Oral Answers to Questions

Mary Macleod Excerpts

Tuesday 24th February 2015 Commons Chamber

[Norman Lamb]

I pay tribute to the professionals in my hon. Friend’s area, which is one of the leading areas for providing strong support in the community, which prevents unnecessary hospital admissions. I am very happy to work with Sue Ryder and others to try to get the message across that if this can be provided throughout the country we will improve the experience of people at the end of life, but critically also save costs further down the line by stopping inappropriate hospital admissions.

[Mary Macleod (Brentford and Isleworth) (Con)]

16. What his priorities are for improving mental health care.

[Mr Speaker]

Minister Lamb.

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[Norman Lamb]

I am so grateful to be reassured, Mr Speaker.

Mental health is a priority for this Government. We have legislated for parity of esteem between mental and physical health, invested £400 million in talking therapies, significantly reduced the numbers of people who are placed in police cells during mental health crises and are introducing the first waiting times standards for mental health services from April this year.

[Mary Macleod]

I recently met a constituent at one of my advice surgeries who had been refused NHS mental health care because she was told that she was entitled to only one batch of free support. Considering how complicated and varied mental health issues can be, is there anything we can do for people who need more support after a relapse of mental ill health?

[Norman Lamb]

If that was the advice the hon. Lady’s constituent received, it is complete and utter nonsense. The idea that someone can have only one episode of care under the NHS is so ridiculous that it hardly merits a proper response. I urge her to encourage her constituent, with her support, to go back to those local services and ensure that she gets further support if she needs it, as she is entitled to it.

Oral Answers to Questions

Mary Macleod Excerpts

Tuesday 1st April 2014 Commons Chamber

[Norman Lamb]

I very much share my right hon. Friend’s frustration that when a medicine is determined by the National Institute for Care Excellence as an evidence-based intervention, the system has to allow it, but when NICE determines that a procedure should be followed, it is discretionary. We must address that to ensure that we use the money in the most effective, evidence-based way.

[Mary Macleod (Brentford and Isleworth) (Con)]

Will the Minister have a discussion with his colleagues in the Department for Work and Pensions and the Department for Business, Innovation and Skills to see what more can be done to help patients with mental health issues to get into the workplace and find employment?

[Norman Lamb]

My hon. Friend raises an incredibly important point. One thing that I am very proud of is that under this Government 80,000 more people a year are getting access to psychological therapies through the improving access to psychological therapies programme—something we that should be very proud of. We have also done some joint work with the Department for Work and Pensions on how we can link up IAPT much more effectively with Jobcentre Plus to get people back to work, rather than paying them benefits.

Health Care (London)

Mary Macleod Excerpts

Wednesday 8th January 2014 Westminster Hall

[Mary Macleod (Brentford and Isleworth) (Con)]

I congratulate the hon. Member for Westminster North (Ms Buck) on securing this important debate. I will keep my comments brief because I want to be fair to other Members who want to speak, not because I do not care deeply about this subject. Previous speakers have talked ably about a lot of the statistics, so I do not need to go over them.

I was actually born in a London hospital, across the river in St Thomas’. I was pleased to go there again recently to visit my hon. Friend the Member for Bournemouth East (Mr Ellwood)—I hasten to add that I was visiting the maternity ward because his wife had given birth to their new son, Oscar. It was lovely to be back at St Thomas’, albeit after so many decades.

Some important issues have been raised in the debate. Health care is critical to all of us—it touches each and every one of us, our loved ones and our constituents. It is crucially important and we must get it right. In London, there are specific problems, as has been said.

I was pleased that in 2010 the Government made £2.7 billion extra available in real terms in the NHS budget across the UK. That has allowed us to have 440,000 more clinical staff, and we also have 23,000 fewer administrative staff, including 7,700 fewer managers. That was absolutely the right approach and what the NHS needed.

The average stay in hospital is shorter than in 2010, although that puts pressure on community care, so we must make sure that that is dealt with. The cancer drugs fund is also critical to the debate, and we have helped more than 38,000 patients through it.

The debate is about London and the issues specific to this great city. In my constituency, in west London, the key health care issues tend to be focused on tuberculosis, obesity—including in children—diabetes and alcohol-related harm. As Members might expect, we have above average problems with healthy eating, given the issues with obesity. Other issues include smoking during pregnancy, smoking deaths and skin cancer. There are therefore specific issues in west London, and I will focus on them.

In my constituency, we have one main hospital—the West Middlesex university hospital, where two thirds of my constituents go when they need to. My Chiswick residents—about a third of my constituents—tend to go to Charing Cross hospital. I want to reiterate what previous speakers have said: we have some excellent patient care and services across our London hospitals, but there are, absolutely, also areas we should focus on.

