Drug Treatment Services

Luke Graham Excerpts

Tuesday 16th July 2019 Westminster Hall

[Ronnie Cowan (Inverclyde) (SNP)]

I thank the hon. Member for Manchester, Withington (Jeff Smith) for securing this debate.

Figures released today show that in Scotland there are more than three deaths a day due to drug use. But who really cares? Who are those people who are dying? It is the homeless; the isolated; the good-for-nothing; the detritus of society. People who inject themselves with poisonous substances do it to themselves—nobody makes them do it. How often have we heard that justification? Nobody is saying it in this place, but we know some people are thinking it.

Through a lack of compassion, but primarily through a lack of understanding, society has created a sub-culture of marginalised people who are pushed to the fringes of our day-to-day consciousness. It has become far too easy to dismiss them, ignore them and exclude them from our cosy lives. Problematic drug users are not getting high for the kicks; they are self-medicating because the pain of everyday life is so great that without the drugs they could not live. The sickness is not the drug use—the pain started long before the addiction. Of the 10% of drug users who develop an addiction, the vast majority have been physically, psychologically or sexually abused. Mix that with financial and aspirational deprivation and it makes a powerful mix that it takes powerful drugs to supress. That is why the support services must be about homelessness, mental health, security, continuity, understanding and compassion—everything that counters the chaos.

When I visited drug consumption rooms in Barcelona, I was particularly struck by one facility: a health centre where people visit their GPs for everyday ailments, which is attached to a hospital that people can be referred to. One part of the health centre is for homeless people to visit and pick up clean clothes, have a shower and shave. Over time, the staff build up a relationship with the clientele and come to understand why they are homeless and what can be done. Another unit attached to the health centre is a drug consumption room; the staff there have exactly the same attitude as the staff in the health centre, the GP surgeries and the homelessness unit. They want to know, “What is your problem, and how can I help?”

That is a million miles away from the stigmatisation that is so common in the UK. The mindset of approaching problematic drug use as a health issue pays great dividends: it is cheaper than pursuing and incarcerating people for drug possession; it frees up the police to fight crime; and, most importantly, it works across the globe. It does not work for everyone; tragically, there will always be drug-related deaths, but as we look at the figures released today let us not forget that, thanks to the naloxone available in DCRs, there has never been a death due to overdose in any DCR anywhere in the world. When will the UK Government come to terms with that?

[Luke Graham (Ochil and South Perthshire) (Con)]

On the reform of drug laws, we probably have a lot in common, but today’s shocking figures show that the number of drug deaths in Scotland is not only three times the average of the rest of the United Kingdom, even though we are all under the same laws, but the highest in Europe. If the hon. Gentleman wants a health-based solution, will he explain what, after 12 years of SNP stewardship of our health service in Scotland, can be done? What should be done through the devolved and central Governments working together?

[Ronnie Cowan]

The policy is a Europe-wide one; it is proven that the methods used elsewhere in Europe have helped the situation.

Glasgow stands ready to pioneer a DCR. There is cross-party support from Glasgow Council, backing from the SNP Scottish Government, and NHS Greater Glasgow and Clyde is fully on board. What in the name of goodness is stopping the UK Government from joining us?

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[Alison Thewliss (Glasgow Central) (SNP)]

I am glad that the hon. Member for Manchester, Withington (Jeff Smith) secured this debate, because it is very timely for Glasgow and for Scotland more widely.

Let me start by saying that every single one of the 1,187 deaths last year is a tragedy—a tragedy for the families who lost a loved one and, as the hon. Member for Glasgow North East (Mr Sweeney) said, a tragedy because of the potential that was lost as a result of that person passing away. We should bear those people in mind whenever we talk about drugs policy.

Ideally, I want those people, who have an illness, to be able to get medical help as if they had any other illness. If they had cancer, we would not stigmatise the cancer drug that kept them well. That is what methadone does—it supports people and stabilises their lives.

[Luke Graham]

rose—

[Alison Thewliss]

I will not hear a word from the hon. Gentleman against that.

[Luke Graham]

It is not stigmatisation; it is data led. We saw information today that more people die from the use of methadone. I am not asking the hon. Lady to cancel anything; I am asking whether she will join me in calling for a review. We need a review of all our drug laws across the board. She knows that I agree with her on many aspects of this policy. I seek a review, not to cancel out or stigmatise.

