Contaminated Blood and Blood Products

Sharon Hodgson Excerpts

Thursday 24th November 2016 Commons Chamber

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

It is a pleasure to speak in such an important debate. I want, first and foremost, to thoroughly thank my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), who for many years now has championed and pushed on this vital matter. Her work cannot and must not go unnoticed or unrecognised. I am sure people across the country, and indeed across the House, will want to join in thanking her.

The experiences of those men and women affected by this awful scandal should never be out of our minds as we continue to do all that we can to support them. Doing all we can for them is paramount, knowing full well that whatever we do will not be enough to give them back their life or a life without suffering or pain. HIV and hepatitis are terrible conditions. Someone living with HIV or hepatitis will face fears of developing other conditions and have to face the stigma that comes with these conditions. This debate is welcome, as it is the first time the House has had the chance to debate the new scheme since it was announced and to continue to hold the Government to account to do more. It is important that we now have the chance to discuss that in a considered and comprehensive manner.

In my contribution, I want to touch upon three areas: first, the current funding system in England; secondly, the involvement of private companies to administer support to beneficiaries; and, thirdly, the need for an independent Hillsborough-style panel to recognise the failures of the system that these people have had to live with.

It was announced earlier in the year that a new financial arrangements system would be introduced, and a public consultation was conducted to get views and opinions on how that would take shape. Although there has been a welcome, if somewhat modest, increase in the annual payment to people with HIV, hepatitis C at stage 2 and those who are co-infected, as well as the first guaranteed ongoing payments for people with stage 1 hepatitis C, it is concerning that these payments fall short of what has been drawn up in Scotland.

Also, the current English system makes no mention of support for people who have been cleared of hepatitis C prior to the chronic stage but who, despite fighting off the disease, may still exhibit symptoms ranging from fatigue to mental health issues and even diabetes. These people have never been entitled to any support, and continue to get none. The scheme does not include support for those infected with other viruses, such as hepatitis B, D or E, and for those people it has meant continuous monitoring of their liver function. It is estimated that that group is extremely small and, according to the Haemophilia Society, would be a minimal cost to the Department of Health.

We find that the new scheme does little or nothing for bereaved partners, parents or children of those who have sadly died from diseases contracted through the contaminated blood scandal. The new system should have gone a long way to supporting those various groups within the affected community. I hope that the Minister can give us some reassurance that those concerns have been noted, and that she will go away and look into what more can be done to help the people I have just mentioned.

There are also concerns regarding the discretionary payments, which, thankfully, were saved, despite it being announced in the consultation earlier this year that they could be scrapped. That should be welcomed, but there is a clear concern that the discretionary support will not go far enough to improve the support on offer for those with HIV or those who are co-infected. The Government need to consider that impact and what more they plan to do. It is worrying that the Government have yet to make clear the minimum and maximum discretionary support that people will be able to receive.

I understand that the Reference Group on Infected Blood is currently considering that policy and that we will hear more from it in the new year, but would it not be worth while for the Minister to give us some indication now, so that those who will depend on this money in the years to come can have some reassurance, especially as we enter the festive period? There are many questions to be answered. That is why I hope that in the time allowed the Minister will give us in the House and those who will be watching the debate the reassurances that they need.

The new scheme will replace the current system so that the five trusts across the country that administer the payments are amalgamated into one, and I know that that has been welcomed. However, there is one very concerning point that was so eloquently put by my hon. Friend the Member for Kingston upon Hull North when she opened the debate and which needs to be addressed by the Minister. I refer to the potential involvement of a private sector company, such as Atos or Capita, which both bid in the tender process. The Minister no doubt expects me to make the typical party political point, but I am not going to do that.

That potential involvement was never included in any talks with the all-party parliamentary group on haemophilia and blood contamination, no consultation was held with the affected community, and there was no mention of it in the Department’s response to the survey, yet we see it happening now. The concern here is that the many thousands of people affected by the mistake—which, it must be remembered, was often made by US private companies—feel aggrieved at the potential involvement of a profit-making private company. That resentment is justified, especially as it was the mistake of a private company that put them in their current situation. There should be no profit making when it comes to compensating for the failures of the private sector. That was highlighted well by my hon. Friend in her speech and was also touched on by the former Health Minister, the right hon. Member for North East Bedfordshire (Alistair Burt).

The issue was highlighted too by the APPG’s survey of nearly 1,000 people affected by the scandal, who clearly had concerns about the involvement of a profit-making private company. It is important that those affected have their say in the administration of the payments and support. I would therefore be interested to hear the Minister’s thoughts on their involvement, as we have seen in Scotland, where there has been an alternative scheme operator which includes beneficiary involvement. Perhaps the Minister can tell us why private involvement is now being considered, but was never consulted upon.

My final point is about co-ordinating an independent panel, such as in the case of Hillsborough. The Prime Minister promised in September that she would keep an open mind about an independent panel, but she has, sadly, quashed the idea. The rationale given is that we have had two public inquiries into this matter already, by Lord Archer and Lord Penrose. That may be the case, but it is important that we consider the approach to helping people to get the justice they deserve, especially as it is clear that neither of the inquiries met the needs of the affected community. The two inquiries were narrow in their focus and were not about apportioning blame. The affected community is not calling for that. What it is calling for, which is strongly supported by the Opposition, is a truth and reconciliation process and public disclosure of the failures, which those affected rightly deserve.

[Mark Durkan]

On the need for some vehicle of inquiry into the background, in an intervention I pointed out that, in the Irish Republic, the right to compensation was established in 1995. There was an Act in 1997, but it was following a tribunal of inquiry that the state admitted liability, so there was further legislation in 2002. The liability of the Irish state rested on the fact that the tribunal found that the state knew that there was a risk and carried it because the UK and others were prepared to carry the same risk.

[Mrs Hodgson]

I am grateful for that important intervention, which emphasises why we need an inquiry into issues such as the one that the hon. Gentleman has raised.

I am sure the Minister can understand the concerns across the House and out in the community among the people affected and their families. Before she replies, I ask her not to adopt the same language as that used by the Prime Minister, who attributed the lack of support for an independent panel to the delay in the introduction of a support system. An independent panel with clearly defined terms of reference would not impede the development and implementation of the new system. I hope the Minister will keep that in mind when she responds, and recognise how important it is for those affected to get the reconciliation for which they have fought so long.

The Government must be committed for reforming the system and listening—must be commended, rather, for reforming the system and listening. I know they are committed to that. However, this is such an important issue that we must get it right, and once more I thank my hon. Friend the Member for Kingston upon Hull North for her steadfast campaigning on this issue over many years. I am sure the community will also recognise that fact. Those people who have had their lives marked so significantly by the failures of the past should rightly be compensated and respected. Those who have died because of that serious mistake, those who are still living with the repercussions of the mistake, and those who have thankfully fought it off but still live with the impact of it all deserve respect and dignity, and I hope that in her reply the Minister will give them just that.

Reducing Health Inequality

Sharon Hodgson Excerpts

Thursday 24th November 2016 Commons Chamber

[Maggie Throup]

My hon. Friend makes a good point. It is not just Tesco that has done that; so have Waitrose and Morrisons, to name just two—I am sure there are many more. It is really good that major retailers have taken on board the severity of the challenge faced both by us as a nation and globally. Parents need to be role models, as do retailers. Sometimes they are not quite the role models that they should be, but we need every bit of help we can get.

It is not just childhood obesity that is linked to social class and to different levels of deprivation; adult obesity is, as well. The highest prevalence of excess weight for both men and women is found among low socioeconomic groups. If current trends continue, almost half of women from the lowest income quintile are predicted to be obese in 2035.

Obesity is the single biggest preventable cause of cancer after smoking. The Government acknowledge the importance of early cancer diagnosis, and dedicated NHS staff at all levels are committed to delivering that, so surely every preventive measure that can be put in place, must be. As previously noted, as well as cancer, obesity leads to a greater risk of type 2 diabetes and heart disease. Those conditions are all life-changing and life-limiting.

I am sure people now understand that there is a link between obesity and diabetes, but, sadly, I fear that many think they can just take a pill to keep diabetes under control. Sadly, for far too many diabetes sufferers, that is not the case. The consequences are vast, with many diabetes patients needing lower limb amputation and suffering kidney disease, heart disease and sight loss—as I said, it is life-limiting and life-changing. Action needs to be taken now to turn around what I believe has become an obesity epidemic.

Everything I have talked about should prompt a reconsideration and review of the Department of Health’s childhood obesity plan. Although the Government were leading the world in producing the plan for action, when it was published, many, myself included, said that it was quite a let-down. I stand by that view. There simply was not enough detail in that 13-page document. It was aspirational, rather than a focused plan of action; it ignored the recommendations of Public Health England, which were endorsed by the Health Committee; and it did not set firm timescales for turning the tide on childhood obesity.

