(2 years, 2 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
It certainly is. Things are never straightforward and there are complex issues. However, today our request is quite simply on behalf of those who have contacted the hon. Member for Central Ayrshire and each and every one of us. We have them in Northern Ireland as well; some of my constituents have been impacted. I think it is really important that we do that.
It is not just a matter of who they sue—whether it is a pharmaceutical company or the Government. As with contaminated blood, is the point not that people injured by vaccines—or damaged in some way through healthcare—should not struggle with some long court battle? Look at how long the contaminated blood scandal has been running—surely we do not want to put people through litigation if it can be settled more fairly.
As always the hon. Lady gives us a focused way forward. Since I was elected as an MP in 2010, the contaminated blood scandal has been at forefront of my mind, as it has been for the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), who is the Opposition spokesperson for that issue. People have waited all that time for compensation, but there is some hope now of it coming.
However, many people in the compensation chain for the contaminated blood scandal have not yet got satisfaction. The hon. Member for Central Ayrshire is absolutely right: litigation, by its nature, is traumatic and it adds to the problems for those who are already distressed because of their physical health, and experience anxiety, depression and all sorts of other issues. If there is a way of doing it—and the right hon. and learned Member for Kenilworth and Southam has referred to what that is—then let us do it.
The Second Reading of the Covid-19 Vaccine Damage Bill is scheduled for the end of October. I would like to hear that we must do well by our constituents across the whole of the United Kingdom of Great Britain and Northern Ireland who fell victim to this particular problem. We know that the 1979 Act does not apply to many other vaccines, and we have heard so much anti-vax rumour and speculation. I, for one, am willing to put my faith in healthcare professionals to ascertain why someone has been impacted in a certain way by the covid vaccines. The hon. Member for Central Ayrshire, who spoke before me, is not here as a healthcare professional; she is here as an MP, but she still has the expertise, knowledge and understanding of that, as do many outside. I previously added my name to present the private Member’s Bill earlier in the year, and I am very happy to do so again.
To conclude, we must stand by those who have stood by us in doing their civic duty to be vaccinated. I call on the Minister and Government, beseechingly, to engage with Health Ministers in the devolved nations in Scotland, Wales and Northern Ireland, and to collectively work to ensure that the Bill can be passed with the support of others. They must ensure that those impacted by the covid vaccines have something to ease burdens past and future. Along with other Members here today, I hope that the Government will address those issues with compassion and understanding, and do so now.
(4 years, 8 months ago)
Commons ChamberThat is an excellent point, which I will come on to shortly, and I absolutely agree with my hon. Friend.
The Bill puts attractiveness as a place to do trials and supply medicines almost on a par with safety and drug availability. What exactly does that mean? The shadow Health Secretary was right to seek a definition of that phrase. Is it about cutting red tape? If so, I would point out that one man’s red tape is another man’s life and limb. The Association of the British Pharmaceutical Industry says that the industry does not want divergence or lower standards, or standards that change all the time. Alignment with the EMA and the FDA in America keeps costs down, reduces delays and keeps bureaucracy down. The industry here will have to match EU standards for the bulk of its production and will not be keen on doing small-batch production for the UK only if that has a totally different set of standards.
It is important that the new measures on falsified and counterfeit medicines be taken. The unique identifier number, including barcode scanning, is important, as are tamper-proof containers. There is a whole market out there in counterfeit drugs and it endangers patient safety, which is vital in all of this. As part of that, we will have to negotiate data sharing with the EU and the EMA to enable pharmacovigilance on a bigger scale and make it possible to recognise much earlier patterns of side effects and complications.
How will the Government provide the extra funding and support to the MHRA, which is to take on an extensive area of extra work? How will it combine that with delivering quicker assessments and licensing so as to encourage companies to launch their devices or other drugs in the UK? As has been referred to, there is a need to replace the clinical trials directive, which in the original version was indeed very bureaucratic. As a clinical trialist within breast cancer, I found it to be often quite off-putting. The new clinical trials regulations create an EU-wide portal—a single point of digital registration of trials and collaboration on design, recruitment, data, entry and analysis. Unfortunately, UK-only regulations will not replace that when it finally goes live in 2022.
International collaboration is critical to research, and the European research network is the biggest in the world—bigger than China and bigger than the US. As mentioned by my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and the hon. Member for Bolton West, that collaboration is vital for rare diseases, where the number of patients in any one country is low. That is why we have made so much progress in rare diseases, childhood diseases and childhood cancers in the past decade or so—because of funding from the EMA and collaboration on an extensive Europe-wide basis. As regards cancer, my own specialty, half of all UK cancer trials are international, and 28% of Cancer Research UK trials involve at least one other EU state. The BEACON trial for recurrent neuroblastoma involves 10 countries. It was designed in the UK, but the principal investigator is in Spain. Some of the original funding came from the UK, but the drug comes from Switzerland. Ten countries are contributing to trying to find hope for children and families suffering from this horrible disease, for which we are struggling to find a cure. There were 4,800 UK-EU trials between 2014 and 2016. How will the Government maintain that sort of collaboration and involvement?
Part 3 of the Bill relates to medical devices, and I totally agree it is not before time. The EU has also moved to bring in regulations regarding medical devices. It is important to apply similar rules to devices as are applied to drugs. Until now, it has been far too lax. As was mentioned, manufacturers pay for assessments, and I would suggest the same apply to digital health apps. At the moment, the companies that design them assess them themselves. We need instead a neutral and independent system of ensuring that they are safe. Just because something is AI or digital does not mean it will give patients good advice.
Registered clinical trials of devices should report all findings. It is far too common, where there are negative findings or findings of no advantage, that they are not published and that therefore in essence the information is hidden. As we have heard, there should be no tabletop licensing of devices whereby a device is simply migrated from one form to another without being retrialled. This was exactly the problem with vaginal mesh, where in essence the end operation, compared to the original operation in the trials, was unrecognisable. The Cumberlege review should give us food for thought and help us focus on safety and not market expediency. It is also important that there is a system to report complications to the MHRA, like the yellow card system with drugs, so that problems are spotted sooner. Again, across a bigger population that is likely to be quicker.
Implants should also have a unique identifier number that can be scanned as a barcode to the patient’s electronic records, to the hospital episode system and to any registers. A register will be data that is just sitting there and which can be interrogated if someone needs to recall patients with certain implants because of a problem. Following the scandal around PIP implants, which did not have medical grade silicon in them, I remember having to wade through the case sheets of patients who had had breast reconstruction. It was not an implant we had ever used in our hospital, but we had to be 100% certain that no patient treated in the plastics unit in Glasgow had had the implants either. It is critical that we avoid such chaos in the future, and if a register has an expert steering committee, it can become a registry, a dynamic beast that can monitor practice and bring knowledge back to medical practitioners, researchers and so on. One of the earliest and biggest examples is the national joint registry.
