The National Health Service

Paul Masterton Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

I am not going to give way after that nonsense, but on his point, perhaps he was not here at the start, but on the first page of my speech it says that

“the NHS is not, and never will be for sale under this government. The Prime Minster and the President have made it abundantly clear that the NHS will not be on the table in any trade talks.”

How many times do I have to say it? I will say it every day of the week.

[Paul Masterton (East Renfrewshire) (Con)]

My right hon. Friend will be aware of a number of women throughout the country, including Elaine Holmes in East Renfrewshire, whose lives have been ruined by vaginal mesh. One of the big problems they have had has been the poor response by the Medicines and Healthcare Products Regulatory Agency to patient concerns about device licensing. Will the Bill that he is talking about give us an opportunity to look again at how the licensing regime works, and in particular how it responds to patient concerns?

[Matt Hancock]

Yes, that will absolutely be addressed. We also have a report by Baroness Cumberlege that will look specifically in that matter, which is incredibly important for many people. We absolutely have to get it right.

I wish to touch briefly on three further measures: first, the Health Service Safety Investigations Bill. Millions of people receive life-saving care in the NHS, but saving lives also involves risk. It is important that we learn both when things go well and when things go badly. We want to create that learning culture right across the NHS. The legislation will establish in law the first independent body of its kind to investigate patient safety concerns and share recommendations to improve care. I pay tribute to my predecessor, my right hon. Friend the Member for South West Surrey (Mr Hunt), for all his ongoing work in this area.

Let me turn now to adult social care. We have already announced a new £1 billion grant for social care to address urgent needs, building on the 11% rise in social care budgets over recent years. We have to end the injustice that means that after a lifetime of hard work—of striving and saving—people are being forced to sell their homes to pay for care.

Oral Answers to Questions

Paul Masterton Excerpts

Tuesday 23rd July 2019 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Seema Kennedy)]

When drugs have been approved by NICE, there is an obligation to prescribe them. If the hon. Lady will write to me, I shall be able to look into this matter more closely.

[Paul Masterton (East Renfrewshire) (Con)]

I welcome the consultation on NHS pensions that was announced this week, and while I do not think that 50:50 is the ultimate solution, I welcome the invitation to present other proposals. However, given that this is causing an issue now, how quickly does the Department think that it will be able to turn the outcome of the consultation into action?

[Matt Hancock]

We are working very hard to turn it into action as soon as possible, and I can give my hon. Friend an absolute commitment that the new rules will be in place in time for the new financial year.

NHS Pensions

Paul Masterton Excerpts

Wednesday 26th June 2019 Westminster Hall

[Sir Robert Syms]

Almost anybody I talk to in any hospital anywhere has an example of the impact of this additional taxation biting, and its impact on working methods. I know my hon. Friend has tried to get a debate on a similar subject, because we are ultimately talking not about consultants, but about the patients and the impact this has on delivering services.

For defined benefit pension rights, the test against annual allowance is complex. The growth in rights over the year must be adjusted to strip out any increase that simply keeps pace with inflation, and is then multiplied by 16 added to any additional lump sum accrual before being tested. Whether the tapered annual allowance applies depends not just on whether someone’s adjusted income is over £150,000, but on whether their threshold income is over £110,000. These two measures are quite different, and adjusted income in particular is calculated in a very complicated way.

That creates unpredictability. A tapered allowance works by using income from the current year to determine the size of the annual allowance for the current year. Many NHS doctors work extra NHS shifts and many do private work; they may have little idea what their income for the year will be until very late in the year. Sometimes, NHS trusts get additional money released at the end of the year, leading to more operations. Sometimes, NHS trusts pay at a rather slow rate, and they may pay in a different year from that in which an operation was undertaken. As a result, doctors who take on a lot of extra work late in the year can suddenly find they have an annual allowance issue.

There is also a cliff edge issue. Although the tapered annual allowance result is a gradual reduction in annual allowance for each £1 of adjusted income over £150,000 per year, the fact that the whole system switches on abruptly for threshold income above £110,000 can create a violent cliff edge effect. For example, those with threshold income that is 1p below £110,000 can effectively ignore the tapered annual allowance, but those with income that is 1p above it can find themselves caught with a rather large tax bill. For the latter group, not only does each extra £1 attract income tax at 40p and a loss of personal allowance equivalent to another 20p in the pound, but they can suddenly face a big drop in their annual allowance.

