ME: Treatment and Research

Patrick Grady Excerpts

Thursday 21st June 2018 Westminster Hall

[Carol Monaghan]

I will come on to the NICE guidelines. They are under review, and all politicians can help with that. I have already written to NICE about the issue and I will ask the Minister about that later.

We now know that 13% of the participants in the PACE trial qualified at baseline as “recovered” or “within the normal range” for one of the study’s two primary measures—self-reported physical function—even though they were classified on the same measure as disabled enough to enter the study. That anomaly, which occurred because the investigators weakened key outcome thresholds after data collection, invalidates any claim that patients recovered or got back to normal. The overlap in entry and outcome criteria is only one of the trial’s unacceptable features.

For patients, the impact of PACE is severe. The recommendation of GET as a treatment for ME has provoked a backlash from patient groups, who report that many people with ME end up more severely disabled after a course of GET than before. I have spoken to people living with ME who have tried to do GET because they are so desperate to get better and have ended up in a wheelchair or bedbound as a result of this programme.

[Patrick Grady (Glasgow North) (SNP)]

I congratulate my hon. Friend on securing the debate. The turnout shows the significance of this issue to all our constituents. Her point about GET is important. It seems perverse that people should be forced to take a course of treatment that patently makes their condition worse. Does she agree that that must be reviewed?

[Carol Monaghan]

Indeed. Many people have written to me about their experience of GET, but some of the most upsetting examples are of children who were forced through a programme of GET and ended up with life-changing disabilities as a result.

Surgical Mesh

Patrick Grady Excerpts

Thursday 19th April 2018 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I congratulate the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing the debate through the Backbench Business Committee. I took part in a powerful debate on the issue in Westminster Hall, and I am delighted that time has now been made available on the Floor of the House. I commend all those involved with the Sling the Mesh campaign and the all-party group, and I commend the hon. Member for Pontypridd (Owen Smith) for the leadership he has shown. This issue is finally getting the attention that it deserves. Like most Members, it was brought to my attention by a constituent who has been affected first hand, and I wish to reflect on some of the experiences and points that she shared with me, as well as considering broader policy issues on which I hope the Minister will respond.

Other Members have already mentioned ventral mesh rectopexy, which has not been included in the UK Government’s proposed audit. Sling the Mesh’s campaign research shows that 7% of its members have been affected by that specific procedure, and there is a certain amount of disappointment that it does not seem to have been included. As the Minister might know, I have written to the Secretary of State about that concern, and asked the Government to think again, particularly given the number of people affected and the devastating effect that this has had on their lives.

I also raised concerns about the need for a hospital episodes code to be allocated to that procedure. Without one, it is difficult to keep track of the number of people affected, and we have already heard about the problems arising from the lack of information about the exact number of people affected by the procedure and the mesh more generally.

There are also concerns that some recent National Institute for Health and Care Excellence guidelines might have been rushed through, partly in response to media attention, which only adds to the argument for a full and comprehensive audit that includes all types of mesh procedure.

The health service is devolved in Scotland, where there is a slightly different situation. In 2014, the Scottish Government requested a suspension in the use of medical mesh by the NHS in Scotland pending safety investigations, and in 2015 the Cabinet Secretary for Health, Wellbeing and Sport, Shona Robison, apologised to women who had been left in severe pain by such operations. Between 2009 and 2016, the number of women receiving mesh surgery in Scotland fell from 2,267 to just 135.

An independent review published in March last year in Scotland made eight recommendations, notably that surgical mesh implants should be used only after all other appropriate alternatives have been exhausted, and—crucially—only when women have given their fully informed consent. Scotland’s chief medical officer accepted the recommendations of that report in full, and has been clear that the requested suspension in the use of mesh implants should remain in place until she is satisfied that all recommendations have been implemented. That means that all women in Scotland who want treatment for urinary incontinence or pelvic organ prolapse should be offered the full range of options available, and they should be fully informed of the benefits and risks associated with those procedures.

Regulation of these devices is reserved, however, and operates at UK-wide level, which is why calls for a UK-wide national clinical audit and database for recording device identifiers are so important. Scottish Government officials are working with UK colleagues to consider the possibility of an automated implant registry, which would allow unique device identifiers to be entered on the patient’s electronic record. As the Minister will know, the now Cabinet Secretary for Health and Sport has written to the Health Secretary to suggest a UK-wide woman’s health summit. That would allow the NHS, and relevant decision makers across the United Kingdom, to work constructively on a range of issues.

I wish to raise other aspects of regulation, and particularly EU regulation on medical devices 2017/745. That will change mesh implants for long-term or permanent use from a class IIB to a class III device, meaning that they are generally regarded as high risk. The regulations will not take full effect until 2020, which is after the Government’s preferred date for Brexit. How will important EU regulations that monitor the use of devices across EU territories be implemented or reflected in UK law and regulation after Brexit? It is important that standards are maintained to the highest possible level.

Campaigners such as my constituent are concerned about the current process of what could be called post-market vigilance, and whether some of the devices are subject to testing that is rigorous enough before they are rolled out to the market. There is a genuine concern that device manufacturers have a profit motive to develop their devices and get them on the market as quickly as possible, although equally, they have a fear of litigation, which is why better and stronger regulation from the start is key.

The risks associated with surgical mesh implants were tragically misunderstood and underestimated by healthcare providers and professionals who provided the treatment, and by patients whose lives have been so badly affected by chronic and debilitating pain. I welcome the conclusions and recommendations of the Scottish and English reviews of this procedure, which must ensure that surgical mesh implants are used only after all other appropriate alternatives have been exhausted and—crucially—only when women have given their fully informed consent.

I hope that Ministers will be willing to work with their counterparts in the devolved Administrations and consider a UK-wide summit on the issue and women’s health more generally. I will finish as I started by paying tribute to my constituent and all campaigners for their bravery and courage in ensuring that this issue has been brought to our attention. It is them we must thank for the small and belated progress that has already been made, and for them we must continue to hope for more and faster progress in future.

Autism

Patrick Grady Excerpts

Thursday 29th March 2018 Commons Chamber

[Chris Stephens (Glasgow South West) (SNP)]

It is a pleasure to follow the hon. Member for Cardiff West (Kevin Brennan). I want first to place on record the fact that many of my constituents have contacted my office and urged me to attend this debate. Many of them have sent emails expressing how much it would mean to them if their Member of Parliament were to attend the debate. I am glad to see so many other hon. Members here as well.

