Access to Migraine Treatment

Paul Girvan Excerpts

Wednesday 20th March 2024 Westminster Hall

[Dehenna Davison]

I completely agree with the hon. Gentleman. As I said, migraine is a condition that does not discriminate. Roughly one in seven people in the world live with migraine, so it is as relevant in the devolved authorities as it is anywhere else. We want to ensure that migraine patients across the whole of the UK have access to the best possible treatment.

For those who cannot access CGRP blockers or alternative treatments through their local NHS trust, or who simply cannot bear the extensive waiting lists to see specialists, drugs bought privately can be incredibly expensive. For example, rimegepant is around £270 per month when taken as a preventive, Botox injections for migraine are around £700 every 12 weeks and Vyepti infusions are around £600 every 12 weeks, and that does not include the cost of seeing specialists and having the prescriptions written, which of course means an additional fee. For those on low incomes, those options are completely inaccessible without NHS treatment, yet some are unable to access them regardless because of the decisions of their local NHS trusts. One survey respondent said:

“I had to spend £8,000 on CGRP treatment privately before moving to a hospital who would fund me under the NHS.”

Nobody should be priced out of quality healthcare, particularly when that healthcare can be truly life changing.

In all, I have outlined a number of tangible steps that could be taken and which would have a real and positive impact on those living with migraine, but let us return to Mollie’s story because, sadly, her experience is an example of how the current system does not always work for patients. In her words:

“Four and a half years later, there is not one second of any day in which I am not in pain. My pain is an average of 7/10 a day, and it soars up to 10/10 at least ten times a day...When it reaches these levels on a daily basis, every single day, you simply cannot live life normally anymore. I can no longer work, see my friends, or do any of the hobbies I used to enjoy. Every single thing that brings me pleasure is now impossible for me.”

For those living with severe chronic migraine, the huge detrimental impact on day-to-day life should not be understated. I have reached the point where I get anxious making plans, either for work or with family and friends, for fear that a severe attack may mean that I have to cancel at the last minute. With attacks seemingly getting more and more frequent, it feels increasingly like cancellation is an inevitability. This may sound really silly to some, but it is a really human example for me. I am a lifelong Swiftie and I managed to achieve the holy grail of getting Taylor Swift tickets for the Eras tour, but I am petrified that on the day a migraine attack might hit and take away my opportunity to see her live, because I would be devastated. Some might say that that is a silly example, but it is one of the things that are on my mind. If someone is living healthily, they do not have to have those sorts of considerations when making plans.

Many survey respondents reported similar concerns. One said:

“Migraine has impacted every job, social occasion and holiday over the last 15 years...It’s caused me countless days of agony. Migraine is a curse I wouldn’t wish on my worst enemy.”

Another said:

“I can’t make plans with people due to migraines making me cancel them last minute. I missed an expensive, once in a lifetime concert opportunity that I had been waiting 12 years for as I had a migraine that day. I had to leave a friend’s funeral early and not attend his wake due to a five-day migraine.”

One said:

“I have missed many family gatherings—New Years, Anniversaries etc. I have also missed events that I have purchased tickets to as I have been too unwell, losing out on both money and experiences.”

Another said:

“I gave up working 14 years ago, stopped socialising and even dread going on holiday, and travel was the thing I always most looked forward to.”

I received an email yesterday from June about her daughter. She is 35 and her migraine attacks are so severe that, in June’s words,

“she can no longer look after her children. At this moment in time,”

she

“cannot complete a simple jigsaw with her two-year-old daughter. This is my daughter who gained a first in her degree...She is upset about missing out on so much of her children’s lives, aged 5 and 2.”

I raise these examples to show that migraine has more than just a trivial impact on the individuals who are suffering; it has a real impact on them and on their loved ones and wider circle.

Many also spoke about the impacts of migraine on their working life. Mollie had just embarked on her dream internship when migraine hit, so she was unable to complete that internship and has struggled to work since. She is not alone. Many here will know that I gave up my ministerial role, as migraine meant that I could not keep up with the additional demands of government. Research by the Migraine Trust found that 29% of people with migraine had to move from full-time to part-time work and 25% had left a job altogether. One survey respondent said:

“I have been at risk of losing my job in the past due to having to take time off for migraines.”

Another said:

“I recently lost my job due to the number of migraine related absences I had.”

[Paul Girvan (South Antrim) (DUP)]

I thank the hon. Member for securing this debate. In the light of what she has just said, I will say that many people who suffer from migraine lose their job and have difficulty even accessing the likes of personal independence payment, because migraine is so debilitating whenever it happens but it is also unpredictable. Their life can become awkward when it comes to just doing things normally, but they have difficulty accessing PIP because of it.

[Dehenna Davison]

I agree with the hon. Member. In severe cases, migraine is absolutely a disability. It ruins lives. There is a separate discussion to have with the Department for Work and Pensions—I do not want to put all the pressure on the Department of Health and Social Care—about how it addresses chronic migraine and intractable migraine when making its assessments. I thank the hon. Member for raising that really important point, which came through from a number of our survey respondents as well.

Some workplaces make adjustments, such as allowing flexible working, but there are also reports of workplaces not making suitable adjustments. One respondent said:

“There is a complete lack of understanding that chronic migraine is a disability and employers are not willing to make allowances for this condition in the way they do with other disabilities.”

Shockingly, the Migraine Trust found that 56% of migraine patients said that their workplace had not made reasonable adjustments. That is why the organisation has launched its workplace pledge this week to encourage employers to make small, often low-cost adjustments that can make a huge difference for staff with migraine. We must remember that with one in seven people living with migraine, there is a good chance that even if someone does not, at least one of their colleagues probably does.

The impact of migraine on the workplace is not just confined to individuals dealing with the stress of potentially losing a job and income; there is a wider impact on the economy too. The Work Foundation has found that migraine causes between 28 million and 43 million lost work days per year in the UK, at a cost of around £4.4 billion. When we add the cost of that absenteeism to the cost of presenteeism—showing up and putting on a brave face but not being able to function normally —the Migraine Trust estimates that the total cost is closer to £9 billion.

We often talk about the need to improve productivity here in the UK, so surely helping those living with migraine access quicker and better treatment so they are able to work and fire on all cylinders would be a great step forward. That is especially so when coupled with the fact that, according to the Journal of Health Economics and Outcomes Research, the excess fiscal costs to the Government of one person living with migraine come to £19,823. That is the cost for one person, when there are 10 million in the UK battling the illness.

Giving up work for health reasons is not a choice that anyone makes lightly. For many, as well as the financial cost, there can be a significant cost to people’s mental health. Research by the Migraine Trust found that 78% of those living with migraine said it had a negative impact on their mental health and 65% reported experiencing anxiety as a result. People are missing work, cancelling arrangements with friends, missing out on social experiences that they have been looking forward to—and paid for—and feeling like they are a burden on their family. Others may not believe them, and they may wait months if not years to see a specialist; or they have the hope of trying another preventive that might work, only to have that shatter when it is another one that does not do so, and all the while they are living with excruciating pain. They are losing friends, losing relationships and feeling like they are losing their mind.

