Cumberlege Review: Pelvic Mesh

Sharon Hodgson Excerpts

Thursday 5th December 2024 Westminster Hall

[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

Do you want to give some guidance on how long is left, Mr Stringer, so I can cut my speech accordingly?

[Graham Stringer (in the Chair)]

I intend to call the spokesperson for the Liberal Democrats at 2.30 pm.

[Mrs Hodgson]

In the short time I have available, I will try to make some important points. It is a pleasure to serve under your chairmanship, Mr Stringer. As co-chair of the all-party parliamentary group for first do no harm—along with Baroness Cumberlege, who it is a pleasure to see in the Public Gallery—it is a pleasure to speak in this important debate. I also point out how many officers of the all-party group are here in the Chamber, on a Thursday and on a one-line Whip. That speaks for itself as to how important the issue is to the House and to all of us. I thank my hon. Friend the Member for Harlow (Chris Vince) for securing this important debate to shed further light on this still under-discussed scandal.

Members present, campaigners watching at home, and especially patients, will all be aware of the extent of the injustice. I have had the privilege of working with wonderful campaigners over many years, and I take this opportunity to pay tribute to Kath Sansom from Sling the Mesh, who is a key campaigner for mesh victims and has been a great support to me and to colleagues over the years. I am glad that she is in the Public Gallery to watch the debate, alongside Debbie, who is the constituent of my hon. Friend the Member for Harlow, and who brought this scandal to his attention.

My first contribution in this House on surgical mesh was in 2017, during my time as shadow Minister for Public Health, and I am glad to see the actual Minister for Public Health and Prevention in his place to hear this debate. I have continued to campaign tirelessly on the issue through debates and my work with the all-party group ever since.

The issue is not only of political importance to me; it matters to me on a profoundly personal level. As I am sure some in the Chamber will know, among the thousands of women affected by mesh complications is my mam, who was one of the 617 mesh-damaged women who met, or made submissions to, Baroness Cumberlege for her review. I took my mam along to an evidence session in Gateshead, and she was able to meet Baroness Cumberlege and tell her story personally. She still talks about that to this day—she is very grateful.

After suffering mild stress incontinence, as we have heard from a number of people who went through the procedure, my mam had SUI surgery to have some tension-free vaginal tape inserted, which was a quick and common treatment offered to women for incontinence. However, had she known the life-limiting complications she was about to suffer as a result, dealing with slight stress incontinence would not have seemed very bad at all.

Two to three years post-surgery, my mam had one health complication after another. She suffered all sorts of autoimmune reactions, recurrent urinary tract infections, and was in constant pain in her groin, arms and legs. She became a shadow of her former self, and it took us quite a few years to work out what was causing the symptoms and pain. It was only through my research for that debate back in 2017 as the shadow Minister that I was able to join the dots together, and from that moment on we both wished constantly that she had never had the operation.

My mam will be 80 in January, and she would say that she is one of the lucky ones. Since I first spoke on the topic, she has been able to get the mesh surgically removed. It was a long delicate operation, thankfully carried out by the amazing Suzy Elneil, which she had to undertake in London in order to avoid the surgeon who put it in her in the first place—something that the right hon. Member for New Forest East (Sir Julian Lewis) and others have spoken about. That is something that many mesh-damaged women will understand. With the removal of the mesh, many of her health complications vanished immediately. The road to recovery is far from smooth for many mesh-damage victims, however, and my mam is no exception. She is still recovering to this day and, in her words,

“will never be the same again.”

I sat next to my mam at her local hospital and watched her be gaslit and undermined by her original surgeon when she first sought help with her pain and symptoms. Our doctors, surgeons and healthcare providers are meant to protect us, not harm us. Hence, “first do no harm”—an unwritten contract between patients and healthcare providers that rightly makes us feel that when we seek medical help, we trust that we will be made better, not worse. Surely the least we can expect in cases where harm does happen is accountability and for wrongs to be righted. Instead, we see a culture of defensiveness and a lack of accountability. It is therefore shocking that the surgeons responsible for the implantation of this life-shattering mesh are the very same people tasked with removing it.

I was going to talk about Baroness Cumberlege’s recommendations—which we have had success with and which we have not—but sadly the right hon. Member for New Forest East used up all the time, so I cannot.

[Sarah Green (Chesham and Amersham) (LD)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for Harlow (Chris Vince) for securing today’s debate. We are here because four years after being published, the Cumberlege review has not been implemented and there is still no redress scheme. I will turn in more detail to the progress made on those recommendations, but first I pay tribute to the many individuals who have campaigned so hard for so long to be heard, for their experiences to be taken seriously, to receive some sort of justice, and to know that the same harm will not be done to others. Some of them are in the Public Gallery today and I thank them for their tireless campaigning.

I also pay tribute to the right hon. Member for Godalming and Ash (Jeremy Hunt), when he was Health and Social Care Secretary, and to the former Member for Maidenhead, when she was Prime Minister, for commissioning the review in the first place in February 2018. Baroness Cumberlege has never stopped giving voice to those she encountered during the two years she led that review. She has gone to great lengths to keep this issue on the agenda. She is due to retire shortly and we will miss her. I would like to say how grateful I am, as I know others will be, not just for her advocacy on this issue but for her encouragement and support of hon. Members in this place to do the same. If I may be so bold, Baroness Cumberlege has played her part. It is now up to us in this place to hold this new Government to account and to ensure that her recommendations are implemented in full.

Let us not forget that the Cumberlege review was called “First Do No Harm”, because at its centre are people who suffered avoidable harm—harm done to them by our health system. I was first introduced to this issue by my constituent Carol. I have shared her story before and remain in awe of her dignity and desire to help others despite having experienced the most devastating medical trauma. She needed her MP to help her get a visa for the United States for urgent medical treatment during the pandemic because of the travel restrictions that hon. Members will remember. She had undergone a hysteropexy and a rectopexy using surgical mesh.

