Coronavirus
Nick Smith Excerpts(4 years, 2 months ago)
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Matt Hancock
Yes. I do not have to check with the chief medical officer before telling you, Mr Speaker, that I love going to Buxton, which is a great place to visit. My hon. Friend makes a serious point. As I said in my statement, there is scientific advice against moving too soon or overreacting, as there is against moving too slowly or not reacting strongly enough. We need to take the measures that are necessary to protect the public.
On taking measures that do not protect the public, the advice is that all of us in a position of responsibility whose communications are heard widely, whether we are Members of this House or members of the media, have a duty of responsibility, because how this is communicated will have a direct impact on how well we as a country cope with this outbreak.
Nick Smith (Blaenau Gwent) (Lab)
Hospital cleaners and porters keep us safe, so will the Government increase SSP to full pay for all staff forced to self-isolate? Low-paid workers in our NHS should not be financially penalised for doing the right thing.
Matt Hancock
As I said, we are keeping the rules on SSP under review. As we directly employ people in the NHS, I am having a conversation about it with the chief executive of the NHS.
Health
Nick Smith Excerpts(4 years, 12 months ago)
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Jonathan Ashworth
My hon. Friend makes an eloquent and powerful point. She is absolutely right. It makes absolutely no sense to cut alcohol addiction services, as that fails a number of vulnerable people in society and only increases pressures on the wider NHS.
The NHS recognises the pressures on alcohol services. It announced in its long-term plan that it wanted to roll out alcohol care teams in hospitals—a proposal that I made at the Labour party conference last year. At the same time, public health budgets are cutting alcohol addiction services in our communities. Years of investment under the Labour Government in drug and alcohol treatment and recovery centres helped to reduce HIV, hepatitis and drug-related deaths, and also helped to reduce drug-related crime and wider social harms. Yet the number of those receiving treatment and in recovery for alcohol problems has fallen by 17% since 2013. When alcohol misuse costs wider society £18 billion a year in crime and lost productivity, and when drug misuse is also a factor in so much crime, surely these cuts represent the very worst type of short-term thinking—cutting proven preventive services for a short-term saving but ignoring the bigger and longer-term human and financial cost.
What about weight management programmes? The Government pride themselves on their obesity strategy, but when the NHS spends £5 billion on obesity, when there are 617,000 hospital admissions because of obesity, when 18% of hospital beds are occupied by a person with diabetes, when 25% of care home residents have diabetes, and when we have one of the worst childhood obesity rates in western Europe, why are weight management programmes being cut in communities? One GP told Pulse magazine:
“This is crazy. It makes conversations between GPs and patients very difficult. They say, “you tell me that I need to lose weight, but the only help you can give me is advice and a diet sheet printed off Google.”
Another GP told Pulse:
“You try to refer someone for bariatric surgery but they can only have it if they’ve undergone 12 months of a weight management programme—but there isn’t one.”
Nick Smith (Blaenau Gwent) (Lab)
My hon. Friend is doing very well. Does he agree that movement is medicine and we need far more physical activity strategies in our NHS? For instance, if we had more ParkRun activities, particularly in working class neighbourhoods, that would help a lot in improving health inequalities in many parts of the country.
Jonathan Ashworth
Absolutely. I hazard a guess that when the Secretary of State stands up, he will talk about the support for social prescribing that he has given to general practice so that GPs can send people for more of this activity. But, at the same time, public health budgets are cutting these very types of activities. One hand does not know what the other hand is doing.
Matt Hancock
I am glad I took that intervention because that was not the intention I was trying to convey at all. We need to do more to tackle smoking, and we will, and we need to continue to tackle the abuse of drugs, and we will. My argument is that this House decided that public health was better delivered through a broad approach by local councils working with the NHS than separately. On sexual health services, I gently say that many such services—for instance, the provision of PrEP—are preventive, not just reactive. However, the boundary between what is prevention and what is cure in sexual health services is, by nature, more complicated.
Nick Smith (Blaenau Gwent) (Lab)
May I take up that issue of prevention? Earlier this afternoon, the Secretary of State said that he would move heaven and earth to achieve healthy outcomes. When will we see a ban on junk food advertising before the watershed?
Matt Hancock
We have not discussed obesity much during this debate, but the Government have a whole programme to tackle it. That includes tackling advertising and, in particular, tackling the pro-obesity environment in which too many children grow up. There is a broad range of actions on our agenda, with more to come.
Matt Hancock
Local authorities and the NHS work very closely in delivering a huge number of services, and authorities often commission services back from the NHS. I can tell the hon. Lady that between 2013 and 2017, the number of attendances at sexual health centres increased by 13%. The suggestion made by many Opposition Members that there has been a cut in the number of such attendances is not supported by the facts.
We will not rest until we can solve these problems.
Matt Hancock
We are putting money in, and we are putting commitment in. The NHS was proposed from this Dispatch Box by a Conservative Minister, under a Conservative Prime Minister, and its expansion has been overseen by Conservative Governments for most of its 71-year history.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. The Secretary of State is not giving way, and we are running out of time.
Oral Answers to Questions
Nick Smith Excerpts(5 years, 2 months ago)
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Caroline Dinenage
Yes. I think this is a really strong signal to clinical commissioning groups about how the NHS values the services provided by children’s hospices—not just end-of-life and palliative care, as I say, but the other respite and outreach services they provide. That is why giving them access to up to £25 million will make an immeasurable difference.
