Oral Answers to Questions

Lilian Greenwood Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Andrew Stephenson]

As an NHS community first responder who served on the frontline during the pandemic, who had to see people say goodbye to their loved ones for the last time before being admitted to hospital, and who has dealt with cardiac arrests, I know the mental toll that working for or volunteering with the NHS can take on our workforce, and therefore we do give a very high priority to the subject. The NHS people plan sets out a range of actions to build a more modern, compassionate and inclusive culture, and includes a much stronger focus on the availability of quality health and wellbeing support. It is right that we keep services under review, so I will not make a commitment today to continuing to fund something that we have agreed to fund for another year while those services are reviewed.

[Lilian Greenwood (Nottingham South) (Lab)]

14. What steps she is taking to improve healthcare for women.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

We are focused on delivering our women’s health priorities for 2024. Recent successes include new women’s health hubs opening across the country, with £25 million of investment; the investment of nearly £35 million over three years in improving maternity safety, on top of the extra £186 million already being invested each year; the success of the hormone replacement therapy prepayment certificates; and research into the important issue of maternity disparities, which I have already mentioned.

[Lilian Greenwood]

House of Commons Library figures reveal that one in four women with suspected breast cancer are waiting more than two weeks to see a specialist. The waiting list for gynaecological treatments has risen by 40,000 in a year, which means that there are now almost 600,000 women waiting, which is up by a third over two years. Labour has pledged to tackle that backlog, so that more women are seen faster. How much pain, misery or worse do women have to endure before this Government start prioritising their health?

[Victoria Atkins]

As the hon. Lady will know—she saw the statistics published very recently—we are in fact treating more people at earlier stages of their cancer. I want to take on her point about gynaecological waits, because that is important. We are spending more than £8 billion in this spending review period on additional elective activity, and investing in additional capacity, including community diagnostic centres and surgical hubs, many of which provide gynaecological tests and procedures. She may have missed it, but the latest published management information for March shows that the longest waits for gynaecology services have reduced by nearly 95% since their peak in September 2021. Of course there is more to do, but we are making progress. I thank all the doctors and teams who are involved in that important work.

Tobacco and Vapes Bill

Lilian Greenwood Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Victoria Atkins]

I am extremely grateful to my right hon. Friend. I will genuinely come to that, because I know that that is a concern that colleagues have. I will develop my arguments, if I may, but I also remind him of my declaration of interest and, believe you me, I have no interest whatsoever in making life easier for smoking gangs. That is why as part of the package I will announce further funding and investment for law enforcement agencies both at the border and at local level.

Some have said that it is concerning that we are banning things. I totally understand the concerns of fellow Conservatives. We are not in the habit of banning things—we do not like that. We will bring these powers in only when we are convinced—following a no doubt robust debate, with the intellectual self-confidence that we have on the Government Benches—that there is no liberty in addiction. Nicotine robs people of their freedom to choose. The vast majority of smokers start when they are young. Three quarters say that if they could turn back the clock, they would not have started. That is why, through the Bill, we are creating a smoke-free generation that will guarantee that no one who is turning 15 or younger this year will ever be legally sold tobacco, saving them from the misery of repeated attempts to give up, making our economy more productive and building an NHS that delivers faster, simpler and fairer care. It is our responsibility—indeed, our duty—to protect the next generation. That is what the Bill will do.

[Lilian Greenwood (Nottingham South) (Lab)]

The Secretary of State is right that we should protect the next generation. Labour proposed the smoke-free generation legislation in January 2023. We voted to crack down on marketing vapes to children in 2021, but the Tories blocked it. I welcome this Bill, but does it not show that where Labour leads, some Conservatives follow? Is she not concerned about the number of her colleagues, who we see lined up in the Chamber, who will vote against this legislation today?

[Victoria Atkins]

That is a brave submission from the hon. Lady, given the debate in the Chamber yesterday. I certainly will not take lectures from Labour on this legislation. We are bringing it forward because we have looked carefully at the evidence. What is more, we have tempered it so that existing adult smokers will not be affected. If the message from the Labour party is that it wants to ban smoking for adults completely, it should make that argument. We have tempered this carefully to ensure that it only deals with future generations.

Prescription Charges: Long-term Health Conditions

Lilian Greenwood Excerpts

Monday 11th March 2024 Westminster Hall

[Christina Rees (Neath) (Lab/Co-op)]

I beg to move,

That this House has considered e-petition 608237 relating to prescription charges for people with chronic or long-term health conditions.

It is always a pleasure to serve under your chairpersonship, Dame Maria. I am honoured to deputise for my hon. Friend the Member for Gower (Tonia Antoniazzi) by reciting her excellent speech to open the debate. She was scheduled to move the motion on behalf of the Petitions Committee, but has duties elsewhere. To use a rugby analogy, as my hon. Friend is a rugby player, I have come off the substitutes bench to replace her. But that is all I will say about rugby, having spent the train journey to Paddington this morning with lots of very happy French rugby fans who got on the train at Cardiff still celebrating their victory over my beloved Wales yesterday.

On 6 March last year, my hon. Friend the Member for Gower opened a debate on e-petition 594390, relating to prescription charges for people aged 60 or over. Many of the issues covered then are also applicable in this debate. I pay tribute to Mia, the petition’s creator, who spoke to the Committee recently about her motivations behind starting it. Only in her 20s, Mia is already feeling the impact of prescription charges for the medication that she needs to alleviate the symptoms of her multiple sclerosis. Having been diagnosed so young, and with the situation as it currently is, she faces paying for her medication for decades.