Instead of resolving Carol’s pelvic organ prolapse, the procedures left her with a serious autoimmune disease, struggling to walk and unable to continue her normal daily life. She had to take long-term sick leave from her job as a doctor and could not remember a day without pain. When she contacted me for help with her visa, she was seriously unwell and had been told that she urgently needed her mesh removed or her prognosis was not good. We managed to get her the visa she needed. She is now mesh-free following a successful removal, and she is the first person in England to have undergone successful rectal mesh removal. She is still suffering, but is no longer in the same danger that she was. She is clear that she was able to look outside the NHS and the UK only because her medical training and personal resources enabled her to find Dr Veronikis, who treated her successfully. I should say at this point that there needs to be more awareness of rectopexy mesh, which affects men, women and children.

Carol and others like her were given hope when the Cumberlege review was initiated, and again when it was published in July 2020 with its nine recommendations. I am sorry that to say that not enough progress has been made on those recommendations since. The reality is that only two of the nine recommendations have been implemented in full. The first was an apology, which was given as soon as the report was published. The second was to establish the office of the Patient Safety Commissioner.

Beyond that, things have stalled. Recommendations 3 and 4 called for an independent redress agency, and for redress schemes to be established for all three interventions. After originally rejecting those two recommendations, the Health Minister at the time asked the Patient Safety Commissioner in late 2022 to look at the options for providing redress for those who had been harmed by mesh and valproate. The commissioner’s report—the Hughes report—was published in February. I was present at its launch, and it really felt like a milestone; it felt as though progress had been made. Surely the Department would not commission that work if it had no intention of following through on a redress scheme.

That was in February this year. By the summer, when the election was called, the previous Government were still saying that they would respond to the report, so they never gave a formal response. To date, there has been no official response from the new Government to the Hughes report. In the words of the Patient Safety Commissioner:

“it is now urgent for the government to give those families some clarity. Many of them live with pressing financial hardship, as well as physical pain and disability…we must not compound the physical and mental harms experienced by these families by setting and raising false expectations if there is no intention to deliver on redress.”

[Mrs Hodgson]

I am grateful to the hon. Lady for covering the recommendations, which I was not able to do. That has relieved me somewhat. We have at last seen some compensation for the victims of Windrush, the infected blood scandal and the Horizon scandal. Does she agree that it is incumbent on the Government to treat this scandal with the same seriousness, fully accept recommendation 4 and put the redress scheme in place?

[Sarah Green]

I could not agree more. This is where I must pick up Carol’s story again. She tried to pursue her claim against her original surgeons through the courts, and she hit on an unexpected problem. She approached multiple legal firms who would not take her case because one or both of the surgeons were advising them on other cases and, as such, it would have been a conflict of interest. Indeed, the same surgeon who caused Carol life-changing injuries acted as an expert witness in an unrelated surgical mesh negligence case. The judge in that case said:

“he had cherry-picked those parts of the evidence which were supportive of the Defendant’s case and did not comment on those parts which were consistent to the Claimant’s. That is not the correct approach to be taken by an independent expert, whose duty is to the court. His evidence lacked balance and was unpersuasive.”

On this occasion, the judge called it out, but that is not the only instance of the medical profession closing ranks—it is not a unique occurrence. Such clear bias and conflicts of interest are a huge barrier to justice for mesh victims around the country.

The point of recommendation 3 in the Cumberlege review was to establish a non-adversarial avenue for redress after someone has been harmed in a healthcare setting. Both the Hughes report and, more recently, the Darzi report found that the current clinical negligence system is difficult for patients to navigate and prevents the healthcare system from learning from its mistakes. It is also eye-wateringly expensive for the taxpayer. If it is the dead hand of the Treasury blocking a redress scheme, Ministers would do well to reflect on that. As the Patient Safety Commissioner points out, the clinical negligence system is behind only nuclear disarmament and pensions on the list of liabilities on the Government’s balance sheet. I must ask the Minister when the Department will respond to the options outlined in the Hughes report, and when families can expect to see redress schemes up and running.

Recommendation 5 relates to the establishment of mesh centres around the country, and while such centres have been established, they get mixed reports from patients. My question on the mesh centres is about their outcomes. How is the Department ensuring a consistent service across them all, and how are outcomes being measured? With so many people reporting dissatisfaction with the centres, it is not enough that they exist; they need to be working well for the patients they are there to serve. Recommendation 6 relates to the MHRA, and it is clear that we still need the yellow card reporting system to improve. I would also welcome the Minister’s thoughts on progress against recommendation 7, which is about creating a central patient-identifiable database. To my understanding, it is still a work in progress.

The previous Government’s decision not to take forward the eighth recommendation, which is for a mandatory register, is disappointing. The recommendation called for

“Transparency of payments made to clinicians”

and

“mandatory reporting for pharmaceutical and medical device industries of payments made to teaching hospitals, research institutions and individual clinicians.”

I fail to understand why more progress has not been made on that. I know that campaigners have written to the Department asking it to consider a sunset Act that speaks to that recommendation, and I urge the Minister to chase a response to them.

Preventable Baby Loss

Sharon Hodgson Excerpts

Wednesday 4th September 2024 Westminster Hall

[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I thank the hon. Member for Ashfield (Lee Anderson) for securing this important debate and for his moving opening speech. My thanks also go to Bliss for the briefing that it provided.

This is an incredibly important debate for me and, I have no doubt, for all of us here today. As some Members will know, I—like many others here today, sadly—have experienced the devastation of baby loss. Having not spoken about my experience of baby loss until 2016, 11 years after I became an MP, I know how difficult this can be to talk about openly. I want to thank all colleagues for being here, some of whom have personal motivations, as we have heard.