Some people can be worse off overall by working an extra shift. I have heard testimony to that effect from many doctors who say they have done additional work and ended up worse off.

[Paul Masterton (East Renfrewshire) (Con)]

I congratulate my hon. Friend on securing this debate. I hope he will not mind my taking the opportunity to plug the event I am hosting with the BMA next Wednesday between 4 pm and 6 pm, which will be a great opportunity for MPs to meet many consultants with stories such as this, and to find out more information about the problem. Does he agree that, because this matter is so complex, it is important for MPs to come along and speak to the BMA, and speak to their local senior consultants, to really understand the impact this is having on the ground?

[Sir Robert Syms]

I thank my hon. Friend for his contribution. This is an area that people start to get interested in only when they start thinking about retirement. Then they realise how complicated the retirement rules are. This issue is upsetting many people who work in the NHS because of the impact it is having.

A survey of GPs to which 46% replied—354—found that their average tax bill owing to the tapered allowance was £18,500, so we really are talking about considerable sums of money being levied on doctors, many of whom do not expect it and suddenly get into arrears. Dr George McInnes, radiologist at Poole Hospital, said to me that most of his radiologists are contracted for 10 sessions, with most working 11 or 12 as a matter of norm to keep the throughput going. However, as is the case in most hospitals, he now finds it terribly difficult to get them to do more than 10, and when people come to review their contracts, they ask to do less work, rather than more, because of the impact of the pension arrangements.

The real problem is that most of the people affected have done years of training and have years of experience—they are the super strikers of the NHS; the team leaders—and despite tax bills have a loyalty to their hospitals and teams and continue working. However, year on year, they find themselves penalised for working. As rational people, they decide to play golf or to spend more time with their families or with Netflix. That is logical, and the Treasury is deterring many people from doing what they have trained for their whole lives to do. The letters, emails and phone calls I get from doctors do not say that they want to work less. They actually want to work more, but they do not really feel that they should work more and be worse off as a result.

The Government have put additional resources into the NHS, and we can argue about whether it is enough or not. However, the key point from the Treasury and the Department of Health and Social Care was the importance of productivity in the NHS, which we can get only if the people within the service are actually able to deal with patients and the issues before them. If, because of the tax issue, people work less, the only way around that—apart from locums, if they can be recruited —is to recruit more people to do fewer operations. That is not increased productivity; that is reduced productivity. If we want to use these people, we have to set a tax system that is proportionate and sensible.

It is not only the NHS. The British Dental Association says the same thing: people are retiring early and are more averse to taking on NHS patients. The consequence is the problem that we are now starting to see, which will get worse and worse. I know that the Department of Health and Social Care understands the issue; I have talked to the Secretary of State. I think the Treasury sort of understands that there is a problem, which is why I think it indicated that it might give additional resources to the NHS. However, the problem is that the only way out of this is to get rid of the taper, because its impact on the way people work is so detrimental to the NHS. Even if we take into account wider issues and other areas, I cannot see how any scheme can be brought in to ameliorate its impact.

We in this House want patients to get the best service, and sometimes we have to pay people to get the best service in the national health service. Most consultants or senior nurses have trained for years and are dedicated to their patients, and all they want to do is to turn up and work. The Government have put money into the NHS to allow operations to take place, but perversely our system of taxation on pensions, which was probably drawn up to stop city slickers avoiding tax, is impacting on a major, important public service and will lead to longer waiting lists, meaning people—who, if not in pain, will be very uncomfortable—waiting to be dealt with.

We all want people to be dealt with, doctors to be happy and the NHS to work properly. We need the Treasury to get out of the way on this one, because it is causing problems.

Interim NHS People Plan

Paul Masterton Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

The Government are taking action specifically on the points that the right hon. Lady made. We committed to increase the number of undergraduate medical school places by 1,500, and 630 are already in place.

[Paul Masterton (East Renfrewshire) (Con)]

I thank the Minister for grappling with the NHS pension scheme issue. I am not convinced that the 50:50 option is a long-term, sustainable option, so will he confirm, as the Secretary of State said yesterday, that the consultation will be open to exploring other mechanisms? In particular, will he keep banging at the Treasury’s door, because the ultimate solution is in its power? The way in which it has tried to dodge this and pass it to the Department of Health and Social Care is a bit of disgrace.