For some people such as Mollie, the darkness takes over entirely. She said that

“deep inside, I still had that same passion for life that all people in their twenties do. I want nothing more than to go outside and live my life, but this condition has me trapped in my own living room. My pain is now so severe, it has impacted on my mental health so intensely I contemplate suicide every single day of my life and have almost succeeded at times simply because I want the physical pain to end”.

We are here today to help people such as Mollie. We have a responsibility to help them and the millions of others suffering through migraine who need a lifeline. By improving access to treatments we can give them that lifeline. I hope the Minister will agree to meet me and the two brilliant charities represented here today to discuss further how we can do just that together.

--- Later in debate ---

[Dehenna Davison]

I am very grateful to the Minister for his remarks, and particularly for the fact that he has already actioned some of the points we raised by asking the MHRA to look into primary care prescribing. He also said that the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), is potentially exploring the further use of pharmacies, which is clearly a positive step.

My right hon. Friend the Member for South Staffordshire (Sir Gavin Williamson) made the brilliant comment that we clearly need to tackle migraine differently. I hope there can be a bit more oomph from the Department when it comes to recommendations from NICE. I appreciate that independence is crucial, but by raising awareness as we are doing today, and hopefully with some input from the Minister, we can perhaps still ask for another review without asking NICE specifically what to put into its guidance.

I am grateful to all right hon. and hon. Members who attended. They made some very interesting points and raised the cases of constituents living with this horrible condition. My right hon. Friend the Member for South Staffordshire talked about the wider impact of migraines, which many of us touched on. This is a health condition that does not just come on every so often; it has a wider impact on a person’s life and causes anxiety. It is about the in-between days when they are wondering when an attack might next strike. I am grateful to the Minister for recognising that and for talking about his own family’s experience of migraine, given that his sister suffers from the condition.

I am grateful to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) and the hon. Member for Midlothian (Owen Thompson) for sharing their experiences of migraine. Though their experiences were different in some ways, they were very similar in others, such as in the severity of attacks and the anxiety about how to tackle them. I was absolutely staggered by the amount that my right hon. Friend the Member for Romsey and Southampton North has spent on tackling her migraine. Botox can be an incredibly effective treatment, yet so many are unable to access it on the NHS, despite it being an approved treatment. That is another lifeline that we need to address. She raised the case of Monica, her constituent, who has had issues with her employer. I completely agree with my right hon. Friend and the hon. Member for Midlothian that migraine should formally be considered a disability, so that employers not only should, but have to put in place reasonable adjustments.

The hon. Member for East Londonderry—

[Paul Girvan]

South Antrim.

[Dehenna Davison]

South Antrim. I have my DUP colleagues confused—I can only apologise. It is because they both share a brilliant passion for Northern Ireland and for tackling the issue of migraine. I thank the hon. Member for South Antrim (Paul Girvan) for raising DWP assessments and the difficulty people have in accessing support when they are out of work as a result of chronic migraine. We have heard the statistics about how many people unfortunately have to give up work as a result of this disease, so hopefully we can take that up with DWP next time so that it can review its processes. Certainly, having chronic migraine listed as a formal disability would be a positive step in helping ensure that that is done.

The hon. Member also discussed the point around the devolved bodies. We heard some great testimonies from the SNP spokesperson, the hon. Member for Midlothian, about the positive steps being taken in Scotland and particularly the number of Scottish trusts that allow CGRP blockers to be prescribed. As he rightly said, that number is still not 100% and we need to go further to make sure that new, innovative treatment options that can work for so many people can be accessed by all those who are struggling.

I am grateful to the shadow Minister, the hon. Member for Bristol South (Karin Smyth), not only for responding here, but for getting in touch with me in advance of today’s debate so we could share a few notes about the impact chronic migraine can have. She is right to raise the impact on children—I did not particularly cover that in my speech, but my right hon. Friend the Member for Romsey and Southampton North touched upon it, given that she started experiencing migraine at such a young age. In some ways, it is even more terrifying for children because there is that lack of awareness of what is happening when a migraine attack strikes. Again, that is one example of how we need to get this right, in order to give people a better quality of life.

The hon. Member for Bristol South also talked about long-term workplace inactivity. Frankly, the best way we can tackle that is by getting people earlier diagnosis and earlier treatment that actually works. Part of that, as has been mentioned, comes down to knowledge and I am grateful to the Minister for talking about how medical training is outlined and done. It is great to hear that there are e-learning modules specifically on headache and migraine available for GPs and other medical practitioners to access—but I say we need to be bolder and I say we need to go further.

Off the back of this debate, therefore, I will be contacting some of those medical bodies to ensure they know just how debilitating and difficult migraine can be, in the hope that they can ensure not only that their educational modules are top notch and delivering the right information to the right people, but that people are taking those modules. They are not an optional extra; they are an absolute necessity.

I have probably missed some bits—yes, I have: I am grateful to the hon. Member for Greenwich and Woolwich (Matthew Pennycook), who is no longer in his place, for raising a point about knowledge, particularly of hormonal migraine, which many people experience. It is right that we continue to research that and make sure that medical practitioners have the knowledge they need.

My hon. Friend the Member for Kettering (Mr Hollobone) also raised the experience of his constituent. Again, it was another human story that tells the tale of chronic migraine; another human story that tells the tale of just how difficult this blooming thing can be. I am grateful to all hon. Members here today for taking part in the debate, for getting involved and for showing that there are people here in Parliament who care. To people watching at home, I say, “We are here, we hear you and we are going to do all we can to make this better.” I will keep nagging the Minister until we really see improvements in migraine care.

Question put and agreed to.

Resolved,

That this House has considered access to migraine treatment.

Oral Answers to Questions

Paul Girvan Excerpts

Tuesday 5th March 2024 Commons Chamber

[Victoria Atkins]

It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [Interruption.] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.

[Paul Girvan (South Antrim) (DUP)]

11. When she plans to introduce a tobacco and vapes bill.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

The hon. Member will know that, shockingly, smoking kills 80,000 people across the UK every year, and costs society £17 billion in ill health and loss of productivity. The Government will introduce the tobacco and vapes Bill shortly. I am delighted to say that Northern Ireland Ministers announced just this morning that we will legislate for the whole of the United Kingdom.

[Paul Girvan]

I thank the Minister for that answer. I just want to say that the age-related Bill on the sale of tobacco products will create the first generation of smoke-free people in the United Kingdom. All politics is local, and it is vital that we have the same legislation in Northern Ireland. In Northern Ireland, smoking contributes to at least 1,300 smoking-related cancers per year. Some 13.9% of the people in my constituency continue to smoke, irrespective of the guidance given. I am glad to hear the Minister’s assurance on the legislation, but will the Government engage with the Northern Ireland Executive to ensure it is on their priority list?

[Dame Andrea Leadsom]

I can tell the hon. Gentleman that the Secretary of State met the Northern Ireland Health Minister just yesterday. I absolutely assure him that all parts of the United Kingdom will be included in the once-in-a-generation public health intervention that will save millions of lives.