I want to tell you a little bit about my daughter Lucy and about my experience of baby loss. My daughter Lucy was born at 23 and a half weeks, and sadly she was stillborn. Her heart beat throughout my labour until just minutes before she was born. The experience of giving birth to a stillborn child is incredibly traumatic, as we have heard and as I have spoken about previously. It feels weird that the world around you is not responding as it would if you had given birth to a live baby. I felt that I made everyone around me, or anyone I met, feel very uncomfortable: it is one of the last taboos, as the hon. Member for Clacton (Nigel Farage) spoke about. No one knows what to say to you when you have lost a baby or given birth to a stillborn baby—it is everyone’s worst nightmare—so I did not talk about it, and I certainly did not tell anyone new to my life who had not known me before I lost Lucy. When I became an MP in 2005, it took me until 2016 to actually talk about it in this place, or to anyone from my post-baby-loss life.

What compounded this grief was the fact that Lucy did not receive a birth or death certificate. Even more upsettingly, in my records it was not recorded as a stillbirth; it was recorded as a miscarriage. Because she was just days away from being 24 weeks, she was three or four days short of the required legal age to be eligible for a death certificate. Because of that, she does not officially exist in any official records other than our own family records.

We did name Lucy during a blessing in a private room, which I was moved to after she was born, when I had to give birth in the maternity ward among all the live babies. She was then taken to the chapel of rest and we held a very small funeral service for her, organised by the chaplain at the hospital and the Co-op, which funded everything. I will be forever grateful for that: it meant a lot at the time and still does. The acknowledgment of Lucy’s existence that they provided us with was truly invaluable, particularly when it had been denied to us by the lack of a death or a birth certificate.

After my experience, I knew things had to change, even though I could not talk about it for a long time. Alongside the former Members Will Quince, Antoinette Sandbach and Victoria Prentis—some of us here will remember Victoria, who left the House at the last election—I became one of the founding members of the all-party parliamentary group on baby loss in 2016. I am pleased that the APPG is still going; I hope it gets reformed. It has become a vehicle for making great progress with regard to baby loss, in particular for securing bereavement suites across the country, improved patient pathways and better recording of data, among many more improvements. Still more are needed, sadly.

I then became one of only two MPs on the pregnancy loss review, alongside our former colleague Tim Loughton, following his private Member’s Bill. The review’s work resulted in significant changes—not least the decision, announced just earlier this year, that parents who lose a baby before 24 weeks of pregnancy in England can now receive a certificate in recognition of their loss. I know that this has been a great source of comfort for many who now feel they can finally get a formal recognition and acknowledgment that their baby existed. I am certain that it would have made a huge difference to me and my family.

[Carla Lockhart]

I thank the hon. Member for the moving real-life story that she has told. I commend her and her colleagues for their efforts on baby loss certificates. Does she agree that a greater effort needs to be made in the devolved regions—I am thinking of Northern Ireland—to replicate what is happening here in England with baby loss certificates, such is the importance of the issue for families?

[Mrs Hodgson]

I absolutely agree. I only realised that the certificates were just for England when we were pulling together my remarks for today. That is remiss; I encourage the devolved nations to follow the example of England and bring the certificates in, because they really make a massive difference to parents suffering early baby loss.

Despite these improvements, we still have a long way to go to provide the care and respect that all families need during such a difficult time, as well as to ensure that we take steps to reduce stillbirth rates. As expressed by Bliss, an organisation that campaigns for change for babies born premature or sick, there has been a concerning increase in the neonatal mortality rate and the pre-term birth rate. It points to a high variation in care as a factor that can be addressed to reduce that worrying increase.

As the MP for Washington and Gateshead South in the north-east, I know just how damaging the impact of inequality can be as we experience the acute end of regional inequality, which can manifest itself through less investment and less access to the resources we need. In relation to baby loss, inequality prevails and, as Bliss highlights, the number of babies lost to mothers from the most deprived areas has increased at a rate twice that of babies lost to mothers living in the least deprived areas.

It would be remiss of me not to mention that neonatal mortality rates are much higher for babies from an ethnic minority. Babies of black ethnicity are twice as likely to be stillborn as babies of white ethnicity. It is a failure of our healthcare system that babies of black and Asian ethnicity continue to have much higher rates of neonatal mortality. Disgracefully, that disparity is also seen in maternal healthcare. Maternal mortality for black women is currently almost four times higher than for white women. As some Members may have heard, the tennis star Serena Williams has spoken in great detail about her awful experience in that regard. I encourage Members to read her article in Elle magazine, which is still available online. Even as a very wealthy and globally recognised figure, Serena’s voice was dismissed during pregnancy and childbirth.

We must ensure that there is the right training and support for healthcare professionals to ensure that all those terrible disparities are addressed. The cases that we have heard today are so traumatic. Crucially, we must centre the voices of patients—usually mothers, but sometimes their partners as well—and listen to what they are saying about their own bodies and experiences. As we have seen with the high level of disparity in neonatal healthcare outcomes, we will fail to achieve change if we are not listening to those at the heart of this crisis.

If we are to effect change, we must also increase our midwifery workforce, as well as increasing the capacity in our NHS to allow the necessary training to be delivered. I am pleased that Labour is taking strong action to get our NHS back on its feet. In our manifesto, we committed to training thousands more midwives as part of the NHS workforce plan. It is also significant that Labour has said that we will ensure that trusts failing on maternity care are robustly supported into rapid improvement, and we will set an explicit target to close the black and Asian maternal mortality gap.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Does the hon. Member agree that two points that have emerged from this important debate are that greater resources are required to deal with the problem, and that a greater understanding is needed of the individualistic nature of the problem? No two mothers or families will react to baby loss in exactly the same way, as she and other hon. Members have so passionately outlined. Those are two of the most important issues arising from the debate, and hopefully we can learn from them.

