Reducing Health Inequality
Liz McInnes Excerpts(7 years, 5 months ago)
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Liz McInnes (Heywood and Middleton) (Lab)
It is a pleasure to follow the hon. Member for Congleton (Fiona Bruce), who made a number of interesting points. She made a convincing argument for introducing compulsory personal, social, health and economic education in schools. That is something that the Government could well do to foster good, healthy relationships, and it would go a long way to reducing health inequalities.
I congratulate the hon. Member for Totnes (Dr Wollaston) on securing the debate and thank the Backbench Business Committee for recognising the importance of the subject. I was pleased to hear the hon. Lady refer to drug and alcohol treatment services, as did the hon. Member for Congleton. The future of substance misuse services is in jeopardy when some local authorities face huge cuts to public health budgets and have no statutory obligation to provide such services. We need to address that when we talk about health inequalities.
I would like to add to the list something that I do not believe anyone has mentioned: the responsibility of local authorities in England to commission sexual health services. Sexually transmitted infections are increasing because cost-efficiency, rather than clinical need, seems to be the overriding factor when commissioning such services. We need to ring-fence funding for sexual health services as a matter of urgency; otherwise we face the development of a serious risk to public health.
I want to concentrate on diabetes and diabetic care, and throughout my speech I will refer to the report by the all-party group for diabetes entitled “Levelling Up: Tackling Variation in Diabetes Care”, which was launched yesterday. I declare an interest as secretary to that group. I urge everyone with an interest in diabetes care, and in health in general, to read a copy of that excellent report. We took evidence from people with diabetes, healthcare professionals and clinical commissioning groups. One theme that came out from people with diabetes was the inconsistent quality of care. I am pleased that the Government and NHS England have recognised the need for improvement in diabetes services. During the investigation, NHS England announced £40 million of funding for diabetes improvements—diabetes is one of the six clinical priorities in the improvement and assessment framework for clinical commissioning groups—and it is vital that this opportunity to transform diabetes services is taken.
Our report identified three key things that people with diabetes need and deserve: first, high-quality consultations with the right healthcare professionals; secondly, support to manage their condition; and thirdly, access to key technologies. On the first point, a big part of how people with diabetes perceive their care is determined by how healthcare professionals communicate with them. People told us that they sometimes felt that they were criticised in appointments for not meeting treatment targets and that they were being dictated to about how to manage a condition that they had to live with. Our report found that people who have an input into their own care have better treatment outcomes. Consideration of their own lifestyles alongside their diabetes management, as well as an interpretation of National Institute for Health and Care Excellence guidelines, allowed for tailored treatment plans. In this case, it seems that collaboration brings far better results than confrontation.
People also talked to us about the difficulty of getting access to specialists, with some reporting that services were simply overwhelmed. Others said that they had to seek local services proactively to get a referral. The services that patients really valued were diabetes specialist nurses, dietetics and podiatry. Additionally, people affected by diabetes also valued their pharmacists and saw how their role might be significantly expanded to provide more information and support. That might well be worth reflecting on, given the Government’s recent cuts to community pharmacy services.
On the second point, about the support given to those with diabetes to help them to manage their condition, there is a huge variation in the information and education that is provided. Those who attended structured education courses generally reported that they found them valuable and that those courses helped them to manage their condition better. However, there is huge variation in the offer and uptake of these courses. In my constituency of Heywood and Middleton, only about 20% of people with diabetes are offered these courses, and the uptake is even lower. Clearly, that health inequality needs addressing. People in work often reported the problem of getting time off work to attend a five-day intensive course, while those with children also reported that accessing childcare was a problem. There is a job of work to be done to persuade employers that they will also reap the benefits of having a happier, healthier and more productive employee if they are reasonable about allowing time off.
The third point, on access to key technologies, serves to emphasise that technology now plays a key role in diabetes care, particularly for type 1 diabetes. Again, however, patients face a postcode lottery in getting the technology they need. That was cited as a major concern by the parents of children with diabetes. Worryingly, many type 2 diabetics reported that they had to self-fund their own blood glucose meters and test strips, which are essential for the self-management of their condition. Some type 1 diabetics reported the same thing, which sounds harsh, as it is a legal requirement for diabetics on insulin to test themselves before driving, and the Driver and Vehicle Licensing Agency now advises people who take medication that causes hypoglycaemia to test themselves before driving. Similar postcode lotteries were reported regarding access to insulin pumps, and continuous and flash glucose monitoring, all of which can help diabetics to control their condition better and improve health outcomes. Sadly, inequalities in health outcomes persist because only the better-off are able to access devices that make living with diabetes easier.