The Bill includes provisions to extend low-risk drug prescribing to other healthcare professionals. We all recognise the changes in the workforce that have already happened and which are coming in the future. There are processes for assessing competency and certifying that someone—an advanced nurse practitioner, for example—can prescribe in their own right. The Royal College of Surgeons and the Royal College of Physicians have raised the issue of physician associates and surgical care practitioners. They feel that if prescription powers are to be given to such individuals it is critical that they are registered and regulated, but while these new professions are developing they are not registered or regulated. If this is the future of the NHS workforce across the UK, it has to be dealt with—they need to be registered practitioners.
The hon. Member refers to physicians and others and to the shortage of doctors, but is there not also a role for pharmacies to play in diagnosing people early on? Is that not something that should be done as well?
In Scotland, we have had the community pharmacy system since 2005, which includes that, and the range of protocols for a pharmacist to prescribe against has been increased, but I agree it has further potential. One advantage is that pharmacies are usually open all day Saturday and often have longer hours. For people who are working who have a relatively minor condition, being able to get both advice and treatment from a pharmacist makes a big difference.
I forgot to mention that I also believe pharmacies could play a role in diagnosing sight loss, glaucoma and other things—small things that can be done in pharmacy. Is that something else that could be addressed?
In Scotland, we put a lot of effort into sweating the assets, if you like, within the community, so optometrists can carry out that job. They no longer refer through a GP. If they diagnose cataracts, for example, they refer directly, and they provide a lot of out-of-hours care for people with acute eye problems, foreign body inflammation, infection and so on, to the point that very few patients now go to A&E with an acute eye problem. We have all sorts of expertise in our communities, and we should use it, so I agree with the hon. Gentleman.
I welcome the Bill’s reference to internet pharmacy provision, but I think that there should be a step up—a whole step change—in the form of stronger action to control internet pharmacy providers, especially in the context of what are described as prescription-only medicines. The son of a constituent who came to see me was able to obtain large quantities of dihydrocodeine, a fairly addictive painkiller, over the internet simply by filling in an online form, having not seen a GP and without producing a prescription. I asked the constituent to find out what the website was so that I could report the organisation, but the website had gone. That is the problem with the internet: it is ephemeral. Unfortunately, that young man has now become addicted to dihydrocodeine, and is trying to be weaned off it. As in the case of other versions of online harm, we need to deal with people who are hiding in the internet: we cannot allow the supply of counterfeit or addictive medicines to patients without any form of control.
I have some concerns about the Bill. For instance, I agree with the hon. Member for Leicester South (Jonathan Ashworth) about the extensive delegated powers. The Secretary of State said that the same powers had been in place when the United Kingdom was in the European Union, but their purpose in the past was to enact EU directives which had been debated and consulted on in the European Council and the European Parliament. They had been worked out before agreement was reached, and were therefore purely about enacting something that had been hammered out and agreed within Europe. That is not the case here. Almost every clause in the Bill simply hands over a delegated power, but I think some of the major changes that are being introduced in the Bill are significant and should be in primary legislation. Of course regulations will flow from that and will be covered by delegated powers, but for radical changes to made purely in relation to such powers represents a missed opportunity, and they should be limited.
Part 3 provides for the maximum sentences for offences against the Bill to be set at six months. In Scotland, the maximum sentence in a summary case is 12 months. Removing that sentencing power in Scotland with no consultation does not seem right, and a presumption against sentences below 12 months there would make custodial sentences less likely. What kind of prevention and what kind of warning will there be if it is clear to people that imprisonment is never going to happen? The civil penalties presided over by the Secretary of State prevent criminal prosecution if either the maximum or a lower sum is paid in advance. That fetters the operation of the Scottish criminal justice system, because those involved in it would lose the right to prosecute if they felt that the issue was serious enough. The Lord Advocate in Scotland should have been consulted on both issues, and I suggest that that should be corrected as the Bill proceeds.
Part 4 does indeed call for consultation prior to any new regulations, but there is no formal mention of Ministers in the devolved Government, despite their responsibility for healthcare. In other Bills with which I have been involved, it has been normal for the Ministers of the devolved nations to be listed specifically. When legislation is to impinge on such a major devolved competency, it is important for them to take part in discussions. I also think it important to have a structure enabling medical bodies, experts and industry to contribute to the consultations, to ensure that all aspects have been considered.
There is no choice but for the Bill to go ahead because of the legislative gap that will result from our leaving Europe and the European Medicines Agency, particularly at the end of the transition period. We will therefore not force a vote, although I hope that we will be able to strengthen some aspects in Committee. Having to leave the EMA is just one example of what we are losing because of Brexit. Far from cutting red tape, Brexit will increase bureaucracy and costs for the pharmaceutical industry, the NHS and patients—and that is even before the possible impact of a United States trade deal on drug costs.
I am concerned by the threat to walk away from negotiations in June and move towards a no-deal outcome yet again. That would increase the risk to patients. Simply calling it an Australian deal does not cut it, because the Australians do not have a trade deal with the EU. I should like to know whether the Prime Minister or the Secretary of State has somehow solved the problem of supplies of insulin and medical radioisotopes, not just for a couple of months around the transition point but in the long term. The UK does not produce insulin or medical radioisotopes, and any friction at the border—which at present looks inevitable—will increase costs and delay access.
I also find it concerning that despite covid-19, which initiated a Cobra meeting this morning, the UK apparently does not even want to remain in the PANDA—Protocol for the Assessment of Nonviolent Direct Action—early warning and response system of the EU post-transition. Such isolationist policies are dangerous for everyone: for our constituents, and for our patients. We cannot get away from it: Brexit is a loss to healthcare and research, and the Bill cannot stop that. The principle of collaboration is central to the EMA, the European research network and, indeed, the EU itself, and it will be hard to replace that if we are throwing up barriers.
(5 years 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
I congratulate the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) on bringing forward this debate. He always speaks passionately on behalf of his people, and on this occasion he did so on behalf of all children in poverty.
I am here to support my colleagues and friends. Although the debate is about child poverty in Scotland, the fact is that child poverty is not specific to Scotland. It is also rampant in other areas of the United Kingdom of Great Britain and Northern Ireland—particularly Northern Ireland—so I want to say a couple of words in support of colleagues who have already spoken and those who will speak after me. Much of what we say will be very similar.