When I was first elected, one of the first things I introduced in my constituency was a surgery specifically for carers. That is important for carers of people with autism, because they often face issues in isolation, including education, social and social security issues. Sometimes, those issues are not faced in isolation; they can become combined. That is why I introduced a specific surgery for carers, so that we could look at all those issues in combination, rather than dealing with them separately.

I want to raise a matter that has not yet been mentioned—namely, the difficulties that those with autism and their carers have when navigating their way through the social security system, particularly the personal independence payment application process. I have a constituent, Mrs Geraldine Lynch, who attended a PIP assessment with her son Jordan, who has autism. Mrs Lynch has said that the descriptions of her son in the reports that came back from the assessment process and the mandatory reconsideration process were unrecognisable. Perhaps they were the wrong files, describing the wrong individual, or perhaps my constituent was misdiagnosed and not given a proper PIP assessment.

My real fear about the PIP process is that far too often there is a lack of specialism among the assessors and a lack of understanding of specific conditions. My experience of my constituency workload tells me that that also affects those who suffer from autism. I encourage the Government to look specifically at ensuring that assessors of PIP, employment and support allowance and other benefits include a specialist on autism and related conditions. That is very important if we are to help those people.

There have been some positive developments in my constituency. One of them relates to my constituents Debbie Elliott and Claire Ellis, who have launched a support group called the Triple A Parents and Carers Support Group in Govan, and I would like to thank the Govan Housing Association for providing free space in its hub to allow the group to organise. It runs a drop-in every Friday. The purpose of the group is to allow parents and carers facing the same issues to share their experiences and to give each other advice, information and support. It is important that carers of those with autism and other related conditions have that kind of support, and the number of support groups is growing in my constituency and elsewhere. They allow support and the sharing of information and experiences, which helps other individuals. Added to that, on the Pollok side of my constituency, Differabled Scotland is organising a parent-to-parent peer support group for parents and carers of children, young people and adults.

[Patrick Grady (Glasgow North) (SNP)]

My hon. Friend has mentioned Differabled Scotland. Some of the people who run that organisation are constituents of mine, and I had a powerful meeting with them during the general election campaign last year. It is clear that the amount of support needed for people with autism is growing, and the work of Differabled Scotland is particularly valuable because it provides a peer support network of parents and carers of children of all ages. It does very valuable work.

[Chris Stephens]

I thank my hon. Friend for that intervention. I, too, met organisers from Differabled Scotland a couple of weeks ago, and it was an excellent meeting. It is quite inspiring that there is peer-to-peer support and that people are sharing their experiences. Both the organisations that have been launched in my constituency are important.

It is also important for people to have access to welfare rights officers, and those officers are in attendance when these groups meet to help people to navigate their way through the various issues that I have mentioned, particularly those relating to social security support. Those groups that are now getting up and running also need funding, and I would like to ask the Minister what kind of funding the Government are planning to put in place to help those peer support groups to grow. What kind of finance will be available to them? I pledge to help them to get the necessary finances, so that they can continue to support carers and parents and help their organisations to grow.

World Antibiotics Awareness Week

Patrick Grady Excerpts

Thursday 16th November 2017 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

I beg to move,

That this House has considered World Antibiotics Awareness Week.

It is a privilege to serve under your chairmanship, Mr Davies. Exactly one century ago, Ernest Rutherford split the atom and humanity entered the nuclear age. The groundbreaking discovery represented a momentous step forward for human progress, but at the same time it unleashed a challenge for those beyond the laboratory and academia—the avoidance of mutual assured destruction. As this debate is about World Antibiotics Awareness Week, some might wonder why I started with the splitting of the atom, but I believe that there is an equally strong argument for the aforementioned period to be referred to as the antibiotic age. It was 11 years after the splitting of the atom that Sir Alexander Fleming discovered penicillin, here in this very city of London.

No one can deny the profound impact of antibiotics on medicine, and their widespread use represents a watershed moment in our evolutionary story. However, as Fleming himself understood, shortly after making his discovery, giant leaps in scientific progress produced wholly new challenges. As antibiotics were readily available, it appeared that we had invented miracle drugs of sorts. The snag is that we now face the real and severe threat of antimicrobial resistance.

Across the globe this week, scientists and healthcare professionals are hosting a wide range of events to make antibiotic resistance a globally recognised health issue. I am delighted that we as parliamentarians are here today to represent the role that lawmakers and Governments will play in facing the challenge of antibiotic and antimicrobial resistance. The week is also intended to raise awareness of the need to preserve the power of antibiotics through appropriate use, to increase recognition that individuals, health and agricultural professionals, and Governments must play in tackling antibiotic resistance, and to encourage behavioural change and convey the message that simple actions can make a difference.

While the threat of antibiotic resistance is often considered a doomsday scenario—one might say a medical Armageddon—we must remember that that menace is all too deadly today. Currently, 700,000 people die each year from drug-resistant infections; the future threat is touted as being so severe and extreme, not because we are not living with the effects today but because of the truly appalling potential scale of the problem if we do not take co-ordinated action. If we do not act now, antimicrobial resistance will be responsible for 10 million deaths per year by 2050. That is more than the number of people worldwide who were killed by cancer in 2015. It is nearly impossible to put a number on the lives that have been saved by antibiotics; some sources put the figure at roughly 2 million, but it is entirely conceivable that we may arrive at a position where the balance tips, and antibiotics pose a greater threat than a remedy.

As I have said previously in this House, we run the risk of returning to a medical dark age, where routine operations such as hip operations cannot be carried out, and infections that are standard today become deadly. This week, the British Society for Antimicrobial Chemotherapy published a report on behalf of the all-party parliamentary group on antibiotics. The report, the briefing for which has been sent to all Members of the House, considers the AMR action plans and strategies set out by the World Health Organisation, the European Union and the UK, and asks, crucially: “Has the world lived up to the challenge?”

The overarching theme of the report is that future strategies to combat antibiotic resistance should incorporate specific, measurable, attainable, relevant and timely—SMART—targets. When the stakes are 10 million deaths each year within four decades, it is easy to become lost in the scale of response that that merits; but as is so often the case, a coherent and clear approach is our greatest weapon. I call on the Government to ensure that all steps are taken to counter AMR and explicitly to incorporate those SMART targets I listed. I believe there is much to be gained from making that standard practice and removing any doubt. I am sure that colleagues will be encouraged to read in the report that

“the UK has taken significant steps to meet the objectives of the EU Action Plan, which in turn satisfies the WHO Europe Strategic Action Plan.”