The motion calls for support for policies to reduce health inequalities, and our report identified four areas the Government should look at: care and support planning; support for self-management; access to key technologies; and a strong, local diabetes system. Variation and inequality in diabetes care show us that good care can be achieved, but our task and the task of the Government is to make that happen everywhere so that best practice is shared, we end the postcode lottery in diabetes care and we tackle the diabetes crisis.
Clinical Commissioning: North Durham
Liz McInnes Excerpts(7 years, 5 months ago)
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Dr Roberta Blackman-Woods (City of Durham) (Lab)
I beg to move,
That this House has considered changes in clinical commissioning group commissioning practices for GP referrals in North Durham.
I asked for this debate as a result of a development that affects many in my constituency and other constituencies covered by the North Durham clinical commissioning group. I was made aware of it not by the clinical commissioning group but by “BBC Look North”, which received a tip-off from a GP about an upcoming change to the way GPs refer patients to a specialist. The change made by North Durham CCG fundamentally alters the way in which a GP refers a patient to a specialist.
It was always the case that if a GP saw a patient and considered that their health condition needed further investigation, they would be able to refer that patient directly to a specialist. The scheme introduced by North Durham CCG adds an additional layer of referral: if a GP wants to refer a patient, they must send a letter and medical records explaining why to a private health company called About Health, which will decide whether a patient should be referred to a specialist. That means that, in effect, a private company that has never seen the patient can overrule the decision of the patient’s GP to refer them to a specialist in a hospital. Conditions that would be referred under the new system include cardiology, gynaecology, dermatology and gastroenterology. Suspected cancer cases would be excluded from the system, although many cancers are detected when patients present with other health issues.
The decision to implement the scheme was taken following a year-long trial carried out by North Tyneside CCG. We do not yet know the clinical outcomes of the patients involved in that trial, but North Durham decided to roll out the scheme even without that information. North Durham CCG’s decision to adopt the new practice for referrals was also made without proper consultation of local residents or patients. Many patients were not even informed that confidential information about their health status was being shared with a private company. My hon. Friend the Member for North Durham (Mr Jones) and I had a meeting with the clinical commissioning group in September, only weeks before it introduced the new scheme, and yet it made no mention of the scheme whatever.
Liz McInnes (Heywood and Middleton) (Lab)
I am listening to the debate with astonishment. General practitioners, by their very name, are generalists, are highly trained and should be aware of the signs and symptoms of diseases and know who to refer patients to, but the intervention of a private company has been inserted as a barrier to patients getting specialist treatment. I cannot believe what I am hearing. I am sure my hon. Friend shares my surprise.
Dr Blackman-Woods
My hon. Friend makes an excellent point. Indeed, I was shocked and surprised. In fact, when “BBC Look North” presented me with the information, my immediate reaction was of huge concern for my constituents. I did an interview for “BBC Look North” and was then contacted by other news outlets. As a result of those interviews, I was contacted by many of my constituents, some of whom had already been adversely affected by the new referral system, and by GPs who said they were being forced to jump through hoops or to refer their patients unnecessarily to physiotherapy services when they knew that treatment would not help before they could refer to a specialist in a hospital.
I was also contacted by a GP in the area covered by North Tyneside CCG who said that he had referred a patient to a specialist for a skin condition but the referral was overruled by the new scheme, which is called the referral management system. The skin condition turned out to be cancer, but that was not discovered until months further down the line, which meant that far more radical surgery was required than would have been the case if the patient had been seen by a specialist when the GP first referred them.
I therefore have a number of serious concerns about the referral system and the way in which the decision to implement it was made. My first concern is the possible negative impact on the health of my constituents and other people who live in areas affected by the new patient referral management schemes. I am concerned because whether a referral to a specialist goes ahead or not could have a long-term impact on the health of the patient or even result in something more serious, especially if decisions are overturned by About Health. A patient might not receive the treatment they need early enough.
I am also concerned about the financial impact of the decision. I understand that the NHS is under considerable financial pressure, but I doubt whether the scheme will end up saving money in the long run. That is because, as I just set out, in many cases where referrals are rejected the problem does not go away and patients return to their GP or even go to A&E with far more serious problems, which take up more of the NHS’ time and resources. About Health, the private company deciding on referrals, will be paid a basic fee and an additional £10 for each referral letter, which in itself will incur a significant cost. I am therefore not at all sure that the scheme is cost-effective.
My final concern is about the lack of public consultation and information on the decision to implement the scheme. Last October, the Secretary of State for Health announced plans to rate CCGs to make
“the most patient-focused NHS culture ever”,
which would be
“much more accountable to their local population than previously.”