Following her diagnosis, Mia has become part of an extensive online community of people with long-term and chronic health conditions. The common feeling of exasperation at paying for medication inspired her to create the petition. Based on the conversations she has had, Mia listed in her petition a number of conditions that are not exempt from prescription charges, including MS, endometriosis, inflammatory bowel disease, postural orthostatic tachycardia syndrome, depression, anxiety and Ehlers-Danlos syndrome. Other conditions that are not exempt and have been the subject of their own e-petitions include cystic fibrosis, sickle cell anaemia, Crohn’s and colitis, along with—this is not a specific condition but a group of people—those who have undergone organ transplantation.

For many of the conditions included in Mia’s non-exhaustive list, there is no gold-standard medication that alleviates symptoms completely. Mia spoke to me about having to try new medications, often knowing full well that they may not work but still having to pay for the pleasure. Perhaps to rub salt in the wound, Mia was told that a potential side effect of her chemotherapy treatment for MS could be that she developed hyperthyroidism. Should that happen, the hyperthyroidism would make her exempt from prescription charges.

I also thank Dan, who the Committee spoke to about his petition on behalf of organ transplant patients. Dan had a liver transplant after having relied on medication since the age of 13 and spent years paying for the medication that kept him alive. Now, he has to take medication to prevent his body from rejecting the new liver and allow him to go back to work, and he still faces paying for prescriptions.

The crux of the issue lies in the criteria for the medical exemption certificate. I find it astonishing that the list of exempt conditions has not been reviewed since 1968, apart from the inclusion of cancer patients in 2009. Treatments have come on in leaps and bounds since the 1960s, as has our knowledge of medical conditions that were once unknown or not spoken about. That the exemption list has not moved with the times is frankly baffling.

The question that came up time and again in conversations about the petition was, “Why were the conditions on the exemption list chosen over others?” That is not to say that the conditions on the list do not belong there, and nobody the Committee spoke to suggested that x condition deserved to be there over y condition; rather, it is to ask on what basis conditions were chosen for the list. What was the evidence for inclusion and for exclusion? I would really appreciate any light that the Minister can shed on that.

Perhaps the list was based on survivability, which has, thanks to decades of improved research, improved by leaps and bounds. To give an example, in 1968 children with cystic fibrosis were not expected to live into adulthood. With medication and physiotherapy, the prognosis now is much different from what it was nearly 60 years ago. However, cystic fibrosis remains life-threatening, and those living with it still face having to pay for the medication that keeps them alive. Over the decades, research has improved our understanding of chronic and long-term health conditions and in turn improved the length and quality of life for so many people. Surely it is only right that the exemption list grows with this knowledge.

The UK Government need to rethink their approach to prescription charges, because their consequences can be dire. Recently, Donna Smitheman has been campaigning for free asthma inhalers, following the tragic death of her 25-year-old son Jordan. Jordan was not able to afford his inhalers, and questioned why he had to, given that he had not asked to have asthma. Donna has taken action because she believes that access to life-saving medication such as inhalers should be a right and not a privilege.

Research published in 2023 by the Prescription Charges Coalition found that almost one in 10 respondents had skipped their medication as a result of the cost. As a result, 30% of those people said that they now suffer with other physical health problems. The Committee spoke to Lindsey Fairbrother, a pharmacist who had conversations with people who were not taking the medication they needed because of its cost. A similar observation was made by Ellen Schafheutle, who has done qualitative research into the subject. She said that her one wish for this debate was that we stress the negative impact of people forgoing medicine because of the cost.

[Lilian Greenwood (Nottingham South) (Lab)]

My hon. Friend is doing a great job of setting out some of the challenges that people with long-term conditions face. Does she share my concern that this situation has a damaging impact not only on people’s health—she rightly says that people have a right to receive prescriptions and improve their health—but potentially on the national health service, because if people skip their medication because they cannot afford it, they will end up making more trips to a GP or to accident and emergency, and potentially have more hospital stays, which would be extremely expensive for the health service and would, of course, have a damaging impact on them and their families?

[Christina Rees]

I thank my hon. Friend for her important intervention. I completely agree with her and will come to that issue later in my speech. I will pass on her support to my hon. Friend the Member for Gower, who I am sure will appreciate it. The UK Government have stated that the revenue raised from prescription charges goes back into the NHS. However, given the cost of enforcing the list of exemptions, as well as the longer-term financial impact on the NHS of people forgoing medication, that argument seems to be a false economy.

Parkinson’s UK has long campaigned for a change to prescription charges for the people it represents, and research published in 2018 found that scrapping the charge for people living with Parkinson’s would save the NHS money. The UK Government’s written response to the petition stated that those with long-term conditions could save money by utilising the prescription prepayment certificate. Although that is a good option for many, it is still too much for some in a cost of living crisis when people are living pay cheque to pay cheque.

We should not forget that it is somewhat of a postcode lottery, as England is the only UK nation where prescriptions are not free. When the Welsh Government abolished prescription charges in 2007, they cited evidence that some people with serious chronic conditions could not afford their prescriptions and were choosing to have only part of them dispensed to reduce the cost. It was seen as a long-term investment in people’s health, with the added bonus of being cost-effective because it prevented further complications arising from people not taking vital medications, which would increase costs to the NHS.