There are two aspects, however, where our country needs to up its game. First, we need to address education and public awareness, so it is entirely fitting that we meet today during World Antibiotic Awareness Week, an occasion aimed directly at bolstering an understanding of resistance and the threat it poses to humanity. We need to be forthright in promoting the “four rights” when consuming antibiotics: the right drug, the right dose, the right time and the right duration. A survey carried out across Europe in 2016 indicated that knowledge about AMR remains low, and antibiotic consumption has decreased by only 6% over the last seven years. To address that, the British Society for Antimicrobial Chemotherapy advocates the use of simple and clear language in all awareness-promoting material. There is a direct recommendation of

“monitoring the efficacy of education campaigns through online channels.”

Fleming himself was once quoted as saying that the best remedy for a common cold was a dram of whiskey.

[Patrick Grady (Glasgow North) (SNP)]

Hear, hear.

[Julian Sturdy]

I know the Scottish Members would certainly agree with that. As Fleming said,

“it’s not very scientific—but it helps.”

We now need to make the message as clear as day: antibiotics are ineffective when taken unnecessarily and doing so bolsters resistance and endangers mankind.

The second area where significant progress can be made is on the incentives for antibiotic discovery, research and development. It should be noted that the antimicrobial challenge is as much economic as it is medical. We must find an alternative to the reimbursement model, whereby profitability of bringing new antibiotics to the marketplace is linked to volume of sales. That is because we are actually seeking to limit the use of such drugs to preserve their power; to use new drugs as a point of last resort, as it were. To use an analogy, it is almost like the fire service—we need it to be there and to be effective, but we do not want to use it. However, nobody would dispute the necessity of investment and funding for that key emergency service.

To overcome this task, it is essential that measures are taken to co-ordinate a review of progress in new drugs, alongside the activation of research and development by industry for new antibiotics and related products achieved by Innovative Medicines Initiative projects. On the economics, we need to seek innovative solutions, with the pricing conditions and “pull” measures needed for the long-term sustainability of new antibiotic development, so that they are promoted. An example of that is the compact initiative of the European Federation of Pharmaceutical Industries and Associations to promote a sustainable business model and adequate conditions for the introduction of effective new antibiotics.

The O’Neill review, published last year and described last week by a columnist from The Times as

“the best argued and most accessible”

report in his lifetime, was very clear on this matter. Lord O’Neill found that much more needed to be done to close the substantial gap in research and development funding between AMR and the best-funded areas of medical science. The report being launched this week quantifies this further, and states that $40 billion is needed over 10 years, representing about 0.05% of G20 countries’ current healthcare spend. I will not claim that that sum is insignificant, but it is certainly affordable given the magnitude of the threats we face.

For improvement on a global level, the report makes it clear that co-ordinated efforts must be made in the veterinary sector, where I am pleased that tangible progress has been made in the UK. Figures from the Countryside Alliance show that sales of livestock antibiotics across the sector have fallen by an average of 27%—their lowest levels since records began—which is a good start, because a failure to address AMR in livestock has fundamental implications for the treatment of human diseases. For that reason, mirrored co-operation between Government Departments is essential.

While I am delighted that we are joined by my hon. Friend the Under-Secretary of State for Health, this matter also encompasses the Department for Environment, Food and Rural Affairs, the Department for International Development and the Department for Exiting the European Union. We need a clear commitment from the Government that that co-operation is there and that an interdepartmental strategy is on the agenda. Beyond that, we require what Antibiotic Research UK describes as a “grand alliance” to come together, comprising the Government, the pharmaceutical industry, collective medical research charities and academics.

To reduce further the overall use of antibiotics in the veterinary sector, guidelines have been developed for prudent use. The EU road map also proposed the creation of an animal health legal framework, based on the principle that prevention is better than the cure. Take the example of colistin. In 2015, evidence emerged of colistin resistance with the potential for transfer and spread between bacterial species. In order to preserve colistin for human medicine and limit the spread of resistant genes, the European Medicines Agency imposed strict limitations on its use and recommended the withdrawal of marketing authorisations for all oral colistin in veterinary medical products. Professor Galloway, from the Royal College of Physicians and Surgeons of Glasgow, is calling for a full review of the use of antibiotics used in both animal husbandry and human clinical practices, and I believe the Government should actively consider that suggestion.

In the UK, some sectors have conclusively beaten the target set by the veterinary medicinal products directive. Such industries represent very clearly what we are aiming for with the SMART targets I referred to at the beginning of my speech. In many cases, progress has been made through voluntary schemes. I request that the Government look directly into specific sectors in order to investigate best practice and what we can learn from it.

However, we must go further as a global leader and recognise that this is an international challenge. Almost 80% of antibiotics used in the USA are not taken by people but used within the livestock sector, which I find astonishing. In India, people consume an average of 11 antibiotic tablets per year. Only today, data has been released showing that antibiotic resistance is growing in Europe. Progress that Britain makes will be quite simply irrelevant in the absence of a confident international stewardship programme.

The British Government must act as an example in their commitment to tackling resistance head-on globally and, while I recognise it is not in the specific gift of my hon. Friend the Under-Secretary of State for Health to dictate his published ministerial responsibilities, I believe it is timely explicitly to add antimicrobial resistance to those responsibilities. That symbolic act would send a clear message that Britain is committed to remaining at the forefront of the fight against antibiotic resistance.

--- Later in debate ---

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Davies. At relatively short notice I am standing in for my hon. Friend the Member for Linlithgow and East Falkirk (Martyn Day), who is not very well. I am not certain of the cause of his illness, but I am sure that if he is seeking advice, he will rightly be following the guidance of the theme of World Antibiotics Awareness Week, which states:

“Seek advice from a qualified healthcare professional before taking antibiotics”.

He will also be taking the advice, as I am sure will everyone else, of my hon. Friend the Member for Central Ayrshire (Dr Whitford), who has been impressing on us the importance of the flu jab. I can testify to the medicinal qualities of a hot toddy, from time to time, but in the careful context of appropriate medication with appropriate medical advice.

I congratulate the hon. Member for York Outer (Julian Sturdy) on securing this debate, which gives us an important opportunity to reflect on the issue of antimicrobial resistance and the importance of being aware of the challenges. It is a timely debate, taking place during the World Antibiotics Awareness Week. Any kind of awareness week has a number of important consequences. In this context, improving the understanding of the risks faced, which we have heard clearly from other hon. Members, is key, as is presenting an opportunity to take action in response to the challenges presented.

