UN International Day of Persons with Disabilities
Debate between Philippa Whitford and Lisa Cameron(2 years, 11 months ago)
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Dr Cameron
I absolutely do agree that those rights should be enshrined and that the democratic process should be open to all.
Dr Philippa Whitford (Central Ayrshire) (SNP)
Does my hon. Friend recognise that if we want people to vote, we want more people with disability in this House? Does she agree that it is a shame that none of the learning from the covid pandemic that might have made working here more flexible for someone with a disability or chronic illness has been kept?
Dr Cameron
I thank my hon. Friend. That is extremely important and I will move on to speak about many of those issues. We should continually be learning and applying best practice. It is extremely important that measures are taken to improve representation in this House for people with disabilities.
There are 14.1 million people with disabilities in the United Kingdom—one in five people—yet despite making up one of the largest minorities, disability often fails to reach the top of the equality agenda.
Medicines and Medical Devices Bill
Debate between Philippa Whitford and Lisa CameronMonday 2nd March 2020
(4 years, 8 months ago)
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Dr Whitford
I thank the hon. Gentleman for that point. When we are trying to collaborate and get a group of 28 countries—indeed, 31 countries, because the European economic area is involved—to all agree to such enormous changes, with legal ramifications for their drug and device producers, and so on, it takes time, but in the end, I think it will be worth it. Of course, I would have liked it earlier. Having been involved in breast cancer trials, I know that the clinical trials directive was clunky and bureaucratic, but it is being changed.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
I thank my hon. Friend for answering the extremely important points that have been raised. Does she agree that it is also extremely important that those with rare diseases still have access to the clinical trials that can perhaps only take place in the EU, because they need to have so many participants? The UK on its own might struggle to have those clinical trials for rare diseases.
Dr Whitford
That 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.
NHS Pay
Debate between Philippa Whitford and Lisa Cameron(7 years, 2 months ago)
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Dr Whitford
If the hon. Gentleman had been following what has been happening in Scotland over the summer, he would know that, following the debate in May, the Cabinet Secretary in Scotland had open discussions with NHS staff side. In June, the Cabinet Secretary for Finance and the Constitution said that our Budget at the end of this year would be looking to get rid of the pay cap. It did not just happen the other week when the programme for Government was announced; it has actually been there all summer. The vacancy rate in Scotland may be 4.5%, but, as the shadow Secretary of State said, it is more than twice that in England. We should be focusing on the fact that nurses and other NHS staff in England are getting almost the rawest deal, which is not right, because they are working just as hard as others.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
Does my hon. Friend agree that it is also extremely important that, if we are to achieve parity between physical and mental health services, we address this issue, particularly for specialist mental health staff—nurses and allied health professionals—who want to work in the service but for whom the work is just not cost effective, as they then seek employment elsewhere?
Dr Whitford
That was exactly the point I made at the start of my speech. Although the Royal College of Nursing led the campaign and the image has been of nurses, the issue affects everyone. I echo what the hon. Member for Lincoln (Ms Lee) said—[Interruption.] Well, it was the RCN out at the front.
Health, Social Care and Security
Debate between Philippa Whitford and Lisa Cameron(7 years, 4 months ago)
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Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
I warmly welcome you back to your place in the House, Madam Deputy Speaker. I also congratulate the hon. Member for Gordon (Colin Clark) on an excellent maiden speech, and welcome him to the House—I am sure he will serve his constituents extremely well.
I welcome the focus, prioritisation and investment in the Queen’s Speech in regard to mental health—parity of esteem must be achieved. I refer the House to my entry in the Register of Members’ Financial Interests and to my background in psychology.
In Scotland, we have a mental health Minister. We also have continued prioritisation and someone who will lead that forward. I am extremely happy to be named the mental health spokesperson for the SNP in this House, where we are also prioritising the issue of mental health.
A number of decades ago, in the 1990s—unfortunately, that shows my age—I started as a young psychologist in the NHS. At that time, patients could wait for up to a year to receive treatment, which was absolutely ineffectual. They came with their problems, one year after those problems had started, but their problems had often changed or multiplied. So I welcome the fact that we have been trying across the United Kingdom to establish waiting times. That is an important step forward for all.
Time is crucial in the delivery of services. It is extremely important that additional funding goes to those on the frontline—to clinicians. Most reviews since the 1990s that I sat on as a clinician sought to increase the number of management staff in our NHS, but it is extremely important that funding goes to the frontline and to the key professionals who will deliver the services—in relation to mental health, that has to be mental health practitioners. I would welcome some words from the Secretary of State about ensuring that staff on the frontline are prioritised when funding is produced.
The training of staff is also crucial. My hon. Friend the Member for Central Ayrshire (Dr Whitford) spoke about the impact of Brexit, and we cannot take that lightly. It is extremely important that we have workforce planning. In recent weeks, I have been contacted by concerned psychologists.