[Mrs Hodgson]

I absolutely agree. The hon. Member makes a very valuable point: resources matter, but it is also about how they are implemented. Human interaction and professional training is so important.

I am hopeful for the future and proud of the change that has been made so far. Looking at all colleagues in the Chamber today, I know that together we are a powerful voice that can make such a difference to families during that terrible time and can help to improve outcomes for others, so that fewer people experience this most dreadful loss in future.

Healthy Start

Sharon Hodgson Excerpts

Wednesday 22nd May 2024 Westminster Hall

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

I beg to move,

That this House has considered the Healthy Start scheme.

It is a pleasure to see you in the Chair, Mr Dowd. What is not a pleasure is that I am here yet again, still trying to get the Government to do something very simple and impactful to help those who need it the most. Auto-enrolment with an opt-out, as opposed to the current opt-in system, would ensure that the Healthy Start scheme operates as it should, so that every single child gets the best start in life.

The last Labour Government introduced the Healthy Start scheme, which provides financial assistance in the form of a prepaid card to all under-18s who are pregnant, families with young children or pregnant women claiming certain benefits. This is to help with the ever-increasing costs of fruit and vegetables, milk, formula milk and vitamins. The scheme is available in pregnancy and until the child’s fourth birthday, yet the scheme is beset with problems—problems that were caused by this Government and can be easily fixed by this Government.

The child of the north all-party parliamentary group has heard evidence that children in the north are more likely to die before reaching their first birthday than those elsewhere in the country. We have heard about desperate mothers who are seeking an abortion because they simply do not know how they will feed their baby. When I raised that with the Prime Minister only two weeks ago, his response was to advise me that he was

“proud that…the Government have overseen a significant fall in poverty, particularly child poverty.”—[Official Report, 8 May 2024; Vol. 749, c. 570.]

Child poverty has not significantly fallen: it stands at more than 4 million. When expectant mothers have had to make these heartbreaking decisions, bragging about the support put in is crass, to say the least. It was followed up with an equally tone-deaf letter from the Secretary of State for Work and Pensions.

It has been widely reported that some parents, in desperation, have resorted to theft of baby milk and formula or are having to water it down, which is not surprising considering that prices of baby formula are at historically high levels and the current Healthy Start payments do not even cover the cost of formula for one week. Despite this, Healthy Start take-up is dropping. The Government’s 75% target—given to the NHS Business Services Authority, which runs the scheme—was missed last year, and take-up continues to decrease: it stands at just 62.5% across England, Wales and Northern Ireland. The comparable scheme in Scotland, however, has reached 92% take-up. Some local councils and organisations have made a dedicated investment to promote the scheme; not only does this create a postcode lottery, but they were left feeling utterly demoralised after the Government provided false, inflated take-up figures and were then unable to provide accurate uptake data.

An opt-out system would ensure proper data and free up organisations to support families instead of having to try to locate them—a point that is supported by research published earlier this month and funded by the Minister’s own Department. In some areas, the take-up is as low as 44%. About 220,000 babies, young children and pregnant women are missing out on the scheme, and Sustain estimates that that leaves £58 million unclaimed.

Despite the Chancellor’s crowing on this morning’s news, low inflation still means rising prices on top of previous high rises. In short, this is just stemming the pain for families. Only last year, UNICEF found that the UK had the worst rise in child poverty, leaving us bottom among 39 of the world’s richest countries. That is why admissions for malnutrition have increased in children and there has been a resurgence of Victorian diseases such as rickets and scurvy. It is no wonder that the Government blocked the United Nations special rapporteur on the right to food from visiting the UK and investigating poverty. When the previous UN special rapporteur on extreme poverty visited the UK, he was very clear that the rise in poverty was the direct result of Government policies.

Food banks, baby banks, faith groups and charities have now become embedded parts of our welfare state. The Key to Life food bank in my constituency reported a 300% increase in demand last year, coupled with a decrease in donations. It is therefore highly unlikely that the £58 million that is going unclaimed is unclaimed because people do not need it. There is a very clear need for the scheme but, as I have been told time and again, awareness is low among the public and professionals. That is why in 2021 the national food strategy recommended that the Government implement a communications plan related to Healthy Start, but they did not.

In 2021, I and others raised concerns about plans to fully digitalise the scheme by 2022, meaning that paper applications and vouchers would no longer be accepted. The result was that, as of October 2023, more than 20,500 households that were previously in receipt of the vouchers were no longer receiving them, 19 months after digitisation. The NHS Business Services Authority then admitted that technical issues meant that applications were being declined, resulting in parents and pregnant women struggling to get through to the helpline and having their payment cards rejected.

As it stands, the application routes are overly complex and varied. When an application is made online, an automated message claims that a response will be given in two days. This very rarely happens. Some mothers report that they have never heard back and that, after multiple attempts, they have given up.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I apologise for missing the first couple of minutes of my hon. Friend’s speech. She is making an excellent speech outlining why the scheme is so needed. She mentions that take-up of the Healthy Start scheme is too low, so proper information about the scheme is needed, along with auto-enrolment. That would cut through the red tape and the hurdles that many families experience. Does she agree that the Government must therefore do more to promote the Healthy Start scheme to families so that people are aware of it, as recommended in the excellent national food strategy?

[Mrs Lewell-Buck]

I thank my hon. Friend for that intervention and for all the work that she does in this space. She has tirelessly championed children for as long as I have known her and for as long as she has been in this place. Charities, organisations and local authorities are using what little money they have to promote a Government scheme, and then when they go to the Government for data about how it is working, they get either false figures or no figures at all, so I could not agree more with my hon. Friend.

