Orkambi and Cystic Fibrosis

Margaret Greenwood Excerpts

Monday 19th March 2018 Westminster Hall

[Mr Stephen Hepburn (Jarrow) (Lab)]

It is a pleasure to see you in the Chair, Mr Evans.

I thank hon. Members on both sides of the House who are here to push this great case forward. I pay tribute to my hon. Friend the Member for Dudley North (Ian Austin), who organised a very constructive roundtable meeting where we learned a hell of a lot. I also pay tribute to all the campaigners, some of whom are represented today. They fought hard, got the petition organised and had such a loud voice that Parliament has not been able to ignore them.

We are all here because we want Orkambi to be made free on the NHS. It is a drug that works, improves lives and gives hope, so there is no reason why it should not be available. We agree that NICE’s 2016 decision to class Orkambi as not cost-effective for the NHS was wrong. Frankly, the Minister is in a position to get round the table with the drug companies, NICE and the NHS to resolve this and break the deadlock.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is making a really good speech. A constituent—a proud and loving grandad—came to my surgery with two sets of photographs of his granddaughter, who is nearly six. One photograph was of a lively little girl, full of energy, and the other was of all the medication that she has to take every single day. The imagery could not have been starker. Does my hon. Friend agree that when someone is nearly six, a year is a very long time to wait for change, and the Minister should get a move on?

[Mr Hepburn]

I agree entirely and am pleased my hon. Friend has repeated my earlier plea to the Minister.

It has been said that Orkambi is recognised in a lot of countries—I do not want to go through the list, because there are many. We are getting left behind. Imagine what it is like to be a sufferer and to be told, “There is something out there that will improve your life and your family’s life, but, sorry, it is just not cost-effective.” Imagine how that makes them feel.

I have two constituents down here today: Emma and Chris Corr. They have a three-year-old daughter who has undergone more hospitalisations, more medical treatments and more operations than the vast majority of people will go through in the whole of their lives. All Emma and Chris want is to give their daughter a future and ensure that she is not limited in her life chances. I will be brief, but my plea is to think of the likes of Harriett: let her go to school and get a full-time education, without impediment; let her get qualifications; let her get a job; and let her live a long life. The alternative is unthinkable, whereby Harriett will have a deteriorating lifespan, leading to an early death, which I am sure we would all agree is unacceptable for anyone.

The final decision is with the Minister. I hope he recognises the unity of purpose in the House and acts immediately.

Eating Disorders Awareness Week

Margaret Greenwood Excerpts

Tuesday 27th February 2018 Commons Chamber

[Edward Argar]

My hon. Friend makes a very important point and if he will perhaps be patient for a few more minutes, I will turn to, among other things, exactly that point.

At the launch that I referred to, I met and heard from some impressive and inspiring people, who had grappled with eating disorders and who wanted to share their experience and raise awareness. I subsequently met Beat to discuss its work and what more needs to be done. The people I met at Beat’s launch event did something important and brave in speaking out, but they had already done something brave in seeking help for their illness in the first place.

[Margaret Greenwood (Wirral West) (Lab)]

One of my constituents is an ambassador for Beat, and I met her recently. Does the hon. Gentleman agree that one of the organisation’s strengths is that it draws on people who have been through the experience, so they can speak knowingly and convincingly to people they recognise as being in the same situation that they were in not that long ago?

[Edward Argar]

The hon. Lady is absolutely right. It is always true in any situation that someone who has been there can speak with much more power and in a much more compelling way than someone who has not, however empathetic they are. The reality is that the recognition of an eating disorder for what it is—an illness—and getting the help and treatment for it is, all too often, still too slow. With an eating disorder, as with illnesses generally, the earlier an intervention and treatment take place, the easier it is to treat and the better the outcome for the patient.

Medicines and Medical Devices Safety Review

Margaret Greenwood Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

International experts from the Commonwealth Fund in New York say that we are the safest healthcare system in the world, but that gives me pause for thought because there is still so much avoidable harm and death in our system right now. If we are the safest, that says that healthcare everywhere needs to improve.

[Margaret Greenwood (Wirral West) (Lab)]

Campaigners on Primodos will be hugely disappointed by the Secretary of State’s statement and his failure to recognise the concerns they have raised about the expert working group. That aside, how many patients does he envisage being involved in the review, and how does he believe that they will be best accessed to ensure that those people who are quiet actually have their voices heard?

[Mr Hunt]

That is the entire purpose of the review. Obviously, Baroness Cumberlege will want to involve patients in the process right from the start, and I will talk to her about that. I will also write to the hon. Lady to spell out in detail the way in which the Baroness intends to involve patients in the process.