Dr Whitford
Does my hon. Friend recognise the impact that Brexit will have on staffing? We have a 95% fall in EU nurses registering to come here, and up to 60% of doctors in a General Medical Council survey said they would go back. That would obviously threaten staffing in the north-east—an issue the hon. Member for Gordon (Colin Clark) raised.
Dr Cameron
As always, my hon. Friend makes an excellent point, which goes to the crux of this. With Brexit looming, we must ensure that our NHS and our social care services continue to be adequately resourced and staffed. Those are crucial issues, which I would certainly wish to be taken forward.
In recent weeks, I have been contacted by a concerned psychologist stating particular worries regarding funding for their profession. If we are going to place mental health as a priority at the core of what we do, then surely we have to ensure that funding for the placements of clinical psychologists continues. I would very much welcome comment and reassurance from the Secretary of State in that regard.
On services for people who have autistic spectrum disorder, very many constituents with families come to see me who are concerned that their children may merit a diagnosis of autism but still continue to find that the situation can be difficult. I am sure, given the background reading that I have done, that it is the same right across the United Kingdom. Diagnosis as early as possible is absolutely crucial to ensure access to services so that children can meet their full potential. What level of funding will be made available, and will any be ring-fenced for diagnosis, particularly for those with specific needs such as autistic spectrum disorder?
In child and adolescent mental health services, there is a real issue of demand at the current time. Prevention is absolutely key, as is early detection. That means that teachers will have an important role, alongside parents, and they must have a point of contact in primary care that they can reach in order to ensure that treatment and support can be taken forward. There is concern from professional bodies in relation to in-patient beds being made available within the locale. I have recently been reading reports saying that one patient from Somerset—a child—was sent for care in the highlands, 587 miles away. Use of out-of-area in-patient beds has apparently risen by 40% from 2014-15 to 2016-17. That really must be addressed. The knock-on effect of slashing mental health beds may be that the A&E bed figure lists are down, but we need particular investment in mental health beds and ring-fencing of money for mental health beds and services.
The very important aspect that we sometimes forget is mental health support for carers. Carers often feel at the very forefront of a crisis when that crisis happens. We must look at services and funding to protect carers to ensure that they have access to the support that they need at their greatest time of crisis.
Public sector pay has been discussed widely across the House today, and obviously pay recommendations must be reviewed. Many nurses and allied health professionals have been receiving a pay level which, given inflation, has meant that they have been, in effect, receiving a pay cut. This has to be taken forward positively. We cannot just rely on our crucial health services at the time of need; we must also walk the walk by ensuring that we pay them effectively and fairly, and give them the justice that they deserve.
World Autism Awareness Week
Debate between Philippa Whitford and Lisa Cameron(8 years, 7 months ago)
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Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
I congratulate the Backbench Business Committee on granting this debate, and the right hon. Member for Chesham and Amersham (Mrs Gillan) on securing it and on being an autism champion. As a clinical psychologist I have worked with many people who have autistic spectrum disorder. I put on the record that it is a privilege to be a member of the all-party parliamentary group on autism and to be a co-sponsor of the debate.
Autistic spectrum disorder is a pervasive lifelong developmental disorder that affects people’s social interactions. It impacts on how people communicate with others, how they relate to people and how they experience the world around them. Being a professional is one thing, but the key lesson we must learn is that the greatest insights come from those who have autistic spectrum disorder and their families. We must listen very carefully to what they tell us.
We know that how we interact with individuals with ASD and their families can have a huge impact on their quality of life. Negative public reactions can encourage people and their families to avoid situations and social contact, leading to their becoming socially isolated and experiencing mental health difficulties.
Dr Philippa Whitford (Central Ayrshire) (SNP)
The debate has covered a lot of the structural and supportive things that need to be done, but does it not also throw down the gauntlet to us about the need to change our view? We think of people with autism as finding it difficult to see the world as we see it. We actually need to see the world as they see it.
Dr Cameron
As usual, my hon. Friend makes an excellent point. We must focus not on the difficulties faced by those with autistic spectrum disorders but on their full potential, and we should have greater awareness of the world as they view it.
Research indicates that 66% of autistic people, and 68% of their families, have reported feeling socially isolated, and 70% of autistic individuals are reported to have mental health disorders such as anxiety or depression. Autistic adults have been reported to be nine times more likely to die from suicide. There is a clear need to address comorbidity, and particularly mental health difficulties.