The challenge is very clear and came through in all the speeches. The right hon. Member for Chipping Barnet (Theresa Villiers) made it clear how difficult it is to overemphasise the scale of the challenge and the risk we face. Some 700,000 deaths a year are attributable to infections from superbugs that are resistant to antibiotics, and that figure is predicted, as we have heard, to rise to almost 10 million in total by 2050.

There are huge challenges in the livestock and veterinary sector as well. I was interested to hear that academics from the University of Glasgow in my constituency are among those taking the lead. I will say a wee bit more about what the university is doing shortly.

As the hon. Member for Stafford (Jeremy Lefroy) has said, the issue also has a big impact on developing countries, where people require access to medicines and the challenge of resistance is huge, and it threatens the progress made in health and tackling poverty. Being aware of the huge risks and then using that as a motivation to action is one of the key opportunities presented by awareness week.

I will reflect briefly on the Scottish Government’s actions. A large amount of health policy is devolved, but there are good examples and good practice on which we can reflect. In March the Scottish Government announced a £4.2 million research grant to investigate the prevention and control of healthcare-associated infections, as well as to research new ways of using existing antibiotics more effectively and efficiently. Some of that funding was provided to a consortium of researchers led, as I have said, by the University of Glasgow in my constituency, working with other Scottish universities to establish a new Scottish Healthcare Associated Infection Prevention Institute, which will conduct important research, bringing together a range of academics, researchers, practitioners and so on.

The Scottish Government have also established the Scottish antimicrobial resistance and healthcare-associated infections strategic framework for between 2016 and 2021. It has a number of aims to do with the containment of antimicrobial resistance; advancing scientific knowledge and innovation; improving efficiency, transparency and accountability; and improved workforce capability. That is important for all environments where healthcare is delivered, such as care homes, community pharmacies and primary care, and for everyone involved in the delivery of care.

There are a number of things we can all do at an individual level. There was a debate in March, I think on the broader issue of antimicrobial resistance, during which we were encouraged to become an antibiotic guardian. In fact, when the sitting was suspended for a Division in the House, many of us signed up online. The number of people signing up to that campaign continues to grow and this is another important opportunity to encourage others to do so. The Scottish Health Secretary, Shona Robison, has pledged to join the scheme and to encourage as many people as possible to do so in order to reach the target of 100,000 people becoming an antibiotic guardian.

This debate has shown that the Government have some challenges and opportunities. Are we ensuring that the right levels of investment are being channelled through the right Departments? The importance of joined-up government across Departments, including DEFRA, DFID and the NHS, has been made clear in this afternoon’s speeches. Towards the end of his remarks, the hon. Member for Stafford touched on the issue of a joined-up global response. There is a sense in some quarters that Brexit might represent some sort of retreat from the world stage. Yet the Government’s response to the O’Neill report in 2016 clearly stated that a global response, including “working closely with Europe”, is required. How do they see that relationship with European institutions in the context of Brexit? How can we be sure that the bonfire of red tape and regulation that so many Brexiteers have dreamed of for so many years will not weaken those efforts? We have already heard about the possibility of chlorine-washed chicken and so on coming into the United Kingdom as a result of potential trade deals with the United States. How can we make sure that meat that comes in as a result of new trade deals is not absolutely overloaded with antibiotics and other treatments that could lead to increased antimicrobial resistance?

In conclusion, this is a significant challenge and awareness is important. Awareness weeks, debates such as this, and the antibiotic guardian scheme play a very important role in tackling some of the challenges. I was interested to hear about the Swab and Send initiative and am keen to sign up to it. I can think of several dusty corners, not just in this Chamber but elsewhere in the Palace of Westminster, where who knows what might be discovered. I think that is a challenge to us all.

We know that there are models out there that can work. The hon. Gentleman spoke about a number of them and some of the many positive actions taken to tackle malaria, as well as the challenges that remain in closing the final gap. The other day I attended an interesting meeting between DFID officials and the all-party parliamentary group on vaccinations for all. We looked at the impact of the near eradication of polio and the challenges that will present for other schemes in the future. Some of the infrastructures that have been built up to deliver that historic achievement of the eradication of polio can perhaps be adapted to meet other healthcare challenges. I am not by any means an expert, but perhaps this is one of those areas.

It is clear from this debate that we can all play our part, and it is also important that the Government lead by example. Once again, I congratulate the hon. Member for York Outer on securing this debate and I look forward to the Government’s response.

Surgical Mesh Implants

Patrick Grady Excerpts

Wednesday 18th October 2017 Westminster Hall

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Owen. I will be as brief as I can, because we are all very keen to hear from the Minister.

A lot of the key points have been extremely well made by all the Members who have spoken. I particularly congratulate the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) on securing the debate and opening it for us. I also want to pay tribute to the chair of the all-party parliamentary group, the hon. Member for Pontypridd (Owen Smith), for the work that he has done.

Like many Members, the issue was brought to my attention by a constituent and the very powerful and emotional meeting held in one of the Committee Rooms before the formal founding of the APPG, where we heard testimony from a range of constituents and campaigners. Many of those testimonies have been echoed and repeated today, notably, but not exclusively, by the hon. Members for St Ives (Derek Thomas), for Gower (Tonia Antoniazzi), for Strangford (Jim Shannon), for Elmet and Rothwell (Alec Shelbrooke) and for Manchester, Withington (Jeff Smith). They are painful enough to listen to—we saw the reactions of Members in the room as we heard those testimonies—so how much more painful and traumatic it must be for people to have to live in those terrible situations.

The hon. Member for East Renfrewshire (Paul Masterton) raised the situation in Scotland, and I want to dwell on that for a moment. He must be one of the first opposition politicians—as he is in Scotland—ever to say the words, “I am disappointed that the results of the independent review were implemented in full.” Normally, Governments get criticised for not implementing the outcomes of an independent review.

In 2014, the Scottish Government requested a suspension in the use of vaginal medical mesh by the NHS in Scotland. In 2015, the Cabinet Secretary for Health apologised to women who had been left in severe pain by these operations. Since that suspension was introduced, the use of mesh has fallen dramatically. Between 2009 and 2016, the number of women receiving mesh surgery in Scotland has fallen from 2,267 to 135.