[Alison Thewliss]

When the hon. Gentleman talks about methadone, the result is that he stigmatises it. That may not be his intention, but that is the result. He may have heard Kirsten Horsburgh from the Scottish Drugs Forum talking on “Good Morning Scotland” this morning about that being stigmatising for people. We need to get away from that stigma. We need to look towards treatment and harm reduction.

To that end, I and my SNP colleagues have argued for three years for a drug consumption room for Glasgow. That could go ahead as a pilot if the UK Government got out of the way and let us do it. It is three years since NHS Greater Glasgow and Clyde produced its “Taking away the chaos” report, the business case for that drug consumption room, which Saket Priyadarshi and his colleagues worked away on. That has been sitting there for three years. The UK Government are standing in the way of the life-saving intervention a drug consumption room would bring.

That drug consumption room would not save everybody—at the moment, it would be just for Glasgow—but it would make a huge difference to the people I know who inject in dirty bin sheds and back lanes and on waste ground yards from my office, time and again. It is the job of the rest of society to try to pick up the pieces of that—to pick up the discarded needles that are left behind. Those people would have the dignity of a drug consumption room within a few paces, where they could go to inject drugs, receive medical help and get support now, if the UK Government approved it. It is an absolute tragedy that that is not happening, and a huge source of frustration.

The hon. Member for Glasgow North East (Mr Sweeney) mentioned the Lord Advocate. The Lord Advocate is the Lord Advocate; we cannot intervene in the decisions that the chief legal officer takes on this. If he says that that is not within the law, that is his legal opinion. He is the chief legal officer, and that is his decision. It rests with the UK Government to make that change under the Misuse of Drugs Act 1971.

[Luke Graham]

Will the hon. Lady give way?

[Alison Thewliss]

I have already given way to the hon. Gentleman, and I am short of time.

The Misuse of Drugs Act is reserved. Where we have had powers in Scotland on alcohol, we brought in minimum unit pricing; on smoking, we brought in the end of smoking in public places. This is a medical intervention that we wish to pursue in order to save people’s lives. Glasgow, where it can, has applied for a heroin-assisted treatment programme; when that is up and running, it will be able to treat 60 people, but there are an estimated 400 to 500 people who inject publicly within Glasgow city centre alone. That medical heroin-assisted treatment programme is limited in size, scope and scale, because it is a treatment programme and people must be able to engage with that.

No doubt the programme will make a huge difference to those lives, but it almost goes without saying that if 394 people died in Glasgow last year, and it can only deal with 60 people at a time, it is not enough. It is clear that we need the entry level that drug consumption rooms will give, meaning that people can go in without any kind of barrier or stigma associated with seeking help, and are able to reach those treatment services. It needs to be an easy way for people to get in and get treatment within those services.

The Scottish Government are pursuing this. We are doing what we can. We have a new drugs taskforce, chaired by Professor Catriona Matheson from the University of Stirling, which is looking at all the things we do in the Scottish Government in the round and where improvements need to be made. Both I and the Scottish Government accept that improvements need to be made, but the UK Government also need to play their part.

I will mention organisations such as Turning Point Scotland in my constituency. They drive a van around as a needle exchange, but they know that as soon as they give that needle to somebody, that person is going around to the car park at the back, to inject in a dirty back lane. That is not good enough. Not one UK Government Minister has yet come to visit Glasgow to justify their position; I urge this Minister and any of her colleagues, whoever they may be, whenever the new Prime Minister eventually turns up, to come to Glasgow and tell me why this cannot be done.

NHS Long-Term Plan: Implementation

Luke Graham Excerpts

Monday 1st July 2019 Commons Chamber

[Matt Hancock]

Yes, I shall be happy to ensure that that meeting happens. As for Island healthcare costs, my hon. Friend is right to say that the Isle of Wight is unique in its health geography, and that there are places in this country—almost certainly including the Isle of Wight—where healthcare costs are higher because of the geography. There is a programme for smaller hospitals that are necessarily smaller because of the local geography, as they need special attention.

As I have said, I shall be happy to ensure that the meeting goes ahead, and I shall continue to talk to my hon. Friend, who makes the case for the Isle of Wight better than any other.

