had been more such debates, instead of the ones we have seen in the last few days, Parliament would have been in a healthier place in the last few months.

AI has the potential to be hugely transformative, as I saw as part of the commission. We need to look at it more, not just in healthcare but in education and elsewhere. Again, I congratulate the APPG on the report, which is a great start in the area of healthcare, but that is an area about which we have to be incredibly careful, as the hon. Member for Cambridge has eloquently outlined—much more eloquently that I can. Our population has trust in our healthcare systems and is willing, at the moment, to innovate in those areas, but those things are hard-won, are not particularly guaranteed and will be easily lost if we are not careful. The worst situation that we could end up with is one where there is huge potential in the area but we are unable to do anything because people do not wish it to be utilised or do not have confidence in it being utilised in the way they want.

I am pleased by some of the statistics in the report, particularly the level of confidence that is already there. Some 85% of people support in principle the use of artificial intelligence to move that area forward and 86% of people are willing to have their anonymised data shared. The hon. Member for Cambridge has already outlined, however, the challenge with that, because we may all like the idea of our data being shared as long as it is anonymous, but it is almost impossible to anonymise it. There are numerous reports that say that it takes only a few data attributes in the same area, even with a population dataset that is not particularly large, to retrofit them and work out where the data has come from and, ultimately, who the data points in it are. That is a challenge that we have to get over if we are to innovate, develop and utilise the technology.

Other aspects of AI’s use concern me greatly, such as security. We have to make sure that we consider security, whatever we are using AI technology for, whether in operations or additions to people. There is also a question about the development of the technology. We have a trade-off to make in which, as the hon. Member for Cambridge rightly said, the development will be judged and accelerated or decelerated by our appetite in this country for how we use data, what we do with it, what consent we have behind it and what the population are willing to do.

Countries elsewhere in the world do not have the same structures, rules, morals and ethics that we do in relation to the usage of data. We see that already in other areas. In China in particular the Government use personal data for the control of their citizens and people are incredibly uncomfortable with how that data is used. We have to create a framework around that. I am a small-state Conservative who believes in as little regulation as possible—not no regulation, as I believe in regulation where it is appropriate, but not in significant amounts. This is one area where, while I am not necessarily convinced that we need lots of regulation, we need to talk about what the regulation is and where we ultimately want to get to. The creation of the Centre for Data Ethics and Innovation is positive. I know the Government, the Secretary of State and the Minister are working hard on this subject, but we need to have more conversations about it. This is a great start. I really welcome the debate and the report.

I have a personal interest, too. My father had a double heart bypass a number of years ago, after a heart attack. Luckily, he came through that. He is now busy doing whatever he is doing today—decorating or whatever. He would not be here today without the innovations of the last 40 or 50 years. I want to make sure that other people’s dads and mums are here in the next 50 years, because of this kind of technology, so long as it is used properly. The APPG is doing sterling work in ensuring that that is the case.

Finally—not to go back to Brexit!—my last point is that we need more of this sort of debate, please, and less of what we have had in the last few days in the other Chamber.

Ovarian Cancer: Diagnosis and Treatment

Lee Rowley Excerpts

Tuesday 30th October 2018 Westminster Hall

[Lee Rowley (North East Derbyshire) (Con)]

I beg to move,

That this House has considered ovarian cancer diagnosis and treatment.

It is a pleasure to serve under your chairmanship, Mr Bone. I thank the Backbench Business Committee for allowing the debate, as well as everyone who is here to support this important and timely event—both my colleagues in the Chamber, and everyone in the Public Gallery. The issue is extremely important, and I am privileged to open the debate. This will be the first time since 2014 that ovarian cancer has been debated in either Chamber.

Ovarian cancer is a quiet, invasive cancer, that robs wives, daughters, sisters, mothers and grandmothers of years of their lives, often unexpectedly and quickly, with devastating impacts on their families. Today about 25,000 women are living with the cancer and every day 20 will be diagnosed with it. Despite some progress in recent years the disease still takes away the lives of 4,000 women a year, and hundreds of thousands around the world. Because of its devastating effects its survival rate is, tragically, not as high as everyone would like, and 46% of sufferers do not survive for five years or more.

[Nick Thomas-Symonds (Torfaen) (Lab)]

I warmly congratulate the hon. Gentleman on securing the debate. To improve survival rates, we need earlier diagnosis. For many years ovarian cancer was known as the silent killer, but there are a number of signs and symptoms. Will he join me in encouraging anyone with those signs and symptoms to see their GP urgently?

[Lee Rowley]

I absolutely will. That is a timely and important point. I was on Radio Sheffield only this morning talking about the debate with someone from Target Ovarian Cancer. We spent an awfully long time talking about the symptoms, because it is important that people understand them, and are aware of them, so they can get the treatment they need if they are, unfortunately, affected.