The Healthy Start phone number is not freephone, and it is fully automated. There is no option at all for callers to speak to anyone unless they need an interpreter or have inquiries relating to their card. The absurdity of an automated system asking whether callers have problems with cards that they do not yet have is not lost on any of us, I am sure. Worse still, if the application is refused, the parent is not told why and is directed to the phone line: again, they cannot speak to anyone. Research by Manchester Central food bank highlights the fact that those on legacy benefits or with no recourse to public funds have to apply via paper or telephone, but that is completely at odds with the Healthy Start phone line and website, which state very clearly that applications must always be made online. The confusion is completely unnecessary.

Repeated questions to the Secretary of State for Health and Social Care about funding for the scheme and future take-up have been equally frustrating. The Government refuse to say how much money they allocate to the scheme each year. They claim it is allocated on a forecast for take-up, but will not say what that forecast is. A cynic would conclude that if the Government forecast low uptake, it is against their interest to do anything to boost it, as they will not have budgeted for that, or that if they forecast higher uptake but do not reach it, millions of pounds that could have been spent on feeding children will be spent elsewhere. Either way, hungry babies and children are once again the ones losing out.

Back in May 2023, a similar debate was held in which the Government were made fully aware of the problems with Healthy Start. The following month, I introduced my Bill on auto-enrolment, the Healthy Start Scheme (Take-Up) (No. 2) Bill. Over the past two years, I have sent the Health Secretary two cross-party letters, signed by MPs and a multitude of outside organisations. This was followed by more questions and speeches in the Chamber and a full report to the Chancellor in advance of the previous Budget. Forty-eight written questions and two well-supported early-day motions later, here we are again.

I am sure that in her response the Minister will reiterate the excuses her colleagues have given for refusing auto-enrolment: that it is not possible because the prepaid card is a financial product that is therefore subject to financial regulations. However, Mastercard has written to me explaining that it is possible, if only the Minister’s Department and the Department for Work and Pensions will work with it. I have been here long enough to know that the Minister will not be able to commit to auto-enrolment today, but at the very least can she give a commitment to working with her colleagues and other organisations to look at piloting auto-enrolment?

Can the Minister assure us that her Department’s uptake data is now accurate and advise us on the progress of her Department’s promise to me to write to all eligible households that are missing out on the scheme? As we debate this today, there will be mothers and fathers who, instead of excitedly preparing for their newborn or enjoying those early years with their little ones, are worried and distressed about how on earth they are going to provide for them.

I know that auto-enrolment is not a panacea. I know that life will continue to be a hard struggle for so many people. But as I did when I presented my Bill, I want to thank all the parents who have shared with me their stories and their pain. They should always be at the forefront of our mind, because nobody should feel such desperation and hopelessness that they can see no other way than stealing to feed their baby or seeking to terminate their pregnancy. I sincerely hope that the Minister agrees with me about that.

[Andrew Western (Stretford and Urmston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for South Shields (Mrs Lewell-Buck) on securing this important debate. She has done a considerable amount of work—some with me and some in her own right—over the past few years and has followed in the footsteps of my predecessor as Member of Parliament for Stretford and Urmston in campaigning on auto-enrolment.

This is a hugely important issue. We know that those families who are eligible to receive the Healthy Start allowance are some of the poorest in our country. We know, too, just what an important component of the benefits system it is. It ensures that youngsters at risk of malnutrition because of a lack of finance and of available cash in the family home are able to access things like healthy foods, fruits and vegetables, as well as milk formula and other important things to help with babies’ early development.

There are a number of aspects to this. My hon. Friend has focused largely on her important campaign to secure auto-enrolment, but I want to take a moment to broaden the debate with some comments about the uplifting of the allowance, given the significant increases in inflation in recent years.

[Mrs Hodgson]

I can see that my hon. Friend is going to make an excellent speech; he has made some important points already. Hon. Members may be aware that an event was held yesterday by Diabetes UK that discussed the shocking rise in the prevalence of type 2 diabetes in young people. They mentioned early years nutrition and the important part that that period plays in establishing the lifelong health of an individual. Does my hon. Friend agree that that very early food system and what food children consume in those very early years is so important, and that schemes such as the Healthy Start scheme should be thought to be central to a good public health mission?

[Andrew Western]

My hon. Friend is correct to make that point and to link diabetes and other negative health experiences that can happen as a result of poor nutrition in early years. She has spent many years campaigning for children and their health in this place, not least during her time as the shadow Minister, and I know that many families up and down the country will be grateful to her for that.

I turn back to the issue of inflationary pressures and the lack of uplift in the Healthy Start allowance since 2021, when it was uplifted for the first and only time since the Government came to power in 2010. We all know the inflationary pressures that we have seen since then; food, in particular, has outstripped other parts of our economy, with an average 30% increase in food prices. That pressure has been especially acute in the price of milk formula.

My hon. Friend the Member for South Shields mentioned our last Westminster Hall debate. I called that debate a year ago yesterday, and things have worsened since then. As my hon. Friend said, uptake has decreased, as prices—although they are not growing as quickly—have continued to rise. Twelve months ago, we were at the point at which there was not a single milk formula product on the market that could be afforded under the Healthy Start allowance. That is a terrible situation to be in, not least because of the other pressures we have seen on family finances in recent years.

I turn to auto-enrolment. Uptake is problematic: it has decreased over the past two months. As I said, these are the poorest families and those in the most need. Families are not deciding that they do not require that money. Families are looking, as my hon. Friend the Member for South Shields so ably outlined, at an opaque and challenging system to navigate. That, as well as a lack of knowledge that this allowance even exists for families, is one of the primary causes, if not the only cause, of this damagingly low uptake.

