Oesophageal Cancer

Mike Weatherley Excerpts

Monday 23rd February 2015 Commons Chamber

[Mike Weatherley (Hove) (Con)]

In November 2011, I had my dinner as normal, but what was not normal was that it did not settle well and I threw up. I dismissed it as probably a bug of some sort, but then it happened again a few days later. Clearly something was not right, but I did not relish the hassle of getting an appointment to see my doctor. I hate going to see my GP, not because I do not like her, but because the booking system is so frustrating. I put it off for another week or so, but by mid-December 2011, still throwing up occasionally, I decided to battle the booking system, and I went to see my wonderful GP. She referred me to the local NHS hospital, and five weeks later I got an appointment to see a gastroenterologist. The first diagnosis was excess stomach acid, so I was put on antacids and on the list for both an endoscopy and colonoscopy. Unfortunately, the painful probes were inconclusive, as was the follow-up CT scan—nothing was really found other than a severely restrictive oesophagus—but by now eating was becoming a major problem.

There are many people who influence and shape a life, but when someone saves a life—well, that is something very special. Professor Robert Mason is one of those exceptional people. He drew on all his experience, and despite no conclusive evidence, he insisted I came in immediately to have my oesophagus removed. Of course, I argued against this, asking for key-hole surgery or to defer the operation until the summer after more tests, but Professor Mason insisted until I changed my mind and a date was set for 18 April 2012. The full extent of just how serious this was had not fully registered with me. When I was in the pre-op room, I was asked what I had done to prepare in the morning, and I said I had gone to work, and indeed I had. I went into Parliament in the morning and drafted letters to constituents, and at the required time I popped across the river and slipped on the less-than-flattering gown.

It turns out that the surgery is equivalent to a triple heart bypass—the whole oesophagus is removed plus, in my case, a third of the stomach. May I pause here to thank all the doctors and nurses who looked after me at St Thomas’, and especially the nurses in the high dependency unit, who were simply fantastic and a tribute to the NHS? I must also mention a second person who was integral to saving my life—James Gossage, who carried out the surgery along with Professor Mason, and who carried out many post-operative follow-up surgical procedures. Mr Gossage is an exceptionally nice specialist who has a dedication to his profession that is inspirational.

Despite the ordeal, the worst moment was still to come. Until this point no cancer had been detected, but a week after the operation, Professor Mason came in and gave me the confirmation—the biopsy confirmed stage 3 cancer. There is nothing in this world that can prepare someone for the words, “You have cancer.” Sadly, oesophageal cancer is particularly aggressive, and more than half of oesophageal cancer patients die within a year. All sorts of things go through your mind when you hear stats like that, from severe regret about potentially not seeing your kids get married, to even more regret about not being treated earlier—every week really does matter—and many more dark thoughts. A sobering fact is that if Professor Mason had not insisted that the operation should be in April, and if he had agreed to wait until July as I wanted, it seems very likely that I would have been dead by Christmas 2012.

Step up the third person I owe my life to—Andy Gaya, who was in charge of my post-operative treatments. Intensive revolutionary radiotherapy and chemotherapy followed. There were days when I was so exhausted that I could not even reach out for the remote control to change TV channels. Andy Gaya made sure that I was going to be given the best chance of survival. We know that almost certainly some cancer cells were not removed during the surgery, and the treatments, while not pleasant, had to be intensive and push the boundaries in order to be sure that the cancer was treated.

Of course, there is a fourth member of the care team that I owe my life to, and that is my partner Niki. I cannot imagine how difficult it is for anyone going through this experience without someone holding their hand throughout. We throw around stats and theoretical outcomes, but the reality is that there is a whole army of real people behind every medical condition. In my case, there are four people who I can say directly saved my life, plus a huge number of attentive hospital staff, post-operative specialists, district care nurses, GPs and others. My dad often says that being born in the UK is like winning the lottery of life, and he is not wrong. We live in a great country. Having seen the NHS from the inside, I can of course see many areas where it is easy to say that this or that could be done better, and of course it is not perfect, but the reality is that it is an amazing institution that performs incredibly well. That is a result of the amazing people who work in that rightly cherished organisation.