NHS Winter Crisis

Margaret Greenwood Excerpts

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

The hon. Gentleman makes quite a serious allegation of my misleading the House. What I was very clear about is that there has been a 35% increase in attendances at A&E as a result of flu this year compared with last year, and that around 3,000 beds are currently occupied by patients with flu and around 700 beds are occupied by those with norovirus. Clearly, that has resulted in significant seasonal pressures this year, which have placed strain on the system. That was recognised by the Government in the additional funding that was put in place. It was recognised by the NHS, as Sir Bruce Keogh set out in the early planning that was undertaken, and it is simply wrong for the hon. Gentleman to ignore the impact of flu this year, given the way that in 2009 the then Opposition were very responsible in recognising its impact.

[Margaret Greenwood (Wirral West) (Lab)]

Can the Minister confirm that accountable care organisations, accountable care services and place-based care are being rebranded as integrated care services? Will he explain whether there is actually any difference between those terms, and will he do all he can to ensure that Members in this House are given the opportunity to scrutinise them, as I believe that they are here to act as a Trojan horse to bring in the break-up and privatisation of the national health service?

[Stephen Barclay]

We continually hear this myth about privatisation. The reality is that this Government appointed to run NHS England, first, Sir David Nicholson, who had previously been appointed by the Labour party, and then Sir Simon Stevens, who has worked for both sides of the House. Numbers show that the level of private healthcare provision has not changed this year compared with last year. I understand that the Health Committee is due to look into ACOs and integration within a matter of weeks as part of its deliberations, and I very much look forward to reading the conclusions in that Committee’s report.

NHS Winter Crisis

Margaret Greenwood Excerpts

Wednesday 10th January 2018 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

The crisis in the national health service this winter is real, and patients and NHS staff are feeling its effects. Thousands of operations have been cancelled, and ambulance crews and patients are waiting in A&E. On one day at Arrowe Park Hospital in my constituency, 26 ambulances, with patients and paramedics, were forced to wait more than an hour just to hand over patients. For 21 days in the period between 20 November and 31 December, we had a bed occupancy rate of over 99%, which is not safe or acceptable. Nineteen per cent. of ambulances that arrived had their handover delayed for over 30 minutes in that period, and 8% were delayed for more than an hour. We have heard of the terrible ordeals suffered throughout the country by patients and NHS staff stretched to the limit. Cancer operations have been cancelled and less serious elective surgery has been postponed until the end of January.

It is estimated that 55,000 operations will be delayed, but there is another crisis in the NHS this winter that deserves parliamentary attention: the Government’s plan to make regulatory changes to facilitate the introduction of accountable care organisations. The Government have failed to provide any time for parliamentary scrutiny of that plan on the Floor of the House. Accountable care organisations and accountable care systems are ideas that have been imported from America. In the US, Government and private insurers award large contracts to commercial bodies to run and provide services. We all know the horror stories of how expensive healthcare is in the US and how people with complex conditions find it difficult to obtain insurance. We hear stories of people with cancer who are forced to sell their home to pay for care. Those horror stories are real, so we all have a responsibility to guard against any introduction of private health insurance models in the UK, which is why we must scrutinise ACOs.

ACOs bring together health and social care so that there is a single finite budget to provide for a specific population. Once that budget has been spent, there is no extra money. ACOs are being developed for delivery in 44 STP areas rather than the country as a whole. It follows that if there is an increase in demand for healthcare in one of those areas—because of an epidemic or a serious accident, for example—the money that is taken out for that squeezes the rest of the system for health and social care.

A great strength of the NHS is that it provides a large risk pool for everyone in England so that they can be supported. Why would a Government who are committed to a national health service choose to replace a large risk pool with 44 little risk pools? It does not make any sense. At the heart of the issue is the serious fact that ACOs are non-NHS entities, so we need clarity from the Secretary of State. We need him to answer serious questions on the Floor of the House. Will ACOs be private companies? It seems logical that they might be, given that the idea has come from America and the Secretary of State considers that the American healthcare company, Kaiser Permanente, provides one of the best examples of practice in integrated care.

If ACOs are allowed to operate, they will be given multi-billion-pound health and social care budgets for 10 years or more. They will blur the boundaries between health and social care, and there is real concern that there will be an increase in the types of things for which people will be asked to pay. An ACO, once established, would have control of a huge budget for an area’s entire health and social care needs, so it would have a huge amount of power to determine what it does and, crucially, what it does not commission.