[Luke Graham (Ochil and South Perthshire) (Con)]

Tomorrow I shall attend the funeral of my Auntie Bib, who has just died of cancer. It was discovered at quite a late stage. May I press my right hon. Friend to ensure that rapid access diagnosis centres are rolled out as quickly as humanly possible, and to give the House more details? May I also—as is my job—remind him that he is, of course, the Secretary of State for Health and Social Care for this entire United Kingdom, and ask him how he intends to engage with devolved authorities when targets are being missed to ensure that standards are maintained across the island? Our constituents are all British citizens, and they all require and deserve the same level of support.

[Matt Hancock]

I am sure that the whole House will want to pass our condolences to my hon. Friend, to his family, and to friends of his aunt. In a way, it is fitting to end this session with a very personal example of why early diagnosis matters.

As for my hon. Friend’s second point, ensuring that we have high-quality health services throughout the UK is, of course, vital. It is true that there has been a smaller increase in funding for the NHS in Scotland, and a consequent smaller increase in the number of healthcare professionals there. We need an improvement right across this country. We are delivering that in England, and I am sure that my hon. Friend will continue to make the case for better health services in Scotland from the Scottish National party Government, who receive the money from the UK Treasury but do not put all of it towards the NHS.

Medical Cannabis under Prescription

Luke Graham Excerpts

Monday 20th May 2019 Commons Chamber

[Charlie Elphicke]

The hon. Gentleman makes a powerful point, with which I wholly agree.

This is not just about speed; it is also about consistency. We can go to the local supermarket and buy ibuprofen, which people say is safe. We can buy as much as we like, yet we need a prescription for naproxen, a similar drug, because it is meant to be more dangerous. This is despite the fact that an article in the British Medical Journal in 2016 showed that, following experiments, the evidence concluded that the risk of heart problems was higher for people taking ibuprofen than for those taking naproxen, and that naproxen was less problematic and had fewer side effects than ibuprofen. Nothing has happened about this.

[Luke Graham (Ochil and South Perthshire) (Con)]

My hon. Friend makes a strong point about consistency. Policy on the legalisation and decriminalisation of drugs is a reserved matter, in contrast to the delivery of health and social care, which is devolved. Does he agree that there should be consistent training and delivery programmes across the United Kingdom, so that people get the same standard of access to help for themselves and their families whether they are in England, Scotland, Wales or Northern Ireland?

[Charlie Elphicke]

I completely agree. The whole House knows that my hon. Friend is a true champion of his constituency and of the Union in which we live. It is important to have consistency so that anyone can go and practise, whether they are in England, Wales, Northern Ireland or Scotland. He makes an important point about the need to ensure that level of consistency.

It is also important to have consistency in the NHS, so that when the necessary evidence on drugs is available, the NHS takes action. It could, for example, look at the issue of naproxen and ibuprofen, rather than just carrying on regardless. It says that evidence is important, so it should be doing something about that. Indeed, in America, naproxen is not a prescription drug at all. People can just go and get it in their local drug store. In the same way, the NHS will not prescribe, or make it easy to prescribe, cannabis oil, yet it is easy to get codeine. For those with a bit more pain, it is easy to get tramadol, and for those with even more pain, there is morphine as well. Those opiates are legal and easy to get on prescription, yet we seem to have a mental barrier about cannabis and cannabis oil.

It is really important that we understand the importance of pain management and take it more seriously. We need to look at what can be done to ease pain for all people with all conditions, and we need to act swiftly and consistently on the evidence and without delay. That is why it is right that we should act to “End Our Pain.” We should act to help people such as Teagan and our many other constituents who are suffering. We need to act to end that suffering and pain, and to make it easier for them to get the medicines that they need to make a difference to their lives.

Acquired Brain Injury

Luke Graham Excerpts

Thursday 9th May 2019 Commons Chamber

[Chris Bryant]

My hon. Friend is absolutely right. If there is one thing that I have learnt from my experience of melanoma this year—incidentally, the thing on the back of my head is not a brain injury; I am still getting over the melanoma being cut out—it is that I, as the patient, wanted to go to the real expert, and I would travel as far as I needed to do that. Sometimes in politics it is easy to join the bandwagon when people say, “No, everything’s got to be intensely local,” but the decision on major trauma centres was a brave one taken by this Government. The Conservatives are not a party that I support, but it was the right decision for saving people’s lives. We can now save people’s quality of life as well.