However, I need to mention the opposite side of the spectrum. There are a lot of people out there in society who should hang their heads in shame. Around that time, as a result of my work in Parliament on various issues, I was getting death threats and other hate-filled correspondence, including from many people who simply tweeted with #getcancer. I wanted to reply saying, “Too late—already have it!”, but of course I refrained. The experience served as a stark contrast. One the one hand I was seeing the best of society in the care delivered by really caring people, but then there were the despicable members of society who contributed nothing positive. When I asked the Prime Minister to hold Russia to account for gay rights violations, I got one particularly nasty threat, which the police tracked down to a 24-year-old postgraduate from Manchester who said that she thought it would “be a laugh”. Anyone who supports that kind of hatred should spend a day in a hospital to see just how lucky they are and how great doing good is.

Moving back to cancer, let me take a moment to consider some statistics. The UK is facing an upcoming battle with cancer. It is projected that by 2020, more than half the European population will receive a cancer diagnosis sometime in their life. However, the rates of cancer survival in the UK rank among the worst in Europe. Reasons for that include, but are not limited to, late diagnosis and a lack of treatment options for cancer patients. In fact, a major study of more than 29 European countries found that the survival rates of almost all the most common cancers are worse in Britain than the European average. How will the NHS cope when, within five years, more than half a million people will be diagnosed?

As a cancer survivor—I say “survivor”, but all people who have had the disease know that it can come back at any time, so we are really just in remission—there are a few things that I have learned. Cancer support groups such as Macmillan Cancer Support and the Oesophageal Patients Association are key in providing aid and comfort to those with cancer. Beside providing emotional support to victims of cancer and their families, they often go the extra mile to provide information on matters such as treatment options, local support groups, holistic alternatives to surgery and chemotherapy, and cancer prevention. I was lucky—I had a great partner who helped me through it all, and I did not need to use the support services. I did have one moment in a restaurant when I could not eat and hit a terrible low, and I started reaching for the support line, but for the most part I did not have to fight it on my own. Sadly, many do, and such support groups are vital.

Specific to my cancer is the Oesophageal Patients Association, started by David Kirby back in 1985, which provides support and advice to patients with oesophageal cancer. It is involved in the campaign to increase awareness and in expanding our self-care groups across the UK. My thanks go also to Alan Moss, chairman of Action Against Heartburn, for his input into this speech.

More than 331,000 people are diagnosed with cancer each year in the UK. More than one in four deaths are caused by it, and 161,000 people died of it in 2012. Cancer is primarily a disease of old people—more than 50% of cases occur in those aged 75 or more—but, surprisingly, it is also the most common cause of death in children aged between eight and 14. In those aged between 25 and 49, cancer accounts for 18% of all deaths, and 41% of deaths among those aged between 50 and 74 are related to it.

[Jim Shannon (Strangford) (DUP)]

In Northern Ireland, the mortality rate among women with oesophageal cancer is rising, and the five-year survival rate among men is only 16%. That indicates a need for resources to be directed towards oesophageal cancer throughout the United Kingdom. Does the hon. Gentleman agree that it may be time for a UK-wide strategy to be applied to all four regions?

[Mike Weatherley]

I could not agree more. Early diagnosis is one of the key recommendations that I shall be making.

It is clear that cancer is one of the leading causes of death, but there are risks for survivors as well. It is estimated that 2.5 million people are living with and beyond cancer, and we know that at least one in four cancer survivors face poor health or disability after treatment. Cancer of the oesophagus is the eighth most common type of cancer in the UK among men. Only 40% of those who are diagnosed with it will live for at least one year after the diagnosis, and, tragically, 85% will die within five years. Let me put that into a personal perspective. According to the statistics, if I survive for another four years, I shall be part of a very small minority of just 15%. When people ask why I am leaving Parliament after one term, I reply that one of the reasons is that, given such a high probability, there is a chance that I will not see out another Parliament, and that does make one think about other options.