According to the Government, 95% of items dispensed in 2023 were exempt from prescription charges, but that proportion is entirely useless given that exemptions do not apply to medicines. It tells us absolutely nothing about who is exempt. Perhaps the Minister could enlighten us with some statistics on that. Mia stated that although the UK Government’s response did not surprise her, she was still gutted by it. She did not feel that it answered any of her concerns, and I must agree with her.

Of course, if we lived in an ideal world, England would catch up with Northern Ireland, Scotland and Wales. Exemption lists are inherently unfair. Expanding the medical exemption list is not a perfect solution to the cost of prescriptions, but we need to start somewhere. I urge the Minister and the UK Government to listen to the thousands who have signed petitions relating to prescription charges. The NHS is under immense pressure, but people’s lives are truly on the line. I give you my sincere thanks, Dame Maria, on behalf of my hon. Friend the Member for Gower.

Building an NHS Fit for the Future

Lilian Greenwood Excerpts

Monday 13th November 2023 Commons Chamber

[Lilian Greenwood (Nottingham South) (Lab)]

My constituents in Nottingham South are deeply disappointed by the thin offering of Bills promised by the Prime Minister for the last year of this Parliament before he finally lets them have a vote on his unelected Government’s dismal record. The legislative affairs team at Downing Street should be applauded for inserting the Automated Vehicles Bill—a Bill about driverless cars—into the speech. Perhaps there is a telling allusion to the absence of leadership behind the great wheel of state at 10 Downing Street.

This Mr Micawber-esque King’s Speech offers precious little change from the past 13 years of the Tories’ mismanaged decline of our country. The only hope emanating from it is the desperate hope coming from the Prime Minister that something might turn up to save his sinking premiership, but, then again, perhaps he has already given up. After all, he seems more interested in interviewing big tech billionaires with a view to a new job in 2025 than rolling up his sleeves and addressing the many challenges facing our country.

When the Prime Minister replaced his short-lived predecessor, he promised to get Britain back to its salad days. Instead, the state of our country now more resembles that of last year’s ill-fated lettuce. This dereliction of public duty is most evident in the stark decline of our national health service, which is already under immense pressure as we enter yet another difficult winter season. My local hospital was forced to declare a critical incident in October. How much worse will things be come January?

Just as the electorate and the Opposition are eagerly waiting for the Prime Minister to call an election, an unprecedented number of people are waiting to be seen by our NHS because of this Conservative Government’s neglect. When the Prime Minister entered 10 Downing Street last year, he pledged to cut NHS waiting lists, yet just last month, and despite the incredible efforts of hard-pressed staff, they rose to a record high of 7.75 million. One in seven people in England are waiting for treatment.

In Nottinghamshire there are still around 60 patients who have been waiting more than 18 months for a procedure, and 1,200 patients who have been waiting for more than 15 months—waiting with their lives on hold, worried and often in pain and discomfort. For some it is worse, because for too many that waiting will have a profound effect on the outcome. The Public Accounts Committee’s finding that waiting times for patients suffering from cancer are at their worst recorded level is hugely concerning.

Many Members of this House will, like me, have received often heartrending testimony from constituents whose families have spent hours waiting for an overwhelmed ambulance crew to arrive to help them in their time of need, waiting in an ambulance outside an overwhelmed emergency department, waiting in overstretched emergency departments in pain and distress, waiting on a trolley in a corridor to be admitted to a ward, waiting for a social care package to be in place so they can leave hospital, or waiting weeks for an appointment just to see their family GP. We have all been waiting 13 long years for the Tories to sort out the growing NHS staff shortage, which is at the heart of many of the issues afflicting our health service.

As a result of the Tories’ inaction, our NHS is now short of 125,000 much-needed staff. That is the population of a small city, and those chronic shortages are leading to all-too-predictable delays in diagnosis and treatment, despite the fact that working people are paying the highest levels of taxation since the end of world war two. We are all paying more and getting less. In many other walks of life that would be deemed a breach of contract. It is therefore no surprise that public satisfaction with the NHS has fallen to its lowest level since 1997. The public, and NHS staff, deserve so much better than this Government.

We have also been waiting for a reformed mental health Act. I have been contacted in recent days by constituents shocked that despite promising to do so in their 2019 election manifesto and, as I mentioned, also promising to do so in their 2017 manifesto, the Conservatives have now refused to introduce a replacement Bill before the next general election. I know that health professionals and the public are rightly concerned that the Mental Health Act 1983 is outdated and that reform is required so that our NHS can treat people with greater effectiveness and dignity, while also giving them greater control over their treatment.

During his failed Tory leadership bid last summer, the Prime Minister also promised a plan to restore NHS dentistry and a review of dentists’ contractual arrangements and incentives. The sad reality is that I am surely not the only Member in this House to receive a depressingly regular number of letters from constituents who are angry that they have been waiting for years to register with an NHS dentist, let alone see one. Research has found that an estimated 4 million people cannot access NHS dental care and cannot afford to go private either. We have heard about DIY dentistry, tooth decay putting children in hospital and increasing levels of oral cancer.

