East Kent Maternity Services: Independent Investigation

Roger Gale Excerpts

Thursday 20th October 2022 Commons Chamber

[Dr Johnson]

I thank the hon. Lady for her questions. The report paints a tragic and harrowing picture of poor maternity care at East Kent Hospitals. She talks about accountability. She will be aware that the chief executive and chairman of that trust board have changed, and that those new in their posts are working hard to ensure that things are turned around and improve.

The hon. Lady talked about funding and workforce. I understand why she did that, but if she reads Dr Kirkup’s report, it is clear that they were not causative factors in this case. This was about culture and workplace practice, not money and staffing levels. She also asked how that money has been spent. It has been spent on staffing, workforce and training. She also asked about culture change and how that will be measured. It is being looked at in several ways, particularly in terms of the outcomes, such as healthy babies and the mother’s experience of their care.

[Sir Roger Gale (North Thanet) (Con)]

Mr Speaker, first, thank you so much for facilitating this statement. You know that as not just the constituency Member of Parliament, but a father and a grandfather, this is a matter of profound importance to me personally. Can I welcome the Minister to the Dispatch Box for the first time and thank her for the tone of her remarks?

Nothing is going to bring back the children who were lost in the Margate unit. Nothing is going to erase the pain felt and continuing to be felt by the parents. I would like to commend them for the quiet dignity with which they have fought their cause under horrific circumstances for so long. I would also like, if I may, craving your indulgence, Mr Speaker, to thank Bill Kirkup and his team for the sensitivity with which they have handled this and listened to the harrowing stories from so many people—stories that should never have had to be told.

What we can do is to try to put this right, so that this never ever happens to another family again. It will come at a cost and, with a Treasury Minister on the Front Bench, I have to say that £33 million-worth of investment is now needed immediately in the maternity unit at Margate. What I would like to do at this stage is to ask my hon. Friend to tell me from the Dispatch Box that she is willing to bring her medical expertise, which is considerable, to Margate, and to come herself to see the unit, meet the staff and meet the new chief executive and the new chairman, who are determined to do their utmost to make amends and to do so as swiftly as possible.

[Dr Johnson]

I thank my right hon. Friend for his comments. I note that he has been a doughty campaigner on this issue, and I know how much it matters to him personally, as well as as a Member of Parliament. I would of course be happy to come to Margate to meet the staff he describes.

Health and Care Bill

Roger Gale Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jeremy Hunt]

I thank my hon. Friend for that comment. He was an excellent cancer Minister. In our time, the biggest pressure was funding, but now people say that the biggest pressure is workforce. It is devastating for morale to refuse to address this issue at a time such as this. Any Government who care about the long-term future of the NHS have an absolute responsibility to make sure that we are training enough doctors and nurses for the future. Any Government who care about value for money for taxpayers should welcome a measure that will help us control a locum and agency budget that has got massively out of control. That is why opposing Lords amendment 29 makes no sense either for the Department of Health and Social Care or for the Treasury. This is why it is supported by more than 100 health organisations; every royal college and every health think tank; people in all parts of this House; many peers in the other place, including Lord Stevens, who used to run the NHS; and—this is the point I wish to conclude with—by thousands of thousands of doctors and nurses on the frontline.

[Sir Roger Gale (North Thanet) (Con)]

Is it not the case that what my right hon. Friend is proposing is custom and practice in very many developed countries already?

[Jeremy Hunt]

It is absolutely the case. We need something like this because, as I know—I will do my self-reflection now—when a Health Secretary negotiates a spending settlement with the Chancellor, the number of doctors they are going to have in 10 or 15 years’ time is quite low down their list of priorities because they are thinking about immediate pressures. So we need something that deals with that market failure. I did set up five new medical schools and was proud to do so, but I do not know whether that was enough. That is why we need something to make sure that we never have to worry, whoever the Government and the Health Secretary are, that this fundamental thing that is vital for the future of the NHS for all of us is always properly looked after.

Let me conclude by remembering what we were discussing this morning in the Ockenden review. We talked about the agonies faced by families. We did not talk enough about the agonies faced by doctors, midwives and nurses who find themselves responsible for the death of a child—it is psychologically incredibly devastating for them. We need to be able to look them in the eye and say, “The No. 1 thing in the Ockenden review that came out was that staffing shortfalls can make a difference. We understand that.” They know and we know that there is no silver bullet; this cannot be solved overnight. It takes seven years to train a doctor, 10 years to train a GP and three or four years to train a nurse or a midwife. No one is expecting a solution tomorrow, but we do at least have a responsibility to look each and every one of those people, who worked so hard for us in the pandemic, in the eye and say, “We do not have a solution right away but we really and truly are training enough for the future.”

