Breast Cancer Screening

Owen Thompson Excerpts

Wednesday 16th December 2020 Westminster Hall

[Owen Thompson (Midlothian) (SNP)]

It is always a pleasure to serve under your chairmanship, Sir Edward. I thank the hon. Member for High Peak (Robert Largan) for securing this important debate. It is also important to thank all the NHS staff who are working so hard to keep services running during this difficult time, and the cancer charities working to keep funds coming in and awareness high, and to support those living with a cancer diagnosis. High-profile breast cancer awareness events such as the “wear it pink” photocalls that we are all so used to were lost to the virus this year, so there is a lot of ground to make up to keep the UK’s fourth biggest killer high on the political agenda.

Thanks to a combination of advances in the medical sciences, treatments, early diagnosis and screening, breast cancer survival has doubled in the last 40 years, but the necessity of disrupting routine screenings has created a danger of progress taking a significant step backwards. There are immense challenges, now, for the NHS, in meeting an influx of demand, when we are clearly still in the teeth of the pandemic. As members of the Royal College of Radiologists report, challenges are made all the tougher by the extra infection control methods needed at screening centres, limited availability of space because of distancing, and, at times, staff and equipment shortages because of redeployment.

As other hon. Members have said, Breast Cancer Now estimates that nearly 1 million women in the UK missed potentially life-saving mammograms because of covid-19. There was also a marked fall in the number of urgent breast cancer referrals from GPs during the pandemic. That was due to a range of factors, including reluctance to take up the scheduled appointments, worry about catching the virus, or a lack of awareness that while routine screenings were paused the majority of cancer treatment services continued throughout. According to Macmillan Cancer Support, 100 fewer women started treatment for breast cancer each working day in May and June 2020, compared with a year ago. It estimates that there are 50,000 missing cancer diagnoses across the UK because of covid-19 disruption.

Those are serious causes for concern. Cancer patients cannot be allowed to be collateral damage as we struggle to fight the pandemic. All of us have a role to play in encouraging take-up of opportunities for screening, self-checks and getting out the message that the NHS is there for people if they are worried about cancer. Covid continues to dominate the headlines, but the NHS has never stopped prioritising cancer cases.

Governments also have a role in communicating about cancer services, and making sure that there is investment in facilities and staff in the NHS cancer workforce. As the RCR reports, the clinical radiology workforce was already under strain before the pandemic. One in four English trusts has at least one vacant consultant breast radiologist post, and the UK has fewer CT and MRI scanners than the majority of comparable OECD countries. Decisions about the NHS are made by the devolved Government in Scotland. Thankfully, the Scottish Government are working to minimise disruption in the face of the covid-19 challenges. They have invested an additional £10 million to support cancer treatment throughout the pandemic and beyond, in addition to purchasing six additional MRI scanners and three additional CT scanners to aid cancer diagnosis, at a cost of £5.6 million.

There is much to be done, but I welcome the fact that there has been an 89.6% increase in consultant oncologists in Scotland under the current SNP Administration and a 54.4% increase in consultant radiologists. Early detection will also be improved by more GPs. Scotland has 76 GPs per 100,000 population, compared with the UK average of just 60. There are also two new early cancer diagnostic centres, which will be opened in the spring of next year.

I have a great deal of sympathy for the request to extend screening to younger men and women in the petition that we are debating today. It is always heartbreaking to hear of cases that are not diagnosed early enough, leading to long battles to fight the disease and a greater chance of lives being lost too early. We know the risk is related to age and is highest in women over 50—they account for 80% of cases—but that is cold comfort to the 10,000 women under 50 and the 370 men in the UK who receive the dreaded diagnosis each year. Catching this disease early is essential to saving more lives. I would back screening for all in a heartbeat if it was justified clinically, but it is just one tool in the toolbox and it is not always the best one to use.

There are harms as well as benefits to getting mammograms, and decisions on routine screening programmes are all about getting the balance right. The four nations of the UK all take advice on screening from medical experts at the UK National Screening Committee and the Scottish Government concur with the points made in the UK Government’s response to the petition.

If there is one thing that the pandemic should have taught politicians—perhaps even the Chancellor of the Duchy of Lancaster—it is that we should be listening to experts. Their views are so important. It is the scientists and clinicians who are guiding us through the pandemic and providing hope for a solution through their incredible efforts to find treatments and vaccines. So, too, should we trust evidence on screening. The Marmot review of the benefits and harms of breast cancer screening identified overdiagnosis as one of the dangers, stating:

“The consequences of overdiagnosis matter, women are turned into patients unnecessarily, surgery and other forms of cancer treatment are undertaken, and quality of life and psychological well being are adversely affected.”

