(6 months ago)
Commons ChamberIt is a pleasure to follow the hon. Member for North West Leicestershire (Andrew Bridgen), as I often seem to in these debates, which often resemble Madame Tussauds: the same faces appear, time after time. As you will know, Madam Deputy Speaker, I have a reputation for brevity in my speeches, and I intend to support that reputation now.
I congratulate my hon. Friend the Member for Watford (Dean Russell) on securing this important and rather timely debate, and I echo the hon. Member for North West Leicestershire in saying that we enjoy seeing him looking so fit and healthy after the trauma that he had. This is a really important matter, and he is right to raise it today. As I highlighted in last month’s Westminster Hall debate on excess death trends, a recent article in The Lancet found that although the causes of ongoing excess deaths in the UK
“are likely to be multiple”,
Office for National Statistics data showed some clear trends—in particular, the “largest relative excess deaths” since the pandemic occurred in young and middle-aged adults, with the number of cardiac deaths happening outside hospitals being the most elevated. In other words, young and previously healthy people are dying at home from cardiac-related events, and we do not know why.
These are not just numbers and statistics—these are real people, loved ones, often from younger age groups, who are dying before their time. It is urgent and our duty to get to the bottom of the situation sooner rather than later. As I am sure we are all aware, there are many theories circulating about the causes of these excess deaths. One is the possibility of a causal link between the population-wide use of covid-19 vaccines and the marked increase in cardiovascular-related critical events, including heart attacks and strokes, among otherwise apparently healthy people. We do not know if that is the cause or not, because the data is not being released. Until certain data sets are released, it is impossible to rule that theory in or out.
That is why I, along with cross-party colleagues, wrote yesterday to the Secretary of State for Health and Social Care; Professor Steven Riley, the director general for data at the UK Health Security Agency; and Dr Alison Cave, the chief safety officer at the Medicines and Healthcare Products Regulatory Agency. We warn that by withholding official data, the Department, UKHSA and MHRA are helping fuel concerns and hesitancy about public health. We have asked that anonymised record-level official mortality data be released, alongside vaccination dates, doses and co-morbidities, without delay. We understand that the MHRA has collected and already shared this data with pharmaceutical companies to enable those companies to produce post-authorisation safety studies for their products, so I see no reason why it cannot also be shared with parliamentarians and the public right away. Will the Minister say whether that data has been shared with pharmaceutical companies? If so, why is not being shared with the rest of us?
As the Minister surely realises, repetitive generic assurances that the Government and the UKHSA take excess deaths “seriously” and monitor them “constantly”, and that the MHRA have
“systems in place to continually monitor the safety of our medicines”—[Official Report, 16 January 2024; Vol. 743, c. 235WH.]
do not serve to reassure anybody at all. Likewise, the news from the Office for National Statistics this week that it has revised its excess deaths methodology, and that there are suddenly 20,000 fewer excess deaths last year, has done little to quell public concern. If anything, it has done the exact opposite: people cynically see it as a convenient sleight of hand.
As we say in our letter, if the Government and their agencies are not willing to share the data we have requested, will the Minister explain to us why not? We are all on the same side and want to look after people. We are all concerned to do the best we can for everybody, but until we have all the data, we just do not know what we do not know. If there is any potential that public health interventions, such as covid-19 vaccines, are causing harm and premature death to some, we must act on that without delay. If the evidence shows that that there is no issue, then it is in everybody’s interest for that reassurance to be in the public domain as quickly as possible.
If that information was in the public domain, then the Prime Minister would have been able to answer the question that he was asked in the GB News interview the night before last.
My hon. Friend is right. It is in everybody’s interest that the information be in the public domain, so that we can reassure people, or at least let them know. Frankly, there is never any harm in giving people information and letting them make their own mind up about what has happened.
Opinions need to be put to one side, and the data need to be examined in the cold, hard light of day. Otherwise, we will do harm to people, and we will do even more and irreparable damage to trust in public health policy. I hope that the Minister will provide some reassurance that the data will be forthcoming as soon as possible, and that the Government do not give the impression that there is something to hide.
(8 months, 1 week ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure as always to serve under your chairmanship, Dame Maria. I am grateful to the hon. Member for Lancaster and Fleetwood (Cat Smith) for moving the motion and agreeing to the debate in her role as Chair of the Petitions Committee—it is very much appreciated. I also thank the 116,391 people who signed the petition, including 189 of my Shipley constituents, which helped secure this important debate.
In preparing for today’s debate, I looked back at the contributions made in April when another petition on this topic was debated here in Westminster Hall, as the hon. Member mentioned in her opening remarks. I have to say that I was disappointed by some of the rhetoric, when valid concerns were dismissed as an “overreaction and hysteria”. It is clear that this is—quite rightly, in my opinion—an important issue for the public. We can see that that is the case from not just the full Gallery, but the large numbers signing the petitions.
So what are we dealing with here? We have two international legal instruments, both designed to increase the WHO’s authority in managing health emergencies. The first concerns the amendments to the existing International Health Regulations 2005—the IHR—and the second is the World Health Organisation’s new pandemic treaty, which would support the bureaucracy and financing of the expanded IHR. Both instruments are designed to transfer decision-making powers to the World Health Organisation, with the admirable aim, no doubt, of improving how the world prevents and better prepares for disease outbreaks. However, in practice, what is being proposed could have a huge and detrimental impact on all parts of society and on our sovereignty. If the IHR amendments go through, countries will have undertaken to follow recommendations, not merely consider them: it is proposed to remove the word “non-binding” from article 1, while the regulations in article 42 are to be
“initiated and completed without delay”
by member states. Therefore, we can only assume that the intention behind the amendments is for them to be binding under international law.
I do not wish to over-egg the nature of the proposals, but I cannot help but be concerned by the thought of removing the word “non-binding”. There is much in the existing IHR that would suspend fundamental human and bioethical rights, such as requirements for vaccinations and medical examinations, and implementing quarantine or other health measures for suspect persons—in other words, mandates and lockdowns. It is all there in black and white under article 18. We may have become only too mindful of the harms of lockdowns, and I am sure that hon. Members will be aware of the latest findings published by the Centre for Social Justice about the harms caused by lockdowns. That is not to mention the non-existent science used to enforce wearing a face mask—the covid inquiry has also uncovered the fact that that was based on absolutely no science whatsoever.
At the debate in April, we were told by the then Minister that it is “simply not the case” that
“the instrument will undermine UK sovereignty and give WHO powers over national public health measures”.—[Official Report, 17 April 2023; Vol. 731, c. 34WH.]
I think it is worth revisiting this question, because I am not clear how national and parliamentary sovereignty can be upheld if the proposals are agreed. I draw attention to draft new article 13A, which calls for member states to
“undertake to follow WHO’s recommendations”
and to recognise the World Health Organisation not as an organisation under the control of countries, but rather as the
“coordinating authority of international public health response during public health Emergency of International Concern”.
Does my hon. Friend share my concern about the lack of accountability? We are having an extensive and public examination of the Government’s response to covid, but there is no comparable examination of the important decisions and advice that the WHO offered to the whole world, and it probably had more influence.
My right hon. Friend is, as ever, absolutely right. We should all be concerned about that and concerned that we do not end up falling into the same problems as we have had in the past, being in a position where there is nothing we can do about it and sleepwalking into a disaster.
We are talking about a top-down approach to global public health hardwired into international law. At the top of that top-down approach we have our single source of truth on all things pandemic: the World Health Organisation’s director general, who it appears will have the sole authority to decide when and where these regulations will be deployed. Let us not forget that the director general is appointed by an opaque, non-democratic process—and I think that is being rather generous.
Rather worryingly, in their response to this petition the Government have said they are
“supporting the process of agreeing targeted amendments of the IHR as a means of strengthening preparedness for and response to future health emergencies; including through increasing compliance and implementation of the IHR”.
They have also previously said that they support
“a new legally-binding instrument”
—that certainly sounds like a threat to parliamentary sovereignty to me. Will the Minister commit today to laying those plans before Parliament so they can be properly debated, and if I had my way, robustly rejected?