Nick Smith (Blaenau Gwent) (Lab)
Ian Murray (Edinburgh South) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
Leaving the EU with a deal remains the Government’s top priority, but we are preparing for every eventuality. I am confident that if everyone does what they need to do, the supply of medicines will continue unhindered.
Nick Smith
Will the Secretary of State say how much has already been spent since the NHS no-deal contingency plans were active, and what the overall bill will be?
Matt Hancock
Yes. About £11 million has been spent already. The NHS is not generally buying the extra medicines that are going into the elongated stockpiles, but the pharmaceutical industry is. We will of course eventually buy most of those medicines for the NHS. There have been costs to the pharmaceutical industry as well, but the cost so far to the taxpayer is £11 million. I expect it will remain at about that level, or a little higher.
Prostate Cancer
Nick Smith Excerpts(5 years, 3 months ago)
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Simon Hoare (North Dorset) (Con)
I rise to open this five-hour Adjournment debate—that was a joke, Mr Deputy Speaker. This debate is certainly timely, given that on Monday this week we celebrated the 20th anniversary of World Cancer Day, and many Members will have attended the event held by Cancer Research UK in Portcullis House this morning. It is timely given the more than welcome announcement by the Treasury and the Department of Health and Social Care of record investment coming into the national health service. It is timely because we have the Government’s welcome and focused cancer strategy. It is timely because at no other time in our history have Government and health campaigners and providers had a greater communication platform to reach out to members of the public and explain, inform and educate. Finally, this debate is also timely because this week, under the auspices of my hon. Friend the Member for Lewes (Maria Caulfield), who has considerable nursing experience, we have seen the launch of the all-party parliamentary group on male cancers, including prostate cancer.
We need to recognise that cancer is still feared in this country. Terms such as “battle, “fight” and “lost the crusade” against cancer are used in countless obituaries, which testifies to that fear. I hope that we all take heart from the commitment in this important health area shown by my right hon. Friend the Secretary of State and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine). That should provide us with a reservoir of optimism about the seriousness and determination of the Department on these issues.
It may just be something to do with my sex—I am not sure—but all the statistics and all the anecdotes tell us that men appear to have a greater aversion to going to the doctor and asking questions about their health than our female counterparts, and certainly anything below the waist is to be avoided at all costs because it is going to be painful, embarrassing and undignified.
I pause for a moment to reflect on the absolute honesty that we have heard from my hon. Friend the Member for Redditch (Rachel Maclean), and indeed the clarity of my right hon. Friend the Prime Minister at the Dispatch Box during a recent Prime Minister’s questions, about cervical cancer testing—admitting some of the inhibitions, but, given the importance, exhorting people to take those tests. I do not think that I hear such exhortations and frank honesty from men about this health issue.
Nick Smith (Blaenau Gwent) (Lab)
I commend the hon. Gentleman for his leadership and for securing this important debate. I have been along to the World Cancer Day event today, where I was told that more than a third of cancer cases can be prevented, and another third can be cured if detected early and treated properly. The message he is sending out today is really important for us to share across the whole country.
Simon Hoare
I agree. In answer to the first part of the hon. Gentleman’s intervention, which I presume was rhetorical, I just want the Minister to carry on with the excellent work he is doing. The hon. Gentleman is right to say that we need to blow away the cloak of secrecy and, sometimes, shame and embarrassment. No family represented in this House will not have heard an aunt or an uncle say, in slightly hushed tones and that silent mouthed way, best exemplified by Les Dawson, that they have the big C. It is as though they cannot quite bring themselves to annunciate the word, in case it brings a plague upon their house. We have to brush all that away.
I am absolutely determined to get on to the issue that I want the Minister to address, which is what I was trying to do about 16 interventions ago. I urge him to grasp the opportunity—provided not least by the additional funding—for efficient, cost-effective and easier diagnosis. I appreciate that there is a whole range of things in the marketplace, but during my research I have been particularly struck by the opportunities presented by the pre-biopsy multiparametric MRI scan. We have a problem, because while demand for MRI scans rose by 30% between 2013 and 2016, this country still has fewer MRI scanners per head of the population than other countries with comparable populations. The additional moneys available provide a golden opportunity to do something about that.
Of course, it is never just a question of cash and kit, so allied with that are the people who can use the kit. The workforce are key. In addressing the issue of money and the benefits it can provide, we should note that we will not realise its full potential if we are short on workforce. The 10% vacancy rate in the national health service cannot be allowed to become the norm. Prostate cancer patients need and would like more clinical nurse specialists, who have the empathy and expertise to provide comfort, hope and a guiding hand. It is difficult to recruit in any specialist nurse area, but that should not put us off the endeavour.
Likewise, we need a recruitment drive for more radiologists. Prostate Cancer UK estimates that an additional 23 to 31 radiologists are needed in the UK. The Royal College of Radiologists estimates that in the financial year 2016-17, a whopping £116 million was spent on the outsourcing and insourcing of radiological skills additional to core contracted hours. To put that in perspective, £116 million would buy about 1,300 full-time consultant radiologists.
As I have said, raising public awareness of prostate cancer—its signs, symptoms, diagnosis and treatment—is pivotal, but so too is the reinforcement of messages from the Department, NHS England and others to our general practitioners. We all know that there is a growing problem of finding people who are interested in and prepared to enter general practice. The myriad drugs that come on to market and myriad other conditions make the already demanding life of a GP ever more so.