The decision made by North Durham CCG to change completely the way in which GPs can refer a patient to a specialist without any consultation flies in the face of CCGs being accountable to the local population. How are people supposed to hold a CCG to account if they are not aware of changes that are being made?
The North Durham patient reference group meets monthly in Durham city to discuss patients’ points of view and give feedback to the CCG about proposals and issues. The group, which is drawn from members of each GP practice forum across Durham, was informed of the new referral scheme only as it was about to be introduced, and it was not given any opportunity to give feedback on proposals. Despite meeting monthly, members of the group had not even heard about the plans before they were presented with them and told that they were to be introduced imminently.
Similarly, members of patient forums at local GP practices were informed of the decision, rather than consulted on it. I am told that patient forums and the North Durham patient reference group were concerned and opposed the immediate implementation of the proposals, but North Durham CCG decided to go ahead and implement the new scheme immediately in any case.
This is a really important point for the Minister. If a patient goes on to the CCG’s website, what they see does not tell them that their details will be given to a private company; they are simply told that a referral system is in place and that referrals are to “consultants” or “specialist GPs”. I think many patients would conclude from that wording that their medical information is to be sent to a specialist at a local hospital rather than to a private company.
I have written to the CCGs in the north-east to invite them to meet me and other members of the northern group of MPs to discuss this issue. It has been extremely difficult to get them to come to a meeting with us or indeed to get any information from them at all. I have some questions, which I will put quickly, to give my hon. Friend the Member for North Durham time to speak. Does the Minister know of any other clinical commissioning groups in the UK that have implemented a patient referral management service? Does he think that it is acceptable that no consultation was carried out? Will the practice be repeated by other CCGs across the UK—particularly ones ranked as in special measures? How can About Health, or other private companies, be held accountable if decisions result in negative outcomes for the health of patients? Does the Minister agree that the referral system is acceptable at all?
Social Care
Liz McInnes Excerpts(7 years, 5 months ago)
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Liz McInnes (Heywood and Middleton) (Lab)
Across the UK, local government funding has been reduced by 37% in real terms between 2010 and 2016, and the Local Government Association has estimated that councils’ overall funding gap will amount to £5.8 billion by the end of this parliamentary cycle. Those cuts to council services have severely taken their toll on the health and social care provision that millions of people rely on. That now presents an immediate risk to those patients and providers. Councils face a £1.9 billion funding gap in adult social care. We are at what the Care Quality Commission has said is “a tipping point”.
In my constituency of Heywood and Middleton, we have been hit hard. Rochdale Council has had to make huge Government cuts of £200 million in the past six years. Social care budgets face even more pressure in the next two years, as the council is forced to save a further £40 million. The social care precept of 2% on council tax this year will raise only about £1.4 million, which is a drop in the ocean of Rochdale’s total adult social care budget of £80 million.
Inevitably, there have been serious consequences as a result of this underfunding. Our hospitals and A&E departments report a 70% increase in bed-blocking. They identify the cause as the fact that social care is not available to allow patients to be discharged safely. The figure was 108,000 in April 2012, but it was a staggering 184,000 this July. Bed occupancy rates exceeded 91% during January to March 2016, which is the highest quarterly rate in the past six years.
These figures serve to emphasise that cuts to social care services have had an inevitable knock-on effect on the NHS, heightening the bed-blocking problem, as patients are forced to stay in hospital for longer because they are unable to get the support that they need at home. By properly funding adult social care, we could remove the burden from our hospitals, so that they could carry on the important acute work for which their services are intended.
I want to talk about home care providers and their staff. According to the local government ombudsman, they are “underfunded and over-stretched”. Sadly, there has been a rise in cases of neglect in patient care and a failure to deliver a decent and fair wage to carers. Some 63% of staff said they had less time to spend with the people they care for because of staff shortages, and nearly two thirds are doing their job alongside fewer staff than they were six years ago. The trade union Unison has said:
“Cuts have left a trail of destruction and this is affecting those in desperate need of care. Care workers do a vital job looking after the most vulnerable in society. But they’re not getting the support they need from their employers.”
I agree with Unison. Carers are an integral part of the healthcare system, and they must be valued and properly remunerated for the work they carry out, year in, year out.
I hope that now we have had a change of Prime Minister and Chancellor, we might have a change of mind and a change of heart on this issue. The autumn statement is the first opportunity to reassure the public that this will be a Government who not only work for everyone, but care for everyone. The importance of investment has been acknowledged on all sides of the debate. Stephen Dalton, chief executive of the NHS Confederation, has said:
“The critical and negative tipping point for the health and care system has been triggered by cuts to social care. It’s imperative the chancellor takes the opportunity, in the autumn statement, to prioritise investment in social care before the winter.”
