Oral Answers to Questions
Sarah Green Excerpts(8 months ago)
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Maria Caulfield
I am very sorry to hear about the experience of my hon. Friend’s constituent. That level of care is absolutely unacceptable. I know he has raised this particular issue with the Patient Safety Commissioner, Henrietta Hughes, but I am very happy to meet with my hon. Friend and his constituent to discuss those complaints, because that care is not acceptable.
Sarah Green (Chesham and Amersham) (LD)
The Minister for Health and Secondary Care (Andrew Stephenson)
At Buckinghamshire Healthcare NHS Trust, the number of gynaecology patients waiting more than 52 weeks reduced by over 30% between August and December, but I sympathise with the many women who are still waiting too long. NHS England has been doing targeted work to help trusts with the most long waiters to support gynaecology patients in the community where appropriate, and to find specialist services that can treat them as quickly as possible.
Sarah Green
My local NHS trust recently stated that the average wait for a gynaecology appointment is 18 weeks, with patients starting treatment within 24 weeks, but that does not include those on cancer pathways. One of my constituents who had been identified as having abnormal cells in her cervix waited more than 60 weeks for a diagnostic assessment. She is one of many contacting me with tales of long delays for gynaecology appointments and paying to go private out of desperation. What steps is the Department taking to reduce waiting times for gynaecology assessments and treatment for those on cancer pathways?
Andrew Stephenson
Significant investment is going in to reduce both general wait times and cancer wait times. More patients on the cancer pathway have been seen than ever before; nearly 220,000 patients were seen last December following an urgent GP referral for suspected cancer, representing 117% of December 2019 levels. We continue to keep this under review and continue to strive to make the system go faster and reduce the elective backlog.
Oral Answers to Questions
Sarah Green Excerpts(9 months, 2 weeks ago)
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Victoria Atkins
I thank the hon. Gentleman for bringing some insight into how we can best reach families. Of course, it is not just mums, but fathers or carers who can have a huge impact on our children. That is why the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), is investing so much energy and commitment in our family hubs. We believe that they can be the centre for families to make the very best start to a child’s life.
Sarah Green (Chesham and Amersham) (LD)
The Minister for Social Care (Helen Whately)
Discharging people on time is better for them and frees up hospital beds. We are changing how our health system works to do that: joining up health and social care and care transfer hubs; helping people to recover at home, with more than 10,000 new virtual ward beds; and investing in social care. And it is working. Last month, delayed discharges were down 9% compared with the end of December 2022 despite almost 1,000 extra urgent admissions to hospitals every day in December.
Sarah Green
Nearly one in six beds in my local healthcare trust in Buckinghamshire continues to be occupied by patients fit for discharge. A recent King’s Fund report found that the Government’s current practice of providing one-off funding to reduce delay, while welcome, comes with insufficient advance notice to allow for effective planning. What steps is the Minister’s Department taking to ensure the best use of this funding?
Helen Whately
One reason we distributed discharge funding back in April last year was to give more advance notice to organisations, so that they could put in place what is needed to speed up discharges. I say to the hon. Lady that our plan is working. That is why, in her own trust, discharges at the end of December were down by a third compared with the previous year.
Crohn’s and Colitis Awareness Week
Sarah Green Excerpts(10 months, 4 weeks ago)
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Hannah Bardell
It almost seems as if the hon. Gentleman has read the next bit of my speech, because I was about to come to the point he has just made—and it is an extremely important and salient point. We do need to ensure that PIP assessors, and the whole framework, can take into consideration those with relapsing and remitting conditions such as Crohn’s and colitis.
I now want to share the experiences of some of those people with the House, because one of them is my brother. When he was diagnosed with ulcerative colitis just over nine years ago, he was in his late 20s and a new dad to a premature little girl. While we were cooing, and worrying a little, about this new bundle of joy—who is now a strapping nine-year-old—my brother was struggling, and had been for some time. I think that, in truth, he was terrified about how fatal the diagnosis might be. It was not until much later that it dawned on us all just what he had been through. When his diagnosis finally came, it was truly devastating. His life and that of our family were, for a period, turned upside down. An active and fit football lover, a new dad and an outgoing and often, frankly, a bit too cheeky young man was stopped in his tracks.