I understand from what was said by the hon. Member for Totnes (Dr Wollaston), who probably knows far more about these issues than many of us in the room, that it would be very difficult to get that figure right down to zero, because there may be occasions when the surgery is appropriate. However, it has to be under very specific conditions and absolutely with the fully informed consent of which she spoke. That comes out clearly in “The Scottish Independent Review of the Use, Safety and Efficacy of Transvaginal Mesh Implants in the Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse in Women”.

The hon. Member for East Renfrewshire is right to say that transabdominal mesh is not yet under suspension, but that remains, and should remain, under constant review by the chief medical officer in Scotland. All the evidence that was submitted to the review are available on the website, along with the different drafts. It is important that we make it clear that the evidence has been fully published, and that the recommendations were made independently by the review and have been accepted in full by the chief medical officer in Scotland, who has been clear that the requested suspension of the use of mesh implants should remain in place until she is satisfied that the recommendations have been implemented.

An oversight group will oversee the recommendations and will be expected to put the patient at the heart of everything it does. Professor Alison Britton has been asked to examine the review process itself, to listen to and take on board some of the concerns that the hon. Gentleman raised. I would be interested to hear from the Minister what discussions she has had with colleagues in Scotland about what lessons can be learned from some of the questions that have been asked there.

The Scottish Government have no power to ban the use of mesh, because the matter remains reserved to the Westminster Parliament and, in particular, to the Medicines and Healthcare Products Regulatory Agency. The Sling the Mesh campaign, as we have heard from a number of Members, has asked for some clarity from the MHRA and a stronger, more stringent system of auditing the efficacy of mesh and other medical practices.

One of the most important things that has come through clearly in the debate is the collection and analysis of data, so that a full picture of the situation can be brought up. We have heard so many times of individual cases where people are told, “This is just you; this is an isolated case,” when it very clearly is not. The evidence has to be gathered, and full investigations have to take place and continue.

There is a clear expectation that the MHRA must continue to review the use of medical mesh implants. That should include considering all available evidence and taking lessons from the use of such implants further afield, such as in the United States and Europe. That is important to ensure not only that the best healthcare options are provided, but that women can be confident that the services they have received have been shown to be effective under robust and effective clinical trials—an important point, which was stressed by the hon. Member for Totnes. One of the key things I have learned from this debate is the difference between the testing regime for medicines and the testing regime for implants and other medical devices. There is clearly a cross-party consensus on that, and I hope the APPG will continue to look at the issue.

I welcome the conclusions and recommendations of the Scottish and English reviews of the use of this procedure. We must ensure that surgical mesh implants are used only after all other appropriate alternatives have been exhausted and, crucially, only when women give their fully informed consent.

Once again, I pay tribute to the campaigners for their bravery and courage and for bringing this issue to our attention. I hope it is not a totally inappropriate comparison, but this reminds me of the Women Against State Pension Inequality campaign, during which individual, isolated cases started to snowball, and the issue got on to the agenda. That campaign for justice made progress and is now being heard loud and clear. There is a parallel with this campaign, although it is not exactly the same. I hope the Government listen. We have to thank those campaigners for the small and belated progress that has been made. They will rightly hold us to account to ensure we make progress.

Oral Answers to Questions

Patrick Grady Excerpts

Tuesday 4th July 2017 Commons Chamber

[Steve Brine]

Yes. Progress is really encouraging, and I am sure that Members on both sides of the House will have been encouraged to see today’s press coverage about the chief medical officer’s independent report on genomics—the age of precision medicine is truly here. The NHS has always been at the forefront of new technologies, and so it must be with this; we are determined that it will be.

[Patrick Grady (Glasgow North) (SNP)]

T3. Would a Minister be willing to meet the all-party group on blood donation after it has been reconvened next week and would they be able to provide an update on the work of the Advisory Committee on the Safety of Blood, Tissues and Organs in respect of lifting or easing the deferral period for gay men who want to donate blood?

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

I would be happy to agree to such a meeting, and I know this issue has support on both sides of the House.

O’Neill Review

Patrick Grady Excerpts

Tuesday 7th March 2017 Westminster Hall

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I was not expecting to be called so soon—[Interruption.]

[Mr Gary Streeter (in the Chair)]

Despite your pleasure, Mr Grady, there is a Division in the House.

--- Later in debate ---

[Patrick Grady]

It is still a pleasure to be serving under your chairmanship, Mr Streeter.

Antimicrobial resistance was described earlier by another Member as a market failure. I have also seen it described as a “tragedy of the commons”, which is a phrase that some of us might associate with the hassle we have to go through because of the antiquated voting systems in this House. It is actually an economic term describing where individual users acting independently according to their own self-interest behave contrary to the common good by depleting a resource that should be there to serve everyone. That is precisely what has happened through the misuse of antibiotic medicines over the years. It shows that the resistance we are discussing today is an avoidable and man-made problem, and it is therefore in our gift to overcome the challenge.

[Chris Green (Bolton West) (Con)]

One of my concerns is that we view this as though there should be a proper market functioning. Does the hon. Gentleman agree that we do not actually want a functioning market, in that we want a new generation of drugs to become available and then, as far as possible, not to be used? We do not want the market to operate; we want the use of such drugs to be in reserve.

[Patrick Grady]

Absolutely. I wholeheartedly agree. That leads me nicely on to my first point about the particular challenge faced in developing countries.

All Governments in the world have an obligation under the sustainable development goals—it is in SDG 3—to ensure health and wellbeing for all, which includes access to safe, effective, quality and affordable medicines and vaccines. That is about access to medicines; it is not about the right to buy or sell them on the market, it is about treating them as a common good. That is precisely what we want to do, otherwise there is a real risk of backsliding on progress that has been made in tackling neglected and tropical diseases. We heard earlier about TB being responsible for more than 5,000 deaths per day, and about malaria, which is often treated by very strong antibiotics and affects more than 200 million people worldwide a year. That is why there needs to be a broad, co-ordinated response. Drugs that treat TB are often used to treat other infections as well, so in boosting research into neglected diseases there is an opportunity to supercharge the pipeline of development and make more drugs available for treatment as we need them.

I am glad the Minister is back in the Chamber. It would be interesting to hear what further commitments the Government can make. We welcomed the commitment to the global fund, but how is the Department for Health working with the Department for International Development on these issues? In particular, how much of her Department’s spending will be counted as official development assistance when it comes to tackling antimicrobial resistance? The Ross fund was set up by the former Chancellor, the right hon. Member for Tatton (Mr Osborne), who is no longer in his place, and I congratulate him on it. What progress is being made on that fund, and what support will there be for researchers on the ground in developing countries? I am not opposed to using the ODA budget to fund Departments other than DFID, but wherever possible it should be used to support research on the ground in developing countries.