Again, that is a crisis of the Tories’ making. What did they expect when they cut funding for dental services in England by 8% in real terms since 2010? I know the Prime Minister wants everyone to learn maths until the age of 18, but they did not need to be Pythagoras to work out that that would lead to droves of dentists quitting and many remaining NHS practices not taking on new patients, creating so-called dental deserts. After waiting a year for the Prime Minister to implement his plan to save NHS dentistry, the British Dental Association stated that there are still

“no new dentists, no new contract and no new money.”

All this waiting would have tested even the patience of Vladimir and Estragon to breaking point. This King’s Speech has shown that the Conservatives have no plan to keep staff working in the NHS, no plan to cut waiting lists and no plan to reform our health service. The Government are more focused on in-fighting and waiting in the vain hope of something better turning up.

Only the Labour party has the ideas and the ambition to save our NHS, restore the vital services it provides us all, and reform it so that it is ready to face future challenges. We are the party with a mission and a 10-year plan to change and modernise our NHS by training more doctors, nurses and health visitors, to lower waiting times, and to raise standards for patients. We will provide 2 million more appointments by paying staff extra to work evenings and weekends, paid for by abolishing the non-dom tax status. We will take the hard decisions to tackle finally the problems with the NHS dental contract so that it properly delivers for patients and staff. And it is Labour that will introduce a new NHS standard that guarantees everyone in England the right to treatment for their mental health within a month, and will back up that commitment by recruiting more than 8,500 mental health professionals to provide support in every school and set up mental health hubs in every community.

The public are rightly fed up of waiting for a change, and the Labour party wholeheartedly agrees with them, not just on health, but on all my constituents’ priorities: help with the cost of living, help creating good jobs, tackling crime and antisocial behaviour, reducing homelessness, ending child poverty and giving every child the opportunities they need to thrive, cutting energy bills, and reaching net zero. We, the Labour party, will give the public the change that they want and cut the waiting.

Access to GP Services and NHS Dentistry

Lilian Greenwood Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I notice that the hon. Gentleman has played the old trick of selecting figures from a specific set of years, but nothing he has said contradicts the facts that I have outlined. In any case, the people of Wakefield will draw their own conclusions on Thursday when they go to vote. The fact is that the Government have had more than enough time to reform general practice in this country, and they have no one other than themselves to blame for the crisis we are in.

Since the Conservative party has been in government for the past 12 years, I thought I would take a trip down memory lane to remind us, the House and the British people exactly what they have been promising since they were first elected in 2010. The 2010 Conservative party manifesto promised that GP surgeries would be open 12 hours a day, seven days a week. The Government failed to deliver that—maybe they blame their coalition partners, although I do not think the Liberal Democrats would have disagreed with GP surgeries being open for that long—so they promised the same again in 2015. That time, they set themselves a deadline of 2020, and guess what? They missed that, too.

In 2015, they promised that everyone over the age of 75 would get a same-day appointment—another promise broken. They said they would hire 5,000 more GPs by 2020—another promise broken. In 2019, they promised 6,000 more GPs, but the Health Secretary has already admitted that he is on course to break that promise, too. They promised 50 million more GP appointments a year, but as the British people know from their experience, appointments are down. That is today’s Conservative party: over-promise and under-deliver, never take responsibility, and leave patients paying the price.

[Lilian Greenwood (Nottingham South) (Lab)]

This morning, one of my constituents contacted me to say she was standing outside her GP practice at 7.15 am in order to secure an appointment. She said that she was successful in securing an appointment, but a number of people who were also standing outside did not. Does my hon. Friend remember the Health Secretary promising that people would have to do that in order to secure a GP appointment?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. This is the problem: they overpromise and underdeliver. If they will not hear it from me, Mr Speaker, let us remind ourselves of what some of the Secretary of State’s colleagues have said. The hon. Member for South West Bedfordshire (Andrew Selous), who is in the Chamber, said in Prime Minister’s questions only last week:

“At one of my surgeries, which has double the recommended number of patients per GP, the bowel cancer diagnosis of a 51-year-old father of four was missed and is now terminal.”—[Official Report, 15 June 2022; Vol. 716, c. 283-4.]

Earlier this month, the hon. Member for Telford (Lucy Allan) read a letter from a constituent to the Health Secretary. It said:

“Trying to get basic healthcare is a joke in Telford. Maybe I would be better off in…a third-world country”.

If the Secretary of State is not going to listen to us, he should at least listen to his own side. Before Conservative Members leap to the defence of their Government’s record, they should probably go back and check the record to make sure that they had not agreed with us in the first place.

As for dentistry, 2,000 dentists quit the NHS last year, around 10% of all dentists employed in England. It is an exodus under the Government’s watch. Four million people cannot access NHS dental care and cannot afford to go private either.

--- Later in debate ---

[Sajid Javid]

My right hon. Friend’s point is important and well made, and I will look at the issue closely and get back to him, if I may.

As we have already heard today—but it is such an important point—the challenge for NHS dentistry predated the pandemic. It is not just about the number of dentists in England, but about the completely outdated contracts under which they are working, which were signed under a Labour Government. [Interruption.] Labour Members do not like it, but it is true. These contracts mean that we are operating almost with one hand tied behind our backs. They do not incentivise prevention, they hold back innovation, and they mean that hard-working families cannot get the dental services that they deserve. However, we will now be changing that; our work with the sector, along with the work of Health Education England on recruitment and retention, will be vital for the future.

[Lilian Greenwood]

Will the Secretary of State give way?

[Sajid Javid]

I will in a moment.