NHS Staffing Levels

Paul Girvan Excerpts

Tuesday 22nd November 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful to the hon. Member for Wirral West (Margaret Greenwood) for raising this important issue. I join her in thanking all NHS staff for everything they do for us. The workforce are the beating heart of everything our NHS does and stands for. I hugely value the work of everyone who works in health and care, from consultants to care workers, nurses to neurosurgeons, and porters to physios. I thank all hon. Members from across the House who have taken part in this important debate. In the time available to me, I will try to respond to as many of the themes raised as possible—I have been franticly scribbling throughout the contributions.

I have only been in post for a handful of weeks, and in that time I have seen the very best and the future of our NHS with cutting-edge technologies and innovation. For example, it was only earlier this week when I saw genuinely world-leading world genome sequencing. Innovation and technological advancement is only as good as the highly trained and qualified clinicians who operate it or, importantly, who interpret the data. Health is a human business. I know this from my own family’s experience of the NHS, and I am sure hon. Members know that too. Only caring NHS staff can provide the patient-centred and compassionate care that we all hope and expect when we interact with our NHS. That is why I am personally passionate about supporting our health and care staff, particularly when we are in challenging times. Last week, the Chancellor announced an additional £3.3 billion a year in the autumn statement to assist in this endeavour.

I turn first to workforce pressures, which were raised by the hon. Members for Batley and Spen (Kim Leadbeater), for Westmorland and Lonsdale (Tim Farron), for Bradford West (Naz Shah) and for Birmingham, Erdington (Mrs Hamilton)—I am particularly grateful to her for sharing her 25 years of nursing experience. I am acutely aware that the workforce remain under sustained pressure. Staff worked tirelessly through the pandemic and they have my huge thanks and gratitude for doing so.

I know that every day hundreds of thousands of NHS staff provide high-quality care under considerable challenges. As well as the pressures we see every winter, in the summer, which is usually—I am told in the NHS you cannot use the Q-word, which stands for quiet—less busy, we had covid waves where we would not ordinarily. There is also the recovery of elective care and the 7 million people on waiting lists, including the 400,000 who have been waiting over a year, as the hon. Member for Wirral West rightly pointed out. There is the rising number of covid and flu cases—I take this opportunity to make a public health announcement encouraging people to check their eligibility and get their covid and flu jabs if they have not already done so.

Of course, it is vital that we support the workforce, not just now but for the future. The NHS workforce have grown since last year, with an extra 3,700 doctors and 9,100 nurses, but I understand that—this point was made eloquently and articulately by hon. Members—demand is growing significantly, too.

[Paul Girvan (South Antrim) (DUP)]

In the light of workforce planning, somebody seems to have taken their eye off the ball. We have doctors who decide they want to be locums and get three times the shift rate. We have nurses who leave the NHS and sign up with the agency, costing three times more. When will we grasp the nettle of workforce planning and deal with it?

[Will Quince]

The hon. Gentleman is right that that is happening and I will come on to that matter in more detail. I would be happy to meet him, because it is an issue that I know needs gripping not just at the national level but by local integrated care boards too.

As hon. Members have pointed out, training the doctors, nurses and allied health professionals of the future takes time. We have to plan for the next decade now, as the hon. Member for York Central (Rachael Maskell) said. Despite the challenges, we have a growing NHS workforce. We have record numbers of staff working in our NHS. There are record numbers of doctors and nurses. The NHS now has over 1.2 million full-time equivalent staff. In the last year alone, there were over 15,800 more professionally qualified clinical staff in trusts, and 129,800 more hospital and community health service staff than in 2019. Nursing numbers are 29,000 higher than in 2019, which means that we are on track to meet the 50,000 extra nurses manifesto commitment.

However, as the hon. Member for Wirral West pointed out, we face challenges. There are over 132,000 vacancies, including, as she rightly said, 40,000 nursing and midwifery vacancies, and vacancies for around 10,000 doctors. As the hon. Member for South Antrim (Paul Girvan) rightly pointed out, that means an over-reliance on bank and agency staff. They have their place, but they come at a significant cost, of which we have to be mindful.

We have a long-term workforce plan, which is an NHS England-commissioned project that will set out what workforce we need across the next five, 10 and 15 years. As the Chancellor said in the autumn statement, it will be independently verified. It will look at recruitment, retention and productivity. It will look at where the challenges and the gaps are. As the hon. Member for York Central, who is no longer in her place, rightly asked, what do we need the NHS to look like? Do we need specialists? Do we need more generalists? Do we need a mixture of skills, where people are specialists but also retain generalist skills so that they can do other work? The plan is for the project to report back by the end of this year—very soon—and that independent verification process will then take place. Integrated care boards will need to do the same, or a similar, piece of work at local level.

I am also aware that there are specific challenges. The hon. Members for Strangford (Jim Shannon) and for Westmorland and Lonsdale rightly raised mental health services. An extra £2.3 billion is going in, and our plan is to recruit an extra 27,000 staff, but it is a challenge, which is why we have the advanced bursary in that area. We have increased staff in the area by an extra 5.4%. I know that is not enough, and I know the challenges on local mental health services, so we have to do more.

There is a similar challenge in rural and coastal communities, which the hon. Member for Westmorland and Lonsdale has raised with me many a time. We have to look to expand the apprenticeship route and blended learning programmes so that people do not have to travel to big towns and cities to undertake their training. That work is being done, and there is an extra £55 million for additional placement capacity.

Investment in training is also important. We funded an extra 1,500 medical school places—a 25% increase—last year and this year. That was an investment in five new medical schools. The £5,000 non-repayable grant for nursing, midwifery and allied health professionals has been in place since 2020. There is also additional funding for certain courses, and for things such as support for childcare, dual accommodation, and costs and travel.

Ockenden Report

Paul Girvan Excerpts

Wednesday 30th March 2022 Commons Chamber

[Sajid Javid]

Yes, I agree very much with my hon. Friend and I thank her for sharing with the House her own valuable experiences. She is right to talk about the importance of continuity of care, and that is part of our maternity transformation plan.

[Paul Girvan (South Antrim) (DUP)]

I thank the Secretary of State for the report, although it is sad that we have to have a report such as this in front of the House. I want to highlight a point and check whether we can do something about it. There are many good people working in our NHS, and the majority of people are probably there for the right reasons, but, unfortunately, due to the culture of institutional blindness that has been mentioned, or to bullying, they cannot whistleblow, and whistleblowers are not being protected. As a consequence, more and more of these types of reports are going to be required, not only on maternity services, because whistleblowers are being targeted and put down. I would ask that whistleblowers be protected and given the opportunity to have their concerns understood and heard.

[Sajid Javid]

The hon. Gentleman is absolutely right. One of the reasons we are creating the special health authority that I referred to earlier is to provide that independence, and also more protection for members of staff to come forward. For example, members of staff will be able for the first time to report things they are concerned about directly to the SHA, and it will have the right to investigate.

Abortion Services Commissioning: Northern Ireland

Paul Girvan Excerpts

Tuesday 14th December 2021 Westminster Hall

[Carla Lockhart (Upper Bann) (DUP)]

It is a matter of deep regret that this House has sought to impose its will above the devolution settlement. At the heart of devolution must lie respect for the areas of legislation that have been determined to fall within the jurisdiction of devolved authorities. In complex and highly charged matters such as abortion, the benefit of the doubt should always be granted to the devolved authorities that they are capable of managing their own affairs.