Fibrodysplasia Ossificans Progressiva

Roger Gale Excerpts

Monday 6th December 2021 Westminster Hall

[Sir Roger Gale (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings when not speaking in the debate. This is in line with current Government guidance and that of the House of Commons Commission. Members are asked by the House to take a covid lateral flow test twice a week if coming on to the estate, which can be done either at the testing centre, formerly the Members centre in Portcullis House, or at home. Please give one another and members of staff space when seated, and when entering and leaving the room.

[Elliot Colburn (Carshalton and Wallington) (Con)]

I beg to move,

That this House has considered e-petition 590405, relating to research into Fibrodysplasia Ossificans Progressiva.

It is a pleasure to serve under your chairmanship, Sir Roger. The petition closed with 111,186 signatures, including 162 from my constituency. First, I thank the petition creators, the Bedford-Gay family, FOP Friends, Dr Alex Bullock and Dr Richard Keen, for meeting with my office to share their stories and experiences of, and expertise on, fibrodysplasia ossificans progressiva. I am incredibly grateful for their help preparing not only me but other right hon. and hon. Members for this debate. Many colleagues are keen to speak, not least my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning), who has been a champion for his constituents on this issue. I look forward to hearing his contribution. I will keep my comments brief to give others the opportunity to speak.

FOP is a very rare, genetic, degenerative condition that causes the body’s bone to develop in areas where normally it would not, progressively locking joints in place and making movement more difficult and, eventually, impossible. Those with the condition will eventually become 100% immobile, almost like a human statue, with a healthy mind locked inside a frozen body. It is one of the most debilitating and disabling conditions known to affect children in their early years, with no treatment, cure or prevention.

Once it progresses there is no way to reverse it, because trauma causes more activity. Something as small as a knock, a bump or a fall can trigger more bone growth. Likewise, the trauma of misdiagnosis and related medical treatments such as biopsies and injections can trigger bone growth. Even unrelated illnesses such as flu can trigger bone growth, so I can only imagine the stress and horror caused by the last two years of the covid-19 pandemic for families with children suffering from FOP. FOP does its worst damage in a child’s early years. While the condition will progress over time at different rates and no two individuals will have the same journey, most people with FOP are immobile by the age of 30.

The statistics and details of FOP are powerful, but not as powerful as the stories of those experiencing this condition. I am very grateful to the petition creators, Helen and Chris Bedford-Gay, for sharing Oliver’s story. When their son Oliver was three months old, he had what some medical professionals considered to be funny toes and a lump that began to appear on the back of his head. Oliver’s consultant concluded that the lump was not cancerous but should be removed none the less. Shortly after Oliver’s first birthday, the consultant diagnosed him with FOP. The family were led to believe that he would be fine as long as he avoided contact sports such as rugby. It was only later, when Oliver’s parents searched for more information, that they discovered the true implications of a diagnosis of FOP.

FOP results from a single gene mutation, which was discovered only in 2006, so there is very little information on or experience of this condition easily available to the public or medical professionals. With such a large barrier to access to relevant knowledge and guidance, the Bedford-Gay family were seemingly alone, with nowhere to turn for help and support. At that point there was just a small patient group but no dedicated UK charity to support families with FOP and fund research. That prompted the Bedford-Gay family to establish Friends of Oliver, now known as FOP Friends. In short, FOP Friends aims to further research into FOP and related conditions by supporting current and future research projects, to support families suffering from the condition and to raise awareness. Since the charity began, FOP Friends has raised more than £700,000 to help that work and has been able to work alongside the Royal National Orthopaedic Hospital, the FOP research team at the University of Oxford and other international FOP patient organisations in this fight. Since Oliver’s diagnosis, there have been leaps forward in research, awareness and treatment, thanks to those organisations. However, there remains so much more to be done, and it cannot be done alone. FOP Friends has three key asks of Government.

The first is to increase research funding into FOP. My right hon. Friend the Member for Hemel Hempstead will no doubt delve deeper into that topic, so I will not steal his thunder. However, I will say that the University of Oxford FOP research team, led by Dr Alex Bullock, has been investigating how the mutation that causes FOP is activated in patients and what might be able to prevent it from progressing, but that research receives no Government funding. The team’s research into a new drug that could treat FOP has been put on ice due to the covid-19 pandemic, and it is unlikely that external funding will be sourced to conclude this clinical trial.

As a rare condition that only impacts one in a million people, many consider there to be no commercial incentive to fund commercial research. However, because of the effects of FOP, research into it could help solve problems in unwanted bone growth, and conversely, how to encourage it in other major disease areas, including military injuries or surgeries, severe burns, osteoporosis or heart disease. FOP is just the tip of the iceberg of the research. Unfortunately, there is no mechanism for the Oxford team to obtain emergency funding for a clinical trial that is already under way. While the Government have pledged more than £6.6 million of funding via the National Institute for Health Research and UK Research and Innovation for more general bone disease research, there is some confusion about how this has or will be applied to FOP research. As I understand it, that funding has not been seen by the Oxford research team. I would be grateful if the Minister could shed some light on this issue and the potential mechanism for the team to access emergency research funding.

