Health and Care Professions Council: Registration Fees

Mary Glindon Excerpts

Thursday 14th March 2019 Westminster Hall

[Liz Twist (Blaydon) (Lab)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I thank my hon. Friend the Member for Coventry South (Mr Cunningham) for securing this important debate, which I am glad to have the opportunity to speak in. For many years, it was my privilege to work with many healthcare professionals, so I take a keen interest in this subject. I was happy to add my signature to the letter to the HCPC to oppose the, at the time, 18% proposed increase in fees.

It is right that healthcare professions should be regulated and that those bodies should be independent of the Government, which means that fees must be attached to the registration. Having set fees, however, those bodies must have a view to the people and the professions that they regulate. Many people covered by the Health and Care Professions Council are not big earners, despite playing an incredibly important part in our healthcare system, and they are often missed out when we talk about healthcare workers.

We talk about doctors and nurses, but we rarely talk about all the other NHS staff who are integral to our healthcare system. I have worked with paramedics, occupational therapists, dieticians and many others, who are an important part of that healthcare team. In the last 18 months, I have had personal experience in my family of the great work they do—on stroke rehabilitation, for example. It is important work, but the pay is not great. Typically, people are paid at band 5, which starts at £23,000 a year, so we are not talking big bucks.

[Mary Glindon (North Tyneside) (Lab)]

My hon. Friend is making a good argument about the different levels of pay. Does she agree that one of the most unfair arguments for raising the fees is that they are lower than for other professional bodies? Dentists and doctors get paid much more money, so there is no fairness in that comparison.

[Liz Twist]

I agree with my hon. Friend and I will come on to that point later.

Although we in this House talk about how valuable healthcare workers are in all kinds of debates, the fact is that their pay has not kept in line with the real cost of living, so an 18% increase in registration fees is huge and out of all proportion with the pay increases that they have had in recent years. Most of them do not have a choice about whether to register; they must be registered to be able to work. The increase will bring the total increase in registration fees to 40% since 2014, which is incredible.

As hon. Members know, one issue that the NHS is facing is staff shortages in certain areas. It cannot be ignored that something such as this increase can only be a disincentive to staff looking to do those important jobs. As other hon. Members have said, another key issue is the impact of social workers. They are currently covered by the HCPC, but they are about to go off to their own regulatory body. The significance of that should not be lost. While it will mean a reduction in income, of course, it will also mean a significant decrease in the number of fitness-to-practise cases, which are inevitably expensive to prepare. Currently, 25% of HCPC registrants are social workers, but more than 50% of fitness-to-practise cases are in the social work field. That significant factor should be taken into account when the HCPC considers its fees.

On fitness-to-practise cases, I well remember from representing people how devastating it is for any health professional to face a complaint or a fitness-to-practise case, but many people are being held in limbo waiting for their case to be heard, or even awaiting a decision that the case should not be pursued. A 2018 report by the Professional Standards Authority for Health and Social Care was critical of the HCPC and suggested that cases were being referred to the fitness-to-practise panel by its investigation committee too readily. The report stated:

“In our review of its performance this year, we set out our concerns about how the HCPC approaches the discontinuance of cases. Our view was that the approval of discontinuance decisions by the HCPC (with no additional information or evidence being presented since the decision of the Investigation Committee to refer the case) may indicate that the Investigation Committee is failing to identify when there is no case to answer.”

Clearly, that has a significant impact on the professional under investigation and on the operation of the HCPC, and is a factor in costs.

As other hon. Members have mentioned, the proposed 18% increase will have a disproportionate impact on part-time workers, who are predominantly women and mostly in the NHS, because it is a flat-rate fee. That does not seem reasonable.

We hope that the Health and Care Professions Council will listen to the comments made in the debate. Unison has also made some suggestions that the HCPC should consider. First, there should be a pause in implementing the decision to increase fees until the impact of social workers moving away can be assessed. It will clearly be a significant factor in the future, so it seems appropriate that the full impact should be known before an important decision to increase by 18% is made. Secondly, I am told that the Health and Care Professions Council has £18 million of cash reserves, which should be used to allow the impact of the move of social workers to be considered before fees are raised. Thirdly, there should be a more stringent look at other means of raising revenue, rather than just increasing fees.

The Health and Care Professions Council carried out a consultation on the fee increase. By its own admission there were 2,398 responses, many of which opposed the proposed increase. The HCPC has written to explain its position to those of us who signed the letter that we wrote before it made the decision. In that letter, it compared its fees with those of other healthcare regulators. Frankly, that comparison is not valid, as my hon. Friend the Member for North Tyneside (Mary Glindon) has already said. A comparison with the fees paid by dentists, which are £890 a year, or doctors, which are £390 a year, is completely misleading. Typically, HCPC registrants will be paid vastly smaller salaries, so it is not just apples and pears, but apples and strawberries. There is a real mismatch and disparity in the comparisons being made, so they are not valid.

As other hon. Members have, I call on the Health and Care Professions Council to reconsider its position and to agree to Unison’s suggestions as a way to avoid the 18% increase in fees.