Only 1% of cases involve men. There is a need for us to focus on messaging and spread the awareness that breast cancer is possible for both sexes, although at a far lower risk for men. Perhaps we all need to do that bit more to highlight that point, to make sure that men self-check and seek treatment where necessary.

Although there is largely consensus on the science, there is perhaps more divergence on these isles about the resources needed. Warm words about tackling cancer are easy, but they need to be backed up by sustained and substantial further investment. Ahead of November’s comprehensive spending review, the SNP called on the Government to increase funding for NHS England to match per capita spending in Scotland. That would have amounted to a £35 billion increase by 2023-24. The £3 billion offered for the next year is only a third of what we have been calling for on a yearly basis. After a decade of austerity, the sum is not even enough to cover the cost of outstanding hospital repairs in England, let alone recover from the coronavirus and deliver decent cancer care moving forwards.

I urge the UK Government to do all they can—to “build back better”, to borrow their phrase—and to properly and genuinely invest in the NHS to save lives.

Mental Health Support: Frontline Staff

Owen Thompson Excerpts

Thursday 8th October 2020 Westminster Hall

[Owen Thompson (Midlothian) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing the debate. It is important to focus on mental health, and today we have a great opportunity to do that. I know that my hon. Friend brings a wealth of invaluable professional experience to the topic, which I cannot begin to understand.

In mental health, as with other aspects of health, time needs to be dedicated to caring for and looking after people, to reduce the chances of someone becoming seriously unwell. If we relentlessly push our bodies every day we soon pick up physical ailments, stresses and strains, and they can develop into something more serious if they are not given time to recover. Our bodies will send signals telling us to stop before we collapse, and the same goes for our minds. Downtime is not a luxury. It is essential, and we all need to be able to read the signs before reaching breaking point. The brain is an unbelievably complex organ, and is constantly processing something even more complex—human experiences and emotions. I am amazed that it does not go down, and that something does not go wrong with it, more often.

On the frontline, our carers and health staff have faced the brunt of the pandemic response. We may moan about working from home, or not being able to go to the pub or to see friends, but they see people scared, alone and in pain, gasping for breath. They see families unable to get close enough to offer their loved ones the most basic human comfort—a hug. Dealing with that every day takes its toll.

[Siobhain McDonagh in the Chair]

The World Health Organisation reported a recent review of healthcare professionals finding that one in four was suffering from depression and anxiety and one in three had insomnia during the coronavirus outbreak. There was also an appalling rise in verbal harassment and discrimination and physical violence. No wonder they are battle-scarred.

Switching off from work is made even harder by the fear of being a spreader, which leads to increased isolation when what we need is social comfort and community. Like all of us, frontline staff cannot access the habitual escape routes that we used to take for granted, whether that might be going out for a drink with friends, to the theatre or to live music, or experiencing the warmth and excitement of the crowd at a football match. Those things just are not possible just now. With NHS resources cut by years of austerity, staff were already working at or beyond capacity before the pandemic, so they had to find a whole new superhuman reserve of energy when the crisis struck. Sheer willpower, determination and dedication keep the staff going and I cannot thank them enough for that, but after eight months with no end in sight more and more of our critical staff are getting to breaking point, traumatised, running on empty, and mentally as well as physically exhausted.

In those serious circumstances it is essentially the responsibility of Government to make sure that there are adequate levels of professional mental health support in place. We need more than a website, an app and a few choicely worded paragraphs in a staff handbook, although all sources of information are very welcome. Any port in a storm, I suppose we could say. We need more trained psychologists and counsellors available to provide tailored support—human faces with experience and expertise in their field. We need to make sure that people are able to talk and share experiences with others, to be listened to, get a bit of breathing space, and be guided to get more help and treatment whenever they cannot cope.

I know that NHS England, like the Scottish Government, brought in helplines to help staff dealing with covid-19. I welcome those efforts. The Scottish Government also established the national wellbeing hub in May for health and social care staff, which takes a psychological first-aid approach, with resources on self-care and 1,000 hours of coaching for staff to maintain health, wellbeing and resilience. I believe that it is the first of its kind in the UK and I know from the feedback that I have had that it has been a welcome move.

I am pleased to see that the national wellbeing hub includes a section for unpaid carers, because the Carers Trust found that 68% of young adult carers in Scotland said their mental health was worse as a result of coronavirus, and 85% were worried about their own future. Those 12 to 17-year-olds, who already have responsibilities beyond their years, are living in an age of anxiety unimaginable when all of us in the Chamber were their age. I recently hosted a virtual meeting with young people in Midlothian to talk about their lockdown experiences and concerns, and it was deeply worrying to hear how many issues they raised, including those related to their mental health, and how little they felt listened to by many of those in power.

