(3 years, 2 months ago)
Commons ChamberWe are transforming mental health services through the NHS long-term plan, investing an additional £2.3 billion a year by 2023-24. Where national waiting time targets exits, the majority are being met. Targets for eating disorder services are sadly not being met, but additional resources have been allocated to increase capacity and address waiting times. We are working on the consultation responses for the Mental Health Act White Paper, and we will bring legislation forward when parliamentary time allows.
We are making good progress on implementing the Green Paper proposals, and I am pleased to say that we have established 11 mental health support teams in Hampshire. Nationwide, there are currently 180 mental health support teams, covering around 15% of pupils in England. Over 200 more are in training or being commissioned, and we expect to have around 400 in place by 2023-24, covering 35% of pupils. We recently announced £9.5 million to train thousands of senior mental health leads among school and college staff.
Last year, in my NHS trust 37% of children referred to mental health services were turned away. That was up from 28% the year before. That is 2,649 children not getting treatment despite referrals from professionals. That will be exacerbated, of course, by the acute children’s mental health unit at Ticehurst being shut and no new hospital provision commissioned.
It is not just Sussex Partnership NHS Foundation Trust that is failing; it is services across the country. In 2019, 140,000 children were turned away from child and adolescent mental health services, and some experience exceptionally long waits. Is the Minister comfortable with these huge numbers of children being turned away from treatment? Does she think that these waiting times are acceptable? What message does she have for those children and families who do not receive the treatment that they desperately need?
The short answer to that question is no, and that is why we have committed an additional £500 million to address some of the issues that the hon. Gentleman highlights. However, I must reiterate that the majority of our targets, where they have been set, are being met. Sadly, in eating disorders—I hold my hands up—we are not meeting the targets that we want to, but as he may be aware, we are trialling four-week waiting targets for children and young people. The results of that review and pilot will be available soon.
We continue to look at ways in which we can increase access to services for children and young people. Children and young people have told me themselves, via organisations such as Barnardo’s, that they want their mental health services delivered in a different way. They do not want to go and sit in a village hall or a hospital, or wherever they may receive their services from community practitioners; they want some of their services delivered via their phones, laptops or computers. Obviously, one-to-one services have to be available where they are needed, but children and young people are demanding a change, and we are going through that change now.
(3 years, 7 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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My hon. Friend is quite right to praise the teams across the north-east who have been doing an unbelievable job. The vaccination of 98% of residents in his area is something we should all celebrate. Making sure that everybody is within 10 miles of a vaccination centre is important. In the very rural areas that may include being 10 miles from a mobile site, because we will send in mobile sites to the most rural areas. Crucially, by 15 February everybody will have the offer of a vaccine. Sometimes they may get two offers. One might be to travel, for instance to go to Newcastle where there is a vaccination centre, but if they get that invitation they can still wait to have the more local offer of a jab from their primary care network. There are different ways to make it happen, but he is absolutely right on the importance of getting the vaccine available for all.
Without increasing the 2 million doses a week to 5 million, we are going to be administering the vaccine to the adult population until the end of the year. That causes great anxiety. People are confused and unclear about if and when they will get a dose, particularly informal carers who worry that they are not on anyone’s list. Will the Secretary of State consider requiring doctors and the NHS to text or write to all patients to outline where they are on the list, so that people have a better reasonable expectation of when they will be vaccinated? That would enable them to ensure their prioritisation is correct, and, actually, stop them phoning up surgeries and blocking up phone lines to ask questions about when they are going to get their vaccine.
All those who are over 70 or clinically extremely vulnerable will have that offer before 15 February. What that means in practice is that if you receive a letter when measures are put in place recommending that you shield—that letter comes from either me or the Communities Secretary—then you are on the list to be vaccinated before 15 February. After that, we will continue through the JCVI cohorts, which of course includes, in cohort six, those who are vulnerable but not in the clinically extremely vulnerable group. We will get there, and we will invite people according to their clinical need. My recommendation to the hon. Gentleman’s constituents is that they should wait for the NHS to get in contact with them. We have a programme to make sure that everybody is reached.
(3 years, 9 months ago)
Commons ChamberThis is a crisis of a proportion that we could never have imagined, but it seems that cronyism has proliferated in a number of recent appointments by this Government. Of course, Dido Harding’s appointment is an example of that. She is someone who continues to sit on the Benches in the House of Lords as a Conservative peer. She asks and answers questions as a Conservative peer. She has been appointed to run part of a Government Department, not as a Minister and not via the standards in public appointments process—in fact, that was totally disregarded in her appointment under the guise of this crisis—but because she has some contacts and was in the telephone industry, which she apparently was not very good at anyway. She has been appointed, and of course her husband is the tsar in charge of anti-corruption and all that kind of stuff.