Prostate Cancer

Mary Glindon Excerpts

Wednesday 6th February 2019 Commons Chamber

[Simon Hoare]

The hon. Gentleman is absolutely right, and I will turn to diagnosis in a moment.

Let me return to the point I made a moment or so ago about fear. We will all have had family and close friends experience being given a diagnosis of prostate cancer or, indeed, other cancers, and the first thing is always to face that in a very black mood and think that there is absolutely no cure. However, we know that there are scientists—clever men and women—striving every day to find such cures. Indeed, life expectancy post an early diagnosis is of course getting better and better. Rightly, we place huge emphasis on breast and cervical cancers, but I suggest to the Minister that, in the shape of male cancers, we need to up the game in communication and education as well.

Some statistics on prostate cancer, provided by Prostate Cancer UK, may be of help to the House. Prostate cancer is the most common male cancer in our country: 47,000 men are diagnosed each year. One in eight men will get prostate cancer, and every 45 minutes one man dies of it in our country. Men over 50—I turned 50 this year, so I do not know whether—[Hon. Members: “No.”] I know; it is almost impossible to believe. I am not sure whether I should therefore declare an interest, but men over 50 are more prone to it, particularly if they have a family history.

A statistic I have learned—I am yet to find any particular reason for it—is that black men are far more at risk of contracting prostate cancer: one in four will get it. Someone’s risk of prostate cancer is heightened—again, this was a new fact to me—if their mother or their sister has had breast cancer. I wonder how many people recognise that and see that, if a female in the family is diagnosed with breast cancer, that should act as a spur for them to go and have a test. In 2016, 11,631 men died of prostate cancer in the UK alone.

At our party conference last year, my right hon. Friend the Prime Minister said:

“The key to boosting your chance of surviving cancer is early diagnosis… Through our Cancer Strategy, we will increase the early detection rate… We will do it by…investing in the very latest scanners.”

[Mary Glindon (North Tyneside) (Lab)]

I congratulate the hon. Gentleman on securing this important Adjournment debate. As well as early diagnosis, this is about people’s awareness that they themselves may possibly have the symptoms. When my husband was diagnosed, he just thought he had a chill. Unfortunately, his is incurable, but he thought no more about it than that he had a chill. An even more important issue than having screening is that we should be aware of our bodies.

[Simon Hoare]

The hon. Lady makes an incredibly telling point, because unless people know what the full range of symptoms are, they do not really know what they should be thinking and whether one of those symptoms or a combination of them should actually trigger a visit to their doctor in the first instance. I think she is absolutely right that we need a better understanding.

This goes back to a point I made a moment or two ago. Because this is a below-the-waist issue and we men get frightfully embarrassed about those sorts of things, we are inclined to say that it might just be something else or that it will pass, and so on. However, for too many people, it is left too late to have any meaningful, beneficial outcome as and when they eventually go to see their GP and then trigger the referral process.

--- Later in debate ---

[Steve Brine]

We do not often use the term, “No decision about me, without me” any more, but I always remember the former Health Secretary—now Lord Lansley—using that a lot, and that is still very true. A patient over that age has every right to request a PSA test, and certainly even more so if they believe that they have symptoms. I would be very concerned about a GP refusing it—I think it would be extremely unlikely for one to do so in such instances—but any patient has the right of travel. Every patient has the right to change GP if they are not satisfied with the relationship that they have. If my hon. Friend did know of an instance of that, I would be very interested to hear about it—as, I suspect, would the Royal College of General Practitioners —but I would be very surprised.

I want to touch on screening, which we talk about a lot at the moment, and I will come on to why. Because of the limitations of the PSA test, there is currently no national screening programme for prostate cancer. In 2016, Prostate Cancer UK, which has been rightly lauded this afternoon, began work to help to develop tests that could form part of a national screening programme. This would potentially involve better blood tests, which are currently in development, combined with more advanced scanning. It is hoping to make that happen in the next five years—nothing happens quickly in this space unfortunately—and I am sure that we all welcome their efforts.

Members will be aware—I have spoken about this quite a lot in the House recently; we have had a number of cancer debates since Christmas—that Sir Mike Richards is leading a review for the Secretary of State of our current screening programmes. As part of that—I met Sir Mike last month—we will consider how we can make screening smarter, targeting those most at risk. We expect that Sir Mike’s work will have positive implications for future programmes. He is an incredibly experienced and respected figure in this space, and I hope that his work will enable us to roll screening out faster when the evidence base is there to support it. I am very hopeful and ambitious about that work, as I know Sir Mike is.

Let us talk about public awareness campaigns, which my hon. Friend mentioned in opening the debate. The Government have to do all that they can to raise awareness of prostate cancer and target high-risk groups, while recognising that there are limitations on how much the public will listen to public health messages from Ministers at the Dispatch Box—I know that it is hard to believe that people do not take this all to heart, but they do not, so we work with our partners.