The West Middlesex has outstanding maternity and midwifery services. One of the best parts of our job as Members of Parliament is rewarding people who have done incredible work in the health service, whether they are clinicians or support staff, and I recently handed out awards at the West Middlesex, which is ably led by Dame Jacqueline Docherty.

I also want to pay tribute to London’s air ambulance service. During the Christmas period, there was a fire and a massive explosion in Chiswick, and the air ambulance was called. The service deserves as much support as possible, because it serves 10 million residents in London, and it has only one helicopter. It is world class, providing high-trauma, acute care. Everywhere else around the country has one helicopter for 1.5 million people, but the figure in London is 10 million, so there is an absolute need for another helicopter. I would push everyone to support the London air ambulance service, which has its 25th anniversary tomorrow.

[Stephen Pound]

I entirely agree, and I think most of us would associate ourselves with the hon. Lady’s comments on the London air ambulance, but does she not agree that it might be better if it were run by the state, instead of relying so much on charity?

[Mary Macleod]

The London air ambulance service is an amazing organisation, so I would not change its structure. It rightly gets some funding from the NHS, but it also derives funding from many other sources, and it is important that we support that. The service does an incredible job, so if the hon. Gentleman knows anyone who can give it a spare helicopter, it would really appreciate that.

My local CCG is chaired by Dr Nicola Burbidge. It started early, it has been absolutely focused on patients and it has been very responsive to any issues I have raised with it.

On reconfiguration, I was recently thankful when, after a lot of campaigning by my hon. Friend the Member for Chelsea and Fulham (Greg Hands) and others, the Secretary of State announced that the A and E at Charing Cross hospital would not be closed, thus helping residents in my part of London. Saving lives and improving patient care is paramount.

[Bob Blackman (Harrow East) (Con)]

I apologise for not being here for the opening speech. Does my hon. Friend agree that one challenge now facing London is the increasing complexity of diseases and the treatments that are required, which means that additional money and expertise are needed? Such diseases often cannot be dealt with at a local level; they must be dealt with nationally. Although we have supported those suffering from cancer and other diseases, much more complex diseases remain to be resolved.

[Mary Macleod]

My hon. Friend makes a good point. I hope the Minister will respond to the issue of how we take up such challenges in London and get the necessary funding.

I shall list some issues on which I would like more improvement. We heard how difficult it is to get appointments at general practices—we call up and know that the answer is going to be no before we say anything. There are also issues with getting to see a specialist as quickly as possible. We want an effective complaints process in hospitals, changing the culture to allow people, whether staff or patients, to complain. There is an issue with how patients are moved around London, and the hon. Member for Westminster North made an important point about having to use public transport to get home. Mental health and community public health are other important issues.

My final comment is about dementia, which is a growing concern in London, as it is across the country. About 30% of patients who go into the West Middlesex hospital have dementia. They do not go there because of dementia, but they have it. There is a lot to be done, and the West Middlesex hospital has just opened a new dementia ward. There needs to be a greater focus on dementia, given our ageing population nationally, and the size of the population in London. We must ensure that we work together to support those who really need and deserve care and support in London. That will improve the NHS for us all.

[Several hon. Members]

rose—

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[Mr Andy Slaughter (Hammersmith) (Lab)]

Given the time constraints, I shall limit myself to one issue, which is the current threat to the emergency hospitals in my constituency, but I begin by congratulating my hon. Friend the Member for Westminster North (Ms Buck) on securing this timely debate. She made her arguments very well.

This morning, I received an e-mail from the Secretary of State that is pertinent to the debate. There was an agreement for him to meet the three Ealing MPs, two of whom—my hon. Friends the Members for Ealing, Southall (Mr Sharma) and for Ealing North (Stephen Pound)—are here, and me next Monday evening. The Secretary of State has withdrawn from that meeting, pleading other engagements, and asked us to meet officials instead. I hope that he will reconsider. The meeting is specifically about the threat to two of London’s major hospitals, Charing Cross and Ealing, and I hope that the comments I am about to make will lead the Minister to intervene and ask that the meeting go ahead. We understand that the Secretary of State has pressures on his time, but it is entirely unacceptable for him not to meet Members on an issue of such crucial and central importance.

It is sad news, but we know—

[Mary Macleod]

Will the hon. Gentleman give way?

[Mr Slaughter]

I would rather not because of the time. I am sorry.

We know what is happening with Hammersmith hospital because it has been announced that the A and E department there is going to close after the winter crisis—as if the crisis is not a continuing one. I have been told informally that it will close two weeks after the local elections to avoid any embarrassment to the Government. We were also told that there might not even be an urgent care centre there; it may be moving. That would mean no emergency access to Hammersmith hospital, unless it is still to receive emergency blue-light coronary cases. At least Hammersmith hospital will continue as a major specialist hospital, and a very fine hospital it is indeed.