Of course, it might well be that the very best people are appointed in a pandemic. It might well be that honest, good decisions have been made, but one of the central points of anti-corruption is the idea of transparency and the idea that public appointments and public contracts are given through due process, even if that due process is extended or expedited, and even if, in the end, the appointments go to the same people. That is not what we have seen and we need urgent action on building trust back into some of those appointments.
We also need to build trust back into many sectors. Teachers need trust put back into many of the decisions around exams, for example. I have just come off a call with the general secretary of the National Education Union and his feeling is that teachers are totally confused about what is actually going to happen. Will there be exams or will there not? Will there not be exams in Wales and Scotland? None of this would have been a problem if we had not had the scrapping of coursework.
The problem would also not be exacerbated if we were able to properly scrutinise Ministers, not just in this place, but in correspondence and parliamentary questions. The reality is that the response time to parliamentary questions is woeful. My caseworkers pull their hair out every single day, and it is not fair. In good times, Government get it wrong and maltreat our constituents. They do it all the time, whatever the Government guise—under whatever party is in government —and one of our roles is to correct those wrongs when they are done. Correction is not always done through the courts. It is very often done by the MP.
If my caseworker has to wait a whole day on the phone for the advice line for immigration, only to be told, “I am terribly sorry; we haven’t followed that case up in three months, even though we promised you three months ago that we would follow it up”—that is routine, Minister—there is a real problem with the system. I have a single mum, for example, who claimed benefits. Someone else fraudulently claimed in her name. She has been chased down by debt collectors about universal credit. She has been treated appallingly. The Department for Work and Pensions agreed with me in the end that it was a fraudulent claim from someone else and that there should be no debt collectors, but it has not informed the debt collectors properly. Normally, we would phone the right people up and get through to the Minister, but that is not possible in this period. That needs to change.
(4 years, 1 month ago)
Commons ChamberNot at this moment in time. However, I am really hopeful that, as we go into September, after the recess, sufficient progress will have been made that we can then start to normalise the proceedings in this Chamber. I fully appreciate that the way that we are currently operating is not how we would all like it to be, but we have to do this at a rate of progress that is safe for all Members and staff here. I do hope that we will make sufficient progress.
Further to that point of order, Mr Deputy Speaker. In ministerial correspondence, the response repeatedly comes back from civil servants and not the Minister themselves, which is a trend that I have noticed more often recently. If I have written to a Minister, I find it uncourteous for the Minister not to respond. I am worried about going into a recess and receiving more civil servants’ responses that do not provide the political context that is often needed. Could you advise me on how I could encourage Ministers to respond directly?
I have been a Member of Parliament for 28 years, and the vast majority of replies I have had have always been from Secretaries of State or the relevant Minister. I know that those on the Treasury Bench will have heard the hon. Gentleman’s point of order, and I hope that the matter will be fed back into the system.
The House is suspended for three minutes.
(4 years, 5 months ago)
Commons ChamberI thank the chief medical officer for ringing me when we had cases earlier in the month in the city; it was very helpful advice. The advice that the Secretary of State has just given is that we need to wash our hands. So will the Government make moves to ensure that, when you enter any building in this country, there is a place for you to wash your hands? I am not just talking about advice; can we introduce health and safety guidelines to put a requirement on every employer, every restaurant and so on? If we are going to take this seriously, we need to up our game. Will the Government commit to that now?
I will look into the extent to which that can be done. Many public buildings do have sinks available. At the core of our response to the problem, which the hon. Gentleman reasonably raises, is getting the communications right, so that people can use existing sinks and soap to do what I know he wishes them to do.
(5 years, 3 months ago)
Commons ChamberYes, what is the phrase about standing on the shoulders of giants? I think that we all admire the work on this issue carried out by Paul Flynn over many years.
I do not understand why the Government will not, at the same time as calling for randomised controlled trails, also look at observational trials, whereby people can actually take the medicine they need and we can see how effective it is. We need an audit of those already using the medicine to see what is happening to them. There is nothing wrong with randomised controlled trials, but the complexity of cannabis as a product makes them very difficult to carry out. We can have them, but there are lots of other ways in which we can gather evidence that will enable us to move forward.