The plan we have is insufficient for the scale of the task we have to tackle. That does not mean starting all over again, however; it means that we need to do more. We need clear actions and timescales. I acknowledge that there is a fine balance between a nanny state, business co-operation, and parental and personal responsibility, but I am sure it is not impossible to find that common ground. Yes, it is the responsibility of parents to ensure their children eat healthily, are physically active and learn good habits that will last a lifetime, but time and again that has proven insufficient by itself. Parents need more help and the current childhood obesity plan cannot and will not give them what they need.

It would also be a mistake to think the answer lies in burdensome regulation of business, namely the food and drink sector. Demonising that sector is both unhelpful and unfair. As we have discussed, some producers, manufacturers and retailers have already taken great strides in reformulating products and encouraging healthier consumer behaviour. We must commend them and welcome those actions. Evidence suggests that the least affluent households in the UK have higher absolute exposure to junk food advertising than the most affluent households. Interventions such as reducing the promotion of junk food, or the soft drinks industry levy, are likely to have a positive impact on reducing health inequalities by delivering change across the population and consequently delivering disproportionate benefit to the most deprived communities.

Just as the current plan does not help parents, however, it likewise does nothing for business, which would be better served by clear goals for reformulation, advertising and labelling, and timeframes in which those must be achieved. Both publicly and privately, many businesses in the sector note that they would be better served by clearer, more far-reaching Government recommendations that at least gave them a measure of certainty for the future.

We may well be horrified by the national child measurement programme figures and other data we read on an almost daily basis now. Just this week, Cancer Research UK revealed that teenagers drink almost a bathtub full of sugary drinks on average a year—I hope that a visual representation will shock some teenagers into changing their habits rather than suffering the consequences.

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

The hon. Lady is making an excellent and thoughtful speech—she will be pleased to hear that there has been nothing in it that I have disagreed with so far. Was she therefore as disappointed as I was at the removal from the childhood obesity plan—we can only guess at why—of targets on halving childhood obesity, as well as measures on advertising and marketing that would have helped with the issues she has been discussing?

[Maggie Throup]

I thank the hon. Lady for that intervention. I will come on to that point when I make some requests of the Minister towards the end of my speech.

We know that childhood obesity levels will not drop tomorrow, but we need to see some signs in the next few years that they are declining. The foundations of an effective strategy are readily available in the form of the Public Health England recommendations and the Health Committee’s report.

In conclusion, when the Minister responds, I would like to hear a firm commitment to the soft drinks levy; clear goals for product reformulation and timeframes within which those should be achieved; action on junk food advertising during family viewing; and action on supermarket and point-of-sale promotions—for example, we do not want to go to buy a newspaper and be offered a large bar of chocolate. I would also like to hear what accountability will be put in place to ensure that schools provide the exercise outlined in the plan. Such measures would ensure that we had a strategy, rather than just a vision, and enable us to start tackling the obesity challenge in our society today.

--- Later in debate ---

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

I welcome the opportunity to speak in the Chamber for a second time today, on yet another important topic. This time we are debating health inequalities and I thank the Backbench Business Committee for allowing this debate to take place following the application by the hon. Member for Totnes (Dr Wollaston) and other hon. Members across the House. The hon. Lady made an excellent speech, and we are very grateful to her for that. I also want to thank other hon. Members across the House for their excellent contributions today. I especially want to highlight the excellent speeches by my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) and my hon. Friends the Members for Stockton North (Alex Cunningham), for Bradford South (Judith Cummins), for Heywood and Middleton (Liz McInnes) and for Hackney South and Shoreditch (Meg Hillier).

I enjoyed the speeches by the hon. Members for Plymouth, Sutton and Devonport (Oliver Colvile)—a fellow member of the all-party parliamentary group on basketball—and for Erewash (Maggie Throup), who made an excellent speech on obesity and childhood obesity. I also enjoyed the speech by the hon. Member for Glasgow Central (Alison Thewliss). As she knows, I agree with most of what she says, especially about breastfeeding. We have had an excellent debate, with excellent contributions all round.

When it comes to addressing health inequalities, there are many conversations about the need for systemic change to reverse the trends. However, I want to look at tangible specifics that the Minister can get to work on in her remit as Minister for public health. I will do that by looking at the current state of health inequality and then the two key areas of smoking and childhood obesity and what more can be done to address those signifiers. I will then move on to the cuts to public health grants, which are exacerbating the situation.

The most recent intervention on health inequality came from the Prime Minister, who used her first speech on the steps of Downing Street to highlight that,

“if you’re born poor, you will die on average 9 years earlier than others.”

We have heard clear examples of that from constituencies around the country. That welcome intervention set the tone of her Government’s serious work to address health inequalities.

It is hard not to agree when the facts speak for themselves. Two indicators from the most recent public health outcomes data show that London and the south-east have the highest life expectancy while the north-east and north-west have the lowest. The same pattern appears when looking at excess weight in adults, which we have also heard about today. Rotherham comes out the highest at 76.2% and Camden is the lowest at 46.5%. Those figures prove what we all know to be true: people living in more deprived parts of the country do not live as long as those in more affluent areas. Contributors to ill health such as smoking, excessive alcohol consumption—which we heard about from the hon. Member for Congleton (Fiona Bruce)—and obesity are more prevalent in deprived areas.

There is a moral argument that it is important for the Government to address such issues, so that we can improve our nation’s health, but there is also an economic argument to be made. If we have an unhealthy population, we will not be as productive. In England, the cost of treating illnesses and diseases arising from health inequalities has been estimated at £5.5 billion a year. As for productivity, ill health among working-age people means a loss to industry of £31 billion to £33 billion each year. Those two arguments must spur the Government into action, but there are many issues to tackle and multiple ways for the Government to address them. Many such issues have been raised in the debate but, as I said, I will examine two key areas that the Minister must get right: smoking cessation and childhood obesity.

My first outing as shadow Public Health Minister was to debate the prevalence of tobacco products in our communities and the need for the Government to bring forward the new tobacco control plan.

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

indicated assent.

[Mrs Hodgson]

The Minister remembers it well. The Government need to set out key actions to work towards a smoke-free society. Smoking is strongly linked to deprivation and has major impacts on the health of those who do smoke, such as being more prone to lung cancer and chronic obstructive pulmonary disease and facing higher mortality rates. If we look at that by region, which I have already established is a factor in health inequality, smoking levels are higher in the north-east at 19.9% compared with the lowest in the south-east at 16.6%. When looking at smoking by socioeconomic status, we find that the smoking rate in professional and managerial jobs is less than half that in routine and manual socioeconomic groups, at 12% and 28% respectively.

In the debate held just over a month ago, the Minister was pushed on when the new tobacco control plan would be published. Concerns have been raised by various charities, including ASH, Fresh NE and the British Lung Foundation, about how the delay could jeopardise the work already done. Sadly, the Minister evaded my specific question back then, so I will ask her the same thing again: when can we expect the new plan? Will it be this year or next year? The plan will not only go a long way to work towards a smoke-free society, but help to reduce health inequalities in our deprived areas. The Minister can surely understand that and the need to come forth with the plans.

The Minister knows that I also take a keen interest in childhood obesity. She has said repeatedly that the publication of the childhood obesity plan was the start of the conversation. Childhood obesity is the issue on everyone’s lips right now as it is the biggest public health crisis facing the country. I will not repeat the stats we all know about the number of children who start school obese and the number who leave obese—they are shocking. Many organisations and individuals, including Cancer Research UK, the Children’s Food Trust and Jamie Oliver, have made clear their dismay at the 13-page document that was snuck out in the summer and have said that it did not go far enough. Incidentally, it came out on the same day as the A-level results, so it looked like it was being hidden.

Obesity-related illnesses cost the NHS an estimated £5.1 billion a year, and obesity is the single biggest preventable cause of cancer after smoking. It is also connected to other long-term conditions such as arthritis and type 2 diabetes. When obesity is linked with socioeconomic status, we see real concern that the plan we have before us will not go far enough to reverse health inequality. National child measurement data show that obesity among children has risen, and based on current trends there could be around 670,000 additional cases of obesity by 2035, with 60% of boys aged five to 11 in deprived communities being either overweight or obese. There is a real need for the Government to come to terms with the fact that many believe the current plan is a squandered opportunity and a lot more must be done. That is why I hope the Minister will be constructive in her reply to this debate, giving us reassurances that move us on from this being “only the start”. At the end of her speech, the hon. Member for Erewash gave us a list of four or five items that we could start straightaway, which would certainly take us further on.