The situation regarding Charing Cross hospital is far less clear. I will précis where we are and explain the matters that we wish the Secretary of State to deal with. In February last year, the decision, which is still extant, was made to close completely and sell off the Charing Cross hospital site, leaving an urgent care centre on 3% of the site. At the same time, there was to be an outline business case, to report in October last year, that might preserve 13% of the facilities and 40% of the site. That business case is now due in March, but we understand—through the Imperial College Healthcare foundation trust process, not any other process—that there will also be elective surgery on the site. That might mean there will be elective surgery as well as primary care and treatment facilities, and some form of emergency centre on the site, with perhaps 50% of the land preserved. That gain, in so far as it is a gain, is St Mary’s loss, because we understand that 50% of its site will be sold in any event. Of course, any amelioration in the position is to be welcomed.

I praise the cross-party Save Our Hospitals group for campaigning tirelessly in both my borough and Ealing on the issues I have mentioned. However, the point it would want me to make very clearly is that what I have described is not what we want. Of course we want good elective care, primary care and treatment services, but the issue of capacity must be addressed.

It is not feasible to close two of the largest emergency hospitals. I use the word “close” advisedly. As emergency hospitals, they are closing: there will be no emergency surgery, no blue-light A and E, no stroke unit and no intensive treatment on those sites. I am afraid that the Secretary of State’s intervention so far has been genuinely unhelpful and done for political reasons. We have invented a second-tier A and E, as it is called. A second-tier A and E is an urgent care centre. The only differences that clinicians could identify for me were that at a second-tier A and E there would be GP cover and X-ray services, and for elderly and vulnerable people there might be some beds for recuperation after minor treatment. Otherwise, it is an urgent care centre or a minor injuries unit.

Let us not play political games. I am not saying that we can keep politics out of the NHS—of course we cannot—but this is dangerous because it will mislead people. If people think that there is an A and E at Charing Cross or at Ealing when there is not, they will go there when they should have gone elsewhere. We will continue to campaign to save emergency services. It is not feasible for the Imperial family to go from three major emergency departments to one. All three are currently under pressure and overcrowded. The decision has to be taken by Ministers, so I implore the Minister to go back to the Secretary of State and ask that he meet us.

The level of politics is not acceptable. Politics comes into these matters all the time. Before the last election, when there was no threat to the hospitals, the Conservatives kept saying that there was—I have their election literature here. We now have taxpayers’ money being spent on campaigns saying that hospitals are staying open when, in fact, departments in them are not. Let us at least tell our constituents the truth. There may be unpalatable decisions to be taken, but as far as Charing Cross is concerned, the health service is clear that it will be a local hospital. It will not be an emergency hospital. That is not acceptable in any way to my constituents. It is not feasible to run a health service in west London on that basis.

I have made my points to the Minister clearly, and I look forward to her response. I also look forward to the meeting with the Secretary of State where I can put my points in more detail and more forcefully.

Changes to Health Services in London

Mary Macleod Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

I hope that I have provided clarity by saying that there will remain an A and E at Ealing and Charing Cross, and that I support what the report says, which is that there should be five major A and E centres, of which St Mary’s Paddington will probably become the most pre-eminent trauma centre in the country. This is a big step for the hon. Lady’s constituents who use St Mary’s, and I think that they will be pleased with what I have said today.

[Mary Macleod (Brentford and Isleworth) (Con)]

I congratulate the Health Secretary on his important announcement regarding the A and Es at Charing Cross and Ealing. My constituents in Chiswick will feel reassured about the ongoing service at Charing Cross, and I thank him for that. Does he agree it is important that at the centre of any decision he makes about health care are improved patient care and saving lives across London?

[Mr Hunt]

My hon. Friend is absolutely right. When the dust settles on these decisions—there is rightly so much local passion, concern and uncertainty relating to hospitals, such as Charing Cross, which has a great tradition—what people will notice is whether their local NHS services are getting better. I am afraid that one of the legacies from the previous Government was the abolition of named GPs in 2004 and a sense that it has become more difficult to access one’s local GP. The proposals mean that her constituents will be some of the first in the country to have seven-day GP services, a big step forward that her constituents will welcome.

Brain Tumours in Children

Mary Macleod Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Mr Raab]

I thank my hon. Friend for his intervention. That sounds to me like a perfectly sensible suggestion. Again, it is a practical recommendation about how to deal with the fast-tracking from diagnosis to treatment, and again I am sure that the Minister has taken it on board.

The key thing that I have realised from being informed by HeadSmart and others about this issue is that the warning signs of a brain tumour—particularly in children, who are the focus of this debate—are not especially technical or terribly difficult to detect. We are talking about regular headaches or vomiting; difficulty in co-ordinating, balancing, or walking; blurred vision; and fits or seizures. Those are the most common symptoms, and they are signs that parents, doctors, teachers and children should be able to pick up on.