Both the Abortion (Northern Ireland) Regulations 2020 and the Abortion (Northern Ireland) Regulations 2021 were passed despite the overwhelming majority of MPs representing Northern Ireland who take their seats in Westminster voting against the regulations on both occasions, despite the overwhelming majority of respondents to the consultation on the legislation being opposed to its imposition in Northern Ireland and despite the Assembly being back up and running prior to those regulations becoming law. The very premise for the legislation was flawed, with the claim that intervention was required by Westminster because Northern Ireland was in breach of international law. That claim has been demonstrated to be absolutely wrong—even the explanatory notes for the legislation noted that the CEDAW report recommendations

“are not binding and do not constitute international obligations.”

My hon. Friend the Member for North Antrim (Ian Paisley) eloquently outlined the change that had to be made in the regulations’ explanatory notes to demonstrate that the very foundation on which that law was brought forward was factually incorrect. That is a crazy way to make law—to build it on something that is fundamentally wrong.

The regulations go far beyond what is legally required, as well as beyond the law in England and Wales. They are also discriminatory against those diagnosed with disabilities. A submission to the Secondary Legislation Scrutiny Committee stated:

“Abortion is a sensitive matter throughout the United Kingdom, but no more so than in Northern Ireland to which the Abortion Act 1967 has not been extended”.

The Abortion (Northern Ireland) (No. 2) Regulations 2020

“radically alter the framework for abortion services in Northern Ireland”,

and

“its provisions exceed those already available elsewhere in the UK. For example,”

that includes unconditional access to abortion where

“the pregnancy has not exceeded its 12th week”.

We hear about Northern Ireland’s stance on pro-life and about the number of people who have had to make a difficult journey to GB for access, but we do not often hear about the 100,000 lives who are alive today in Northern Ireland because we did not sign up to the 1967 Act. One hundred thousand lives—people working in our hospitals and the NHS, teachers, and those right throughout our society who are alive today and contributing to society because they were not aborted. Our law values life.

Tragically, the radical regulations permit sex-selective abortion, since the sex of a foetus can be determined through non-invasive prenatal testing. Imagine, baby girls—in the main—being aborted just because they are girls. We call ourselves a progressive society; there is nothing progressive about having a law that allows for babies to be aborted because of their sex.

On the subject of disability, Lord Shinkwin noted during the debate in the other place on the latest version of the abortion regulations imposed on Northern Ireland earlier this year:

“The regulations…threaten me because they challenge that right by devaluing my existence. The narrative of the regulations is that I should not really exist. Indeed, I would be better off dead.”—[Official Report, House of Lords, 28 April 2021; Vol. 811, c. 2271.]

[Paul Girvan (South Antrim) (DUP)]

On that point, on the importance of the unborn and of protection for the unborn, and on the recognition of that in law, whenever we hear of incidents such as the Omagh bombing, when the unborn were killed, they are included in the numbers of the dead. In the incident at Hillsborough, the unborn were included among the dead. I believe that that is the point: they are a life and they are deemed in law to be a life. The recognition is there, and yet now we believe that we can snuff it out.

Randox Covid Contracts

Paul Girvan Excerpts

Wednesday 17th November 2021 Commons Chamber

[Brendan O’Hara]

The difference, quite simply, is that we never fast-tracked our pals, we never operated a get- rich-quick scheme for our pals, and we did not stuff unelected second Chambers full of people who bankrolled our party.

[Paul Girvan (South Antrim) (DUP)]

I represent the constituency where Randox’s headquarters is, and they are a major employer. There are not that many firms or pharmaceutical companies in the United Kingdom that would have had the capacity to deliver the amounts of tests that needed to be done at that time.

[Brendan O’Hara]

The hon. Gentleman makes an important point, but what has to be remembered is that nobody is above scrutiny, and if there is nothing to hide they should have nothing to fear. This is all about scrutiny and shining a light where I fear a lot of Conservative Members do not want a light to be shone.

Medicinal Cannabis

Paul Girvan Excerpts

Monday 6th September 2021 Commons Chamber

[Crispin Blunt (Reigate) (Con)]

I congratulate the hon. Member for Edinburgh West (Christine Jardine) on securing the debate and on her brilliant timing in doing so on an evening where we can debate not only the narrow issue being focused on by the wonderful campaign End Our Pain—the plight of these epileptic children. I do not have one of those children in my constituency, but a number of us do, and by goodness, if I did, I absolutely would be championing their cause. However, this discussion also needs to take place in the context of the whole debate about medicine and how we need to improve our nation’s and people’s access to medicines that work.

My right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) was behind me on the day that I asked the urgent question that followed the march and the petition that we presented to Downing Street. It was when he leaned over to me in the Chamber and said, “We don’t agree about very much, Crispin, but I support you on this,” that I realised that what I would have regarded as the Taliban, as far as drugs policy was concerned, had come on side. With enthusiasm, we embraced my right hon. Friend’s help because of his influence with the Prime Minister. Having worked with him, I will not disguise the fact that we come from a very different place on wider drugs policy; he managed to get me a splash in The Sun when he was taking the Psychoactive Substances Bill through the House, which was my moment of notoriety in the Chamber. However, the context of what we are considering today is a drugs policy in the United Kingdom that is nothing short of catastrophic.

We need to work towards creating institutions that can advise the Government with evidence, authority and expertise. The truth is that we have proceeded with drugs policy for more than five decades on the basis not of evidence, but of reputation and what people think—exactly what my right hon. Friend was saying about the implications of the word “cannabis” and what people adduce to it. We have not proceeded on the evidence.

[Paul Girvan (South Antrim) (DUP)]

I thank the hon. Member for making that point, because if we were to adopt the same approach with opiates, we would be giving people “heroin” as pain relief: we call it morphine, but it is heroin by another name. If we continue to talk about medicinal “cannabis”, stigma will continue to attach to the part that gives a hallucinogenic effect. That is the part that everyone will focus on unless we start to change the direction, the language and the naming, which is why the medical profession is blackballing it on every occasion.

[Crispin Blunt]

The hon. Gentleman has landed on the core of the problem: the reputational issues that we are dealing with.

We owe it to our constituents to do just a little better. We owe it to them to try to understand the evidence and create institutions that will advise our Government based on the evidence. We have a duty not to be stampeded by the popular press in a particular direction about the particular meanings of words, but we have done so for 50 years in regard to cannabis: it was shoved in schedule 1 to the regulations made under the 1971 Act, which governed the most dangerous narcotics, and we kissed goodbye to 50 years of understanding within the medical research sector of what might be possible.

We were then left with the situation that we faced in 2017: after my two and a half years’ experience as prisons Minister, the evidence was plain throughout the entire justice system, as it is today, that our wider drugs policy is an unqualified disaster. We have watched the frog in the pot as the temperature has risen and risen over five decades; it is now boiling over and shreds are coming off. We have the worst drugs death rate in Europe and our drugs policy has dominance over the criminal justice system, driving half of acquisitive crime in the UK. Those issues elide into the narrow issue of medicine from cannabis, but we owe it to our constituents to understand the context.