The Government have stalled or not gone far enough on the plans I have mentioned, but there is also deep concern that the perverse and damaging cuts to public health spending will widen the health inequality gap. The Minister knows the numbers that I have cited to her previously, but I will cite them again, even after my right hon. Friend the Member for Kingston upon Hull West and Hessle has done so. We are greatly concerned about the £200 million cut to local public health spending following last year’s Budget, which was followed by the average real-terms cut of 3.9% each year to 2020-21 in last year’s autumn statement. I want to add some further concerns that go beyond those raised by Labour.

Concerns were identified in a survey by the Association of Directors of Public Health, which found that 75% of its members were worried that cuts to public health funding would threaten work on tackling health inequalities. Those concerns are backed up by further evidence published by the ADPH, which found that local authorities are planning cuts across a wide range of public health services, because of central Government cuts. For example, smoking cessation services saw a 34% reduction in 2015-16, and that will become 61% in 2016-17, with 5% of services being decommissioned. That is seen across the board among local public health services and will be detrimental to reversing health inequalities. For the Government to fail to realise that cutting from this important budget will not help the overall vision on health inequality, set out by the Prime Minister earlier this year, is deeply worrying and shows a distinct lack of joined-up thinking around this issue.

In conclusion, health inequality is a serious issue that we cannot ignore or let the Government get wrong, as the health of our nation is so important, not only in a moral sense, but economically. I know the Minister will fully agree with the Prime Minister’s statement from earlier this year—there is no second-guessing that, as we all do—but we need radical proposals that get to the bottom of this persistent issue, which blights the lives of so many people living in our most deprived communities. We all want to see a healthier population, where nobody’s health is determined by factors outside their control, and we must all work together to get to the point where it is no longer the case that the postcode where somebody is born or lives determines how long they will live or how healthily they will live that life.

Diabetes Technologies

Sharon Hodgson Excerpts

Wednesday 23rd November 2016 Westminster Hall

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

It is an honour to serve under your chairmanship today, Mrs Gillan.

I welcome today’s timely debate on access to diabetes technology, which falls in Diabetes Awareness Month. I congratulate the hon. Member for St Ives (Derek Thomas) on securing this important debate and I pay tribute to my hon. Friend the Member for Copeland (Mr Reed), who is not present today, for all his campaigning, work and efforts on the subject over the years.

I also thank the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the Scottish National party, and I commend my right hon. Friend the Member for Knowsley (Mr Howarth) on his excellent contribution on young people with type 1 diabetes, and for highlighting the worrying danger of abuse by young people who skip insulin in order to lose weight. I had heard of that before, but I am grateful that he brought it to our attention today, so that the Minister may respond. As my right hon. Friend said, it is often due to the pressures of society and body shaming and it can, sadly, often be fatal. It is yet another pressure on these young people: aside from having the diabetes diagnosis in the first place, it is something else that they have to deal with.

I also want to disclose from the off that sadly I was diagnosed as a type 2 diabetic just a year ago, but through getting control of my diet and achieving weight loss, which is still ongoing, my diabetes is thankfully very well under control. This debate is therefore very close to my heart.

More than 4 million people and counting in the UK are now living with diagnosed diabetes. Some 400,000 live with type 1 diabetes, and 29,000 of those are children. I am hopeful that in the future, artificial pancreas technology, which we have heard about today, will be effective, safe and accessible to patients, and that eventually, thanks to important research undertaken by the Juvenile Diabetes Research Foundation, Diabetes UK and others, we will create a world without diabetes.

However, until that time comes, it is paramount that we do all we can to support adults and children living with the condition. Patients need accessible and high-quality education and support, and access to technology that will allow them to manage their condition and to achieve positive outcomes. Not only will that have a positive effect upon the lives of those 4 million people, especially including children, but it could also reduce NHS spend on diabetes-related complications.

There have been significant advances and improvements in care for people living with diabetes over the last 15 years or so, but it would be an enormous mistake for us to believe that the job was done. It is far from done and a significant amount of work needs to be undertaken to improve diabetes outcomes. That is because more than 24,000 people a year currently still die from a complication or condition related to diabetes, and many more will encounter life-altering, non-fatal complications. It is worth noting that diabetes-related complications account for a staggering 80% of the £10 billion annual NHS spend on diabetes.

Worryingly, there is also a regional dimension to the challenges presented in relation to positive diabetes outcomes. According to the national diabetes audit 2012-13, diabetes education courses are not being commissioned for people in more than a third of areas in England. Moreover, gateway treatment for both type 1 and type 2 diabetes is undertaken through primary care. However, with a GP shortfall of 40% across the north of England—my region—it is clear that accessibility is limited in certain parts of the country. Meanwhile, some CCGs have particularly large concentrations of people with type 2 diabetes and, it has to be said, there are correlations between those areas and socioeconomic disadvantage. The Government might well approach funding allocations with that in mind.

However, the issue we are discussing, which must be considered alongside the aforementioned points, is supporting patients to access technologies easily that will better help them to manage their condition, from insulin pumps to continuous glucose monitors, to flash glucose meters—a lot of them were spoken about by the hon. Member for St Ives. The technologies to which I refer make monitoring blood glucose more convenient for people than a standard blood glucose meter does, and in turn, those technologies can transform peoples’ lives. Continuous glucose monitors—CGMs—such as the Dexcom device, and flash glucose meters, such as the Abbott FreeStyle Libre device, are considered by many to be a less invasive technique than blood glucose meters for measuring blood glucose. They work 24 hours a day and CGMs can include alarms to indicate when glucose levels are too high. That is particularly important for people who do not know that they are experiencing hypoglycaemia, and children who may be unable yet to communicate it.

It is critical that the House understands the importance of blood glucose readings for people living with diabetes—both types—but it is of essential importance for people living with type 1. With type 2 patients, as I have found, blood glucose is usually monitored and controlled over a long period of time and the scope for immediate blood glucose correction is limited. For people living with type 1—people whose control depends upon the use of insulin delivered through an injection or a pump—accurate, real-time data are essential for blood glucose control.

To put it simply: better blood glucose control will result in better outcomes for people living with type 1 or type 2. It will relieve significant pressure on the NHS and result in a significant and positive long-term financial gain. Access to CGMs and flash glucose meters is limited on the NHS, and National Institute for Health and Care Excellence guidelines do not recommend that CGMs are offered routinely even to adults with type 1 diabetes, but funding should be considered in a small number of specified circumstances. Meanwhile, children and young people must either have frequent severe hypoglycaemia, impaired awareness of hypoglycaemia associated with adverse consequences, or the inability to recognise or communicate about symptoms of hypoglycaemia in order to be eligible for a CGM at the moment.

The guidelines, which can be difficult for health professionals, adult patients, and parents alike to navigate, are an obstacle to accessing life-changing technologies for people living with diabetes. As such, I hope that the Government will take steps to encourage CCGs to increase the take-up of CGMs—I apologise for all the acronyms—and flash glucose meters, and that eventually work will be undertaken, in conjunction with NICE, to look at increasing and improving access to diabetes technologies at a faster rate than patients currently experience.

The running cost of a CGM is around £3,000 to £4,000 a year, whereas a flash glucose meter costs around £1,300 a year. That represents a significant personal cost to many of those who are unable to access these technologies through their CCG, and who therefore have little choice but to self-fund. Lots of parents do this for their children especially. In considering the financial impact of diabetes, we must recognise that diabetic technologies should not be available only to those who can afford to self-fund. Allowing the continuation of the disparity between people with diabetes who can afford to make use of life-changing technologies and those who cannot undermines the principle of a truly national health service.

It is also important to consider that investment in the new technologies could save the NHS vast amounts in the long term. That is because they can help to avoid severe night-time hypos, and severe hypos cost the NHS £13 million a year. In addition, as I have mentioned, diabetes-related complications account for 80% of the total NHS spend on diabetes, and supporting patients to better manage their condition through access to CGMs and flash glucose meters will inevitably seek to reduce that cost. That is a significant saving, before we even begin considering the impact of hypoglycaemia on the UK economy as a whole.

Finally, during Prime Minister’s questions, in response to my hon. Friend the Member for Copeland, the Prime Minister stated:

“There are many youngsters out there, from tiny tots to teenagers, living with type 1 diabetes. It is important that we send a message to them that their future is not limited: they can do whatever they want.”—[Official Report, 20 July 2016; Vol. 613, c. 821-22.]

I am sure that all of us in the Chamber today very much welcome her comments. I hope that they represent a forthcoming commitment by the Government to improve access to life-changing technologies for adults and children to reduce any obstacles that they might otherwise face.

I ask the Government to commit to working to improve access to diabetes management education, support, and access to emerging technologies. We must ensure that emerging technologies reach the public in a timely manner, and that innovation, to make them even more user-friendly and to encourage take-up, is also supported and encouraged by the Government.