I am a proud Ulster Scot. I love my heritage. I come from the Stewarts of the lowlands of Scotland, so my heritage goes way back to Scotland. I share a cultural identity with the hon. Gentleman and other friends and colleagues in the Chamber, and my values are very similar to theirs.
Unfortunately, the children in my constituency face the same difficulties as those in the hon. Gentleman’s constituency. Official estimates published by the Northern Ireland Department for Communities—the figures are a matter for the Northern Ireland Assembly—show that in 2017-18, 19% of children in Northern Ireland from birth up to the age of 16, including dependent children aged between 16 and 19, lived below the poverty line, in households with an income of less than 60% of the UK average. I suspect the figures are the same in the hon. Gentleman’s constituency and in those of the hon. Member for Motherwell and Wishaw (Marion Fellows) and the hon. Members who speak after me.
In 2017-18, the poverty threshold in Northern Ireland stood at £19,016 of annual income for a single person with two children, and £24,245 for a couple with two children. The Minister knows that I am very fond of him and what he does, and I believe he will answer our questions to the best of his ability, but I say to him that we need a UK strategy and additional funding to tackle child poverty. The situation in my constituency is the same as the situation that the hon. Members for Coatbridge, Chryston and Bellshill and for Motherwell and Wishaw described. Society, the Government and elected representatives are marked by the way they respond to those who are less well off. I do not believe for one second that we can ignore them; the Government must reach out and help.
During Northern Ireland questions today, an hon. Member—in fact, it was the hon. Member for Motherwell and Wishaw; I should have recognised her name earlier—asked the Secretary of State:
“What economic assessment he has made of the potential effect of the Government’s proposed withdrawal agreement on Northern Ireland.”
In a subsequent question, the hon. Member for Birmingham, Selly Oak (Steve McCabe) asked about
“legislative proposals to maintain welfare mitigation payments in Northern Ireland after March 2020.”
The right hon. Member for Birkenhead (Frank Field) and the hon. Member for Bermondsey and Old Southwark (Neil Coyle) tabled the same question.
My party—the Democratic Unionist party—and our Minister at that time were instrumental in achieving those welfare mitigation payments. At the end of March 2020, those provisions will end, and members of the public from all communities and of all political and religious persuasions across Northern Ireland will be disadvantaged because of Sinn Féin’s intransigence. We have an opportunity because my party put on the statute book legislation that enabled welfare mitigation payments to be made. Those payments came out of the block budget, by the way, but we agreed to that and acted accordingly. I did not get the chance to ask Northern Ireland Office Ministers directly earlier, but I ask this Minister: what can be done to mitigate the impact, which will be severe?
I will make a final comment about food banks, Sir David. Food banks are often talked about, and have probably been mentioned by everyone who is present here. The first Trussell Trust food bank in Northern Ireland was in my constituency. It came to Strangford because a number of church groups got together and recognised the need to reach out as faith groups, in order to help others who found themselves in difficulties making payments or paying bills, or when everything seemed to turn against them.
On the television this morning there was a discussion about debt organisations; I have not had a chance to watch it yet. It is not always a person who has benefit delays or benefit short payments who needs debt management; more often it is people who do not fit into the normal category. Minister, when it comes to addressing child poverty, what has been done to help those who need debt management? It is always better to try to address debt management early on, rather than let people get to the final moment, when letters are coming through their door, they are under pressure, their credit cards are over-egged and they find themselves in difficulties. People who are in employment, have a mortgage and who own a house may also need help.
There are people who come to my office who use the Thriving Life food bank in my area. I highlight the DWP and the changes that have been made to benefits, as referred to by the hon. Members for Motherwell and Wishaw and for Coatbridge, Chryston and Bellshill. There is a follow-on that is down to benefits being reduced or, when the issue of housing benefit is looked at, delayed. It is also down to employment issues, such as shorter hours and changes to minimum pay.
The hon. Gentleman raises the issue of food banks. There is hardly an area that does not now have a food bank. My local area is supported by churches that have a rota to collect goods. Recently, our food bank has often had to put out crisis calls because its shelves are simply empty; it cannot keep up with demand. As the health spokesperson for his party, does the hon. Gentleman recognise the impact on life expectancy and on long-term physical and mental health that comes from growing up in poverty?
I thank the hon. Lady; she is always good in this House when it comes to bringing forward issues that are pertinent to the debate. She again excels today in bringing forward this issue of food banks and the needs they address. The people who use them are under pressure emotionally and mentally, which transfers to physical issues. When that happens, the problems that the hon. Lady refers to become real for them.
I recognise, as I know the hon. Lady does, that those who have set up the food banks are genuine, interested people who bring the best of people together. They reach out to those who need help, as their faith tells them to do, which is a great motivation. I almost feel encouraged by the food banks and those who are motivated to make them happen, but calls go out to ensure that people bring in more stock, because demand is sometimes high.
We appreciate what the food banks, the volunteers and the churches do when they work together. When it comes to child poverty, whether it be in Scotland or Northern Ireland, we all want the same. We want children to have a good quality of life and we want their families to be able to look after them in the way it was designed in life that they should. For that to happen I believe, with great respect, that the Government must look genuinely at what they do.
The issue of debt management is important to child poverty; it is crucial. Nothing disturbs me as much as seeing children in difficulty; there are two or three such children who come to my office. The hon. Member for Motherwell and Wishaw mentioned Christmas. As Christmas comes, the child who lives three doors down will probably get almost anything he or she wants, but the child living in poverty will not get anything. There is a terrible injustice in society when we come to Christmas, a time of giving and good will, that those who are in poverty will not be able to have the same as everyone else.
(5 years, 5 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
I, too, pay tribute to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this crucial debate.
As has been said, the number of people suffering dementia in the UK is 850,000—I apologise, because I have already said “suffering” instead of “living with”, but many people are suffering. We talk about what is being done in pockets and what is being done well, but that is not happening for all those 850,000 people. Some of them are stuck in their houses, some are tutted at by people behind them in supermarkets and some are made to feel unwelcome in certain places. Until we can say that all 850,000 of those people are living well with dementia, we have not done our jobs.
There are 90,000 people living with dementia in Scotland, and more than 3,000 of them are under 65. The impact on those people has been touched on. It is estimated that only two thirds of people with dementia have been diagnosed, and that means that we do not actually have a handle on the scale of the problem.
Alzheimer’s—a term that many people use interchangeably with dementia—is the commonest form of dementia, but there is also vascular dementia; in many patients, it is mixed. A rarer form of dementia, Lewy body dementia, causes a particular type of dementia, with less memory loss but big impacts on movement. In particular, it causes hallucinations, and our police and firefighters should know about that. If they have had 50 calls from the same patient, it may be not because there is a burglar, but because that person is having hallucinations of a burglar. That is why we need to integrate all our public services, so that they learn from each other. Other conditions, such as HIV and Parkinson’s, can also lead to dementia. Many people know about memory loss, but there is not so much awareness of the difficulties that dementia creates with making decisions, concentrating and spatial awareness. People with advanced dementia have real difficulty moving around in our environment, and the situation is even worse if certain parts of the brain are impacted.