The APPG also called for proper return-to-school plans for every child with acquired brain injury, training for teachers, prison officers and benefits assessors, and proper protocols shared across all sports for concussion in sport.

The effects of a brain injury can be profound. Some sufferers have severely impaired physical mobility, and there can be major behavioural challenges. I have heard of patients losing all sense of inhibition, suddenly becoming tactless, using crude and abusive language, divulging private information and becoming impulsive, irritable and aggressive; or, on the opposite side, completely passive, unresponsive and lacking initiative. Others become obsessive, repeatedly checking their possessions or becoming profoundly self-centred.

[Luke Graham (Ochil and South Perthshire) (Con)]

I thank the hon. Gentleman for securing this debate. I have experienced some of the characteristics he mentions within my family—my auntie experienced a riding accident and my cousin experienced a motorcycle accident, and they both suffered brain shears. I also understand it from the experience of constituents.

Does the hon. Gentleman agree that, although trauma centres are very successful in trying to get the right expertise in the right place, they are required throughout the UK? Outreach is also required for subsequent rehabilitation, especially in rural constituencies such as mine.

[Chris Bryant]

That is one of the key points that everyone on the all-party group wanted to make. It is all very well saving someone’s life but, because we have seen so many miracles done by good neuro-rehabilitation in the community, we need to make sure it is available where people live. Otherwise we are condemning people to a half-life existence when we could restore real quality of life—they might go back to work and be fully independent.

The hon. Gentleman is absolutely right to say it is a matter of getting social care to work with NHS and getting all the different organisations to work as a whole. That is why we hope that the Government—there are signs of this, but we would like to see more signs—will not work in silos of departmental and organisational thinking. We have to think across the whole, because this affects nearly every Government Department.

Many patients lose their executive functions, so they find it next to impossible to plan, make decisions, monitor what they are doing or control their emotions—that can make it difficult even to cook for themselves. In particular, a brain injury to the frontal lobes during the teenage years, when that part of the brain is still developing, can turn a charming, ambitious and able young person into an out-of-control youngster. All too often, if the brain injury is missed or misunderstood, they get into trouble, they are excluded from school and they fall into the criminal justice system. I read Edward Timpson’s report this week. It is an important piece of work, but it is a shame that it does not mention brain injury at any point. I will be writing to him about that to see whether it is another element that we need to address if we are to stop exclusions, which are currently so prevalent.

Even a minor brain injury can lead to headaches, dizziness, fatigue, depression, irritability and memory problems. Sometimes the effects last long after the injury, and sometimes they do not even appear until some time after the injury, which makes them particularly difficult to spot.

Partners and family members have a tough time, too. The hon. Member for Ochil and South Perthshire (Luke Graham) will know from his own family how complicated it is to make sure that people get the support they need. Loved ones have the terrible fear of the unknown. What is going on inside their loved one’s head? Will the anger and frustration they seem to be suffering get stronger, or will it ease off? How much will they be able to recover their former abilities and personality? And how hard will they have to struggle to get the support they need?

In too many instances, families and patients are being pushed from pillar to post when it comes to benefits. Listen to what happened to Jordan Bell, who had a motorcycle accident some six years ago, when he was 17. The accident left him in a coma for six weeks and in rehabilitation for six months before he went home. He had to learn to walk, talk, eat and socialise all over again. I am glad to say that he has made a remarkable recovery and is now a father, but he lives with significant, serious and completely unseeable impairments.

Jordan’s father describes dealing with the welfare system as

“the most demoralising and depressing experience for us all.”

This is a professional family. The initial application for personal independence payment took six months, with interventions from the family’s MP. David Bell writes:

“A year or so after our son’s condition had improved we contacted the relevant department to advise them that he was in our judgement no longer entitled to some elements of the PIP. We were ‘quietly’ advised not to inform them of the changes at all, but as we are honest people we felt duty bound to inform them of our son’s improvement. The advice given to us was correct; instead of adjusting the PIP in what would have been a sensible way the PIP was cut entirely. This then set in motion another six months of huge effort and stress and again the involvement of our MP to get the PIP reinstated. We eventually succeeded. But two years later it was reduced again to nothing.”

I cannot emphasise enough the stress this process puts on people with ABI.