[Mary Macleod (Brentford and Isleworth) (Con)]

Will my hon. Friend give way?

[Mr Raab]

Again, I will make a small amount of progress and then I will give way to my hon. Friend. As I was saying, those signs are symptoms that we should be able to pick up on, even if it is just to get them checked out properly so as to allay fears.

The scale of these tragedies led the Brain Tumour Charity to launch the HeadSmart campaign in 2011, to try to raise greater awareness and in particular to cut this life-threatening delay in diagnosis; there is also the issue of the delay between diagnosis and treatment. The thing that occurs to me is that we have seen truly amazing public awareness campaigns in this country. Think of the drink driving adverts; think of the campaigns in the 1990s to “Just Say No” to drugs; and more recently there have been the Vinnie Jones CPR adverts and the campaign to identify the early signs of a stroke, which is particularly germane to this debate. We are quite good at this work in this country, if we get hold of an issue and grasp it. HeadSmart wants to do something similar about brain tumours in children, but in a different way.

[Mary Macleod]

I am delighted that my hon. Friend has taken up this issue. I have already been to see the Minister about it, and generally she has been very helpful on brain tumours. Does he not find the statistics that he mentioned about the delay of 12 to 13 weeks unacceptable? If there was some sort of public awareness campaign on those symptoms, more people might be helped to go to their GP earlier and then we might also need extra sharing of best practice among the primary health sector.

[Mr Raab]

My hon. Friend is right. It is particularly regrettable that we have such a delay in comparison with other countries if we could take simple steps, which would not even cost the taxpayer money, to reduce the delay through political will and co-ordination.

--- Later in debate ---

[Mary Macleod]

I have a quick suggestion based on my hon. Friend’s last two points. Might MPs perhaps help in the co-ordination effort? HeadSmart could send their leaflets to MPs to distribute to schools in their own areas. I, for one, would be perfectly happy to do so.

[Mr Raab]

I thank my hon. Friend for her intervention. I am open to that idea, but the point is that councils have an internal mail system for delivering items to schools and nurseries. They are used to distributing in bulk, which is what we are talking about, to all schools. If we distributed the cards via MPs, I am not sure that it would happen in every case, although it certainly would for many. We need a comprehensive, co-ordinated approach, and, of course, our local councils have responsibility in this area.

Backbench business

Mary Macleod Excerpts

Thursday 14th February 2013 Westminster Hall

[Mr David Burrowes (Enfield, Southgate) (Con)]

I congratulate my hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) on securing this debate. I was privileged to support her application to the Backbench Business Committee and, with others from across the House, to commit firmly to this debate. I hope that, at the very least, one thing that comes out of it will be a greater number of Members of Parliament pressing for improvement.

I, too, am straddling debates and trying to be in two places at once. I apologise, Mrs Osborne, for the fact that I must leave to go to the Marriage (Same Sex Couples) Public Bill Committee, which is continuing its deliberations.

All of us must declare an interest when it comes to eating disorders. All of us have to accept that we know a friend, family member or constituent who is dealing with the issue, and if we do not know one, we are out of touch with what, sadly, is the reality. All too often, that is a hidden reality, which is why I so welcome our shining a light on this important concern.

I do not come to the subject as a great expert, but I have been involved over the years—I share this with the Minister—in the issue of addiction, which is similar. I increasingly see great similarities between the issues. There is the profound loss of freedom; the diminished and, sadly, lost lives; the effect not only on patients, but on family members and all those around them; the health concerns, and the wider social concerns for society; and the whole process of treatment and recovery, with individuals, their family and society at large having to make a long-term, continual commitment. That matters, in terms of the quality of treatment and the support from family members and peers. All those issues should be promoted.

Although there are, sadly, the negatives—I will predominantly talk about the problems—I have been particularly impressed by the power of recovery. The positive stories of those in recovery are immensely powerful, and we must given them a much louder voice.

I have said that I am no great expert, but from those close to me and from constituents, I have learned that we cannot find one magic solution, or seek a simplistic or generalised one. Eating disorders are complex and contradictory, and in many ways there is ambiguity as regards recovery. That makes them particularly problematic, in terms of illness, mental illness and recovery. They are highly resistant to change; unlike with a physical illness, the patient wants to hold on to these disorders as a method of coping, so they are inherently hard to treat.

I want to concentrate on treatment and recovery. We must accept that we have a problem, and I would be interested to hear the Minister’s response to that. We have a problem in terms of the prevalence of eating disorders. They are on the rise in the UK, which has one of the highest rates of hospital admissions in Europe. The most vulnerable may well be teenagers, but eating disorders cover all genders and ages. Indeed, it is right to mention boys: 25% of those affected at school age are boys, whereas I understand that 10 years ago that figure was 10%. We also have an NHS problem—I have to say that—and a family problem in relation to how families are involved.