As a frontline police officer with big ambitions and talent, my brother had to adjust to a very different life, existence and career path. The pain, the fatigue and the various other symptoms that he, like many others, had experienced suddenly had a name. Apart from the initial period when he was off work to recover and adapt, his condition meant that, for instance, our annual camping holiday in the west highlands was suddenly in jeopardy. A four-hour drive when it could not be predicted whether toilets would be open or available was suddenly something that was potentially out of reach. My brother, however, being the resourceful problem-solver that he is, traded his car for a pick-up truck and popped a portable loo in the back, which meant that while he adjusted to his anxiety about being able to find a toilet when travelling, such things could be managed. I do not think he ever used the portable loo, but it was there just in case.
I believe that my brother would now count himself one of the lucky ones, and that, in fact, is just the point. For those who suffer from any kind of inflammatory bowel disease—and I acknowledge that people with endometriosis or conditions like cancer suffer very similar challenges—finding a loo that is working, stocked and clean is a perennial problem. Perhaps the Minister would like to meet me some time to discuss how we can develop better facilities—perhaps some kind of interactive map, in an app, of “loos that will do”.
My constituent Steven Sharp, to whom I pay tribute, is a brilliant young man from Fauldhouse. He is a Crohn’s sufferer, and he has raised thousands of pounds for charity over the years by, for instance, doing a bungee jump. He has often spoken to me about the joint pain, the fatigue and the unpredictability of the disease and its impact on his life. That unpredictability is one of the major challenges; the symptoms can change and be different every single day. Steven also lives with a stoma. He and I recently met the Prime Minister, and I have to say that the Prime Minister was incredibly supportive and kind to him. I hope that that kindness will be extended to provisions to ensure that those living with Crohn’s and colitis can obtain the support they need.
My friend Rachel Agnew, who I hope is watching the debate and with whom I spent time this summer, also talked to me about her many years of illness with Crohn’s disease and a possible misdiagnosis. Having had many major operations, she now has “Stan the stoma”, who can sometimes be cantankerous but has ultimately saved her life. Rachel recently had to give up a job that she loved, and is now having to navigate the complexities of the benefit system while having a relapsing and remitting disease.
Research commissioned by Crohn’s and Colitis UK has revealed that the scale of Crohn’s and colitis has been vastly underestimated, and that twice as many people as previously thought are living with the condition. In particular, as we know from recent debates and briefings, young children are being diagnosed earlier and earlier in their lives. I think that we need to pause and consider why that is happening. What are the environmental impacts? What are the impacts of over-processed food? I have no doubt that those elements play a part, and we need to fund research to enable us to get to the bottom of that.
Sarah Green (Chesham and Amersham) (LD)
I thank the hon. Lady for securing today’s Adjournment debate to raise awareness of Crohn’s and colitis. Symptoms such as abdominal pain, diarrhoea and fatigue are too often dismissed, especially when they come and go. A poll by Crohn’s and Colitis UK found that more than one in 10 people would put off speaking to a healthcare professional if they had diarrhoea with blood or mucus and stomach pain because they found it too embarrassing to speak to a healthcare professional about their symptoms. Does the hon. Lady agree that a public awareness campaign on lower gastrointestinal symptoms is needed to help people access reliable healthcare and advice and to take control of their health?
Hannah Bardell
The hon. Lady is absolutely right that we need greater awareness. People need to live without that stigma, and they must not be scared to talk about their poo. They need to be able to go to their doctor and discuss this openly, and their doctors need to be able to offer the right care.