Secondly, the petitioners call for the Government to transform the standard of care that patients receive. The Government’s rare diseases policy, the UK Rare Diseases Framework, offers a vital opportunity to transform and improve standards of care for patients and families across the country. With only a handful of NHS clinicians with FOP experience, FOP patients receive varying levels of medical care and home support. I am aware that FOP Friends does amazing work assisting families in school settings with education, health and care plans. Carers of FOP patients are often parents or siblings as the specific needs of FOP patients can be tricky for others to understand or manage. Too often, the ability of those who suffer from FOP and their families to work, live and contribute to society is limited by the condition without wider institutional support. I would be grateful if the Minister could confirm and outline further how the UK Rare Diseases Framework could better support FOP patients and their families.

Thirdly, the petitioners call for the Government to help increase awareness of FOP and to transform diagnosis. As I mentioned, as it is a fairly newly discovered condition, there is a serious lack of knowledge and experience of FOP. Misdiagnosis and mistreatment, such as through biopsies and vaccinations and so on, can cause the condition to worsen and trigger irreversible bone growth. Early diagnosis is crucial not only to treat the condition but to prevent avoidable early progressions, which is why it is so important to raise awareness of FOP among medical practitioners. I understand that there have been calls to make the teaching of FOP mandatory in medical schools, so I would appreciate the Minister’s saying a few words on that.

A genetic test exists to confirm a diagnosis of FOP, but currently only specialist clinicians can request a test. An application has been made to include FOP as part of the roll-out of the NHS genomic medicine service, which is funded by NHS England, to allow a wide range of clinicians to request a test if they suspect FOP. I understand the directory of approved tests will be updated in April 2022, and I hope the Minister will enlighten us as to whether FOP will be included in that because that will increase access to genetic testing and reduce the time to diagnosis.

I want to once again pay tribute to Oliver and his family, as well as the many organisations, researchers, campaigners and other families who have worked tirelessly to fight FOP, many of whom I am sure we will hear about this afternoon. I appreciate that many other colleagues want to get in, especially my right hon. Friend the Member for Hemel Hempstead, who has a great degree of knowledge in this area, so I will bring my remarks to a close. I hope that we can have a productive debate on this issue and the key asks outlined by the petitioners.

Covid-19 Update

Roger Gale Excerpts

Monday 19th July 2021 Commons Chamber

[Nadhim Zahawi]

I thank the hon. Gentleman for that excellent question and for his support on the weekly MPs’ briefing that we deliver on a Friday. Long covid is a serious issue among adults and children, and the JCVI of course looks at the available evidence. I caveat what I say by reminding the House that obviously this virus has been with us for only 17 months and we have had vaccines for only the past eight of those months, so we are learning all the time. As I said in answer to an earlier question, we have made money available to the health service so that it can look at how to support, for example, GPs in diagnosing long covid.

[Sir Roger Gale (North Thanet) (Con) [V]]

In addition to holidaymakers, hundreds of UK citizens want to go to France, a country with a much lower infection rate than the United Kingdom, to visit family, and there are also hundreds of UK citizens—expats—who wish to visit families in the United Kingdom. As a result of the decision taken by the Department of Health and Social Care, all those people now face exorbitant test costs and isolation when they come into the United Kingdom. The House of Commons has an excellent test system that generates a result within around 30 minutes and is reliable. Will my hon. Friend, who is the most effective of Ministers, use his influence to make sure that at the very least people who come back into the United Kingdom and have to be tested can do so at a reasonable and not disproportionate cost?

[Nadhim Zahawi]

I am very grateful to my right hon. Friend, who is always diligent in his questioning, including on the Friday calls, on behalf of his constituents. He raises a really important point about the beta variant, which as a precautionary measure is clearly a variant of concern to us. It is the one that would give us the greatest headache, in terms of vaccine escape—hence why we took those precautionary measures. We keep that under review, and the biosecurity team does that very effectively.

My right hon. Friend also raises a really important point about the cost of testing. I will certainly take away his comments and discuss them within Government, including with the Secretary of State for Transport, who has looked at this and talked to those involved in the testing process to ensure that people are not penalised by exorbitant PCR test costs.

Vaccine Roll-out

Roger Gale Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

I am delighted to say that primary care—the GP surgeries across the country—are rising to the challenge brilliantly, especially in County Durham, which is doing an absolutely magnificent job. It is far ahead of the national averages in terms of the roll-out and is doing brilliantly. Of course there are challenges; as the supply comes in, we are getting it to the frontline as fast as we can, and that does mean some rapid turnaround times. I urge the right hon. Gentleman to cheer up and back his local team. Yes, it is difficult, but I know that we will get there.