[Steve Brine (Winchester) (Con)]

I congratulate my hon. Friend on raising this issue in the House. As ever, he is making a powerful speech. He will know—because he is living proof of it—that oesophageal cancer is curable if diagnosed early, and I know from all the work that has been done in connection with cancer, and particularly as a result of the interest that I have taken in the House over the years in the subject of breast cancer, that early diagnosis is the key. However, although timely and equitable access to diagnostic tests is hugely important, there is considerable evidence that access to referral for endoscopies is not as readily available in less affluent areas, and that treatments differ widely across the country. The equity of access for endoscopies from which my hon. Friend was so lucky to benefit is the key to early diagnosis, and hence to enabling many more people to survive oesophageal cancer.

[Mike Weatherley]

My hon. Friend makes a very important point that I was not going to cover, and I thank him immensely for doing so.

Crucially, as with many other types of cancer, the outcome of oesophageal cancer depends on how advanced it is when it is diagnosed. The reason not many people can have surgery is that by the time a difficulty in swallowing is recognised, the tumour has become fairly large and has spread. As my hon. Friend pointed out, the surgeons see most people when they are already too late for curative treatment, which makes it difficult to identify survival rates for each individual stage of the disease.

What measures would I like the Minister to consider? Let me make six points. First and, I think, most important, we should make the process of seeing the doctor much easier. No one should be put off from making an appointment at the first available opportunity. Access to evening and weekend GP clinics remains patchy at best, and, as we know, that has a knock-on effect on A and E departments.

Secondly, we should make every effort to improve testing at the point of contact with GPs, and to ensure that there is rapid follow-up access to hospital diagnostic tests. Giving some GPs direct access to hospital specialist tests such as endoscopies and CT scanning would speed up the process of diagnosis.

Thirdly, we should educate patients so that they recognise the symptoms of oesophageal cancer. That will lead to earlier detection of cancer, which in turn will lead to higher survival rates. A good oesophageal awareness campaign is currently running on television.

Fourthly, 1 believe there are some “quick wins” which, if implemented, could speed up processes, remove inefficiencies and save money. For example, at the moment if someone is referred for a chest X-ray and the findings are abnormal, the results go back to the consultant or GP and the person has to have another appointment before they can be referred for an additional test, such as a CT scan. If a chest X-ray was found to be abnormal and the person was then referred straight for a CT scan, it would save on unnecessary GP or consultant appointments, and ensure that when the person is seen, their GP or consultant has all the information they need to make a diagnosis and set out next steps.

Fifthly, another factor in poor care is that it is almost invariably because of pressure on specialists due to the volume of work. When campaigns are announced by the Government, they create a surge in demand, which causes problems for medical staff because they cannot cope with the high volume of work. I would like the Minister to consider allocating extra resources for endoscopy. Targets and high outputs mean that patients are treated as statistics rather than as individuals. Take this quote, for example, from an upper-GI surgeon:

“I get lists of potential 62 day target breaches with no details of the patients themselves. We see about 20 patients in two hours in our cancer clinic on the one morning we have for these appointments—that equates to just six minutes per patient. In order to give patients dignity and respect, most doctors would need an hour per patient to talk them through their diagnosis, treatment and surgery.”

Here is a similar point direct from another specialist surgeon:

“I fully support the ‘Action Against Heartburn’ organisation emphasising the need to take seriously symptoms of persistent heartburn and dysphagia, and not having more and more medications without investigation.”

This will increase demand on endoscopy services significantly, as well as CT scanning, which of course would need extra funding to cope. However, the increased detection of early disease will enable more minimally invasive endoscopic therapy, avoiding surgery and saving money.

[Dr Julian Lewis (New Forest East) (Con)]

I recently had the advantage of an intensive briefing on oesophageal cancer from Professor Tim Underwood, a specialist at Southampton general. My hon. Friend may be interested to know that it is developing a technique that would enable the discovery of the cancer cells earlier and without an endoscopy being carried out. Research is constantly going on to try to remedy the very problem that he has identified so clearly.

[Mike Weatherley]

I thank my hon. Friend for that intervention, and my surgeons have made similar points to me. Clearly the tools are available to do that.

The sixth strategy I recommend is greater hospice care to provide end-of-life care away from hospitals that supports people and allows them to spend their final weeks and days in a place of their choice, rather than in a hospital bed.