All cancers are important. Extremely sadly—sometimes tragically—ovarian cancer tends not to receive the bulk of the attention or funding. That is partly because it does not affect as many people as other cancers, but it is also because of survival rates. The 46% rate of survival beyond five years compares unfavourably with the rate for breast cancer, which is 87%, and prostate cancer, which is 85%. There are simply fewer survivors of ovarian cancer in the UK who could highlight the importance of fighting the disease and succeeding than there are survivors of other cancers. There is a need for people to speak up about ovarian cancer. Thanks to the work of those who are doing so, it has started to receive the attention that it needs. Charities such as Target Ovarian Cancer work tirelessly every day to raise the profile of the disease, support those who have been affected, improve diagnosis and treatment, and work for a cure. I pay tribute to the work of the all-party parliamentary group on ovarian cancer, and in particular the hon. Member for Washington and Sunderland West (Mrs Hodgson), who chairs it. It has been a privilege to be involved in the work and I am grateful to be able to help in a small way.

What is it about ovarian cancer that requires a particular focus? From the work I have seen, there are four things: improving awareness of the disease, as the hon. Member for Torfaen (Nick Thomas-Symonds) mentioned, so that it can be caught earlier; speeding up the diagnosis when it is suspected that someone has the disease; improving the data available for tracking the disease and our progress in the fight against it; and improving the treatment, allowing people to recover and be disease-free more quickly.

[Nick Boles (Grantham and Stamford) (Con)]

On the point about early diagnosis, my constituent and good friend Jane Sagar had a cyst of 6.5 cm, which a specialist identified. However, its removal was not recommended, although she was later told that any cyst greater than 5 cm on her ovary should automatically have been removed, because it was likely to be cancerous. As a result she is entering her fourth year of treatment for advanced ovarian cancer.

[Lee Rowley]

My hon. Friend makes an important point. Treatment around the country needs to be made more consistent and clearer, to put a stop to the issues that many of us have heard in stories from constituents.

[Theresa Villiers (Chipping Barnet) (Con)]

I apologise that I shall not be able to stay for the whole of this important debate. Does my hon. Friend agree that the additional resources that the Government are devoting to the NHS are welcome, and that it is important for it to use them wisely, which includes improving early diagnosis and treatment of cancer? Early diagnosis is crucial to successful outcomes and the raising of survival rates for ovarian and other cancers.

[Lee Rowley]

My right hon. Friend is right and I hope that the Minister will recognise that. It is a matter of getting a diagnosis, and encouraging people who feel that something may not be quite right to go to the doctor, so that the pathway starts. Then, if there is an issue—most of the time there is not—there can be progress, and people can get the treatment they need earlier.

The first step in improving outcomes on ovarian cancer is improving awareness among the general public, and among GPs and in doctors’ surgeries in general. As has been mentioned, the symptoms of ovarian cancer are often easy to mistake for something else. Too often it is easy to dismiss them as inconsequential or not worth further attention. Symptoms include bloating, a need to go to the toilet more frequently, pain in the tummy or always feeling full. Recognising that those symptoms are potentially problematic is a key to survival. Those diagnosed at the earliest stage, stage 1, are almost certain to be alive a year after the diagnosis; 98% of them will be. Only half of those diagnosed at stage 4 are alive a year later.

Awareness of the symptoms among the general public remains low. For example, only 20% of women can name bloating as a symptom, and only 3% can name feeling full and loss of appetite as an issue. A regional Be Clear on Cancer pilot on ovarian cancer symptoms in 2014 was promising. There was an increase in both spontaneous and prompted awareness of the issues. There were also promising findings from a further regional pilot last year, which focused on abdominal symptoms, including bloating. Initial findings showed that the campaign led to an increase in the number of GP referrals for suspected cancer. We ask that if the Government propose to run any future public health campaigns, they should include work to make people aware of those symptoms.

The second area where there is work to be done is diagnosis, not least because 45% of women reported that it took three months or longer from first presenting to their GP with concerns to recognition that they might have an issue. Diagnosis relies on two forms of assessment—an ultrasound and a blood test called CA125. In too many areas the assessments are done sequentially rather than simultaneously, which often means vital weeks are lost. We have urged the National Institute for Health and Care Excellence and the NHS to review that process and extend the coverage of multidisciplinary diagnostic centres. Those centres prove very useful for the sort of cancers that hide behind vague, less common symptoms, which it is important to get to the bottom of as quickly as possible.