[Sir Roger Gale (North Thanet) (Con) [V]]

My right hon. Friend is engaged in a herculean task, and I think we all appreciate the work that he is doing. I know that he is aware of what he described as the “lumpy” delivery of vaccines, particularly in East Kent. The vaccines Minister—the Under-Secretary of State for Health and Social Care, the hon. Member for Stratford-on-Avon (Nadhim Zahawi)—is sitting on the Front Bench, and I hope that he is addressing that issue as we speak.

Let me turn to two further matters. Would my right hon. Friend the Secretary of State consider ensuring that all hospitals be allowed to have supplies to vaccinate their employees, because at the moment national health service employees working in hospitals are still having to travel far too far to get vaccinated? And when the priority groups have been addressed, will my right hon. Friend give particular attention to the needs of teachers, so that they can get back to work, and to the police constabulary, who are exposed every day of their working lives?

[Matt Hancock]

My right hon. Friend is quite right to raise the issue of getting supply out to East Kent. In fact, we are opening more centres just outside his patch, in Folkestone, next week. We are putting more vaccination into East Kent, and putting the support there to ensure that the vaccination roll-out can happen. I am glad to say that the majority of over-80s have now been vaccinated, but there is clearly still a lot of work to do. He is absolutely right to highlight the case that both teachers and police officers are understandably making— that, after we have got through the priority groups according to clinical need, we should consider their case for early vaccination.

Maternity Services: East Kent

Roger Gale Excerpts

Thursday 13th February 2020 Commons Chamber

[Sir Roger Gale (North Thanet) (Con)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the provision and safety of maternity services in East Kent.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

I will set out the situation concerning East Kent Hospitals University NHS Foundation Trust in line with the written statement laid in Parliament this morning. In fact, I took steps to inform Parliament of this matter before the UQ was requested, and I hope that reflects the importance I place on this issue. Before I begin, I would like to express my deepest and most heartfelt sympathies for the patients and families who have been affected.

I made a statement on 28 January on concerns about maternity services in East Kent Hospitals University NHS Foundation Trust, and I would now like to update the House based on the reports from the independent Healthcare Safety Investigation Branch and the Care Quality Commission. I requested that both HSIB and the CQC report back to me within 14 days when I instructed them to go into East Kent trust two weeks ago, and they reported to me on Monday.

HSIB has already conducted a number of maternity investigations at the trust as part of its national maternity investigation programme. These identified a number of safety concerns, including the availability of skilled staff—particularly out of hours—access to neonatal resuscitation equipment and the speed with which patients’ concerns are escalated up to senior clinicians and obstetricians, along with failings in leadership and governance.

As requested, the CQC carried out an unannounced inspection of the trust’s maternity services between 22 January and 5 February. It has written to the trust with an oversight of its findings, and the full inspection report will be published in due course. The CQC received additional information from the trust this week, following its request for further assurances on triage, day care and medical staffing. The CQC is considering this information. It is important that everyone is aware that the CQC is in regular contact with the trust and will continue to be so for the foreseeable future.

From the findings provided to me by HSIB and the CQC, it is clear that the challenges at East Kent point to a range of issues, including having the right staff with the right skills in the right place, effective multidisciplinary working, clear collaborative working between midwives and doctors, good communication and effective leadership support, but it would be wrong to speculate that there is indeed one single cause.

NHS England and NHS Improvement are working closely with the trust and have taken some immediate actions. First, the regional director and regional chief nurse are providing support to the trust, and the medical director will address concerns surrounding appropriate senior medical oversight. Secondly, the regional chief nurse is providing support to the director of nursing and head of midwifery, to prioritise and focus their local maternity improvement plans and address identified safety concerns. They will also review the effectiveness of clinical governance and executive leadership support. That will include ensuring that the trust learns from all historical cases, and disseminates that learning throughout the trust.

The Chief Midwifery Officer, Jacqueline Dunkley-Bent, has sent an independent clinical support team to the trust to provide assurances that all possible measures are being taken. That expert team includes a director of midwifery services from an outstanding trust, two consultant obstetricians, and a consultant paediatrician and neonatologist. She has placed the very best at the heart of the trust, on the wards, and at the bedsides of patients, with fresh eyes to oversee the care currently being delivered. The independent team is working with trust staff to deliver immediate improvements to care, and to put in place robust and comprehensive processes to support improvements in standards over the long term. Jacqueline Dunkley-Bent has personally visited the trust to assess the changes being put in place, and to ensure that improvements are moving at pace.

Jenny Hughes, chief midwife for the south-east region, is working with the trust directly, and regional and national teams from NHS England and NHS Improvement will continue to work with the trust. The trust is taking the issue seriously and is working closely with NHS England and NHS Improvement. It has created and filled several specialist midwife posts. Safety huddles, where safety issues are regularly and frequently discussed, have been embedded on both sites to anticipate problems before they occur, and multidisciplinary teams are working collaboratively.