Is it not the case that we have been flexible on trials with other diseases and drugs? I think particularly of the flexibility on HIV after campaigners fought to get the drugs to people who were terminal before trials had finished because there was an understanding that the harm of the disease was far greater than any side effects could possibly be. That is how we should be treating this issue as well. We understand that the risk is relatively low, although there might be some, but the potential gain is rather great.
My hon. Friend makes an excellent point. Yes, there may be risks, but we should look at the risks of some of the other treatments that people are using. Opiate treatments are much more risky than cannabis.
We need to find another way forward. We need to take into account the different types of evidence. We need, really, a bespoke medical response to this. I ask the Minister, how can we use the different types of evidence to get an evidence base that will satisfy Government and satisfy clinicians? How can we use, for example, the Access to Medical Treatments (Innovation) Act 2016? We also need a bespoke regulatory response. The question for the Minister is, why not? Other countries have done this, such as the Netherlands, Germany and Canada. They all treat cannabis differently from other products and other treatments. Holland has set up an office for medical cannabis to deal with the complexity of the issue and I do not see why we cannot do something similar.
We have heard some really rather touching and heartfelt speeches, and I suspect that I cannot justice to some of what we have heard. Although of course I condemn the current policy of criminalisation, I am incredibly sceptical about the use of cannabis in a recreational sense, but I am very much in favour of us moving towards a proper, normalised relationship with cannabis and cannabinoids in our health system.
The cruelty of what happened last year was that we dangled hope in front of lots of people’s faces—not only the children and their families who led the campaign, but many adults who suffer with long-term pain conditions and other conditions that would be helped by medical cannabis—and said that medical cannabis would be available for them. Through administrative burden—deliberately or because of a cock-up, I cannot quite tell—we have created a system in which the barriers are so high that the drugs are not being prescribed. Part of the problem is to do with the rescheduling, which has not been sufficient. The rescheduling has not normalised cannabis and cannabinoids even to the level of opiates. Extra conditions have been laid down through which clinicians have to jump; they have to know that no other drug could work.
I thank the hon. Gentleman for giving way. I am very conscious of my constituents Darren and Dannielle Gibson and their young daughter Sophia. I see that the Minister, the right hon. Member for Ruislip, Northwood and Pinner (Mr Hurd), is in his place. We are greatly indebted to him for his co-operation and help. [Interruption.] The Minister is in the House, but not in his place. Let me get it right. There were very memorable moments in the fight for Sophia’s medication, including coming to terms with the differences in policy between Northern Ireland and the mainland, jumping through the hoops in Northern Ireland, liaising with the Minister to find a way for my constituent to get what she needed in time and my constituent being rushed into intensive care. But here is the story. That young girl today is in receipt of medicinal cannabis. Her epileptic fits have been reduced to one a month. She can attend school again and do all the recreational things with her young friends at school and in the playground that she never could do before. It happens. It can be done. It changes lives.
It can be done if it is given to patients at the right time and in the right manner. Part of the reason why clinicians are possibly nervous about prescribing these drugs is that additional thresholds have been added to doing so. There is an extra nervousness, particularly with new drugs, as we require their use to be based on already pre-existing proven evidence.
Earlier, I mentioned what had happened with other life-threatening diseases, such as HIV, and what had happened at other times. We have now changed, relaxed and modified the rules around testing, but that was not done immediately. Those who remember will know that there was a vociferous campaign from people, particularly in America but also here in Britain, about the folly of this requirement for pre-existing medical knowledge. The shift was to look at harm: what is the harm done to not trial and not implement anything versus what is the harm done of any potential risks. In this case, we need to employ that kind of sense. Back then, it was not the clinicians or the Government who shifted the issue; the shift was achieved through the fantastic work of campaigners.
We are again seeing that fantastic work of campaigners. They may need the drug themselves, or one of their family may need the drug, and so they are having to push this debate. It is frustrating to some extent that we have not learned the lessons of previous eras when this issue was argued out. In fact, time and again, the issue has been won on the side of prescribing. Why this time are we coming down on the wrong side of the argument? What is it about cannabis that suddenly sets off some kind of alarm bell in the heads of Ministers or civil servants so that we create a system that is not particularly conducive to prescribing?