The third area is data. There are many calls on the Government from many sources to ensure that the cancer dashboard demonstrates the progress already being made on a variety of cancers. I understand the challenge, but we also hope that in time the Government may look favourably on the idea of including ovarian cancer data in the dashboard. We hope that that would be relatively simple, as much of the data is already collected and published elsewhere. Good data is vital in driving forward and improving early diagnosis. Huge strides have been made in its collection, and making it available would help with the continuing work to drive up standards.

Finally, treatment also requires further attention. As with many health issues, ovarian cancer treatment is invasive and often difficult. It centres primarily on surgery and chemotherapy. There has been much progress in recent years on drugs to treat the cancer, with the development of a number of PARP inhibitors, providing new tools and opportunities to improve the outcome. However, spending and research on ovarian cancer remain lower than for other cancers, and there is much work to focus on. Where surgery is required there is a strong case for specialist centres around the country, supported by a detailed service specification from NHS England.

To further drive up the quality of treatment, charities such as Target Ovarian Cancer and Ovarian Cancer Action, together with the British Gynaecological Cancer Society, are funding an ovarian cancer feasibility audit. Over the next two years, it will map and analyse existing data on ovarian cancer, and look at the treatment provided and the outcomes for women.

[Liz Twist (Blaydon) (Lab)]

Will the hon. Gentleman join me in congratulating Target Ovarian Cancer and other cancer charities on highlighting this issue and putting forward some very sensible recommendations for improving treatment? Does he agree that it is shocking that our survival rates in the UK are among the lowest in Europe?

[Lee Rowley]

I absolutely do. All these things are a work in progress, but I hope that through debates such as this, through talking about it and through all the fantastic work the charities and the APPG do we can move things forward, make progress and, in time, have fewer women suffering from this and more women getting treatment more quickly than today.

The question of ovarian cancer is, however, more than a technical discussion about diagnosis, awareness, data and treatment, as important as those are. Behind each statistic is a real person who has been unexpectedly struck down by the disease and, in far too many cases, might not be around today to tell the story of their fight. As part of the preparation for this debate, the parliamentary digital team and Target Ovarian Cancer asked people to share stories of their fight and those of their family members.

I am hugely grateful to both organisations for helping with that, and to everyone who got in touch. The stories we received were heartbreaking and heartwarming in equal measure, tragic and terrific, and whatever the outcome, they were inspiring to us all. I cannot possibly do justice to everybody who got in touch or to all the stories and experiences out there, but I will share a few today to remind us of the importance of making progress on this disease.

Danielle got in touch to tell us about her mum, who was diagnosed with stage 3 ovarian cancer in September of last year. Like many other people’s, her symptoms were fuzzy: irritable bowel syndrome, feeling full, swelling and weight loss, which could have been a hundred other things. By chance, the doctor who saw Danielle’s mum also sent her for a blood test, which quickly confirmed that there was an issue. A month or so later, Danielle’s mum started chemotherapy, and in January this year she had a full hysterectomy. After a 10-hour operation, it was hoped that everything had been caught and the focus was on recovery. By June, however, the cancer had returned; sadly, a few months later, in August, Danielle’s mum lost her battle, just 10 months after diagnosis.

Forty-year-old Sarah also had symptoms such as weight loss, feeling full and ovary pain. Before the cancer was diagnosed, she tried many times to find out what the issue was, including once being told, “Well done,” for having lost weight. In Sarah’s case the blood test that often highlights an issue came back normal, which emphasises the imperfect nature of the diagnosis. A nine-hour operation and six rounds of chemotherapy later, Sarah continues to battle her cancer while looking after her two young children.

We also heard the story of the daughter of Jean, who was diagnosed in 2011 with stage 4 ovarian cancer as a result of severe bloating and loss of appetite. After major surgery and four rounds of chemotherapy, the news came through that the cancer had spread. Her battle ended early in 2013.

Emma told us about her mum, who was told she was suffering from irritable bowel syndrome; the actual issue was found too late and she lost her battle, aged 64, just six weeks after diagnosis.

Seren started feeling unwell while at university, aged just 19. Unable to get a doctor’s appointment, she came back home and was diagnosed with cancer. Her tumour was the size of a rugby ball and her operation was pushed forward as it was stopping her eating and affecting her breathing. Chemotherapy followed and today Seren is recovered and working for a cancer charity.

Christine is also one of the good news stories. She was diagnosed with stage 2 ovarian cancer aged 35, having had to visit three different GPs to resolve the problems she was suffering from, which had initially been put down to colitis and anxiety. After her diagnosis, an emergency operation and 10 chemotherapy sessions followed. That was in 1985 and Christine is still here; she has been able to share her story in the last few days.