I recently met Jim Davis, the chairman of the Dorset branch of the Prostate Cancer Support Organisation, a charity that covers Hampshire, Dorset and Sussex. It is run for men diagnosed with prostate cancer, by patients with prostate cancer. Last year, they held 23 free prostate-specific antigen testing events, which delivered those tests for 4,813 men. They have found that people are more inclined to go into that sort of environment than to their GP surgery. Their work involves—as a Hampshire Member of Parliament, the Minister may already know this—raising money, advertising the tests and hiring village halls and other places. Men then come and have the test, which is sent—in effect, the work is subcontracted—to the local hospital, which analyses it and sends back the results. I will not detain the Minister, but I could read out a whole legion of extracts from letters from grateful men who availed themselves of that opportunity and found their life chances and health much improved.
Although the national health service says that any man over 50 is entitled to a free PSA test, evidence suggests that some GPs—I stress the word “some”, but one is too many—are either unaware of that entitlement or express and demonstrate an unwillingness to refer. Last May, David Radbourne, the director of commissioning operations at NHS England South East, wrote in response to a letter from Jim, who had produced a list of affected patients:
“If there are individuals who feel they are being refused legitimate access to this test…please ask them to file a complaint through the appropriate NHS complaints process.”
I say to my hon. Friend the Minister that in those circumstances, people should not be forced to go through an NHS complaints process. Like other campaigners, I see a lacuna, or an information gap—call it what you will—among certain GPs, and I urge the Department to consider ways in which to plug it. That issue needs to be addressed quickly. The official in the Box is waving a piece of paper and the Parliamentary Private Secretary, my hon. Friend the Member for Erewash (Maggie Throup), is up on her feet with alacrity, as always.
The Public Health England advisory note, “Advising well men aged 50 and over about the PSA test for prostate cancer”, needs to be reviewed and updated. It states:
“GPs should use their clinical judgement”.
That is a pejorative term—it is an open term—so perhaps that language should be revisited. The approach needs to be a little more robust.
Nick Smith
The hon. Gentleman is making a really important point. I am over 50, but I did not know about the test. Does he know how many men over 50 as a proportion of the population have had the test?
Simon Hoare
I am sure that I have come across that figure in my research, but I do not have it to hand. However, as I mentioned in my introductory remarks, the platforms to inform, encourage and educate us all as health citizens, for want of a better phrase, that we seem to avail ourselves of very much relate to—this is not a criticism; it is perfectly correct—cervical cancer, breast cancer and other cancers. The opportunity presented by additional funding and by the very welcome cancer strategy should now allow us all to give—I do not know whether this is quite the right phrase—parity of esteem between male and female cancers. Cancer has a devastating effect on family irrespective of which member has it. I am afraid I cannot answer that query, but the Minister may have that figure. As it is an entitlement, I urge as many men over 50 as possible to see it as routine and regular as going to the optician or the dentist.
In conclusion, with the cancer strategy, fantastic levels of funding and the active commitment, energy and understanding shown by Ministers in the Department, now is the time to make positive progress.
The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
It is always a pleasure to see you in the Chair, Madam Deputy Speaker. Here we are again and for once we are not in a rush. It will be dark outside before we finish. I congratulate my hon. Friend the Member for North Dorset (Simon Hoare) on securing today’s important debate. He entertained us and educated us, and he set out his stall very well.
Let us start with a positive: cancer survival in this country has never been better. Survival rates are at their best ever, having improved every year since 2010. That is a hard-fought success, and we should celebrate it. Among men, prostate cancer is the most common cancer in the UK and the second most common cause of cancer deaths. However, prostate cancer survival has tripled in the past 40 years, with 85% of men surviving for five or more years.
It is worth stating at the outset—some people who are watching may not be familiar with this subject—that the prostate is found only in men. It produces some of the fluid in semen and is found below the bladder. It is about the size of a walnut and surrounds the urethra, the tube that carries urine from the bladder. The causes of prostate cancer are not that well known. The strongest risk factor is age, but about 5% to 10% of prostate cancer is thought to be due to family history. Black men, whether of black African or black Caribbean origin, are more likely to develop prostate cancer than white men. One in four will get the disease, as opposed to one in eight of all men. Asian and oriental men have the lowest chance of developing prostate cancer, which is interesting—we should always look at this sort of data when looking at prevention. I will come on to that point.
The way that prostate cancer develops is not fully understood. It is not a single disease, but a spectrum of diseases ranging from slow-growing tumours that may not cause any symptoms and may not shorten life at all to very aggressive tumours that can kill. We should remember that. As I said, the strongest risk factor is age, but younger people get it, too. I have a school friend who has recently contracted and beaten—I will come on to the use of language in a moment—prostate cancer. He may even be watching today’s debate; he may be mowing the lawn, who knows? We wish him well.
My hon. Friend raised some very good points in his speech, and I should be able to touch on them all. This is a timely debate for all the reasons he set out, but also because it was World Cancer Day on Monday. It was great to see Cancer Research UK light up the Palace of Westminster in pink and blue.