I am interested to hear the Government’s thoughts on the thorny issue of auto-enrolment, although I am not sure why it is so thorny. I also wish to broaden out my hon. Friend’s comments about the interim proposal that she and I put forward to Government of writing to those families who are eligible for the Healthy Start allowance but who are not taking it up. We have had a number of excuses from the Government over the past 12 months, similar to those that my hon. Friend outlined on data sharing and a financial agreement through a card system, which have since been quashed by Mastercard.

I have submitted a number of written questions about where we are with the data, given previous undertakings from Ministers that they would draw the data together to write to those families. In September 2023 I was told that that data was being brought forward. In November I asked again, in pursuance of the previous question, and we were told that the data would be available in early 2024. My hon. Friend the Member for South Shields and I seem to dovetail on this issue a lot: she then submitted a question in March this year. There was still no sign, despite previous suggestions that the data would be available in early 2024 for that work to happen.

There is a lack of transparency and accessibility in the application process. The Government are not helping to disavail people of that view when they refuse to let even those who are eligible for the scheme know that that is the case. The impact on our communities is significant. In my constituency of Stretford and Urmston, one child in five lives in poverty. My local food bank in Stretford told me recently that 40% of the people it serves are first-time users, such is the enormous increase in demand that it has seen of late. Most damningly of all, in my community they also tell me that there has been an 80% increase over the past 12 months in the number of families with children that they are supporting.

We are in crisis. Families are struggling. The allowance is targeted at those in the greatest need, yet just this weekend, in Old Trafford in my constituency, residents were having a real-time WhatsApp conversation about the fact that milk formula and milk itself are security-tagged in some—not all—supermarkets up and down this country. There was a debate going on: if they were a retail worker, would they stop somebody who was clearly in need from taking milk or baby formula?

I said 12 months ago that people were watering down formula, and my hon. Friend the Member for South Shields mentioned it today. Worse still, as Sky News covered at the time, in some cases there were suggestions that mothers were adding flour and other such substances into milk formula to pad it out further. The impact that that can have on a baby’s digestion is significant and risks long-term health problems. This is the scale of the challenge that we face.

I would be incredibly grateful for an update on the Government’s thinking about whether they should be uprating the Healthy Start allowance in line with inflation, given the significant pressures on the price of food and especially on milk formula since the allowance was last uprated in 2021. Are the Government serious about the issue of auto-enrolment? If not, why on earth is more not being done to bring together the data that is required? That would at least let families know whether they can embark on this admittedly opaque process to try to bolster their family budgets and try to ensure that their babies, their children under the age of four or they themselves, if they are more than 10 weeks pregnant, can access healthy things such as fruit, vegetables or milk for their baby.

This is a crisis. The need is there. We all see it in our communities. The time to act is now, and I beg the Minister to do it urgently.

Liver Disease and Liver Cancer

Sharon Hodgson Excerpts

Thursday 25th April 2024 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship today, Sir Christopher. I thank my hon. Friend the Member for Stockport (Navendu Mishra) and the hon. Member for Glasgow Central (Alison Thewliss) for securing this important debate, and hon. Members for their excellent opening speeches, setting the scene.

Addressing liver disease and cancer has for far too long been put on the back burner. Despite the vital work of organisations like the British Liver Trust and Liver Cancer UK, liver disease remains a leading cause of premature death, and is now the fastest rising cause of cancer death in the UK, yet 90% of liver disease is preventable, and it is in many cases reversible. It is a travesty, and an indictment of the state of our healthcare system, that three quarters of people living in the UK are diagnosed when it is too late for effective intervention or treatment.

I am acutely aware of the effect that liver disease has, because Washington and Sunderland West is at the heart of this public health crisis, which disproportionately affects those living in the north-east. In Sunderland, hospital admission rates due to liver disease were, shockingly, 84% higher than the national average in 2022-23, and the region suffers one of the worst hospital admission rates in England for women with liver disease. We see the hand of inequality stretch even further, as over a third of all premature deaths reported in 2022 were in the north of England, despite the Government’s manifesto pledge and levelling-up mission to narrow the gap in healthy life expectancy. The Government’s inaction on tackling health inequality is clearly indicated by the simple fact that, since the Marmot review was published in 2010, health inequalities have widened.

If we are to tackle this issue, we must finally start to tackle its root causes. We must reform our approach to liver disease and cancer, no longer allowing the prevailing myth of it being self-inflicted—as my hon. Friend the Member for Stockport said in his opening speech—to impact policy decisions, when we know the fatal consequences of the status quo. Despite hospital admissions caused by liver disease having risen by almost 80% over the last decade, liver disease was omitted from the major conditions strategy and was overlooked in the core modalities for community diagnostic centres.

We owe it to all those affected by liver disease to set out a proper plan to improve diagnosis and treatment. We must take a holistic approach, focusing on improving every area, from research to prevention to treatment. I believe the creation of the new nationally endorsed diagnostic pathway will be key to ensuring earlier diagnosis, with less regional disparity. In the short term, I urge Ministers to deliver a prompt and comprehensive review of adult liver services by NHS England, and to ensure that local health commissioners learn from areas where fully effective pathways for the early detection and management of liver disease are already in place.

We must no longer ignore the simple truth that we cannot improve outcomes for liver disease and cancer if the staffing crisis, long waiting times for diagnosis and barriers to accessing specialist care once diagnosed continue. We are seeing it with liver disease, where the cross-over of specialist services means that those affected experience the pressures on the NHS acutely, but the same story is told in every aspect of healthcare. We must deliver more scans and more appointments every year if we are to catch cancer early.