In 2014, along with Public Health England, we worked on the phenomenally successful “Be Clear on Cancer” campaign, which has had a number of iterations, on prostate cancer in black men. The campaign messaging included:

“1 in 4 black men will get prostate cancer”,

which was one of its tag lines. It urged black men over 45 who were concerned about their risk of prostate cancer to visit their GPs. The campaign evaluation showed that it had stimulated new conversations about prostate cancer among families and the black community. Public Health England has made all the materials developed for the campaign available online, so that groups and other organisations can use them locally if they wish. They are very striking and powerful, and we believe that they were very successful.

We also welcome the work that Prostate Cancer UK is doing with the Football Association to raise awareness through their “relegate prostate cancer” campaign. It is fronted by high-profile celebrity football figures, including the England football manager, Gareth Southgate, and includes the slogan:

“One man dies every 45 minutes of prostate cancer”.

Anyone who can stay awake for “Match of the Day” on a Saturday night—thank goodness for the repeat on a Sunday morning—will see very many people, including the pundits and the managers interviewed afterwards, wearing the badge that I am wearing today. Members will be very familiar with that badge, which demonstrates the widespread support that Prostate Cancer UK has in continuing to raise awareness of this disease.

Let me turn to research, as I come to a conclusion. Research has played a crucial part in the advances that we have made in cancer survival over the past four decades. More than 15 years ago, the Department identified the need for further research into prostate cancer, and we have since worked closely with Cancer Research UK—it was here this morning; I was pleased to pop into its drop-in—Prostate Cancer UK, the Medical Research Council and others, through the National Cancer Research Institute, which is a strategic partnership of the major UK funders of cancer research. NCRI spend specifically on prostate cancer research increased from £17.1 million in 2011-12 to £26.5 million in 2015-16.

[Mary Glindon]

On research, does the Minister think that those who are diagnosed with cancer should be encouraged to take part in clinical trials that aid research and help us to find ways to halt or even cure these horrendous diseases? I think this is underplayed and that we should encourage as many people as possible to help with research by themselves getting involved in trials.

[Steve Brine]

I am happy to agree with the hon. Lady. In her work on brain cancer, the late Baroness Jowell made the point about stimulating new research projects, and that work has been incredibly successful, including subsequent to her death. She also spoke a lot about clinical trials. Anybody diagnosed with a cancer for which there is no significant treatment would want to load the gun with the trial bullet, but there are challenges there. There is only so much that one can do, and there is a toxicity issue with moving from trial to trial that patients do not always fully appreciate, but in consultation with one’s oncologist and physician absolutely it has a critical role to play. Without trials, we would not have any of the treatments we have today, so I thank the hon. Lady for raising that point.

My hon. Friend the Member for North Dorset said that women’s cancers, such as breast cancer and the gynaecological cancers, perhaps get more Government attention. I have to disagree. Last April, the Prime Minister pledged £75 million towards clinical trials for prostate cancer, which will focus on improving early diagnosis and survival rates as well as exploring options for different treatments for men affected by the disease. We expect 40,000 men to be recruited to new research projects with this cash boost. I hope this demonstrates our ongoing commitment to male cancers as well as female cancers.

I am the first guy to hold the post of Public Health Minister in a long time, possibly ever, and it is true that there is a lot of focus on female cancers, but I am determined to raise the bar for men’s health generally, but for male cancers in particular, which is why I was pleased to mention the all-party group earlier.

Alongside the £75 million for research, in 2016-17 the NIHR clinical research network recruited patients to over 90 trials—the hon. Member for North Tyneside (Mary Glindon) raised the point about trials—and other studies on prostate cancer, so there are a lot of trials in this area. The NIHR biomedical research centre at The Royal Marsden here in London and the Institute of Cancer Research also have a five-year £3.1 million prostate cancer research theme.

I started by saying that we do not know everything about prostate cancer. We hope to see these projects deliver more personalised diagnosis, treatment and care of men with prostate cancer through better understanding of the molecular and genetic pathways that determine the non-uniform nature of prostate cancer. The prostate testing for cancer and treatment—ProtecT—trial was the largest publicly funded clinical trial ever to take place in the UK. NIHR funding to date is £40million, which is quite a significant sum.

I agree with what my hon. Friend said about the workforce. The NHS is nothing without the 1.3 million staff on whom patients depend day and night, and for no group is that more true than for cancer patients. We will not achieve our cancer ambitions without an increased cancer workforce, which is why the Secretary of State has commissioned Baroness Dido Harding, working closely with Sir David Behan, who used to lead the Care Quality Commission, to lead a number of programmes to engage with key NHS stakeholders to develop a detailed workforce implementation plan. Baroness Harding and Sir David will present initial recommendations to the Department in March, and these will consider detailed proposals for growing the workforce rapidly alongside the implementation of the NHS long-term plan, including that early diagnosis of cancer target I mentioned.

In connection with that, my hon. Friend mentioned cancer nurse specialists. Health Education England is working to expand the number of cancer nurse specialists and to develop their competencies and routes into training. This will mean every cancer patient having access to a CNS or other support worker by 2021, which I think he will agree is a very good thing.

I have covered today just some of the many initiatives the Government are undertaking in our significant efforts to tackle prostate cancer for many of our constituents, including my friend. I hope I have given the House some information today and a promise of some more. The Government remain totally committed to maintaining and improving cancer survival rates. Prostate cancer is the second-biggest cancer killer among men and is right at the top of our list of priorities.