Unfortunately, at the moment treatment is very limited; there have been no new drugs for dementia since 2002. The most commonly used drugs are those that stop the breakdown of acetylcholine, a neurotransmitter that sends messages from one brain cell to the next. Those drugs can improve concentration, but they do not work against the underlying causes of dementia, partly because we still do not understand all the underlying causes. We see the breakdown of proteins, we see bits of proteins appearing in the brain and we see brain cells getting tangled up, but what exactly is causing all that? We need to upscale research to a totally game-changing level to understand the cause so that we can try to prevent and treat dementia. In Scotland in 2013, the Scottish Dementia Research Consortium was set up as an umbrella organisation to try to bring all such projects together. As well as laboratory research into the cause and treatment of dementia, research into a human rights approach to those living with dementia is critical in improving support and care.
We are also looking at adapting our health and care systems. As my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) mentioned, two years ago Scotland published a national strategy for dementia, which is the country’s third such strategy; the first was in 2010. This one will focus on the whole pathway, from providing post-diagnostic support right through to end of life, and including community co-ordinators.
Dementia is the disease that our generation fears. My grandmother feared tuberculosis—people did not even name it; they called it “consumption”—and the people I looked after as a surgeon feared cancer. What many of us now fear is losing ourself, as we have heard described so graphically this morning, or losing the person we have loved all our adult life.
Providing social care is critical for those living with dementia and for their families. In Scotland, we have spent more on social care, which allows us to provide free personal care. That means that if someone can be supported at home to live with independence and dignity, it will not cost them or their family. Since Frank’s law came into effect in Scotland just two months ago, that has also applied to those under the age of 65. The care they receive is thus related to their illness and particular needs, without a bizarre cut-off at 65 that prevents a 64-year-old from receiving the care that they require.
The problem is that we are struggling to recruit people as carers, whether in care homes or in home care. Most people want to be cared for in their own home, but it is very labour-intensive. Some aspects of the situation are being made worse by Brexit. In parts of Scotland, such as the highlands, 30% of carers are from Europe, so there will be an existential problem for care services. We also need to turn caring into a proper professional career, with training, career development and a decent salary that rewards carers for the very difficult job that they do.
It is critical that we support a person with dementia along their entire journey. All we have to do is to sit in this Chamber and imagine ourselves in that clinic, getting that diagnosis, and then going home and finding that there is nothing—no information, no support and no one to answer questions. The integration agenda, which is further down the line in Scotland, is linking things up. We have linked our NHS back into integration since devolution, but integrating healthcare and social care is a lot harder; social care is much more fragmented, because it is provided by multiple private companies.
We have multiple projects going on in Scotland that are often recognised through Scotland’s dementia awards. My local health board has won one such award for its “Bridging the gap” project, which provides a dementia support adviser to liaise between hospital, community and family along the patient’s journey. In Wishaw, there is a theatre buddy scheme, so that if someone with dementia requires surgery, their buddy—they could be a worker or a relative—is there at the last moment before the operation and when the patient wakes up. One project that I particularly like is the provision of assistance dogs that have been trained by prisoners in Castle Huntly, which involves a double win: the prisoners are proud that they are helping someone in the community, and those living with dementia have assistance dogs.
However, for those who are living with dementia now, the most important thing is to make them feel welcome and included in the communities that we live in. In 2016, I was lucky enough to be invited to speak at the launch of Dementia Friendly Prestwick, which is led by a very impressive team, particularly Julie and Lorna, who are leading lights within it. I had not done any of the work required to set it up; I was just asked to give a speech at the launch. However, I was inspired by that launch to set up Dementia Friendly Troon and Villages, Troon being the community that I live in.
In Prestwick, a relaxed cinema has been running for three years. There are subtitles, the cinema is free, it is not as dark as most cinemas, they serve home-baked food and they have even had a local potter make double-handed cups. The baking is all done by Berelands House, one of our local nursing homes. The cinema was a finalist in the Scottish Dementia Awards, and the sound and screen are of really high quality; I went to watch one of the movies myself. That service is provided by Friends of the Broadway, the Broadway being an old cinema in Prestwick.
In Troon, we have relaxed golf and an allotment, which is supported by other gardeners. We started by asking, “Why do we love living in Ayrshire, and how do we help people to hang on to that for as long as possible?”
First, I apologise for not being here at the start of the debate; I had a meeting with the Turkish ambassador, so I just could not be here earlier. Does the hon. Lady agree that greater support should be provided for those living with dementia to enable family members and other close relatives to take care of their loved ones—that is really important—for as long as possible before putting them into care facilities?
I absolutely agree; care should be provided in the home, if at all possible. That is where we would all want to be. The hon. Member for Ayr, Carrick and Cumnock (Bill Grant) mentioned the hotel room that uses colour as well as technology to make it easier for a person with dementia to stay in it, as well as making it easier for their carer to be there.
Guided walks are provided in Troon. Troon promenade is being redesigned to make it easier to move around on, and Troon is part of Cycling Without Age, which provides cycle rides along the promenade on trishaws every Sunday afternoon. Staff at our local airport, Prestwick, have received the training to make it a dementia-friendly airport. That all depends on Alzheimer Scotland, which provides training to staff at the airport and at other, smaller businesses, such as hairdressers and cafés.
We are the ones who have to make the change. All we are asked to do is be patient, rather than tutting behind someone in a supermarket. In our area, we have managed to get two supermarkets to provide relaxed lanes where people will not be rushed, but will be invited and chatted to as they come through. Let us all be less hectic, and let us make everyone feel welcome in our communities.
(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.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I thank the hon. Gentleman for his intervention, and I commend him for his industry and for the fact that he will be there on Saturday. He will have no bother getting the signatures for that petition; I have no doubt about that whatsoever. However, I hope that Santander is listening to what he says, because that situation clearly illustrates to me that his bank needs to be there and the customers want it to be there, and we are all here for the same purpose. That is the critical issue for me and for others who are here in Westminster Hall today.
I often think that if the Independent Parliamentary Standards Authority can allow my staff members’ names and addresses to be released by accident, or whatever way it happened, what chance does our money have of withstanding banking attacks? That did happen—it was an oversight, it was a mistake, but it still happened. Honestly, that is why I just have this wee doubt about online banking and other things.