This is issue needs to be addressed immediately. It cannot wait any longer.
Some people are of the view, locally, that the devolution deal in Greater Manchester might provide a solution to the underfunding of adult social care. My right hon. Friend the Member for Leigh (Andy Burnham), who is now Labour’s Greater Manchester mayoral candidate, has long campaigned on the integration of health and social care, which he has talked about in this debate. If he is elected, that will give him an opportunity to put these plans into action. However, with devolution comes a £1.2 billion to £2 billion black hole in the finances. For healthcare to be properly devolved, it is vital that it is properly resourced and properly funded.
The Government must act to give health and social care services the investment and protection that they desperately need. In the long term, we must fully integrate health and social care, otherwise many of the most vulnerable and defenceless people will be left facing a prolonged winter of discontent and displacement.
Coeliac Disease and Prescriptions
Liz McInnes Excerpts(7 years, 6 months ago)
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Rebecca Pow
This is highly relevant. I, too, have been contacted by constituents who have suggested this voucher idea—that the bona fide coeliacs get the staples and so many vouchers a month, not for all their products, but for the bread, pasta and absolute staples.
Liz McInnes
Is the Minister aware that the annual cost per diagnosed patient of prescribing gluten-free food is £180 per year? Weigh that up against the cost of avoiding infertility, bowel cancer and osteoporosis. What is the obvious conclusion for any NHS professional?
Mr Adrian Bailey (in the Chair)
Order. Before the Minister responds, can I point out that he has been very generous in taking interventions, but the debate has to finish at 4.45 pm?
National Arthritis Week
Liz McInnes Excerpts(7 years, 6 months ago)
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This information is provided by Parallel Parliament and does not comprise part of the offical record
Liz McInnes (Heywood and Middleton) (Lab)
It is a pleasure to serve under your chairmanship, Mr Betts, and an honour to be mistaken for my very athletic hon. Friend the Member for Neath (Christina Rees). I thank the hon. Member for Strangford (Jim Shannon) for championing this debate. I know from my role as the chair of the all-party parliamentary group on medical research that this debate on arthritis has been a long time coming, given the five-year hiatus in discussing the issue in this House.
First, I pay tribute to the courage and strength of the 10 million people living in the UK who suffer from the disease of arthritis and musculoskeletal conditions. Secondly, we must celebrate the work, commitment and endeavour of thousands of carers who look after, whether in a personal or professional capacity, those who suffer from this illness.
Mr George Howarth (Knowsley) (Lab)
Although I do not, as far as I know, have an arthritic condition, I do have an impacted disc. Frankly, when it flares up, without the support of family members, and in particular my wife, I would be in an impossible situation. It is important that we pay tribute to all those carers and family members who support people with these conditions.
Liz McInnes
I thank my right hon. Friend for that relevant intervention. We must never forget the usually unpaid work that carers do and the vast contribution they make to keeping people out of hospital and saving the NHS money.
As many other hon. Members have done, I also thank Arthritis Research UK for the work it does highlighting the issues around this disease, which affects nearly one in six people in the UK. Arthritis Research UK provides the support that people with arthritis need, such as in-work help and funding for accessibility, social care and medical research. Arthritis Research UK spent £6.6 million on research this year, and during 2014-15, it committed £30.9 million of funding across Europe with its research partners. As many hon. Members have mentioned, it promoted World Arthritis Day, which was last week, and the excellent “Share your Everyday” campaign.
I was fortunate enough to be able to table an early-day motion, which garnered signatures from across the House, recognising the issues and people I have just spoken about. To date, that early-day motion has attracted 44 signatures, and I thank all those hon. Members who supported the motion; hopefully, after this debate there might be more.
Before entering this House, as a biochemist in the NHS, I worked at the forefront of patient care and research and development. The work on arthritis research in the UK is pioneering; it is uncovering new ideas and breakthrough treatments that will end the way in which arthritis limits lives. In the 1990s, it was UK scientists who discovered that a molecule called tumour necrosis factor—one of the cytokines that my hon. Friend the Member for West Ham (Lyn Brown) referred to—was the key molecule causing the destructive autoimmune inflammation of joints that leads to the problems of arthritis. The anti-tumour necrosis factor therapy that they developed has freed millions from rheumatoid arthritis and has also inspired the field of biologics—medicines that use the body’s own molecules to combat diseases. That is something we should be very proud of.