A national focus on access to diabetes technologies has its roots not only in clinical, but in financial arguments, as well having national support. So far, more than 26,000 people, from every single constituency in the UK, have signed a petition initiated by my hon. Friend the Member for Copeland calling for CGMs to be made available as a right on the NHS to adults and children living with type 1 diabetes. Moreover, 25 cross-party colleagues have signed an early-day motion in a similar vein. I extend my support to those cross-party calls to ensure that such technologies become accessible to adults and children living with diabetes—especially type 1—so as, ultimately, to improve the lives of those who need those technologies.

Self Care Week

Sharon Hodgson Excerpts

Tuesday 22nd November 2016 Westminster Hall

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

It is an honour to serve under your chairmanship, Mr Walker. I welcome this important debate and the fact that it has been secured during Self Care Week—

[Sir Kevin Barron]

Just after it.

[Mrs Hodgson]

Just after Self Care Week. I commend my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) for securing this debate and for his excellent speech, which shows his deep knowledge of and passion for all matters relating to the health of our nation, especially with regard to preventive health measures. I thank him for that.

This debate is especially important, as it is the first time we have had a dedicated debate on self-care in a very long time. We heard an excellent contribution from the hon. Member for Linlithgow and East Falkirk (Martyn Day). Before we hear from the Minister, I want to look at the issue of self-care and the wider picture of preventive measures through the lens of the cultural shift in the NHS away from care and repair to prevention and wellbeing promotion. I will also look at how aspects of current Government policy, such as the cuts to public health funding—I know I keep banging on about that, but it is important—is detrimental to our shared vision for an improved NHS and to achieving a healthier nation.

When NHS England’s “Five Year Forward View” was published just over two years ago, we were promised a radical upgrade in prevention and public health. That belief in reshaping the approach of the NHS and our health services away from a sickness alleviation service towards a wellbeing service that promotes healthier lifestyles choices, improved wellbeing and the prevention of ill health through behavioural change is supported across the NHS and in wider society.

That shift is paramount when we see the NHS in a state of crisis, with longer A&E waiting times and GP appointments becoming harder and harder to come by. One in four patients wait at least a week to see their GP. My husband had to wait three weeks to see the GP because it was not an emergency, but he thought it was an emergency; sometimes we do not know, and it is up to the doctor to decide what is important and what is not.

Some parts of the NHS are at crisis point. That is not a party political point at all; it is supported by health organisations such as the Nuffield Trust and the Health Foundation, which professed this time last year that the NHS was at risk of a “catastrophic collapse”. If the worrying trends in waiting times that I have described are ever to be reversed and we are to save the NHS, we need to have a wholesale rethink about the way we approach health policy. Prevention must be the key, and self-care should be a central part of that reconsidered approach.

Self-care is about empowering people and patients to maintain their own health through informed lifestyle choices, better awareness of symptoms and better awareness of when it is important to seek professional advice—for example, for possible cancer symptoms, where early diagnosis is absolutely crucial and a matter of life and death—and when an ailment can be treated by someone themselves in the appropriate manner by talking to their community pharmacist, as my right hon. Friend the Member for Rother Valley described on the occasion of a family holiday. With improved confidence, people can take control of their own health or long-term conditions much better and make decisions that are far better for the NHS.

It is completely understandable that when we are unsure about the cause of symptoms or the best course of treatment or care, our first port of call is the NHS. However, being more aware of how we can treat ourselves and having preventive practices in place that reduce the prevalence of ill health will help go some way towards pulling the NHS back from the brink. The NHS is a trusted bastion, but sadly we are seeing more and more people accessing NHS services when there is no need and when a chat to one of our excellent community pharmacists would have sufficed—for example, in the cases we have heard about today of splinters, paper cuts, hiccups or broken nails. A bit of common sense is all that is needed, certainly not a trip to A&E.

In 2014, A&E departments across the country dealt with 3.7 million visits for self-treatable conditions such as those mentioned today, as well as the common cold, flu or muscle pain, combined with 52 million visits to the GP for similar conditions. It is no wonder people cannot get an appointment when some people are going to see their GP for that sort of thing. That has an estimated cost to the NHS of more than £10 billion over the past five years, which is not a small or insignificant amount of money.

Self-care is a crucial preventive measure that must be developed further to ensure that the NHS is as resilient as possible and can respond in more effective and meaningful ways to the nation’s health. With all that in mind, it is deeply worrying that the vision set out in the “Five Year Forward View” has progressed little or not at all. That is seen most clearly through the Making Every Contact Count initiative, which aims to make NHS staff members an important part of boosting awareness of healthy living, rather than only administering healthcare to the sick. It is a fantastic initiative. In theory, that strategy can go far in addressing issues around lifestyle choices such as smoking, drugs, diet and alcohol consumption by just adding a one or two-minute conversation when a healthcare professional already has someone in front of them.

It is worrying that the progress and roll-out of that scheme is patchy, despite there being lots of good practice across the country, such as the social prescribing service in Rotherham that my right hon. Friend talked about. Where such system change is flourishing and showing that it can support a reduction in pressures on NHS services such as A&E and GP practices, it should be encouraged, and the roll-out should be far more substantial.

I hope the Minister can give us some reassurance on three key asks for the Make Every Contact Count initiative: first, that we see progress made on the scheme in the new year, as promised by Professor Fenton from Public Health England during the second oral evidence session for the APPG on primary care and public health inquiry; secondly, that best practice is made more readily available to improve provision across the country through the Self Care Forum’s database of best practice; and thirdly, that he commits to ensuring CCGs prioritise implementation of the scheme in their local areas and that training is provided for staff, to equip them to provide consistent self-care messaging.

It should not go without saying that there are examples across the country that show the innovative and positive impacts of improving self-care, such as a scheme in my own neck of the woods in South Tyneside—the neighbouring borough to my own—where a borough-wide conversation has been developed that shifts away from asking, “How can I help you?” and instead asks, “How can I help you to help yourself?”

Those initiatives need funding and encouraging from Government to succeed. However, what we are currently seeing has been described as a frustrating and perverse approach to preventive measures, with cuts to public health funding of £200 million in last year’s Budget, along with an average real-terms cut of 3.9% each year to 2021, announced in last year’s autumn statement. Hopefully tomorrow we will see our new Chancellor go some way to rectifying and reversing that; we can live in hope, unless the Minister has some insight into what the Chancellor will announce. We will keep our fingers crossed.

The Minister is well aware of my opinion on those cuts, because we discuss them every time we meet, and the need to rethink the whole approach, but it is not only me saying this. Only recently, the Health Committee, chaired by the hon. Member for Totnes (Dr Wollaston)—who I am sure would have been here today if not for the health debate coming up in the Chamber very soon—uncovered serious concerns about the finances and funding of the NHS and public health. In a letter to the Health Secretary in October, the Committee said:

“All the indicators suggest that demand is continuing to grow and that we need to go further on prevention”.

I could not agree more. These cuts are a false economy and are exacerbating the situation within our health services. We are seeing funding directed to our crisis-ridden A&E departments, which are having to crisis-manage failures that could have been addressed a lot sooner.

The Minister needs fully to understand that to make cuts to one part of our health service without considering the impact on other parts is leading us down the road to rack and ruin. To give him some understanding of the cuts, I suggest that he look at the Health Committee report “Public health post-2013”. The Select Committee does good work, but the Chair is not here to hear me highlight all this work. The report that I have just mentioned highlights research by the Association of Directors of Public Health, which found that local authorities are planning deep cuts to public health services due to the cuts coming from central Government to local authorities. It shows a marked rise for 2016-17 compared with 2015-16.

The Government need to have a wholesale rethink of the funding of the NHS and public health services that sees a redirection to prevention, which will go some way towards addressing many of the problems in our health service that are now being documented weekly. I hope that the Minister takes some time in his response to consider the points that I have raised in relation to public health funding and how current actions are failing the vision of the five year forward view and the health of our nation. Self-care needs properly to be funded and supported to be innovative, so that we ensure that the continuing crisis facing the NHS can be reversed. We cannot continue as we are, because our NHS is too precious to let it fail. The health of the nation needs to be protected, where possible, to enable people to lead long, happy and fulfilling lives.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 15th November 2016 Commons Chamber

[Nicola Blackwood]

I very much welcome the hon. Gentleman’s support for a key plank of the childhood obesity strategy, which is helping all children to enjoy an hour of physical activity every day and which will include physical movement as well as specific physical education.