My hon. Friend’s point about language was very interesting. He may have seen a poll by Macmillan that came out last month. It showed how many people with cancer are fed up with the language of war. We often say “cancer stricken” or “victim”. We often call a person’s cancer diagnosis a “war” or a “battle”. We say that they “lost their battle” or “lost their fight” when they pass away. It is no surprise that articles in the media and posts on social networks were found to be the worst offenders. My advice is to be real and honest. Macmillan has launched the “Right there with you” campaign to highlight the challenges posed by a cancer diagnosis and the support that is available. As we all know, Macmillan does fantastic work, including in this House. I urge people to take a look at its campaign.
My hon. Friend also touched on the all-party group on male cancers, formed by my hon. Friend the Member for Lewes (Maria Caulfield) who is a former nurse. It had one of its first gatherings this week. Orchid, the male cancer charity, will provide the secretariat for the group. It is not that well known as a charity, but it is growing fast. I met the charity at Britain against Cancer a couple of years ago, and it is now part of my cancer roundtable work here in the House every quarter. I pay tribute to its works and to the all-party group. I had a good conversation in the Lobby with my hon. Friend last night. We are going to do an awful lot together. The group is very important. If it did not exist, it would need to be invented, and I congratulate her on inventing it.
My hon. Friend the Member for North Dorset raised early diagnosis, so let us deal with that. The biggest weapon we have in successfully treating cancer is early diagnosis. I have said many times, as did the former chair of the all-party group on cancer, that it is the magic key or magic bullet. That is true, but there are many cancers where early diagnosis is all but impossible. We do not see presentation of symptoms until it is very late and then it becomes incredibly difficult. They will be a big challenge for the cancer ambition that I will come on to talk about in a moment.
As my hon. Friend and others said, we men are notorious for not visiting the doctor at the first sign of a concerning symptom. I think that that is changing, but anything that can raise awareness of prostate cancer, where early diagnosis is indeed the magic key, is to be welcomed. I pay tribute to public figures such as Stephen Fry and Bill Turnbull from “BBC News” for speaking out so honestly about their own prostate cancer diagnosis. They provided an invaluable public service in raising the profile and awareness of the disease, giving some men the vital nudge they need to see their GP if they think something is not right. For some men, it can be a quick burst of symptoms that come on very quickly. They can go to a doctor, are seen and treated and have surgery in a very short space of time. For others, it can be a very slow burn.
I hope that the work that Stephen Fry, Bill Turnbull and others have done will have an impact similar to 10 years ago when the TV personality Jade Goody, following her cervical cancer diagnosis from which tragically she died, spoke out about how vital it was for women to attend their smear tests. We had an excellent debate in Westminster Hall last week on Natasha’s Army—there is that word again. Natasha was a 31-year-old mother from Newton Abbott who died of cervical cancer, leaving four young children just before Christmas. Natasha’s Army are her friends and family who campaign on awareness and smear tests. That is so important. The work Jade Goody did led to a huge uptake in screening, enabling the NHS to detect and treat more cancers early. I hope that, as more people talk about prostate cancer, something similar can happen.
Nick Smith
I join the Minister in congratulating people like Stephen Fry and the grassroots movements on doing such a good job in talking about the importance of early diagnosis. The hon. Member for North Dorset talked about the important PSA test. The Minister may not have the figures available, but if he does could he let us know the proportion of men over 50 who have had the test? That would be an interesting indicator as to what is going on.
Steve Brine
I do not have that figure with me today, but I will write to Members attending the debate and I will tweet it @BrineMinister—but enough of the advert.
Early diagnosis and the NHS long-term plan is where I want to turn next. Straight after the Christmas recess, we launched the NHS long-term plan, which is a seismic piece of work. I would be the first to say, along with many other people working clinically in the field, that we cannot rely solely on the celebrity cases that I mentioned to improve early diagnosis. The long-term plan included a comprehensive package of measures that will be rolled out across the country, with the aim of securing the Prime Minister’s promise, which my hon. Friend the Member for North Dorset spoke about, from party conference back in the autumn: that three quarters of all cancers will be detected at an early stage—stage 1 and stage 2, when they are most beatable—by 2028. The plan will provide new investment in state-of-the-art technology to transform the process of diagnosis and boost research and innovation, with the aim of ensuring that 55,000 more people are surviving cancer for five years in England every year from 2028.
That ambition refers to all cancers, including prostate. When we came out with that ambition, a number of people, in the breast cancer community, for instance, said, “But what about us? We are already above 75%”, and some said, in relation to the rarer and less survivable cancers, “What about us?” It is very important for me to restate at the Dispatch Box that this ambition does refer to all cancers—not just those that afflict men or women, old or young, or that are easily treatable or more difficult and less survivable. We are clear that to achieve the five-year survival ambition, we have to improve outcomes for all cancers, and we will.
As I said, early diagnosis is key. Early diagnosis of prostate cancer is challenging, in truth, because the symptoms are similar to those of an enlarged prostate and very often, there can be no symptoms at all. As has been said, the most common method of identifying an increased risk of localised prostate cancer is the prostate specific antigen test. However, that is not perfect. The House will have seen press reports a year or so ago stating that a raised PSA level is not necessarily a sign of prostate cancer, and that a low PSA level is not necessarily a sign of it not being there either. That is not entirely helpful, but we must always remember in these debates—and I am not a doctor, as is clear—that medicine is not an exact science. I thought that story was a good example of that.