I have received a lot of correspondence from constituents who are very concerned that the introduction of ACOs is yet another major step towards the wholesale privatisation of the national health service. They have expressed real concern that ACOs could be a means to introduce private health insurance models area by area. That could not be done on a national basis because it would be politically unacceptable. Let us have no more talk about taking the politics out of the NHS. The NHS is a political entity. People need to take responsibility for their decisions around the Health and Social Care Act 2012.

--- Later in debate ---

[Steve Brine]

Thank you, Madam Deputy Speaker. The Members appear to be heckling themselves.

The hon. Member for Wirral West (Margaret Greenwood) said that the NHS was a political organisation. I totally disagree. The NHS is an organisation run by hard-working people who are public servants. They go to work every day to do a job for our constituents, and the NHS is not a political organisation. The Labour party is a political organisation, and it is politicising the NHS—

[Margaret Greenwood]

Will the Minister give way?

[Steve Brine]

I will not give way; the hon. Lady has had her say.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) spoke about leadership, and he was absolutely right. He knows the Luton and Dunstable University Hospital NHS Foundation Trust, which has been ably led by Dame Pauline Philip. She has achieved 98.6% of patients meeting the four-hour target. That is the kind of leadership that can be achieved, which is why Dame Pauline was brought in to NHS England to help with our national response to winter pressures.

My hon. Friend the Member for South West Wiltshire (Dr Murrison) said that this was all about outcomes and that, on cancer, we do not do well. We have had the best cancer outcomes ever in our country, but I agree that our ambition for the long term needs to be even better and that we need to aim higher. His point on a royal commission is noted.

My hon. Friend the Member for Henley (John Howell) spoke about the out-of-hospital care work that Henley’s hospital is doing. I thank him very much for his invitation. My ministerial colleagues also heard what he had to say, and it was good to hear about the cross-party working that is going on in Oxfordshire. My hon. Friend the Member for Southport (Damien Moore), a new Member of the House, talked about joined-up care and continuous improvement. He reminded us that without a strong economy there is no strong NHS. This is not the Government’s money; it is the public’s money. We need to spend it well, and I think we are doing so.

My hon. Friend the Member for North Dorset (Simon Hoare) spoke about community pharmacies, a subject close to my heart. They play a key part, and better integration of them within the NHS is part of the prevention and primary care agenda. I completely agree with the points that he made. My hon. Friend the Member for Taunton Deane (Rebecca Pow) spoke about the A&E hub at Musgrove Park Hospital. That sounds very interesting indeed, and the new Minister of State, Department of Health and Social Care, my hon. Friend the Member for North East Cambridgeshire (Stephen Barclay), was also interested to hear what she had to say. We would like to come and see it, and we will take her up on her invitation.

Finally, I welcome back my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns) and congratulate her on the birth of Clifford. She spoke very well, as always, about the integration of health and social care, saying that it can only make sense and will only serve to make the preparations for next winter better.

I hope to end this debate on a note on which both sides of the House can agree. We are all truly thankful for the extraordinary dedication of NHS staff in caring for their patients—our constituents—during this extremely challenging time. As ever, they are doing a brilliant job.

Question put and agreed to.

Resolved,

That this House expresses concern at the effect on patient care of the closure of 14,000 hospital beds since 2010; records its alarm at there being vacancies for 100,000 posts across the NHS; regrets the decision of the Government to reduce social care funding since 2010; notes that hospital trusts have been compelled by NHS England to delay elective operations because of the Government’s failure to allocate adequate to the NHS; condemns the privatisation of community health services; and calls on the Government to increase cash limits for the current year to enable hospitals to resume a full service to the public, including rescheduling elective operations, and to report to the House by Oral Statement and written report before 1 February 2018 on what steps it is taking to comply with this resolution.

Hormone Pregnancy Tests

Margaret Greenwood Excerpts

Thursday 14th December 2017 Commons Chamber

[Sir Mike Penning]

Thousands of people went in good faith to see their GP because they thought they might be pregnant. That is probably the most important time in any woman’s life. Certainly, as the father of two gorgeous girls, the most important time in my life was when my wife told me that she was expecting our children. It was so important to these families that often they went to their GP, which is a natural thing to do, so we had an NHS patient going to an NHS surgery to see an NHS doctor for advice about whether they were pregnant.

Look at the dates for when these potential mothers-to-be went to see their GP: between 1953 and 1975. That is quite a span of time. My mother could have gone to her GP then, because I was born in 1957. In many ways, it could easily have been me who was a victim of this—God forbid—and my mother would have been a victim as well. That is one of the reasons why I am so passionate about getting to the bottom of the disaster that happened to these ladies who went to their GPs.