[Stephen Hammond]

My right hon. Friend—I am sorry, my hon. Friend; I am only presaging something that will happen in future—will know that when my right hon. Friend the Secretary of State speaks he says what he means. The consultation will be open to looking at other schemes and other potential flexibility. My hon. Friend will know that the British Medical Association has welcomed the 50:50 option but would like to see other options. He will also know, much as the Department might like to make tax policy, we do not do so, so it would be injudicious of me to commit, but I am happy to continue our long-standing conversations with the Treasury on this matter.

Oral Answers to Questions

Paul Masterton Excerpts

Tuesday 7th May 2019 Commons Chamber

[Matt Hancock]

No, the NHS is going to be there for us no matter what the outcome of Brexit is. The British people voted for Brexit, and we are going to deliver Brexit, and then we are going to get on to doing all the other things. Even over the last few months, we have been able to put extra money into the NHS to ensure that its future is guaranteed.

[Paul Masterton (East Renfrewshire) (Con)]

T6. I was pleased when the Department of Health and Social Care accepted that changes to our pensions legislation are driving early retirement and reduced hours among senior consultants. Can the Minister give an update on what discussions are being had with the Treasury to attempt to find a solution to that issue?

NHS Pension Scheme: Tapered Annual Allowance

Paul Masterton Excerpts

Tuesday 2nd April 2019 Westminster Hall

[Paul Masterton (East Renfrewshire) (Con)]

I beg to move,

That this House has considered the effect of the tapered annual allowance on NHS pension scheme members.

I have been aware of this issue for some time, as a local MP and as a former pensions law practitioner. Primarily through the work of the journalist Josephine Cumbo at the Financial Times, it has come to light that it is significantly more widespread and has much more serious implications for the NHS than I had originally understood.

I do not want to take up too much time on what the annual allowance taper is and how it works, partly because it is boring and incredibly complex, but a small amount of background is needed before explaining why it is an issue in the NHS and the consequences that seem to be flowing from it.

The tapered annual allowance was introduced from 6 April 2016. In short, it meant that from the 2016-17 tax year, a reduced annual allowance may apply to all pension savings by or on behalf of a member, depending on the level of taxable income within the tax year. It applies to individuals with a threshold income of more than £110,000 and an adjusted income of more than £150,000. For every £2 that an individual’s adjusted income goes over £150,000, their annual allowance for that year reduces by £1. The minimum reduced annual allowance someone can have is £10,000.

It will not be a surprise that the calculations of threshold and adjusted incomes are not simple in the least. They are massively confusing and make it very difficult to predict what tax bill will be incurred. As it cuts the annual allowance for the current year, an individual has no idea how much pension saving they can make.

[Jim Shannon (Strangford) (DUP)]

The Financial Times reported that some doctors, GPs and dentists will receive a potential tax bill of £80,000. Does the hon. Gentleman agree that we and this Government have a duty to ensure that NHS staff have all the information so that no one faces unexpected tax bills?

[Paul Masterton]

The hon. Gentleman is absolutely right. One of the key issues is that because it reduces the tax allowance in the current year of work, it is impossible to work out what the annual allowance will reduce to, and people cannot plan. I will go on to raise some examples from my own constituents, as I am sure other hon. Members will want to do.

[Andrea Jenkyns (Morley and Outwood) (Con)]

A constituent told me that he has been advised to take early retirement to avoid taxes. Does my hon. Friend agree that retaining long-serving consultants with experience in their fields is vital to the NHS’s success?

[Paul Masterton]

My hon. Friend is absolutely right, and that is why the issue is so important. I appreciate that we are talking about people who earn a lot of money and who have good pension schemes, but there is a serious potential knock-on effect of very senior doctors turning down hours or taking early retirement.

[Jonathan Edwards (Carmarthen East and Dinefwr) (PC)]

I received an email from a consultant who works in my constituency, informing me that one of the unintended consequences of the new arrangement is that he has reduced the number of hours he works in the NHS.

[Paul Masterton]

That is exactly right. I asked for a Treasury Minister to reply to this debate, because the underlying legislation is a Treasury issue, but it is important to have a Health Minister here today to hear at first hand the stories that are being raised by MPs.