--- Later in debate ---

[Ms Dorries]

I will go straight to my closing statement, Mr Speaker. I reiterate my condolences, particular to the family of Harry Richford and all those affected. I also thank my right hon. Friend the Member for North Thanet (Sir Roger Gale) for raising this important issue. The Government are fully committed to reducing patient harm and improving the safety of maternity services.

[Sir Roger Gale]

I will try hard not to abuse your generosity, Mr Speaker, and on behalf of Tom and Sarah Richford I thank you for allowing me to ask this desperately sad and desperately urgent question. I also thank the Minister for her swift and robust action since the report landed on her desk on Monday night, which was based largely on her personal professional experience. I am deeply grateful, and I know that the families are too.

This morning, at an early hour, I spoke for half an hour with a husband and wife who now live in Australia. Two months after the death of Harry Richford, they lost their own child under similarly tragic circumstances, and it was the most harrowing call I have taken in 36 years in this House. Those parents deserve and need the opportunity to achieve closure and move forward, and they need to know that the failures in protocol, in clinical judgment, and in management, have been addressed.

Will my hon. Friend publish the Care Quality Commission report to which she referred as soon as possible? Will she seriously consider establishing an independent inquiry, so that at the very least, Harry Richford’s parents, Rosie’s parents, and others, will know that their children have not died in vain, and that this will never, ever, happen again?

[Ms Dorries]

I thank my right hon. Friend for his comments and suggestions. In response to his call for an independent inquiry, last night I asked my officials to look into sending the independent Healthcare Safety Investigation Branch back in to do a deep dive into historical and existing cases at the trust. I want to reiterate that the trust is a safe place for any woman who is pregnant or giving birth. We have some of the very best people and clinicians working in that trust right now.

I would just like to add that NHS England and NHS Improvement are themselves commissioning an independent review into East Kent maternity services, so my right hon. Friend’s question has been answered. That is the news I have just been given. We are taking this situation very seriously. We will publish the findings of the HSIB and CQC reports in due course, because we take this matter—I personally take this matter—very seriously.

Healthcare (International Arrangements) Bill

Roger Gale Excerpts

Wednesday 14th November 2018 Commons Chamber

[Sir Roger Gale (North Thanet) (Con)]

I welcome this paving measure, which I think will give significant comfort to many thousands of mainly elderly and often very frightened United Kingdom expat citizens mainly in Europe, but also around the world. For reasons I will not bore the House with, I have a very extended network of contacts with the expat community mainly within European Union countries but also worldwide. I want to concentrate for a few minutes mostly on those people.

The people I want to talk about are expat United Kingdom citizens who by and large have spent their working lives paying taxes and national insurance here in Britain, and who, for reasons of family, health or sun, have moved to France or Spain. There is also a significant community living throughout the rest of the European Union and one should most certainly not overlook the needs of those who are resident in the EU for professional purposes. Those include all manner of circumstances, for example people working for companies or on Her Majesty’s service in one form or another. The degree of uncertainty that has surrounded their healthcare futures has been considerable and very worrying. I do not think we can over-egg that.

I want to raise one specific concern, which relates to the emphasis on reciprocity. I say that because I happen to chair the all-party group on frozen British pensions. A frozen pensioner is one who is living in any country other than the United Kingdom and is entitled to a UK pension, but who receives that pension frozen at the point of departure unless there is reciprocity. For example, a pensioner living on one side of the Niagara Falls in Canada has their pension frozen, whereas a pensioner living on the other side in the United States has their pension uprated in line with inflation. What I do not want to see is that situation replicated in this deal, so that we get a second class healthcare system whereby people in some countries within the European Union get healthcare while others do not. I hope very much it will be possible to strike a deal with the remaining 27 European Union countries, rather than cherry-picking each country and then having to work out who is entitled to “free” healthcare and who is not. That would be a nightmare. If we are going to get this right, and we must get it right, we have to make sure that everybody is covered.

Tourists fall under a slightly different category. Tourists who go right around the world expect to take out health insurance for their travel. I see no reason why they should not do so and why they should not do so in the European Union countries once we have left.

For those who choose to live in countries such as France, Spain, Greece and Italy in the European Union, we have to make very special provision. I would therefore like to take this opportunity to ask my hon. Friend the Minister to make sure that we do not allow this measure, which is very valuable indeed, to become subject to the law of unintended consequences. We must roll as smoothly as possible from EHIC to a new system that is fair to the taxpayer. I take entirely the point that this cannot be a blank cheque, but we must make sure that the elderly and vulnerable, who have chosen to live overseas having paid their taxes here, are well, truly and properly covered.