These women went to their NHS GP in an NHS surgery as an NHS patient, and very often that GP would open the drawer and give them a tablet—two sometimes—with no prescription or advice, and no concern about the consequences or side effects of the drug. The GPs handed the tablets over to the ladies, and many of them took them there in the surgery. The GP simply said, “If your period starts tomorrow, you’re not pregnant. If your period doesn’t start, you are.” In good faith, which we all have for our GPs, the ladies followed that advice, even though the Department of Health and the drug companies knew that there were issues with this drug.

I am going to use a tiny bit of privilege, because every time I look around for information to do with this subject, including in the House of Commons Library debate pack “Hormone pregnancy tests” and the “Report of the Commission on Human Medicines’ Expert Working Group on Hormone Pregnancy Tests”, I see the phrase “hormone pregnancy tests”. The drug was Primodos. It was made by a drug company and often given free to GPs, who then handed it out without a prescription to determine whether a lady was pregnant.

Other companies in the world knew that there were issues. I will not go into all the evidence that was given to the so-called review, but let me just touch on some of the things that Ministers asked for when the group was set up. The first point was that the Government should set up an expert working panel “inquiry”. No such inquiry took place. At the third meeting, as I understand it, the barrister to the inquiry advised that the word “inquiry” should be changed to “review”. Under whose authority? When a Minister sets up an inquiry, should there not be an inquiry? Perhaps those people did not want an inquiry, but who cares? They should have come back to the group—the victims—and, more importantly, to the Minister. They could have spelled out their advice and the Minister could have made a decision. Some might think that this is just semantics, but it is not. If people are trying to get to the truth, it is vital that they know what a group can do. Even when the report came out—not the original report, because that was removed and draft was changed, as others will mention—it did not say “review”, because it was not a review.

There should be full disclosure and a review of all the evidence. That “review” said that it did that, but it did not. The Royal College of General Practitioners, to give just one example, informed the Department and the drug company that it had concerns way back in the 1960s, but its evidence was never sought. If Members read the report, they will find that no evidence at all from the Royal College of GPs was given to this review, which should have been an inquiry.

[Margaret Greenwood (Wirral West) (Lab)]

rose—

[Sir Mike Penning]

I will give way, but I will only give way on a couple of occasions because I am conscious of the time and I want everybody to have the opportunity to speak.

[Margaret Greenwood]

I thank the right hon. Gentleman for giving way. Is he aware that The BMJ reported that most of the scientific evidence considered by the working group was from the 1960s, ’70s and early ’80s. One expert in the field, Dr Neil Vargesson of Aberdeen University, told The BMJ that there were not that many scientific studies available. Does he agree that the Government should fund new research with the aim of enabling a definitive conclusion to be reached?

[Sir Mike Penning]

Yes, I do, and I will come on to that point. It is vital that we have proper evidence, not some historical evidence that was used by the report. More modern evidence was rejected because it had not yet been peer reviewed. The whole point about having all the evidence is one reason why the motion under debate today, which I hope will be passed unanimously, actually says that there should be a judge-led inquiry so that all that evidence can be considered.

King’s College Hospital Foundation Trust

Margaret Greenwood Excerpts

Tuesday 12th December 2017 Commons Chamber

[Mr Dunne]

My hon. Friend is very ingenious with his question. Clearly, there will be more time available for Lord Kerslake to take on his other responsibilities. The Leader of the Opposition might like to look very closely and keenly at the financial performance of the organisation over which Lord Kerslake has taken responsibility before he adopts any of his other advice.

[Margaret Greenwood (Wirral West) (Lab)]

It is abundantly clear that the Government are accelerating the privatisation of our national health service by reducing supply in the NHS to create demand for private health insurance. We do not want a US-style health insurance here. Will the Minister please give the NHS the money it needs?

[Mr Dunne]

I cannot understand how the hon. Lady can make such an interpretation from any discussions that have been held, either in this urgent question or further afield. The Government have just given an additional £2.8 billion over and above that asked for by the chief executive of NHS England when he set out the five year forward view and up to £10 billion of capital. This is nothing whatever to do with privatisation.

NHS Pay

Margaret Greenwood Excerpts

Wednesday 13th September 2017 Commons Chamber

[Simon Hoare (North Dorset) (Con)]

I will not take that personally, Mr Deputy Speaker.

I thank the Labour party for giving the Conservative side of the House, and me in particular, the opportunity to put on the record the grateful thanks of all our constituents to public sector workers for their fantastic work in hospitals in places such as Blandford, Shaftesbury, Poole, Dorchester, Salisbury, Southampton and Bournemouth, all of which will have served my constituents over the years. We are all grateful to them.