Finally, I could not close without paying tribute to Prostate Cancer UK, led by Angela Culhane, and the work it does on research and early diagnosis and in supporting men with prostate cancer and reassuring them that they are not alone and that there is often a way out. As cancer Minister, I have been told many times by cancer patients that the cliff edge of an all clear is every bit as bad as the original diagnosis. Owing to our successes, people are living much longer and perfectly normal and full lives after cancer, but we need to support them better, so I pay tribute to the work of Prostate Cancer UK. Its work is invaluable, as is that of all those members of staff who make the NHS what it is. I thank everybody for taking part in today’s debate.

Question put and agreed to.

Children with Life-limiting Conditions

Mary Glindon Excerpts

Tuesday 29th January 2019 Westminster Hall

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to serve under your chairmanship, Ms Dorries.

I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. He and I are both members of the all-party group for muscular dystrophy, so I know that his commitment to the issues being discussed this morning is genuine.

Following on from my hon. Friend the Member for West Ham (Lyn Brown), I will talk about Spinraza, because nothing is more fundamental for anyone with a life-limiting or life-threatening condition, or their families, than to have access to treatment that will give the chance of a better quality of life and, possibly, some chance of longevity.

As my hon. Friend said, one of the rare conditions that until the last few years has had no proven treatment is SMA. There are four types, and the most severe is type 1. Infants diagnosed with that have a life expectancy of no more than two years. The condition affects the lower motor neurones in the spinal cord, leading to loss of mobility and eventually of the ability to breathe and swallow.

The drug Spinraza, which was developed and marketed by the pharmaceutical company Biogen, is the only treatment that has proved successful for children with SMA. Spinraza was granted a marketing authorisation by the European Medicines Agency more than 18 months ago. It is available in 24 European countries including Scotland, as has been said, but not in other parts of the UK.

The APPG, which I chair, has supported the work of our excellent secretariat organisation, Muscular Dystrophy UK, and other groups to press for Spinraza to be approved by NICE. Many MPs across the House with constituents who suffer from SMA feel the frustration of families waiting for Spinraza to be approved. So far, however, progress has been slow. That is largely due to the fact that Spinraza has been assessed by NICE under the single technology appraisal, or STA, route, which is not appropriate for such a rare condition. That route is normally used for more common conditions, and it is now a year since the assessment began. Also, in August, when NICE published its initial decision on access to the drug, it did not recommend Spinraza for use on the NHS. That was a bitter blow for all the families, including the family of young Sam McKie from North Tyneside, who has the condition.

Biogen opened an expanded access programme globally in 2016, as an interim solution for patients with infantile-onset SMA. In the UK, the programme was extended to support continued access for those patients until NICE completed its appraisal. To date, more than 80 eligible children in the UK have received the drug free of charge. Under the timeframes provided by NICE, the final appraisal document was scheduled for last November; therefore, disappointingly, Biogen closed its access to the EAP for new patients.

Since August, the APPG has been active in pressing NICE, NHS England and Ministers to be flexible in finding a way forward, and I raised the issue at Prime Minister’s questions in September. There is an impasse, because NICE continues to require that Spinraza should be cost-effective through the STA route, but Biogen has pointed out that, given the smaller patient population in rare diseases, it is inappropriate to expect treatments to achieve the same cost-effectiveness thresholds as medicines in disease areas that have much larger patient populations.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 19th June 2018 Commons Chamber

[Mr Hunt]

Yes, I can.

[Mary Glindon (North Tyneside) (Lab)]

11. What recent discussions his Department has had with representatives of NICE on increasing the capacity of the highly specialised technologies evaluation process.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

My officials have regular discussions with the National Institute for Health and Care Excellence, of course, but we are clear that there is no fixed capacity in NICE’s HST programme. The number of drugs that it evaluates each year is driven by the pipeline of drugs expected to come to market, and we will refer any suitable drugs to it for evaluation.

[Mary Glindon]

There is a risk that new treatments for life-limiting conditions, such as Duchenne muscular dystrophy and spinal muscular atrophy, might not be approved by NICE, so will the Minister meet me and Muscular Dystrophy UK to discuss ways to facilitate access to treatments, as highlighted by the charity’s FastTrack campaign?

[Steve Brine]

NICE has recommended the drug Translarna for use in the treatment of Duchenne muscular dystrophy; it is now routinely available on the NHS. It is a disease that I grew up with—the friends that I grew up with did not, and I did, and this is a timely reminder of how terrible this disease can be. I would be really pleased, therefore, to meet the hon. Lady and the charity that she mentioned.

Neuroblastoma

Mary Glindon Excerpts

Tuesday 23rd January 2018 Commons Chamber

[Steve Brine]

I am glad that the hon. Gentleman is here. He raised the same point last week during the Westminster Hall debate on blood cancers, to which I responded. As he had to leave before I did so, I will repeat what I said then. Obviously, once devolved government returns to Stormont and there is a Health Minister in the Northern Ireland Executive, I shall be happy to meet him or her, and I am sure that the hon. Gentleman would like to be involved in that meeting. We shall then be able to talk about some of the successes that we have had in England and some of the things that I am sure we can learn from Northern Ireland.