In recent months, it has become increasingly apparent that the pension tax rules are resulting in unexpected tax charges being levied on a large number of GPs, senior doctors, surgeons and consultants right across the UK. I believe that if the issue is not addressed, serious capacity gaps in the NHS will only be made worse.

In Scotland, 7.6% of consultant posts are vacant, and more than half of those have been vacant for more than six months. There is a similar picture in the NHS in all other parts of the United Kingdom. In a recent survey by the Hospital Consultants and Specialists Association, more than 40% of the doctors questioned said that pension taxation changes had led them to change their plans and retire earlier than expected.

The way in which the tapered annual allowance operates means a significantly reduced annual allowance ceiling is hitting many of the NHS professionals that I, and the hon. Member for Strangford (Jim Shannon), mentioned in their mid to late careers. As their entire income is taken into account for the purposes of tapering, the threshold can be breached even by doing non-pensionable work, including covering for absent colleagues, extra programmed activities or waiting list initiatives. NHS staff on pay-as-you-earn cannot avoid the notional pension input amount calculation. As a result, many consultants are being hit with unexpected five-figure tax charges. A number are now dropping extra work, turning down hours or going part-time to negate or avoid the penalties.

Of course high earners should pay their fair share, and all the doctors who have contacted me want to do so, but they are paying rates of more than 60% as a result of the taper. Some are paying effective rates of more than 100%. Many consultants who continue to do non-pensionable overtime are effectively paying the Government to go to work, while receiving no additional pension benefit.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

The hon. Gentleman is making a powerful, forensic speech on this critical issue facing the national health service. Several of my constituents have been in touch about it. One consultant mentioned that the impact of this issue on NHS Greater Glasgow and Clyde will be huge, because waiting list initiatives ensure that the health board does not receive penalties, so it militates against efficiency in the national health service and will cost more in the long run. It is a total false economy. Surely the Minister can take action with the Treasury to get this sorted out quickly.

[Paul Masterton]

The hon. Gentleman raises a good point. Our constituencies share a health board. The examples of people who work for NHS Greater Glasgow and Clyde show exactly the consequences and knock-on effects.

One surgeon contacted me to tell me that he was hit with a tax bill of £62,000 because he received a national award. People who receive a bonus or a pay rise can find themselves with a whopping tax penalty as a consequence. Rigid pay and pension rules in the NHS mean that their ability to mitigate the issue is pretty much non-existent, certainly compared with people in the private sector, because there is not the flexibility to reduce contributions or request cash in lieu of pension if there is a danger of breaching the allowance. The only option, as we have heard in Members’ examples, is to opt out of the scheme altogether or drastically reduce working hours. This issue is becoming a huge driver not only of early retirement, which in itself is extremely serious, but of enforced reduced working hours. That is having an impact on NHS care and creating lost capacity. Waiting times, which are a problem in various areas across the UK, are hit because these perverse rules mean that consultants refuse the overtime that is needed to help clear the backlog.

The investigation by the Financial Times found that the issue had increased the risk of delays in cancer diagnosis in some parts of the UK and lengthened waiting times for procedures such as hip replacements. Critical areas such as intensive care and radiology are also being affected. One consultant said that about 50 fewer patients were being seen per week in the cancer clinics they cover, as a result of doctors turning down extra shifts.

A consultant who lives in my constituency contacted me following receipt of a tax charge of £29,000, despite doing no work outside the NHS. He told me that he will now have to drop a session of clinical work to try to ensure that it does not happen again, and that he is actively considering early retirement, having reluctantly started to reach the conclusion that there is no incentive for him to continue his career beyond the age of 60. He has been forced into that position by the clear unintended consequences of the pension system.

[David Linden (Glasgow East) (SNP)]

I congratulate the hon. Gentleman on securing this debate; the interest today shows that there is probably support for a Back-Bench business debate. He is absolutely right to highlight the huge financial penalties that people are incurring. One of my constituents in Barrachnie is looking at a £15,000 bill, which he got at the end of January. That is not helpful. He has already told me that he is planning to retire early. Surely these examples only make the case to the Government that they need to take action.

[Paul Masterton]

I thank the hon. Gentleman for raising another specific case. I hope the Minister will bear in mind the added weight of evidence.