The crucial work of all medical research charities is supported, in the long term, by Government through a real-terms increase in science spending. It is essential that that is continued, and that we back research and development, now and post-Brexit. The Government also need to play their part in supporting medical research funded by charities. The charity research support fund provides an uplift to support charity-funded research in universities and to contribute towards the full economic costs of research—costs such as lighting, heating and maintaining labs. This may seem a minimal ask, but it is the basis and foundation of what scientists, and the laboratories they use, require to continue their vital research.
This joint funding approach ensures that charitable donations are directly invested in research that meets the needs of people with health conditions. In 2013, the Government’s £198 million investment through the charity research support fund leveraged £833 million of investment by charities in English universities. That is a staggering amount; without the charity research support fund, we would have less funding to invest in our leading research. We must commit to securing continual funding for this, to help those with debilitating diseases.
Hormone Pregnancy Tests
Liz McInnes Excerpts(7 years, 7 months ago)
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Liz McInnes (Heywood and Middleton) (Lab)
I want to thank my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for bringing this debate to the Chamber. I congratulate her on her work on this matter, on continuing to put pressure on the Government to hold an inquiry and now on working to ensure that they are held accountable following their promise. I also wish to express my support and admiration for the campaigners, particularly Marie Lyon, whom it has been my pleasure to meet over the past couple of years since I became an MP. The campaigners have pursued justice on this issue over decades to have their voices heard and their questions answered. They have shown resilience and fortitude in their search for clarification on the possible association between the prescription of hormone pregnancy tests having adverse effects in pregnancy and subsequent birth defects in their children.
My predecessor in Heywood and Middleton, Jim Dobbin, was working with constituents, trying to get some answers to their strongly held beliefs that the prescription of hormone pregnancy tests had led to birth defects in their children. After Jim’s sad death in 2014, I have carried on his work. No one was more pleased than me when, finally in 2015—40 years after hormone pregnancy tests were banned—an independent inquiry was finally set up. The families, the children and the campaigning group, the Association of Children Damaged by Hormone Pregnancy Tests, would finally receive the answers that they had sought for so long.
Hormone pregnancy tests were banned in 1975 following advice from the former Committee on Safety of Medicines that they should not be used and that a warning about a possible hazard in pregnancy should be inserted in all promotional literature. Let us consider that for a moment: this was a pregnancy test, and yet it was suggested that a warning should be inserted that it should not be used in pregnancy. The Committee on Safety of Medicines wanted a clear statement that pregnant women should not use these products. Clearly, there had been sufficient adverse reactions reported for the committee to reach those conclusions.
I can remember how jubilant we were last year when the inquiry was finally agreed to. We thought that, finally, the evidence and the causal relationships would be examined. We even thought that we might get an explanation of why the medical notes had mysteriously gone missing. We felt that we had achieved something and that we would get answers to the questions that had tormented affected families for decades.
The Government had promised in good faith that the inquiry would be transparent and in good time, but, disappointingly, the inquiry has delivered on neither transparency nor timeliness so far. Questions need to be answered. Why did it take more than a year to set up the expert working group? Why has the working group met only three times? We have no idea at what stage the inquiry is now. The Government must now provide reassurances and clarity.
The expert working group has to be more accountable and more open to scrutiny. It has to engage and work with the Association of Children Damaged by Hormone Pregnancy Tests to address its concerns on the current progress, or lack of it, of the inquiry process. A key concern, which has been voiced by many Members, is that the expert working group has also signed a confidentiality clause. It is felt that that compromises the possibility of a fair and just outcome.
The former Minister for Life Sciences, the hon. Member for Mid Norfolk (George Freeman) set out quite clearly to the families that his Government would establish a means to closure and justice, while alleviating their fears that past failings would not be investigated. The delays and deliberation on following through on those promises should now be over. The Government must now give answers and make sure that they deliver on that deal to the thousands of affected families.
Baby Loss
Liz McInnes Excerpts(7 years, 7 months ago)
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Liz McInnes (Heywood and Middleton) (Lab)
It is a pleasure to follow the excellent and very moving, yet very practical speech made by the hon. Member for Banbury (Victoria Prentis), who is making me want to cry as well. I think the idea of having a tissue manufacturer to sponsor this debate was quite a good one.
I pay tribute to the hon. Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince) for bringing this very important debate to the House. We owe both hon. Members and their families a great deal of gratitude for raising awareness about this issue through Baby Loss Awareness Week and their commitment to the all-party group.