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

Another target that “Dispatches” uncovered was to be scrapped was the target to halve childhood obesity by 2026. This was compounded by recent national childhood measurement data showing that obesity is on the rise and that obesity rates are more than double in deprived areas compared with more affluent ones. Instead of squandering this opportunity, the Government should be pushing ahead with a comprehensive and preventive strategy. Can the Minister explain, therefore, why this significant target was dropped from the Government’s plans to tackle childhood obesity?

[Nicola Blackwood]

The hon. Lady is right to say that the childhood obesity strategy is one of our key priorities for tackling health inequalities in the UK. Obesity prevalence for children living in the most deprived areas is double that for those living in the least deprived areas, and the gap continues to widen. That is exactly why we will press ahead with the plan, but, as she has said, this is just the beginning of the conversation and we will continue to fight obesity as a government priority.

National Arthritis Week

Sharon Hodgson Excerpts

Thursday 20th October 2016 Westminster Hall

[Lyn Brown (West Ham) (Lab)]

I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate, and for his excellent contribution. I also thank the charities, such as Arthritis Research UK, that work every day to reduce the suffering brought about by joint disorders.

Last week was National Arthritis Week. The pain of arthritis is often invisible. Trying to explain its constant, chaotic pain to someone who has not lived with it can be very hard. A survey conducted by Arthritis Research UK found that 28% of women with arthritis feel that people do not really understand the pain they face. Despite trying to talk about it, they feel lonely with the disease. That is why today’s debate is so important. By talking about arthritis in this place, we can begin to tell people that they are not alone.

I want to do that in a literal sense, by sharing my experiences of arthritis. In March 2015, we were two months away from a general election, which, as Members on both sides of the House know, is a difficult, stressful and busy time to be a politician. As part of the shadow ministerial team, I was driving up and down the country with my tiny dog Cara in tow, visiting fire stations and sharing Labour’s plans for the future of the fire service. It should have been an exciting spring, sharing a vision that I was passionate about, and introducing my little four-legged friend to a bunch of soppy but very brave firefighters. However, it was made difficult as I had been experiencing mobility problems for quite a while, and it was not unusual for me to be in constant pain and experiencing stiffness. However, until that point I had been able to fight through. I had not considered that I had a condition.

In March, I finally hit a brick wall. I felt completely and utterly drained of energy and could barely walk more than a few steps. I had to drag myself up the stairs of my house by pulling on the bannister. I was unable to stand at street stalls for any length of time, or go canvassing. I contacted voters only on the phone, or at meetings where I could be completely sedentary. I needed help putting on my bra. I felt humiliated, embarrassed and a complete and utter failure. At the worst, I was struggling to stay awake for more than six hours a day. It can be imagined what that did to my mental health. The stress of not being able to fight that election on my own terms was overwhelming. The tiredness and pain were looked after by a specialist, but throughout that period I had no idea whatever of what the problem was. At times like that, the internet is not a best friend. My imagination was in overdrive. Only the support of good friends, comrades, my wonderful husband and my family got me through that election.

Let me be clear. I do not want to come across as some kind of stoic hero. I am not. I cried, mainly in my doctor’s surgery as I was trying to get some answers. The staff must have thought I was completely wet. I found it really difficult to cope with the condition and the demands of work at that time. I know that many people have that feeling, and it is little wonder that musculoskeletal conditions account for one in five working days lost to ill health in the UK.

Despite being referred to my arthritis service in November 2014, it was early May 2015 before I was finally diagnosed with seronegative inflammatory arthritis. I now know that fatigue is very common among sufferers of arthritis due to pain, stress and sleep disturbance. More specifically—this is not very well known out there—fatigue is a symptom of inflammatory arthritis. Chemicals called cytokines are found in the inflamed tissues and cause extreme fatigue.

At that point I was put on a course of methotrexate, which thankfully caused the aggressive nature of the condition to begin to recede, but it was still quite aggressive, and I needed additional medication to get me to where I am now, taking methotrexate and injecting myself every fortnight with CIMZIA, a biological injectable medicine. The pain and restrictive movement have now subsided considerably. A number of colleagues have told me as I walk around the House that I seem to be doing much better, and I am.

When I first met my arthritis specialist, she asked me what my goals were. I said I wanted to be able to walk Cara again, to wear heels and to play tennis, which would be some feat as I have never played tennis before. She laughed and said, “Let’s keep this realistic and start with walking the dog.” I am happy to say that with the support of the NHS I can now walk Cara for over an hour, almost entirely pain-free. At Christmas last year, I bought a pair of blue polka dot shoes as an incentive and a symbol of hope. I have worn them twice and, although they are not as high as those of the Prime Minister, or indeed our former shadow Chief Whip, my right hon. Friend the Member for Doncaster Central (Dame Rosie Winterton), they are a symbol of the progress I am making. What is more, I have just enrolled on a course of tennis lessons, which I will start in March next year, two years after I hit that dreaded wall.

I have had good treatment, advice and support, and I thank my doctors for that from the bottom of my heart. Ten million people in the UK suffer the pain of arthritis and not all are as lucky as I have been. Moreover, I am told that with an ageing population and rising physical inactivity, the number of people living with arthritis will rise. We must make sure that every patient has access to excellent treatment. Due to the high cost of the drugs and the guidelines of the National Institute for Health and Care Excellence, most patients have to wait at least a year before they can access the transformative biologics that have made such a huge difference to my life. I had to wait just over a year, and that year was hard.

The wait means that we are not controlling the condition at an early stage or enabling patients to stay active, independent and in employment. Surely this wait is not cost-effective to industry and the economy. I know that this is ultimately an issue for NICE, but making these drugs more widely available will transform arthritis care for many, as it has done for me. Let us be honest: there are problems with traditional treatments. Although methotrexate has been really important for me, it can have long-term negative effects on the liver, but coming off it is certainly not an option for me at the moment. I urge the Government to support research on the long-term effects of existing drugs, and to continue to support vital research into new treatments and life-saving drugs, so that we can help people to live pain-free into old age.

I will be positive: there have been substantial breakthroughs in arthritis treatment as a result of research funded by Arthritis Research UK. They include treatment for rheumatoid and inflammatory arthritis, and treatment to prevent miscarriages in women suffering from antiphospholipid syndrome, which again is something I have. If only I had known a couple of decades earlier.

World-leading scientists, working in British institutions, such as Leeds, Birmingham and Keele Universities, the Kennedy Institute at Oxford, and St Mary's hospital, London, developed these treatments. The biological treatments I am on have been developed here in the UK. We should be so proud of these achievements, but we must make sure that our medical research sector remains at the cutting edge. Now more than ever, the UK’s excellence in medical research is under threat. Many of us warned before the EU referendum that funding for medical research would be hit if we voted to leave. Vicky Forster, a researcher, wrote in The Guardian:

“many scientific disciplines will lose EU funding post-Brexit”.

That is certainly the case with arthritis.

Figures provided by Arthritis Research UK show that between 2011 and 2015 the EU contributed over £2.5 million to its projects. Those researchers have gone on to secure more than £18 million of European funding to support the next stage of their work. It should be a priority for the Government to maintain our world-leading medical research sector. To do this, they need to ensure that overall investment in UK science and research is protected and grown in the longer term.

The risk to research posed by Brexit does not stop at funding. Sir Paul Nurse, director of the Francis Crick Institute, said:

“Science thrives on the permeability of ideas and people and flourishes in environments that pool intelligence, minimise barriers, and are open to free exchange and collaboration.”

Leaving the European Union threatens this melting pot of ideas. In 2014-15, Arthritis Research UK committed more than £30 million to research that was hosted in the UK, but had collaborators in 13 European Union countries. If the Government want to make sure that our medical research sector remains as vibrant and as successful as it is, it is important to maintain the current ease with which those involved in medical research are able to travel and work across the EU and the UK.

We should be truly ambitious as a country and aim to expand arthritis research and medical research more generally, not merely preserve what we have. I have been told that structures need to be in place to encourage our NHS clinicians to participate in research. At the moment, this is not possible due to the demands on the NHS and a medical culture that puts research second.

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

I commend my hon. Friend on making this excellent debate so moving. She shows how important this issue is. She is a living, breathing example of why research is so necessary. She looks 10 years younger than she did last year.

[Lyn Brown]

rose—

--- Later in debate ---

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

It is an honour to serve under your chairmanship, Mr Betts.

Today we are debating arthritis and what more can be done to help those who suffer from this terrible health condition. It is very welcome that the Backbench Business Committee allowed this debate to happen today, which is in arthritis awareness week and so soon after World Arthritis Day. I also thank the Members from across the House who secured the debate with the Backbench Business Committee, and the hon. Member for Strangford (Jim Shannon) for leading the debate this afternoon. He eloquently and clearly set the tone, and I thank him for that.