It is also vital to take a step back and understand what is driving this pandemic preparedness agenda. At a recent meeting of the all-party parliamentary group on pandemic response and recovery, Dr David Bell gave a briefing on how the World Health Organisation, with the backing of the World Bank, says these amendments are the only way to prepare for future pandemics that it says are getting more frequent, and where there is more risk from zoonotic—animal to human—spread. The reality is that the WHO’s figures do not tell the whole story. When we take into account population growth, significant natural pandemics are rare events. We also have to take into account that there has been a huge expansion of tests and genome sequencing over the last few decades. The invention of polymerase chain reaction testing, for example, has had a massive impact on the detection rate of those outbreaks that the World Health Organisation is now using to justify its agenda.
Since the Spanish flu over 100 years ago, we have only had two pandemics above the average yearly seasonal influenza mortality rates, thanks to antibiotics and advances in modern medical care. We hear a lot about disease outbreaks that actually have low mortality burdens when compared to other public health threats: for example, in 2003, SARS-CoV-1—severe acute respiratory syndrome —had the equivalent disease burden of about five hours of tuberculosis. Funnily enough, in its 2019 pandemic influenza recommendations, the World Health Organisation itself could find no evidence that serious zoonotic pandemics were increasing. What is undoubtedly increasing are the eye-watering costs of managing pandemics, with vast sums of taxpayer money being wasted on poorly conceived initiatives, such as locking down the economy for two years.
It seems to me that the World Health Organisation has no need to rush any of this—we have time to reassess and get it right—and it seems I am not the only one to think that. In recent weeks, we have seen signs that some countries, including Estonia, Slovakia and New Zealand, are looking to question the proposals. It is not clear if any member states have submitted formal notices to reject them and opt out, but New Zealand does appear to have lodged a reservation to allow the incoming Government more time to consider whether the amendments are consistent with a national interest test required by New Zealand law. That is entirely sensible, and I would like to see our own Government take a pause to apply some critical thinking to this situation before blindly supporting the World Health Organisation’s installation as our new global public health power.
It is absolutely essential that the Government make a clear and unambiguous promise that they will neither support nor abide by anything that in any way undermines our national sovereignty. We have not spent so many years battling to get out of the frying pan of the EU to jump straight back into the fire with the equally unaccountable, undemocratic and hopeless World Health Organisation.
Forgive me, but the hon. Gentleman spoke at some length; perhaps he will let some of the rest of us have a go.
Up to 300 amendments to the international health regulations are being negotiated and finalised, to be voted on in May 2024 at the 77th World Health Assembly. The amendments being negotiated include: first, amendments to make WHO emergency guidance legally binding—it is currently only advisory—on member states; and secondly, amendments that would empower the WHO director general to single-handedly declare a public health emergency of international concern, giving this unelected, unaccountable individual unprecedented levels of power to dictate UK public health policy and to restrict fundamental freedoms.
Is it not even more extraordinary that that power would be given to that person, given that, as I understand it, the UK voted against his becoming the director general of the World Health Organisation in the first place, and he was China’s man for the job. Does that not make it even more extraordinary that the UK would want him to have those powers?
For the avoidance of doubt, will my hon. Friend agree that none of us has argued this afternoon for withdrawal from the World Health Organisation—we might call it Wexit, for want of a better phrase—
“Yet,” says another hon. Friend. But we want to be assured that the WHO cannot overrule this sovereign Parliament. That is a fundamental difference, is it not?
I was holding the book as I was about to quote from it, Dame Maria. I was not trying to advertise it, and I have not contributed to it, although I have to admit that it was given to me; I did not pay for it. However, so that I can put it down, and so that people do not have to look at me waving it around any more, I will get to the quote. On the WHO’s recommendation against ivermectin, Doctor Kory says:
“The corrupt anti-recommendation that followed read like this:
We recommend not to use ivermectin in patients with COVID-19 except in the context of a clinical trial. This recommendation applies to patients with any disease severity and any duration of symptoms. A recommendation to only use a drug in the setting of a clinical trials…is appropriate when there is very low certainty evidence and future research has a large potential for reducing uncertainty about the effects of the intervention and for doing so at reasonable cost.”
That recommendation was given in the knowledge, as a result of work that had been done that, there was an 81% reduced risk of dying. Indeed, the reason that India was very successful in reducing the number of deaths immediately after the pandemic started was that it was using ivermectin in extenso. In the eyes of Dr Kory, the WHO’s refusal to endorse a remedy or treatment contributed to the loss of
“millions of lives across the world.”
Those are quotes from his book, which I will now put down, Dame Maria.
When I first read about that aspect of the work of the WHO, and the way in which it had been corruptly influenced by drug companies that had a direct financial interest in discrediting ivermectin, it raised alarm bells. I thought, “Hang on a minute, why is the WHO engaged in this sort of activity?” I hope that the Government will start looking really seriously, and sceptically, at the work of the WHO, and at the extent to which it is unduly influenced by external factors. A lot of its work is not based on straight science, but is actually political. Reference has already been made to the fact that the WHO does not seem too interested in getting to the bottom of how covid-19 began. Did it begin in a laboratory in China? That narrative would not fit in with the WHO effectively being under the control of the Chinese Government.
This comes back to the point that our hon. Friend the Member for Devizes (Danny Kruger) made so effectively. The WHO said, prematurely, that it was “extremely unlikely” that covid started from a lab leak. Then, over a year later, I think, the director general said there had been a “premature push” to rule out the lab leak theory. Does that not confirm the point made by my hon. Friend the Member for Christchurch (Sir Christopher Chope) that there are clearly external factors at play when the WHO gives its advice, and that it should be treated with caution, not as gospel?
Absolutely, and I am grateful to my hon. Friend for bringing that to our attention.
Let us reflect for a minute on what other countries are doing. I would have thought that we were one of the proudest sovereign countries, determined to ensure that our Parliament retains control over these sorts of issues; but we seem to have been sidelined by Slovakia, Estonia and New Zealand. If those countries have already come out publicly with their scepticism about the process, why have our Government been sitting on their hands, not saying anything? Instead of being mum about this, I hope that our Government will now say, “By all means, let’s keep the WHO as a body that provides advice, but under no circumstances will we sign up to anything that will give them control over our lives.” It was bad enough that we effectively had a requirement in this country that people should take vaccines—that there was a vaccine mandate.
I spoke the other day to a constituent of mine who worked as an inspector of care homes. He was told that he would lose his job if he refused to be vaccinated; he still refused, and he lost his job. I am pleased to say that he won his case in the tribunal, but that was the sort of consequence for people who fell foul of vaccine mandates. The prospect that it would not be our Government telling people what vaccines they had to take, but rather some unaccountable, foreign international organisation, is even more disturbing.
These are really important issues, and I hope that my friends in Government will take them a lot more seriously than they seem to have done up to now. It is still not clear whether the Department of Health and Social Care or the Foreign Office is in charge of these issues. As has been said, we need to know who among the Ministers will get down to the detail, argue the toss, and ensure that the WHO continues as an organisation but does not take control of our lives.
[Sir George Howarth in the Chair]
I am pleased to see you in the Chair, Sir George. If I sit down now, we will have just shy of two hours in which to hear from the Front Benchers—it is significant that there does not seem to be any SNP spokesman here—on what action they will take to address the concerns of more than 100,000 petitioners on this subject, and a whole lot of other people besides.
I hear where my right hon. Friend comes from and I share his concern. As I hope he will recognise, the WHO is led by its 193 member states, which are currently negotiating this. All international health regulations to date have been agreed by consensus, and we would hope that any changes to the regulations are also agreed by consensus. As I say, there are many amendments and parts of the draft that we would not agree to in their current form. I believe these negotiations will hopefully get us into a position—because I believe it is in all our interests and in the national interest—to agree revisions to the IHR. That has to be done through negotiation and consensus. I think that having an approaching deadline focuses minds, and I think it is the right thing to do.
I will give another concrete example of why I believe this is important. During the pandemic, the genomic data shared by our friends in India and elsewhere helped us to tailor vaccines as new variants emerged around the globe. We all saw over the pandemic that, as the shadow Minister, the hon. Member for Birmingham, Edgbaston said, no one is safe until everyone is safe and that global problems require global solutions.