One woman told me:

“I know I should use all my energy to try and get my brain back together. But I end up spending all my energy on forms”—

filling in forms and fighting bureaucracy. An unresponsive, intransigent welfare system is effectively preventing people from healing. I beg Ministers to take this issue seriously and to make sure that all PIP advisers are trained in the fluctuating and unseeable nature of brain injury. After all, one common feature is that patients become over-keen to please people. Often, they will tell the assessor everything they think the assessor wants to hear, because that is part of the condition.

Mental Health Support: Young People

Luke Graham Excerpts

Tuesday 9th April 2019 Commons Chamber

[Jackie Doyle-Price]

I am sure that the right hon. Gentleman will be reassured to hear that I do not think that is good enough. I have heard anecdotal evidence that that has been said to a number of people. Clearly it is a matter of clinical judgment when people are referred to mental health services; we just need to ensure that happens. If he has specific examples, I would be happy to investigate them.

[Luke Graham (Ochil and South Perthshire) (Con)]

Mental health is raised with me time and again by my constituents, both young people and parents, in Clackmannanshire and in Perth and Kinross. Can my hon. Friend explain to the House how we can help champion the 111 crisis line, which is available UK-wide? It can be pre-emptive, because a young person can dial it on their mobile phone and get immediate support. Sometimes that pressure release valve is exactly what is needed.

[Jackie Doyle-Price]

My hon. Friend makes an important point. Just as we have the 999 service for physical health emergencies, we need the same provision for mental health emergencies, and that is what we intend to deliver through the 111 service. That is a clear ambition articulated in the forward plan.

Access to Medical Cannabis

Luke Graham Excerpts

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

One of the great frustrations for me, for the Home Secretary and, of course, for the families is that, before the law was changed on 1 November, that course of action was open. For a few dozen cases, the Home Secretary made those special licences to allow for the use of medicinal cannabis. He and I changed the law together to try to make sure that medicinal cannabis is available on a mainstream basis. Now it is available on a mainstream basis, as a normal drug, it therefore needs clinical sign-off. The problem is there are so many cases where that clinical sign-off has not been forthcoming. That is a source of immense frustration to me, as I hope the hon. Lady can imagine, and it is what we are trying to resolve.

[Luke Graham (Ochil and South Perthshire) (Con)]

Does my right hon. Friend agree that we should be led by evidence? As our scientific knowledge continues to progress, so should the views and the laws made in this House. Will he provide more clarity, not just in this instance but as new and more radical drugs become available in the near future, on how our constituents and this House could benefit and push through laws more quickly?

[Matt Hancock]

My hon. Friend makes a very important point. To ensure that the use of medical cannabis becomes mainstream, we need to ensure that the evidence base is there. Essentially, doctors think there is a much deeper evidence base for CBD than for THC. There is a broader point, which is that the medical profession and this House need to keep up to speed with the evidence as it is developed. In this case, that means going out of our way to develop the evidence and to have clinical trials in which some of the patients who want the drug can participate. That will provide the evidence base that allows the vast array of specialists to prescribe it.

Oral Answers to Questions

Luke Graham Excerpts

Tuesday 19th February 2019 Commons Chamber

[Jackie Doyle-Price]

I quite agree with my hon. Friend. Frankly, I am horrified to hear the account he has just given. We have made a priority of getting rid of out-of-area placements, because we know that patients do better when they are among family and friends. Clearly the case he has just outlined, which has lasted the past 11 years, is totally unacceptable. I will give it my personal attention and meet him to discuss it.

[Luke Graham (Ochil and South Perthshire) (Con)]

6. What UK-wide steps is my hon. Friend taking to ensure that Scotland is not left behind in mental health provision, especially given that only two thirds of young people are referred within the 18-week timeline, against a 90% target?

[Jackie Doyle-Price]

As my hon. Friend knows, health is a devolved matter, but I am keen to share best practice with colleagues in Scotland, who face many similar challenges. In England, we will test four-week waiting times for access to NHS support in the community and we are committed to sharing that expertise, as we often do, with colleagues in Scotland.

Diabetes

Luke Graham Excerpts

Wednesday 9th January 2019 Westminster Hall

[Sir John Hayes]

My right hon. Friend makes a very shrewd point about cause and effect. In Scotland, for example, both the processes leading to allocation and the actual allocation of technology are much more routine, as he suggests should be the case. I hope the Minister will tell us today or subsequently how he will ensure that that becomes true for the whole of our kingdom—that the very principles set out by my right hon. Friend become embedded in the way in which we approach technology, ensuring that it is allocated according to need.