I thank the hon. Member for Strangford (Jim Shannon) for giving way; I usually get his constituency the wrong way round. After some of the scandals that we have had with TSB and others locking their customers out of their online banking, is it not the case that for all this digital innovation we are nowhere close to it being reliable?
The hon. Lady is absolutely right. In my first year and a half here in Parliament, there were a number of banking breakdowns—one would say—within the Ulster Bank. It happened not once, but twice, and perhaps even three times. Honestly, customers could not access their accounts by any means and it was absolutely ridiculous.
I am coming to an end, Mr Davies; I am very conscious of the time. Santander will retain a network of 614 UK branches, with its customers also having the option to bank using more than 11,000 post office sites across the UK. It is very important to have the post office. I have to say that the post offices in my constituency have been geared up to fill some of the gaps—in Ballynahinch, Killyleagh, Portaferry, Kircubbin and in Newtownards town—where there are post offices. Credit unions have also filled some of the gaps; it has been incredibly important to have the credit unions, as well.
I still have a real fear that this consolidation of banks to cities further isolates rural communities and adds to people’s sense of being alone, with no one to talk to and no one to help, and I believe that we are further isolating an older generation, which cannot be acceptable. That is the critical fact for me. I look to the Minister, as I always do, for a comprehensive response to the issues that we are all bringing collectively to his attention today.
I conclude by saying that I believe we must put in place a minimum expectation of service provision for customers, and if we do not ask the financial institutions to step up and step in, the service provision will continue to dwindle, jobs will be lost and the only winners will be the shareholders and those who get the dividends. I believe that reform must take place and that banks must fulfil obligations to people, and not simply to profit margins.
(6 years, 1 month 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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The Minister is listening intently to what is being said and I look forward to her response. I know this matter is not ultimately her responsibility and she is filling in; nevertheless, I hope she is able to respond to my hon. Friend’s intervention.
When the company went into liquidation, many customers found themselves at a total loss, unable to take up their case with either the ombudsman or the company. The fact that the green deal was backed by Government undoubtedly gave the scheme credibility. The hon. Member for Paisley and Renfrewshire North said that one of his constituents phoned to check the scheme and found that it was Government-backed, so thought that it must be all right, but it was not. Coupled with the idea of saving money and being green, that resulted in many customers signing agreements that they did not necessarily understand, on the premise that their bills would not increase. It was disappointing for many that that did not turn out to be the case.
Members have given evidence that these operators of the scheme took advantage of their constituents. That said, Members must ensure that we do not undermine public trust in these types of scheme, given the potential benefits they can deliver. For example, in Northern Ireland, we have worked hard to tackle fuel poverty, and earlier this year, fuel poverty figures for the Province fell to 22%—a welcome drop from 42%. That indicates what we are doing back home, even with a stuttering Assembly.
I understand that the Government hope to do a future green deal project. Will that not be completely undermined if this issue is not resolved?
The hon. Lady is absolutely right. The Government have a great responsibility to address the issue for the sake of the credibility of any future schemes and so that participants in them will not worry about the future.
It is important to recognise that price fluctuations in home heating oil played a role in the fuel poverty figures I just gave. The reduction is welcome news, but we should not rest on our laurels: 22% of people considered fuel poor is still 22% too many.
A scheme that has proved to be extremely successful is the Northern Ireland sustainable energy programme. It has a particular focus on tackling fuel poverty, with 80% of funding ring-fenced for vulnerable and low-income families. The NISEP provides help to install energy-saving measures in homes, including energy-efficient boilers, heating controls, loft insulation and cavity wall insulation. With funding coming from a levy paid by all electricity customers, the scheme is delivered by energy companies and managed by the Utility Regulator. We have a system in place that has managed the programme well and delivered.
In 2017-18, five energy companies provided schemes, each of which had different eligibility criteria and incentives and/or grants to help people to make their homes more energy efficient and perhaps reduce their overall energy bills. As I mentioned, the focus is on those at risk of fuel poverty—for example, many of the schemes work directly with housing associations, which identify eligible tenants. The sheer variety of schemes means that people can make informed decisions about which scheme would best suit them and address their specific needs.
The NISEP provides some £7.9 million towards energy efficiency interventions, which include insulation and heating upgrades. It has proved so successful that it has been extended again until March 2019. The programme is working. The hon. Member for Paisley and Renfrewshire North referred to a different scheme. I only wish that scheme were the same as then we would not have needed this debate. We have accountability whereas, as he said and as we want to illustrate, there is no accountability in that scheme.
(6 years, 1 month 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 always a pleasure to speak in any health debates—as my party’s health spokesperson, I am interested in them—but it is particularly pleasing to speak in this debate. I thank the hon. Member for Crewe and Nantwich (Laura Smith) for presenting the case so well and, through having secured the debate, giving us other MPs the opportunity to make a contribution. It is also always a pleasure to follow the hon. Member for Lincoln (Karen Lee). All of us in the Chamber today, or who were in the main Chamber when she spoke on this topic some time ago, will remember her contributions. I thank her for them.
I am pleased that we again have an opportunity to highlight breast cancer issues while we have the Minister’s attention. We all know he is deeply interested in this subject, and we look forward to his response. I also look forward to the contribution by the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), because I know she has an interest in the subject, too. There may be few of us here, but I know everyone’s contribution will be significant.
Some 55,000 people in the UK are diagnosed with breast cancer every year. Breast Cancer Now’s new 55000Reasons campaign calls for investment in breast cancer to feature in the NHS’s long-term plan. That beseechment is worthy of the Minister’s attention. Some 11,500 women and 80 men in the UK still lose their lives to breast cancer every year. I know men are a smaller proportion of sufferers, but we sometimes forget that they can be susceptible to breast cancer; I was given a salient reminder of that while researching for the debate. We sometimes do not think about that, but we should be aware of it.
Does the hon. Gentleman recognise that although far fewer men suffer from breast cancer, because services—particularly support services—are designed for women, men often delay coming forward with concerns and find it difficult to access support? Because they still see breast cancer as a women’s issue, they are almost afraid to be open about it.
As always, the hon. Lady makes an intelligent contribution; I do not mean to say that nobody else does, but she always brings her knowledge of her subject to our debates. I told her beforehand that I looked forward to her contribution, because, as always, it will be full of information we can learn from.
The hon. Lady is right: as the men present will know, we hide our health problems. We do not go to the doctor as often as we should. We just grin and bear it—except in the case of man flu, when we are probably dying almost before it starts. I should not be facetious—that is not right. I am just saying we do not react in the way we should. As the hon. Lady said, when we do go to the health service, the services are not there. We need to address that.
