Organ Transplants

Sandra Osborne Excerpts

Tuesday 8th July 2014 Westminster Hall

[Luciana Berger]

I was just about to come to the specific challenges of regional differences and of people from different communities having access to organs. To finish my point about the important campaign by the Anthony Nolan trust, as part of that campaign the organisation wrote to all MPs to encourage us to write to schools in our constituencies to inform them about the opportunity to have the Anthony Nolan trust come in and inform 16 to 18-year-olds about the chance to be a life saver. I want to put on the record that I strongly encourage other Members to write that letter if they have not already done so—I sent mine off only last week—because it is something that we can do as MPs to encourage people locally to get involved.

In response to the hon. Gentleman’s point about specific communities, the challenge, as we have heard from a number of Members, is not simply getting more sign-ups to the register but targeting specific communities and areas that we know are losing out from the stark inequalities in our system. In the north-west, for example, where my constituency is situated, patients are waiting longest for a transplant and we have the highest death rate among those who are waiting: 62.2% of patients in the north-west wait more than six months for a transplant, compared with an average for England of 47.3%. Some 23.2% of patients in the north-west have waited more than 18 months for a lung transplant, compared with an average for England of 15.8%. We need to take regional differences into account.

Many Members have referred to lung donation. My hon. Friend the Member for Bristol East (Kerry McCarthy) referred to the zonal lung allocation system, an important issue that I will focus on in more detail. The Cystic Fibrosis Trust has raised legitimate concerns about that system and is concerned about equity in lung allocation.

Currently the allocation of lungs to transplant centres operates on a rota system. When a donor becomes available, the organs are offered to the closest transplant centre if a matching recipient has been identified. If no suitable candidate is found, the organs are then offered to the next centre, as per the pre-agreed rota. The likelihood of getting a lung transplant and the time frame for the procedure will therefore vary according to where an individual is listed. A donated organ will not currently always reach the candidate most in need anywhere in the country. Will the Minister give her view on the zonal lung allocation system? Does she have any plans to develop a more needs-based system?

It is not just where someone lives that can affect their chance of having a transplant operation if they need one. People from BAME communities are up to three times more likely to need a transplant than others, yet, because organ matching is likely to be closer when the ethnicity of the donor and the recipient are the same, they have to wait much longer. For example, on average a person from a BAME community will wait a whole year longer for a kidney transplant than other patients.

The #Spit4Mum campaign to find suitable stem cell donors for a woman called Sharon Berger—I am not related to her—highlighted the specific challenge of finding suitable donors for members of the Ashkenazi Jewish community. I am a member of that community and I have done my bit to contribute to that specific campaign. But we know that there are many different ethnic minority communities that struggle to find donors of organs and stem cells.

Such inequalities are not acceptable. We cannot accept that some of our citizens will be far more likely to die than others because of where they live or their ethnic background. Will the Minister address that point specifically and outline what concerted action the Government will be taking to tackle it?

Many Members on both sides have raised their concerns about what more we can do to support families in honouring the wishes of their loved ones. It is very difficult when someone passes away, but we know that in 2011-12, 125 families overruled an individual’s intention as recorded on the NHS organ donor register to become an organ donor. Many people do not realise that if they have not made their donation decision clear, their family could be asked to agree to a donation taking place. Nobody wants to leave their family with such a burden, so it is vital that we encourage and support families in having those conversations earlier. The theme of the current national transplant week is “Spell it out”. Will the Minister outline what she is doing to promote that message further? There is a great disparity between those people who sign up and share their intentions with their families and those who do not, and there can then be issues with vetoing.

I will touch briefly on the issue of the opt-out or presumed consent system, which was raised both by my hon. Friend the Member for Bridgend (Mrs Moon) and by the hon. Member for Montgomeryshire (Glyn Davies). There are many obvious advantages to the system. I return to the point I made earlier: there is a gap between the 51% of the population who definitely want to donate their organs, the 31% who would encourage it and the 31% who have actually signed the register. The system will be introduced in Wales in 2015. Any change in legislation will need to take into account the impact of the system in Wales and must have the backing of the public. What consideration is the Minister giving to learning from the introduction of the system in Wales and to introducing a similar system in England?