Oral Answers to Questions

Roger Gale Excerpts

Tuesday 19th June 2018 Commons Chamber

[Jackie Doyle-Price]

I am grateful to the hon. Lady for her question. She will be aware that I have been working with her colleague the hon. Member for Croydon North (Mr Reed) on his Bill to limit the use of restraint, because we on the Government Benches also very firmly believe in that. An essential part of his measure will be to improve training for staff in mental health units. That will be a tool in making sure that restraint is minimised.

[Sir Roger Gale (North Thanet) (Con)]

10. What funding his Department has recently allocated to capital investment projects in the NHS.

[Kevin Foster (Torbay) (Con)]

23. What funding his Department has recently allocated to capital investment projects in the NHS.

[The Secretary of State for Health and Social Care (Mr Jeremy Hunt)]

In the Budget we announced £3.9 billion of additional capital funding, and 77 projects have conditional approval.

[Sir Roger Gale]

Could my right hon. Friend indicate what implications that welcome statement might have for the much needed rebuilding and refurbishment of the A&E unit at the Queen Elizabeth the Queen Mother Hospital in Margate?

[Mr Hunt]

I hope it will have a positive impact. We are asking NHS trusts to get their proposals in during July. We are also delighted that there is a new medical school in Canterbury and we hope that this will be the start of a transformation of NHS services.

--- Later in debate ---

[Mr Hunt]

There are record numbers of tier 4 beds, and we are putting record amounts of money into mental health.

[Sir Roger Gale (North Thanet) (Con)]

Mr Speaker, you will recall recently granting me a Westminster Hall debate on the HPV vaccine for boys. Will the Department update me on progress?

[Steve Brine]

I remember that debate. The matter was on the Joint Committee on Vaccination and Immunisation’s June agenda, and I am awaiting its advice with bated breath. As I said in the debate, I will turn that advice around as soon as I get it and get a decision. I know a lot of people are waiting on that.

HPV Vaccination for Boys

Roger Gale Excerpts

Wednesday 2nd May 2018 Westminster Hall

[Sir Roger Gale (North Thanet) (Con)]

I beg to move,

That this House has considered the case for HPV vaccination for boys.

I am delighted to find you in the Chair, Sir Henry. Before I start the substance of my speech, I want to place on the record my appreciation for the help I have received from a number of people, most notably Professor Christopher Nutting, one of the country’s most eminent oncologists specialising in throat and thyroid cancers, and Peter Baker, the campaign director for HPV Action. I am grateful to them both for educating me. I am also indebted to Stephen Bergman and Jamie Rae, two sufferers from the condition we are going to discuss—I shall say more about them later. Finally, I place on record my appreciation of the work done by my hon. Friend the Member for Finchley and Golders Green (Mike Freer). The Minister will understand that he cannot be here this morning; he has Government duties and a vow of Trappist silence as a Government Whip.

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

I have been there.

[Sir Roger Gale]

My hon. Friend the Minister indicates that he knows the problem only too well. My hon. Friend the Member for Finchley and Golders Green has done a significant amount of work in achieving the provision of human papillomavirus vaccine for gay men—a small but significant step in the direction in which I hope we may travel further this morning.

Until a relatively few weeks ago, I knew very little about this issue. I concede that entirely. Unlike one of my colleagues who was here in this Chamber yesterday morning while I was in the Chair listening to the debate, who had a relative who had died of bowel cancer, I have no personal experience. However, when I met Professor Nutting and Peter Baker, I was astonished at the speed with which they convinced me of the argument—and I am not a pushover when it comes to spending taxpayers’ money. I think it is a no-brainer, and I hope to persuade my hon. Friend the Minister, and others, on this cause.

The human papillomavirus causes, among other things, cervical cancer, throat cancer, anal and penile cancers, and cancer of the back of the tongue. The virus is carried by about 80% of the population, which means somebody in this room is a carrier; it is not uncommon. I would like everybody to take that on board. Go on the tube in the morning and there will be dozens of people carrying the virus—most of it dormant, and a lot of it non-malignant. It is contracted in sexually active youth and, for men, usually in their teens or 20s.

The point is that it is a slow-burn issue. Its effects are not experienced overnight. A condition contracted as a teenager or at university may not rear its head for 30 years. We are talking about men now in their 50s and 60s, who some of the eminent people sitting behind me in the Public Gallery are treating, waiting that length of time without realising that they have anything wrong with them at all, because there is no screening process for men, unlike the screening process for cervical cancer.