I want to speak briefly about domestic responses. I recently met a constituent, Linda Brooks, who has become the chair of the Scottish steering committee for synthetic biology—an initiative supported by Scottish Enterprise. She is also a manager at the company Thermo Fisher, which supports research in the life sciences sector including pioneering work on antimicrobial resistance and, in particular, the technology of genome editing, which has huge potential. It would be interesting to hear whether the Government provide any support in those areas.

We all have responsibility for the effective use of antibiotics. During the hiatus in this debate I was able to sign up online to become an antibiotic guardian, which Public Health England supports with the encouragement of all the devolved Administrations. It includes a range of pledges to treat symptoms, to talk to pharmacists, to dispose of unused antibiotics carefully, to take the flu vaccine and to always complete the course—I hope everyone will sign up to that pledge.

[Several hon. Members rose—]

Health and Social Care

Patrick Grady Excerpts

Monday 27th February 2017 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I do not intend to detain the House for desperately long. The debate has been filled with trepidation and anticipation as Members, and perhaps the wider public, wait to see whether the House will actually debate any of the estimates before us. To pay tribute to hon. Members, we have not done too badly. The estimates document, HC 946—all 748 pages of it, at three and a half inches thick—and the Order Paper give us an estimate of £8,716,216,000 for the NHS. That takes up pages 137 to 151 of the document, but the only line that actually includes expenditure for health and social care is for the

“Health and Social Care Information Centre (known as NHS Digital)”

on page 151, which has £151 million of resources. That might have made for a considerably shorter debate, if hon. Members had not used their ingenuity to quite the extent they have.

We have debated the 10 detailed reports from the Health Committee and the Public Accounts Committee. I congratulate the Chairs of those Committees on securing time from the Liaison Committee, but even that raises the question of why 10 reports are squeezed into a three-hour debate that is supposed to be about supplying the Government with the resources needed. I congratulate the Committees on securing that time, but perhaps those reports ought to have had more time to themselves.

The NHS is one of the biggest areas of Government spending, second only to pensions. Adequate funding of aspects of the NHS is a constant major feature of political discourse, as it has been today, but there are no means to seek to amend any of this in any meaningful way through the estimates process. All we can do is table amendments that might lower the amount, but the theme of the entire debate seems to have been that the NHS in England needs more money, not less. Of course, any change to the NHS budget in England has some sort of Barnett consequentials in Scotland. I wonder whether, at any point today or anywhere in the Supply estimates book, we can find out what those are. I suspect we cannot.

Nevertheless, a number of important points have been made. The Chairs of the Public Accounts Committee and the Health Committees spoke in detail about the different budget lines and departmental spending lines and about the important long-term consequences of the transfers from the capital budget to the revenue budget. The hon. Member for Newton Abbot (Anne Marie Morris) spoke about the need to ring-fence certain lines. The hon. Member for Colne Valley (Jason McCartney), who is no longer in his place, made important points about the disaster that PFI has been in the health service, and that is true north and south of the border.

The hon. Member for Bishop Auckland (Helen Goodman) rightly asked where the £350 million a week for the NHS was. It certainly is not in the Supply documents brought to the House by the Government today. There is, in fact, a systematic underfunding of the NHS in England under this Tory Government, and that has serious implications for the NHS across the UK as a whole. As we have heard from Members on both sides of the House, that environment will only become more challenging as the population ages and demographics continue to change.

The Scottish Government, as I am sure we will hear from my hon. Friend the Member for Central Ayrshire (Dr Whitford) on the Front Bench shortly, are focused on these challenges and on building a health service that meets the demands of the 21st century. They are not just investing in the NHS but reforming it—integrating health and social care, and engaging with communities and the medical workforce, to bring about sustainable and positive NHS reform, as opposed to pressing ahead with the hasty cost-cutting exercises that seem to be the priority of the Tory Government.

However, perhaps it suits the Tory Government to have an NHS that is in the crisis described by Labour Members, because that gives Ministers an excuse to bring in private capital and private management and to outsource services to private providers. That, in turn, would have major consequences for the NHS budget in England and consequentials for the devolved budget, which brings us back to the inadequacies of the estimates and Supply process in this House.

The former Leader of the House promised us that these Supply days and estimates days were our chance to scrutinise the Government on things that we were otherwise excluded from during the English votes for English laws processes.

[Mr Speaker]

Order. May I just very gently say to the hon. Gentleman that he is a distinguished ornament of the Procedure Committee, which has deliberated upon this matter? The question of the character of debates on the estimates has been, at this point, decided by the House, and the hon. Gentleman should not use his opportunity to speak in this debate, which he should guard jealously, to dilate on his disapproval of the process. What he ought to do is to focus on the subject which has been chosen. [Interruption.] It is no good him grinning at me like a Cheshire cat—I trust that that means that he is acquiescing in the judgment that has been reached. We always look forward to the mellifluous tones of the hon. Gentleman, but they should focus on the subject that we have chosen and not on that which he would prefer to have been chosen.

[Patrick Grady]

Indeed, Mr Speaker. I do not intend to detain the House very much further. What I have been trying to demonstrate is how the health and social care budget in England and Wales affects the health and social care budget north of the border and the overall Scottish Parliament budget. We have precisely proved the point that we do not have the appropriate opportunities to scrutinise those things in this debate, so the Government have to live up to their promises, and then we will see whether they are prepared to allow Members of this House a proper say over spending on the NHS and social care or on any of the other budget lines or Departments included in the estimates.

--- Later in debate ---

[David Mowat]

I have given way to the hon. Lady once already, and I need to make some progress.

[Patrick Grady]

Some Conservative Back Benchers have suggested—not in today’s debate but at other times—that some of the 0.7% gross national income aid budget could be used to fund health and social care. Can the Minister confirm that the Government remain committed to that target? By reading out the proportions of GNI spent on health and social care, he has shown how small that budget is in comparison.

[David Mowat]

The 0.7% budget for overseas aid is not being discussed here today and it is not my ministerial or my Department’s responsibility. I am proud that we are one of the few countries in the world that meets that commitment, and many of the other countries among our EU partners that have been mentioned do not make that commitment. However, I shall not be diverted any further down that road today.