If there is one thing that unites all our work on primary care and dentistry, it is this. We are shifting to a new mode of operating—one that is about helping the whole population to stay healthy, not just about treating those who ask for help. We need to get to a place where we are healthier for longer, because freedom is hollow without our health.

Our new Health and Social Care Act 2022 is an important step in that ambition. Statutory integrated care systems will be responsible for the funding to support the health of their respective areas—not just treating people, but helping people to stay healthy in the first place. The Act also allows us to make safe and effective public health interventions such as water fluoridation, and we will set out further plans for that shortly.

Prevention, personalisation, people and performance: those will be our watchwords for modernising NHS services. They will sit at the heart of everything to come, from the health disparities White Paper to the update of the NHS long-term plan. While the Opposition continue to go off the rails, we remain firmly on track, laying down our plans to deliver a truly 21st-century offer for the profession and, most of all, for patients.

--- Later in debate ---

[Paul Blomfield (Sheffield Central) (Lab)]

A range of important issues has been raised by those on both Front Benches and in the interventions on them, but I want to focus specifically on NHS dentistry issues.

We have all had so many constituents contact us, and I would like to share a small selection of mine. One new resident to the city said:

“I moved to Sheffield earlier in the year. I am unable to register for an NHS dentist. I am being quoted waiting lists of eighteen months just for a check-up.”

Another wrote:

“My partner has been trying to get into a dentist for a check-up for around 18 months. We have rung every dentist within a 6-mile radius to be told they are not taking on NHS patients…and he will need to go private.”

One woman wrote to me:

“I have a MATB1 form entitling me to free dental care whilst I’m pregnant and for a year after birth. Unfortunately, I can’t use this as I can’t find an NHS dentist”.

A young mother told me:

“We’re told dental care is important and that we should get our children seen early and regularly. We moved to Sheffield in December 2020. I started to look for a dentist. I’ve been on a waiting list for a year with no progress.”

Another parent told me:

“Our son was referred for NHS orthodontic treatment by his dental practice in February 2019 at the age of 12. He has now been on the waiting list for 35 months and will turn 15 next month. He still has not had an initial assessment appointment.”

[Lilian Greenwood]

I thank my hon. Friend for giving way; the Secretary of State seemed to forget to do so. Does my hon. Friend share my concern that, even before the pandemic, the No. 1 reason for hospital admission among children aged five to nine was tooth decay? Is that not a shocking indictment of the failure to address health prevention and care for children and their teeth, and is it not a bit galling for the Secretary of State to suggest that this is the fault of the last Labour Government, when before the pandemic his Government had already been in power for 10 years?

[Paul Blomfield]

I thank my hon. Friend for that intervention, and she is absolutely right about how that highlights the crisis we are facing in NHS dentistry. That exists right across England, and it was interesting to hear comments from other nations, because significantly less is spent on dentistry in England than in Wales, Scotland or Northern Ireland. The Secretary of State blames everything on the contract, but the cuts to dentistry have been deeper than in the rest of the NHS, with spending a quarter less than it was in 2010, and I am not surprised that he made no mention of that.

Last Wednesday, I met our local dental committee to discuss the problem—dentists who are committed to their profession and to NHS provision, and who want a solution—and following our discussion, they commissioned a survey of waiting lists across the city. Some 37 practices responded, which is about half of the city’s providers, but only one practice could offer a waiting time shorter than a year. For 29% it was up to two years and for 32% more than two years. The most significant number was that 35% of practices were unable to add any patients to their waiting lists.

Across England, the number of dentists providing NHS services fell from 24,700 in 2019-20 to 21,500 now, which is a fall of 15% in just two years—

Menopause

Lilian Greenwood Excerpts

Thursday 9th June 2022 Westminster Hall

[Carolyn Harris]

I totally agree with my hon. Friend. As she knows, my passion for this subject means that I will champion every one of the issues she has brought to my attention.

Women such as Brioni say:

“We live in deprived communities where HRT is considered a luxury item. The women I support work part time for minimum wage and on temporary contracts. We simply can’t afford the resources, products, private consultations that other women from more privileged backgrounds can.”

I can testify to the truth of that. I discovered quite early on that my own menopause was menopause, not depression, and when I spoke publicly about it, my friends said to me, “You’re posh having a menopause, Carolyn”—posh, because all the symptoms they were experiencing were things they just put up with and shut up with. I put it under the label of menopause, and the fact that I was able to have HRT—because I went private—made me posh. That was the only time in my life I have ever been called posh.

Brioni is from Doncaster, but what she says is relevant in working-class communities right across the country. Women will always put the needs of their families first, and as long as they have to choose between feeding their kids and paying for their prescriptions, we know where they are going to put their money. To all the Brionis out there struggling, I send my personal apologies that their hopes were prematurely raised. It is not what I expected or wanted, and it is certainly not what I am prepared to accept.

Outside this place, the menopause is a priority, and credit for that must go to all those who are campaigning for change at a grassroots level. Thanks to the willingness of so many of them to work together for the greater good, we now have the menopause mandate in place. We are joining women’s voices into a chorus whose mantra is menopause, menopause, menopause, amplifying the individual voices of grassroots campaigners so that all those individuals and their cases, with all their passions, are brought together in one collective.