I spoke yesterday to two people, Jamie Rae and Stephen Bergman—both sufferers, and both in their mid-50s—who described their experiences to me. I will not go into too much of the gory detail. I heard again this morning of another experience: somebody’s colleague, himself an eminent surgeon, who had throat cancer and suffered many months out of work, which was a loss to the health service, damage to his family and, of course, the treatment. The treatment involves chemotherapy and radiotherapy; it may involve a tracheostomy; and it inevitably damages the saliva glands in the mouth, leaving the patient who survives with permanent dryness, considerable pain and ongoing discomfort. As I have indicated, there is also the social damage. Both Jamie Rae and Stephen Bergman described to me in graphic detail the processes they have been through and the discomfort—I use that word very modestly indeed—they have experienced. They described themselves as the lucky ones, because both those gentlemen have come through it relatively unharmed, but of course there are many others who do not.

The HPV vaccine has been available to adolescent girls since 2008. A pubescent girl of 12 or 13 is offered the opportunity to be vaccinated in school. The parents, quite properly, have a right to refuse that vaccine. Just in case anybody has any doubt, I am aware that there are a small number of cases where parents believe that things have gone wrong and that children have suffered as a result of the vaccination. That is medically unproven, but we have to recognise that the parents believe it. Parental choice is vital, and in the case of pubescent girls there is parental choice.

The process ties in directly with the Department of Health and Social Care’s cancer strategy, which of course is about prevention. The Department has done significant work on preventing or seeking to prevent other prominent cancers. Lung cancer is the obvious one, and the anti-smoking campaign is highly relevant in this context. Melanoma is another; something that people of a certain age, such as myself, probably did not bother with at all has suddenly become prominent as the realisation of the damage that the sun’s rays can do to the skin and the cancers that can arise from that has dawned on the population. Any responsible parent or grandparent now takes the trouble to ensure that their children have appropriate sunscreens at all times when enjoying the sun. HPV vaccine falls directly into that category. It is usable for prevention and, used properly, it works. That is proven. As I said, this has been available to adolescent girls since 2008.

We now come to the hard bit of the argument, because up until now I think everybody would probably agree that we are on a winner in using HPV vaccine, but of course there is the question of cost and efficacy. The argument has been deployed that herd immunity, to use the colloquial phrase, will mean it is not necessary to vaccinate boys, because if we eliminate the infection in girls, boys will not catch it from the girls. That is nice in theory, but wrong in practice.

I am told by those who know better than I do that the average young male has at least 10 sexual partners. The Minister might find that surprising; I did myself, but it is so. It depends whom we believe, but in the United Kingdom the vaccine has an uptake of between 70% and 83%, although in some parts of the country it is as low as 50%. A young man embarking on an exciting night out with his girlfriend therefore has a very high risk of contracting HPV from a girl who has not been vaccinated, and that is just in the UK. We overlay on that the foreign travel that many young people are now happily able to enjoy. Sometimes, with sun, sea and sand goes sex, and the risk of exposure to HPV in those circumstances can be even greater. Therefore, the idea that herd immunity will in time address the problem is fallacious, and this is where I have to accuse those who are responsible for taking the decisions—that is not the Minister—of short-termism.

I can see the attraction of the argument that extending vaccination would not be cost-effective and that herd immunity is coming downstream. Yes, the cases coming through now are historical, in the sense that the disease was contracted 20 or 30 years ago, so well before any immunisation. If we want to save money and damage health at the same time, that is quite a good way of going about it. I am seeking to persuade the Minister of the real value of having the courage—he is not lacking in courage—to take a long-term decision now.

The cost of immunising every adolescent boy within the relevant range in the UK is estimated to be, at the top end—this includes the purchase of the vaccine, which of course has to be negotiated by the health service, and its application—about £22 million a year. That is a lot of money, but in health service terms it is almost a bagatelle. Set against that, I am told by those with real experience, some of whom are sitting behind me in the Public Gallery, that there are about 2,000 patients a year—men in their 50s and 60s—who have developed throat, penile or anal cancers. The cost of treating those is about £21 million a year. Of course, that takes no account of the social costs and the other damage that can be done. In the case described to me this morning, of a surgeon who was taken out of play for a considerable time, the cost of treatment—of a replacement jaw, as well as the chemotherapy, radiotherapy, hospitalisation and everything else that goes with it—is looking like being somewhere between £50,000 and £100,000, and that is just one case.

[John Howell (Henley) (Con)]

My hon. Friend mentions the 2,000 people. Does he have an estimate of the total number of people who might be spared the effects of the virus if the actions that he proposes are taken?

[Sir Roger Gale]

I am afraid that I do not. The figure that I have is 2,000 people a year, so one has to assume that it is that—but it is growing.

The reason the condition is becoming more prominent, not less, is the change in sexual attitudes from the 1960s onwards, when practices that were previously unacceptable became acceptable. Oral sex, for example, became relatively commonplace. We can therefore expect, certainly within the next 10, 15 or 20 years, a significant rise in the number of cases. The discussion has to be about what happens after that and whether the herd immunity actually works. I am arguing that it will not, for the reasons I have given.