We have of course had a difficult winter in the NHS. We know that A&E targets are on about 86% rather than the 95% we expect; and ambulance targets are at 60% rather than the 75% we expect. As we have heard, delayed transfers of care—not “bed blocking”—have probably doubled over the past three years. In response, I make one point that I am always keen to raise in these discussions: we do not talk enough about cancer. There are cancer metrics, and we should be proud of the fact that NHS England, is meeting seven of our eight cancer metrics. The trend is towards meeting them more easily than in the past. We have heard quite a lot this evening about how well they are doing in Scotland. In fairness, to redress the balance that we have heard about in respect of A&E, I make the point that Scotland is doing somewhat worse than we are on those cancer metrics.

Oral Answers to Questions

Patrick Grady Excerpts

Tuesday 5th July 2016 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I am pleased to report that the commissioning of the systematic reviews of the diagnosis and treatment of Lyme disease, which I mentioned at that time, is under way. We expect that work to start in the autumn, and the researchers will approach relevant stakeholders. Once that work is under way, I would be happy to organise a meeting for colleagues at which the experts leading it can brief them further.

[Patrick Grady (Glasgow North) (SNP)]

T3. Will the Secretary of State join me in welcoming the formation of the all-party parliamentary group on blood donation? Will he agree to take part in and perhaps give evidence to its inquiry into the criteria for blood donation, particularly those regarding men who have sex with men?

[Jane Ellison]

As Members will know, the Department has asked the Advisory Committee on the Safety of Blood, Tissues and Organs—SaBTO—to review the donor selection criteria for blood donation that relate to men who have sex with men. SaBTO has approved the remit, the terms of reference and the work streams, and it is cracking on. It has a second meeting coming up later this month. The chair of the working group has written to the chair of the all-party group, welcoming its inquiry and inviting it to contribute evidence during the autumn.

Space Policy

Patrick Grady Excerpts

Thursday 14th January 2016 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I think this is the first time I have been called to speak in the Chamber without there being a formal time limit on speeches, but I will do my best not to go to infinity and beyond. I thank my co-sponsors of the motion, and the Backbench Business Committee for giving us the time to have this debate at relatively short notice. As my hon. Friend the Member for Central Ayrshire (Dr Whitford) has said, the debate has come at an opportune moment, the day before Major Tim Peake makes his spacewalk.

Adjournment debates secured by the hon. Member for Bracknell (Dr Lee) notwithstanding, I understand that this is the first time since a 2005 Westminster Hall debate that the House as a whole has considered space policy, so this debate is very timely indeed. It is great to hear that today’s important deliberations have been recognised by good wishes from Captain Kirk and Mr Sulu themselves. Indeed, our very own chief Trekkie, my right hon. Friend the Member for Gordon (Alex Salmond), who usually occupies the spot on which I am standing, has sent us his best wishes as well. On space issues, there is a close link between the inspiration provided by both science fiction and science fact. Perhaps I will come back to that later.

It is also appropriate to finish the week in which the English votes for English laws procedures were used for the first time by discussing matters about which there can be no question but that Scottish National party Members have a mandate to speak and vote on. Later today we will discuss the House of Lords, which is reserved. Schedule 5, part II, section L6 of the Scotland Act 1998 proudly and clearly reserves to the Parliament of the United Kingdom,

“Regulation of activities in outer space.”

If a Starman waiting in the sky read that, he might think it was quite a claim or question whether Parliament really has the power to regulate the infinite majesty of all creation, although I am sure some Members think that it does. However, the explanatory notes to the legislation make it clear that the reservation applies specifically to matters regulated by the Outer Space Act 1986.

The 1986 Act gave effect to a number of international treaties on the exploration and, for want of a better word, the exploitation—I will touch on that later—of outer space. The principles behind the treaties are hugely important, particularly those in the 1967 United Nations outer space treaty:

“The exploration and use of outer space…shall be carried out for the benefit and in the interests of all countries…and shall be the province of all mankind”,

and:

“Outer space, including the Moon and other celestial bodies, is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means.”

My hon. Friend the Member for Central Ayrshire spoke powerfully about the role played throughout the cold war by the development of the international space station, which demonstrated that global co-operation was possible even at a time of significant political tension. The ISS has been described as the most complex international scientific and engineering project in history. It is the largest structure that humans have ever put into space. It can be seen on a clear night if not quite with the naked eye, except perhaps through the Prestwick hole, then certainly through binoculars or a home telescope. It was the result of collaboration between five different space agencies, representing 15 countries. It has been permanently occupied since 2 November 2000, or just over 15 years, which is a truly remarkable achievement.

It will be interesting to hear whether the Minister will recommit the Government to such principles of space law today. In particular, will he offer any reflections on the possible impact of recent legislation passed in the United States recognising the right of US citizens to own any resources they obtain from asteroids? A number of academics and observers have expressed concern about that, especially if other countries begin to follow suit. Indeed, Gbenga Oduntan, a senior lecturer in international commercial law at the University of Kent, has said that the US Space Act 2015 represents

“a full-frontal attack on settled principles of space law”,

and is

“nothing but a classic rendition of the ‘he who dares wins’ philosophy of the Wild West.”

Space should be for exploration, not for exploitation in any sense that excludes anyone from the benefits it can provide, or what the motion calls

“scientific, cultural and technological opportunities”.

In drafting the motion, we were very careful to list those aspects of space exploration and opportunity before mentioning the economic impact of the space industry. Indeed, UKspace, the trade association, has said that the Government must

“ensure its positioning maintains the balance between economic growth, excellent science and the inspiration of young people”.

As we have heard, we have certainly lived through an inspiring era of space exploration. In recent years, there has been huge interest in the Philae lander and the Rosetta mission, the evidence of water on Mars and the New Horizons fly-by of Pluto. I was particularly struck by NASA’s use of the “children will never know” hashtag when images were first beamed back from Pluto. The new generation of children will never know a day when they could not see images of Pluto in such great detail. Sadly, children born today will also never know the thrill of the space shuttle, which certainly inspired me when I was growing up. I remember watching the final launch of Atlantis back in 2011, and thinking about all the other things then going on in the world.

[Dr Lee]

I apologise for being a bit of a pedant, but the first British-born astronaut to walk in space was Michael Foale when he was on the US space shuttle.

[Patrick Grady]

That is a fair point. It is important to recognise the huge achievement of all the astronauts of various heritages and from various parts of the United Kingdom. There is certainly no intention to play trumps.

[Dr Philippa Whitford]

Did not that gentleman change his nationality? He had dual nationality, and did not fly with the Union flag on his suit, as Helen Sharman did.