[Lilian Greenwood (Nottingham South) (Lab)]

My hon. Friend is making an incredibly powerful speech, and we are all very grateful. One of my constituents, who wrote to me recently, wants to be one of the voices joining my hon. Friend in calling for change. She says:

“I’m tired of worrying about my next prescription. Will I be able to talk to the GP? Can I persuade the receptionist to talk to the GP on my behalf and get them to issue a repeat? Will the prescribed HRT be available? Will the pharmacy leave me guessing and calling daily for updates? Will they eventually admit they can’t get hold of it? I don’t want to feel helpless, anxious, potentially suicidal again. Not when this is easily and cheaply treatable.”

She is right, isn’t she? Those are precisely the problems that we need to sort out.

Dementia Research in the UK

Lilian Greenwood Excerpts

Thursday 10th February 2022 Commons Chamber

[Lilian Greenwood (Nottingham South) (Lab)]

I congratulate my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) on securing and leading today’s important debate, and I have enjoyed all the contributions. I thank her for the work of the all-party parliamentary group on dementia, which she co-chairs, and the excellent report it published last year on dementia research. The report rightly sets out the need for the Government to honour their commitment and bring forward the dementia moonshot funding as soon as possible. The report also sets out some of the key challenges the sector is facing and where that additional funding could be best used. I know that the Government are currently working on a new national dementia strategy, and I hope that the Minister will use the APPG’s report in its development.

I echo the words of my hon. Friend in her opening contribution: dementia is one of the biggest health challenges facing us today. There are currently 900,000 people in the UK living with dementia. In my city, there are already around 2,690 people living with dementia, and that figure is expected to grow to more than 3,800 by 2030. It is one of the consequences of our ageing population. Dementia does not just affect those who have the condition; it also has a profound impact on family, carers and loved ones. Many, if not all of us know someone who is facing the challenges of living with dementia, and we owe it to them and their families to do what we can to make life that bit easier in the future.

As we all know, there is currently no cure for dementia. Finding a cure must be a key aim, but it is not the only one; we must also invest in research to explore how people with dementia can best be treated and cared for. Dementia is a progressive condition, with the symptoms likely to get worse over time. That has severe implications for family members providing care. I take this opportunity to highlight the work of the Centre for Dementia at the University of Nottingham, based in the Institute of Mental Health. It is addressing precisely that issue. The centre’s mission is to improve the lives of people with dementia and their carers through high-quality, useful research, looking at how people with dementia spend their time and what can help them to get the maximum quality from life.

The University of Nottingham is an excellent example of what can be achieved when there is investment in research, and I know from the Alzheimer’s Society, and from what my hon. Friend said, that there are similar programmes in Exeter and Newcastle. She highlighted their centres of excellence. I hope that the Government will work closely with the charitable funders of dementia research and look to replicate those best practice examples. That is very important for improving healthcare, but that investment in research and development, particularly when it is targeted outside of London, can provide real benefits to places such as Nottingham.

Since the pandemic began, we have seen what can be achieved by our life sciences sector when it has the funding, the leadership and the clarity of purpose it needs. The huge advances we have seen in the last decade around dementia research—whether that is the creation of world-leading research institutions, such as the UK Dementia Research Institute, or the vast increase in the number of people attracted to the UK to do dementia research—have all come about because of increased targeted funding and a national strategy to bring together charities, academics and private investors. It is worrying that the state of the UK’s dementia research sector is now at risk. To be honest, it is deeply disappointing that the Government, two years on from their initial promise of a moonshot, have not yet brought forward the funding. When the Minister replies, I hope that he will set out a timetable for when that will be delivered and confirm that the new strategy will be ambitious about what can be achieved.

One point that really struck me when reading my hon. Friend’s report was the impact of the pandemic and the lack of secure funding on researchers. It is clear from the report and researchers’ testimonies that for many of them this is not just a job but a vocation. Not only are they passionate about science, but many also have a personal link to dementia. Their motivation is to find a cure or treatment, or to improve the lives of people living with dementia, but even before the effects of the pandemic, which shut down many labs and prevented people from properly carrying out their work, it is clear that there was a career bottleneck, causing many researchers to leave the field.

There is no shortage of talent among dementia researchers in the UK, but there is a leaky pipeline. New cohorts of doctoral students are often encouraged to enter dementia research without the funding in place to ensure that they can continue and progress into post-doctoral research. Will the Minister tell us what is being done in the upcoming strategy to address that pipeline—to ensure that our talented researchers do not have to move abroad to continue their work or, worse still, leave the field altogether? I know that the Government gave £20 million last year to support charity-funded researchers, but that is far from what was promised; they must do more.

How can we ensure that more people with dementia and their carers can participate in research? As part of the 2020 dementia challenge, the Government set out an ambition for 25% of people living with dementia to be registered with Join Dementia Research, which my hon. Friend mentioned. However, just 2% of people living with dementia in England have registered on the site, despite the policy being written into NHS commissioning guidance and National Institute for Health and Care Excellence guidance. Attracting the world’s best researchers and private investment relies on us as a country being able to show that we can get the right number and right type of participants taking part in research, so what are the Government doing to encourage and enable that? Of course, it is about not just the benefit to the academic research, but the benefit to participants themselves; the report details how being involved in research can provide a sense of empowerment.