I also pay tribute to the families who started Infant Loss Awareness Day back in 2002, and to the thousands of families across the country who continue to make a commitment to helping other families through their grief while highlighting the lack of maternity bereavement care in hospitals and in the community. As we have heard, thousands of families each year in the UK suffer the tragedy of losing a child. I hope that this debate may in a small way lead to their not having to suffer in silence and to their realising that they are not alone in their grief. This debate has raised many issues, some of which are uncomfortable, albeit very necessary if we are to change policy to help to reduce infant death, to save bereaved families from isolation and to make sure that the best possible maternity and neonatal care is available to everyone across the NHS.
Before I was elected to this place, I worked for the Pennine Acute Hospitals NHS Trust, which is based in the north-west. It performed some good work in this area, including by holding an annual baby memorial day for parents who had lost babies in the hospital. That was led by our excellent hospital chaplains, who perform such a good service for bereaved parents.
I was asked to attend this debate by my constituent Jane Casey, whose daughter Niamh tragically died shortly after her birth at the trust. Jane has still not received the root cause analysis of her daughter’s death from the trust and, 11 months after Niamh’s death, I am helping her to obtain the report. Jane says:
“The hospital has made me feel that my daughter’s life was not important. I am completely broken and find life a struggle. I keep on going because of my son.”
Those are such sad words, but they are typical of the examples that have been shared today. I really hope that this debate will achieve some practical steps to help other families to avoid such grief.
Health visitors, who have not yet been mentioned, play an important role pre and post-pregnancy. They can give support and practical help, but I feel that their role is undervalued. Since 2015, health visitors have been devolved to local authorities, but in that time there have been cuts to local authorities of nearly £200 million. The former Chancellor of the Exchequer announced a further £77 million cut in 2016-17 and an £84 million cut in 2017-18. The funding that was transferred with the health visiting services was not ring-fenced. I sincerely hope that, under the guidance of a new Prime Minister and Chancellor, the Government will consider protecting this vital service and investing more.
Staggeringly, 68% of local authorities do not commission bereavement support, and neither do nearly a fifth of clinical commissioning groups. This is a vital provision for families at their time of greatest need, and the failure to provide it is clearly apparent in our healthcare structures. I am pleased that NHS England is developing the children’s palliative care funding currency. That includes pre-bereavement care before a baby or child dies, but it sadly overlooks bereavement care after a baby or child dies, so I hope that amendments will be made to that policy.
The Government and the House have the opportunity, by passing the Parental Bereavement Leave (Statutory Entitlement) Bill, which was introduced by the hon. Member for Colchester, to put parental bereavement leave on the statute book. It would give bereaved parents the entitlement to a leave of absence from employment, which is a common right across Europe. That would be an important first step in the right direction as the entitlement should be afforded to all at their time of greatest need.
Although mothers, fathers and families will never forget the children they have lost, baby loss awareness week is a chance for them to meet other families and share memories in remembrance. The collective sharing of experiences can begin the process of healing and alleviate a small part of the pain. The most powerful thing it provides is the opportunity to speak out and prevent other parents across the UK from suffering the same agony. We, as legislators, must act upon the words that have been spoken today in the House and create a better environment of support for bereaved families.
Finally, I pay tribute to my hon. Friend the Member for Lewisham, Deptford (Vicky Foxcroft) for sharing the tragic story of her daughter, Veronica. I am in awe of the bravery and courage she showed in speaking out today. Her bravery and courage were echoed in the words of the hon. Member for North Ayrshire and Arran (Patricia Gibson), my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), the hon. Member for Banbury and the two hon. Members who brought this debate to the House, whom I thank for giving me this opportunity to speak.
European Medicines Agency
Liz McInnes Excerpts(7 years, 7 months ago)
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Liz McInnes (Heywood and Middleton) (Lab)
It is a pleasure to serve under your chairmanship, Mr McCabe. I thank my hon. Friend the Member for Cambridge (Daniel Zeichner) for securing this important and timely debate. I am aware of how important academic and medical research is to his constituents and his constituency. I am also aware of the standing that the work done in Cambridge gives to the United Kingdom on a global stage. Given our current state of political uncertainty, I thank him for all the work he is doing in this area.
Some hon. Members will know that I worked as a biochemist in the National Health Service for 33 years before being elected to serve as the MP for Heywood and Middleton. Medical research and innovation have been at the very heart of my professional career, working and collaborating with others from across the world here in the UK to focus on improving the quality of patient care. Like other hon. Members, I respect and will uphold the decision of the referendum on 23 June that the British public wish to leave the European Union, but I will continue to argue that our leaving does not mean isolation from the European Union.