I hope that this short Adjournment debate has two positive outcomes. The first is an increased awareness of this cancer, with many more people detecting problems earlier. If we can save lives through early detection, that has to be a good thing. The second is a commitment to additional specific resources. Of course this would mean more money being allocated, and I am well aware that there are huge conflicting demands on limited budgets, but part of this could be achieved by a quicker, more efficient diagnostic procedure. Our radiotherapy capacity is far short of what we need and access to the latest advanced techniques to spare normal tissues is limited—although I would stress again that, as my hon. Friend the Member for New Forest East (Dr Lewis) said, we do have diagnostic tools to deal with this disease and change outcomes, so it is not a huge step to save more lives.

I look forward to hearing the Minister’s comments and, hopefully, Government determination to be on the patient’s side in treating this particular cancer. We really do need to improve on just 15% of patients living longer than five years once diagnosed.

HIV

Mike Weatherley Excerpts

Tuesday 29th November 2011 Westminster Hall

[Pamela Nash (Airdrie and Shotts) (Lab)]

I am grateful to have secured this debate during the week in which world AIDS day is marked. The HIV virus was discovered 30 years ago, since when it has claimed the lives of more than 30 million people throughout the world, including 20,000 in the UK. Over the past 20 years, we have seen remarkable progress in the medication available to people living with HIV, including today’s welcome approval of a drug that will provide triple antiretroviral therapy in a single tablet taken once a day. That does not, however, diminish the fact that there is still no vaccine or cure for HIV, and more efforts must be made to prevent the transmission of the virus.

Let me take this opportunity to pay tribute to my predecessor as chair of the all-party group on HIV and AIDS, the late David Cairns. One year ago in this Chamber, he spoke on this topic with eloquence and passion, and he consistently spoke out against the stigma and discrimination faced by people living with HIV both in the UK and overseas. I am glad that his work continues in the all-party group and through the David Cairns Foundation set up in his name, which was launched last week.

The House of Lords Committee on HIV and AIDS, led by the vice-chair of the all-party group and former Health Minister, Lord Fowler, recently published a report on HIV in the UK. Lord Fowler has done much to champion the cause over his long and distinguished career, and I believe that many owe their lives to the work he carried out as HIV began to take hold in the United Kingdom. The needle exchange programme that he introduced is a good example of that work, and it changed the course of the epidemic, particularly in Edinburgh and the rest of Scotland. In September this year, the Committee concluded that the Government’s current policies on tackling HIV in the UK are “woefully inadequate.” I will focus on some of the report’s recommendations, and I look forward to the Minister setting out the Government’s response to that report.

I will start with some startling headline figures. Some 30 years after the virus was discovered, almost 100,000 people in the UK live with HIV. Newly diagnosed cases of HIV among young people have risen by 48% over the past decade, and it is estimated that about a quarter of those living with HIV in the UK do not know that they have the virus. Half of all cases of HIV in the UK are diagnosed late, meaning a greater cost to public health and the public purse. HIV is spreading for many reasons, but principally because of high levels of undiagnosed HIV, too few people with HIV receiving stable treatment, persistent risk-taking behaviour, and a lack of HIV awareness. That is set against a dangerous backdrop of inconsistent sex and relationships education in our schools and beyond.

Early diagnosis of HIV for one person can obviously translate into prevention of the disease for their future sexual partners. People diagnosed with HIV are far less likely to pass the virus to others, as they can take steps to prevent transmission such as using a condom. Once diagnosed, people can receive HIV treatment that dramatically reduces levels of the virus in the body, so that the risk of transmission can be reduced to almost zero. This year I was surprised by the results of a remarkable clinical trial in South Africa that proved that putting people on medication for HIV can reduce the risk of transmission by an enormous 96%. That has extraordinary ramifications for efforts to tackle the HIV epidemic around the world and makes the need for the early diagnosis of HIV all the more pressing.

It is estimated that 51% of all people with HIV in the UK have undetectable levels of the virus. That is great news, although the UK should aim to increase that percentage to at least 65% over the next four years.

[Mike Weatherley (Hove) (Con)]

I congratulate the hon. Lady on securing this important debate. Does she agree with the recent remarks made by the US Secretary of State, Hillary Clinton, who said that an “AIDS-free generation” should be a policy priority for all Governments, including that of the UK?