[Mary Macleod (Brentford and Isleworth) (Con)]

Does my hon. Friend agree that there might also be a problem in schools? We need to talk more about the issues with children at a very young age. Teachers can be part of that process by aiming to explain some of the issues and making young people feel more comfortable about body image.

[Mr Burrowes]

Very much so. The guidance is all on the side of early intervention. Indeed, the Government are very much on that side, and I am sure that there is a cross-party call for early intervention. That is a key area, and we must tackle the issue through not only better treatment, but profoundly better education and prevention, as well as culturally, through the media. That is an area on which we can give our views, which we are airing here, and where we can be part of a changed culture, but it really happens at an early age.

I particularly point to the pressure on services and waiting lists—an issue that has already been mentioned. The pressures on GPs and others for referrals to out-patient and in-patient services are growing. Anorexia and Bulimia Care—I pay great tribute to that leading national charity, among other good ones, on eating disorders—has told me that adult sufferers can wait up to nine months or even a year to receive treatment. That is profoundly damaging for adults, but think of young children who are susceptible to rapid weight loss waiting, at a time when they are growing. That wait for treatment while the right service is found could quickly put their life in danger.

Training in the complexities of eating disorders has been mentioned, but the general training that should be mainstreamed for GPs does not exist. Health professionals wrongly diagnose patients, mishandle their cases and lack sensitivity and proper judgment. Short time allocations for appointments mean that GPs cannot get to the heart of the physical and emotional needs of patients, who require time and cannot simply be moved on quickly. They need a proper rapport with GPs and investigations that involve the wider health community. With the pressures on GPs, are patients properly followed up, rather than allowed to slide into both physical and mental danger?

Sadly, among the most common causes of death are heart failure and, indeed, suicide, and the issue therefore needs to be grappled with properly and carefully. We must ensure sensitivity in the handling of that long-term involvement—because shortages in treatment services mean that patients end up falling back on pressurised GPs for the monitoring of their health and safety—but, sadly, that does not happen.

We have too few specialist in-patient units for eating disorders. The NHS has St George’s hospital, Tooting, a mental health unit largely for adolescents, which offers general mental health provision. Children who are already traumatised are going there; they are even more traumatised after going to units that do not have the specialists that we want them to see. We want more eating-disorder-only establishments. I will return to that in due course.

As has been mentioned, there is a profound issue about parents and carers. Parents raise the issue of their needs, and the important role that they play in recovery; those things are sometimes ignored or excluded, particularly if the child lives at home, as 16-year-olds often do. I understand that carer support services can be hard to find in several counties, and parents complain that they are simply shut out from the practical care of their children. That is totally contrary to the way that child and adolescent mental health services were set up to deal with such cases, but sadly, it happens all too often.

We have already taken up the issue of the statute with the Under-Secretary of State for Education, my hon. Friend the Member for Crewe and Nantwich (Mr Timpson), who has responsibility for children, and I look forward to meetings with the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb) in relation to mental health. The Children Act 1989 seems to lead to a statutory anomaly, in that those aged 16 and over are given the right to refuse treatment for an eating disorder; there is therefore the prospect that they will be sectioned, and that that will be on their health record for life.

In effect, the Children Act enables GPs to tell children aged 16 and above that they can refuse treatment, which might sometimes undermine the work and values of parents. The number of complaints that I have received on that issue reflects the fact that it is a systemic concern. One set of parents told me about their 16-year-old child who was living at home—I know that this illness covers all ages and not just 16-year-olds. They were responsible for feeding and looking after her, but were excluded from her care. Such treatment might well have perpetuated the illness, and the dire straits that she was in; she may have been at the stage of trying to manipulate the system. These 16-year-olds, who are often intelligent and able young people, know the system as well as anyone else, and their manipulation of it can hinder the practical medical process of recovery.

Mental health legislation, including the Mental Capacity Act 2005, and the inherent jurisdiction of the High Court are interwoven in the treatment of this complex condition. We must also consider how we link in the organisations on the ground, such as CAMHS, to ensure that we involve all the relevant bodies in the health and care of our loved ones. Stigma and public misconception are also important issues, as the attitudes of the public and of health service professionals can hinder treatment.

I want to leave the final word to the experts—the families, who, sadly, have never wanted to be experts in this area. These are the sorts of stories that I hear all too often. One constituent became concerned about their daughter’s sudden loss of weight. They went to their GP, who made a referral to the local CAMHS team, which passed the matter on to the specialist eating disorder unit at the Royal Free hospital. The first appointment came up a couple of months later. The girl saw a consultant and dietician weekly or fortnightly. She attended various groups and family therapy sessions, but at no time did she receive any individual therapy.