Only one in four people are diagnosed before they are 30, thus affecting the most productive years of their lives. Crohn’s and colitis are complicated diseases that follow a relapsing and remitting disease course. We therefore need a benefits and social security system that supports people with these conditions. As the hon. Lady has said, it is also crucial that we raise awareness. People are waiting far too long for a diagnosis of Crohn’s or colitis. Even before the pandemic, one in four people waited a year to be diagnosed, with nearly half ending up in accident and emergency at least once before their diagnosis.
Delays to diagnosis affect people’s ability to continue education and work. They also narrow the treatment options while increasing the risk of being hospitalised. We do not want anybody to feel that they are a burden on the NHS, but there is a greater burden on the NHS when people are diagnosed later and are unable to access that care. Research found that only one in two people had ever heard of these conditions and that even fewer could name the symptoms. To make matters worse, people are not facing up to this, not understanding it, and putting it down to other things. You could say that it is time to talk more crap than we already do. If sufferers struggle to discuss incontinence with health professionals, it can have a profound impact, but these discussions are vital to ensure that people with Crohn’s and colitis receive the support and accommodations they need.
I would like to highlight the work of the SNP-led Scottish Government, who are committed to ensuring that those living with Crohn’s and colitis can access the best possible care and support, and access health services that are safe and effective and that put people at the centre of their care. For example, in March this year the Scottish Government launched an awareness campaign to help increase awareness of Crohn’s and colitis symptoms and to signpost reliable information so that people would feel empowered to seek help from a medical professional when needed. I would be delighted to hear the Minister say that the UK Government will do the same and that they will work across the UK and internationally with those who are leading in the field of research.
Bowel conditions are notoriously difficult to diagnose, so we must remind people that the symptoms of some of these conditions, including IBS, coeliac disease and bowel cancer, can be similar to those of Crohn’s or colitis. It is crucial that those with Crohn’s or colitis have these conversations and get a diagnosis as early as possible. If left untreated and poorly managed, these conditions can cause serious complications that require emergency medical or surgical intervention.
At a recent meeting of the all-party parliamentary group on Crohn’s and colitis, we heard from a sufferer who had had the most horrific experience during covid. She was taken by ambulance after terrible weight loss, and hearing her experience, particularly during covid, brought home to us how awful this can be and how difficult it is for young people, in particular, to face up to something that will be lifelong and debilitating.
Inflammatory bowel disease care is often overlooked and under-resourced. Current resource planning is based on outdated data on the number of people living with these conditions, which we know is twice as many as was previously estimated. One long-serving IBD clinical nurse specialist recently told us how, 18 years ago, her service was supporting 250 patients living with Crohn’s and colitis and is now supporting more than 7,000. That kind of increase is not realistic for our healthcare staff to deal with. Consequently, there is a significant variation in quality of care across the UK. No IBD service currently meets the IBD standards, so we need to work together to improve that.
The Scottish Government will continue to improve services for people with the conditions through modernising the patient pathways programme. It has a specific workstream that is continuing to promote improvements in inflammatory bowel disease care for patients across Scotland, in partnership with the third sector and people with lived experience. Additionally, the Scottish Government are funding gastroenterology specialty groups that lead on research into Crohn’s disease and ulcerative colitis, with a focus on a range of areas, including early diagnosis of these conditions.
We look forward to seeing the results of IBD UK’s benchmarking surveys, which are currently being undertaken. There will be data from over 15,000 patients and 63% of IBD services, and I hope the Government will take that into consideration and give it their very close attention.
As we have discussed, Crohn’s and colitis not only affect the gut; they can affect almost every part of the body and every aspect of life, from digestion, eyes and joints to energy. However, many people tell us that the hardest part of living with these conditions is the prejudice and discrimination that come from living with a hidden disability. The awareness cards that are now available from Crohn’s and Colitis UK and other charities do help, but we need awareness not only from people who suffer from Crohn’s and colitis, but from the public at large. When somebody who does not appear to have a physical impairment uses a disabled toilet, it does not mean that they do not need to use that toilet. Three in four people will experience bowel incontinence, and therefore quick access to a suitable toilet facility is crucial, either to prevent or to act should an accident occur.