As we have heard, this condition can often go unnoticed or ignored by individuals and wider society, and I hope that the awareness work seen this week has helped somewhat in changing that, along with the role that everyone here has played in supporting that culture change. Nearly 10 million people in the UK live with arthritis. The symptoms can vary; there are over 200 known types of arthritis and rheumatic disease. The symptoms include inflammation of the joints, pain, fatigue, stiffness and difficulty moving. It is quite a common misconception that arthritis is a health condition affecting only the elderly, but it can often affect all ages. That is why it is important that we raise awareness, and that more be done to educate the public on the symptoms, and on the support and help that is out there.

However, we must also be aware that, given the ageing population, more people will suffer with arthritis. The number of sufferers is expected to rise by 50% by 2030. It has to be said that the Government’s short-sighted cuts to public health grants will only cause havoc if the proper finances are not put in place to address our nation’s health.

Arthritis may not be a killer, but it does attack the way of life of many people. As has been put so eloquently today, this condition can make life a very painful struggle, with one in 10 people saying that they live with unbearable pain, day in and day out. The words of those who suffer with this condition can make the strongest cases for reminding us just how tough it can be to live with arthritis.

In the words of Sharon—I am not talking about myself in the third person here, Mr Betts—who suffers with psoriatic arthritis,

“It’s the forgotten condition that no-one thinks is important. It affects everything. It’s exhausting, depressing and makes you feel angry and frustrated.

It robs you of the life you thought you were going to have, the one you planned with your family. It robs you of a sense of purpose. You can’t do what you want, when you want, it’s unpredictable.

Life has to be adapted and constantly changed. The drugs make you feel sick and depressed and have side effects as long as your arm. It becomes important not to look back at what is lost and make an effort every day to look forward and think positively. But it’s invisible, other people don’t see any of that, you just look a bit stiff.”

Those are extremely powerful words and should be a reminder to us all of how important it is to do more to help those suffering with arthritis.

Hearing the stories and experiences of those who live with the condition is important to help raise awareness. That is why the aim of the awareness campaign “The Future is in your Hands” for World Arthritis Day last week was to highlight the stories of those who suffer. It reinforced the comments made by the chief medical officer back in 2012, who said that osteoarthritis, the most common musculoskeletal condition, is a

“generally unrecognised public health priority”.

The Government must listen to contributions of medical experts such as the chief medical officer, and to the expert opinion of those who experience arthritis. They must then act to do more to help those suffering with the condition.

The Government could help to prevent the development of arthritis with preventive measures that relate to obesity and physical activity. Studies have shown that obesity is the single biggest avoidable cause of osteoarthritis in weight-bearing joints. With two out of three obese people developing osteoarthritis, it is important that we seriously get to terms with addressing obesity; that will create an environment in which those suffering with arthritis can flourish, rather than struggle.

One key way to alleviate symptoms and support people who suffer with arthritis is by promoting physical activity, as it has been shown that regular physical activity can be beneficial in helping to reduce the impact of the condition on people’s lives. My hon. Friend the Member for Neath (Christina Rees), who is no longer in her place, pointed out that it was a lifetime of sporting activities—she is a very well-known squash player—that probably caused, or exacerbated, her arthritis. However, the National Institute for Health and Care Excellence has published clinical guidelines that recommend exercise as a core treatment for people with arthritis, irrespective of the severity of their condition.

We need to know which services are out there, so that we can help people acquire the recommended treatment. That is why it would be beneficial for the National Audit Office to conduct a review into physical activity services for people with arthritis. That would help to ensure that we, as policy makers, have the necessary information to drive the policy agenda, and would help to map areas with a shortfall in support and services for those with arthritis. I hope that the Minister will shed some light on plans to undertake that work. Such an investigation would also be important in the light of the cuts to public health grants under this Government. Those cuts are a false economy, and compound the problems accessing services for people who are seeking to manage and improve their lives.

I quoted the following figures to the Public Health Minister at about this time last week from this very spot, but they are worth repeating to the Minister here today. In the autumn statement, the former Chancellor announced further cuts to public health grants, which amounted to an average real-term cut of 3.9% each year to 2021. That translates to a further cash reduction of 9.6%. That is in addition to the £200 million of cuts to public health grants announced in the 2015 Budget. The Minister must bear those figures in mind when responding to the debate and whenever the Department takes action on public health issues. It really is a false economy to cut funding to already overstretched and burdened public health services, as that will obviously exacerbate the problems with those services in the long term.

The need for further awareness of arthritis and its symptoms was clearly shown in a UK-wide survey of more than 2,000 people conducted by Arthritis Care last year, which found that more than a quarter of arthritis sufferers had waited two years to seek help after their symptoms began. When asked why, some 52% said that it was because it did not occur to them that they could have arthritis, and 28% felt that nothing could be done to address their arthritis. I hope that those who have listened to this debate have heard, loud and clear, that help is out there, and that delaying seeking that help will not aid them or their long-term health and wellbeing. That point was made eloquently by my hon. Friend the Member for West Ham (Lyn Brown), who, I think hon. Members will agree, looks 10 years younger than she did a little over a year ago.

Raising awareness is vital. Last week, world-famous performer Robbie Williams gave a candid interview explaining that he suffers with arthritis and describing the impact that has had on his performance; as a Robbie fan, that concerns me. The more we talk about the condition, and the more that high-profile people, such as the MPs here today, talk about their experiences, the better.

There have been so many eloquent and personal accounts in this debate. I particularly mention the brave and moving account of my hon. Friend the Member for West Ham. She will be playing tennis soon with our own parliamentary tennis champion, Mr Speaker, and I, for one, definitely want a front-row seat for that one. My hon. Friend is a true inspiration to the 10 million arthritis sufferers across the country.

I hope that the Minister has listened not only to the debate and contributions from Members present, but to the voices of those outside this place who have called on the Government to do more for those living with arthritis and the pain that comes with it. There are many ways for the Government to do something, and ideas have come from across the House to steer the Minister in a direction that will help the 10 million people who suffer with the various levels of pain associated with arthritis. Let us hope that this time next year, when we recognise National Arthritis Week again, we will have helped more people to lead a healthier, happier and more pain-free life.

--- Later in debate ---

[David Mowat]

Don’t take it as a compliment. It has been a long day.

It seems extraordinary, thinking about some of the subjects we debate, that it has been five years since we have debated this subject in the House of Commons. The debate has been such a pleasure, and I am sure that hon. Members here will see to it that it is not five years before we debate it again. An objective of having a debate in Westminster Hall is to raise awareness. People watch these things, so it is right that we do that and it is important that we do it again next year.

I have been a Minister for about two months, during which time I have met many people, so it has probably been remiss of me not to have met with Arthritis Research UK yet. I am keen to do that. Its representatives are pushing at an open door if they would like to come and see me. As the hon. Member for Coatbridge, Chryston and Bellshill (Philip Boswell) said, it is about action, not words. We will organise that meeting if Arthritis Research UK would like it to happen.

Several hon. Members have mentioned the statistics, but I will repeat them because they are so important. Some 10 million people in the UK—one in six of the population—have an MSK condition. The most common, with 3 million sufferers, is osteoporosis. One in six is an extraordinary figure, and there are 200 variations of MSK conditions. One in 10 people in the UK suffers chronic pain as a consequence of arthritis.

The numbers are mind-boggling. Some 20% of GP consultations are due to MSK conditions, and this at a time when our GP services are stretched in Scotland and in England. MSK conditions account for 30% of GP consultations for the over-55s, and some 7.5 million working days are lost each year. This long-term condition alone costs the NHS between £4 billion and £6 billion, so it is right that we are having this debate.

There have been a number of interesting and useful speeches. Westminster Hall is sometimes a better place to debate such topics. The hon. Member for Strangford talked about lifestyle factors and preventive factors, and he and another Member made an interesting point about DWP and PIP. We need to be more joined up in how we deal with some of these long-term conditions, particularly as they become more prevalent. He also talked extensively and knowledgeably about research—he has clearly been well briefed—and about what we are doing.

The hon. Member for West Ham (Lyn Brown) made an excellent speech about her personal experience, and she emphasised the overlap with mental health. She talked about first suffering from this during her election campaign last year. In fact, it prevented her from canvassing. I note that she got 36,000 votes and her vote went up by 6%. I do not know whether those factors are related. Well done on 36,000. We pass on our congratulations and awe at her performance.

[Mrs Hodgson]

Maybe it was a telephone canvass.

[David Mowat]

Maybe it was. The hon. Lady also talked about the delays to the start of her treatment and the one-year delay before she got the right drugs, which have been so transformative for her. That is an impressive story.