We must not become isolated from world-leading medical and academic research or from collaborative innovation on life-saving medicines. We must reject isolation from funding and economic prosperity. We must ensure we are not isolated from regulatory safeguards or from providing our citizens and patients with the best quality of life and healthcare. Isolation in medical terminology denotes a hospital or ward for patients with contagious or infectious diseases. We should not isolate or quarantine ourselves and become, in effect, the sick man of Europe. Keeping institutions such as the European Medicines Agency is key to the future of British science and medicine, and to accelerated access to treatments for patients in the UK.
As a representative of a north-west England constituency, I know just how important the pharmaceutical industry is, not only in providing life-saving drugs, but in providing high-skilled training and jobs. Greater Manchester has the most pharmaceutical employees of any region with just over 6,000 workers, totalling 18% of the total jobs in this industry across the UK. The pharmaceutical market in the EU as a whole employs 700,000 people. Every job in the pharmaceutical industry creates three to four more jobs through indirect employment.
As chair of the all-party parliamentary group on medical research, I know how imperative enabling timely patient access to new medicines is and how it plays a vital role in supporting the development of medicines for the benefit of patients, based on a comprehensive scientific evaluation of data and procedural clinical testing. The EMA does that by developing guidelines and setting standards, while co-ordinating the rigorous monitoring of pharmaceutical companies’ compliance with their pharmacovigilance obligations. It provides comprehensive information for the public on the safety of medicines and co-operates extensively with external parties—in particular, representatives of patients and healthcare professionals. The proposed great repeal Bill should ensure that all those aspects are preserved in UK law and harmonised with EU legislation and directives. Let us take, for example, Cancer Research UK, which directly funds more than 200 clinical trials, 28% of which involve at least one other EU country. Any change to EU legislation would put those pan-EU trials at risk.
The EMA has achieved notable and substantial advancements in its field, recommending approximately 1,000 medicines to the European Commission for a marketing authorisation for all EU member states. Those medicines benefit patients suffering from all types of diseases, including cancer, diabetes, neurological disorders, infectious diseases and autoimmune disorders. The EMA has also excelled in specialised areas such as medicines for rare diseases, medicines for children and advanced-therapy medicines. It has built a broad access to clinical data, allowing shared knowledge to be applied in future research, and has thus increased the efficiency of the development of medicines.
Of course, behind all those achievements are people. We have a duty to give reassurance immediately to the staff of the EMA. Of its 890 employees, 93% were born outside the UK. We must clarify that they will be able to continue to live and work in the UK; indeed, we must strive to end the uncertainty that so many of these workers are feeling at the moment. Although the complexities of this matter and the wider issues that this debate raises cannot be confined to a soundbite or a sentence, some of the language and tone on immigration during the past few weeks has been regrettably toxic. The French microbiologist Louis Pasteur said: “Science knows no country”. In that spirit, I advocate the positives of not only immigration, but innovation. The two are inherently intertwined in the scientific and healthcare community.
Only last week, two British scientists, Duncan Haldane and Sir Fraser Stoddart, collected Nobel prizes for science. I congratulate them and their teams on those awards. Both those eminent British-born scientists have worked in the UK and abroad, and each of them warned that the risk of Brexit could mean “a big negative” for British science.
We must continue to foster scientific excellence post Brexit, full stop. Retaining the EMA here in London is essential to harbouring and cementing those values. The time for speculation is over. The Government proclaim that they want “a country that works for everyone”, but if they do not stand up now and speak up for the scientific community, they will end up creating a country that stands isolated from scientific research and innovation —a country that is neither welcoming nor working.
David Mowat
That is a fair point. It could be a danger. The point I was making was that they made the plea to remain in the EU from the United States, which is the leader in many aspects of science. I think we can agree that science is international—it operates in Japan, the US, the UK, Germany, France and elsewhere—and that, however we achieve Brexit, we should do what we can to avoid creating barriers to internationalisation.
Liz McInnes
There is no irony in the comments of the Nobel prize winners just because they were made by British scientists working in the United States. That fact only emphasises how international science is. We must not fall into the trap of taking the line that was spread before the referendum:—that this country has had enough of experts. Those people are experts, and we should listen to what they have to say because they are the people who know what is going on. They know what the effect on British science will be if the EMA and its principles are lost.
David Mowat
We can agree that the scientific principles at the core of our world-leading science must not be lost in regulation. We can also agree that science is international. It is in all our interests, and in the interests of our communities and our children, that this country continues to do world-class science as part of an international collaboration. That is the Government’s intent and will.
I will finish by talking about our world-class industry.