We all agree that the resources should be targeted to secure optimal outcomes for the 4.6 million people who have been diagnosed with the condition. In addition to those diagnosed, however, one in three adults in the UK has pre-diabetes and might be at risk of developing type 2 diabetes if they do not change their lifestyle—a point made by a number of Members in interventions. About three in five cases of type 2 diabetes can be prevented or delayed. A focus on preventing the onset of diabetes should be of paramount importance. G. K. Chesterton said:

“It isn’t that they can’t see the solution. It is that they can’t see the problem.”

By seeing the problem, the solution will be implicit, because many more people will never develop type 2 diabetes if they make those adjustments to their lifestyle.

There is a dilemma, though: is it better that 50,000 people get a perfect solution and are prevented from having diabetes, or that 5 million people reduce their risk marginally? Let me set that out more clearly. Is it better that a small number of people achieve what the deputy leader of the Labour party, the hon. Member for West Bromwich East, has done—losing immense amounts of weight, changing their lifestyle and completely revising their diet? Or is it better that a very much larger number of people make a smaller change, lose less weight and change their lifestyle more marginally, but by so doing significantly reduce their risk of developing type 2 diabetes?

That is a challenge in health education; it affects many aspects of the health service’s work. It probably means that, rather than seeing this issue purely from a clinical perspective, we have to democratise the diabetes debate, spread the word much more widely and get many more people to lose a couple of inches off their waist, to lose a stone or half a stone. That effect would be immense in reducing the risk of diabetes, not for tens of thousands but for millions of people.

If the figures I have brought forward are so—I have cited them only because I have learnt them from Diabetes UK and others who have helped me to prepare for this debate—we would change the lives of very large numbers of constituents in a way they would be able to manage, understand, comprehend and act upon reasonably quickly. I want the Minister to reflect on the dilemma I have described; it may not be quite so much of an either/or as I have painted it, but we need a democratic debate about that, which is part of the reason I have brought this debate to the House. Certainly we need an open and grown-up conversation about some of those measures and how we go about tackling what I have described as a crisis.

I do not want to speak forever, Mr Robertson—I know you and others in the Chamber will be disappointed to hear me say that. That will cause disappointment and even alarm among some, but I want others to contribute the debate. However, I have a couple of other points to make so I will move on—having taken a number of interventions already, I hope colleagues will bear with me.

I have been fascinated to read about research funded by Diabetes UK that proves that remission is possible. I would like to take the time to congratulate the hon. Member for West Bromwich East once again and to say that I hope many more people will recognise that remission is a real possibility for them by making changes in what they do.

Part of the issue is how lives more generally have changed. My father cycled five miles to work and five miles home every day, but now most people do not do that. Once many more people worked in manual jobs—my father had a physique like Charles Atlas, but the nearest I have come to Charles Atlas is reading an atlas. Part of the problem is the way we live now; far fewer people exercise implicitly in the way he did, and it seems that junk food is more appealing to many people than eating fresh, healthy produce—indeed, that has been recognised by successive Governments as significant for health outcomes.

Evidence shows the best way to reduce the risk of diabetes is through a healthy diet, being physically active and reducing weight. That can be facilitated through societal approaches and targeted individual interventions. Technology, including digital services to support lifestyle changes, is increasingly critical in diabetes prevention. To be sustainable, methods to prevent type 2 diabetes should focus on individual behaviour change, not just short-term activity levels.

We recently learned that, by their 10th birthday, the average child in the UK has consumed 18 years’ worth of sugar. That means they consume 2,800 more sugar cubes per year than recommended levels. The current food chain has become badly distorted. Basic knowledge that my parents’ generation took for granted about how to buy, cook, prepare and store food has steadily but alarming declined.

We have allowed soulless supermarkets to drive needless overconsumption of packaged, processed, passive, perturbing products, and it is time that the greed and carelessness of corporate multinational food retailers gave way to a better model. It is not a coincidence, it is something considerably more than that; as local food retailers have declined—people knew from whom they were buying, understood what they were buying and where it came from—the consumption of processed, packaged ready meals has grown. We need to rebalance the food chain in favour of locally produced, healthy produce and to re-educate people about how to buy, cook, eat and enjoy it.