Health & Safety Matters reports that a survey

“into the mental health of frontline staff and healthcare professionals has revealed that over 90% believe there is not enough mental health support available for the general public to deal with the aftermath of the pandemic and 66% felt there is not enough workplace support for healthcare professionals and frontline staff.”

We rightly call our frontline workers heroes, and we admire their courage and dedication, but those in Government need to look after them and not just praise them.

It is good to see carers, who have insultingly been called “low-skilled” by some in the Government, getting the recognition they deserve, but most key workers do not have a choice but to keep going. They would rather not risk their mental or physical health for a care badge or a clap. They should be proud of their jobs, but pride does not pay the bills or keep them and their loved ones safe. I suggest the best thing the Government could do is to find an appropriate way of honouring those heroes in our NHS, care sector and essential services who work tirelessly day after day to defeat coronavirus and look after all the rest of us.

Oral Answers to Questions

Owen Thompson Excerpts

Tuesday 6th October 2020 Commons Chamber

[Bill Esterson (Sefton Central) (Lab)]

What assessment he has made of the effectiveness of local restrictions on reducing the rate of transmission of covid-19.

[Owen Thompson (Midlothian) (SNP)]

What assessment he has made of the effectiveness of lockdown restrictions on limiting the second wave of covid-19.

[Judith Cummins (Bradford South) (Lab)]

What assessment he has made of the effectiveness of local restrictions on reducing the transmission of covid-19.

--- Later in debate ---

[Matt Hancock]

We are, as the hon. Gentleman said in his question, putting money into local councils in areas where local action needs to be taken. We have an open dialogue with councils and local mayors about what needs to be done. But I urge him, on behalf of all of his constituents in Sefton, that it is better to support the whole effort to control this virus, not just part of it.

[Owen Thompson]

The Mayor of London has warned that the virus is now spreading widely again across London, although vital knowledge is being hampered by the problems with test and trace. Are the Government now looking at introducing wider restrictions across London? As a matter of interest for this House, will the Cabinet Secretary, as a part of that, commit to reintroducing a hybrid Parliament in such a situation?

[Matt Hancock]

I discuss these matters with the Cabinet Secretary and other colleagues across government all the time, and I also speak regularly to the Mayor of London. We maintain vigilance over the transmission of the virus right across the country.

Covid-19

Owen Thompson Excerpts

Tuesday 12th May 2020 Commons Chamber

[Owen Thompson (Midlothian) (SNP) [V]]

I begin with an observation: there had been a consistent approach across the four nations, but, at a time when clarity is critical, we find ourselves in a situation where three of the four nations of the UK are still trying to be clear, consistent and cautious in their approach to tackling and beating the coronavirus pandemic; it is a great pity that the Prime Minister muddied the waters so badly over the weekend. While it is absolutely the Prime Minister’s right to change from a very clear “Stay at home” message to the imprecise “Stay alert” message for England, it is irresponsible to spread the change in the media as if it applied collectively across the entire UK without even consulting the Scottish, Welsh or Northern Irish Governments. This is a public health matter that is rightly being considered by the devolved Administrations on the basis of scientific evidence. It seems that the UK Government’s idea of a four nations approach is less about working respectfully together and more about, “Do as we say.”

The advice in Scotland remains clear. For the avoidance of any doubt, I will reiterate it here: stay at home, protect the NHS, save lives. While the pandemic has undoubtedly brought challenges, it has also brought out the best in our communities. From fundraising to helping neighbours to the willingness of our communities to help, it has been incredible, nowhere more so than in my own Midlothian constituency, with resilience groups in Bonnyrigg and Lasswade, Dalkeith and Woodburn, Danderhall, Eskbank and Newbattle, Gorebridge, Howgate, Loanhead, Newtongrange, Penicuik, Roslin and Bilston, Rosewell and the Tynewater area. I make particular mention of the Mayfield and Easthouses community resilience team, which has so far delivered more than 3,550 hot meals to elderly and vulnerable members of our community. There will undoubtedly be other amazing examples of help and support, and Midlothian Council’s #KindnessMidlothian campaign is certainly well-named to reflect that.