A raised PSA level can indicate prostate cancer, but in some cases it can miss indicating a cancer. It can also suggest a cancer when there is not one, or identify slow-growing tumours that may never cause any symptoms for a man or shorten his natural lifespan. This can all be very difficult in primary care. My hon. Friend talked about GPs, and there is a clue in the name. I sometimes get a lot of flak for saying this, but general practitioners are so called for a reason—they are general practitioners—and we should remember the devilish job that general practitioners have, given the huge variety in what comes through their door.
The prostate cancer risk management programme—the PCRMP; we love our acronyms in the health service—was established so that men considering a PSA test are given information about the benefits, limitations, which I have touched on, and associated risks. It supports GPs in giving and discussing information with their male patients. A pack of materials is available for primary care to help men to make an informed choice about the PSA test, which includes a leaflet that they can take away to discuss with partners. There is also an evidence booklet and summary sheet for GPs. These are all widely available online.
As I said, there are pros and cons of having a PSA test, but it is so important that men arm themselves with as much information as they can and speak to their GP or practice nurse, including when they go for their NHS health checks—I will be going for one of those at the end of this month. I know that it is hard to believe that I am old enough to be called for one, but they phoned me yesterday, so I have been booked in.
As has been said, men over 50 have the right to be given a PSA test free on the NHS once they have discussed the advantages and disadvantages with their GP. The PCRMP makes that very clear to GPs, and, having discussed the pros and cons, no one over 50 should be told “No”, as we have heard today. I will find those figures—I agree that they will be very interesting.
Oral Answers to Questions
Nick Smith Excerpts(5 years, 5 months ago)
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Steve Brine
Yes, we are interested in access to services for all people, wherever they are on the income scheme. The hon. Lady is right to raise that issue. We need to do better on cancer diagnosis, so I would be interested to hear more about the cancer hub that she mentions.
Nick Smith (Blaenau Gwent) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)
Since 2013, when local authorities took on responsibility for these services, attendance has increased from 2.9 million to 3.3 million. Tests for sexually transmitted infections and access to long-acting contraception have also increased, which shows that people are taking their sexual health seriously and that services are responding.
Nick Smith
Unfortunately, syphilis and gonorrhoea diagnoses are up 20% since 2016. What are the Government going to do to address this growing trend, given that sexual health services are at their limit?
Jackie Doyle-Price
The evidence I have is that sexually transmitted infection rates are stable, that rates of teen pregnancy are falling, that rates of abortion are stable and that rates of HIV testing are increasing. However, the hon. Gentleman raises an important point, and I will look into it. The most important thing is not necessarily where or how people access their services, because we want to make tests and long-term contraception available online too. We will keep the issue under review.
Budget Resolutions
Nick Smith Excerpts(5 years, 6 months ago)
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Nick Smith (Blaenau Gwent) (Lab)
It is a pleasure to participate in the Budget debate. There were some announcements to be welcomed yesterday, such as the tax on big tech companies. I have been calling for those changes since my time on the Public Accounts Committee, and they are long overdue. In the round, though, this Budget fell well short of what is required. After the Prime Minister’s big talk of ending austerity, what we got was too little, too late. To get the changes we need to create jobs and prosperity in all parts of the UK, there is only one solution: a Labour Government.
Today, I want to focus on a key issue that has affected families in south Wales and on which the Government have failed to act, and that is helping people to protect their pensions. Last year I called attention to a brewing steel pensions crisis. Facing a hard deadline on their future options, British Steel pension scheme members found themselves targeted by unscrupulous pensions advisers. There were nearly 8,000 transfers out of the scheme, and we know that 872 of those were advised by firms that were eventually required to stop advising. Worryingly, one financial planner has said that the high number of compensation claims submitted against just one of those firms might be the tip of an iceberg.
Too many people saw their hard-earned pension pots put at risk, including constituents of mine who were worried sick about their future. They needed an immediate, robust and decisive response from the regulators. Unfortunately, poor co-ordination, unclear consumer information and weak oversight meant that the response for those consumers has been hesitant and insufficient. It was often unclear who they needed to approach for help. Unbelievably, they were expected to take up their concerns with the advisers they suspected of fleecing them. Pensioners researching specific advisers had to go through a lengthy process to find out basic information. They needed to search the Financial Conduct Authority’s register to decipher legal notes that were sometimes closer to double Dutch than plain English. The FCA is now making changes to its register, but it still is not giving people critical information in a straightforward enough way.
The most pressing problem remains the sorry state of financial regulation and pensions oversight. As a Work and Pensions Committee report found, while interest in steel pension transfers was increasing from late April 2017, it was not until November that the FCA began to take action. At that point, a full-scale crisis was under way. Even then, it was not until December that it was taking regular action against suspect firms. While there has been some progress, it has not been clear enough for us to give concrete answers to the people affected, or to give us confidence that this will not happen again.
Nowhere is this more evident than with one of the firms most closely identified with this scandal, Active Wealth (UK), and its director Mr Darren Reynolds. The Financial Services Compensation Scheme is paying out over £500,000 for claims related to this firm alone, yet 162 claims, many from steelworkers, are still open. Mr Reynolds failed to turn up to Parliament to answer questions. The ability of his company to advise on pension transfers was restricted and the company is now in liquidation. Despite this, Darren Reynolds is still listed as an active person on the FCA register. From my inquiries, he does not appear to have been referred for more serious investigation. What needs to be done for this sector to tackle this bad behaviour and for this character to be properly held to account?