[Luke Graham (Ochil and South Perthshire) (Con)]

I will certainly give no lectures on buying and cooking food, but will my right hon. Friend join me in supporting Diabetes UK’s Food Upfront campaign, which calls for a front-of-pack traffic light system to ensure that the content and nutritional value of processed foods are much clearer for people who are suffering from diabetes, and for a whole other range of dietary and nutritional needs?

[Sir John Hayes]

Entirely; in fact, I call on the Minister to do just that: will he introduce a mandatory front-of-pack traffic light labelling system, which is supported not only by my hon. Friend but by 83% of the population when asked whether that should happen? The Minister will be in tune with popular opinion; he will become something of a popular hero by responding to my hon. Friend’s request, which I amplify.

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[Mr George Howarth (Knowsley) (Lab)]

I congratulate the right hon. Member for South Holland and The Deepings (Sir John Hayes) on giving us the opportunity to debate this subject, and on the comprehensive way he introduced it. He rightly spoke about the potential of technology—I will say more about that in a moment—and about the distinction between those who deal with type 1 diabetes and those with type 2 diabetes. It is important always to make that distinction, because type 1 diabetes is an autoimmune condition over which the person involved has no control. It is not a lifestyle-related problem; someone is born with a predisposition to diabetes and something—we do not really understand what—will trigger it at some point in their life, often at a young age. There is also increasing incidence of people developing type 1 diabetes at an older age, which is a relatively new phenomenon. I will confine my remarks to type 1 diabetes and consider what can be done to help people better to manage their condition.

The Juvenile Diabetes Research Foundation is working with Cambridge University to develop an artificial pancreas. The problem with type 1 diabetes is that the pancreas does not work to produce the required levels of insulin—indeed, in most cases it produces no insulin at all. Currently, a person can have a device for continuous blood glucose monitoring, and if it is judged that the condition is not being managed satisfactorily, they can also have an insulin pump. Those are two separate devices; the beauty of the artificial pancreas is that through an algorithm the two are linked, so while the person receives continuous blood glucose level monitoring, the algorithm also enables the insulin pump to respond to a requirement for additional insulin, depending on the blood glucose level. The potential is enormous, and I commend the Juvenile Diabetes Research Foundation for its work. The technology the right hon. Gentleman referred to is now close to being so good that type 1 diabetes will become much easier to manage, which is important.

Before Christmas, I secured an Adjournment debate on the development of the artificial pancreas in which I mentioned the fact that people are now devising their own artificial pancreases. It seems mostly to involve young people who, in some cases, are technologically savvy enough to devise their own algorithms and link a blood glucose monitoring device to a pump. They are devising those devices in their bedrooms or other normal settings. Someone who is a bit older contacted me after the debate and said, “I didn’t devise this in my bedroom. I’m an engineer and I did it on the kitchen table.” The point is that people are capable of doing such things. I am not saying that that is the way forward, because although many of those devices work and people are pleased with the results of the things they have devised, it cannot be right that they are being left to create such devices on their own without them being quality assured and tested by people who are competent to do so. It shows, however, the potential of what people can do for themselves.

We should not fool ourselves into believing that technology will resolve all the problems, because the situation is difficult, particularly for some young people. Think about when we were teenagers: no matter how well disciplined or well behaved people are, the lifestyle of a teenager does not easily lend itself to monitoring a diabetic condition. Going out with a group of friends for a meal or drink and having to adjust one’s insulin level with an injection can be awkward. Young people also face challenges with the way their condition is perceived by their peer group. In some instances, people confuse type 1 and type 2 diabetes and young people in school get bullied on the basis that they have brought their diabetes on themselves because they eat too much sugar. I have seen examples of that. An autoimmune condition is not triggered by one’s lifestyle at all, yet people get bullied on that basis and it is important that they receive the necessary support.

One of my worries—I hope the Minister will try to address this when he responds to the debate—is that there is often a need for psychological, or even in some cases psychiatric, support because the challenges of being a young diabetic are such that people need other support. Schools, by the way, need better training in supporting pupils with diabetes. There have been examples of young people becoming hypoglycaemic and, when they have tried to raise their need to deal with it with the teacher, being told off and humiliated because they happen to have that condition at that time.