The best way to protect the UK from the next pandemic is by ensuring all WHO members can contain and respond effectively to public health events through compliance with strengthened IHR. Targeted amendments to the IHR will further strengthen our global health security, by helping Governments plan together, detect pathogens swiftly, and share data where helpful and necessary. The pandemic highlighted weaknesses in the implementation of the IHR for global health emergency response. For example, covid demonstrated that the IHR could be strengthened through a more effective early-warning system with a rapid risk assessment trigger for appropriate responses to public health threats.
Does my right hon. Friend the Minister not fear that what happens in the World Health Organisation negotiations will be very similar to what happens at things such as COP26, COP27 and COP28, at which all these countries sign up to something—most of them knowing full well they have absolutely no intention of following what they have signed up to—and we are left following the agreements when other countries do not even bother?
I hope that no Government would sign up to any treaty that it will not follow. I agree that, in a whole range of areas, countries around the world have sometimes not fulfilled their part of international obligations, but the UK Government will certainly not sign up to something that we do not believe is fair and proportionate, that is not our national interests and that we would not seek to follow ourselves. I share my hon. Friend’s concern that other countries have not followed regulations in the past, and there is no point in our passing strengthened regulations if we do not believe that other countries will follow them. We believe that the regulations are designed to prevent and control the international spread of disease. They are limited to public health risks and designed to avoid unnecessary interference with international traffic and trade. That is why we support the process of agreeing targeted amendments to the IHR as an important way to better prepare for future global health emergencies.
I can give a categorical reassurance to my right hon. Friend that that is a red line for the UK Government. We would never allow the World Health Organisation to impose a lockdown in the UK. That is a clear red line for us. I cannot think of any Minister who would agree to such a request.
I can confidently say to my colleagues—as someone who campaigned for Brexit and who has helped to deliver Brexit in this place—that I am passionate about this country’s sovereignty. I believe that the Government’s position needs to be crystal clear and it is one that I endorse. We support the member state-led process of agreeing targeted amendments to the IHR and the new pandemic accord for the sake of global health preparedness, but we will not agree in any circumstances to provisions that would cede sovereignty to the WHO. That includes the ability to make decisions on national public health measures, whether lockdowns, which we just mentioned, or vaccine programmes.
The Minister will understand people’s nervousness about this. As my right hon. Friend the Member for Wokingham (John Redwood) referred to, in the 1971 White Paper Ted Heath said that there was no question of Britain losing essential sovereignty by joining the Common Market. We saw how that went. My point, and what I am worried about, is whether the Government will have to bring forward proposals that the WHO insists on even if they do not like it, and so bring the power of Government voting to that decision. That is what I worry about, that Parliament will still decide, but that the Government will be forced to bring forward measures in Parliament, even though they may not necessarily agree with them.
I reiterate: this is a member state-led process, with 193 member states negotiating. It will be a difficult negotiation, but all previous regulations have been agreed by consensus. If the text ends up in a position where the UK Government do not feel that we can sign up to it, the other member states may decide to proceed, but they will not be regulations that we are bound by, because we will not agree to them. This is an evolving situation and we have agreed a pathway for negotiations. As right hon. and hon. Members know, the text and the amendments are available online.
May I turn to some of the contributions? I will start with those paying tribute to my right hon. Friend the Member for Rayleigh and Wickford in paying tribute to his wife and other NHS staff, who did an incredible job during the pandemic. Sometimes, when debating technical issues such as this, we can overlook their incredible contribution, but it is right what my right hon. Friend said today. He also talked about the importance of data sharing globally, which I think we would all agree is vital.
My hon. Friend the Member for Devizes asked when the next iteration of the text will be available. No new texts or amendments have been agreed yet, so there is nothing further to be shared. However, we expect negotiations to continue until May 2024, when member states will agree completion at the World Health Assembly. I am actively exploring ways in which I can keep the House informed of further developments, although as I say, the standing position of the Government on such issues is that we do not do a running commentary on negotiations. I am actively looking at what more we can do to keep Members informed.
That leads me on to another question that my hon. Friend asked about the costs of these measures. Obviously, as we have not agreed the provisions of the treaty, we cannot yet estimate how much it might cost and whether we would publish our red lines. Unfortunately, as I say, I will decline to say more on red lines now; I have set out one clear red line today and we have a very clear red line on sovereignty. However, I do not believe that we should run through these negotiations in public; I believe that we should give our negotiators time to reach as much international consensus as possible.
(1 year, 10 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Order. Given the number of Members who wish to speak, I have to impose an immediate four-minute time limit. We need to get to the Front Benchers no later than 10.30.
It is a pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Hartlepool (Jill Mortimer) for bringing this important debate to Westminster Hall and for bravely sharing her experience. I also thank the hon. Member for Hexham (Guy Opperman). Sharing these experiences is what makes this House real to people. I know it is difficult to do so.
Today, I want to concentrate not on healthcare, which is devolved in Scotland, but on the professionals. Through my work in the APPG and on the Miscarriage Leave Bill, many have written to me to express their concerns and fears about returning to work after their own personal experiences of pregnancy loss. A swathe of healthcare professionals working in healthcare settings each and every day experience pregnancy loss themselves, and then return to work quite soon after to help to deliver another couple’s baby. It must truly be one of the most traumatic and devastating experiences to have to return to work after pregnancy loss, for anyone, but it must be especially devastating for these healthcare professionals.
Much of this debate is about safe staffing, and rightly so, because there is no more vulnerable time for any parent than through the pregnancy and at the birth of their own child. It is a time of fear and apprehension; a time when people ultimately place all of their trust and faith in healthcare professionals. I cannot imagine how triggering it must be for those healthcare professionals who have to return to work each and every day, and experience their own trauma time and again while supporting other parents to have their happy ever after. For some, that is not possible, which just reopens the trauma for those healthcare professionals.
The loss of a baby at any stage can be truly devastating for anyone, in any profession. That is why I have pushed repeatedly in the House for a basic minimum of three paid days leave for any individual who experiences pregnancy loss. Many people in this House have bravely shared their experiences. I do not particularly wish to go into each individual experience, but sharing experiences is so important because it reminds people that we are individuals, that we are human, and that we ourselves have an understanding of the pain and grief that come with pregnancy loss.
The Minister will no doubt tell me that there is provision for parents who experience pregnancy loss before 24 weeks in the form of sick leave, unpaid leave and other vehicles, but the fact is that there is no statutory provision. Last week, I met with the Chartered Institute of Personnel and Development, which informed me that, thankfully, there are whole sectors and industries that are introducing pregnancy loss policies. Sadly, however, no healthcare professions were among the list of organisations that are introducing such policies.
It is imperative that, regardless of sector or industry, when someone experiences pregnancy loss—there is no provision in law before 24 weeks—they are at least recognised and supported on their return to the workplace. The sad fact is that, for healthcare professionals, that is not the case. A third of employers say that they do not have a formal policy, and the CIPD notes that most smaller businesses feel that a formal policy is a luxury that they cannot afford. Without statutory provision, and without implementation in the healthcare profession itself, the reality is that day in, day out, more individuals will experience pregnancy loss and will have to return to work without the recognition of that loss. That is simply too much; it is simply a tragedy.
Order. I am sorry to cut the hon. Lady off during her speech.
I thank the hon. Member for Hartlepool (Jill Mortimer) for setting the scene so very well and the hon. Member for Hexham (Guy Opperman) his contribution. It is always good to hear about personal experiences in speeches, as it shows us all what some people have gone through. My mother has had four miscarriages, while my sister has had two; Naomi, who works in my office, has had one. Although I cannot say that I have personally experienced miscarriage in a real sense, I understand it through the losses of my mother, my sister and my assistant. It is something that very much touches all our hearts.
My heart aches knowing that one in four pregnancies ends in miscarriage, one in 80 pregnancies is ectopic and 13 babies are stillborn each day. For some, those figures may be just stats, but, in reality, every one is a personal story. We have heard some of those stories today.
I have been contacted by countless organisations and constituents about maternity staffing and training. In 2021, the Government announced an investment of £95 million to increase staffing, while a subsequent £51 million is being made available until 2024. I was shocked, although not really surprised, to be told by the charity Sands that that is still not enough to ensure that services across the UK are safely staffed.