One constituent who contacted me advised that the “Too Much Information” video and campaign, which must be commended, had resonated with her. Her eight-year-old daughter has autism, and she shared with me some of her personal experiences. Her daughter is extremely vulnerable and sensitive to everyday sights, sounds, touches and smells, which cause her anxiety, panic or obsessive worries and despair. She cannot cope with changes to her environment, and she is prone to becoming distressed in public. As a result, she has experienced negative community responses, including from school peers. Her reaction has been reluctance to go back to school, and withdrawal from her extracurricular activities. Sadly, that means that she is at risk of becoming further isolated, and it is clear from this story—such stories were common among those who contacted me—that we all need to do more in many areas.
I recently attended Milton Primary School in my constituency, where the lack of understanding about pupils with autism among peers and their parents was highlighted to me. The headteacher is now engaged in good work to increase understanding through planned awareness sessions, and I commend her on that fantastic local development. Again, that highlights how teacher training and awareness in schools is key.
As has been mentioned, we must raise awareness and understanding among employers to help support people with autism into employment. Having a job is about earning a living, but it also contributes to psychological wellbeing. It can provide people with a sense of belonging and purpose, and build confidence and self-esteem. The autism employment gap is even bigger than the general disability employment gap, and only 15% of autistic adults in the UK are in full-time work. The Association of Graduate Careers Advisory Services has reported that 26% of graduates on the autistic spectrum are unemployed. Mainstream employment programmes currently on offer are failing to capitalise on the potential of those with autism. I urge the Minister to ensure appropriate support for people with autism, and for that to be covered by proposals in the disability and employment White Paper.
In 2011 the SNP Scottish Government launched the Scottish strategy for autism, and declared that autism is a national priority. That strategy attempts to improve diagnosis and assessment, and to create consistent service standards. It also helped to establish one-stop shops. We must continue to support that issue, and I offer my full co-operation and involvement with my hon. Friend the Member for Motherwell and Wishaw (Marion Fellows) to save our local one-stop shop.
We must all be champions of autism, and I ask the Minister to support an awareness campaign, promote training for teachers and local authority staff, tackle issues raised in the White Paper, ensure that more clinicians are trained, and consider waiting time guidelines. Society must not continue to fail people with autistic spectrum disorder, so let us do all that we can together to ensure that we succeed.
State Pension Age (Women)
Debate between Philippa Whitford and Lisa Cameron(8 years, 10 months ago)
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Dr Philippa Whitford (Central Ayrshire) (SNP)
A lot of the issues have already been covered. The issue of equalisation is totally accepted, but in response to a Government Member who is no longer in his place I should say that we did point out that the life expectancy increase is not equal. In parts of Scotland we have huge differences in life expectancy, which relates to wealth, in particular. Women who are lower paid, who are unlikely to have a decent pension, who have no chance of having any other kind of pension are exactly the ones who do not get this extended life expectancy.
We also heard from a Government Member that women were definitely written to and that maybe they chose to ignore it. However, we know from FOI 3231 that the information campaign was from 2009 to 2013; in other words, 14 years later. I am sad to challenge Labour Members, but the DWP in 2004, under a Labour Government, recognised from its survey that only 46% of women knew what was coming. For most of these women it is not an extension of a year or 18 months; it is literally a change from 60 to 66.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
One of my constituents from Strathaven contacted me this week to say that she had only heard about the changes through word of mouth and a web search. At 59, the Government website suggested she could retire at 62. That was then changed and put up to 64-and-a-half. The changes are unfair because they penalise people at the later stages, when they cannot make alternative arrangements.
Dr Whitford
We have heard from right across the Chamber about the lack of communication and the acceleration of the age extension, and the fact that women could do nothing about it. This is built on a generation of women who had a lifetime of poor pay. We need to think about that going forward.
Auto-enrolment does not cover the modern worker who has multiple mini-jobs, as they are called. Their combined earnings are not considered. We will therefore have another pension debate in another 30 years about the people who have been left with no pension because of current approaches to work. We know that the derived pension benefit from their husbands is not counted. We know that only 22% of women who retire this year will qualify for the full flat-rate pension. This is just unacceptable. We are talking about women who are often unemployed at 60. They are facing jobseeker’s allowance and multiple job applications. They do not qualify for free transport here in England, free prescriptions or any other benefits, such as cold weather fuel payments. For these women, this is a multiple and accelerating problem.
We have been asked by those on the Government Benches—they are now horrifically empty for such an important debate—to come up with a solution. I understand that HMRC is looking at the higher rate of pension relief, which may claw back £45 billion. That more than covers the £30 billion, which we are told would cover full transitional arrangements. High level tax relief is for the wealthiest people, those who this week, the first proper working week of the year, have already earned more than the average wage. Three-quarters of them are men. The route we should be following is to take away money that goes to people who probably, despite their long life expectancy, will not live long enough to spend it, and share it more equally with women who have been very badly treated. This is an issue of fairness and the Government have a responsibility to deal with it.