Oral Answers to Questions
Sarah Green Excerpts(1 year, 5 months ago)
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Sarah Green (Chesham and Amersham) (LD)
The Secretary of State for Health and Social Care (Steve Barclay)
We have recruited an extra 4,500 NHS children’s mental health specialists, which is a 40% increase on 2019. That is part of our additional £2.3 billion of investment into mental health services, compared to four years ago.
Sarah Green
Earlier this year, I was contacted by a mother who told me how her daughter, who has been both autistic and anorexic, has been receiving treatment since she was 13. Sadly, her condition has significantly deteriorated in that time, and it is her firm belief that closer integration of the different services she was accessing would have resulted in much better outcomes for her daughter. Will the Secretary of State consider a review of mental health services for children and young people, to look at how to better integrate services and ensure continuity of care?
Steve Barclay
I am sure the whole House is sorry to hear that her constituent’s condition has deteriorated. The hon. Lady raises a very important point about integration, which is exactly the right approach. The 2022 reforms were about integrating health and social care and empowering commissioners to take a more integrated place-based approach. I am sure her local commissioners will take note of the valid point that she raises.
Food Labelling and Allergies
Sarah Green Excerpts(1 year, 5 months ago)
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Sarah Green (Chesham and Amersham) (LD)
It is a pleasure to serve under your chairmanship, Sir Graham. I thank the hon. Member for Don Valley (Nick Fletcher) for opening the debate and all those who signed both petitions. I express my support for the appointment of an allergy tsar to act as a champion for allergy sufferers.
Last year, I was contacted by a then eight-year-old constituent who shared with me the harrowing experience she had had following an allergic reaction. She had been baking with her grandparents and ended up consuming what doctors suspect might have been trace amounts of either pistachio or cashew nut. The reaction led to her being rushed to hospital in an ambulance terrified and, in her own words, thinking she might die. Thankfully, my constituent was able to receive treatment in time, but her parents have told me how they have had to become food manufacturing detectives to keep their daughter safe. They routinely contact food companies directly to understand the company’s cross-contamination policies, which then allows them to make informed decisions on what food they give her. Surely, in today’s Britain, parents should not have to play detective to keep their children safe.
While there is a legal requirement to label products that contain any of the 14 most common allergens, such a requirement is sadly lacking when it comes to precautionary labelling on the risks of cross-contamination. That means there remains significant variation in whether and how food companies provide that information. Some companies that clean machinery between manufacturing different food products decide not to include precautionary labelling at all, despite the risk of cross-contamination from trace amounts of allergens. Where companies do provide such information, the way in which it is shared can vary drastically, including the location of labels on the packaging and the phraseology used. This lack of consistency can lead to confusion, as the Food Standards Agency identified in its report published last summer. Most importantly, it can lead to sufferers or their parents missing critical information that could help them decide whether a particular food is safe.
My constituents have also raised with me the fact that where there are warnings about nuts in particular, they are almost always generic, with statements such as “This product may contain nuts.” In some cases, where sufferers are allergic to some types of nuts but not others, the lack of detail means that large amounts of food products that otherwise might be suitable for them are automatically ruled out. As the Food Standards Agency report makes clear, this much-needed change is supported by industry. It says that food businesses
“want a standardised approach, with clear requirements that provide certainty and a level playing field, giving confidence that their risk assessments protect consumers.”
I therefore urge the Government to appoint an allergy tsar and to take action on precautionary labelling, to ensure that allergy sufferers are able to make informed decisions about what they eat and to reduce the risk that they will expose themselves to potentially deadly allergens.
Cumberlege Report
Sarah Green Excerpts(2 years, 9 months ago)
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Sarah Green (Chesham and Amersham) (LD)
It is a pleasure to serve under your chairmanship, Mr Rosindell. I add my thanks to the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) for securing this debate.