[Sandra Osborne (in the Chair)]

Order. I am sorry to interrupt the hon. Lady, but I ask her to be mindful of the fact that the Minister has many points to answer in the debate.

[Luciana Berger]

My hon. Friend the Member for Bristol East referred to the international comparison that suggests that there is room for improvement in ensuring that we are making the most of donor organs. The Cystic Fibrosis Trust has pointed out that a large number of donor lungs are never used, despite consent from the next of kin. Lungs from fewer than 25% of brain-dead donors are utilised in clinical transplantation. The need for suitable organs must be balanced against possible risks to the recipient, such as transplanting an organ that does not work properly or transmitting a serious disease from donor to recipient. However, I echo the concerns raised by my hon. Friend the Member for Stretford and Urmston (Kate Green) on donor lungs: there are clinically viable lungs within the 75% that are not used and more can be done to address the issue.

Anxiety over the likely function of an organ largely explains why it is only in a minority of cases that all possible solid organs are used. The Government strategy for organ donation and transplantation, published last year, highlighted that sometimes actions that could be taken to improve the function of a retrievable organ are not taken and the organ is declined. On other occasions, organs declined on the grounds of poor function should have been accepted and implanted. What steps are the Government taking to ensure that we are using as many donor organs as possible? I also echo and reinforce the points made and questions raised about supporting patients who are waiting for organs to ensure that, when the time comes, they are psychologically prepared.

This issue is important to all Members, across the political divide. Anyone in this room could one day need an organ donation or have a loved one who does. We are making progress but we must maintain our momentum. I welcome the Government strategy for organ donation and transplantation set out last year. I am happy to work with the Minister and do all I can to promote efforts to improve organ donation and transplantation, to ensure that anyone who needs an organ transplant has one. I look forward to the Minister’s response.

Hospices (Children and Young People)

Sandra Osborne Excerpts

Wednesday 18th December 2013 Westminster Hall

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

I begin by congratulating the hon. Member for Pudsey (Stuart Andrew) on securing this debate on a topic about which he is clearly passionate. I pay tribute to him and to all the members of the all-party parliamentary group on hospice and palliative care for the work that they have done to bring this important issue to the fore.

As we have heard, there are 49 children’s hospices across the UK, which all do fantastic work for young people and their loved ones. As my right hon. Friend the Member for Rother Valley (Mr Barron) said, much of the hospice movement is supported by volunteers and millions of pounds of charitable donations. Many hon. Members from both sides of the House made passionate representations on behalf of their local hospices and the holistic care that they provide. Hon. Members have raised many powerful points, and I hope to touch on several of them. I want to focus on three points covered in the debate. First, I will set out the full scale of the care crisis facing young people with complex health and care needs; secondly, I will explain why that is an issue not simply for individual families but for society at large; and thirdly, I will touch on some of the areas that need attention to make life better for those young people, particularly those receiving palliative care.

As we have heard, more than 40,000 children and young people in England have palliative care needs. That includes children suffering from curable and chronic conditions, children with severe disabilities, and children and young people nearing the end of their life. That represents a 30% jump over the past 10 years. There has been a particularly marked increase in the number of 16 to 19-year-olds requiring palliative care, as we have heard from several hon. Members, to around 4,000 young people, which accounts for roughly 10% of young people under the age of 19 with complex care needs. That is in many ways a positive sign, because it demonstrates the great advances made in science and medical technology, and the fact that they have resulted in people living longer.

Cancer accounts for around 14% of young people diagnosed. Cancer Research UK figures show that five-year survival rates for teenagers and young adults have risen significantly across all cancers across the past 25 years. In the late 1980s, less than three quarters of young men lived longer than five years after having cancer, but the rate is now better than eight in 10. For girls and young women, the five-year survival rate now stands at 84%. There has been a particular improvement in leukaemia; the survival rate has jumped from less than 50% to more than 60%.