Between 2012 and 2016, an average of 66 women a year were diagnosed with breast cancer in the Strangford constituency. On average, 20 of those women—almost 30%—lost their battle with breast cancer in each of those years. As the MP for Strangford, that puts the issue into perspective for me, but it also tells me that the survival rate is not as good as we would like. The hon. Member for Bexhill and Battle (Huw Merriman) referred to early diagnosis, which I will come to. That statistic represents 20 homes deprived of a mother, a daughter, a sister, an aunt or a friend.
Outcomes vary tremendously among clinical commissioning groups. We continue to lag behind other European countries, such as Sweden, Portugal, Malta, Germany and France, on breast cancer survival. Projections indicate that if current trends continue and we do not address the increase in the number of people diagnosed with the disease, the number of breast cancer deaths will begin to increase within four years. I know the Minister has a cancer strategy in place and is addressing these issues, but perhaps he will indicate what is happening.
Those projections are shocking when we consider how far cancer diagnostics and treatment have progressed. My colleague the hon. Member for North Down (Lady Hermon) told me this week that a good friend of hers—a 42-year-old—has just died from cancer. Again, the reality is pertinent for us all.
I said to the hon. Member for Crewe and Nantwich that these debates always seem to come at the time when we can relate to them best. A very good friend of our family was diagnosed with breast cancer and is going through all the radiotherapy treatment. She has lost all her hair, as so often happens, and wears a scarf. The treatment is quite harsh. She is a friend of my son and the wife, and she works just down the road from us. Her employers have been good with her—they have ensured that she can at least do some part-time work. It is important for people to have something to focus their mind on when things are difficult.
Breast cancer is no respecter of the person. The large number of people affected by it means that even seemingly incremental changes have a huge potential to save more lives. Before I highlight some of the Breast Cancer Now recommendations, let me thank the Library for its work on the excellent briefing for the debate, which outlines the things we need, including public awareness and screening. It states:
“On 2 May 2018 the Secretary of State for Health and Social Care reported to Parliament a serious failure in the national breast screening programme in England and announced an independent review to investigate.”
Again, perhaps the Minister will indicate where we are with that review.
I underline the need for access to breast cancer drugs for people who are going through the most difficult times. We all know it is not just the patient who suffers—their family suffer, too. The hon. Member for Lincoln referred to that in a very personal way, which we all understand. The cancer care strategy refers to earlier diagnosis. One of its priorities is:
“A shift towards faster testing and responding more quickly to patients who present with symptoms. A target that by 2020, 95% of patients referred by a GP will be definitively diagnosed and receive test results within four weeks.”
If we reach that wonderful target, we will certainly be going the right way.
I often say to the hon. Member for Central Ayrshire, (Dr Whitford) who speaks for the Scottish National party, that she genuinely—she knows I mean this—brings a wealth of knowledge to our debates. I also tell her that, in many cases, Scotland leads the way with some of its health strategies and plans. We should look at its cancer strategy, which was published in 2016 and deals with prevention, detection, diagnosis and treatment—and aftercare, too, which is so important.
People who suffer from breast cancer often worry about financial issues, because they have a mortgage to pay and a family to look after, and sometimes the lady is the breadwinner. We must have all those things in place, so I encourage the Minister to look at Scotland’s cancer strategy, which I know the hon. Lady will refer to, probably in some detail. We look forward to that.
The excellent Breast Cancer Now recommendations include: specific lifestyle interventions; optimising the screening programme through increased uptake; strengthening the workforce; introducing new technologies; developing a screening programme tailored to an individual’s risk so cancers may be detected earlier; and reducing variation by reinforcing the position and ambition of cancer alliances. We will do this better if we do it together—I often say we are better together in everything. We can certainly learn from one another.
We should provide long-term funding and look at funding specific CNS posts to support secondary breast cancer patients in trusts where there is not a dedicated secondary CNS. We should ensure access to clinically effective drugs at a price that is affordable for the NHS. Let us have a price system. The Minister knows about the issues with the price structure for some drugs, and I know he is pursuing that matter so we get good drugs at a fair price.
I will take the time to list Breast Cancer Now’s recommendations. Its first priority is to fund
“specific interventions to prevent the 23% of breast cancer cases that are attributable to lifestyle factors in England every year.”
We should address the avoidable cancers.
The second priority is:
“Prevent over 1,200 breast cancer deaths by increasing breast screening uptake from the current decade low of 71.1% to the 80% standard set for breast screening units.”
It is so important to have that in place.
The third priority is:
“Urgently invest £39 million in recruitment to the breast imaging and diagnostic workforce to enable breast services to cope with increasing demand over the next ten years.”
I welcome, as we all should, the Government’s commitment to spend an extra £20 billion on health; it is a step in the right direction and it is quite a commitment.
The fourth priority is:
“Adopt new technologies, such as tomosynthesis and Artificial Intelligence, into the breast screening and symptomatic services as soon as proven effective.”
The fifth priority is:
“Transform breast screening to risk stratified screening to spearhead the prevention and earlier diagnosis of breast cancer over the next ten years based on evidence as it emerges.”
As evidence indicates the trends and how to respond to them, we should make the changes to make that happen.
The sixth priority is:
“Ensure that innovative, clinically effective cancer treatments are quickly available to NHS patients at a price that is fair and affordable, including by reviewing the NICE appraisal methodology.”
The seventh priority is:
“Introduce a Catalyst Fund worth £3 million to incentivise generic manufacturers to make it quicker and easier for patients to routinely access cheap, off-patent drugs found to be effective in new uses.”
The eighth priority is:
“Fund new Clinical Nurse Specialist posts to support secondary breast cancer patients in over 120 Hospital Trusts without a dedicated post.”
Those things can make a difference.
The hon. Gentleman talks about having a separate secondary breast cancer nurse as opposed to the breast cancer nurses who are involved in the initial treatment, but that is a discussion about local set-up. The hardest thing is to tell a patient, “It’s back.” To have a nurse to support her, who she knows from five or three years ago, is a big contribution. At our hospital, there was a conscious decision not to have a separate nurse—if a patient got sent to her, that would be a bad sign—but to have the nurse they already knew.
The hon. Lady is right and I accept that we should look at what is being done in Scotland. If there is a better of way of doing something, let us do it that way.
The ninth priority is:
“Improve the Cancer Dashboard by including more detailed data on performance across Cancer Alliance geographies to identify inequalities within and between Alliances.”
The tenth priority is:
“Provide multi-year funding for Cancer Alliances, to increase confidence and encourage long-term thinking to drive investment in innovation, including a dedicated fund to address pathway variation.”