I am pleased that Labour has committed to a £171 million a year investment to provide the NHS with state-of-the-art equipment and new technology to cut waiting times and speed up diagnosis and treatment. I very much hope we can take momentum forward from this debate and push the Government to finally implement measures to increase diagnostic rates, invest in preventative measures and improve treatment for liver disease and cancer, because those seeking treatment cannot afford for us not to.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

My hon. Friend is right about the importance of the social care workforce: social care is its workforce. I can assure him that we already have a plan for the care workforce, set out in the “People at the Heart of Care” White Paper, and now we are putting it into practice. Our care workforce pathway is already being implemented, our new accredited qualification for care workers will be launched later this year, and we are backing social care with up to £8.6 billion in extra available funding.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I was concerned to hear that a constituent of mine was initially denied access to social care for his mother who suffers from Alzheimer’s despite her inability to administer her own medication. Will the Government look to broadening the criteria of the Care Act 2014 to include those requiring support with administering medication?

[Helen Whately]

We very much want everybody who needs care to get it and everyone who is eligible for financial support should get it. That, of course, is assessed by local authorities. We are introducing Care Quality Commission assurance of social care commissioned by local authorities, to make sure people get the care they deserve and to shine a light on where local authorities are doing a really good job and where others could do better.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 17th October 2023 Commons Chamber

[Maria Caulfield]

We have had a huge response to the opening of the grant, with over 1,800 applications from voluntary groups and organisations. We are assessing those bids and hope to make an announcement before the end of the year.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Campaigns such as 3 Dads Walking and Just 3 Mums Walking have worked incredibly hard to raise awareness of suicide prevention. Has the Minister had time to meet with either of those campaigns yet?

[Maria Caulfield]

I have met with 3 Dads Walking; I have not met the mums group but am very happy to do so. Because of their intervention and campaigning, we were able to successfully put their campaign about improving mental health awareness in the school curriculum into our suicide prevention strategy. It is a cross-Government strategy, and the Department for Education has very much taken their points on board.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 11th July 2023 Commons Chamber

[Helen Whately]

The hon. Member is right that the duration is very important. One reason why we are focused so much on increasing early diagnosis is because we know that the sooner we diagnose people, the more likely they are to have a successful outcome from cancer treatment. We are seeing improvements in cancer survival. For instance, in 2010, two thirds of people would survive for one year after a cancer diagnosis; now the figure is three quarters. The NHS is working very hard on further improving cancer diagnosis, and we have reduced the number of people waiting more than 62 days since the pandemic by over a third.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

4. What steps he is taking to increase awareness of (a) cervical screening and (b) ovarian cancer.

[The Minister for Social Care (Helen Whately)]

We are catching more cancers early than ever before, and work to raise awareness of cancer signs and symptoms, screening programmes and investment in early diagnosis are all playing their part. We fund community events to raise awareness of ovarian cancer, and NHS England is working to increase cervical screening take-up by providing more convenient appointments, including at weekends and evenings.

[Mrs Hodgson]

I thank the Minister for that answer, but Target Ovarian Cancer has found that 40% of women in the UK wrongly believe that their smear test will detect ovarian cancer. There is currently no viable screening process for ovarian cancer. However, messaging remains unclear when women are going for their smear test. What steps are being taken to ensure that information provided at such screening is clear?

[Helen Whately]

On the one hand, cervical screening is incredibly important and very effective at saving lives from cervical cancer—we estimate that it saves around 5,000 lives per year. There is no evidence to support a screening programme for ovarian cancer, and I will take away the hon. Lady’s question about whether there should be communications about that when people go for a cervical smear.

Reforms to NHS Dentistry

Sharon Hodgson Excerpts

Thursday 27th April 2023 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Sadly we have been here before, time and again, and this Conservative Government still refuse to act, consigning yet another public service to the scrapheap. Once again my constituents are paying more and getting less under this Tory Government. I thank my hon. Friend the Member for Bradford South (Judith Cummins) and the hon. Member for Waveney (Peter Aldous) for securing this very important debate. We need this crisis to be urgently addressed.

It cannot be denied any longer: we face an existential crisis in NHS dentistry. It really is at breaking point. The latest area in my constituency to be affected is Pennywell in Sunderland, where the Bupa branch will close its doors in June, affecting 7,800 NHS patients. Not a week goes by without correspondence from a constituent in dire need, in despair and often in acute pain, unable to find an NHS dentist and unable to afford a private one. The nearest NHS practice accepting new patients for those constituents is in South Shields, nearly an hour away from Pennywell on public transport. That is completely unacceptable.

We cannot accept dental care becoming a luxury available only to those who can afford it. To add insult to injury, during this Conservative cost of living crisis the Government have hiked dental care prices by 8.5%. Those choices are being made by the Prime Minister and his billionaire buddies, who have never had to worry about the cost of anything such as this and do not understand the effect that that record increase will have on the cost of living pressures facing ordinary people in my constituency and across the north-east. The hike will not put a penny into NHS dentistry, either; it will just force millions to reconsider whether they can afford necessary dental treatment. We risk the horror of DIY dentistry becoming the norm.

Across 13 years, the Conservatives have chosen millions of pounds of short-term cuts, but the long-term cost of health inequalities is a price my constituents will pay for generations. The Government chose not to listen to dentists and they knew that the woefully inadequate NHS dentistry contract was not fit for purpose. That is not a new problem. Make no mistake, not only are the Conservatives allowing this crisis to worsen, but their inaction suggests to me that this is actually the result they desire.

My constituents are furious, as am I. They are either forced to pay over £100 more for the exact same NHS care they could get under a Labour Government in Wales or they are left unable to access any treatment at all. We need a Labour Government who will prioritise healthcare access for all, clear up 13 years of Tory underfunding and mismanagement, and abolish the Prime Minister’s precious non-dom status in order to provide the treatment and dental care that the British people deserve. The people of Sunderland and Washington should not have to suffer because of Tory chaos and managed decline that leave dental care a luxury for the few.