[Patrick Grady]

My hon. Friend was absolutely correct to pay tribute to Helen Sharman. I remember that as well. I was particularly young at the time, but I will leave Members to work that out for themselves, if they want to look up my biography.

The shuttle programme was a huge inspiration to many people. It is a very sad loss, but if its end several years ago was a low, we are now going through something of a renaissance. There have certainly been a number of highs recently, as I have mentioned. The fact that 15,000 people attended events to watch the launch of the Principia mission just before Christmas, including those of us in the Jubilee Room and later in Portcullis House, demonstrates how the international space station continues to serve as an inspiration.

Many of us who watched the amazing opening ceremony of the Glasgow Commonwealth Games will remember that, just when we thought it could not get any more exhilarating, a live broadcast was beamed down from the ISS. I was not at the ceremony, but with thousands of other people on Glasgow Green on that great day of celebration. There was a real coming together, with exactly the kind of inspiration that the hon. Member for Bracknell spoke about. It was humanity at its finest: people coming together from all over the world to take part in sporting endeavour and being supported by their fellow human beings hundreds of miles above the ground. It was particularly appropriate because, as we have heard and will continue to hear, Glasgow—and indeed Scotland—plays a significant role in the modern space industry and in space science.

In December 2015, my old university, Strathclyde, hosted the annual Canada-UK colloquium on the future of the space industry, which was attended by the Scottish Cabinet Secretary for Culture, Europe and External Affairs. Delegates visited two companies in the city, Clyde Space and Spire, which specialise in cube satellites technology and data. In the margins of that event, the First Minister strongly backed the calls that we have heard and will no doubt continue to hear for a spaceport to be located in Scotland. She pledged that the Scottish Government will do whatever they can to ensure that one of the bids is successful.

In my constituency, the University of Glasgow has one of the leading centres for space science and research in the UK, or indeed in the world. Space Glasgow brings together more than 20 academics from a range of disciplines to co-ordinate research, especially under the key themes of exploring and understanding space, mission analysis, risk and technology.

One recent achievement has been the university’s involvement in the launch of the European Space Agency’s LISA—laser interferometer space antenna—Pathfinder spacecraft. The launch in December marked the end of a decade of work for a team from the university’s institute for gravitational research, which helped to develop the craft’s sensitive optical bench. The bench is a hugely complex and important technology. It has a laser interferometer. [Interruption.] My hon. Friend the Member for Glasgow North West (Carol Monaghan) congratulates me on my pronunciation. It was developed, built and tested by the university’s team, and is capable of detecting changes in distance between test masses of as small as 10 picometres. It is an outstanding scientific achievement in its own right, and the images and knowledge that the Pathfinder will produce will no doubt help to inspire generations to come.

[Carol Monaghan (Glasgow North West) (SNP)]

Can my hon. Friend explain to the House what a picometre is?

[Patrick Grady]

A measurement of picos—[Laughter.] My hon. Friend may be able to enlighten us later, if she catches your eye, Madam Deputy Speaker.

Like any academic discipline, research in space science and technology costs money and requires certainty. I am happy to back calls from researchers for greater transparency in the relationship between the UK Space Agency and research councils on funding decisions. It would be useful to hear from the Minister how the Government are engaging with research departments at the cutting edge of this important technology. Much of this technology has an impact on our daily lives, especially in the west, where we rely on satellite technology for everything from weather forecasting to our mobile phones.

We have spoken of the inspiration that space exploration can provide, so it is important that Governments in the UK and Scotland continue to support science and technological education, as well as initiatives such as dark sky parks. In boasting of our satellite technology industries, we must also remain vigilant about the risk of space debris, as my hon. Friend the Member for Central Ayrshire mentioned. Too many of our oceans and geological ecosystems are poisoned by the unthinking results of attempts at technological progress, and the same must not be allowed to happen in near or outer space.

Those of us on social media will have seen the internet activity about NASA’s recruitment of a planetary defence officer recently. That is not as outlandish or as “outspacious” as it might sound. It is not simply about the risk of asteroids—I know that former Members who are no longer with us used to champion that issue—but about the risk of near-Earth objects too. If the satellites we put into space are not properly managed and regulated, there is a risk that they will crash into population centres.

[Dr Lee]

Does the hon. Gentleman know that a piece of British technology has been developed that can be put into space to capture space debris and bring it back to Earth?

[Patrick Grady]

That is a helpful contribution that demonstrates the point that we are making about the importance of the space industry, not only to the economy but to the greater collective good.

I spoke of the relation between science fiction and science fact. NASA recently collaborated successfully in the production of the movie, “The Martian”, which is about a man stranded on the planet after a mission goes wrong. It is based on a realistic understanding of the technologies and science that would be involved in a mission to the red planet.

I have spent the little free time I have had over the past 18 months reading through Kim Stanley Robinson’s Mars trilogy, which is rightly described as a “future history”. It was written in the 1990s with exceptional clarity and foresight. It was forensically researched, to the extent that after reading it for several hours, one can easily look out of the window and expect to see a Martian landscape unfolding. The trilogy is also a well-observed study of human societies and the possibilities open to mankind in building an economy and polity from scratch. There is much to commend in, and much to learn from, how science fiction authors have used the inspiration of space exploration to reflect on our current earthbound condition.

This is a valuable opportunity for debate, and I look forward to hearing further contributions from Members and a response from the Minister, particularly on the questions of ensuring the neutrality of and common access to space, support for education and science, the preservation of dark skies and the minimisation of space debris. We have talked about nationalities and laying claims. Scotland lays claim to one astronaut so far—Brian Binnie, who was brought up in Aberdeen and Stirling, and has test piloted a number of private space flights. Let us hope that the inspiration from the many space missions, which are growing in number, and not least Major Tim Peake’s, will encourage more young people to pursue careers in the sector and that, before long, we will see more astronauts from Scotland and across the UK who will have the opportunity to contribute to the good of humanity, to explore strange new worlds and, if Hansard will allow a split infinitive, to boldly go where no one has gone before.

--- Later in debate ---

[Carol Monaghan]

Absolutely. It is often not understood that satellite launches take place regularly. The next such launch is in fact on Sunday, but we have not heard very much about it in the news. The micro-satellites that my hon. Friend has just mentioned are providing us with more and more great services.

[Patrick Grady]

Geostationary satellites were first conceptualised as science fiction by Arthur C. Clarke. This reinforces the point that I was making earlier about the inspiration that space provides to the creative and cultural scene, which has a knock-on effect in scientific applications.