I am bemused by the current situation in which, for some reason, private prescriptions are acceptable—others have talked about this—and seem to be getting through if people can raise the right amount of money, but our NHS is not able to reflect that. I do not know whether that is a consequence of cuts or of an NHS that is at breaking point. It could be a consequence of commissioners not wanting to prescribe these drugs, which seems strange to me because, when I look at the figures, the cost does not seem too high. It is cheaper than prescribing some other traditional medicines. It seems to me therefore that this is not an austerity issue, which we know is a bigger problem in the NHS, but some other hidden force, which means that parents need to raise thousands and thousands of pounds to try to get private prescriptions and self-prescribe.
I would like to slightly widen the debate from children, on whom we have quite rightly focused, to some of my constituents who are adults in chronic pain. Although it is right that, through the story of a child, we can push this issue forward, the fact is that this drug could help millions who, as we have heard earlier, may already be self-prescribing with cannabis. Self-prescribing is not good for a person’s long-term health or for the state of healthcare. Doctors who are trying to provide them with holistic and rounded care cannot fully do so if people are having to go off and self-prescribe elsewhere.
United Patients Alliance is very active across the UK, but particularly in my constituency. One of my constituents, a 42-year-old man, was diagnosed with complex regional pain syndrome in October 2006. If he took conventional medication, he would be expected to take 10 ml of oral morphine a day, which is a huge amount. It means that his actual life quality is completely reduced. He is as not as cognisant as he should be or as able to interact and hold down a job. With the head of the pain clinic at St Thomas’s Hospital, he has discussed moving on to medical cannabis. They have even said that it would be a real possibility, but they believe that the hurdles are too high for them to be able to prescribe it now. He has now resorted to getting medical cannabis from other sources—to some extent involving his doctor or his clinician and creating a network of people having almost to lie and deceive the state. It is a bizarre situation. We end up making people do things in hushed conversations, rather than being able to record things properly in medical records.
This absurdity must end. We thought that it had ended. My view is that the schedulisation of drugs should not fall under the remit of the Home Office; it should be in the Department of Health and Social Care. It makes no sense for scheduling to be anywhere near the Home Office, because it should be based on medical evidence—the Home Office should, of course, decide on classification. The Department of Health and Social Care needs to make some real moves very quickly to demonstrate that this has not all been hot words and big let downs.
(5 years, 5 months ago)
Commons ChamberI am a huge fan of the public health approach to tackling knife crime. In fact, I was in Croydon yesterday to talk to charities and to students at Croydon College about the role the NHS can play in tackling the scourge of knife crime. I am a big fan of this agenda, and I look forward to working with the hon. Lady and colleagues from across the House.
All children should receive good-quality relationships and sex education so that they understand the benefits of healthy relationships and how to protect themselves against sexually transmitted infections, HIV, unplanned pregnancy and abuse.
Does the Minister believe that the £6 million allocated for relationships and sex education is enough when it equates to a few hundred quid per school? Her Department has cut £3.2 billion from public health spending, meaning that many young people now cannot access STI testing, and we are seeing a boom in STIs among young people.
The hon. Gentleman’s question is actually a matter for the Department for Education, but I do not accept his statement. The new relationships and sex education proposals were widely welcomed across the House when they were announced, and we will improve children’s ability to look after themselves and have healthy sexual relationships.
I commend my hon. Friend for his commitment to raising the local priorities of his constituents and for the campaigning he does on behalf of the local NHS. I think that these plans are best worked through by the local NHS. However, if he would like, I would be happy to meet him to discuss the concerns that he has on behalf of his constituents.
The hon. Gentleman is absolutely right to draw the House’s attention to how vital local community services are in supporting people and to say that we really do need to invest in them. Clearly, these matters of investment are for local areas, which is why we allow CCGs to make these decisions, but I am more than happy to meet him to discuss the matter.
(5 years, 8 months ago)
Commons ChamberOn 1 December 1988, we observed the first World AIDS Day. It was created as an international day to raise awareness of the AIDS pandemic caused by the spread of HIV and to mourn those who had died from the disease. In two days’ time, we mark its 30th anniversary, and this event gives us pause to reflect on how far we have come and to remember those we have lost.
Such events are also deeply personal to me, because next year I will be marking an anniversary of my own —10 years since I became HIV-positive. It has been a long journey from the fear of acceptance to today and, hopefully, advocacy, knowing that my treatment keeps me healthy and protects any partner that I may have.