An even more precise form of radiotherapy that can be used in neuroblastoma treatment is proton beam therapy. It sounds like something out of the future, and in many ways it is, but the future is coming. In 2012, the Government provided some £250 million for the building of two PBT centres in England, at University College Hospital here in the capital and at the Christie cancer centre in Manchester. I had the privilege of visiting the Christie last year—I happened to be there in the autumn, for some reason—to see its new PBT facilities, which are incredible and which will be providing treatment for patients later this year. As a result, the NHS will no longer need to send young patients to the United States—which has caused great upheaval to patients and their families, has had an impact on patient outcomes and has, of course, involved huge expense to the families and the NHS—for this cutting-edge treatment.

My hon. Friend the Member for Spelthorne spoke about guidance from the National Institute for Health and Clinical Excellence. We want the very best new innovative treatments, such as the promising antibody therapy we have heard about today, to be available on the NHS. NICE is the independent body that provides guidance on whether drugs and other treatments represent a clinically effective and cost-effective use of resources in the NHS—a publicly funded health system. I am advised that NICE is currently considering two antibody-based treatments for neuroblastoma. It is appraising Dinutuximab-beta for use in high-risk neuroblastoma, but the appraisal has been delayed as NICE awaits additional evidence from the drug company. Final guidance on the use of any drug can be issued only after careful consideration of all the available evidence and extensive engagement with stakeholders. That has to be the right approach, however frustrating it is. Another drug used in the treatment of high-risk neuroblastoma is dinutuximab or Unituxin. NICE’S appraisal of this drug, which is in the same family as Dinutuximab-beta but is distinctly different, has also been suspended as demand for the drug in the United States has exceeded expectations and is outstripping the company’s ability to meet global need.

I stress that just because drugs are not routinely available to patients on the NHS that does not preclude their use. Clinicians can make a case on a patient’s behalf for exceptional funding if they believe a particular treatment would deliver the best clinical outcomes. I understand that Alfie’s consultant is looking at doing that. Individual funding requests made by a supporting clinician are always a potential route for access to treatments that are not currently commissioned by the NHS. NHS England is not aware of any IFR in Alfie’s case, but I will be happy to make it so, working with my hon. Friend, following tonight’s debate.

Despite the strides we have made in increasing overall cancer survival rates, we recognise that there are some cancers where progress has been far too slow. That is why our focus for these cancers is on research and innovation, and ensuring that proven innovations, once they are discovered, are adopted swiftly across the health service in England. I am pleased to say that the Government are fully supportive of the Less Survivable Cancers Taskforce, which I launched last summer here in the House, specifically to address the survivability gap between the least and the most survivable cancers. I met the taskforce just before Christmas to discuss how we can work together to raise awareness of the symptoms of cancer and how we can ensure that less survivable cancers have better access to research funding. That is a promising workstream. The taskforce is a cutting-edge group and I look forward to working with it.

Cancer Research UK is also funding research to better understand childhood cancers such as neuroblastoma. In September 2016, the Government announced the largest ever investment in health research infrastructure—£816 million over five years from April 2017 for 20 National Institute for Health Research biomedical research centres in England. That was a big step, and I am sure hon. Members recall the Prime Minister’s announcement. That includes £61.5 million in the biomedical research centre at the Royal Marsden Hospital here in London and the Institute of Cancer Research. The NIHR spent £137 million on cancer research in 2016-17—an increase from just over £100 million in 2010-11. That investment in cancer research is of huge importance and constitutes the largest in a disease area.

[Mary Glindon (North Tyneside) (Lab)]

I am not sure whether this has any bearing on the subject of the debate, but will the accelerated access review help to bring some of these potential new treatments forward more quickly?

[Steve Brine]

The accelerated access review is an important piece of work, and I will be happy to write to the hon. Lady in more detail than I have time to go into now. It is about bringing treatments quickly to the market for patients’ use once they are approved, instead of having to take a rather arduous and tortuous route.

I want to put on record that we want the NHS to be the best in the world at treating childhood cancers and all cancers. We can only imagine the pain that Alfie’s family are going through, and they have our prayers and our support. I hope my hon. Friend the Member for Spelthorne will agree that the Government are working hard, even in difficult economic times, to implement the cancer strategy, to invest in research and to continue the investment in cancer treatment to ensure that we can lead the world in the fight against cancer and make this a reality by making life better for people like Alfie.

Question put and agreed to.

Drug Addiction

Mary Glindon Excerpts

Wednesday 22nd November 2017 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gapes.

Let me start by thanking the hon. Member for South Thanet (Craig Mackinlay) for securing this important debate, and for his excellent opening speech, which laid out all the human and associated monetary costs that drug addiction costs society and indeed the Exchequer. His figures are even greater than the ones I will be citing in my contribution, which is perhaps because he included all classes of drugs. I will only be citing figures for class A drugs, but that shows the enormity of the costs that we are dealing with today.