Four months later, the child became abusive and violent towards her family. Despite attending regular hospital appointments, her intake of food was becoming more and more restricted. Her weight loss continued until she became skeletal. At times, the parents were in desperation. They phoned the hospital, pleading with it to admit their child, because they were reaching a point where they just could not cope. The response from the hospital was that in its opinion hospitalisation was not deemed necessary.

The parents felt completely helpless and as if they were battling the illness on their own. That went on until they found a helpline number for Anorexia and Bulimia Care, which proved to be a lifeline. A doctor eventually saw their daughter, who was so poorly that they were unable to get a blood pressure reading. There was no hospital involvement or admission at that stage, but the parents realised how important it was, and that their daughter needed to be admitted. Indeed she was admitted, not to an NHS clinic, but to Rhodes Farm clinic, which provides exceptional care. ABC underwrote the cost of treatment. We have been battling ever since to try to get the health service to take some responsibility for that cost of treatment.

Since then, there has been progress. No one would say that the girl is out of the woods, because it is a continuing process, but for her to be able to take food, gain weight steadily, feed the mind and the brain, and engage with processes has helped. The parents have said that without the support of ABC, they dread to think where they would be today; it saved their lives.

I have another example, which involves not lay people but a local doctor, who says:

“doctors know all about Anorexia and the best way to treat it, and the latest development in treatment—WRONG!”

She goes on to say:

“The help was not there. The doctors at best were sympathetic, at worst were downright dangerous.”

This is the mother of an intelligent and gifted daughter. She said that she could have been anyone’s 15-year-old, and yes, it could have happened to a boy as well as a girl. She was a normal loving child. The mother told me what happened:

“We went to doctors, paediatricians, bowel specialists. They found nothing wrong with her stomach. I told them of my worries. ‘Oh no. She is not thin enough to be anorexic!’”

The daughter was asked whether she was eating. “Yes”, she said. “Well, you need to eat more, sweetie”, her mother said. The daughter promised that she would try,

“But she didn’t. Always there was an excuse.”

The problem got worse. It is a familiar story:

“Every time we mentioned food or insisted on eating, she threw plates, broke things, kicked, screamed, destroyed her room. Her brain was now completely malnourished, starved of even basic nutrients. She had the look of a wild, caged animal. She told us…she was a bad person and wanted to die. ‘Please let me die mummy’ she would scream.”

Eventually, the parents got her to casualty and were told that she most likely had anorexia. The doctors said that a referral would be made to the CAMHS team. The parents were desperate. Their child had become psychotic and was in danger of starvation. The mother said,

“Even though I knew, hearing the doctor actually say ‘Anorexia’ made it real. ‘Anorexic? No way! She’s normal. She’s clever. She wouldn’t do this. She is not one of those silly girls!’ The guilt. The feelings of desperation, the sheer magnitude of what was happening was overwhelming. What a terrible parent I was! How could I have let this happen? How could I have not realised?”

There were no terrible parents involved in that story. This is an issue that must be tackled at an earlier stage, so parents do not go through that desperate nightmare. In conclusion, there is a good end to that story—well, not so much an end as a positive outcome.

Another parent who had the help of ABC and who used Rhodes Farm clinic said that they considered their daughter to be one of the lucky ones who has, through that excellent treatment facility, been given the chance of having a full life again one day. They said, “For every such one, there are 100 others who are not receiving the care they need or deserve for this dreadful illness, but hopefully they will.” As hon. Members on both sides of the House have said today, we can, hopefully, help to change that.

Oral Answers to Questions

Mary Macleod Excerpts

Tuesday 27th November 2012 Commons Chamber

[Mr Hunt]

The reason why the CQC undertook its shocking investigation into the state of care in our country was that this Government introduced dignity and nutrition inspections, which never happened when the right hon. Gentleman was Secretary of State. He talked about numbers employed in the NHS, so let us look at them. Yes, there has been a 2% decline in the number of nurses, but there has been an increase in the nurse-to-bed ratio. There has been a 4% increase in the number of midwives, a 5% increase in the number of doctors and an increase of more than 50% in the number of health visitors—their number went down when he was in office. How much worse would those numbers have been if we had had the cut in NHS funding that he wanted?

[Mary Macleod (Brentford and Isleworth) (Con)]

2. What steps the Government are taking to raise awareness of and help those who have brain tumours.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Forgive me, Mr Speaker, but as you can hear—you may indeed be pleased to hear this—I am losing my voice. This is a serious matter, as you know, and I pay tribute to all the work you did on behalf of people suffering from brain cancer. The Government are proud to have been behind some important initiatives, such as promoting among general practitioners direct access to MRI scans. From January next year we are introducing a pilot scheme to alert people to the particular symptoms of common cancers, and we are confident that that will improve awareness about brain tumours.