It would be remiss of us all not to thank the charities, which work so hard. We all know them and I will mention just a few I am aware of: Cancer Focus Northern Ireland; CancerCare; and Marie Curie—I met a Marie Curie lady at the Northern Ireland Affairs Committee yesterday. I know Marie Curie’s work because some of my constituents have been referred there in the last month. Its end-of-life care is incredible, as is that of Macmillan Cancer Support.
We need a plan of action and we must have the funding for that plan of action to be put into place. I support so fervently the English reforms that the Minister will put forward, in the hope that the ethos and the funding for my constituents will follow. We are in a different place in Northern Ireland; health is a devolved matter and the responsibility falls under the Northern Ireland Assembly, but it is not functioning correctly at this moment. Men and women need to know that there is a way forward, to ensure that no one dies of breast cancer anywhere in the UK in the not-so-distant future.
(6 years, 4 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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I utterly agree. It is important to be clear that a disclosure in the NHS, which is what we are focusing on, regarding patient safety as opposed to employment issues, which are quite separate and dealt with differently, is in the public interest. The problem is that in cases where whistleblowers have been punished and have suffered detriment, what starts as reporting becomes a bullying and harassment issue that ends up in a normal employment tribunal setting, and the original concern is not dealt with.
I congratulate the hon. Lady on bringing this matter to Westminster Hall for consideration. Some 7,000 staff raised concerns about bullying or patient safety in 2017-18. Over the same period, some 356 whistleblowers said that they had experienced repercussions, ranging from subtle persecution, such as career opportunities being closed off, to being fired unjustly. That is truly shocking. Does she agree that the Minister may have to look at a full investigation into just how far-ranging these matters are?
I thank the hon. Gentleman for his intervention. I hope that this is just the first little step towards putting the matter on the agenda. The tragedies at Gosport brought the whole issue back. A nurse had come forward years and years ago, and could have saved hundreds of lives had she been listened to. Not being listened to is almost the least that can happen to a whistleblower, in that often they suffer detriment or reprisals and even lose their jobs.
The one change that Sir Robert Francis suggested to PIDA that has been made in England and Scotland is redress for discrimination regarding new employment—that is, applying for a new post within the NHS. Work is under way to introduce that in Wales as well. However, the main Act remains as it was. The first key weakness of PIDA is that it does not ensure an investigation of the whistleblower’s concern. Given the risks they take when they come forward, the detriment they may face, and the months or years of tribunals or other stages, it is crucial that the concern that made them step forward is not either overshadowed or completely ignored. I think that is their biggest frustration.
The Act most certainly does not protect whistleblowers. It describes itself as protecting whistleblowers from detriment, intimidation and reprisals, but PIDA can be used only for litigation after the detriment. Once someone has lost their job they can take their employer to an employment tribunal and attempt to have redress. The problem at that point is that the whistleblower has to prove that it was their disclosure—their coming forward and speaking up—that drove the loss of their job. Of course, employers will find all sorts of other excuses, such as, “Oh, they didn’t get on with their colleagues,” or, “They were a trouble maker,” or, “They were late for work.”
The success rate of litigation under PIDA is 3%, which is appalling, and shows how utterly weak the law is. Whistleblowers suffer further detriment while going through litigation. They know that they may face being landed with the costs. They may face bankruptcy, and stress that could go on for extended periods. Furthermore, between 2013 and 2017, people had to pay for employment tribunals. That, of course, closed that avenue off to many whistleblowers.
I make the simple case that we need a new public interest disclosure law. It should not sit inside employment law. It should not be a tweak to what we have now. We should recognise that the Public Interest Disclosure Act covers all sectors. The NHS may be one of the most common sectors to have whistleblowers, but the Act covers finance, research and business. We need a specific law.
It must be utterly clear that such disclosures are in the public interest, and that is where I disagree with the hon. Member for Stirling (Stephen Kerr), who may speak later. I do not agree with paying bounties to those who would disclose. Whether or not it creates a conflict of interest, it certainly gives the impression of doing so. It is utterly important, in the defence and protection of whistleblowers, that they can show that the only reason they have come forward is to protect patients or whoever the consumer is in their service.
(6 years, 8 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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I absolutely welcome them. Similarly, in Scotland the new graduate medical programme will take on people who have done other degrees, and that is particularly aimed at encouraging those people to go into general practice and rural practice.
May I gently ask the hon. Lady whether Scotland has a bursary scheme? Both I and the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) referred to that, as we feel that such a scheme might help.
Obviously, in Scotland we do not have tuition fees, so that is a considerable difference in student debt, particularly for a five-year medical course. We do not, as yet, have a system of bonding or tying students down. The worry is that that would create a feeling of being trapped, and that as soon as the bond finishes, the person runs away. I am sure that all Governments in the UK are thinking about such things, but it is about working out whether such a scheme is beneficial or negative in the long term. We do have a GP bursary scheme for those entering a traineeship, so that when someone moves from a hospital where they work on-call, and becomes a GP trainee, the drop in salary is compensated.
As the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) said, in Scotland we have a particular issue with the provision of rural services. We have a much higher ratio of GP per head of population, with 91 GPs per 100,000 people, as opposed to 71 in England, 73 in Wales and 70 in Northern Ireland. What often gets forgotten when people look at the weirdly angled weather map, is that although Scotland is one third of Great Britain’s landmass, it has 8.3% of the population. Anything that involves providing services across an enormous area is a challenge. We also have 70 inhabited islands that require services. Our recruitment and retention fund is putting additional money into this issue. The Scottish Rural Medicine Collaborative involves 10 health board areas, and relocation money—the golden hello for trainees or indeed any GP moving into practice—has been increased from £2,000 to £5,000. Any GP moving into rural practice will have a golden hello of £10,000, and trainees will have £20,000. That has been rolled out from the 44 island practices to all 160 rural and remote practices.
One key issue driving this problem, which perhaps is not often recognised, is the change from full-time to part-time working. Headcount for GPs is up by 5% in Scotland, but down by 4% from 2013. The change seems to have been in the last five years—indeed, there is a real culture change as the next generation comes in. When my husband became a GP, he was the first part-timer in his practice. They interviewed all the women before him, because it seemed so weird to have a man who wanted to work part time—that is because I was always in the hospital. Now, out of eight GPs, only two are full time. The number of patients in the practice has not changed, but instead of six actual GPs, there are eight. Therefore, the average GP is working considerably less. In England, the change in headcount of those looking to work full time meant that numbers went from 39,000 to 27,000. That shows the dramatic difference between the full-time equivalent and headcount, and it means that the average GP is working about 70% of what a full-time GP worked. The problem for any Government is that they then need to train 30% more GPs to cover that.