My final point today is about prevention. We simply are not doing enough to communicate to the public what every one of us can do to prevent dementia—reducing our risk by keeping ourselves healthy. One of the key slogans about brain health is “healthy heart, healthy brain.” Cardiovascular problems all increase the risk of memory loss, thinking problems and dementia, but it is never too late in life to reduce those risks.

There are 12 modifiable risk factors for dementia, including smoking, alcohol consumption, exposure to pollution and traumatic brain injury. Cutting out or reducing those risk factors can reduce the likelihood of developing dementia, but despite clear research in this area, Alzheimer’s Research UK’s 2018 dementia attitudes monitor showed that just 34% of people thought that they could reduce their risk of developing dementia—far behind the equivalent figures for conditions such as diabetes and heart disease, which were 81% and 77% respectively. If people do not believe that they can do something about it, they will clearly not take the actions that they could. Will the Minister set out what the Government are doing to improve the health information provided to the public? Will that form part of the new national dementia strategy?

In conclusion, it is obvious that we have a wonderful, rich and diverse dementia research sector in the UK. We have passionate, dedicated academics who work tirelessly to improve the life of people with dementia, and of their families and carers. We have clearly come a long way. We have built terrific infrastructure, and have world-leading facilities, but just as dementia does not stop progressing, neither should we. We have to build on this, particularly given the impact that the pandemic has had on the field. We must offer opportunities and support to academics. If we do not, we are at risk of wasting all the great work done over the past decade. We must not allow that to happen, particularly when there are new, exciting developments that will drastically improve the life of people with dementia. As my hon. Friend the Member for Oldham East and Saddleworth said, we have to provide hope. The Government must bring forward a plan for delivering the moonshot funding as soon as possible. I look forward to the Minister giving us some hope when he responds.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

I wholeheartedly thank my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this vital debate, and for the work that she does as co-chair of the all-party parliamentary group on dementia. I also thank the Backbench Business Committee for granting the time for the debate. What it lacked in quantity of Members, given that it is the last debate before the recess, it certainly did not lack in quality.

I think there is unanimity on recognising the value of dementia research and on willing the Government to do more. That degree of unanimity is unusual in such an adversarial Chamber as the House of Commons, but we have had a good debate today. I pay tribute not just to my hon. Friend the Member for Oldham East and Saddleworth but to my hon. Friend the Member for Nottingham South (Lilian Greenwood), the right hon. and gallant Member for Beckenham (Bob Stewart), and the hon. Members for Bexhill and Battle (Huw Merriman), for Rutherglen and Hamilton West (Margaret Ferrier), for Strangford (Jim Shannon), and for Coatbridge, Chryston and Bellshill (Steven Bonnar).

Dementia is the only condition out of the 10 conditions with the highest mortality rates for which there is no treatment to prevent, cure or slow its progression. Almost 1 million people are currently living with dementia. Every three minutes, someone develops the condition. As we heard very powerfully from the hon. Member for Ochil and South Perthshire (John Nicolson), it affects not just the individual but those around them—their family and friends. Dementia is also severely underdiagnosed, and that has been further exacerbated by covid-19. There is a backlog of approximately 35,000 people aged 65 and over waiting for dementia diagnoses. I would be grateful if the Minister, in his response, could outline the specific measures that the Government will take to improve early detection of dementia. I also pay tribute to the many charities working on dementia, to the individuals working in research and, as the right hon. Member for Beckenham rightly did, to those caring for people with dementia—not just the professional carers, but the massive army of often family carers looking after their loved ones.

Unless we find a prevention or cure for the disease that causes dementia, the number of people in the UK living with the condition is likely to reach 2 million by 2050—a shocking statistic. As we have heard, dementia and Alzheimer’s disease were the leading cause of death in 2021. As the hon. Member for Bexhill and Battle said, in 2021, we were in the middle of the covid pandemic and rightly focused on the tragic deaths of people from covid-19-related illnesses, but dementia and Alzheimer’s topped the league table. Indeed, in 2019, 15.9% of all recorded female deaths were due to the condition. This is big, and I know that the Minister understands the severity. Those shocking statistics mean that dementia has consistently, for whatever reason, over a long period of time, suffered from under-investment in research.

Great work is being done in my constituency of Denton and Reddish in Greater Manchester, as it is across the United Kingdom. I pay particular thanks to those working in Tameside and Stockport memory services, who give the initial dementia diagnosis, provide individuals with initiating and monitoring medication, and connect them to support groups in their community. That kind of holistic approach to dementia care is crucial.

Dementia can be cured only with research, however, which is why I am also proud of the work that the Greater Manchester dementia research centre is doing in this field. The centre aims to connect people living with dementia to cutting-edge studies and to the National Institute for Health Research. The centre works across the UK through the UK Brain Health Network, which has researchers in Bristol, Edinburgh, London, Cambridge, Oxford, Cardiff and Belfast, and which aims to bring molecular diagnostics into routine practice throughout the country.

Alongside the wider Greater Manchester “Dementia United” strategy, that innovative work gives my constituents who suffer from dementia the research, support and clarity that they deserve. It is just one example of the really good work taking place across the country. We need world-class research to achieve the best quality of life for people and families living with dementia.