The pensions debacle that hit steelworkers last winter should never have happened. It is a stark warning that regulating these businesses is not working well enough. It happened because we have a system of pensions and financial regulation that fails to protect hard-working people. After much criticism, the FCA and the Pensions Regulator say they are working better together, and that is a positive step. However, this is not a problem of co-ordination alone; we also need stricter penalties, better information and far tighter oversight. The Government urgently need to look at what has happened to drive improvements in the future. They need to review current regulation on pensions advice regularly, make sure that any wrongdoing is aggressively dealt with and ensure that consumer information is easy to find and to understand.
I want to include this personal plea for action. Many of my family were steelworkers or miners, and our steelworkers put in decades of toil to earn these pension pots. Some have found these pension pots put at risk because of the wrongdoing of some and the inaction of others. The Chancellor needs to put this right and to get on the side of working people.
I will end by focusing on the extreme pressure that the Government’s recent proposals on pension valuations could cause our police forces. Gwent police estimate these could cost them the same amount of money as 100 officers. The Government need to give our police more funding. Instead, however, they are forcing expensive accounting tricks on them with no notice. That is not right.
Finally, I point out that there is a better path. For a genuine end to austerity, real help for our public services, and rules and systems that work for working people and those in retirement, we need a Labour Government.
Oral Answers to Questions
Nick Smith Excerpts(5 years, 9 months ago)
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Nick Smith (Blaenau Gwent) (Lab)
I, too, welcome the Secretary of State to his new job. Today’s figures show that levels of severe obesity in children are at a record high, so will the Government speed up their childhood obesity strategy to tackle this urgent public health challenge?
Matt Hancock
We published chapter 2 less than a month ago. There is further work to do, because that sets out a whole series of areas in which we are going to take action, and I am already working on pushing it faster.
Matt Hancock
That is a great question. Not only can technology improve in health settings; there are even greater opportunities on the research side. Getting the data structures right is mission critical, but there is so much more that we can do.
Nick Smith (Blaenau Gwent) (Lab)
Matt Hancock
We announced that we will be consulting less than a month ago. I have been closely involved in this in my previous role, as well as in this one. We will ensure that we take an evidence-based approach, but I am determined that we proceed.
Adult Social Care: Long-term Funding
Nick Smith Excerpts(5 years, 10 months ago)
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Mr Betts
Absolutely. Most people receive care in their own home. The Committee’s report on housing for older people looked at the nature of the home. It showed the importance of the warmth of the home and the ability to get around the home—trip hazards and so on. Means-testing for the disability facilities grant relates to means-testing for care provision and other benefits, so they need to be properly integrated. Another recommendation in the report was that where means tests exist, they need to be joined up together.
Nick Smith (Blaenau Gwent) (Lab)
The economics of the sector are fluid. Does my hon. Friend agree that there has been a high turnover of ownership of care provider organisations? The Government need to monitor buyouts in the sector carefully, so that those living in care do not worry about who owns their home.
Mr Betts
Absolutely. The Committee did not discuss the ownership of care homes, but we did discuss the number of homes that had gone out of business or had been contracted back to local authorities. This is an ongoing and very real problem. We need not just a well-paid and well-trained workforce but viable care providers, so the money needs to be there for the providers as well as the workforce.
NHS 70th Anniversary
Nick Smith Excerpts(5 years, 12 months ago)
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Nick Smith (Blaenau Gwent) (Lab)
I beg to move,
That this House has considered the 70th anniversary of the NHS and public health.
It is a pleasure to serve under your chairmanship, Mr Hosie. The 70th anniversary of the NHS is an important time for the country, but it is also a special time for Blaenau Gwent. Aneurin Bevan, and the health service he created, was born and bred in Blaenau Gwent—in Tredegar. Since Nye’s death in the 1960s, Blaenau Gwent MPs have followed in the footsteps of a colossus. We in the borough are immensely proud and fiercely protective of his legacy. When he said he wanted to “Tredegar-ise” the NHS, he was basing his plans on the Tredegar Medical Aid Society, a mutual and an organisation established for all, supported and funded by the people of Tredegar, whether they be miners at the Ty Trist colliery, like my grandfather George, quarry workers at Trefil or nurses at the St James Hospital. If Bevan established an NHS for the 20th century, at this anniversary it is important that we ask ourselves what sort of NHS we need for the 21st century.
Nick Thomas-Symonds (Torfaen) (Lab)
I should declare an interest as a biographer of Aneurin Bevan. Before my hon. Friend moves on to talk more generally about the future, does he agree that the decision to nationalise the hospitals, and the painstaking work that Bevan did in negotiations with the British Medical Association, mean that he truly is the architect of the national health service?
Nick Smith
My hon. Friend has written a terrific biography of Aneurin Bevan. He absolutely captured what Nye did for us all.
On 5 July it will not be good enough just to celebrate the past, the history of this brilliant institution and its architect; we must also look to its future and the challenges it now faces. Many of those challenges have been created by eight years of Tory austerity, which has left our national health service underfunded, understaffed and underprepared. Labour would provide more doctors and nurses and provide a funding level to support the service for years to come. Other challenges cannot be put down to politics. The epidemics of old—diseases once fatal that we have almost eradicated—are being replaced with new health problems that are putting massive strains on our NHS. It is wonderful that people are now living longer, but that also means our population is an ageing one that needs support. As our society gets to grips with caring for our mental health, more people need access to these services than ever before.