The hon. Lady also talked about the concerns about the consequences of Brexit. The Government have made it clear that, whatever version of Brexit we end up with, science research will continue to grow in real terms and ongoing scientific programmes will continue. I was a remainer, and we often talk about the money that Europe gives to programmes. She said that £2.5 million was given to a particular programme, which should be seen in the context of the £20 billion that flows in the other direction. The real point is that we understand the need for science and will continue to ensure that that funding happens.

The hon. Member for Neath (Christina Rees) made a good intervention about the consequences of sport and the unpredictable flare-ups that she has. She made the interesting point that arthritis can be invisible for much of the time before flaring up. The right hon. Member for Knowsley (Mr Howarth) is right to remind us of the role of carers. I remind Members that we are putting together a carers strategy, which will focus on unpaid carers in particular. That will come out at the end of this year. We are talking to a number of charities about that because it is important, given the stress and strain on our various systems.

Baby Loss

Sharon Hodgson Excerpts

Thursday 13th October 2016 Commons Chamber

[Antoinette Sandbach]

I agree with the hon. Gentleman. It should not matter what kind of loss a person suffers; they should be able to access that bereavement care pathway whether it is inside or outside hospital.

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

The hon. Lady has been very generous with her time. Before she concludes her remarks, may I, as an officer of the all-party group, commend her and my fellow officers, including the hon. Members for Colchester (Will Quince) and for Banbury (Victoria Prentis), for breaking the taboo, as my hon. Friend the Member for Wirral South (Alison McGovern) has said? I also commend the hon. Member for Eddisbury (Antoinette Sandbach) for her bravery in bringing this important issue forward for debate in the House. My daughter, Lucy, would have been 18 this year. When I became an MP 11 years ago, I intended to raise the issue, but I never had the hon. Lady’s bravery—I just wanted to commend her for that.

--- Later in debate ---

[Will Quince]

Yes. I thank my hon. Friend for that contribution. The all-party parliamentary group is very much looking at that. He is absolutely right to say how important this is. There are people who have suffered what is currently termed a miscarriage when—let us be clear—we are talking about a life, a baby. However, because of our abortion laws and all sorts of other rules and regulations, we are not allowed to register that life and give that baby a name. We are certainly looking at that.

[Mrs Hodgson]

Lucy, my daughter, was born at 23 and a half weeks. Sadly, she did not live; if she had, she would have been rushed straight to the special care baby unit at the Royal Victoria infirmary. I always class her as a stillbirth, but officially it was put down as a miscarriage, and I was not given a death certificate, which was another trauma on top of the trauma I had already gone through. On paper, it was a miscarriage, but she was blessed by the chaplain while I was still in hospital, and we went on to have a funeral, which I felt was right; I had held her in my arms, and she was a fully formed baby. There is an anomaly that has to be addressed.

[Will Quince]

Indeed. I absolutely agree with the hon. Lady. Moreover, I thank her for the huge role that she plays on the all-party group, and played in its formation.

To come back to the point that I was making about the importance of today’s debate, we are really lucky—I hope that all hon. Members agree—to have the best job in the world. We have a duty and responsibility to try to use our experiences—some great, some good, and some terrible—where we can to make the lives of others better. Through this debate, we would like to, in the fullness of time, reduce the stillbirth rate and neonatal death rate by 50% and save the lives of 2,000 babies. That is an incredible target to aim for.

Tobacco Control Plan

Sharon Hodgson Excerpts

Thursday 13th October 2016 Westminster Hall

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

It is a pleasure to serve under your chairmanship again, Ms Buck. I start by paying tribute to my hon. Friend the Member for Stockton North (Alex Cunningham) and to the Backbench Business Committee for allowing him and others to secure this important debate. As we all know, he has done much during his time in Parliament to address the sale and use of tobacco products, not only in his own constituency, just up the road from my own, but across the country. That includes his excellent work with my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) to bring forward the ban on smoking in cars with children. I commend him for his tireless campaigning and commitment to this hugely important area of public health policy.

I thank right hon. and hon. Members who have taken part in the debate. I pay tribute in particular to the hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, for the support and expertise she brings to the debate. Her predecessor plus one or two, my right hon. Friend the Member for Rother Valley (Kevin Barron), also has a huge wealth of expertise and knowledge across the whole health brief. In my new role, I will certainly be calling on him a fair bit—I hope that he is prepared and willing for that to happen. I also want to commend the other right hon. and hon. Members who spoke today: the hon. Member for Harrow East (Bob Blackman), the right hon. Member for North Norfolk (Norman Lamb) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke on behalf of the SNP.

I wish to say a few words to the public health Minister. This is our second outing together and I have had this role for only four days, so I think this will be a regular thing. I am definitely looking forward to keeping a close eye on her work at the Department of Health and to debating across the Chamber. I am sure we will do that on many important issues facing our country’s health. If the tireless work of my predecessor, the hon. Member for Denton and Reddish (Andrew Gwynne), is anything to go by, that will be often—surely he has his own seat in here with his name on it because he was in here so much. That is a daunting prospect.

Today we are debating the important topic of tobacco products. It is crucial that the message is put across to the Government that more can and should be done to ensure that we all lead healthier lives. The control of the sale and use of tobacco is an important public health matter not only for those individuals who use it but for all around them.

During Labour’s time in office, we recognised that fact, which is why we did a lot to address smoking in society, most famously with the introduction of the ban on smoking in public places. The ban brought in a culture change in our society. When we used to walk into any indoor public space, it was the norm to be met with a cloud of stale tobacco smoke, whereas now all of us—especially children and families—can enjoy ourselves freely without having to breathe in second-hand smoke or have the overhang of smoke in the air.

The Tory-led coalition Government came into power and brought in their own tobacco control plan, and it was welcome that it achieved so much over its lifetime, including the prohibition of point-of-sale displays in shops; the introduction of standardised packaging for tobacco products; and the national ambitions on reducing smoking, which were all met. However, when the plan ceased at the end of last year, it was vital that the Government published a new plan in a timely manner to build on the work of previous Governments. Sadly, nearly a year on, the Government have failed to come forth with such a plan, despite the promise and a commitment to do so last December.

Last month, the Health Minister in the House of Lords failed to commit to a final date for publication. We were expecting to have sight of that plan over the summer; we are now hopeful that we will see it during the Indian summer. Changes in Government meant the plan was put on hold. The delay is not too dissimilar in some ways to the constant delay to the childhood obesity plan—although at least that was rushed out over the summer.

A change in ministerial personnel should not be an excuse for delaying such an important intervention in the health of our society, especially when the new Prime Minister stood on the steps of No. 10 Downing Street in the summer and committed her Government to

“fighting against the burning injustice that, if you’re born poor, you will die on average 9 years earlier than others.”

We were led to assume that was going to be the driving force of the Prime Minister’s Government, and I hope it is, but the rhetoric has not yet translated into reality when it comes to this serious public health issue facing our country.

The Government have faced a vocal chorus from charities and organisations, including the British Medical Association, Action on Smoking and Health and the British Lung Foundation, which have all called on the Government to get their act together and publish the new plan. In that regard I also commend the work of Fresh, which my hon. Friend the Member for Stockton North mentioned, which does such sterling work in the region with the highest smoking rates and some of the worst health outcomes.

The Minister and her officials at the Department of Health are being told loud and clear to get on with the job at hand and to answer the crucial question that has come out of today’s debate: what is the delay? I hope she will shed some light on that important question in her response and—finally—tell us when we can expect the new tobacco control plan.

I want to set the scene on why it is so important we have a new plan, on top of what has already been said today, by looking at the facts and figures on smoking, including the variation of smoking habits among certain groups of society—especially children, young people and pregnant women. The smoking rate in England is 19%, but that varies from region to region. It is highest in the north-east, where it reaches 19.9%, and lowest, at 16.6%, in the south-east. Those are regional figures. When looking at the figures borough by borough, my local authority of Sunderland does not fare well at all, with 23% of the population smoking. That is much higher than even the highest of the regional averages.

Looking at smokers based on their socioeconomic status, it is clear that the less well-off in society are more likely to smoke. I am not going to go into all of the reasons for that. We just have to accept that it is where we are—but what can we do about it? Smoking rates among those in the professional and managerial socioeconomic group are less than half the rate of those in routine and manual socioeconomic groups, at 12% and 28% respectively. When the net income of a family and their smoking expenditure are both taken into consideration across England, 1.4 million, or 27%, of the households with a smoker fall below the poverty line. If those costs were returned to the families, it is estimated that approximately 769,900 adults and 324,550 dependent children would be lifted out of poverty.