While there is a very important debate going on in the main Chamber, it is welcome to see the number of MPs here today to discuss this important issue. We have had many excellent contributions to the debate, including from the right hon. Member for North Norfolk (Norman Lamb), the hon. Members for Reigate (Crispin Blunt), for Inverclyde (Ronnie Cowan) and for Henley (John Howell), and the hon. Member for Glasgow East (David Linden), who is the Scottish National party spokesperson; he made a pertinent and moving speech, and I commend him for that. They all made strong and thought-provoking speeches, and we have had some excellent interventions. I thank all Members for taking the time to set out their positions and thoughts on drug addiction and the costs to society.

As we have heard, drug addiction is one of the most deeply concerning issues we face today. Drug addiction, in its many guises, can blight communities and the lives of so many people, which is why it is vital that policy is developed to significantly reduce the harm that addiction can inflict on individuals and communities. According to Home Office figures, the number of people taking drugs has fallen significantly over the past decade. That is to be welcomed. Reducing the number of people taking drugs is a step in the right direction to not only improve the health of the nation but reduce crime and pressures on our public services.

Sadly, if we scratch the surface, we unveil more uncomfortable truths that the Government must face. In 2016, there were a total of 2,593 drug misuse deaths involving illegal drugs—the highest number since comparable records began in 1993. That trend in avoidable deaths is reflected across both genders. However, for men the drug misuse mortality rate has jumped sharply over the last three years and reached a new peak of 67.1 deaths per million people—another high since records began in 1993. The female rate is less pronounced but is also at an all-time high.

Across Europe, it is estimated that a total of 8,441 deaths occurred due to drug overdose in 2015, mainly from heroin or other opioids. Here in the UK, we come out on top with the highest percentage of those deaths, at 31%. That is absolutely damning, especially when the Advisory Council on the Misuse of Drugs stated in a report last year that England alone saw an increase of 58% in opioid deaths between 2012 and 2015. Much of that is put down to ageing users of heroin and opioids, which gives rise to the question: what are the Government doing to address the often complex social care needs of drug addicts?

It is not only the deaths that occur from drug misuse and addiction that are concerning, but the costs to society in general, as we heard from the hon. Member for South Thanet. In terms of monetary costs, it is estimated that class A drugs such as heroin and crack cocaine cost us £15.4 billion a year, which is £44,231 per problematic user. Broken down, that figure is roughly £13.86 billion on social and economic costs, £535 million on drug arrests and £488 million on the NHS dealing with mortality and morbidity and providing acute treatment and support for mental health and behavioural disorders associated with drug misuse. As I said, that is just for class A drugs. When we include all classes of drugs, the sums increase substantially, as has been set out in detail.

[Mary Glindon (North Tyneside) (Lab)]

Does my hon. Friend agree with the drugs, alcohol and justice cross-party parliamentary group that, to reduce alcohol and drugs-related deaths and illnesses, a co-ordinated harm reduction strategy needs to be prioritised?

[Mrs Hodgson]

Yes, I do agree.

It is no wonder, when we go off all these figures, that earlier this year the UK was deemed the overdose capital of Europe and is now seen internationally as having serious shortcomings when it comes to addressing addiction and drug misuse. What are the Government going to do to address these problems? I am sure the Minister will cite the recent publication of the drugs strategy in the summer. As he will know, Opposition Members welcomed the strategy, but it left us wanting. There is much to be welcomed in it, but it is clear that what was announced has not moved us on any further from what was happening in 2010 and now works within a seriously reduced financial envelope due to short-sighted cuts to public health budgets.

The Minister knows all too well that public health budgets have been decimated, with an estimated £800 million expected to be siphoned out of local budgets by 2021. That has meant drug rehabilitation services being closed and budgets to tackle drug abuse cut, all against a backdrop of an NHS under significant pressure. Labour’s analysis of figures published by the Department for Communities and Local Government shows that this year we will see 106 councils reduce drug treatment and prevention budgets by a total of £28.4 million; 95 councils reduce alcohol treatment and prevention, at a total of £6.5 million; and 70 local authorities reduce drug and alcohol services for children, at a total of £8.3 million. That works out at a total reduction of £43.3 million imposed by the Minister’s Government on a whole host of services created to prevent and treat addiction problems. Those figures are unavoidable and shameful. We should be putting greater emphasis on the radical upgrade in public health and prevention promised in the “Five Year Forward View” in 2014.

The Minister cannot come before us today and honestly say that his Government are improving services and seriously addressing this issue when they are overseeing such significant cuts that are rolling back provision on addiction services. It is not just me or Labour making that case, but the likes of the chief executive of Collective Voices, Paul Hayes, who said earlier this year:

“The more we disinvest in treatment, as we are doing at the moment, the more we will put increasing numbers of people at risk of early avoidable deaths.”

The Minister has the power to go back to his Department and ensure that these avoidable deaths are avoided and the unnecessary losses of life halted.