Finally, Linda was diagnosed with ovarian cancer in September 2017, having initially felt unwell at the beginning of summer while she was on holiday. The classic symptoms were there: bloating, feeling full and knowing that something “wasn’t right”. Multiple trips to the GP followed until, finally, a blood test was taken, confirming the cancer. Linda had a full hysterectomy that same month and spent much of the next few months recovering.

I know that many hon. Members may be wondering the obvious: why am I standing here making the case about a disease that cannot and will not ever affect my body? As with so many others, although it may not have touched me personally, it has touched my family. Linda is my mum. Up until last year, she had had relatively good health and there is no history of ovarian cancer in my family. I generally try to keep my family out of politics—I was the fool who ran for Parliament, not them—but last year was a nightmare that none of us wants to experience again, and we have no wish to see anyone else experience the same. My dad, my brother and I watched my mum live through an extremely scary diagnosis, hugely invasive treatment and one of the hidden aspects of all cancers, the brush with mortality that takes time for sufferers to get to grips with.

Happily for me and my family, my mum is one of the lucky ones. She is sitting at home in north Derbyshire right now, possibly watching this debate on the internet. She has had a hard year and we are extremely proud of her. Yet I know that for every family like mine who have had good news, there are more people who face a tragic outcome. My mum and Danielle’s mum were diagnosed about the same time and I know that my mum’s journey, like that of Danielle’s mum, could have been so different. I do not want anyone else to face what those of us who know and understand what this disease forces on sufferers have faced. Better treatment, diagnosis and a cure cannot wait. I am grateful for the opportunity to discuss these hugely important issues; I look forward to the debate and the Government’s response. Together, I hope we can beat ovarian cancer.

--- Later in debate ---

[Lee Rowley]

I thank all right hon. and hon. Members who have contributed to this exemplary debate. It has been one of those debates that we all aspire to have, in which we talk about the detail and leave out a lot of the politics, and in which there is unity regarding wanting the same outcome: we all want to be able to treat the disease more quickly, with better outcomes and fewer people experiencing it. I am grateful to everyone for entering into the discussion in that spirit.

I thank the hon. Member for Strangford (Jim Shannon) for attending this morning, for highlighting the importance of the issue to him, and for mentioning all the work being done in Northern Ireland—particularly for raising the point about genome testing. I thank my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for sharing his experience north of the border. He, like so many others, provided some of the most important elements of the debate—examples of constituents’ own experiences. I also thank the Front-Bench spokespeople: the hon. Member for Lanark and Hamilton East (Angela Crawley) for also sharing her experience north of the border; and my colleague on the all-party parliamentary group, the hon. Member for Washington and Sunderland West (Mrs Hodgson), who spent so much time highlighting the group’s great work. It has been a privilege to be part of that work over the past few months; the report is a great piece of work and I hope to see improvements coming out of it.

I also thank the Minister. I am a relatively new Member, but I can often tell in debates when Ministers are going through the motions and when they actually care, and today I have heard a speech that demonstrates a genuine interest. It was great to hear about the Minister’s personal connection and about how he cares about the issue, and it was interesting to hear some of the things he highlighted. “Lots to come” is the summary I think it is fair to say we can take from the speech, with regard to the ACE centres, the potential for more public health campaigns, the genome point and the screening. I was particularly glad to hear about the dashboard, which I hope, in time, will give us an opportunity to push forward and demonstrate greater transparency.

Although they are not all still in their place, I thank my hon. Friends the Members for Grantham and Stamford (Nick Boles) and for Nuneaton (Mr Jones), my right hon. Friend the Member for Chipping Barnet (Theresa Villiers), and the hon. Members for Blaydon (Liz Twist), for Torfaen (Nick Thomas-Symonds) and for Upper Bann (David Simpson). I am incredibly grateful for their contributions. I also thank everyone in the Public Gallery, who has listened and provided support. I am aware that there are Members in the room to whom the matter means much but who, by convention, are not able to speak: my hon. Friend the Members for Erewash (Maggie Throup) and you, Mr Bone. You are undertaking a different role today, as Chair, but you were so kind in supporting me when we applied to the Backbench Business Committee for the debate. I am grateful to you and my hon. Friend for your silent but heartfelt support.

This is an important area. It has affected me personally, but it is not about the personal effects; it is about ensuring that we make progress as a country in sorting out the disease and resolving the issues, reducing the number of people out there who get a diagnosis. The debate has shown that a lot has been achieved, that a lot can be done, and that there is a lot of progress we can make, and I look forward to seeing that progress in the coming years.

[Mr Peter Bone (in the Chair)]

I thank all Members for the excellent debate.

Question put and agreed to.

Resolved,

That this House has considered ovarian cancer diagnosis and treatment.