Three weeks ago, I had the opportunity to meet Karen Murray and Jayne Cardwell of the Royal College of Midwives and the South Eastern Health and Social Care Trust. I know that the Minister is not responsible for health in Northern Ireland, but I want to give that perspective to the debate, if I can. Midwives in Northern Ireland are experiencing the very same things as here on the mainland, as hon. Members present have spoken to. Karen Murray and Jayne Cardwell brought to light just how dire the situation is in Northern Ireland. We have witnessed recent reports of scandals in Morecambe Bay, where the deaths of 45 babies could have been prevented if adequate maternity care was provided. I stand here blessed and grateful that we have not experienced something similar in Northern Ireland. The representatives I met said that
“it is by the grace of God”
that we have not experienced similar scandals.
The Royal College of Midwives has issued a blueprint for Northern Ireland that paves the way for sustainable, efficient and safe maternity services for women in Northern Ireland. It is a blueprint that could be carried out across the whole UK. The RCM has made it clear that there must be an allocation of money to maternity services that is ringfenced for the full implementation of safety initiatives. There are serious systematic failings—the RCM’s words—that are putting the safety of mothers and newborns at risk. We need more midwives and more specialist bereavement care, especially having heard the stories from hon. Members today. Those are some of the things we need to look after. We also need better supervised neonatal units and consistent financial commitments from our Governments, both regionally and in Westminster, to deliver this.
Organisations such as Bliss, Sands and the RCM have made many recommendations on how we can improve the situation with our maternity services. First, the maternity strategy is in serious need of updating. We must see more midwives and those qualified in specialist care to ensure that even people in the most intricate circumstances are looked after. The Royal College of Midwives says its staff feel the pain of the people they work with; that came across clearly in the meetings I had with the organisation. All our healthcare professionals need better financial, emotional and mental health support as they recover from the devastating impact of the pandemic.
I urge the Minister to engage with our regional Minister, Robin Swann, to ensure that there is never again a repeat of the recent scandals and reports we have heard across the UK. Everyone involved in the political sphere wants to improve the situation, and we can all unite to ensure that our constituents are protected and safe through their maternity journey. Let today be the start of the journey for better maternity care.
Before we get to the Front Benchers, last but by no means least I call Richard Burgon.
(2 years, 7 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Before we begin, I remind Members that they are expected to wear face coverings when they are not speaking in the debate. This is in line with current guidance from the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test before coming on to the estate. Please also give each other and members of staff space when seated and when entering and leaving the room. I call Grahame Morris to move the motion.
I beg to move,
That this House has considered access to radiotherapy.
It is always a pleasure to serve under your chairmanship, Mr Davies, and if it is not too late I would like to wish you and the Officers of the House a happy new year.
I am delighted to have secured this vital and timely debate on access to radiotherapy services. On occasion, it may seem like groundhog day: we come here on a fairly regular basis and outline the case for more investment in radiotherapy services. However, the covid crisis has brought many of these issues into sharp focus, and indeed there is a growing cancer backlog crisis that the Government really must address.
I also want to thank the Chamber engagement team for its fantastic work. This is the first time that I have had any interaction with the team, but it has been most helpful in engaging the public ahead of this debate. I am immensely grateful to the team for carrying out a survey over the course of only a few days—over this weekend, really. We had over 800 responses, and I thank all the respondents for taking the time to express and submit their views and experiences. I believe that those contributions, a couple of which I will refer to, will significantly enrich the debate. I am eagerly anticipating what I am sure will be comprehensive and compelling contributions from colleagues in the Chamber, many of whom I have served with and been involved with in debates like this previously.
It is only right that I begin by declaring an interest. I have the privilege of serving as vice chair of the all-party parliamentary group for radiotherapy, and I am also one of the vice chairs of the all-party parliamentary group on cancer. I also want to thank Macmillan Cancer Support and Radiotherapy UK, the charity with which I am associated, for their assistance in preparing for today’s debate. I am immensely grateful to colleagues from the all-party groups who have come along today; I know that there are many pressing demands on Members’ time.
The reason the debate is so important is that cancer will affect all of us at some point in our lifetimes. I want to take this opportunity to mention a good friend of mine, Nick Munting, who, as some might know, is a chef in the House of Commons and has very recently been diagnosed with cancer. I wish him all the very best for his speedy recovery.
I have personally had cancer on three occasions—a type of lymphatic cancer called non-Hodgkin lymphoma. Without the care and treatment that I received from the NHS, I would not be here today. I thank the dedicated staff at the Macmillan cancer centre at the Freeman Hospital in Newcastle, and those working at cancer hospitals throughout the country, for the excellent work that they do in diagnosing and treating cancer patients. I have received a plethora of cancer treatment. I have had the works: surgery, chemotherapy and radiotherapy—including advanced radiotherapy.
There is a reason why I am concentrating on radiotherapy today. Radiotherapy is by far the least understood of the three pillars of cancer treatment, with chemotherapy and surgery far more widely understood and referred to in public life. Despite that, one in four of us will have radiotherapy at some time in our lifetime. I want to begin by highlighting the many advantages of this highly specialised treatment and the major breakthroughs that there have been over the last 10 years.
Unlike other cancer treatments, modern radiotherapy is accurate to within millimetres, limiting damage to healthy cells around the cancer. A specialist in the field and a dear friend, Professor Pat Price, explained in simple terms to me, as a layman, the concept of a banana in a box. Imagine that the tumour is a banana in the box. With older, less precise forms of radiotherapy, the whole box would be irradiated and there would be considerable collateral damage to healthy cells. With modern, advanced precision radiotherapy techniques, just the banana would receive the high dose of radiation, and there would be no collateral damage. That significant advance has come about because of digital technologies and advances in this form of treatment. It is especially useful for treating cancers in areas vulnerable to damage, and it requires fewer patient visits than other treatments. Unlike surgery, it does not take up intensive care capacity, and unlike chemotherapy, it does not impact on the immune system.
Furthermore, radiotherapy is the most cost-effective treatment. Typically, a patient can be cured at a cost of about £6,000. If we contrast that with the cost of some chemotherapy drugs, which for individual treatments may run into hundreds of thousands of pounds, there is a cost argument for expanding radiotherapy, in addition to its effectiveness as a treatment. In many respects, it is a silver bullet. It is often referred to as a “Cinderella” service: it is immensely effective, but it suffers from chronic under-investment and suboptimal clinical commissioning. Let me remind the Minister that the UK spends only about 5% of the cancer budget—I do not mean the entire NHS budget; I mean just the cancer budget—on radiotherapy. Compared with what is spent in many other advanced European countries, that is a very small proportion; the European average is about 10% of the cancer budget.
In England, access to treatment can depend on people’s postcode; often, patients in more affluent, urban areas benefit from the most modern equipment, and from ease of access because of excellent public transport provision. In contrast, patients in less affluent, more rural areas, such as mine—Easington in County Durham—do not enjoy the same levels of access. My constituents make up a proportion of the 3.5 million people in England who do not have a radiotherapy centre within the recommended 45 minutes of their home.
That statement of the situation was supported and confirmed by a number of the respondents to the survey carried out by the Chamber engagement team. If I may, I will refer to a couple of their contributions. A lady called Penelope had positive experiences of accessing the service herself, but feared for others who might not be so fortunate. She said:
“In my experience, which involves my father’s radiotherapy last summer, he did not have to wait long, but he lives in Berkshire…near several hospitals, and I think the situation is very different in other areas of the country.”
Similarly, David said:
“My own wait time…before the covid situation was only weeks, and by that time I had already started other treatment regimes as well. I am lucky to be close to a centre of excellence: the University Hospital Coventry and Warwick. This is not normal though, a close friend, now passed on, had to drive from their home near Boston in Lincolnshire to the Leicestershire Infirmary for treatment, when there was a possible ‘slot’. That was a 4-hour round trip as neither the Boston nor Lincoln hospital had”
radiotherapy
“facilities. Lack of facilities meant the cancer spread out of control and he died.”