Today I want to concentrate on another big challenge: rising levels of obesity, particularly among children. In this case, it is a challenge where an ounce of prevention can be better than a pound of cure. Back in Blaenau Gwent, surveys estimate that 70% of adults are overweight or obese and 11% are being treated for diabetes. Most troublingly, the latest figures from the child measurement programme reveal that last year 15% of four and five-year-olds in my constituency were classed as obese. We should all be worried by that trend, which is being replicated across our country.
Jessica Morden (Newport East) (Lab)
My hon. Friend is making some important points. Does he agree that we should urge Ministers to take more of a lead in restricting junk food advertising and to provide extra money and the consequentials to the Welsh health service for such things as earlier intervention by GPs and practice nurses?
Nick Smith
My hon. Friend makes an important point. As always, she is ahead of the game—I will come on to that point shortly.
Obesity is the second biggest preventable cause of cancer. Diabetes leads to significant complications, including, in extreme cases, amputation. The consequences for our society are massive. NHS England has said that around £16 billion a year is spent on the direct medical costs of diabetes and conditions related to being overweight or obese. That is more than the cost of delivering all our countries’ police and fire services combined. The Government cannot shirk their responsibility to tackle the issue head on. When the next chapter of their childhood obesity plan comes into effect, it needs an effective UK-wide public health drive. It needs to do more to deal with that priority. The 2015 Conservative manifesto pledge to clamp down on advertising unhealthy brands vanished into thin air by the time of the first childhood obesity plan.
It now looks like junk food ads may be banned from programmes where three quarters of the viewers are children. That is to be applauded. It is a good thing, but it fails to tackle the big primetime shows that families gather around the sofa for: shows such as “The X Factors” and the aptly named “Saturday Night Takeaway”. That is without mentioning, with the World cup on the horizon, the premium advertising space around sport. There is a real contradiction when fantastic displays of athletic prowess are bookended by burgers and packaged with pizzas.
Alongside others, Cancer Research UK is pushing for a 9 o’clock watershed for junk food adverts, and the Government must consider that proposal seriously. It is not only me who thinks that; the head of the NHS, Simon Stevens, thinks it would be a good way to tackle this scourge. He believes that even the likes of Facebook must be roped into any plans that limit junk food advertising. The Jamie Oliver Food Foundation suggests having mandatory training for GPs and health professionals to talk about weight in a helpful way and to refer patients to nutritional experts. Whatever the Government decide, they will need to be bold in the face of pressure from the industry heavyweights and their lobbying teams. When plans emerge from this Government, every organisation should be doing their bit.
I was pleased to see the Mayor of London, Sadiq Khan, take real steps to address junk food advertising last week with his announcement that such adverts are to be banned from the tube and bus networks. Almost 40% of London’s 10 and 11-year-olds are obese or overweight. The Mayor is taking a positive step to tackle what he has rightly called “a ticking time bomb”, and that must be supported. However, it is up to all public bodies, including devolved Administrations, councils and housing associations, to weigh in. Primary schools should promote walking every day to their pupils. It is about using soft power and nudge, as well as improved regulation to make legislative and cultural change.
Neil Gray (Airdrie and Shotts) (SNP)
The hon. Gentleman is talking about action to tackle childhood obesity and junk food adverts, and also about Jamie Oliver. He will perhaps be aware that Jamie Oliver met the First Minister of Scotland on Monday and welcomed and supported the Scottish Government’s plan to halve childhood obesity by 2030. Would he care to welcome that, as Jamie Oliver did?
Nick Smith
I am pleased to welcome that support for a UK issue that we all need to work on.
With further support, we could achieve the healthy lifestyles that so many people want by using influence and our voices. I want to round this speech off with one initiative that I think deserves real backing. It will help our society get on track to healthier lifestyles. To return to Bevan, the initiative is about harnessing community support to deliver improved health for all. Dame Kelly Holmes teamed up with the NHS and parkrun last weekend to encourage people to “take care of yourself” in the build-up to a special parkrun for the NHS on 9 June. My local parkrun group is the Parc Bryn Bach running club, and I can report what a difference such initiatives can make. After a year of running every week, my blood pressure is down and I have tightened my belt a few notches.
I am grateful for the esprit de corps of my local running club. Parc Bryn Bach has Saturday parkruns, special Sunday sessions for parkrun juniors and is a backer of the brilliant NHS Couch to 5k scheme. Just a few Mondays ago, it had 150 people running through a wet, windy April evening to get their fitness up. Over three months, many of those local people will gain confidence and a level of fitness to help them change their lifestyle. The camaraderie and support on offer is fantastic, and that is what makes these schemes fun to join and easy to keep up. Unsurprisingly, the club membership has doubled in recent years, and the coaches and volunteers include many health professionals. They are a great team. I am pleased that the Welsh Labour Government have seen the value of that. Welsh Athletics is supporting clubs with regional Couch to 5k programmes.
Gerald Jones (Merthyr Tydfil and Rhymney) (Lab)
I thank my hon. Friend for giving way and congratulate him on his passionate speech that marks this historic anniversary and the part that his constituency and the wider south Wales region played in the formation of the NHS. Does he agree that in order to tackle our modern health challenges it is important that we have further investment and that the UK Government match the Welsh Government’s passion and commitment to this most cherished national institution?