[Luke Graham]

The right hon. Gentleman makes a valid point. I have friends and family members with diabetes, and there are tell-tale signs. At the moment there is a great schools initiative to encourage teachers and students to do CPR and first aid; perhaps spotting the tell-tale signs of a hypo could be included in that package, and promoted in schools. Will he join me in supporting that?

[Mr Howarth]

Yes. I will not labour the point, but the hon. Gentleman is right. I would add that quite often teachers are left with such responsibilities, although they have enough challenges in their working life, but there is a need for someone in the school to have the expertise and to be trained to deal with young people with type 1 diabetes.

I know that I assured you, Mr Robertson, that I would try to be briefer than I have been, but I am coming to the end of my remarks, and the matter is important. I join the right hon. Member for South Holland and The Deepings in saying that it would be useful to have a meeting with the Minister to discuss the matter in more depth and get his thoughts on how to move forward. There is much that we can do to make people’s lives better. I hope that the debate will inform that process, and that we will be able to move forward on the basis of consensus across the House. The Minister faces challenges, and Members of this House will want to share the burden of them.

Oral Answers to Questions

Luke Graham Excerpts

Tuesday 27th November 2018 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman says they are killing people; that is not the debate I want on the NHS.

[Luke Graham (Ochil and South Perthshire) (Con)]

Scotland has the lowest life expectancies of all parts of the United Kingdom, with the figures falling for the first time in 35 years. The average life expectancy in 2017 was 77 years for men and 81.1 for women, compared with 79.2 for men and 82.9 for women in the rest of the UK. What can my hon. Friend do to support the devolved Administration to ensure that Scotland is not left behind the rest of the United Kingdom?

[Jackie Doyle-Price]

My hon. Friend is right to draw attention to that. I am always very keen to work with the devolved nations to both learn from what they do well and to share our expertise and experience where we are doing better, and I hope we will all co-operate to do exactly that.

Budget Resolutions

Luke Graham Excerpts

Tuesday 30th October 2018 Commons Chamber

[Brendan O'Hara (Argyll and Bute) (SNP)]

It is a pleasure to follow the hon. Member for Berwick-upon-Tweed (Mrs Trevelyan), who, despite being on the wrong side of the line at the border, is always entertaining.

Despite the Chancellor’s rather dead-pan delivery of yesterday’s lengthy Budget, the simple truth is that not one of us can trust or believe a single word we heard. Whether on jobs, investment, tax cuts, austerity, extra funding for the NHS or universal credit, the truth is that the Budget is little more than a wish list cobbled together by someone seriously lacking in ambition. It is, none the less, a wish list of what the Chancellor would like if everything turns out the way he hopes it will in the Brexit negotiations. If those negotiations go pear-shaped—I reckon one would get pretty short odds on that being the case—he has admitted that we will all be back here in the spring for what he described, rather euphemistically, as a fiscal event.

In short, what we heard yesterday was, “This is what I’d like to do in an ideal world, but just don’t mortgage the farm on it happening because we have absolutely no idea how Brexit will turn out, and if it doesn’t go well, everything will be up in the air and we will have to do it all again before the clocks go forward.” The Chancellor basically admitted that his Budget will not be able to withstand Brexit. What a way to run a country. What a way to run an economy. Perhaps saddest of all, given that this was his best shot, what a paucity of ambition on the part of the Chancellor.

Anyone watching yesterday who had hoped for or expected the fulfilment of the Prime Minister’s promise of an end to austerity would have been left sorely disappointed. This Budget most certainly did not sound the death knell for austerity. Public sector workers, the low-paid, the disabled, the sick and those seeking employment will all still continue to bear an unfair share of the burden of austerity. Frances O’Grady, the general secretary of the TUC, was absolutely right when she said:

“This Budget does not undo the austerity that has devastated public services. And it lacks the investment needed to speed up wage growth after the longest pay squeeze in 200 years”.

Let no one be in any doubt that, 10 years on from the financial crash, austerity is far from over. The UK Government will continue to balance the books on the backs of the poorest, weakest and most vulnerable in our society.

[Luke Graham (Ochil and South Perthshire) (Con)]

The growth commission that was commissioned by the Scottish Government said that there would be 25 years of austerity if Scotland separated. How would Scotland balance the books then?