When you are first diagnosed, you get that call from the clinic and they just say, “You need to come in.” They do not tell you the details, and you know immediately that something is wrong. All the different worst-case scenarios flash through your mind, and of course, being a sexually active young man, HIV is one of them. Going in, you kind of know that something is wrong and it might well be serious, but at the same time you are working out all the ways that this is just some joke, some technical error, some tiny thing they are going to tell you that you will be laughing about later. You try to imagine the ways you are going to get out of this, and then in that NHS room, with those cream carpets and the plastic seating we all know, they tell you, and it hits you like a wall. Although you have prepared yourself for it in your mind, nothing quite prepares you for when they say those words. I remember looking up at that ceiling—those false ceilings you get—and wishing that one of the tiles would rip away and it would suck me up, and that I would wake up and it would all be a dream and all be over.
But, of course, the reality is that that is not what happens. Instead, you walk out of that room and, even with all the greatest support and advice that they offer, you feel totally numb. You have a million things running through your mind and, at the same time, a sense of absolute nothingness.
I have decided to make this announcement and speech today, because earlier this year I was at an awards ceremony in Brighton. I had nominated Gary Pargeter, who for a number of years has been running a local club for people living with HIV called Lunch Positive. He had won the award and people were coming up to talk about how important the project was and how brave he had been to talk about his HIV status, and I felt like, “I am watching someone who has done inspiring work, and I am proud to have nominated him, but I have not told anyone else in this room that I am HIV positive, too.” Just like so many who attend Lunch Positive, I am lucky because the medication means I will not get sick and I cannot transmit HIV. I felt that if Gary and so many others can talk openly about it, then so should I.
The second reason I wanted to have this debate today is because we are genuinely on the cusp of eradicating new HIV transmissions in this country. Figures today show that we are already, in parts of this country, halting the rates of HIV diagnosis, but we are at a fork in the road and I worry that we might be starting to head in the wrong direction, with £700 million of cuts to public health having been made between 2014 and 2017. We are not investing in the universal roll-out of PrEP—Pre-exposure prophylaxis—the pill that prevents HIV. So it is important for me politically to speak out.
Finally, I wanted to be able to stand here in this place and say to those who are living with HIV that their status does not define them and we can be whoever we want to be, and to say to those who have not been tested, perhaps out of fear, that it is better to live in knowledge than to die in fear. HIV in this country is no longer the death sentence it once was. A recent study led by the University of Bristol found that due to the advances in HIV treatment, people living with HIV can expect to live a near normal life. The improvement in survival rates for people with HIV is one of the greatest success stories of recent times. What was once considered a terminal disease is now seen as a manageable condition. Yet this information has not changed the narrative, which is still, sadly, framed in those scare campaigns of the tombstones of the 1980s. So much of LGBT culture also is marked by this spectre of HIV, which has led to an incredible sense of fear about the disease.
In that hospital room, and in the days and weeks that followed, I had to come to terms with that fear myself. I am a HIV-positive man, but because I have been taking the right medication for several years I am what the NHS calls “HIV-positive undetectable”. That means not only can HIV not be detected in my system and so I do not get sick, but I cannot transmit HIV to someone else. As the virus lie undetectable and dormant in my body, my medication ensures that the virus does not reactivate, does not progress and cannot be passed on. That is why the NHS says “undetectable equals untransmittable”. UNAIDS highlights three large studies conducted between 2007 and 2016 of HIV transmissions among thousands of couples where one partner was positive and the other was negative. In those studies there was not a single case of sexual transmission of HIV from a positive undetectable person to a HIV-negative partner. It is safer to have sex with someone who is HIV-positive undetectable than with someone who does not know their status, because undetectable equals untransmittable.
Understanding that I was unable to transmit HIV sexually has been life-changing, too. I went from thinking that I would never have a HIV-negative partner, or that if I had sex with someone, I could pass this on, to knowing that I can live a normal life and that any partner I have is totally protected. I cannot transmit HIV to my sexual partner, I have a perfectly healthy life, so my announcement here today should go totally unnoticed—
My hon. Friend is being immensely courageous in what he is doing today. I, for one, am sure that his bravery will reduce the stigma and the fear of so many living in our country and beyond.
I thank my hon. Friend for that. He is right to say that my name will help those people, and it might appear in tomorrow’s newspapers as a result of my being the first MP to declare themselves HIV-positive in this Chamber and the second, after only Chris Smith, to openly live with HIV as an MP.
I just want to say what a typical gesture of my hon. Friend this is and how proud of him we all are.
Perhaps foolishly, to gauge what the public reaction might be like, I went on social media to read some of the comments on recent HIV news stories. One does not have to scroll down far to find comments like:
“Anyone with HIV who has sex should be tried for murder”,
or
“fags getting what they deserve”,
or “disgusting lifestyle choice”. Now, most of the people behind such comments will be homophobes who are weaponising HIV to attack LGBT people. If it was not HIV, they would find something else, because they are haters and they are not pleasant people.