We are moving in the right direction, but as we have heard from hon. Members today, that presents a particular challenge, because more young people live beyond the reach of children’s care and transition into social care. Too many young people who receive care from children’s services turn 16, 17 or 18 and then fall off a cliff during the transition to adult social and health care. The right hon. Member for Chelmsford (Mr Burns) and the hon. Member for Pudsey highlighted the specific challenges facing young adults, and we heard an emotive quote from Lucy Watts, who summed up the situation well. Much more needs to be done to make the transition work better. Some of my constituents who have accessed wonderful services at the Alder Hey children’s hospital struggle when the health professionals and familiar surroundings that they have been accustomed to for so long change—a point that my hon. Friend the Member for Rotherham (Sarah Champion) articulated. Many families are shocked by the reduced support that they receive in many aspects of adult social care after they have made that switch.

Transition is a hugely stressful process, and in most cases families are moving from dealing with a single, comprehensive agency to managing several different agencies with up to four points of contact. It is easy for gaps to emerge in that fragmented process. Many conditions reach crisis point in late adolescence, so it is all the more important that young people and their families receive responses from care and health agencies in an appropriate, sensitive and timely fashion. There are too many instances of people having to endure the agony of being put on hold, or waiting for a reply to an e-mail, when their loved one has an urgent care need.

That is all in the context of a crisis in adult social care. Since 2010, £1.8 billion has been cut from council budgets for adult social care, and we await the impact of the local authority settlements which have been released today. That means that fewer people receive help with paying for their care and more people face increased charges for vital services that help them to get up and get washed, dressed, fed and helped to bed at the end of the day.

Let me make a brief comment on the wider costs to society. Demand for care is growing at a time when resources are being reduced. The costs to society of a bad care transition—whether those costs take the form of greater illness, negative social and educational outcomes, or possible early death—are far greater than the cost of putting in place adequate resources to ensure a good transition. I welcome some of the modest measures that the Government—[Interruption.]

[Sandra Osborne (in the Chair)]

Order. The sitting is suspended for a Division for a minimum of 10 minutes.

Gay-to-straight Conversion Therapy

Sandra Osborne Excerpts

Wednesday 20th November 2013 Westminster Hall

[Sandra Osborne (Ayr, Carrick and Cumnock) (Lab)]

It is a great pleasure, Mr Hood, to serve under your chairmanship. I am raising this debate as part of an ongoing discussion on gay-to-straight conversion therapy, and I refer to my early-day motion, which attracted 52 signatures; the petition presented to the House by my hon. Friend the Member for Kingston upon Hull North (Diana Johnson); and the private Member’s Bill, the Counsellors and Psychotherapists (Regulation) Bill, which was introduced by my hon. Friend the Member for Swansea West (Geraint Davies).

[Diana Johnson (Kingston upon Hull North) (Lab)]

I congratulate my hon. Friend on securing this debate. I want to put on record the enormously helpful work of Tom Stevens and Colin Levitt, who live in Hull and were behind the petition that was presented to Parliament because they felt strongly about the matter and decided something had to be done.

[Sandra Osborne]

I, too, have reason to be grateful to those people.

I want to place on the record the fact that several hon. Members indicated that they wanted to attend this debate but had other commitments.

[Geraint Davies (Swansea West) (Lab/Co-op)]

As my hon. Friend was so kind as to mention my Bill, does she agree that our joint ambition to get rid of gay-to-straight conversion therapy needs to be embraced in a regulatory context so that all psychotherapists are regulated, which they are not at present?

[Sandra Osborne]

I agree, and I will go into that further. Conversion or reparative therapy is the attempt by individuals, often posing as professionals, to alter the sexuality of lesbian, gay or bisexual patients. Virtually every major national and international professional organisation has condemned the practice as ineffective and potentially extremely harmful to patients.

[Simon Kirby (Brighton, Kemptown) (Con)]

I want to place on the record the fact that I am proud to represent some 6,000 gay men in my constituency, and that conversion of any sort is unacceptable in this day and age.

[Sandra Osborne]

I thank the hon. Gentleman for his intervention.