I have talked about the slow burn, the 20 or 30-year wait, and the costs to the health service, on which the view seems to be, “Okay, fine. Let’s kick that into the long grass. It’s not our problem.” There will be 15 Ministers between the present one, sadly, and the time when people are developing diseases. However, the condition of genital warts, which is also caused by HPV, takes only three, four or five years to incubate, and the cost of that annually is £50 million, so do the maths. The economics of this are unassailable, and on those grounds I defy anyone to challenge my argument. The argument comes down to herd immunity. Will vaccinating girls do the job or not? I have made it clear that I believe it will not, and I think that the time has come for the Department to take a further long, hard look at the issue.

Up to now, the Joint Committee on Vaccination and Immunisation has indubitably taken a short-term approach to this: “Does it work? Well, yes, the vaccine works. Is it worth it? Well, not if we are vaccinating girls. Let’s see what happens—kick it down the line and save £20 million a year today,” even if that means that in 10, 15 or 20 years’ time we will be spending not £20 million but £200 million a year, which will be in addition to all the social costs. I understand that the JCVI will meet in the first week of June. We were promised that a decision on extending vaccination would be taken in 2015. That was deferred until 2017 and has now been deferred without a date being set for the final result.

Before I conclude with a request to the Minister, I want to say this. Chris Curtis, chairman of The Swallows head and neck cancer charity, sent me a video this morning. It was compelling, because he has been a sufferer himself and he described his own circumstances. I want to say something to the JCVI, to each and every member of that august body, who are of course medically qualified in a way that I am not. What I want to say on behalf of all the people who have been treated and have approached me is what Chris Curtis said at the end of his video. Friends, when you are thinking of kicking this into the long grass because it is not going to affect many people for a very long time and we do not have to concern ourselves with tomorrow, remember what Chris Curtis said, very starkly: “Tomorrow comes very quickly.”

I will not ask the Minister to second-guess the JCVI—that would not be right. I do not believe that this is his decision to make, in the sense that I suspect he is little more medically qualified than I am. Neither of us has the expertise to make this judgment. Will he please convey that sense of urgency about tomorrow to the JCVI, with the firm and genuine request that he wants them to take a long-term view, and to make the decision on the balance of long-term cost, not savings tomorrow?

--- Later in debate ---

[Sir Roger Gale]

May I first thank you, Sir Henry, for presiding over this debate with lenience, and for allowing a frank discussion of what is clearly a sensitive subject? When we do not write speeches, as I do not, we fly by the seat of our pants and ad lib. Inevitably, we miss things. I am therefore particularly grateful to my hon. Friends the Members for Worthing West (Sir Peter Bottomley) and for Henley (John Howell), and to the hon. Members for West Dunbartonshire (Martin Docherty-Hughes) and for Washington and Sunderland West (Mrs Hodgson), who clearly has a tremendous grasp of the subject. Together colleagues have put flesh on the skeleton that I sought to create at the start of the debate. I am very thankful indeed for that.

I hugely appreciate the candour with which the Minister has spoken and the positive attitude he takes to this difficult issue. I also understand that from his point of view the timing is not easy, given the imminence of the JCVI discussions. I hope and believe that as a result of all the representations that have been made, not only in this debate but across the piece, the JCVI will now take what to some of us is the obvious decision and, for a relatively small amount of money, create a much better environment for both boys and girls in the future.

To conclude, the Minister said that he had two children. I have five grandchildren. We cannot wait. I quote again the remarks that were made earlier: “Tomorrow comes very quickly.”

Question put and agreed to.

Resolved,

That this House has considered the case for HPV vaccination for boys.

Bowel Cancer Screening

Roger Gale Excerpts

Tuesday 1st May 2018 Westminster Hall

[Sir Roger Gale (in the Chair)]

I apologise to Members for my late arrival; the previous debate finished early and I was under the impression that I was in the Chair only until 11 o’clock.

[Nick Thomas-Symonds (Torfaen) (Lab)]

I beg to move,

That this House has considered bowel cancer screening.

It is a great pleasure to serve with you in the Chair, Sir Roger, and I am glad that you have taken your seat.

Bowel cancer is the fourth most common cancer in the UK. Sadly, around 16,000 people die from the disease each year. It is estimated that between now and 2035, around 332,000 more lives could be taken by this awful condition. Nearly everyone will survive bowel cancer if it is detected at its earliest stage, but unfortunately only 15% of bowel cancer patients fall into that category.

--- Later in debate ---

[Nick Thomas-Symonds]

rose—

[Sir Roger Gale (in the Chair)]

Order. The situation we are in is entirely of my making, and for that I can only apologise. Given that there are so many Members present who might wish to intervene, I am prepared to stay in the Chair for six minutes of injury time to enable the hon. Gentleman to take interventions. I am sure that is illegal, but I am willing to do it, provided that the Minister and the hon. Gentleman, who are in charge of the debate, are prepared to accept that.

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

indicated assent.