[Pamela Nash]

I completely agree with the Secretary of State’s remarks. I raised the issue during Deputy Prime Minister’s questions last week. I hope that the coalition will take that aim on board and that it will be raised by the Prime Minister. The all-party group on HIV and AIDS is a member of the “Halve It” coalition that campaigns for levels of late-diagnosed and undiagnosed HIV to be halved in five years through more testing. That will help to stop the spread of HIV, improve health outcomes for those living with the virus, and in the long term save the Government money.

Patients and doctors have a large role to play. A study of people of sub-Saharan African origin in the UK who were diagnosed late with HIV found that three quarters had visited a doctor in the year preceding their diagnosis. Doctors and patients must be more aware of the primary infection symptoms of HIV. Incentivising HIV testing, particularly in areas with a high prevalence of HIV, is vital to ensure that people are diagnosed in time. One powerful incentive would be to ensure the inclusion of the late HIV diagnosis indicator in the Government’s revised public health outcomes framework. We have heard several times that a decision on that will be made later in the year. Will the Minister assure hon. Members that that indicator will be included, or at least say when the Department will reach a final decision?

As I understand it, the Department is investigating the possibility of legalising home-testing kits. I look forward to the outcome of that investigation. It is clear from the House of Lords report that home-testing kits ordered from overseas, usually over the internet, are already in use in the UK. If legalised, that practice could be regulated and allow people to test themselves securely and safely in their own home, again producing savings for public health and the public purse.

How else can we prevent the transmission of the HIV virus? The House of Lords report stated:

“More resources must be provided at national and local levels… The current levels of investment in national HIV prevention programmes are insufficient to provide the level of intervention required.”

Hon. Members may be surprised to learn that the Department of Health currently spends just £2.9 million a year on two national HIV prevention programmes for gay men and black Africans. That compares with an enormous £762 million spent on treatment. Preventing one infection avoids lifetime treatment costs for HIV of between £280,000 and £360,000, but as local service cuts kick in throughout the country, HIV prevention programmes are being reduced.

Under the new NHS structure, local HIV prevention work, campaigns and testing will be commissioned by local authorities, leading—we hope—to additional national campaigns, but I am concerned about the possible fragmentation and subsequent prioritisation of prevention work between HIV treatment that is commissioned nationally by the commissioning board, prevention and testing work commissioned by local authorities, and national campaigns overseen by Public Health England. Within local authorities, HIV prevention work is likely to face strong competition for funding within constrained budgets. A fragmented health care system will not deliver the results that we desperately need, or enable us to make headway against the rising tide of new HIV infections. We do not want a postcode lottery, or for sexual health services to be sidelined because of local sensitivities.

Manufacturing

Mike Weatherley Excerpts

Thursday 24th November 2011 Commons Chamber

[Guy Opperman]

My hon. Friend anticipates my next move, which is to say that such matters are already road-tested in other jurisdictions in other countries. Sadly, the FSA is reluctant to change its regulatory system. I have heard other examples of its failing to meet individuals who want to provide local financing—something that would be immensely good for local communities and could provide a flexible approach. Instead of being stuck with a loan from Barclays, for example, people would have a much lower flexible interest rate and adopt a much more interesting way to recuperate their finances at a later stage when the company was in profit. Banking would be local. We all know what happens when we are approached by a constituent when a business is in trouble. The decisions in relation to such financing are made not in Hexham or Newcastle or even in the north-east, but in a place such as Nottingham or Leatherhead or, ultimately, in London. That must change.

[Mike Weatherley (Hove) (Con)]

Does my hon. Friend agree that the banks in his example would facilitate help for some of the failures in respect of the enterprise finance guarantee scheme? There are 4.8 million SMEs, but the Government are targeting only 6,000 of them with help through the EFG at the moment.

[Guy Opperman]

My proposal would provide an alternative way forward for the financing that those businesses clearly need. I suggest that the Minister take it back to the future Minister for manufacturing and the Treasury, with a view to trying to move forward. I am conscious of the time, so I will not take any further interventions.