Another of my constituents, who has worked as an NHS constituent for 14 years at the Queen Elizabeth University Hospital in Glasgow told me that he is employed on a 40-hour per week full-time contract and provides eight hours per week of additional clinical work, making 48 hours in total. He does not do any private practice outside the NHS, but he was hit with an unexpected bill of nearly £17,000 as a result of the tapered annual allowance. The only way the consultant can avoid those charges is to reduce his income below the various thresholds, and the only way he can reduce his income is to reduce the amount of work he does for the NHS. He has told me that he has no desire to do that and would happily volunteer to do extra work occasionally at weekends to tackle waiting lists or fill gaps in the service, but the tax implications make that impossible and he has already stopped doing any extra work.

Another consultant from East Renfrewshire with 16 years’ experience—eight as a consultant—told me that he was actively declining extra work to support stretched services in order to avoid the tax penalties. That means that he does not apply for the discretionary points that are awarded for additional work that is taken on above the normal daily remit, such as developing new services, research and teaching. As the hon. Member for Glasgow North East (Mr Sweeney) said, that impacts not just on the daily running of services, but on the development of a culture of excellence within the NHS.

[Julian Knight (Solihull) (Con)]

I apologise for missing the first couple of minutes of the debate. My hon. Friend is a great thinker on pensions, which is the main reason I wanted to come here today, and I want to ask him a very simple question. Does he wish to dispense with the annual allowance and lifetime limit, or does he want a special dispensation for senior NHS workers, who are quite high-income earners?

[Paul Masterton]

I thank my hon. Friend for his kind comments, which are undeserved. There is a wider issue of the general complexity of the systems of reliefs and allowances in the UK pensions system. I hope not that there will be one single dispensation for one area of the public sector, but that we start to recognise that we need to look at the way the system is operating more generally and to work out whether some of the allowances and reliefs are actually necessary or effective, and whether they should be subject to a broader review.

A recent report showed that over 50% of respondents reported using the NHS “scheme pays” facility to pay off their unexpected tax charges. However, this does not work for all cases, and the amount is effectively treated as a loan that is then paid back from the retirement benefit, with interest charged against the pension at high rates. That means it is usually costlier than paying up front, particularly for younger members. I fear that this issue could see us sleepwalk into a deepening workforce crisis in the NHS and result in consultants leaving the NHS early, even though they still have the skills and experience we need. Those individuals are important not just for patients, but for junior doctors in terms of the training and mentoring they receive on the job.

The British Medical Association firmly believes that long-term changes to the pensions taxation system are required in order to remove the disincentives that exist, and I certainly agree. The Library’s excellent briefing on pensions taxation makes reference to the impact of changes in the annual allowance on the public sector, and notes that the 2017 report of the Doctors and Dentists Review Body requested more evidence about the impact of the annual and lifetime allowance on early departure rates. The Treasury indicated that it would consider revisions to the NHS pension scheme if there was evidence that the number of doctors and dentists taking early retirement as a result of its inflexibility was substantial.

I want to ask the Minister a series of questions, and I appreciate that she might not be able to cover them all today. A number of them fall within the remit of the Treasury, but hopefully she will be able to take those away and arrange for either herself or a Treasury Minister to get back to me. First, what discussions did the Treasury have with the Department of Health and Social Care when the tapered annual allowance was introduced, and was this ever flagged as a potential problem? Secondly, what evidence has the Treasury collected on the numbers of doctors and dentists taking early retirement, following the 2017 report? If the answer is none, why is that the case and when will analysis be carried out of the impact on changes to the lifetime and annual allowances on the NHS? If evidence has been collected, what were the findings of that analysis, and are any changes being considered?

Thirdly, what consideration has the Treasury given to a review of the annual allowance taper more generally, perhaps as part of a wider review into simplifying the incredibly complex system of reliefs and allowances in the UK pensions system? Finally, have the relevant Government Departments had any discussions with the relevant parties on whether permitting more individual flexibility in the NHS pension scheme could be a solution? That is something that NHS Employers is calling for. This issue is not specific to the NHS—I have heard in recent days from armed forces personnel—but it does appear to be an area with a particular problem.

Although I appreciate that many people will not hold great swathes of sympathy for individuals on such high earnings who will still receive high levels of retirement pension that most of our constituents can only dream of, the reality is that if this results in consultants with much-needed expertise turning down work or leaving the NHS altogether, it will have major implications for the provision of services and the quality of care our constituents receive right across the UK, whichever colour of Government is in control of their NHS.