I say this to the Minister particularly: if we can get the change of approach right, there is a huge opportunity. It is not just about the magnificent campaign by End Our Pain and my right hon. Friend the Member for Hemel Hempstead for the 17 identified epileptic children and their families, although of course there are duties that we all owe to them, and they raise the question of what we would do in their position. I was in the Chamber when my right hon. Friend said that he and Frank Field would be at customs to deliver the bottles of medicine—and an absolutely splendid occasion it was, too.

It is not just about epileptic children; it is also about people with multiple sclerosis. An estimated 50,000 people in this country are growing their own medicine, at peril of a 14-year prison sentence, all to try to make themselves better. From those 50,000, there is a huge amount of research evidence, all of which is lost to the legal system: people are growing particular plants and adjusting the exact balance of the cannabis product that they produce to best use for their condition.

Coronavirus

Paul Girvan Excerpts

Wednesday 26th February 2020 Commons Chamber

[Matt Hancock]

It is best here that we follow the clinical advice, which is as I set out. One of the good things about the covid-19 coronavirus, compared with similar illnesses, is that it seems to be much less impactful in terms of symptoms on children, which is good news, because with the flu it is normally the other way around. That observation underpins the clinical advice. We need to listen to the scientists.

[Paul Girvan (South Antrim) (DUP)]

I thank the Secretary of State for his statement to the House. What advice and help is being given to airport staff, given that they are often the gatekeepers?

[Matt Hancock]

We should thank Border Force, which has done a fantastic job, and the staff at the international ports. We are constantly engaged with them, through the Department for Transport—and the Home Office in the case of Border Force—to ensure they get the right information and support, but if the hon. Member has any specific worries, I would be happy to answer them.

Diabetes: Tailored Prevention Messaging

Paul Girvan Excerpts

Thursday 24th October 2019 Westminster Hall

[Jim Shannon]

I know the Minister will reply to that, because that is one of the questions that I had hoped to get an answer on.

On the Monday before last, we had a diabetes event in the House. Before I came over, some of my constituents said, “Will you go along to this event about diabetes? It is really important, because some great things are being done in some parts of England and we would like to know about them.” When I got there, the people were most helpful and informed me that Northern Ireland has one of the better type 1 diabetes schemes, which is reaching out to 70% of people. As we often do in Northern Ireland, in this case we have a scheme in place that is almost voluntary. We have an un-functioning Assembly, which is disappointing, but we have a system whereby that scheme is working. Some of the things that we are doing, we are doing quite well.

There are 4.7 million people living with diabetes across the UK, each of whom should be treated as an individual. In Northern Ireland, we have 100,000 people with diabetes in that 17-plus bracket, but obviously it is more than that when it is all added up. Every day across the United Kingdom of Great Britain and Northern Ireland, 700 people are diagnosed with diabetes; that is one person every two minutes.

I had a good friend—he is not in this world any more, but that is not because of diabetes—who was a type 1 diabetic. He ate whatever he wanted and I always said to him, “You cannot eat all those things.” He said, “Oh, I can. All I do is take an extra shot of insulin.” I said, “That’s not how it works!” I do not know how many times I told him that. My three hon. Friends—my hon. Friends the Members for East Londonderry (Mr Campbell), for South Antrim (Paul Girvan) and for Upper Bann (David Simpson)—will know who it is, so I will not mention his name. He was very flippant about the control of his diabetes, but it seemed to work for him. I could never get my head around the idea that an extra shot of insulin seemed to cure the problem.

[Paul Girvan (South Antrim) (DUP)]

I thank my hon. Friend for bringing this important debate to the Chamber. My wife is a type 1 diabetic who is insulin-dependent. She has already—she is a bit younger than me—lost a kidney, because of lack of control, which can cause problems. That needs to be identified: control is vital, and it is important for people to monitor regularly. New technology is available that can actually give readings constantly, as people go. It is important that people start to use the available technology, so they do not have to take more insulin than they need, but can take it only when it is needed.

[Jim Shannon]

Like my hon. Friend, my wife is younger than me. It must be a Northern Ireland DUP MP thing—we look for younger wives to keep us young. I am not sure if that is right or wrong, or if it is politically correct to say that, but my wife is nine years younger than me. She understands the issue of me and diabetes.

Some 10% of people with diabetes have type 1 and 90% have type 2. I will refer to both throughout my speech, and I encourage hon. Members to do the same and to acknowledge the different factors at play with each. We can manage type 2 with medication, provided we control what we eat and what we put in our bodies. Of those living with diabetes, we have the broadest cross-section of society. The condition affects all genders, ages, ethnicities and financial situations. However, too often I see that policy makers and clinicians fall into the trap of treating people with type 1 or type 2 diabetes as homogenous groups that will respond to the same approach and message, but they respond in different ways.

During this debate I want to focus on four things: the primary prevention of type 2 diabetes; the need to offer different messaging to ensure that the support is appropriate for each individual living with diabetes; the necessity of preventing the complications of all forms of diabetes; and innovations in technology—there is marvellous technology —and patient pathways that can improve outcomes for people living both type 1 and type 2 diabetes. I wish that I had known 12 months before I was diagnosed that the way I was living—the lifestyle, the stress—was putting me at risk. We all need a bit of stress; it is good and keeps us sharp, but high stress levels with the wrong eating and living habits is harmful. I do not drink fizzy lemonade any more because it was one of the things pushing me over the edge. That was probably why I lost most of the weight fairly quickly.

Let us talk about prevention. Today more than 12 million people are at increased risk of type 2 diabetes across the UK. More than half of all cases of type 2 diabetes could be prevented or delayed. If I had known a year before my diagnosis, I could have stopped the downward trend in my health, but I did not know, and I wish that I had done. Many in this House offer leadership on type 2 diabetes prevention; the right hon. Member for Leicester East is certainly one of them. England is a world leader on this front, having recently committed to doubling its national diabetes prevention programme.

I was pleased to attend a roundtable discussion last summer, chaired by the hon. Member for Enfield, Southgate (Bambos Charalambous), at which we considered the link between obesity and diabetes and the importance of tailored messaging for the different subsets of the population. During the discussion I met the inimitable Professor Valabhji, the national clinical director for obesity and diabetes at NHS England, whose leadership in this space should be celebrated. I put that on the record because his knowledge and help for those around him, and his research into and development of how we deal with diabetes, are incredible.

For people with type 2 diabetes, there is the additional aspiration of achieving remission. I echo colleagues’ congratulations to the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson). We watched him almost shrink. One day I stopped him and said, “Tom, is everything all right?” He was losing so much weight, but it was his choice to diet as he did. He is an inspiration for many people because of what he has done, and I commend him for it. The concept of remission can be alienating, however, because it is not possible for every person with type 2 diabetes.

Central to the effectiveness of all types of support for the individual and the wider population is the messaging used, which is what this debate is about. Tailored messaging should be developed for the sub-groups most at risk of type 2 diabetes. For example, those in the most deprived areas of the country are nearly 50% more likely to be obese and have type 2 diabetes than those in the most affluent areas: there is type 2 diabetes in areas where people do not have the same standard of living.