I want to make two points to the Labour party. I entirely endorse what my right hon. Friend the Member for Broxtowe (Anna Soubry) had to say, because this is not a bidding war over which party loves the NHS more; it is about all of us trying to come together to ensure that the NHS is fit for purpose for the next 70 years, delivering quality care that is free at the point of use in the face of ever-increasing demand in the ever-more competitive space of medical advancement. At the heart of that, I am afraid to say, is cruelty from the Labour party, which makes huge promises about raising this, doing that or scrapping the other without saying how, by how much, or how it is going to be paid for. Labour raises expectations only for them to be dashed, as always, on the rocks of what would ultimately be the folly of a Labour Government. Labour’s childish approach to economic management defines what it is to be a Conservative. Broadly, being a Conservative in public life is to be the man or woman with the bucket, the brush and the shovel following behind the horse of Labour Government and picking up the mess.

[Margaret Greenwood (Wirral West) (Lab)]

I wonder whether the hon. Gentleman is aware of how his Government are reducing supply in the national health service, creating demand for private healthcare. People outside the Chamber are fully aware of the Conservative Government’s privatisation agenda and their agenda of selling off buildings—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. It is not normal to intervene just after coming into the Chamber. The fact is that Members who have been here all day are desperate to get in, and I am worried that they may not.

Autism Diagnosis

Margaret Greenwood Excerpts

Wednesday 13th September 2017 Westminster Hall

[Bambos Charalambous]

My hon. Friend makes an excellent point. Other additional conditions can develop, and suicidal tendencies are one of them. Other mental health conditions can similarly manifest themselves in young people in particular. I congratulate her on looking at that research.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is being very generous in giving way. He is making such an important speech, and I congratulate him on calling this debate. One of my constituents wrote to me about how she was diagnosed as autistic in her 40s and the struggle she had in getting past her doctor. She said that once she had that diagnosis, it was life-changing, because she could understand that she was not lazy, weird or anything else; she was autistic. She wrote to me to say that she believes there is a need for greater training of GPs to spot the signs of autism. Does my hon. Friend agree?

[Bambos Charalambous]

My hon. Friend makes an excellent point. Sometimes the behaviours for autism in women and girls are not picked up as much as they are in boys, because they do not always display the behaviours that would lead someone to detect autism. I wish her constituent well for the future.

The lengthy delay in diagnosis can lead not only to the development of further secondary conditions to autism, but will invariably end up costing the NHS more money for more GP appointments, emergency admissions and reliance on mental health services at a time of crisis. In addition, delayed diagnosis has a disproportionate effect on women. Girls are often diagnosed late as they do not always display the same classic behaviour associated with autism as boys do.

How can the situation be remedied? I urge the Minister to consider implementing three things. First, we need to ensure that the NHS collects and publishes data for each NHS trust or CCG from the date that a child is referred to them until the date of diagnosis. At present there is no such requirement, so such a database should be cemented in the NHS accountability frameworks and should be held by the CCGs in their improvement and assurance frameworks. CCGs and the NHS trusts should be measured by how they perform on referrals and diagnoses.

Secondly, we need more investment in the NHS. To miss a standard set by NICE by more than three years leads me to believe that the Government are not really trying hard enough when it comes to ensuring that the children are seen and properly diagnosed within a timely period. It is scandalous that children’s futures are put at risk in such a way. Although the Minister may say that the three months is only a guideline and not mandatory, I believe the guideline should be strictly adhered to. The guidance is there for a reason.

We also need more specialist units to deal with diagnosing autism. We have in recent months heard some bold promises from the Government about funding for mental health, but we have yet to see any sign of firm action. We need investment in the NHS and we need it now.

Finally, we need to ensure that the improved record- keeping of autism diagnosis helps to identify where there are gaps, and that work can begin to tackle the health inequalities we face. I wish to thank the National Autistic Society and Autistica, and also the House of Commons Library for its excellent briefings on this matter. I await the Minister’s response.

NHS Shared Business Services

Margaret Greenwood Excerpts

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

The NHS is extremely good at responding to crises and emergencies, as tragically we have found out in recent months. This is an example of the NHS doing a very good job when it realises the scale of the problem. For me, the lessons that really need to be learned are about not the response to the issue but the assurance processes that allowed the problem to happen in the first place.

[Margaret Greenwood (Wirral West) (Lab)]

The National Audit Office says that the review of the backlog of correspondence has found 1,788 cases of potential patient harm, so what action is the Secretary of State taking to support those patients?

[Mr Hunt]

All those cases have already been looked at by two sets of clinicians, and so far, on the basis of those two reviews, no patient harm has been identified. However, because we want to be absolutely sure, we are having a third clinical review that will be even more thorough, potentially with more than one set of clinicians, so that we can get to the bottom of this and find out.