I am sure that the Treasury did not intend these changes to force experienced and committed consultants, surgeons and GPs to do less work for the NHS, but this is the reality being faced in the hospitals that serve my constituents and the Minister’s. It is good that the British Medical Association and NHS Employers recognise that this is a serious concern and met last week to discuss it, but they have not agreed a solution or a joint action plan. In reality, the ball is in the Treasury’s court.

I absolutely respect and agree with the Government’s position that we need to get the balance right between encouraging saving and managing Government finances, but this issue cannot be easily ignored. Legitimate aims to restrict tax perks for the wealthiest in society are exposing ever increasing numbers of long-serving and highly experienced NHS workers to massive tax charges. If we want high quality care in the NHS in Scotland and across the UK, we need senior doctors who have devoted their professional lives to the care and wellbeing of our constituents. It is ludicrous for us to face a situation in which the pensions system is acting as a disincentive and effectively forcing consultants to choose between working for nothing and affecting patient care.

I hope that this debate provides the first opportunity for us to say clearly that, whether the answer lies in adding flexibility to strict NHS pay and pension terms or with the Treasury using this as a reason to take a fresh look at the ridiculously complicated tapered annual allowance, this is an unintended consequence of the UK’s complex pension regime, which we need to sort out quickly to let those consultants get back to work.

Oral Answers to Questions

Paul Masterton Excerpts

Tuesday 19th February 2019 Commons Chamber

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

The award of the contract for the Central and East London screening service to the Royal Free was approved by both NHS England’s London region and NHS England’s commercial executive group. An agreed recovery plan was put into place to address the various issues. While the service did plummet to 1,100 in April 2018, it is currently inviting 3,000 women per month, which has been the normal monthly invitation rate for the service for the past three years. Women are currently being offered appointments in line with the agreed recovery plan and with the national breast screening standard, with 90% or more being invited within 36 months of their previous screening by October 2019.

[Paul Masterton (East Renfrewshire) (Con)]

The internet and social media have provided huge opportunities and positives for our young people, but we have been far too slow to react to the negatives, including cyber-bullying and issues around body image. Will the Minister responsible for suicide prevention, or my right hon. Friend the Secretary of State, confirm that they are taking a truly cross-Government approach to this issue and that they will seriously tackle the role of the tech companies?

[Matt Hancock]

Yes; my hon. Friend is dead right to bring up this subject. The rise in material promoting self-harm and suicide online is dangerous, and it needs to be stopped. I am delighted that, under pressure from this House, Instagram has now decided to take down that material, but there is much more to do. In this country, it is this House that makes the rules, not the global companies.

Licensing of Medical Devices

Paul Masterton Excerpts

Tuesday 12th February 2019 Commons Chamber

[Paul Masterton (East Renfrewshire) (Con)]

I pay tribute to the hon. Gentleman for the work he does as chair of the all-party group on surgical mesh implants. He will be aware that when the Medicines and Healthcare Products Regulatory Agency appeared before the Public Petitions Committee in the Scottish Parliament it admitted that its verification process for use of mesh implants amounted effectively to a two-week desktop exercise carried out by three people at a cost of £20,000. Does he agree that that example fundamentally shows that the way the MHRA is reviewing these devices is not fit for purpose, is completely inadequate and, as we know from the work of the APPG, puts patients, and in the case of mesh implants lots of women across the UK, at risk?

[Owen Smith]

The hon. Gentleman, who has also done excellent work on mesh as co-chair of the group, is completely right.

Our regulatory system for these devices, including mesh, is more akin to the system that applies to toasters or plugs, and the way in which they get kitemarks, than to the way in which medicines are approved. It is so problematic that, last year, the journalist I was talking about applied to get a kitemark—known as a CE mark—for surgical mesh. However, the item in question was a bag that had previously been used to keep oranges in, but they still succeeded in getting a CE mark for it. It obviously was not put into a woman, but real mesh has been and is being put into thousands of women all over the world, including those suffering from organ prolapse and stress urinary incontinence. The real impact of the mesh has been revealed in the chronic pain, disability and even death suffered by many women as a result of the mesh warping, breaking, morphing, changing its constitution and cutting into organs inside the body. This was revealed only after years of sales.