The Government’s failure to seriously get to grips with the issue of drug addiction and the sad outcomes associated with it is shaming us across the world. Yasmin Batliwala, chair of the Westminster Drug Project, was recently reported as saying:

“We once had services that led the way.”

She went on:

“We now need to do a lot to catch up with countries in the developing world that are doing a lot more for their service users. The sign of a civilised society is how it cares for its most vulnerable.”

The Minister needs to acknowledge that his Government are overseeing such a negative and backwards approach to prevention, instead of taking radical steps to address and prevent drug addiction.

It is high time this Government seriously came to terms with the actions they have taken over the last few years on public health and rethink their short-sighted approach. Otherwise, we will see the figures that I quoted at the beginning of my speech become ever worse under their watch. The people who struggle and battle with addiction deserve and need our support, not just for them, to improve their lives, but for the rest of society, so that we can finally ensure that no one’s life is blighted by drug addiction.

Abortion Act 1967: 50th Anniversary

Mary Glindon Excerpts

Monday 6th November 2017 Commons Chamber

[Jackie Doyle-Price]

Central to this is that Parliament needs to be satisfied that the regime is safe for women. The law has been on the statute book for 50 years, and until Parliament decides to change that, that is the law that I will implement as safely as possible. I hear many polls quoted but, frankly, when it comes to this issue, on which people have very strong views, we need to ensure that we maintain the law with integrity.

Thanks to the dedication, hard work and expertise of the doctors and nurses working in abortion clinics, termination of pregnancy is now an extremely safe procedure. In marked contrast to some of the statistics before the Act, which the hon. Member for Kingston upon Hull North outlined, data for 2016 show a complication rate of just one in every 630 abortions, which is substantially lower than just 10 years ago, when the rate was one in 500. The choice of early medical abortion, which is less invasive than a surgical procedure and does not involve use of anaesthetics, has helped to increase the overall percentage of abortions performed at under ten weeks gestation from 68% in 2006 to 81% in 2016. Clearly, the more we can encourage that, the better it will be for the welfare of women undertaking terminations.

[Mary Glindon (North Tyneside) (Lab)]

I congratulate my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) on securing the debate. The Minister is talking about what happens to women during the procedure and about how much care should be taken. However, does she share my concern that, as the report “Abortion and Women’s Health” from the Society for the Protection of Unborn Children highlighted last week, counselling and support for women who suffer mental distress after they have had an abortion is seriously lacking in this country?

[Jackie Doyle-Price]

At the risk of being really controversial, I think there are lots of elements of counselling for women that are seriously lacking. That possibly reflects the fact that decisions about the welfare of women have generally been taken by men. It is great that there are now lots more women in this House able to influence exactly that.

Tobacco Control Plan

Mary Glindon Excerpts

Thursday 19th October 2017 Commons Chamber

[Mary Glindon (North Tyneside) (Lab)]

It is an honour to follow my friend the hon. Member for Colchester (Will Quince). He highlighted, importantly, the dangers of pregnant women smoking, and he was very supportive of women who find themselves smoking during pregnancy. I congratulate my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) on securing this Back-Bench debate. The knowledge he brought to his opening speech set the tone for the debate.

I am pleased to take part in the debate because I am a member of the all-party group on e-cigarettes, and I believe that vaping is a safe and popular alternative to smoking. I have never smoked or vaped. I am the oldest of five siblings, and none of us has ever been a smoker. I put that down to the fact that both my parents smoked all their lives, and smoking never held any charm or attraction for me or my brothers and sisters when we were young people.

Because my parents, other relatives and friends smoked, and I am married to someone who started smoking at the age of nine, I think I understand why people smoke and the impact it can have on their lives. When my parents started to smoke in the 1940s, people were not fully aware of the dangers of smoking. Now, we all know that smoking can kill or cause serious lifelong illness. It makes me so sad to see so many young people starting to smoke.

The hon. Member for Harrow East (Bob Blackman) mentioned mouth cancer. That reminded me that I lost a colleague, who was in her early 60s, to mouth cancer, and only a year before she had seen her son, aged in his 40s, die of the same horrible disease, so I know how awful it can be.

Vaping is important as a safe alternative to smoking for people of all ages. I am pleased that for the first time the tobacco control plan focuses on vaping as a viable alternative to cigarettes. As my right hon. Friend the Member for Rother Valley has said, independent studies by Public Health England and the Royal College of Physicians have recognised that vaping is at least 95% less harmful than smoking, and research by the University of St Andrews has found that the cancer risk from vaping is only 1% of that of smoking. Many other valid statistics from various bodies now support vaping as a safe alternative for smokers, as has been highlighted in the debate.

I am pleased to say that many of my family and friends, including my husband, have all stopped smoking and now use vape products, and although many people so dear to me tried to give up smoking and always returned to tobacco, I am sure many others across the country are as happy as I am that relatives and friends have made this choice on vaping.

The commitment to support stop-smoking services is commendable, but in my experience—I undertook training to run smoking cessation sessions some years ago—it is very difficult for people diagnosed with diseases that might be smoke related to give up smoking. We all know that ill health can increase stress levels, so reliance on the habit at such a time can increase and it can be really tough to give up. Being able to switch to vaping for people in such situations is very welcome. I wish I had been able to recommend people, such as those who had had a heart attack, to switch to vaping when I was trying to help them to stop smoking, because those were difficult times for them.