Obesity is responsible for around 85% of someone’s risk of developing type 2 diabetes. Additionally, south Asians are six times more likely to develop type 2 diabetes than Europeans are. It is a well-known cliché that men are not so open or proactive—I can say this is true—about their health needs, and men are 26% more likely than women to develop type 2 diabetes. I am willing to speculate, as one who fell into that category, that that is in part due to messaging not being in a format that reaches men. I did not know what it was, did not know what it meant, did not know what the symptoms were, but it was happening.

We need to focus some of the messaging on the importance of prevention and the risk of type 2 diabetes for men. Will the Minister commit to ensuring that all messaging to support those with type 1 and type 2 diabetes, as well as for type 2 diabetes prevention, is tailored to the relevant sections of our society?

I have to manage my diabetes every day. I take my tablets in the morning and at night. I am careful about what I eat. By and large, I manage it. I check my sugar levels every morning. The doctor tells me to check and I do it every day so that I know where I am. I am a creature of habit; I do it all the time so that I know exactly where I am. Some days it is out of kilter, probably because I transgressed and had a cream bun when I knew it was the wrong thing to have. None the less, we do such things.

On self-management, the average person with diabetes will spend just three hours a year with a healthcare professional. That means that they will spend most of their time managing the condition themselves and will need appropriate education. The right hon. Member for Leicester East chairs the all-party parliamentary group on diabetes. He organised a seminar where we looked at healthcare professionals and how people manage their own condition and therefore need appropriate education. The current delivery of structured education does not reflect the varying needs of each individual living with diabetes. We are all different.

The best efforts of healthcare professionals and those who provide education often focus on perfect self-management or no self-management at all. In reality, the daily struggle of living with a long-term condition means that every marginal improvement should be seen as a true achievement. We have to manage it and encourage ourselves as we move forward. We have to make sure that by moving a step forward we can then move forward again. There has been an admirable drive to increase the uptake of education, but education alone will not help an individual manage the ups and downs of living with the condition. They need the tools and confidence, as well as the education, necessary to manage their condition.

When I speak to people in my constituency who live with diabetes, they often highlight the feeling of isolation. I am sure we can all agree today that there is a need to provide each of those individuals with the support they need to take away the isolation. Being a diabetic can be lonely if someone does not know how to manage it. They might think they are doing the right thing when they are not. Issues have been highlighted to me about the delivery and format of education programmes. Digital solutions and coaching services should be explored. The Minister referred to that in a conversation that we had prior to this debate. I look forward to her response. We always get something positive from her, and we will certainly get something positive today.

Will the Minister commit to ensuring that the delivery, format and content of structured education programmes is improved through the use of digital solutions, and that national guidelines are adapted to accommodate that? Health apps could also be used to refine and augment diabetes training programmes by enabling clinicians to learn from patients about what motivates them and therefore what support to provide.

I want to congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on her leadership on how health apps can be used to improve care and patient self-management. Many MPs in this House are diabetic or have an interest in diabetes. That is why we are here today. We are either diabetic or interested in the matter and here to make a contribution. I commend and thank right hon. and hon. Members for their commitment.

Will the Minister commit to undertaking an extensive public engagement and education programme, using digital platforms where appropriate, to showcase effective and evidence-based health apps and encourage their wider usage? Support needs to be tailored to individuals’ particular needs, in recognition that no single solution works in self-management for everyone. Everybody’s needs are different. I was the first diabetic in my family. When the doctor diagnosed me as a diabetic he asked me about my mum and dad and my wife’s mum and dad, and whether there was anybody in my family tree with the condition, but there was no one there. Unfortunately, my condition was caused by my diet and my lifestyle, so I created the problem. It was not hereditary, but it is how we deal with such things and tailor our responses that matters.

I have recently been convinced that health coaches—the Minister will comment on this—can play a key role in this space. Coaches can bring a distinct non-clinical skillset that poses questions for patients to help them devise the solutions that work for them, to help build their self-confidence and self-motivation—in stark contrast to the more prescriptive approach taken in clinical settings. Coaching needs to be clearly defined, and the full range of support that coaches can provide to support tailored prevention messaging needs to be identified. I look to the Minister’s response, because I believe it will have some positivity in relation to what we seek and what will happen.

It has been brought to my attention that the health service may ultimately need to decide whether to adopt a population-based approach to support improved outcomes across the entire population, or a more targeted approach aimed at those facing the greatest barriers to effective self-management. Will the Minister ensure that the health system explores the full range of ways in which health coaches can support people living with long-term health conditions, as well as carers and family members, through the development of an NHS definition of health coaching? Does she agree with me—and I hope with others in the House—that the UK has an opportunity to be an exemplar in the use of health coaches? It is an excellent opportunity and I hope that through the Minister we can make those changes.

I want finally to discuss the potential of innovations and technology in addressing issues related to self-management. That is what I do—I self-manage my diabetes. A flexible approach to the provision of structured education is vital to support self-management. Once equipped with the information and skills necessary to self-manage, people must have access to, and choice from, a range of proven technologies to help them manage their condition in everyday life. There has been a big investment in technology recently in the NHS.

We welcome the Government’s commitment to the extra spend on health, which we talk about regularly. All us in the House are particularly appreciative of the Government commitment. People with type 2 diabetes are now provided with glucose monitors; my hon. Friend the Member for South Antrim (Paul Girvan) referred to those in an intervention. However, people are offered little education on how to use them appropriately. There may be something more that we can do about that. It is good to have the technology, and to be taking steps forward, but it is also good for people to understand how to use it appropriately for management.

The level of investment in innovative hardware for people with type 1 diabetes is substantial and should be commended. However, individuals can be left lost if timely support is not available to help them to interpret and utilise those tools as a means of preventing complications. Many people with type 1 diabetes choose not to access the technologies now available to them. Why is that? I do not know the reason, but it is a question we must ask. I believe that it is partly because of a lack of individual awareness. In the case of my diabetes, that would be right. It could, potentially, be linked to a lack of information. If information is not being provided, I should hope that something could be done about that.

Later in the month an event is being held in Parliament, chaired by the right hon. Member for Knowsley (Sir George Howarth). The event, held in partnership with the type 1 diabetes charity JDRF, is to do with the development of a new report on access to technology for people with type 1 diabetes, “Pathway to Choice”. I look forward to reading the report when it is published, and I know the Minister will be keen to read it.

All of us with an interest in diabetes—and that is why Members are here for the debate—will be interested to read it. Can the Minister inform colleagues here today what measure will be introduced to ensure that all people living with either type 1 or type 2 diabetes can access the latest proven technologies that are right for their situation?

--- Later in debate ---

[Liz McInnes]

My right hon. Friend is absolutely right. There is an unfortunate blame culture and children can be quite cruel to each other at times; we, as adults, must be careful about the language that we use about diabetes. If I achieve one thing in this place, I would like to get people to understand the difference between type 1 and type 2 diabetes—then I would feel as though I had achieved something.

Despite the growing public pressures associated with both type 1 and type 2 diabetes, a person living with diabetes only spends, on average, three hours a year with a clinician. People with diabetes are often put under a great deal of stress, because of the challenges and complexity in managing the condition and the multiple day-to-day decisions they have to make. In order to allow them to develop the necessary skills to manage their own condition, further support is required—including, but by no means limited to, weight management support.