My next suggestion is an industry bank. We could extend the remit of the existing green investment bank to form a general enterprise bank, for which there are successful models in Germany and the United States. The German KFW—a product of Germany’s social market tradition—and the US Small Business Administration industry bank are specialists in long-term lending to SMEs, and they are effectively financed by their Governments, with a bottom line of commercial viability and social benefit.

The blueprint also exists in this country. What is presently 3i, which is a FTSE 100 company, was originally the UK Industrial and Commercial Finance Corporation, which had tremendous success when it was set up. On practical realisation, given that we have quantitative easing, would it not be better, instead of investing all those sums in bank bonds, for some of that money to go into an industry bank, so that it would go directly to the people who need it most and who are creating the jobs and growth that we all want and need?

I must conclude my remarks. I urge the Government to have a more pro-business policy. Others will talk of what the Government are doing and the positive steps they are taking, but I put in a plea for flexibility. There are repeated examples in my constituency of viable and successful businesses being penalised heavily for being a day late with their tax returns, or three days late with their VAT returns. Effectively, the Government are penalising those who are working the hardest to create the jobs that we need. I thank the House for its indulgence.

--- Later in debate ---

[Mike Weatherley (Hove) (Con)]

I shall be brief and hope not to take up the full eight minutes I have been allotted. I want to concentrate on smaller manufacturers. My hon. Friend the Member for Warwick and Leamington (Chris White) might be interested to know that I come to the debate with a certain amount of expertise. First, I am a chartered management accountant and that profession is geared towards manufacturing. In addition, I was previously the owner and finance director of a manufacturing company in East Sussex. While I was there, we won a Queen’s Award for Export, a Queen’s Award for Enterprise, and Sussex company of the year. The company exported to 48 countries worldwide and had five satellite offices overseas. I pay tribute to my previous business partners Hugh Burnett and David Westcott and to all the staff at Cash Bases.

The two areas I would like to highlight today are staffing and finance. When I owned that company in the late ’90s we had enormous trouble recruiting staff at all levels. We even laid on buses from outlying areas. That was in the boom years after the Conservatives had put the economy on a good financial basis but the shortage of both skilled and unskilled workers was exceptionally high. The fact that our education system was, and almost certainly still is, geared towards service sector jobs rather than traditional engineering and machine operation is to our detriment. I recognise many of the points that the hon. Member for Huddersfield (Mr Sheerman) made about education, so I shall not revisit them. I appreciate the apprenticeships that the Minister mentioned earlier, but we need more of those to cover the skills gaps.

A far more worrying issue, which is a huge hindrance to growth generally but manufacturing in particular, is the availability of funds, which my hon. Friend the Member for Calder Valley (Craig Whittaker) mentioned. The banks can give very small loans but when the requirement creeps over the £10,000 mark, it gets very difficult. The enterprise finance guarantee scheme is supposed to fill the gap between equity investment and the lower levels at which banks are lending, but it fails on two counts. First, the banks do not like it and will not lend with the 25% risk factor. Secondly, the amounts being loaned are just too small.

There are 4.8 million SMEs in this country, but the Government are currently targeting loans at only 6,000 for this year. In comparison with previous years, the amount of funding has decreased. There was £1.3 billion in 2009-10 and £700 million in 2010-11, and the figure has gone down to £600 million for 2011-12. They are not just grants; they are loans that the Government get back.

I recognise what the right hon. Member for Wolverhampton South East (Mr McFadden) was saying about the creative industries. To my knowledge, not a single small firms loan guarantee has been given to the music industry, and that is a great shame. In the first half of 2011, just 1,779 firms were successful in obtaining such loan guarantees, and the average amount is just under £100,000 per loan.

My second point is the funding gap. Anything under £5 million is difficult to finance. When I purchased the company in Newhaven, East Sussex in 1997, we bought it for £4.2 million. The venture capital company that backed us then has said that it would not back a similarly low investment again. Anything under £5 million is considered totally uneconomic. That and the funding for small businesses trying to grow our industries need to be addressed.

Exports are another financing-related issue. I was pleased to hear what the Minister said about the Government’s growth targets. I will certainly hold the Government to account to try to reach the levels that we would like to achieve. However, funding for exports is not balanced sufficiently when compared with inward investment. Of course, inward investment is good for a short-term fix for jobs, but we must substantially address the fact that exporting is an important part of any recovery in the long term.