Radiotherapy is needed in almost half of treatments, but according to Cancer Research UK, only 27% of UK cancer patients actually receive it. I respectfully point out to the Minister that we will never level up the country while access to life-saving treatment depends on people’s postcode—where they live—entrenching already existing regional health inequalities.
Let me also address some of the workforce issues. The radiotherapy workforce are at breaking point. A survey conducted by Radiotherapy UK and the Institute of Physics and Engineering in Medicine in October 2021 found that almost 80% of professionals were considering leaving their position or knew a colleague who was. That was echoed by members of the radiotherapy workforce who submitted their views to the survey. A lady called Lauren said:
“Most radiotherapy staff can travel over an hour as that is their nearest radiotherapy centre. Increasing working hours and increasing workload is leading to more staff wanting to leave the profession in addition to the fact most of us have to travel long distances to find a centre to work at. Due to housing not being affordable in the locations of radiotherapy centres,”
which are often in big city centres. The Minister can address that fairly simply, and we have a solution—investment in IT networks, which I will come to in a moment—that we have put to successive Ministers who have occupied the post.
The tariff system generating income to trusts is based on the number of patient visits. Those perverse tariffs mean that radiotherapy trusts with advanced machines that can treat patients in fewer sessions are incentivised to treat patients less effectively over more treatments. That is a ludicrous, perverse incentive that I am sure the Minister could do something about.
Similarly, trusts seeking to replace ageing machines—the advice is to replace radiotherapy machines after 10 years—are required to conduct 9,000 treatments even to be considered for funding. The pandemic saw referrals plummet and services overstretched, so centres are not reaching that threshold and are therefore blocked from providing patients with access to the latest life-saving technologies. We have poor patient access and exhausted, demoralised staff, with senseless bureaucracy and a tariff system promoting less effective treatment. That is a pretty poor report card.
That was the state of radiotherapy even before the covid-19 pandemic. Holly, a radiotherapy professional, said:
“Currently we are having to delay patients due to poor staffing levels, this started way before the current surge in omicron cases. We have been understaffed for some time, and this has been made so much worse by omicron, we are having to close machines to make sure we have staff to cover”
the covid patients. She added that
“those that are in are getting burnt out by having to work longer, more days and harder each shift, meaning it’s a cycle of being off ill.”
Covid has created a cancer crisis that the current system cannot effectively manage. On that note, I want to pay tribute to the Catch Up With Cancer campaign, which was launched in conjunction with Craig and Mandy Russell, who very sadly lost their daughter Kelly to bowel cancer when her treatment was delayed owing to resources being transferred to the treatment of covid patients. Some of us here today handed in to 10 Downing Street a petition, signed by more than 300,000 members of the public, calling for action on the issue.
Of all the health backlogs, the cancer backlog is the most time-sensitive because, for every month that diagnosis of treatment is delayed, cancer survival rates can drop by as much as 10%. These are life-and-death issues for many tens of thousands of people. Without urgent action, cancer experts predict that survival rates in the UK may fall back to where they were 15 years ago, resulting in tens of thousands of extra cancer deaths. I know the Minister is new to her post, and I do not want to be unfair, but there is a crisis. I have been with colleagues to see a succession of Health Ministers, on many occasions, to set out proposals to improve the position. The lack of action is frankly lamentable, and many thousands of people will pay the price.
Before the pandemic, the all-party parliamentary group for radiotherapy branded radiotherapy “Britain’s secret lifesaver”. Ministers and NHS leaders need to recognise that it could be a game changer; it could have an immense impact on tackling the covid-induced cancer backlog, but to do that, it needs sufficient investment.
The all-party group has put together a six-point covid-19 recovery programme. I urge the Minister to look at that and to implement its proposals, which were developed not by me or other parliamentarians but by experts in the field—radiotherapy specialists and oncologists—who understand their patients and understand the service and how we can improve it.
The first point in our six-point plan is that we need to appoint a Minister in charge of and accountable for the transformation of radiotherapy. We need to invest in IT solutions to modernise radiotherapy. The problem that radiotherapy is available in only relatively few urban centres could be mitigated, to a degree, with modern IT that allowed specialists hundreds of miles away to interpret digital imagery and advise on the appropriate treatment.
We need to replace ageing machines—those that are more than 10 years old—and forget the bureaucratic nonsense about machines having to have done 9,000 treatments, because referrals for treatment have reduced due to covid. We need to invest approximately £200 million in the highly specialised workforce, where staff redeployment will be insufficient to fill the gaps.
We need to improve capacity and access by placing radiotherapy machines in some of the planned new diagnostic hubs. Ministers often respond to debates such as this one by referring to the £130 million that the Government promised to improve diagnostic services. That is welcome, but we need to address not just diagnosis but treatment. Radiotherapy is a quick and highly effective treatment, so I urge the Minister to consider using these machines in the diagnostic hubs.
Finally, we need to raise the profile of radiotherapy, ensuring full awareness among the public of the treatment’s curative and palliative potential. The six-point plan is underpinned by a need for a national strategy. The lack of a cohesive national approach has caused unacceptable inequality and disparities between trusts in different parts of the country.
It comes down to this: every day, every week and every month that the Government fail to take sufficient action, the public suffer, money is wasted and patients die. The Government are in denial about the situation and there is a huge disconnect in ministerial statements. Just last week, I heard the Leader of the House say that the situation had been normalised, but that is far from the truth. We cannot ignore the cancer crisis any longer.
I want to ask the Minister a number of questions, which I hope she will address in her response. I hope she understands the frustration felt by radiotherapy staff, but I want her to make a commitment to investigate the bureaucracy that is holding back radiotherapy trusts and denying patients the most effective treatment. Will she act urgently on that? Is she aware that the Government have not reported radiotherapy-specific data, which we refer to as the radiotherapy datasets, since May 2021? Will she publish the datasets that are available next month? Those will show clearly the levels of treatment that radiotherapy machines have been involved in during this period compared with previous years. That will make perfectly clear the level of the backlog, which estimates from the frontline put at between 50,000 and 60,000.
Will the Minister outline the plan in the event that radiotherapy services find they are no longer able to cope? Finally, will she agree to a meeting with radiotherapy commissioners, the Secretary of State and representatives of the radiotherapy community, in order to address these essential life-or-death issues? It has been useful for me to open the debate, but I know colleagues have issues that they would like to put to the Minister, so with that, I will conclude.
(2 years, 8 months ago)
Commons ChamberWhen it comes to travel measures such as the recent announcements in respect of the red list, I think the hon. Gentleman will understand why the Government took that action to buy time and to try to slow any incursion of this new variant. I am afraid it is just not possible to give a guarantee for any particular country that there will not potentially be any future measures. As he has raised the important issue of travel measures, one thing I would say is that very soon, in the days and weeks that lie ahead, if, as I think is likely, we see many more infections and this variant becomes the dominant variant, there will be less need to have any kind of travel restrictions at all.
Earlier this week, the Secretary of State came to the Chamber and said, in answer to my right hon. Friend the Member for New Forest West (Sir Desmond Swayne), that there had been not one single hospitalisation from this new variant. Today, he comes here with his latest in a long line of arbitrary, unnecessary, socialist measures, supported by the socialists on the Opposition Benches. I am sorry that the Secretary of State seems to have gone native so fast and has come forward with this announcement without even doing a cost-benefit analysis. Will he give me any reason at all why I should not tell my constituents to treat these new rules in exactly the same way that No. 10 Downing Street treated last year’s rules?
I understand the importance of my hon. Friend’s point. First, we all know that in South Africa, where we believe this variant originated, we are seeing significant hospitalisations of people with the new variant, and they have been doubling on a weekly basis. Also, we know from the history of viruses, and particularly with this pandemic, that there is a lag—sometimes a significant lag—between infection and hospitalisation. It takes time for the virus to incubate and, sadly, in some people that might lead to serious disease, which might mean hospitalisation. It is worth noting that the UK had its very first case of covid-19 back in January 2019 but it was not until, I think, two months later that we experienced the first death.