This debate is very timely and follows a meeting we held in parliament in June of this year, which was attended by the hon. Member for Strangford and my right hon. Friend the Member for Knowsley (Sir George Howarth), among other MPs. The meeting was about realising the potential of health coaches in diabetes care, which the hon. Member for Strangford has already mentioned, and it was supported by Roche Diabetes Care—although of course I have to say that other diagnostic companies are available.

The meeting heard from health coaches about how they support participants in a lifestyle management programme, using their professional expertise as qualified nutritionists to support people to better manage their weight.

[Paul Girvan]

Does the hon. Lady agree that sometimes GPs do not give the right advice to patients? Perhaps a patient who presents with a bad infection is put on antibiotics, which can have an impact on their absorption of insulin, and as a result they can go into a hypo or take a low. That can cause major problems unless they have someone who knows them well, who can watch the signs and knows how to deal with them. Some GPs do not relay that information to patients when prescribing.

[Liz McInnes]

The hon. Gentleman makes a very important point, which I will come to later in my speech, about the need for all health professionals to be aware of diabetes and the complications that can arise, particularly in the situation he describes, where a GP may prescribe something without asking how it will impact on other conditions. The hon. Gentleman highlights the need for more and better training for health professionals around the whole condition of diabetes.

The meeting held in Parliament in June had three main themes. The first theme was relieving workforce pressures in diabetes care by providing non-clinical advice where there are gaps in clinical capacity, which refers back to the point that the average diabetic does not spend a lot of time every year with a clinician. The second theme—it is very pertinent to this debate—was about helping people to find their own tailored solutions to immediate health challenges such as weight management, as well as changing the way they think about their situation. The third theme, which the hon. Member for Strangford mentioned, was digital solutions to deliver 24/7 services to users. The health coaches explained to us how, through apps and other devices, users can message them at any time of day or night. The health coaches will get back to the individual, talk to them and help to address the issue.

Health coaching should be seen as a complement to clinical work and not as a tangent to it. It does not necessarily have to be done by discrete health coaches and could be incorporated into the day-to-day work of NHS staff; that relates to the point made by the hon. Member for South Antrim (Paul Girvan) on GP coaching. It should be incorporated into the day-to-day practice of all staff who work with people with diabetes. That is a point that NHS England and Health Education England should be considering.

Some would say that coaching on lifestyle and weight management is a role that should be fulfilled by the diabetes specialist nurse. I am interested to hear the Minister’s comments on the decline in the numbers of those who perform that very important specialist role. The National Diabetes Inpatient Audit reported that more than a quarter of hospital sites do not have a dedicated in-patient specialist nurse—there is a real gap that we need to examine. The specialist nurse is recognised by most diabetics as their go-to person, so it is quite shocking to hear that they are no longer available in a quarter of our hospitals.

I agree with the basic premise of the hon. Member for Strangford on tailored solutions and prevention messaging for diabetes. I hope the Government will follow the issue up, as well as ensuring that provision is equitable and that variations in uptake are addressed.

Of course, underpinning the whole issue is the need for better public health funding. It is no coincidence that just yesterday in this very Chamber in a debate on the declining numbers of health visitors, I quoted the figures for the national reduction in public health funding and the local reduction in my own borough of Rochdale. Nationally, there has been a reduction of £531 million on public health spending. In my local borough, there has been a cumulative reduction of £8 million over the last four years.

We cannot provide important services on an ever-decreasing budget. It was short-sighted of the Government to try to cut costs by reducing public health funding, and the chickens are now coming home to roost on this ill-thought-out decision. Given the emphasis on prevention in the NHS long-term plan, I will be interested to hear what the Minister has to say about how the cuts to public health funding will be reversed, and how quickly.

Finally, I understand that a National Audit Office report on health inequalities will come out at midnight tonight. I suspect that that report will lay bare the health impacts of cuts to public health services. I will certainly read it with great interest, and I hope the Minister will too.

--- Later in debate ---

[Keith Vaz]

I say yes to the hon. Gentleman on all those points—I agree with them all. I will come to the sugar tax later, but I can take a chunk out of my speech by saying that I agree with all those six points. His shopping list is fine with me, and I will happily copy it.

However, campaigns are extremely important. Very soon, we will have World Diabetes Day. Diabetes UK writes to everyone, asking them to turn buildings in their constituency blue. That is in just 26 days’ time. As chair of the APPG, I have written to mayors across the country, asking them to turn their landmark buildings blue. I ask the Minister to turn the Department of Health and Social Care blue on the outside—it may well be blue on the inside—on World Diabetes Day. I say to the hon. Member for Strangford that he should turn the Castle Ward or the statue of St Patrick blue in his constituency to raise awareness. Of course, one day we will have a statue to the hon. Gentleman himself in Strangford, next to the one of Jamie Vardy, and we will turn them both blue.

We in the all-party parliamentary group, of which we have so many members here—one could call them the usual suspects, but I call them the all-stars—meet every month. We produce reports, one of the most important of which is on mental health and diabetes, something that diabetics are simply not aware of when they get diabetes. I certainly was not aware of it. Support for mental health and wellbeing is critically important to people who have type 2 diabetes. It is an ongoing thing; people do not know why they have depression or why their lifestyle has changed, but it is to do with diabetes. I pay tribute to Diabetes UK, to Chris Askew, and to Nycolle Diniz for the work she does for the APPG.

It is not only specialist nurses who can help us, but other professionals, such as pharmacists. Everyone knows that pharmacies and pharmacists have great expertise in diabetes. My mum—I go back to talking about my mum—could spend more time with her pharmacist in Evington in Leicester talking about her condition than she ever did with her doctor. Maybe the Government should run the awareness campaigns through the pharmacies. That would mean reducing the money going to the doctors a little, and they will quaff around and complain—but if we fund pharmacies to do the testing, we will save so much money in the end. Pharmacists such as our APPG ambassador, Jimmy Desai in Ilford, have done an amazing job. Let us empower them to do things.

The third pillar is prevention, which we have all talked about, and reversal if possible. The hon. Member for Strangford has changed in terms of his weight; we have heard from people such as Dr David Unwin, another of our ambassadors at the all-party parliamentary group, that around 60% of cases of type 2 diabetes can be delayed or prevented by making those lifestyle changes and having a healthy, balanced diet.

At the Health Hub in Doha, which I recommend the Minister visits—although obviously not if there is a crucial vote, as the Government will need her here; I am happy to pair with her and we can go together—if a doctor says, “You are borderline diabetic,” they do not give the patient tablets. Rather, they say, “Here is a prescription to go to the gym downstairs. Start doing your gym work, and don’t see me again until you get your lifestyle sorted out,” because lifestyle makes a great deal of difference. Some of us have our watches connected to our phones—I do not know whether my right hon. Friend the Member for Knowsley (Sir George Howarth) does—so we know about our steps. I very rarely hit 10,000, but at least there is a willingness to try to do more exercise, and walking round the Palace is a way to make sure we do that.