The Minister is perhaps one of the nicest people I have to face—other than you, Mr Deputy Speaker—and I know that he genuinely wants to do the right thing, which is good. He knows, however, as has been referred to on numerous occasions, that his Government’s 2019 election manifesto promised to pour £1.6 billion into dementia research over the next decade as part of the so-called dementia moonshot. There has been huge unanimity in the debate that we want to see that happen. That was a point made powerfully by my hon. Friend the Member for Nottingham South. Over two years on from the general election, we have seen no plans to deliver that funding increase. The latest figures show there has actually been a decrease in Government spending on dementia research, with funding down by over £20 million since 2016. It has gone down by £7.2 million per year under this Prime Minister. That is totally unacceptable. I hope that in his response the Minister will address how on earth that has been allowed to happen.

[Lilian Greenwood]

Does my hon. Friend agree that the reduction in Government funding is particularly concerning, because the pandemic has had a devastating impact on the ability of charities to fundraise? Medical research charities, which fund 51% of all medical research in the UK, have seen their ability to fundraise reduced drastically.

[Andrew Gwynne]

My hon. Friend makes a crucial point. There has been a perfect storm. As we have heard, there is a growing list of people waiting to be diagnosed properly with dementia as a consequence of the covid pandemic, and, as she rightly says, the very research groups doing in-depth analysis and research into this disease are largely reliant on charitable sources of funding, which have almost completely dried up over the course of the pandemic.

Covid-19 Update

Lilian Greenwood Excerpts

Thursday 13th January 2022 Commons Chamber

[Sajid Javid]

First, I agree with my hon. Friend about the points she has made on these issues. On her final point about travelling, as she has seen just in the last few days, the UK Government keep our travel rules under constant review. The moment we have been able to safely remove any of those rules based on the evidence, we have done so, and I know my hon. Friend has respected that. When it comes to the rules of other countries for British citizens wishing to travel for holiday, business or otherwise, those are of course their rules. However, we are working at many levels—in my Department, the Department for Transport, the Foreign Office and others—with those countries to see how we can best co-ordinate on such rules.

[Lilian Greenwood (Nottingham South) (Lab)]

I am delighted that JVT is returning to the University of Nottingham, but I am worried about what he will hear from local clinicians. This week, I received an email from a doctor working in our local NHS. She says:

“I am crying as I write this. For years now the talk has been that the NHS is ‘at breaking point’. Well that point has passed. We are broken. We are on our knees.”

Of course, covid has taken a huge toll on staff, but we went into the pandemic with huge waiting lists and chronic staff shortages as a direct result of under-investment and mismanagement over the previous decade. Has not the right hon. Gentleman’s party failed my constituent and her NHS colleagues?

[Sajid Javid]

As I have mentioned, JVT’s move is the country’s loss, but Nottingham’s gain, and I am glad that the hon. Lady is delighted. On investment in the NHS, she will know that, even before covid-19, the Government had already set out, in the long-term plan for investment in the NHS, the extra £30 billion going into the NHS by the end of that period, with huge investment in areas such as cancer care, mental health care and electives. Then during the crisis, which has of course been very challenging for our health and care services, as it has been across the world, we have set out over £40 billion of extra investment, including this year, to help us get through this crisis.

Covid-19 Update

Lilian Greenwood Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

I very much agree: the omicron emergency is UK-wide and all parts of the UK should respond by increasing whatever they are doing on the booster programme further. I think that that view is shared throughout the UK. We will provide more support to Wales, Northern Ireland and Scotland to make sure that they can increase their booster programmes.

[Lilian Greenwood (Nottingham South) (Lab)]

Testing and self-isolating are vital in preventing transmission, but for people in precarious jobs who are struggling to make ends meet, it can be incredibly worrying and difficult. Why have the Government still not fixed sick pay so that everyone is properly supported to do the right thing, including those who might be worried about getting their vaccination or booster due to possible side effects and the need to take time off work?

[Sajid Javid]

We of course keep under review the support that is available throughout the pandemic. It is important that the House decided to extend the availability of sick pay from day one. There is also a hardship fund that is administered by local authorities.

Health and Social Care

Lilian Greenwood Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

I am not right hon., but I am grateful to my hon. Friend for the promotion. Of course I pay tribute to the staff at Watford General Hospital and, indeed, to him for his volunteering on the frontline in that hospital trust during the pandemic. He is absolutely right. As I said to my hon. Friend the Member for Kensington (Felicity Buchan), it is vital that this money gets to the frontline and is used to improve patient care, which is exactly what we intend to do.

[Lilian Greenwood (Nottingham South) (Lab)]

I am shocked and saddened by reports of a 23% increase in physical assaults on staff in Nottinghamshire hospitals in the past year, including 436 assaults on NHS workers in Nottingham hospitals. As we head into the season of Christmas revelry and hopefully responsible celebrations, will the Minister join me in condemning this completely unacceptable violence, which should never be part of any NHS worker’s job, and can he set out what he is doing to prevent such assaults and to protect and support NHS staff?

[Edward Argar]

I am grateful to the hon. Lady; I had the pleasure some months ago of visiting one of her local hospitals, where I had the opportunity to speak to staff. They do an amazing job. No one, irrespective of the role they perform, should be subject to intimidation or violence in doing their job, still less those who are working hard to save lives, to protect us and to get us through this pandemic. I join with her entirely in condemning both physical and verbal assaults on members of our emergency services. I highlight the important legislation that went through recently to increase the penalties, and pay tribute to those responsible for getting it on the statute book—the hon. Member for Rhondda (Chris Bryant) once again. No one, absolutely no one, particularly in our emergency services, should be subject to abuse of any sort while doing their job.