But HIV stigma is not just a symptom of homophobes. Even the most well-meaning people can perpetuate HIV stigma. It takes many shapes. It can be believing that HIV and AIDS are always associated with a death sentence. It can be thinking that HIV is transmitted only through sex. It is thinking that HIV infections are the result of some personal or moral fault. It can be believing inaccurate information about how HIV is transmitted, which in turn creates irrational behaviour and misconceptions about personal risk.
Before I was diagnosed, I myself perpetuated some of those stigmas, so it is not without judgment that I ask people to reflect; it is a genuine ask that we begin to think, talk and act differently when it comes to HIV. That is even harder when there is a taboo about talking about sex, which means that stigma is often compounded, thereby creating a more risky environment because people do not seek the treatment that they need.
The Sussex Beacon in my constituency is one of only two residential care facilities in the country for people living with HIV. It originally started as a hospice in the 1990s, when three to four people died there each week. Fortunately, end-of-life care is now a rare occurrence at the Beacon, and today most of its support services are utilised by people with HIV from marginalised groups who face a big stigma. Older people diagnosed late, women, black and ethnic minorities—all these groups are disproportionately affected by stigma and rely on the good work of the Sussex Beacon and other charities like it. But their funding is being reduced.
Yesterday, I was lucky enough to get a photo with Stiggy the Stigmasaurus at the Martin Fisher Foundation, as part of the foundation’s campaign to make HIV stigma history. I hope that Members who could not be there yesterday will be able to join me in that pledge going forward. Stigma causes a treatable disease to become life-threatening, because of the impact on an individual’s mental health and their access to medication. No person diagnosed with HIV today should feel any less able than anyone else to thrive and enjoy life because of their status.
Stigma is not just a UK problem; it is a global one. Fifteen years ago, 200,000 people around the world were receiving treatment for HIV. Today, the number is 22 million, but we still have 15 million more who need access to regular medicine.
First, may I thank the hon. Gentleman for bringing his personal story to the House today? I mean that very much. I also wish him continued good health and that he continues to prosper, as he quite clearly is doing.
I mentioned to him before the debate that I wanted to intervene, and I wish to bring to his attention the Elim church in my constituency. The church has an HIV programme in Swaziland, which has the highest levels of HIV in the world. Every year, the children from a choir group come over. Every one of them is HIV-positive, but every one of them is surviving today because of the medication that is available. If the medication is there, we can do lots of things, save lives and give opportunity. Among many churches and individuals around the world, there is a lot of good will to help.
That is quite right.
We are making progress on treatment, but when it comes to stigma we still have so much further to go. Last week, I was in Kenya with the International Development Committee and met a HIV-positive mother of eight children from the Democratic Republic of the Congo. Although she was on medication, she had suffered such abuse that she was forced to flee the DRC and now lives in a refugee camp. Because of the prejudice and violence that she faced as a result of her status, she was forced to leave without her children, and she knows not of their future.
I thank my hon. Friend for giving way. He is making an absolutely brilliant and historic speech. I am very grateful that he mentioned my good friend, Chris Smith, who very bravely told the world in 1984 that he was gay and proud of it, and we are proud of Chris for doing that. I am also pleased that my hon. Friend has brought up the international context, where there are appalling levels of prejudice and abuse against HIV-positive people and against the LGBT community of many countries around the world. We just need to send out a message from this House of Commons that this country has changed its attitudes. We have done a great deal medically to help people. We need to ensure that the rest of the world understands that we can do the same in every other country. We have to close our minds to prejudice and open up our minds to human rights and justice for people all across the globe.
I thank my right hon. Friend for his intervention, and I totally agree with him. There are some countries in the world I may now struggle to travel to because of this announcement. It is important that we continue to make international efforts. I do not have time to talk about all the international aspects here. I commend the work of the HIV/AIDS Alliance and plan to come back to this House in future months to talk about its ENDAIDS 2030 Festival, which is really important.