The prevalence of conversion therapy in Britain has been the subject of recent interest in Parliament. Hon. Members will have received a recent communiqué from the pro-conversion group, Core Issues, calling on us not to support the private Member’s Bill introduced by my hon. Friend the Member for Swansea West on the regulation of counsellors and psychotherapists. The people in Core Issues are the very same who tried and, fortunately, failed to put up posters on London buses advertising conversion therapy. On 30 January, alongside Christian Concern, they hosted a debate on conversion therapy in a Committee Room of this House. One of the speakers at that debate, Canadian psychiatrist Dr Joseph Berger, is on the record as advocating the bullying of cross-dressing children in schools.

--- Later in debate ---

[Mr Jim Hood (in the Chair)]

Order. I remind hon. Members that this is a 30-minute debate, and interventions should be brief to allow the hon. Member whose debate it is to speak.

[Sandra Osborne]

Thank you, Mr Hood.

I want to focus on the main aspects of the problem of conversion therapy, and to debunk three common myths: first, that conversion therapy is something that happens only in America; secondly, that conversion therapy is carried out only by religious fundamentalists operating outside professional channels; thirdly, that the debate about conversion therapy is a simplistic one between allowing people freely to choose conversion therapy and infringing people’s personal choices. On the contrary, I hope to show that conversion therapy is a real and present danger in Britain, and that instead of being a problem just among religious fundamentalists, it is an issue for the national health service and the professional sector. This is not a simplistic debate about freedom to choose. If lesbian, gay, bisexual and transgender community patients are coaxed into undertaking therapy by peer pressure or referred to conversion therapists after approaching professionals, that is hardly free choice.

[Mike Freer (Finchley and Golders Green) (Con)]

Does the hon. Lady agree that until now the Department of Health has been weak on the matter? Instead of condoning it, it should ban the voodoo medicine and conversion therapy.

[Sandra Osborne]

I agree with the hon. Gentleman and I hope to get some answers from the Minister.

Conversion therapy used to be a much greater and more systemic problem in Britain than it is today. In the 1950s and ’60s, LGBT patients were routinely forwarded by teachers, GPs and, as in the case of Alan Turing, criminal courts to NHS so-called specialists in sexual orientation treatment. During that period, all branches of psychology from the cognitive to the behavioural and the psychodynamic had their own cruel and unpalatable methods of dealing with same-sex attraction.

The watershed moment came when homosexuality was removed from the American “Diagnostic and Statistical Manual of Mental Disorders” in 1973. However, simply changing the rules does not change an entire system overnight. Conversion therapy persisted and psychotherapy remains an unregulated profession in Britain. Anyone in the country can set up as a psychotherapist without being part of a professional body, and there are professionals practising in the NHS and therapy sectors who received their training well before homosexuality ceased to be classed a mental illness. Even the new intake of therapists is a cause for concern.

In 2008, a survey of 226 British psychology undergraduates was published in the Journal of Homosexuality and found that only 66% agreed with an equal age of consent. That is the context in which we should view the extent of conversion therapy in Britain. In a 2009 survey of more than 1,300 accredited mental health professionals, nearly 300 willingly admitted to having attempted to change at least one patient’s sexuality. Even more shocking, the therapists admitted that some 35% of the patients they treated were referred to them for treatment by GPs, and 40% were treated inside an NHS practice.

[Nia Griffith (Llanelli) (Lab)]

Does my hon. Friend agree that it is very serious that the issue is so widespread among GPs and other professionals, and that we must tackle that when regulating psychotherapy and the health professionals who refer people?

[Sandra Osborne]

The issue is serious and it is not recognised to the extent it should be, which is one reason why I am so pleased that we are having this debate.

In 2010, Patrick Strudwick of The Independent carried out an undercover investigation. One psychotherapist who attempted to “cure” him, Lesley Pilkington, readily admitted that most of her clients were referred to her from her local GP’s surgery. Many professionals receive little training in what to do when a gay person approaches them expressing uneasiness about their sexuality. There is legitimate concern that some professionals in the NHS and elsewhere are referring LGBT patients to conversion therapists.