I also for the most part welcome the Treasury’s response to this pandemic, although there are many areas that still need to be addressed. I welcome the business support that has been put in place by the Chancellor and his efforts so far to resolve problems that have emerged with the schemes, but a lot more urgently needs to be done to help those still left behind. I have many constituents who have yet to receive any support and who had a viable business but cannot get a loan to see them through. The business interruption loan scheme is too cumbersome, and too many banks are still failing to lend. While the bounce-back scheme tackles some of those issues for smaller businesses, the reports that I have heard suggest that it remains far from a streamlined process, and there are only five accredited lenders compared with 50 for the interruption loan scheme. There is also still the issue of support for the self-employed, particularly those who left a good job to run their own business.

I welcome the extension of the furlough scheme announced by the Chancellor earlier today and the suggested flexibility. I am keen to see the detail of that much more clearly. As we move forward, we need to ensure that protection remains in place for those who need it. At the end of the day, I argue that the best and most flexible support that could be put in place would be for the Government to introduce a universal basic income and genuinely ensure that nobody is missed through these tough times.

Protecting people’s lives while they are protecting their livelihoods is a complex matter. One size does not fit all and a degree of flexibility to suit differing circumstances is needed from Government—flexible support and flexibility over strategy in the different parts of these isles. I welcome the more cautious approach from the Scottish Government in easing lockdown. I advise the UK Government to take a similar approach. I appreciate that they would choose not to, but they must respect the devolved settlement and not undermine the clarity of message we have here in Scotland.

Oral Answers to Questions

Owen Thompson Excerpts

Tuesday 5th May 2020 Commons Chamber

[Owen Thompson (Midlothian) (SNP)]

What discussions he has had with Cabinet colleagues on support for the further and higher education sectors during the covid-19 outbreak.

[The Minister for Universities (Michelle Donelan) [V]]

I take this opportunity to thank all staff in the further and higher education sector for their hard work in responding to this unprecedented challenge. I reassure the House that we have protected grant funding for the FE sector for the full year, and we will provide additional targeted support. Yesterday, we announced an HE package of measures to boost support for students, stabilise the admissions system and ease pressures on universities’ finances.

[Michelle Donelan]

We understand that this is a difficult time for everyone, including students, which is why we have worked with the Office for Students to help providers. We have reallocated funds totalling £46 million for April and May for hardship funds for students. On accommodation specifically, we have sent the clear message that accommodation providers need to be fair and transparent in their policies for students. The Treasury has announced additional measures to protect renters who are tenants.

[Owen Thompson [V]]

Researchers at the University of Edinburgh’s world-leading Roslin Institute in my constituency are at the very heart of the global fight to find solutions for covid-19, but such higher education institutions are struggling to get the support that they need through existing Government schemes. Given the complexities of the funding models for higher education and the immense impact of the lockdown on such institutions’ current and future finances, will the UK Government provide a support package specifically tailored for jobs in the higher education sector, to support the economy and their covid-19-fighting efforts? What additional support is the Minister seeking to support research groups throughout the UK?

[Michelle Donelan]

We should not underestimate the impact of the package that we announced yesterday, which builds on the Treasury announcement that universities are eligible for Government financial support worth at least £700 million. This package also brought forward £100 million of research funding. We have also brought forward £2.6 billion in tuition fees to help with cash flow. Most fundamentally, this is a package that is designed to stabilise the higher education sector and safeguard it as a whole.

Covid-19 Update

Owen Thompson Excerpts

Tuesday 24th March 2020 Commons Chamber

[Matt Hancock]

Although I was not in the Chamber, I heard the comments that my right hon. Friend the Chair of the Health and Social Care Committee made about this yesterday, and he is right to push on this issue. I am not going to give him a date today, because we are in the middle of buying the tests that are needed, especially the new tests that have just come on stream. I have been able to give him the update that we have now purchased millions of these tests, which will arrive in the next days and weeks. I will be in a position to give him a more concrete timetable, and I will make sure he gets that as soon as we can make it public.

[Owen Thompson (Midlothian) (SNP)]

I extend our continued thanks and gratitude to all who are working around the clock to help keep us all safe, and to look after us and the most vulnerable in our communities. I also extend our thanks to the millions of people who have already acted on the Government’s advice to stay at home. The importance of that cannot be stressed nearly enough, because that is what we all need to do to protect our friends and families and the vulnerable people in our communities. It is deeply unfortunate that some employers, such as Sports Direct, seem to be acting in an entirely irresponsible manner, and I welcome the Secretary of State’s comments about that.

In looking to see what more we can do, will the Secretary of State outline when he expects all frontline NHS staff to have the PPE that they need? We need to do everything we can to support them, given the extent of the risks that they are facing. How many additional ventilators have we managed to procure since the Prime Minister put out the call to manufacturers? Are the Government planning to accept the EU’s offer to share in central procurement of ventilators, testing kits and PPE?