In summary, the enterprise loan guarantee scheme must be improved. The 25% collateral that the banks require puts them off making proposals. Indeed, the amount available under such schemes must be increased to get closer to where equity investment becomes sufficiently realistic. Lastly, let us not forget the staffing implications. We must gear towards manufacturing, not just the service sectors.

Organ Donation

Mike Weatherley Excerpts

Wednesday 9th November 2011 Westminster Hall

[Paul Uppal]

My hon. Friend makes an important point. This is a difficult issue, and the nub of the problem is that clinicians and individuals in our communities often find it difficult to talk about the matter and to face reality. I see no reason why it would be harmful if GPs spoke openly and candidly about it to people who attend their surgeries. They could highlight the matter, and spread the broader message among the broader populace about how vital the need is.

[Mike Weatherley (Hove) (Con)]

I congratulate my hon. Friend on securing this debate. Does he recognise the work of those calling for an opt-out system of organ donation, which includes national campaigns such as the British Heart Foundation, as well as local campaigners, including Valerie Paynter, who underwent a kidney transplant 20 years ago, which saved her life? Her story is very moving. Will my hon. Friend encourage hon. Members to sign my recently tabled early-day motion, although I appreciate that he does not sign them?

[Paul Uppal]

My hon. Friend is correct: I do not sign early-day motions. On the opt-out, we have made some progress, and we should continue on that route, but increase the pace. I have seen some of the research from various task forces. Some work in 2008 suggested that there was no substantive evidence that going down that route would increase organ donation. That is probably a matter for debate another time, but my personal opinion is that we must deal with it sequentially. Let us get to 2013, then see where we are.

HIV

Mike Weatherley Excerpts

Wednesday 1st December 2010 Westminster Hall

[Mike Weatherley (Hove) (Con)]

I congratulate the hon. Member for Inverclyde (David Cairns) on securing this important debate, whether by skill or fortune.

The Hove and Brighton area has one the highest rates of HIV in the UK. Many of my constituents live with the virus, and others have friends and colleagues that do so. It is a great privilege to speak up for them on any day, but especially on world AIDS day.

I wish to make two clear points. First, HIV does not always conform to stereotypes. HIV does not affect only young men on the gay scene, or people in or from Africa. As we heard earlier, it also affects white, middle-aged and older straight men and women. Until politicians, policy makers, doctors and the general public take that fact on board, dealing with HIV will continue to be hard work. Secondly, 26% of all who live with HIV in the United Kingdom are undiagnosed. Tackling this must be a priority.

In Brighton and Hove City primary care trust, about 450 people are HIV positive without knowing it. The Government and local services must do everything that they can to bring the number down, and I am determined to do what I can to support the NHS at the local level in this task.

My two earlier points are linked, because it is precisely those who are not in what are known as high-risk groups who get diagnosed the latest. Heterosexual men have the worst rates of late diagnosis, at 65%. That is possibly because they are less likely to consider themselves at risk, as we heard earlier, and unlike women they will never be tested in ante-natal settings. It could also be because clinicians may not consider them to be at risk. Heterosexual men over 50 years old have the worst rates of diagnosis; 73% of those not diagnosed until over the age of 50 are diagnosed late.

HIV comes in many shapes and sizes. At 54%, more than half of new diagnoses in 2009 were among heterosexuals, something that surprised me when researching for the debate. At 51%, more than half of HIV-diagnosed individuals accessing HIV care in 2009 were infected through heterosexual sex. The proportion of heterosexual diagnoses in which people are believed to have been infected in the UK has risen year on year throughout the epidemic. From 2003 to 2007, it doubled from 12% to 24%, and it continues to rise. It is now about 32%. The over-50s represent one in five of all adults seen for HIV care in 2009. That is due to an ageing cohort of people diagnosed previously, as well as an increase in new diagnoses among older people.