As we have heard, obesity is a killer. Obesity-related conditions cost the NHS—cost the Minister—£6.1 billion a year. I adopt as my own the shopping list of the hon. Member for Strangford: the six things he has asked for, from the watershed to multiple offers in supermarkets. We should all do that and say, “Let’s do it.” The private sector has done its bit. Kellogg’s has put traffic light labelling on most of its cereal packs sold in the United Kingdom since 2018—well done to it!

[Paul Girvan]

On food and how manufacturers can help, does the right hon. Gentleman agree that much of the focus is on sugar, and little is on carbs, which normally convert to sugar in the body? With the Dose Adjustment For Normal Eating—DAFNE—programme, instead of counting sugar, people count carbs. It is really only for type 1 diabetics, but it helps them administer their insulin according to the carbs they have eaten during the day.

[Keith Vaz]

That is extremely important. I support the DAFNE programme and the work being done on the conversion to sugar. That brings me on to the sugar tax—a great achievement of the previous Government. All praise to George Osborne for introducing it.

Baby Loss Awareness Week

Paul Girvan Excerpts

Tuesday 8th October 2019 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), in her absence, for moving the motion. It is always a pleasure to follow the hon. Member for Rotherham (Sarah Champion).

We have heard some marvellous speeches today about personal experiences, and every one of them has been very poignant and has encapsulated what this is all about. I have spoken to previous motions on baby loss, and I am happy to continue doing so in remembrance of those little lives lost.

The fact of the matter is that, since last year, more hearts have been broken, more arms have been left empty and more grief has entered homes throughout the United Kingdom of Great Britain and Northern Ireland. That deserves recognition in the House this year and every year, as the hon. Member for Banbury (Victoria Prentis) said.

This does not take away from anyone else who has contributed to the debate, but I would particularly like to mention the hon. Members for Thirsk and Malton (Kevin Hollinrake), for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince). In our debates in this House they have told us their personal stories and have helped us to understand exactly what it means to lose a child. One thing that came out of those Adjournment debates and those contributions in this House was the need to have a separate room in hospital where people can grieve and have privacy, and the hon. Member for Brigg and Goole (Andrew Percy) talked about the one in his constituency. [Interruption.] I hope Members excuse me; I have a bit of a chest infection and am trying to keep it off if I can.

I mentioned the next thing to the hon. Member for Colchester and he can probably remember it: the importance of having faith involved, as people can use that to help get to the other side of the grieving process. Where there are rooms where people can have privacy, it is important that they can call upon someone of faith to come to give support. The hon. Member for Rotherham spoke about how important it is to have someone to speak to, relate to and understand.

Most miscarriages happen in the first 12 weeks, which is known as “early pregnancy”, and an estimated one in four pregnancies ends in miscarriage—it is one in five if we only count women who realise and report the miscarriage. About 11 in 1,000 pregnancies are ectopic. About one in 100 women in the UK experience recurrent miscarriages—three or more in a row—and more than six in 10 women who have a recurrent miscarriage go on to have a successful pregnancy. The risk of miscarriage greatly reduces in the second trimester—miscarriages then are called “late miscarriage”. My mother miscarried on three occasions, and seven in our family have had this happen; my sister also miscarried on three occasions. The girl who is, in effect, my Parliamentary Private Secretary and writes my speeches in this House—she is a very busy girl, as people would understand, given the contributions that are made—has also had two miscarriages.

[Paul Girvan (South Antrim) (DUP)]

On the number of people who have had difficulties, the problem we have perhaps relates to the level of focus on care, aftercare and counselling. I am not saying this is inevitable and will always be the case, but we do not have the necessary focus on counselling for the individuals and families who have gone through this traumatic experience. Unfortunately the fear of what they have been through sometimes means that they do not want to have another child and go through this again, so they are denied the opportunity to have a family because of what they have experienced; a lack of counselling means that that can sometimes be a fear.

[Jim Shannon]

I thank my hon. Friend for that intervention and I can relate it to my constituency and the people I have spoken to. The thing that sustained my sister, my mother and my PPS was their faith, which is why I come back to the importance of having faith, as I said to the hon. Member for Colchester. In the past year, I have known of two women in my constituency who knew that their baby would not live for more than a couple of hours after the birth yet they carried their baby to its full nine months and enjoyed those few hours together. I am a member of many organisations, one of which is the Royal Black Preceptory. We helped the father of a young child who was lost with a charity event at the bowling club in Ballywater to raise money for this issue, and we raised some £1,000.

I wanted to say all that because it is important, as everyone deals with things in their own way. About one to two in 100 women have a miscarriage in the second trimester. According to one study, once a pregnancy gets past six to seven weeks and there is a heartbeat, the risk of having a miscarriage drops to about 10%. Those are the facts and they are worthy of noting, but they cannot begin to deal with the process of grief that is suffered. It may sound comforting for people to understand that one in four pregnancies ends in a loss and so they are not alone, but, as one lady said, “I don’t want to be the one in four, I want to be the three who live their life as normal and don’t have this emptiness inside.”

It is important to note the facts, but it is more important to acknowledge the grief and the right to grieve. Long gone are the days of, “Just don’t talk about your loss.” We have learned that for those who wish to express themselves it is healing to do so. Some people need to talk about it, but some decide that they may not. Of course many women will never talk of their loss, and that too is part of their process and is to be respected. For others, the symbolism of a balloon release or the lighting of a candle is a way of acknowledging a life that did not blossom but was most definitely there.

We do not understand why many miscarriages take place, but with an NHS under such pressure—I say that really gently, because we have a wonderful NHS that does great work—we do not investigate until the third miscarriage. That in itself is incredibly difficult. I know of one lady whose parents, after encouragement by the midwife after her second miscarriage, paid for private care and for private tests and all the rest, to learn that taking baby aspirin would increase her chance of keeping the next little one. A baby aspirin once a day saw her have a beautiful baby girl. There could well have been another miscarriage had she not been able to seek private advice. When it comes to that example of how that lady dealt with a miscarriage and then had a child, I wonder whether the necessary advice is there in the system and throughout the process. I have said it before and I shall say it again: three miscarriages but no investigation is too much. I sincerely urge change in the NHS procedure. Perhaps the Minister will be able to respond to that point or give me some idea of where we are.

This debate cannot solve the issue of baby loss and grief, but it can validate the fact that a miscarriage was a loss. It happened and should be remembered, and we as a nation should mourn. The fact that a death certificate cannot be issued until 24 weeks must be reviewed. I find that quite incredible. It does not mean that it is not widely understood that someone has suffered through a death. And it is not simply the mother who suffers, but the father and the would-be grandparents, too. The hon. Member for Eddisbury referred to it, and although the hon. Member for Colchester has not spoken today, I remember his previous contributions. The wider family suffer as well. It is like throwing a stone into a pond: the ripples go right to the edge—they touch everyone in the family circle and all the friends. Everyone should remember that.

We must do more to recognise and support those who suffer from a miscarriage. A pamphlet in a cold, sterile procedure room is not enough. I read a little quote that touched my heart. This lady said:

“I carried you for every second of your life—and I will love you for every second of mine…Let sweet Jesus hold you until mummy and daddy can hold you”—[Interruption.]