Scotland has a number of qualified doctors and nurses who arrived in the country during the refugee crisis. Will the Secretary of State commit to talking to the Home Secretary about what possible actions could be taken to relax the existing rules, to allow those qualified medical professionals to support the country that they have adopted as their home?

In the light of the outcome of the Keeling study, which was published by the Government on 20 March, is the Secretary of State ensuring that we have rapid and effective contact tracing? The review showed that such action could reduce the number of people infected by each case from 3.11 to 0.21, and that would be a significant step towards greater containment of the current outbreak.

Finally, I stress to the Secretary of State the need to impress on other Cabinet members the urgency of finding support for the self-employed, who are still waiting to find out what position they will find themselves in. We know that people with no financial backing come under pressures that may have an impact on their health, which would put further pressure on the system.

[Matt Hancock]

On the last point, there was an urgent question about exactly that issue. It really is a matter for the Treasury. The hon. Gentleman is right that contact tracing is incredibly important, and the amount of contact tracing that we have done is one of the reasons why we have managed to be behind other European countries in the curve. At this stage in the epidemic, it is not possible to have contact tracing for everybody, as we can when there is a very small number. We are looking at how we can do that better and enable individuals to contact trace, including by using technology.

The hon. Gentleman asked about refugees. I do not know whether he was in the Chamber yesterday, but that subject was brought up and I said that I would look into it. I will get back on that as soon as I can.

The hon. Gentleman asked about the number of ventilators. We started with around 5,000 and we now have more than 12,000, which we have bought. We have also made the call to arms for manufacturing capability to be turned over to ventilators, and that has been very successful.

I strongly endorse and support the backing of the Scottish Government and the SNP in the UK-wide approach to getting the message out to everybody that the most important thing anybody can do is stay at home.

Oral Answers to Questions

Owen Thompson Excerpts

Tuesday 10th March 2020 Commons Chamber

[Brendan O'Hara (Argyll and Bute) (SNP)]

11. What assessment he has made of the potential effect of the proposed points-based immigration system on the provision of health and social care.

[Owen Thompson (Midlothian) (SNP)]

23. What assessment he has made of the potential effect of the proposed points-based immigration system on the provision of health and social care.

[The Minister for Care (Helen Whately)]

The points-based immigration system is designed so that the UK can attract the brightest and best individuals to work here. As the hon. Member no doubt knows, jobs where there is a recognised shortage of supply, such as nurses, are on the shortage occupation list, and people filling those roles will score more than enough points to come to the UK. We are also introducing the NHS visa to make it easier for doctors, nurses and health professionals from all around the world to come to work here.

[Helen Whately]

I thank the hon. Member for his question. I am in contact with stakeholders, as a relatively new Minister in this post, reaching out as much as I can. I am mindful of concerns about vacancy levels but absolutely committed to making sure that, across health and social care, we have the workforce we need.

[Owen Thompson]

Not only do this Government treat the Scottish Government with contempt, but they treat their own Scottish Tory colleagues in the same way, as they were reportedly livid about the points-based immigration system introduced. Given the implications for health and social care staffing in Scotland, will the Minister ask Cabinet colleagues to reconsider our proposals for a Scottish visa?

[Helen Whately]

We have the NHS visa, which applies to the whole United Kingdom. The Migration Advisory Committee has been clear that UK immigration policy must benefit the whole UK, and Scotland benefits from its own shortage occupation list, which will continue to exist.

Oral Answers to Questions

Owen Thompson Excerpts

Tuesday 13th October 2015 Commons Chamber

[Mr Jeremy Hunt]

I thank my hon. Friend for her great interest in this issue and for the campaigning she did before entering Parliament, which I know stemmed from personal tragedy. This is an incredibly important issue. We face a crisis in global healthcare as a result of anti-microbial resistance, which means the current generation of antibiotics is no longer as effective as it needs to be. Proper hygiene in hospitals is therefore vital, and we have a lot of plans that I will be happy to share with her.

[Owen Thompson (Midlothian) (SNP)]

T7. What measures is the Secretary of State putting in place to recruit and retain GPs? Given that he has indicated recruiting 5,000, where does he plan to find them?

[Alistair Burt]

As part of the proposal to see an increase of 5,000 in the number of doctors working in general practice by 2020, work is being done not only to recruit more, but to retain them and to bring back those who have left general practice but want to return. Health Education England is working with the Department on all these plans and proposals. The hon. Gentleman is right to identify that as a key source of those who will come into the service in future.