I dwell for a moment on the growing cohort of people of more than 50 years of age that live with HIV. This cohort will be bringing new needs to the NHS, and it should be ready for them. As people get older, they see more of their GPs. Many older people living with HIV suffer side effects from treatment; overall, they report twice as many other long-term non-HIV conditions as their non-HIV positive peers. As a consequence, they need to spend more time in health care, including primary health-care settings, than their peers. That makes their relationship with non-HIV specialist doctors almost as important as their relationship with HIV doctors.

The Terrence Higgins Trust surveyed about 400 people aged over 50. It found that

“respondents repeatedly told stories of discrimination, ignorance and poor clinical treatment in generalist healthcare, particularly in primary settings.”

The survey concluded that there was important work to be done to address HIV discrimination in primary care settings, as doctors there may not be so familiar with people who have the virus.

In Hove and in Brighton, we have some of the most HIV-aware clinicians in the country, and our specialists are among the best in the world. However, we must not be complacent, as parts of the NHS in our area will be less HIV-aware, as we heard earlier. I urge the Minister to work with her colleagues, the all-party group on HIV and AIDS and charities such as the Terrence Higgins Trust to tackle the problem. Training for GPs and surgery staff could be one way to do so.

Medical care is not the only service needed by older people. In the same Terrence Higgins survey, fewer than one in 12 older people with HIV said that they would approach a mainstream organisation for older people for support. Age UK and the Terrence Higgins Trust are working to change attitudes and to improve understanding of HIV in mainstream social care and social networks for older people. Again, I hope that the Minister will listen to the views of people living with HIV. as her Department moves to create a social care system fit for the 21st century.

I turn next to late and undiagnosed HIV. Of all adults diagnosed with HIV in 2009, 52% were diagnosed late, when their CD4 count dropped below 350. People with the worst rates of late diagnosis are over the 50s. Recent research suggests that the majority of those people will have had previous contact with their doctors. Late diagnosis, whatever the age, is a problem; if treatment is not started promptly, it can do serious damage to the body and severely cut life expectancy.

HIV treatment is excellent, and if diagnosed promptly, one can live to an old age. It is not right that some of my constituents will not have this opportunity by being diagnosed too late to benefit from it. It even makes financial sense to treat people early; it is much cheaper to have people someone stable on HIV treatment than it is to treat them for the endlessly recurring serious conditions that can result from undiagnosed HIV. HIV treatment also reduces viral load; as a result, those who are diagnosed and on treatment are less likely to pass on the virus.

Now is the time, while we are focusing on public health and while we are worrying about public finances, to take action to tackle late diagnosis and undiagnosed HIV. I am proud to say that people in Brighton and Hove are not sitting back waiting for someone to come up with a solution but are already working hard to tackle the problem. There have been two pilot studies in our area looking into ways of reducing undiagnosed HIV, using clinicians in the area. Of 596 people tested, only two positives were found. However, even more people were identified through an anonymous survey done by the university of Brighton. I urge as many people as possible to be tested, because of the 3,872 anonymous tests 54 were positive.

My constituency is proof that HIV can affect anybody, whatever their background, age or sexuality. As more people with HIV grow to old age, we must ensure that they receive services of which we can be proud. Such services should include prompt diagnosis.

Public Health White Paper

Mike Weatherley Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

I must disappoint the hon. Gentleman. We will publish shortly—I hope before Christmas—the consultation on the funding arrangements. We started by establishing the baseline spend for public health, which was never identified under the last Government. It has taken months even to get to the point where we can establish what it looks like—[Interruption.] The hon. Member for Leicester West (Liz Kendall) mentions Julian Le Grand from a sedentary position. He did good work, but it included the whole of maternity services as a public health service. Julian Le Grand and Health England’s work arrived at the figure of £4 billion. In fact, the baseline is in excess of £4 billion, but its composition is completely different. We will set out shortly the structure and proposals for funding local authorities’ public health activity.

[Mike Weatherley (Hove) (Con)]

Given my right hon. Friend’s voting record in the last Parliament, and indeed that of most Government Members, will he advise the House what specifically he is looking to achieve through the tobacco display ban analysis?

[Mr Lansley]

Through our tobacco control strategy, I am looking to achieve, as we will set out, a continuing reduction in smoking prevalence. In particular, I want to identify how we can substantially reduce the initiation into smoking among young people.