I would like to highlight the excellent work of the Epilepsy Society on sodium valproate. The Epilepsy Society is based at Chalfont St Peter, in my constituency, and its “Safe Mum, Safe Baby” campaign calls on the Government to fund research into safer epilepsy medication for pregnant women. It is a necessary and worthwhile campaign and I support it wholeheartedly. I hope the Government will give it due consideration.
I also pay tribute to my constituent Carol Nunn, who has given me permission to share her experience of surgical mesh. I understand from the Government’s response to the Cumberlege report that their priority is to make medicines and devices safer and prevent future harm. While that is good to hear, I agree with the right hon. Member for Elmet and Rothwell and others that maintaining this narrow focus entirely misses much of what is at the heart of the report, which is improving the lives of people who have already been harmed.
The Government have stated that supporting these women is one of their priorities. If that is the case, I do not understand why they repeatedly refuse to establish redress schemes. The Minister has claimed that there is no evidence that a redress scheme would improve the outcomes for these women. Respectfully, is the Minister really listening? Victims have lost jobs, endured relationship difficulties and financial stress and been left with chronic and often debilitating pain. They deserve redress.
I want to tell Members about Carol. When I first spoke to her last summer, she told me how, four years earlier, she had undergone a hysteropexy and rectopexy using surgical mesh. Instead of resolving her pelvic organ prolapse, the procedures left Carol with a serious autoimmune disease, struggling to walk and unable to continue with her normal daily life. She had to take long-term sick leave from her job as a medical doctor. She told me that she could not remember a day without pain.
I am pleased to say that today Carol is mesh-free following a successful removal surgery last year. She is the first person in England to have undergone successful rectal mesh removal. Although she is still suffering, Carol told me that she feels fortunate to have reached this outcome because, unlike many others, she was able to look outside the national health service and outside the United Kingdom. She feels fortunate because her professional training as a doctor gave her access to the knowledge and resources that allowed her to find Dr Veronikis—I apologise if I have pronounced that incorrectly—and fly out to the United States to have her mesh removed there. I am not convinced that anyone who has had to endure what Carol endured can be classified as fortunate, but I understand her point.
Having lost jobs and shouldered the financial burden of life-changing symptoms, others cannot afford to pay out thousands of pounds for private surgery or international travel to remedy harm that could and should have been avoided. That has now been acknowledged elsewhere in the UK. Last week, a Bill that will allow the Scottish Government to reimburse women who have had to pay for transvaginal mesh removal was passed in the Scottish Parliament. The Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Bill enjoyed cross-party support. I regret that it excludes the removal of mesh used in other parts of the body, but it is an excellent first step towards justice for mesh victims. I am pleased that patients north of the border now have access to support. I would like to be able to offer the same to my own constituents, which is why I urge the Government to look again at recommendations 3 and 4 of the Cumberlege report and to set up redress schemes.
I want to be clear: the mesh centres set up across the UK are, for many, inaccessible. For those, like Carol, who had rectopexy mesh, there is nowhere in the country offering removal without life-changing surgery involving the removal of organs. Carol, who is herself a doctor, described that type of surgery as barbaric. As has been mentioned, where removal is available the Government too often expect women to have the mesh removed by the same surgeon who inserted it. The choice facing victims is really no choice at all.
At the heart of the report is the recommendation that financial redress should be made available. In denying it, the Government completely miss the point of the report—the need to listen to victims. Baroness Cumberlege and her team met more than 700 affected individuals, mostly women, and found that they were not being listened to by medical professionals. Now they are not being listened to by their own Government. What is the point of commissioning a review if Ministers ignore one of its central findings? I hope the Minister and the Government will revisit the report’s recommendations and look again at offering financial redress, because ultimately it is the right thing to do.
Maria Caulfield
I take the hon. Lady’s point, but the vast majority of claims that come through NHS Resolution are settled out of court. We want to make sure that patients get the redress that they are entitled to. There are mechanisms other than going to court in place right now.