[Mary Macleod]

I thank the Minister for her answer, but in the UK about 4,800 adults and 100 children lose their lives to brain tumours each year. Brain tumours kill more children than any other cancer, kill 65% more women than cervical cancer and kill more males under 40 than any other cancer, yet only 0.7% of Government funding goes to brain tumour cancer research. Will the Minister meet my constituent, Romi Patel, and others who have had brain tumours to discuss with them what more the Government can do to save lives?

[Anna Soubry]

The short answer is yes, I am more than happy to meet my hon. Friend’s constituent to discuss this matter. The figures she relies on for the amount of money going into brain tumour research are based on 2006 data, but the simple answer is that of course we can do far more. I pay tribute to the great advances made by a number of charities, including Headcase Cancer Trust, in my constituency, and others such as the Joseph Foote Trust. They are all raising considerable amounts of money specifically for research projects such as the one at Portsmouth university. I am more than happy to meet my hon. Friend’s constituent. This is an important topic on which we can do more.

Oral Answers to Questions

Mary Macleod Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Anna Soubry]

That was not my understanding of the former Secretary of State’s comments, but I can say that we are absolutely determined to ensure that fairness is achieved, and all the factors she mentions are important in ensuring that fairness.

[Mary Macleod (Brentford and Isleworth) (Con)]

9. What steps the Government are taking to improve care for people with dementia.

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

Tackling dementia—particularly the shockingly low diagnosis rates—is a key priority for me and the Prime Minister.

[Mary Macleod]

I welcome the Government’s steps to support carers and the work they have done, especially on the £400 million to give carers’ breaks from their important responsibilities. Will my right hon. Friend explain what is being done to increase awareness and understanding of carers’ health care needs?

[Mr Hunt]

My hon. Friend is right to highlight this point. In the draft Care and Support Bill, local authorities will be required to meet the eligible needs of carers. That is a particular concern with dementia, because, all too often, someone looking after a partner with dementia gets to a tipping point where there is no alternative to residential care, but, if we can give them better support, they will have a better chance of remaining at home, which, in the vast majority of cases, is where they want to be.

Oral Answers to Questions

Mary Macleod Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Burns]

I give the hon. Lady that assurance. Specialised commissioning will be carried out through the NHS Commissioning Board.

[Mary Macleod (Brentford and Isleworth) (Con)]

T10. I commend the Government for their plans to improve the care and support system, especially for an ageing population. How will the changes make a real difference to carers, particularly those supporting people with Alzheimer’s and dementia? Is there more we can do to support them?

[Paul Burstow]

I am grateful to the hon. Lady for her question. She is right: we have to do as much as we possibly can to recognise and support family carers. In the White Paper, we have set out a number of steps, not least investment of £400 million to fund more breaks for carers. We are working with the Royal College of General Practitioners to make sure that they are more aware of carers and can identify more carers. We are doing work to make sure we have earlier, quicker diagnosis in more areas of dementia so that people get the support they need. Most important of all, we are making sure that hospitals, as part of the services they provide for people with dementia, actually deliver on NICE guidance on supporting family members. Finally, the Government are legislating, for the first time ever, on support for the needs of carers.

Hospital Services (West London)

Mary Macleod Excerpts

Wednesday 11th July 2012 Westminster Hall

[Mr Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to be here under your chairmanship, Mr Gray, and a pleasure to see so many colleagues from west London, of various parties, here for an important debate that concerns us all. It is a particular pleasure to see the hon. Member for Ealing Central and Acton (Angie Bray), relieved of the cares and constraints of office and therefore able to speak. I am slightly surprised that she chose to be pushed over House of Lords reform rather than this issue, the third and fourth runways at Heathrow airport or the cuts to Sure Start, pensions and other things that are going into the next manifesto, but we all find our path to salvation. I also welcome the hon. Member for Cities of London and Westminster (Mark Field), who already adorns the Back Benches. I hope that we can see others, including the hon. Member for Chelsea and Fulham (Greg Hands), joining the hon. Member for Ealing Central and Acton soon in order to fight the appalling changes to our health service.

Members of Parliament for the north-west London NHS area represent 2 million Londoners, and I know that all of them, whether they can be here or not, are very concerned by the proposals in the consultation document, “Shaping a healthier future”, published on 2 July. I will primarily deal with that document today. I intend to confine my comments, as the debate’s title suggests, to the effect on the major hospitals in north-west London of the proposed changes. Given the time constraints and the fact that hon. Members with more knowledge of hospitals in their own constituencies are here to speak, I will deal principally with the risks to Charing Cross and Hammersmith hospitals, but I will try to put those in the wider context of what can only be called a crisis in the NHS in north-west London. That is in the light of the further decision last week to put the future of Royal Brompton hospital at risk by the closure of children’s cardiac services there and the failure by Imperial College Healthcare NHS Trust to manage waiting lists and GP referrals.