(2 years, 9 months ago)
Commons ChamberThere are more clinics in England delivering covid-19 vaccines than there were at any point during the covid-19 vaccination programme. A lot of planning has gone into ensuring that sites are distributed according to demand. I can tell my hon. Friend that there are three vaccination sites in Shipley itself—at Lynfield Mount Hospital, Shipley health centre and Windhill Green’s emerald suite—and eight walk-in centres within 10 miles of Shipley. These sites are available to all those who are eligible and need to book.
Lynfield Mount is not in my constituency. Many of my constituents want to have the booster vaccine, but are unable to access it locally and are instead being told to go to Bradford, which many are unable or unwilling to do. If the Government want a bigger take-up of the booster vaccine, may I urge my right hon. Friend to ensure that there are more places available in the Shipley constituency where my constituents can have their booster?
My hon. Friend, as always, make an important point. I thank his constituents for their excellent response to the national roll-out of the vaccination programme, and for playing their part in that. I have heard what he has said very clearly. We want to make access to vaccination as easy and convenient as possible. I will speak to the NHS to see what more can be done.
(3 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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I remind Members of the changes to normal practice to support the new call list system and ensure that social distancing can be respected. Before they use them, Members should sanitise their microphones using the cleaning materials provided, and they should respect the one-way system around the room.
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I was having Chinese takeaway five nights a week with two bottles of Coke. It was not the way to live life, but I had a very sweet tooth.
Until about a year before I realised I was a diabetic I did not know the symptoms. My vision was a wee bit blurred and I was drinking lots of liquids—two signs that should tell you right away that something is not right. I took a drastic decision to reduce weight and lost some 4 stone, which I have managed to keep off.
We need to look at our diet and our lifestyle. We all live under stress, and we all need a bit of stress because it keeps us sharp, but there is a point where we draw the line. I recall the day I went to the doctor and he told me, “We are going to put you on a wee blood pressure tablet.” I said: “If that is what you think, doctor, I will do what you say.” He added: “When you start it, you have to keep at it. You cannot take a blood pressure tablet today and then not take it next week, because your system will go askew.”
Obesity leads to high blood pressure and some types of cancer and is strongly associated with mental health and wellbeing, which is so important in the current crisis. There are strong links between the prevalence of obesity and social and economic deprivation. People living with obesity face extraordinary levels of stigma and abuse. We need to be careful and to be cognisant of other people’s circumstances, because they might have a genetic imbalance, which I will speak about later.
The outbreak of covid-19 makes the obesity epidemic more urgent. It is deeply concerning that obesity is a risk factor for hospitalisation, admission to intensive care and death from covid-19. The facts are real. People with a body mass index of 35 to 40 are 40% more likely to die from covid-19 than those of a healthy weight. In people with a BMI of 40-plus, it rises to 90%. That places the UK population in a very vulnerable position.
In the latest report from the Intensive Care National Audit and Research Centre, which audits intensive care units in England, Wales and Northern Ireland, almost half—47%—of patients in critical care with covid-19 since 1 September had a BMI of 30 or more. In other words, they were classified as obese. Those figures show that almost half the people in critical care had a lifestyle that they needed to address. That figure compares with the 29% of the adult population in England who have a BMI of 30 or more. People with obesity are much more likely to be admitted to critical care with coronavirus.
We also know that covid-19 has a greater impact among black, Asian and minority ethnic communities. Currently, 74% of black adults are either overweight or living with obesity. That is the highest percentage of all ethnic groups. That is a fact—an observation—not a statement against any group, but we have to look to where the problems are and see how we can reach out to help, because we need to reach those groups.
It is encouraging to see the Government setting out the steps that they will take to support people to live healthier lives and reduce obesity. Those steps will make a positive contribution to the environment we live in and will encourage people to make healthier choices, helping to prevent obesity. I will also speak about other groups, because it is sometimes those in a certain financial group who do not have the ability to buy the correct foods and are driven by the moneys that they have available.
The Government now have to implement their proposals and fund them adequately. Then they need to measure their success and to review what more can be done. Three childhood obesity strategies have been published since 2016, and the proposals have not yet been fully implemented. One reason we are here today is to see how those proposals can be implemented, and we need a timescale. I know we are on the cusp of finding a vaccine, but we also need to address the issue of obesity in the nation as a whole. Perhaps covid-19 is an opportunity to address it. We cannot afford a delay. It has to be an urgent priority for the Government and the Minister if we are to protect people from severe illness from covid-19.
Furthermore, we need to address the structural drivers of obesity. Inequality is a key element, as I mentioned a little earlier. Obesity prevalence in children is strongly linked to socioeconomic deprivation. Families with lower incomes are more likely to buy cheaper and unhealthier food because what drives them—let us be honest—is what is on offer this week and what budget is available to buy the food that is on the shelf. We do not always check the labels. Is it high in calories, sugar and salt? Those are things that we probably should check, but we do not, because the driver is money.
A report by the Food Foundation in 2018 found that the poorest 10% of households need to spend 74% of their income on food to meet its Eatwell guide costs. That is impossible for people on low incomes. When the Minister sums up, perhaps she will give us her thoughts on how we can address that issue directly.
I welcome the Prime Minister’s commitment to the support for schoolchildren and school meals. It is good news; it is good to know that the four nations in this great United Kingdom of Great Britain and Northern Ireland are united in taking action on that issue. Scotland is doing it, Northern Ireland is doing it, Wales is doing it and now England is doing it. That is good news, because by reaching out and offering those school meals we will help to address some of the issues of deprivation and how the mums and dads spend the money for food in the shop. This is a way of doing that. We all know that school meals have a balance as well, so it is really important over the coming school breaks and other times that children have the opportunity to have them. In Northern Ireland, the Education Minister set aside £1.3 million to help to provide school meals over the coming period.
The Government need to work more closely with the food and drink industry as well, to make the healthy option the easiest option. However, while we need to support healthier choices and behaviours, there is no point in seeking to make individuals’ behaviours healthier if the environment in which they live is not suited to healthy behaviour. It is okay to say these things, but how do we make them happen? We need to look further at the social factors that lead to obesity, and we need to address them to make them more conducive to healthy living. To give just two examples, eating more fruit and vegetables and walking, which gives the opportunity to be out and about, are among the things that we need to look at.
There is a long-term process, which involves planning, housing, the workplace, the food supply, communities and even the culture of life in the places that we live in. It is about the groups of people we live with and the people we have everyday contact with. Earlier, I mentioned genetics, which is also an important factor in causing obesity. Again, it is a fact of life that there are people who may carry extra weight because of their genetics. Indeed, it is suggested that between 40% and 70% of variance in body weight is due to genetic factors, with many different genes contributing to obesity. Again, I am sure the Government have done some research on that issue, working with the bodies that would have an interest and even an involvement in it. It might be helpful to hear how those people who have a genetic imbalance, for want of a better description, can address it.
Without going into the motivations and challenges faced by people living with obesity, and particularly those living with severe obesity, it is clear that it is not always easy for them to lose weight. Let us be honest: it is not easy to lose weight. Some people say, “Well, what do you do? Do you stop eating? Do you cut back on your eating?” But if someone enjoys their food—I enjoy my food, although in smaller quantities, I have to say—and overeats, we have to address that issue as well.
We want to encourage people to improve their wellbeing and mental health and to have the willpower. There are a lot of factors that need to be part of that process. I was therefore pleased that the Government strategy sets out plans to work with the NHS to expand weight management services. Again, perhaps the Minister will give us some idea of what those services will be.
Support for people to manage their weight can range from diet and exercise advice to specialist multidisciplinary support, including on psychological and mental health aspects, and bariatric surgery. We have the National Institute for Health and Care Excellence guidance on these treatment options, which sets out who should be eligible for them, yet they are not universally commissioned, which means that many patients cannot access support even if they want to. Given the urgent need for people to reduce weight to protect themselves against covid-19, we need to make these services more accessible by increasing their availability and the information provided about them to patients and the public.
Over the years, I have had occasion to help constituents who probably had a genetic imbalance and were severely overweight. The only way forward for those people—men and women—was to have bariatric surgery. On every occasion that I am aware of involving one of my constituents, bariatric surgery was successful. It helped them to achieve the weight loss that they needed and it reduced their appetite. That made sure that their future was going to be a healthy one.