Sarah Green
My constituent has approached several legal firms who will not take on her case because the two surgeons who operated on her also work for the law firms advising them on whether such cases will be successful, so that option is not open to her.
Maria Caulfield
If the hon. Lady writes to me about that specific case, I am happy to look at it.
The Government published their response to the review in July last year and accepted the majority of the recommendations for improvement. I want to update Members on those because we are absolutely committed to making rapid progress in all the areas in our response. We have committed to publishing an update on the progress of all the recommendations that we accepted, and we aim to publish that in the summer. If colleagues want to hold my feet to the fire, they will certainly get a formal update in the summer.
We have made strong progress on some of the changes.
Oral Answers to Questions
Sarah Green Excerpts(2 years, 9 months ago)
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Sajid Javid
First, I think the hon. Gentleman accused me of doing something inappropriate, and I think that that is not appropriate, unless he has something else to say or some evidence, but it is true to form for the Labour Front Bench, which just constantly makes things up to make false points. When it comes to testing, as he has just heard me say, we have purchased 1.7 billion lateral flow tests since the start of the pandemic. Wherever possible, whether it is PCR testing or lateral flow testing, whenever tests are approved by our independent regulator, we buy British.
Sarah Green (Chesham and Amersham) (LD)
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
At the present time, no decision has been made to increase the upper age exemption for free prescriptions.
Sarah Green
Such a policy change would hit a vulnerable age bracket who are more likely to have one or more long-term illnesses requiring medication. A constituent of mine has told me of his concern at the cost of paying for his wife’s Parkinson’s medication, should such a change be introduced. Given that the millions facing a new charge will also be hit by a rise in living costs, will the Secretary of State shelve such proposals and review the list of conditions that qualify for a medical exemption certificate?
Maria Caulfield
Can I just reinforce the answer I have just given? There is no decision to increase the upper age exemption for free prescriptions, and the rumour circulating that the Government are removing free prescriptions for pensioners is completely false. The Government are absolutely committed to maintaining free prescriptions for pensioners.
Sajid Javid
My hon. Friend is right to raise that point, and I commend him on the fantastic work that he has done in leading this campaign. We were delighted to announce £50 million of funding for MND research. That will support a new MND research unit, which has already started work to co-ordinate research applications, and a new MND partnership, which will be formed to pool expertise across the research community.
Sarah Green (Chesham and Amersham) (LD)
Sajid Javid
The hon. Lady is right to raise that issue. Healthcare workers have been under significant pressure, especially over the past two years, and of course that applies to GPs. The support we have provided through the winter access fund—the £250 million—is there to help GPs’ surgeries across the country, including with their workforce.
Oral Answers to Questions
Sarah Green Excerpts(2 years, 11 months ago)
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The Minister for Health (Edward Argar)
I am grateful to my right hon. Friend, who has taken a long-term and consistent interest in the matter. The strategic outline case for transforming the Royal Shrewsbury Hospital and Princess Royal Hospital Telford was received at the end of October 2021. It has been reviewed by the NHS and detailed feedback has been given; I look forward to it coming forward to me early next year. We remain committed to delivering the investment and improvement that Shropshire’s hospitals need and that he and his colleagues have helped to secure.
Sarah Green (Chesham and Amersham) (LD)
Women across the country have lost jobs and life savings as a result of chronic pain and disability caused by complications after the use of medical mesh. Many, including one of my constituents, have had to pay for corrective surgery overseas. The Government have so far refused to set up agencies to provide financial redress, as was recommended in the Cumberlege report. Will the Secretary of State revisit the Cumberlege report, and in particular the need for financial redress?
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
Women who have suffered are being helped and supported through the difficult choices that they are having to make. The Government have set up eight specialist mesh centres across the country to provide them with the specialist treatment that they need. Our priority is patient safety, preventing anything like this from happening again, and supporting women who have been affected. There is no evidence that a redress system would improve patient safety or improve the outcome for those women.