World Cancer Day

Paul Masterton Excerpts

Wednesday 30th January 2019 Westminster Hall

[John Lamont]

I am grateful to my hon. Friend for raising that example, which demonstrates that it is not just in large cities, but smaller communities, whether they be in Angus and Dundee, in Moray or across our county, that people are coming together to produce such great work to tackle this dreadful disease.

[Paul Masterton (East Renfrewshire) (Con)]

My hon. Friend is making an excellent speech. One issue that is not often raised is that of people with cancer who have disabilities. Wendy Douglas, a constituent of mine, died of breast cancer aged just 36. She had very severe autism, and her cancer was caught too late because she was not able to communicate any symptoms or pain verbally to her family or doctors. Will my hon. Friend join me in paying tribute to Wendy’s mother Eileen, who raises money for all kinds of cancer charities, and particularly for her work trying to raise awareness of cancer in those who cannot communicate it?

[John Lamont]

Again, I am grateful to my hon. Friend for raising a powerful case and example. I suppose the question is what would happen were it not for all these volunteers, raising huge amounts of money and raising awareness of cancer, and filling a gap that otherwise the NHS and the state would have to provide for. That is something we should not forget.

That is not to say that we have not made huge progress in tackling cancer. While diagnosis rates have risen significantly in the past decade, the number of people dying from cancer in this country is falling.

Early Parenthood: Supporting Fathers

Paul Masterton Excerpts

Wednesday 30th January 2019 Westminster Hall

[Paul Masterton (East Renfrewshire) (Con)]

Thank you, Mr Davies. I congratulate my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) on securing this debate, and I thank her for her support for new MPs who are also fairly new dads. I very much valued the advice that she gave to me in conversations in the Tea Room in my early days here, as I tried to struggle with the largely impossible balance of being an MP and having a young family.

I will touch on a few things from my own experience as a dad of two under-fives. Both my kids were born between midnight and 2 am. It is quite difficult, about 90 minutes after a child is born, for a father to have his wife and child go to the maternity ward while he is simply waved off to drive home. I am lucky; I live about 20 minutes from the hospital, the roads are good, and both my kids were born in May. Lots of dads will drive home in very difficult conditions and will be mentally, physically and emotionally exhausted. Would it not be nice if dads could spend a bit more time on the maternity ward in those early days? It sets much of the tone for how dads feel in those early months—as if they are one step removed from everything that is going on around them.

After I went back to work, my two overriding emotions were guilt and jealousy, neither of which are very healthy. I felt guilty that my wife had to do all the legwork, and jealous of the fact that she was spending all the time with the kids. I really welcome all the stuff that is being introduced by NHS England—and now also up in Scotland—to try to include dads more in those early parts of the services. As my hon. Friend the Member for Chatham and Aylesford said, things are quite good on the pre-birth element. Dads go along to the scans and classes, but then they are just chucked to the side in a lot of ways. We need to involve dads much more.

A lot of the support groups are very helpful. I always used to try to get away from work as early as possible and rush home, and I wanted to do loads when I got home. My wife used to say to me, “Well, no, actually, I need you to be the best version of yourself, so don’t feel guilty about getting a good night’s sleep. Don’t feel guilty about going to the pub or seeing your friends, because if you’re in a better frame of mind and feeling better, then you’re a better support for me.” It is important to help new dads to have that confidence in what they are doing.

The last thing I want to mention is although new dads are lots of things, they are not counsellors or trained mental health professionals. It is very difficult for a dad if he is not sure whether his partner is just feeling a bit down or whether there is something that he should be more worried about. I will never forget my wife saying to me one day when she was a bit upset, “I just feel like my world is so small and I don’t know where I stand anymore.” I did not know what to do about that or whether it was something that I should be bothered about. If I am supposed to speak to somebody, who do I speak to? The health visitor comes when I am at work, and I am not going to speak to my colleagues about it. I am not going to sit at my computer at work and type in, “Is my wife depressed?” on Google.

We should not think of support for new dads as just support for them as individuals; we should think about it as supporting new dads to support their partners better. That is the best way to ensure that kids get the best possible grounding in their early years, and to keep a strong, solid functioning family unit that is needed to give children the best start in life.