Addressing the problem of conversion therapy in Britain requires a range of measures. In the therapeutic profession, affirmative therapy, which begins from the premise that no efforts should be made to change sexuality and that homosexuality is perfectly normal, should be promoted as the appropriate, healthy way of assisting LGBT patients who feel uneasy about their sexuality. To promote this therapy, we must ensure that therapists and students are properly trained in LGBT-friendly mental health provision.

The public sector equality duty mandates the public sector to address inequality and is vital to drive forward reform. That is why recent Government calls to review the duty are particularly concerning. It is important to consider the role that the public sector equality duty can play in improving the quality of care for LGBT patients. What initiatives has the Department of Health supported from the Equality and Human Rights Commission, for example, and from non-governmental organisations such as Stonewall, to identify and promote good practice in relation to the public sector equality duty and LGBT patients? We know that when public bodies are proactive, it can make a real difference.

We need to explore the regulation of psychotherapy. At the very least, it has to become a protected profession in which nobody can legally call themselves a psychotherapist without being accredited by a professional body. We also need to ensure that professional bodies have an appropriate complaints procedure, so that LGBT patients who undergo conversion therapy can achieve justice. Patrick Strudwick, to whom I referred, has raised concerns about the complex bureaucratic process that he had to go through to ensure that the conversion therapist who treated him was struck off her professional body.

We need to ensure that psychotherapists who are not members of those professional bodies that explicitly have a position against conversion therapy are not commissioned by the NHS. Will the Minister tell us whether groups without professional affiliations are commissioned by the NHS for services? What about the advertising to which I referred earlier? A New York Times advert in the ’90s for conversion therapy is credited with causing a revival in the practice. That is why restricting advertisements for conversion therapies is vital and should be explored. What is the Minister’s view on that?

At the very least, the Government must force practitioner full disclosure, which was advocated as the desired alternative to the model of Health Professions Council regulation in the Maresfield report of 2009, and involves

“the establishment of an independent body to administer a register of therapists, with the statutory requirement that anyone practising a therapy supply full details of training and professional history.”

The Government’s regulatory model for psychotherapy falls far short of PFD. Why?

Finally, I want to raise the question of the role of the law in tackling the practice of conversion therapy. The Government could opt to ban conversion therapy for all under-18s and go further with an all-out ban for all age groups, as happens in other countries.

[Stephen Gilbert (St Austell and Newquay) (LD)]

I congratulate the hon. Lady on the measures that she has outlined and support her fully. Is it not the case that in 21st-century Britain, no lesbian, gay, bisexual or transsexual individual should be accessing this kind of voodoo psychology? Instead, we should provide services that help to give confidence and which support them in discovering their sexuality and about themselves, rather than making them feel more ashamed about it.

[Sandra Osborne]

I totally agree, and thank the hon. Gentleman for his contribution. In addition to a ban, we must go further in the training of professionals who are dealing with LGBT patients and provide friendly public service provision.

Other than a solitary remark from the Government that they do “not condone” conversion therapy, made in response to a written question tabled by my hon. Friend the Member for Kingston upon Hull North, the Government have said nothing about their views on conversion therapy. I look forward to the contribution of other Members and, in particular, to the Minister’s reply on the issues that I have raised.

[Mr Jim Hood (in the Chair)]

I have received a letter from the hon. Member for Washington and Sunderland West (Mrs Hodgson) requesting permission to speak in the debate. She assures me that she has had the agreement of the hon. Member for Ayr, Carrick and Cumnock (Sandra Osborne), and the Minister has told me that he agrees. To be fair to the Minister, he has to have the same time as the hon. Member for Ayr, Carrick and Cumnock had in opening the debate, so I ask the hon. Member for Washington and Sunderland West to take only a few minutes, which will hopefully leave time for the Minister.

--- Later in debate ---

[The Minister of State, Department of Health (Norman Lamb)]

Thank you, Mr Hood. I congratulate the hon. Member for Ayr, Carrick and Cumnock (Sandra Osborne) on securing the debate and thank the hon. Member for Washington and Sunderland West (Mrs Hodgson) for her contribution, which I was pleased to hear as well. I found myself agreeing with the vast bulk of what has been said and with the interventions that have been made—in fact, I agreed with everything that has been said.