We have strict acceptance criteria in the NHS for obesity treatment that are not found with other conditions. If a person has a BMI of 50, they must follow diet and exercise advice and receive a multidisciplinary specialist report. These services are otherwise known as tier 2 and tier 3 services. We are almost sick of hearing of tiers 1, 2 and 3, but they are a fact of life for obese people before they are even eligible for surgery.
If a patient does not complete those courses, they must start again, which can make some people lose motivation. The lower levels of support are absolutely necessary and effective for the appropriate patients, but it would be better to remove the loopholes and duplications. That would allow more people to achieve the appropriate support, even before additional resource is provided.
Currently, the United Kingdom performs 5,000 bariatric surgeries every year, which represents just 0.2% of eligible patients. If more people had the opportunity to have that bariatric surgery, they would probably take it. Can the Minister indicate what intention there is to increase the opportunities for surgery? We lag behind our European counterparts when it comes to surgery for obesity, despite it showing benefits in terms of cost, safety and the ability to reverse type 2 diabetes.
Many reports in the papers in the last few months have indicated how people can reverse their type 2 diabetes and the implications of that. Talking as a type 2 diabetic, I am ever mindful that if people do those things and reduce their weight, it helps, but it may not always be the method whereby type 2 diabetes can be reversed. When I lost that weight, I found that my sugar level was starting to rise again after four years, and I moved on to tablets and medication, which controls it now. Ultimately, the control will be insulin, if the level continues to go the wrong way.
The British Obesity and Metabolic Surgery Society has recommended that the number of surgeries should increase incrementally to 20,000 a year—a massive increase from 5,000, but we believe it will heal some of the physical issues for the nation. This is a small proportion of the total number of people with obesity, but they would also benefit the most. This debate is not about highlighting the issues, but about solutions. I always believe that we should look at solutions and try to be the “glass half-full” person rather than the “glass half-empty” person, because we have to be positive in our approach.
For people who require nutritional, exercise or psychological advice, face-to-face services were closed during the first wave of the pandemic. I understand the reasons for that. While digital and remote services can provide help to vulnerable people during lockdown, these new ways of working cannot reach everyone. How do we reach out to all the people who need help? That is vital as the country moves through future stages of the pandemic. We hope we have turned the corner, but time will tell in relation to the trialling for the new vaccine. Obesity continues to be a priority, and services should remain available.
Lastly, in future, obesity services should not be cut as part of difficult funding decisions. I understand very well the conditions in the country and the responsibility that falls on the shoulders of the Health Ministers not just here in Westminster, but in Scotland, Wales and Northern Ireland. It is vital that the inequity in access to these services is corrected to ensure that people can access support, no matter where they are in the country. What discussions has the Minister had with the regional Administrations—with the Northern Ireland Assembly and particularly with the Minister, Robin Swann, and with our colleagues in Scotland and Wales? If we have a joint strategy, it will be an advantage for everyone. I would like to see the person in Belfast having the same opportunities as the person in Cardiff, Edinburgh, London and across the whole of this great nation.
I have three asks of the Minister, along with all the other questions I have asked throughout my speech—I apologise for that. Can she reassure us of the continued political prioritisation of the prevention and treatment of obesity? I call on the Government to implement, evaluate and build on strategies to reduce obesity. Can the Minister tell us how have discussions on that been undertaken with the regional Administrations across the UK? I also call on the Government to work with local NHS organisations and local authorities to ensure that services are available to our constituents who wish to manage their weight.
In summary, given the range of secondary conditions caused by obesity—this also applies to covid-19—would it not be more prudent to address their underlying cause before they occur? I always think that prevention, early diagnosis and early steps to engage are without doubt the best way forward, and it would be helpful for the nation as a whole if those things were in place. I believe that would help to reduce the impact of conditions such as type 2 diabetes, heart disease, kidney disease, high blood pressure, stroke, sleep apnoea, many types of cancer and more. The problem with covid-19 is that although our focus should rightly be on covid-19, we must not forget about all the other, normal—if that is the right word—health problems that people have, because dealing with those is very important for our nation to move forward.
The NHS currently faces huge demands, but reducing obesity now would significantly reduce demand on wider NHS services. It is a question of spending now to save later, if we are looking at the financial end of it. It is not always fair to look at the financial end, but we cannot ignore it, because there is not an infinite budget available to do the things we want to do; we have to work within what our pocket indicates. And we have to do that while also protecting people who are vulnerable to coronavirus.
I commend the Minister and our Government for their focus on obesity. I very much wish their new obesity strategy success. How it will work across the four nations is important, but we need to do more, in both the short and long term, to prevent and treat obesity, and we must do so with adequate funding, which is crucial to enable the operations, strategies, early detection and early diagnosis to be in place.
I hope that our future strategies to reduce obesity will continue to focus on how people can also be supported to live healthily. When it comes to these things, we have to be aware that it is not just one person who is living with the obesity; the family also live with it. Sometimes we forget about the impact on children, partners, wives, husbands and so on. Whenever someone sits down for a meal, is their meal the same as what the rest of the family are having? It would be better if they were all eating the same food, in terms of diet and content. I believe that if we can achieve that, we will find a way forward.
May I thank in advance all right hon. and hon. Members for taking the time to come to this Chamber and participate in the debate? Like me, they are deeply concerned about how covid-19 is affecting those with obesity issues. Today is an opportunity to address this issue, and I very much look forward to hearing other contributions; I am leaving plenty of time for everybody to speak.
It might be helpful if I say that I intend to get to the Front Benchers no later than 10.30 am. There are currently five Members on the Back Benches who want to speak, so if people could take seven minutes or so each, that would be helpful to give everyone a fair crack of the whip.
(3 years, 10 months ago)
Commons ChamberI welcome the hon. Gentleman’s support for the measures that we have had to take and for the £7 million of extra financial support for the councils affected—not just Merseyside, and Halton and Warrington, but Hartlepool and Middlesbrough—which is on the same basis as the support for the seven north-east councils announced at the end of last week.
It is true that some parts of the country have come through a local lockdown. In fact, we have lifted many of the measures that were in place in Leicester, for instance. We were not able to lift all the measures, and the case rate there then went back up again, although it has now appeared to have stabilised. Luton is another example where there was a significant local outbreak that was brought under control.
The hon. Gentleman asked about increased testing. Increased testing is, of course, going into Merseyside, and we can do that because we have record capacity, which has increased yet again this week. He also asked about backward contact tracing; absolutely we have backward contact tracing in these areas. And that is one of the reasons we know that, sadly, the highest likelihood of picking up coronavirus outside our own households comes from social settings. Public Health England will be publishing further information today on backward contact tracing to understand how this virus spreads.
The hon. Gentleman asks about the speed of test results. I am glad to say that the turnaround time for test results in care homes is speeding up. He asked about Deloitte and its contact tracing capabilities. Deloitte has done an incredible job in helping us put together the contact tracing and backward contact tracing that we have, and of course it should offer its services to local councils too. He says that local councils should have more impetus and more involvement in contact tracing, but when a company with great experience in contact tracing comes forward to offer its services, he criticises it. He cannot have it both ways. Of course, these services cost money and they have to be delivered, and I pay tribute to Deloitte, which is doing a brilliant job.
Finally, the hon. Gentleman asked about flu jabs. It is absolutely true, as he says, that there is a record roll-out of flu jabs. There are enough for everybody in a priority group who needs them. I stress that this is a roll-out: nobody needs to have a flu jab before the start of December, but people can have it in September or October and it will then cover them for the winter, so we are rolling this out and more appointments will become available in good time. We have 30 million jabs in total, more than we have ever had before and almost double what we typically have had in the past, and those are available. I am really glad to say that record numbers of people are coming forward to get flu jabs, and I welcome that, but, as the Royal College of General Practitioners has said, people will need to have patience. For those in the target group—the over-65s and those with clinical conditions—flu jabs are available, and it will take us the coming weeks in order to ensure that people who need those flu jabs can get them.