I believe that the promotion of vaping and e-cigarettes is key to the Government achieving their vision of a smoke-free generation as part of the tobacco control plan. I support the view of the UK Vaping Industry Association that article 20 of the tobacco products directive, which conflates vaping products with tobacco products, should be reviewed, and that restrictions on advertising, packaging and product size should be lifted.

I do, however, have a warning for the Government. Much of the attraction of vaping is that, after the initial outlay for equipment, it proves a much cheaper way to enjoy the habit than smoking. I seek an assurance from the Government that they will ensure vaping always remains affordable, and that they will not be tempted to impose an excise tax that would force up prices and give smokers less reason to switch. Finally, I agree with colleagues that the Government must put their money where their mouth is if the tobacco control plan is to succeed.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 10th October 2017 Commons Chamber

[Steve Brine]

The Government are already investing £16 billion in public health services over the spending review period. We made it a condition of the public health grant that local authorities have regard to the need to improve the take-up and outcomes of their drug and alcohol services. Local authorities are best placed to make those decisions. The investment in effective services means that the average waiting time is just three days and, according to our monitoring systems, treatment outcomes in Greater Manchester are generally better than or in line with the rest of England.

[Mary Glindon (North Tyneside) (Lab)]

10. What discussions he has had with the Secretary of State for Education on promoting improved education in schools and youth settings to tackle the stigma associated with mental health.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Ahead of our autumn Green Paper on children and young people’s mental health, we are having productive discussions with the Department for Education on the vital role that schools can play in tackling both mental health problems and the stigma surrounding them.

[Mary Glindon]

The YMCA and NHS’s #IAMWHOLE campaign, which was launched this morning, shows that young people seeking help are often dismissed by those around them, largely due to a lack of understanding of mental health difficulties. Will the Secretary of State meet the YMCA to discuss what can be done to combat the stigma?

[Mr Hunt]

I am more than happy to meet the YMCA. I also want to point out the amazing work done by the “Time2Change” campaign. I was at an event to mark its 10th anniversary, and I heard from young people who have spoken up about their mental health conditions, which takes a lot of courage. Things are changing, and we can draw a lot of hope from what is happening on the ground.

--- Later in debate ---

[Steve Brine]

I thank my hon. Friend for that. We expect the first launch to be the bilateral UK-China partnership £10 million fund, which we expect to go live early in 2018. Further information on the calls for the remaining £40 million will be announced in due course.

[Mary Glindon (North Tyneside) (Lab)]

T10. In the light of the latest statistics from the Office for National Statistics showing a record number of drug-related deaths registered in England and Wales, will the Minister meet members of the drugs, alcohol and justice parliamentary group to discuss this issue and see how it can be addressed?

[Steve Brine]

I am very happy to meet the group, and the hon. Lady should contact my office. The Home Office is the lead Department for cross-governmental drugs policy, and we obviously released the new cross-Government drugs strategy earlier this year. However, this cannot all be about drugs services and picking up the pieces after things have gone wrong; it can also be about prevention. We should, as somebody once said at this Dispatch Box, understand a little more and condemn a little less.

Agenda for Change: NHS Pay Restraint

Mary Glindon Excerpts

Monday 30th January 2017 Westminster Hall

[Andy Burnham]

My hon. Friend the Member for Foyle (Mark Durkan) said that this is a pay cut. We should not call it a pay freeze because it is, in fact, a pay cut. The Government have manipulated the figures in this area. Let us call it what it is: a pay cut that has now been sustained over a number of years.

People are at their limits. They cannot carry on having their pay cut every single year while they face other pressures and rising costs, such as accommodation costs, without there being a consequence. The consequences will be for their own sense of wellbeing, their own mental health or, indeed, their children’s quality of life. Nurses are now saying, in large numbers, that enough is enough.

[Mary Glindon (North Tyneside) (Lab)]

Further to what my right hon. Friend just said, does he agree that there is a culture under this Government and the previous coalition Government of devaluing the whole of the public sector? This is one stark example of what is happening across the public sector.

[Andy Burnham]

That is how it begins to appear. The Government are pushing people beyond their limits. There was the attempt to introduce regional pay, and there was the attempt to cut what is called the unsocial hours payment—there has been a whole series of initiatives that try to strip away support for the profession. It begins to feel like an attack on the profession. That is certainly how junior doctors felt, and I think GPs feel the same. The nursing profession is making clear today that it feels the same too.

As I said, this is a false economy. As well as damaging the good will and the extra hours that people were willing to offer before, it has also, as my hon. Friend the Member for Foyle indicated, pushed people into the arms of private staffing agencies. That, in the end, is another false economy for the national health service. Over recent years, we have seen the bill for private staffing agencies in the NHS increase year on year, to the point where it is now in the region of several billion pounds every year. Many trusts are in the grip of the private staffing agencies. That, of course, is also a factor in the cuts to nurse training that we have seen in recent years.