Turning back to the UK, it is the case not just that HIV is treatable, but that it is preventable with one tablet a day. A person can prevent themselves from contracting HIV with pre-exposure prophylaxis. PrEP is revolutionising the fight against HIV transmissions. It has an almost 100% success rate, a higher rate than condoms, in the prevention of HIV, and it is just one pill. We expect this pill to be soon available as a generic drug and, according to the NHS’s own analysis, it could save the health service £1 billion in preventing HIV transmissions for future generations. Astoundingly, however, the only way to access PrEP in England is through a limited trial. This is not a medical trial—those have been done and approved. This is not about financing—we know the cost. This trial, as far as I can see, is about delaying the roll-out of PrEP in England because someone meddling in the Ministry thinks that they know better than doctors when it comes to people’s health. It seems to me that this trial is more concerned about what a person does between the sheets than the health of the nation. Despite being just one year into this three-year trial, 3,000 additional places have already had to be added, and it looks like the 13,000 places will run out early next year. England now lags behind all the other nations in the UK as the only country with capped PrEP access on the NHS. There are two years to go until this trial ends, yet people cannot get immediate access to PrEP, with many clinics now having long waiting lists, and some completely full.
We know that there are cases of young men who have sought out this prevention pill and have been turned away because the clinics cannot accommodate them, and they have subsequently become HIV-positive. Those men now have to live with HIV and everything associated with it because of the misguided morality of this decision. Let us make no mistake: these are not isolated cases. The longer this Government wait to roll out PrEP properly, the more people will be diagnosed.
Will the Minister intervene to ensure that PrEP is made routinely available on the NHS in England—just like his Government have already done with Northern Ireland with direct rule, just like the Scottish Government have done, and just like a Labour Government have done in Wales? Failing that, will he at least uncap the trial to ensure that those trying to access the drug can do so? Will he reverse public health cuts, including those in sexual health, so that the Government meet demand, including that of people affected by HIV, otherwise we seriously risk undoing the really good progress that we have all made?
Just today, the latest Public Health England statistics show that the UK has met its UN AIDS target of 90-90-90, ahead of 2020, which was the date. This is amazing progress, with 92% of people living with HIV diagnosed, 98% on treatment and 97% with undetectable viral load, meaning that they cannot pass it on.
At the Terrence Higgins Trust World AIDS Day reception earlier this week, I am told that the Minister hinted that the Government were considering bolstering their ambition on HIV to committing to reaching zero new HIV transmissions by 2030. In the light of today’s statistics, now is the time to seize that opportunity of reaching zero new HIV infections and be a true global leader. Can the Minister provide details of how the UK Government plan to end HIV infections and what timescale they will commit to?
At present, one young person every day is still diagnosed with HIV and young people continue to suffer some of the worst sexual health outcomes. We cannot be complicit on this. Will the Minister agree to work with the Department for Education to ensure that relationship and sex education guidance has a strong focus on not only HIV prevention, but anti-HIV stigma? Will the Minister also liaise with Department for International Development colleagues to ensure that research funding is increased so that we can make huge gains in scientific breakthroughs to eradicate this disease globally?
In two days’ time, on World AIDS Day, I will stand with my community to mourn the losses of those who have died of AIDS. I will do so at the Brighton AIDS memorial—the only such dedicated public memorial in the country. I will stand there in the knowledge that I will live a life that so many could not. I am able to do that because of the people who have come before me: the people who have fought and lost their lives, and the people who stood up and had their lives changed. We owe it to these people to beat the disease—something we have the power to do. I hope that future generations will look at HIV in the same way that we look at smallpox and polio, as diseases that were once killers but can now be eradicated.
LGBT people often talk about coming out as something that you constantly have to do to new neighbours, friends and work colleagues. You could say the same about your HIV status. I have spent many nervous moments deciding whether to tell new friends and acquaintances about my status. The lump forms in your throat and your heart flutters, and you finally kind of blurt it out and hopefully move on. Well, Mr Deputy Speaker, I would like to thank you for giving me this platform to do just that. I thank my friends, family and colleagues for supporting me. I also thank the Terrence Higgins Trust for all its work and the support it has given me in preparing for this debate.
We have the ability to end new HIV transmissions, as well as to end stigma and discrimination—not only here, but globally. I hope we can all make that our mission. [Applause.]
We should not clap in the House, but I understand why people have. That was a very brave and moving speech, which will give hope to a lot of people around the world. I should also say that I broke with convention today by allowing an Opposition Front-Bench Member to speak in the Adjournment debate. Please be reassured that this is not the norm; it is a one-off.
(5 years, 9 months ago)
Commons ChamberBecause it was not on a scale that would have had sufficient impact. I welcome interventions, but I think we should have a rule that when Members intervene they should describe their background, in this case as advisor to George Osborne, who cut back on the solar energy industry, who undermined wind power in this country, and who set us back so that we will never meet our climate change targets.