Bradford has been in a local lockdown for weeks and weeks, and the number of cases is going up, not down. Is the Secretary of State aware of the damage the arbitrary 10 pm curfew is doing to pubs, restaurants, bowling alleys and casinos? Is he aware of the jobs that are being lost, all just to see people congregating on the streets instead and shop staff getting more abuse? When will the Secretary of State start acting like a Conservative with a belief in individual responsibility and abandon this arbitrary nanny-state socialist approach, which is serving no purpose at all, apart from to further collapse the economy and erode our freedoms?
(5 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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Order. It is not for me to rule on whether people should or should not give way, but I should say that it is not really on for people just to wander into the Chamber and seek to intervene within two minutes of doing so. I say that gently, but it is not for me to decide who should be given way to; that is a matter for the speaker.
That is not the point, if I may say so to the hon. Lady. Would the hon. Member for Wolverhampton South West (Eleanor Smith) like to give way?
I will take this intervention and then I would like to make some progress.
There are about seven Members seeking to catch my eye. We need to get to the Front-Bench speeches by 3.30 pm. Therefore, I will impose a five-minute limit on all speeches straightaway. I should also point out that any interventions might reduce that further, so that is in colleagues’ hands.
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on securing a debate on this very important subject and the Minister for Health on his new role.
I do not think there is anybody in Westminster Hall today who would doubt the value of nursing or the importance of good nursing and nurse training. I have worked for my entire career as a paediatrician; I am now a consultant paediatrician. Nurses and midwives have had a significant impact on both my career and my personal experiences. When I worked on a neonatal intensive care unit, many nurses influenced my career. However, there was one in particular—a lady called Mary Palfreman, a nurse in Nottingham—who had a profound effect on me, because she is such a fantastic nurse. On a personal level, I was cared for through several of my pregnancies by a midwife called Marie Robinson, who was able to balance treating me as a medic, who had more knowledge of neonates and babies than the average first-time mum, with treating me as a mum. She recognised that I was a bit of both and perhaps needed a slightly different approach from others—even a unique approach. She treated everybody as she found them, and she is a fabulous woman.
None of us, therefore, would doubt the value of a good nurse and the importance of making sure that there are adequate numbers of nurses. Nursing is a great and varied career, which is something we should be selling more. Nurses have the opportunity to nurse in many different fields. As their career progresses, they can go into administrative roles, managerial roles and specialist technical roles in the community or in a hospital, and develop a good and, at the high level, extremely well paid career.
So what should a good training scheme do? Obviously, it should provide high-quality experience, so that students develop the necessary expertise; it should provide the opportunity for continuing personal development; and it should ensure that there is an adequate supply of nurses. We have a change in demographics: the population is getting older, there are more people with complex health needs, and the population is increasing in size. So we need to ensure that the number of new nurses keeps up with both those developments and the natural attrition of nurses as people retire and so on. We also need to ensure—this is very important to me as a Conservative— that anyone who has the desire and the aptitude to train as a nurse can do so and is not limited by how much money they have or where they are from.
Looking at some of the figures, it is evident there has been a drop in the number of people applying to become nurses, but at this stage there are still many more applications for nursing than there are nursing training places. I was not a parliamentarian when the new policy was introduced, but I understand that the aim behind it was to ensure that more places were available so that more people with the desire and the aptitude could train. The figures I have been given show there are 13,000 more nurses on the wards now than there were in 2010.
In January I was a member of the Select Committee on Health when it produced the nursing workforce report that the hon. Member for Stockton South (Dr Williams) mentioned earlier. It showed specific shortages in mental health, learning disability and district nursing. I understand that the previous Minister undertook to give up to £10,000 to people training in that field, to try to address the shortages. Will the Minister tell us how that is working and whether it is increasing applications? Also, the Government had recognised specific challenges for people wishing to go back into nursing or to develop nursing as a career after having children. Is the Minister looking into what support can be offered to those with disabilities and those with children to make sure that they are still able to access nurse training and become the fabulous nurses that they can be?
The issue of part-time jobs has been raised. Most of the nursing students I have worked with in my career have had part-time jobs, usually as a healthcare assistant, often on the same ward that they have worked on as a nurse, so I am not sure the point that was made entirely reflects what I have seen.
Finally, I want to mention alternative routes into nursing. There is more than one route to achieving a goal. There are opportunities for people to work as nursing associates. Some of the healthcare assistants I have worked with have done that, and they really enjoy their training. There is also the opportunity to go into a nurse apprenticeship as an alternative way of training while working. That is not for everybody, because people want different things, but it is another way in which we can increase nurse numbers without having an impact on training. I am aware of the time, but will the Minister update us on—
It is a great pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Wolverhampton South West (Eleanor Smith) for securing the debate. I declare an interest: I am the child of two doctors, the sister of a doctor and the wife of a doctor. Through my entire life I have been humbled by how hard all the doctors, nurses and midwives in our NHS work and by their dedication to their patients and the fundamentally huge professionalism that they show every day.
A couple of weeks ago I visited the palliative care team at the J’s Hospice, which helps people towards the end of their life in Chelmsford and across large parts of Essex. I give my huge thanks to the nurses there for the work that they do. As I left, I asked them whether there was one thing that would change their lives that they would really like politicians to do, and they said, “Please can you get us a car park permit so that, when we go out to meet the patients we try to care for in their homes, we do not get a parking ticket if we end up having to park in a residential parking bay?” I do not know whether the Minister can change that, but that is a real ask from them. They do amazing work. One more thing they said was that if there was a little bit of capital funding, they would love some help with some digital technology so that they do not need to go back to base to fill out their patient records.
I am also proud to have a brand-new medical school in my constituency. Anglia Ruskin University has a medical school that opened this autumn. I spoke to the acting vice-chancellor earlier in the week and he told me that things are going really well. It has its 100 students, it is brilliantly vibrant, and it is doing great work. I also asked him how the nursing courses are doing. On the good side, ARU has pioneered alternative routes into nursing. Nurse apprenticeships and nurse associateships are going really well and are very encouraging. They give people who would not necessarily have gone on to a traditional nursing course an alternative route into the career, and it is really appreciated. However, it was pointed out to me that since the bursaries went, there has been a drop in the number of applicants from eight per place to five. So there are still many more people applying for courses than places on the courses, which is good news, as is the fact that the quality of applicants is not dropping.
There is concern, however, at the fact that in some areas there are not enough high-quality applicants because of the changes. Mature students in particular are more debt-averse—that is probably the best phrase—and concerned about taking on a student loan. Those older students tend to be women. Today is a special day for women; the 50:50 Parliament campaign reminds us that women have been able to do the job we do here for 100 years. We need to make sure that women across the country can do the jobs they want to do. The change in nursing bursaries has had an effect on more mature students, especially with regard to entering adult nursing and mental health nursing. That is particularly true in my constituency, although it is less of an issue at other nursing colleges further from London.
The acting vice-chancellor of ARU says that the golden hello that a previous Minister introduced for mental health and learning disability nurses is welcome, but asks whether we could please consider it for adult nursing as well. The previous Minister, now the Secretary of State for Exiting the European Union, was prepared to give help in the form of an additional £10,000 golden hello to help people in particular targeted areas not to have to take on debt, so can we consider that for adult nursing?
The second ask from Anglia Ruskin is a higher-profile campaign. There was some publicity, and a national campaign encouraging people to consider nursing, but it did not have much visibility. Nurses are wonderful people, and they make a huge difference to all of us. As well as encouraging the idea of supporting them through financial golden hellos when they are needed, we need more publicity about the routes into nursing, and the benefits.
Order. I am afraid that I shall have to reduce the time available for the last two Back-Bench speakers to four minutes. I apologise.
(6 years, 1 month ago)
Commons ChamberWe published chapter 2 less than a month ago. There is further work to do, because that sets out a whole series of areas in which we are going to take action, and I am already working on pushing it faster.
I know that the Secretary of State has a track record of evidence-free, nanny-state policies from his time in DCMS. Can we expect more of the same in his new Department, or is he going to try out some Conservative principles, such as individual freedom, and individual and parental responsibility?
I am delighted to see that the teamwork between my hon. Friend and I is going to continue. You might be surprised to know, Mr Speaker, that there are some things on which my hon. Friend and I agree. One is the importance of individuals taking responsibility—a critical part of public health and tackling obesity—supported by an enabling state.