NHS Sustainability and Transformation Plans
Liz McInnes Excerpts(7 years, 7 months ago)
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Liz McInnes (Heywood and Middleton) (Lab)
Before entering the Commons, I worked for 33 years in the NHS and saw and experienced on a daily basis the service that it provides to millions across the UK, from its GPs to its world-leading research and development. With 80% of hospitals in debt, bed-blocking at record highs, an ageing population, waiting times for cancer treatment lengthening, underfunding of social care, mass staff shortages in hospitals and a future where collaboration with the European Union is unclear, we should show our commitment to our NHS in its time of need and give it the funding it deserves so that it can succeed for all patients.
The NHS STPs do not clearly address those issues. As many hon. Members have said, they have been shrouded in secrecy and drawn up behind closed doors. There has been no public consultation, and there is a staggering lack of evidence that they will deliver the reductions and improvements the Government promise. They will be untried and untested, and will come at an unimaginable cost to patients if they are found not to be the right path to pursue.
I am a Greater Manchester MP. When the metro mayor plan was introduced, bold promises of devolving power to the region were made, including in health.
Dr Huq
My hon. Friend mentions local government. Is she aware that, in north-west London, which is one of the few areas not to have had its STP published, the London boroughs of Ealing and of Hammersmith and Fulham have not signed up to the STP? They are refusing to do so because it threatens the closure of both Ealing and Charing Cross hospitals. The mistrust and secrecy is everywhere, including in local government.
Liz McInnes
My hon. Friend highlights the secrecy surrounding STPs and the attempts of local authorities and the devolved regions, including Greater Manchester, to deal with devolved health issues, as they are supposed to do.
The promise to devolve health was front and centre of the Cities and Local Government Devolution Act 2016. Metro mayors would need to be consulted like any other political leader, and the plans jeopardise the autonomy of the metro mayor’s powers. The British Medical Journal states that STPs may risk the post of metro mayor
“becoming a rallying point for opposition to service reconfigurations.”
Not only metro mayors and clear legislation are needed if the STPs are to be effective. Councillors and committees must be at heart of the planning process, and health and wellbeing boards must be an integral part of it. They are the only place where local political, clinical and professional leaders come together. They can be pivotal in driving change, but they seem to have been put on the waiting list for consultation.
As with the disastrous Health and Social Care Act 2012, overseen by the former Prime Minister, and now former MP for Witney, the proposals take us on a journey to another calamitous reorganisation of the NHS. It is now a necessity that the Government abandon the timetabling and scheduling of such a major restructure package. Perhaps now is the time to step down and take stock, like the former Prime Minister. I call on the Government and Secretary of State for Health to go back and reconsider not only the timeframe but the proposals in general, and to have a full and frank public consultation, allowing for transparency and debate at local and national level.
Junior Doctors Contract
Liz McInnes Excerpts(7 years, 10 months ago)
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Mr Hunt
My hon. and learned Friend is correct to have raised that before and I can reassure him that we have subsequently started a very big piece of work to look at those exact issues. The difficulty is that throughout their training junior doctors are rotated every six months. That is particularly disruptive to family life or, for example, if they have a partner and one is sent to Sheffield and the other to Bristol. We are seeing what we can do to deal with that. The other issue that we are looking at is that of people who for family reasons discover that they have a caring responsibility, maybe for children or for a parent with dementia, and want to switch to a specialty that may not have quite so many unsocial hours, and whether it is possible to novate their training across from one specialty to another, which does not happen at present.
Liz McInnes (Heywood and Middleton) (Lab)
We are all congratulating each other on the measured tone of this debate, but Dr Johann Malawana has said in very measured tones:
“Given the result, both sides must look again at the proposals and there should be no transition to a new contract until further talks take place.”
Will the Health Secretary commit to hold further talks in order to avoid further conflict and the possibility that he may provoke further strike action if he does not? If he provokes further industrial action among the junior doctors, the blame will lie fairly and squarely at his open door.
Mr Hunt
Let me tell the hon. Lady the words that Dr Malawana actually said:
“I will happily state that I think this is a good deal.”
He talked about junior doctors benefiting from
“massively strengthened areas of safety precautions…equalities improvements, improvements to whistleblowing protection and appropriate pay for unsocial hours.”
He thought this deal was a big step forward. As I said, if I thought that there was any prospect of further negotiations leading to a consensus that could get the support of the BMA membership, that is what I would be doing, but my honest assessment of the situation—given that the people who most strongly opposed the Government recommended accepting this deal and still they were not listened to—is that there is no such prospect, and I therefore need to take the difficult decision that I have taken this afternoon.