The impact—[Interruption.] Calm down, calm down—George Osborne used to say that to me, and I said “I’ll calm down when you resign,” and he did. The impact on the self-employed and small businesses has been equally stark. Some 51,000 high street stores closed last year. Wages for the self-employed have collapsed to around the same level as 20 years ago.
Does my right hon. Friend agree that it was a disgrace that yesterday we heard that the Government are going to save the high street by turning our shops into residential properties and risking the very fundamentals of how the high street operates?
My hon. Friend is right. Yesterday we needed serious action to address the bias against high streets, which has led to so many empty shops. Instead we got legislation that will help turn shops into flats.
We then had a huge media presentation about an online tax being introduced: it was said that £400 million will be found from this online tax in a few years’ time. At the weekend the Tax Justice Network said the top five tech companies have avoided £5 billion-worth of tax.
My second concern about the austerity debate is that if we understand and appreciate what people have been forced to go through with austerity, only callous complacency could drive us to inflict those policies on people. Yesterday the Chancellor’s speech, with references to “Labour’s recession,” demonstrated that he is trapped in a time warp of a political propaganda exercise by the Tories of a decade ago. [Interruption.] I thought they would like that one. Let us be clear: the financial crash was the result of greed and speculation, and a lack of regulation that goes right back to the 1980s. Austerity was always a bad idea.
(6 years, 4 months ago)
Commons ChamberIt absolutely is not acceptable. I hope that the Minister is not going to repeat what other Ministers have said in written statements and in this place, which is that 1% to 3% is the sort of failure rate, or complication rate, that one would expect with all sorts of surgery. The reality is that the numbers are far greater than that—far, far greater—as the audit this week shows. I will come on to address that.
Does my hon. Friend share my concern that some hospitals are still advertising low failure rates, particularly for tape? That disguises the issue, particularly when they refer to failure rates in the first year and do not talk about long-term studies.
Yes. We have heard that many women have this undertaken in private clinics—perhaps half of them, although we do not know how many that means. Those clinics advertise success rates very widely; we can find it all over the internet. The fact that this is described as mesh, sling, tape or ways to uplift the bladder obfuscates what we are really talking about and makes it difficult for women—and indeed, I suspect, occasionally doctors—to know the nature of what they are dealing with. What has emerged, as evidence has come through, is that there are greater problems than was appreciated. That is why, given that mesh was originally licensed to treat stress-related urinary incontinence and then extended to pelvic organ prolapse, we should be deeply concerned. Mesh is already effectively banned in our country for pelvic organ prolapse—that happened just last year. It is now to be used in research only, which is tantamount to a ban. That is happening in countries all over the world—just last year New Zealand effectively banned mesh for both SUI and POP, although I gather it may lift the ban in future. This is a worldwide problem.
We have had the audit results this week. Let us be clear that we only had an audit because of the great campaigning by Sling the Mesh, the APPG and other bodies. We asked Ministers directly to conduct it, they were good enough to do so, and I am pleased they have. The results show that far from there being just a 1% to 3% occurrence of serious complications, there is a 4% rate for complete removal of mesh. Five hundred and fifty out of the 14,000 women who were given mesh in 2008, the first year of the study, have had it removed at some point in the last decade. That is not rates of complications such as pain or sexual dysfunction: the mesh is so problematic that women have had to go back under the knife to have it cut out.
As for the complications, which the audit has tried to measure by looking at the volume of outpatient appointments, the 100,000 women who have had mesh inserted have needed almost 1 million outpatient appointments. They have gone to their GP to say they have a problem and been referred to a consultant for an outpatient appointment, whether for pain management, residual gynaecological problems or some other problem—trauma, in some instances. That must be indicative of the scale of the problem and the cost to the NHS, as illustrated by the work done for the APPG by Carl Heneghan. Some £250 million may have been spent in a decade to sort out the problems.
Mesh is a much bigger problem than has been appreciated by the clinical community, which has been incredibly defensive in dealing with it. The community must be much more open and honest about it. We have to address the issues of licensing: it cannot be enough for follow-on devices to only have to prove equivalence, or for a registry to be run simply by the royal colleges, which have been resistant in the past to having a registry. We should have a standardised process to put a registry in place to follow patients. Crucially, NICE must also get its act together. Why have we waited three years for NICE to bring forward new guidelines? It is still saying that that will not happen until next year—it needs to be done this year. This issue needs to be dealt with tomorrow.