The key, however, is satisfaction. At the deep end, the 100 most deprived GP practices in Scotland face the inverse care law: people do not demand, and therefore service is not delivered. Govan health centre is running the SHIP project—social care and health integrated partnerships, and that innovation is now being picked up elsewhere. It means that GPs have extra time, and a significant multidisciplinary team, but in those areas, 31% of patients will have four or more conditions.
We have an even deeper problem, however, which is the attitude to general practice. Other specialisms look down their nose at it, and therefore a student may not be encouraged to enter general practice. Students are not getting enough exposure to general practice, either as students or in their foundation years. We also have a particular problem with the two foundation years since “Modernising Medical Careers” came in. We pour all our young doctors into a hopper—a computer—and they get divvied out. They will struggle to be with their family or where they were living before. In 2011, 29% of young doctors left after the two foundation years. Last year it was 50%. They do not feel part of the team or have a sense of continuity—things that are utterly crucial to general practice. Therefore, although we may be putting in more money and coming up with schemes, we must also reform the foundation years so that we do not have an entire lost generation.
(8 years, 1 month 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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I thank my hon. Friend for his comment. I was not aware until seeing the briefing pack that there had been a decrease in the pharmaceutical business over the past few years; I actually thought we were holding our own and moving forward. Brexit will give us the opportunity to move forward, so we should look positively upon where we are.
This debate is not simply an opportunity for remainers to highlight something that may be difficult to negotiate, with no desire other than to prove their opinion on Europe. There is nothing wrong with that—people have different opinions—but let us work together to ensure that we deliver.
Is it not possible that part of the reason why the pharmaceutical industry has gone down is that the clinical trials directive of 2001 was very bureaucratic? Following that, we had a fall of one quarter in trial research in the UK, particularly in oncology. That directive is due to be replaced in 2018 with the EMA’s new regulation, which will streamline it.
I thank the hon. Lady for her intervention and the knowledge she brings to this Chamber and the House. I hope that we can improve on what she refers to when we get into the Brexit negotiations, and through our negotiations outside Europe when article 50 is triggered next year.
Let us work together to allow the EMA and the MHRA to come to an arrangement to continue what has been a great partnership to date and has achieved many results. According to the Financial Times, the EMA outsources up to a third of its work to the MHRA, and that work is responsible for a third of the MHRA’s income. A report in The BMJ states that that work makes the UK an attractive location to carry out clinical trials. The hon. Lady outlined that in her intervention, and I know that the Minister will respond and the shadow Front-Bench spokesman will add his comments.
That relationship, which has been proven to work, does not have to die because the EMA may—I emphasise “may”—move its headquarters. Work must be undertaken to underline the fact that although we will not be in the EU, we will remain the best in Europe at this type of clinical work. We have many things to be thankful for in our experience of it. We all understand the red tape in Europe, and I find it very hard to believe that the only reason why the work was outsourced to the MHRA was the location of the EMA.
(8 years, 10 months ago)
Commons ChamberAbsolutely.
Ensuring that the space sector has a place in Northern Ireland and is aware of what we have to offer will go some way towards addressing the brain drain issue of too many of our young people emigrating. I would like to hear from the Minister how the space policy can better connect with Northern Ireland.
Northern Ireland has a proud history of air flight, although it is not linked directly to space policy. Henry George Ferguson, who was better known as Harry, a brother Orangeman, was a Northern Ireland engineer and inventor who was noted for his role in the development of the agricultural tractor. He was also the first Ulsterman and Irishman to build and fly his own aeroplane. The first ever airport in Northern Ireland was in my constituency of Strangford, in Newtownards, and was built in about 1910.
Northern Ireland has a fantastic aerospace industry with Magellan and Bombardier, which has been established for many years. I believe that there is a role for those aircraft companies to play in space policy and development. They can and should be part of it.
The space sector is fundamental to the future UK economy. I welcome the Government’s civil space strategy and the goal that the space sector will contribute £40 billion a year to the UK economy by 2030.
The point that I was trying to make in my opening speech was that the bid talks about a UK spaceport, whereas I think there will be different sectors. One sector that will come in the not-too-distant future is hyperbolic sub-orbital flight. Once we get past the Virgin Galactic model of a plane and a wee rocket, we will have the combination of jet and rocket engines, such as SABRE—the synergistic air-breathing rocket engine—which will go from standstill to orbit and back down. We will be able to fly to Japan in a short period of time. Different sites around the UK may therefore follow totally different routes. That should be enabled, not blocked.
I thank the hon. Lady for that significant and important intervention. She shows the vision that all of us in this House should have. There are no barriers to what we can do. Some of the things that are in “Star Trek” are not impossible, so let us look forward to those developments. I look forward to being able to travel from A to Z—from Belfast City to Heathrow—in a matter of seconds. If that is ever possible, we will be able to get here and back a couple of times and to do business at home and here, all in the same hour. Is that possible? I do not know, but I hope it will happen.
Thinking back on how space has been discovered, I am always mindful of the first time man stepped on the moon. It was one small step for man, one giant leap for mankind. For me, and I think for many others, that showed us the immensity and size of the universe that God created, and it focused our minds on God’s power and the fact that it was not for us as children, and that he is in total control of the universe.
(9 years, 5 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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Obviously, devolution gave us the power to do things differently, but I do not think that we should re-invent the wheel. Often, we will accept work done by NICE or re-evaluate it quickly, to see whether things should be applied differently, but we do not just go back to the beginning. However, I am sure that ideas can be shared in both directions.
It seems that certain drugs were left as orphans when the system changed. We know that patients with the brain tumour form of tuberous sclerosis, which the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) mentioned, can access the drug through the cancer drugs fund, but if they have a kidney tumour and are treated by urologists they are not part of that system and simply will not be aware of it. Such random unfairness exists.
There is a forum and association, driven by the Health Minister, that discusses matters together with the three regions. A UK-wide strategy is already in place. The process is allowing that to happen already. However, it is delayed and has not happened yet; that is why we are concerned.
I think it is a matter of what ideas go on the table and what is being discussed in the meetings. Good ideas are going ahead. I commend the idea of including patients and clinicians in evaluations, because the numerical data from trials will often be small due to the nature of the diseases in question, and we will have to look wider. The problem for children is that if these drugs are to prevent deformity, they have to be got in early. People with Morquio already have the changes. We do not know yet how much change could be prevented, or how much saving there could be on a person’s disability in the long term if metastatic breast cancer treatments, which eventually become adjuvant treatments, are given earlier.
I commend the system I have talked about. I know it is difficult and challenging, but it is clearly fair, with an interim period for compassionate reasons, and people know where their voice should be heard.