Nick Smith
As usual, my hon. Friend and neighbour makes a very good point. I went on his Merthyr parkrun a few months ago and had a good time.
Nick Thomas-Symonds
I join my hon. Friend in congratulating all those involved in parkrun. Will he join me in congratulating the volunteers who make parkrun possible in his constituency and in mine in Pontypool and Cwmbran, where I too have taken part in parkruns, but I have not quite reached my hon. Friend’s running level yet?
Nick Smith
I thank my hon. Friend for supporting parkrun. Perhaps we should have a south Wales eastern region parkrun championship at some point in the coming months. He is absolutely right about volunteers and the running club supporters who are out there at 9 o’clock on a Saturday morning, or sometimes on a Sunday morning for the junior parkrun, in parks all across the country. They do a great job in all weather. It is brilliant to see. More than 30,000 runners took part in parkruns in Wales alone last year. It is that sort of activity with cross-body support and backing from our community role models that can make a big difference to making such schemes stick.
When Nye wanted to Tredegar-ise the national health service, he wanted a service built on community where we all bought in and all had a stake. In that spirit the public health challenges we face 70 years on should not be tackled alone. To truly take care of ourselves, we need a society that sets us up for success, a system that has our backs, a public service that recognises what needs to be changed and how to do it. The Government have a real chance to honour the anniversary of the national health service in the months ahead, not with pomp and ceremony, but with the sort of action that people will celebrate another 70 years from now.
Stewart Hosie (in the Chair)
Numerous Members wish to speak and I intend to start the summing-up speeches at about 10.30. Members are not particularly time limited, but speeches of six or seven minutes will get everybody in.
Nick Smith
I thank my comrades and other colleagues for their contributions. I agree with the Minister that it was good to hear a Rabbie Burns poem emphasising good health. My hon. Friend the Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) praised health service workers, and I was pleased to hear that his mum is better and at home now.
My hon. Friend the Member for York Central (Rachael Maskell) emphasised the enormous contribution that Tessa Jowell made to her career. I too would like to support and emphasise that. From the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) we heard about the huge difficulties of getting healthcare on the Scottish islands before 1948. He supported the then Attlee Government’s legislative jewel in the crown: the establishment of the NHS. I thank him for that.
My hon. Friend the Member for Bristol South (Karin Smyth) emphasised the importance of William Beveridge and the thinking he did to address the five “giant evils” in 1942. That was important for our Labour Government after the second world war. I was pleased to hear from the hon. Member for Airdrie and Shotts (Neil Gray) about the Scottish Government’s plans to halve child obesity. I support that, and of course it should be done everywhere. I was also pleased to hear that our parliamentary running group is getting stronger weekly.
I was glad to hear the Minister emphasise the importance of addressing child obesity, but we really must do better. I will not accept his political barbs about the NHS across our country. I remind him that Churchill and the Conservatives voted against the establishment of the NHS in 1948, and that crucial fact is never forgotten—certainly not in my constituency. I want to praise Nye and the people of my constituency for helping to establish the national health service. We on the Opposition side will guard it with every muscle in our bodies.
Question put and agreed to.
Resolved,
That this House has considered the 70th anniversary of the NHS and public health.
Austerity: Life Expectancy
Nick Smith Excerpts(6 years ago)
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Chris Ruane
I agree. All those issues are part of the mix as to why we are seeing a decrease in life expectancy. It is a complex issue that needs further inquiry.
Chris Ruane
I am afraid that I must move on, because I have been getting eyes from the Chair and I do not want to upset Mr Paisley.
The Government have said that the situation is a blip because of flu or the cold weather. The Department of Health has seemed to downplay fears about life expectancy, pointing out that smoking rates have gone down and cancer rates have gone down, but that is all the more reason to be worried. If those indicators are going down and life expectancy is going down, what is causing that? Those are good indicators, but there are some bad outcomes for certain people in certain areas.
A report by Professor Martin McKee, whom I had the pleasure of meeting yesterday, notes that the most recent period
“has seen one of the greatest slowdowns in the rate of improvement”
in life expectancy
“for both sexes since the 1890s”.
The relative data on life expectancy today is comparable to a time before workers’ rights, advancements in medicine and technology, and the welfare state. That slowdown, as reported by the Office for National Statistics last July, shows that the increases in the previous period, before 2010, meant that for every five years that a woman was living, she could expect to live one year extra. Now it is the case that for every 10 years that a woman is living, she can expect to live one year extra. The rate has been halved.
Let me add to those figures some of my own, which I received through parliamentary questions that I tabled in January. Between 2009-11 and 2014-16, 19.8% and 20.3% of local authorities reported a decline for females at birth and at 65-plus respectively. There are certain areas of the country, certain demographics and certain genders—women—who are feeling this the most. That is no surprise, because 80% of the austerity cuts made since 2010 have fallen on the shoulders of women. The link between life expectancy and cuts to social care budgets has already been highlighted.
The hon. Member for South West Bedfordshire mentioned Scotland. I do not want to stick up for the Scots: they can do a good job themselves, especially the hon. Member for Central Ayrshire (Dr Whitford), with her medical background. However, there are national and regional variations within the United Kingdom. If we look at local authorities in England, we see that 22% of them have seen a decrease in life expectancy.