--- Later in debate ---

[Jill Mortimer (Hartlepool) (Con)]

I, too, thank everyone involved in securing this important debate, including the hon. Member for Bradford South (Judith Cummins), who so eloquently laid out the terrible state of NHS dental services in this country today and the desperate need for reform of that terrible Labour 2006 contract, which, in effect, destroyed NHS dental services in the UK. That is why I welcome the general direction of the Government’s plans for NHS dental reform, as outlined in the statement on 19 July last year. It is a good start, but we must do more. We must take this opportunity to not only put NHS dentistry back on track after disruptions during covid, but ensure we create a long-term sustainable plan to enable good NHS dentistry for all who want it.

I wholeheartedly agreed with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), when she said that

“the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work.”—[Official Report, 14 June 2022; Vol. 716, c. 135.]

That contract is the primary structural issue in NHS dentistry at the moment and has been since 2006. I have spoken to a dentist who owns 17 NHS practices across England, including two in my constituency. They are struggling financially to keep those practices going, but are totally committed to providing NHS dental services to my constituents and so push on despite the difficult environment.

[Mrs Hodgson]

Will the hon. Lady give way?

[Jill Mortimer]

No, I want to make progress.

That dentist’s many problems include the unfair way UDA rates are calculated, which ironically disadvantages areas such as Hartlepool, which have severe health deprivation. That has knock-on effects on their ability to employ staff at competitive rates and leads to a reliance on expensive locum dentists, further stretching the viability of the business. Dentists find a way to make their practices work with access contracts, but the lack of certainty they face because of the difference in competences between different integrated care boards adds further issues. For example, under one ICB’s access contract they were provided with clarity for a two-year period, but under our ICB they were still waiting to hear at the end of the month whether a contract would be renewed four days later. Not only did the survival of the practice and the jobs of 30 staff depend on that contract, but the dental care of 20,000 patients also depended on it. Thankfully it was renewed, but it is unacceptable that the ICB provided them with no indication of whether the contract would be renewed so close to its end. No business can run like that.

For areas such as mine that have a desperate need of NHS dental services, we should be fully valuing and supporting good dentists like that to ensure the survival of their essential services. I urge the Minister to consider radical reform of the way in which NHS dental service contracts are remunerated, so that established NHS dentists continue to offer NHS services to new patients. I would also like to see changes to stop newly qualified dentists being tempted into private work. It costs the taxpayer a significant amount of money to train a dentist, but they are not then required to work in the NHS. It is only fair on working people who have subsidised these professionals to train in their chosen career to expect a degree of payback. I would therefore welcome the Minister looking into the possibility of a staggered mandatory amount of NHS work per year for the first few years after qualification.

Good dental care starts with good preventive care, and I want to see a day when everyone who wants it can access NHS dental services for all routine procedures and check-ups, not just emergencies, without the difficulties that my constituents are currently facing.

--- Later in debate ---

[Mrs Hodgson]

I am listening intently to what the Minister is saying. When I go back to speak to my local dentists, what do I tell them about the “when”? He is saying all the things that we would like to do and the Government would like to do. We want to see all that happen, but when will this contract that has needed changing since 2010—[Hon. Members: “2006!”.] We had changing it in our 2010 manifesto; we said we would update it in 2010. The Government have had 13 years to fix this, so when is it going to happen?

[Neil O’Brien]

I have mentioned some things that are already changing—some of the first reforms to the contract since 2006 that we have started to bring in. We are working on the plan at pace. There is no date for its publication yet, but we are working on it at pace because we are conscious of the urgency.

I thank the hon. Member for Bradford South and my hon. Friend the Member for Waveney for securing this important debate. I hope they have been assured that we have started to reform dentistry, that we are seized of the importance of the issue, and that we recognise that we can and must go further to further strengthen NHS dentistry.

Access to GP Services and NHS Dentistry

Sharon Hodgson Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I will give way first to my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), then to my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) and then to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone).

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

My hon. Friend mentioned Somerset, but can I also mention Sunderland, to keep up the alliteration? In Sunderland, we cannot find an NHS dentist and the few good ones we have are now turning to private practice to make it work. It is an existential crisis in dentistry—it really is at breaking point. Does my hon. Friend agree that the blame lies squarely with the Conservative Government, with backlog Britain, and that this is the effect on our constituents?

[Wes Streeting]

My hon. Friend is absolutely right about the state of dentistry. It is not alliterative, but I suspect that my hon. Friend the Member for Hackney South and Shoreditch has similar points to make.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 14th June 2022 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for her tireless campaigning on the issue, which she brought up recently in the Health and Social Care Committee. I am pleased to tell her that elective orthopaedic surgery at the Princess Royal Hospital will resume from 20 June.

My hon. Friend is right about the importance of the Messenger review. There were many examples of excellent leadership in it, but sadly there were also examples of poor leadership, including bullying and blame cultures. That is why it is essential that we have this huge reform.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

As hard as all hospital leaders and managers work, sometimes something goes wrong on their watch. What follows is one such example.

On Friday, I met Joanna, a lovely mum of two young children, who was diagnosed with secondary cancer three months ago. Since then, she has been passed from pillar to post and has received no treatment at all. Unfortunately, she is now receiving palliative care. What Joanna wants more than anything is to stop what happened to her happening to anyone else. Will the Secretary of State personally look into Joanna’s case to make sure that she finally gets the treatment she urgently needs, and that no one else is failed by the system as Joanna has been?

[Sajid Javid]

Yes, of course I can give the hon. Lady that commitment. I am very sorry to hear about Joanna; I think of her, her loved ones and her two children. I will absolutely look personally into the case. I hope that the hon. Lady agrees that where we see poor outcomes, it is important to make sure that we have the best possible leadership in place.