The Minister will have seen the letter that I sent last week to the Secretary of State, asking for independent intervention to rescue the health service in west London before matters get more out of hand. I will expand on that and hope that the Minister can respond positively.

The other point that I will make in opening the debate is that the consultation should not be a Dutch auction. I do not think that any hon. Member will have come here to say, “Don’t close my hospital; close his or hers.” Every hon. Member and, indeed, every member of the public I have spoken to in the past few weeks wants to challenge not the detail or options that we are offered, such as they are, but the premise that such a major downgrading of the health service is sustainable, safe or sensible. If any hon. Member here felt a moment’s relief when they saw the schedule of closures—in particular, of accident and emergency departments—and realised that their local hospital was not on it, that relief was short-lived. The question immediately arose: how will the five remaining A and Es cope with the consequence of closing four busy departments and the consequent downgrading of other hospital services?

I am pleased to see here hon. Members representing, I think, all the north-west London hospitals, not only those under threat. Neither I nor my constituents are resistant to change in the NHS or unaware of the cost pressures that it faces. Indeed, it is the Government, not us, who need to be candid about both their failure to fund the NHS and the underlying financial motivation for these proposals.

The medical director for north-west London has been admirably frank. In approving the consultation two weeks ago, he stated that the local NHS would

“literally run out of money”

if the closures did not go ahead.

[Mary Macleod (Brentford and Isleworth) (Con)]

I congratulate the hon. Gentleman on securing the debate. Does he agree that whatever the shortfall in funding in London that he talks about, more funding has gone into the NHS from the current Government than ever before?

[Mr Slaughter]

Apart from the bit of fun that I had at the beginning of the debate, I am going to stay off party politics. I think the hon. Lady knows that the NHS was rescued under a Labour Government, and knows about the increase in funding then. She will also know from articles in the press this week and last that in fact, the promise made by the Prime Minister before the election to increase funding for the health service is not being kept. [Interruption.] I therefore think that that was a bad point to make. [Interruption.]

--- Later in debate ---

[Angie Bray (Ealing Central and Acton) (Con)]

I congratulate the hon. Member for Hammersmith (Mr Slaughter) on securing this important debate. He is right to extend its scope to hospital services across west London because the proposed imminent reorganisation of services—the “Shaping a healthier future” programme, led by NHS North West London—will affect all hospital users in the area. It is a hugely ambitious and, I am sure, well-intentioned programme, but none the less it presents perhaps more questions than it answers. It raises serious concerns, especially for my constituents in Ealing and Acton.

[Mary Macleod]

I thank my hon. Friend and neighbour for giving way. My constituents use the West Middlesex university hospital and Charing Cross hospital, and I was glad to see that the aim is to retain the West Middlesex as a major acute hospital with A and E and its award-winning maternity provision. Does my hon. Friend agree that the ultimate aim of what is happening, whatever decision is made—any constituent would find the closure of any part of a hospital a difficult thing—is better clinical outcomes, and the key issue is whether they are achieved?

[Angie Bray]

Of course, we all want better clinical outcomes for all our constituents. The question is how to get to that result, and how to provide services for residents. An unfortunate aspect of the way things have been done is the pitching of one hospital against another, with everyone being asked to decide on one or another. That has been a divisive process.

My constituents face the real possibility of Ealing, Central Middlesex, Hammersmith and Charing Cross hospitals all having their A and E departments downgraded —a result that would surely be disproportionately negative for them and that threatens to destabilise health care provision across my constituency. In making its three key recommendations for the current consultation, NHS North West London seems to have completely overlooked their needs. While the consultation document does at least mention the full list of eight possible options, the pressure on people to support one of its three main recommendations leaves the impression that minds have already been made up. Minds should not be made up when my constituents in Acton—a place with a rapidly expanding population—look set to be left without any local emergency cover.

The consultation and pre-consultation business case documents make bold predictions when calculating travel times to justify recommendations. One document even states that the

“geographic distribution is proposed to apply to the remaining sites to minimise the impact of changes on local residents”.

Tell that to the people of Acton, as they battle their way through traffic to Chelsea and Westminster hospital, or the people on the western edge of my patch doing the same to get to Hillingdon hospital, in the event of downgraded services at Ealing hospital. With London’s transport infrastructure as it is, I remain unconvinced that those bold predictions stack up.

The current recommendations take all my constituents further away from access to emergency health. That is why I am encouraging all constituents who get in touch with me on this issue to contribute to the ongoing consultation, regardless of my concerns. That seems to be the best way forward. After all, we all know that, for many people, their local hospital is more than just a physical structure. Attachments to hospitals are often incredibly emotional. Quite naturally, people want to know, when or if they or their loved ones fall ill, that they can access the care that they need in good time. It is all very well presenting a case for change based on facts, figures and statistics in a hefty document, but it is clearly important that local people—the people who use these hospitals—are given a proper chance to have a proper say on their future.