Personally, I find the practice utterly abhorrent and it has no place in a modern society. That is my personal view, and many of the questions that have been asked are questions that I have asked officials about the powers that might be available. If hon. Members would welcome it, I would be very happy to meet with all of them or a group of them to discuss the matter further. That is an open offer, which I make genuinely.

The Government have a proud record of supporting the rights of lesbian, gay and bisexual people. Most recently, we witnessed and welcomed the enactment of the Marriage (Same Sex Couples) Act 2013. Our support for the legislation demonstrates absolutely our belief that extending the right to marry to lesbians and gay men is part of recognising that loving and committed relationships and families in modern Britain come in all shapes and sizes and should be celebrated.

[Sandra Osborne]

Is the Minister aware that today in the Scottish Parliament the same-sex marriage Bill is being introduced? Does he not think that that is ironic, given that we are discussing this matter?

[Norman Lamb]

I thank the hon. Lady for that intervention, and I note her point. Being lesbian, gay or bisexual is not an illness—it is sad that we need to state that, but it needs to be stated. It is not an illness to be treated or cured. Way back in 1973, the American Psychiatric Association removed homosexuality from its diagnostic glossary of mental disorders. Thankfully, the international classification of diseases produced by the World Health Organisation eventually followed suit in 1992; there was quite a long delay before that happened. Therefore, we are concerned about the issue of so-called gay-to-straight conversion therapy.

The Department of Health has received 15 or so letters in the past few months about the issue. All but one of those letters have been supportive of gay people and against the notion of gay-to-straight conversion therapy. That surely reflects the fact that most people in society today are far more relaxed and understanding about people’s sexuality than they ever were in the past.

We are not aware that the NHS commissions this type of therapy. It is completely inappropriate for any GP to be referring a patient for such a thing. It is unacceptable that that should happen through someone working in our national health service.

Backbench business

Sandra Osborne Excerpts

Thursday 14th February 2013 Westminster Hall

[Mr Howarth]

The hon. Lady makes a good point. There is this idea of politicians wagging our fingers and saying, “This is what you should do”. For a couple of years in the previous Government, I had the responsibility in the Home Office for drugs policy, and one thing I know is that middle-aged men like me—perhaps I am flattering myself there—are probably the worst people to go into the media and say, “Actually, you should not be taking drugs.” A subtle, sophisticated approach is needed. A lesson from that, which applies equally here, is to provide information to young people so that they know the consequences of what they do. One problem we are dealing with is that people think there is an easy way to lose weight and to get to be the shape that they, or others, think they should be. Action has to be taken smartly, on the basis of real information about consequences, but it still has to be done.

The hon. Lady anticipated my next point, which is the responsibility of people in different industries. There is relentless media hype about what the perfect body shape should be, and the irresponsible attitudes often displayed by the fashion and entertainment industries need to be highlighted. Looking round the room, there might be one or two people who can remember what it was like to be a teenager—[Interruption.] I take that back. Several people around the room well remember what it is like to be a teenager, and one experience that we probably all share, and that every teenager in history has shared, is insecurity. They have not developed into who they are going to be, and they are insecure about everything, including their appearance—as is obvious, I have long since given up worrying about my appearance—the way they present themselves to the world, what it is to be cool, and all those things. A lot of that is dictated by what they read in magazines and see on cable channels—even on mainstream reality television shows.

It is wholly unrealistic for the industries that show those images to say, “Well, that’s a matter for the Government.” They have a responsibility to provide for young people role models that are realistic, that are just like the rest of the world, that show young people that they do not have to look like those images to be an acceptable, successful and attractive member of society. That responsibility is not just for Government or politicians, but for everyone who is in a position to influence how these things are presented to young people in particular, and to society in general. I hope that, as a result of this debate, we can at least move that agenda along a little further.

[Sandra Osborne (in the Chair)]

I call Heather Wheeler.