That is a striking statistic, especially given the study published only a few weeks ago that showed that 250,000 children will be pushed into poverty during the lifetime of this Parliament due to the Government’s policies. Getting it right on smoking could totally negate that impact, so it is definitely something worth looking at. The stats show we must do more to address the cycle of health inequality, which spans generations and continues the awful situation in which there are huge life expectancy gaps between the rich and poor, as we have clearly heard today. If the Government want to change that, one way would be to step up and continue the work of reducing smoking in society.

If those figures do not spur the Minister on to bring forward the new tobacco control plan, hopefully looking at the issue of smoking among our children and young people will. It is welcome that smoking among children and young people fell to an all-time low of 6% under the last tobacco control plan, as we have heard, but it remains an issue when two thirds of adult smokers report taking up the habit before the age of 18, with 80% saying it was before 20. That is compounded when children who live with parents or siblings who smoke are three times more likely to take up the habit than children from non-smoking households. It is also estimated that 23,000 young people in England and Wales start smoking by the age of 15 due to exposure to smoking in the home.

[Kevin Barron]

My hon. Friend uses the statistics very well. Do they not defeat the myth that smoking is an adult habit?

[Mrs Hodgson]

They certainly do. The situation on children smoking is quite stark. The earlier children start smoking, the more serious the consequences are for their health. Children who take up smoking are two to six times more susceptible to coughs and increased phlegm, wheeziness and shortness of breath than those who do not smoke. It can also impact their lung growth, which can impair lung function and increase the risk of chronic obstructive pulmonary disease in later life. As we heard from my hon. Friend the Member for Stockton North, 25,000 people a year die from COPD. Surely we do not want any child in this country to die in that way. The prevalence of these conditions among smokers shows it is paramount that we seriously tackle smoking among our children and young people. We do not want to see the children of today being the COPD sufferers of the future, as well as having those other conditions.

[Alex Cunningham]

I am really pleased my hon. Friend is framing the issue specifically around children. My wife, Evaline, worked as a school nurse and used to hold classes talking to young people about this. She would put forward the economic argument—“If you smoke so many cigarettes over so many days over so many months it costs £2,000, which could buy you a summer holiday.” She was then told, “No, Miss, you’ve got it wrong; it is only £3.20 a packet from Mrs Bloggs down the road.” Do we not also need to ensure we tackle illicit tobacco and ensure children understand the dangers of that as well?

[Mrs Hodgson]

My hon. Friend raises a very good point. The danger and quality of illicit tobacco can often be far worse for health than just long-term smoking. The substances used in those cigarettes can be life threatening.

I will move on to the dangers of smoking during pregnancy, which was raised by the hon. Member for Totnes. While we know the harms of living in a household with a smoker, for some that harm starts before birth as 10.6% of women are smokers at the time of delivery. That equates to 67,000 infants born to smoking mothers each year, while up to 5,000 miscarriages, 300 perinatal deaths and around 2,200 premature births each year have been attributed to smoking during pregnancy.

Smoking during pregnancy has been identified as the No. 1 risk factor for babies to die unexpectedly. According to research by the British Medical Association, if parents stop smoking, that could reduce the number of sudden infant deaths by 30%. Those are shocking figures that show the heartache and pain a mother and the family around her will go through from the horrific events of losing a baby through, for example, miscarriage, stillbirth or sudden infant death. That is especially pertinent this week as it is baby loss awareness week, which I know some of us are wearing little pins to commemorate. There is a debate currently going on in the main Chamber —there was; it has just finished—in which many colleagues gave heartbreaking accounts of their personal experiences or those of their constituents who have suffered the loss of a baby. I was able to intervene and give a personal account of my own experience.

Baby loss due to smoking is preventable if Government action is taken as soon as possible. Important work has been implemented on smoking during pregnancy that has seen the number of pregnant women smoking fall to its lowest-ever levels, but I welcome the calls from the Smoking in Pregnancy Challenge Group to see a commitment from the Minister today to work to reduce the percentage of women smoking during pregnancy to 6% or lower by 2020. It may be an aspirational figure, but it can be achieved as long as a comprehensive plan is put in place to control the use and sale of tobacco.

Regional variations, including those I mentioned earlier, must be addressed; other colleagues have mentioned them, too. We are seeing 16% of women in the north-east and Cumbria smoking at the point of delivery, compared with only 4.9% in London. This stark figure shows that more regional action and support must be offered by the Department of Health to ensure that regional inequalities are addressed. The regional variations and the other variations mentioned show that the slashing of the public health grants is a false economy when it comes to seriously driving forward the agenda on public health, especially in relation to smoking.

In last year’s autumn statement, the then Chancellor announced further cuts in the public health grant, which amounted to an average real-terms cut of 3.9% each year to 2020-21, and translates to a further cash reduction of 9.6% in addition to the £200 million worth of cuts announced in the 2015 Budget. As we know, specialist support and stop smoking services help to get people off cigarettes and to lead a far healthier lifestyle. However, cuts to public health funding have meant that it has proven far more difficult for local authorities to provide that much-needed specialist support.

In a survey of local tobacco control leads conducted by Action on Smoking and Health and commissioned by Cancer Research UK, a total of 40% of local stop smoking services were being reconfigured or decommissioned in 2014-15. In Manchester, we have seen a complete decommissioning of stop smoking services. This is even more concerning when the initial results of the 2015-16 survey show that the rate of decommissioning and reconfiguring is increasing. Therefore, I hope that the Minister will be able to commit to ensuring that we have a substantial source of funding for specialist services that help to support in particular those in lower social economic groups as well as pregnant women to quit smoking. We must end the intergenerational cycle of health inequality that I have spoken about.

It is important that we have a plan and that we have it now—a plan that continues the work of previous Governments to reduce smoking in our society. We have seen inroads into creating a healthier society, but we all recognise we have a long way to go, as the facts and figures show. The Government’s delayed plan must be published now, and it must have measures in place that will address the many variations, from geographical variation to deprivation and socioeconomic background variation.

We must see further work to address the take-up of smoking by children and young people if we are to ever achieve our goal of the next generation being healthier than the last. We need to address smoking among young people head on. Achieving a smoke-free society is within our reach, but what we do not need is further delay and hesitation by the Government; what we need is bold action.

I hope that the Minister can give us that bold action today and that she does so by finally giving us the date when the new tobacco control plan will be published. The longer we wait, the more children will take up smoking, the more people will get ill and, sadly, the more people will die. The time for waiting is over. We now need bold action.

--- Later in debate ---

[Nicola Blackwood]

Prevention is a core part of the NHS five year forward view and should be embedded in NHS funding, public health funding and social care funding, as the right hon. Gentleman has stated. We are looking for the STPs to show a joined-up plan for how prevention, acute delivery services and social care will work together. PHE can and does advise and support local councils to tailor their services effectively, but we need to see how we can improve that. The local tobacco control profiles are one way in which we are doing that, but we must ensure that we see some of that work implemented.

At national level, to help drive a reduction in variation, the Government are committed to publishing the new tobacco control plan that all Members have mentioned, which has tackling inequalities at its heart. The plan will build on our success so far and will include renewed national ambitions. We have to maintain the proactive, comprehensive and non-partisan approach we have seen so far. The UK is recognised as a world leader in tobacco control strategy, and we intend to maintain that. However, I am afraid that on this occasion I will not be able to match my predecessor by announcing the date of publication. [Hon. Members: “Oh!”] I know; I feel inadequate.

My hon. Friend the Member for Harrow East is right in identifying my desire to ensure that the plan is evidence-led. It is reasonable for a new Government to want to check that the plan offers the best possible strategy, based on evidence. On something as important as a tobacco control plan, which is a golden moment, we have to ensure that we do not publish the plan until we get it right. It has been valuable to have the opportunity to listen to and engage with this debate, so that I can hear from colleagues as expert and engaged as those present before going forward. I assure all Members that the Government see the issue as a matter of urgency and are pressing forward with the plan as quickly as possible. I will certainly take away the suggestion from the hon. Member for Stockton North about incorporating respiratory health monitoring into the NHS health check.

I would like to go through a few of the points that we have discussed before I finish. As I have highlighted, it is right to turn our focus to population groups in which smoking prevalence remains higher than elsewhere. In particular, we must turn our attention to reducing health inequalities in populations who already suffer from poorer health and social outcomes, such as those in routine or manual occupations or those who suffer from mental health conditions.

As my hon. Friend the Member for Totnes said, improving maternity outcomes and giving children the best start in life is an important priority for this Government, and supporting pregnant women to quit smoking will be an important factor in working towards that. We all know that smoking during pregnancy increases the risk of stillbirth, as the shadow Minister said, and of problems for a child after birth. We also know that babies born to mothers who smoke are more likely to be born underdeveloped and in poor health. Tackling that was a priority under the previous tobacco control plan, during the period of which smoking prevalence among that group fell by three percentage points, but more can be done to reduce it further and, most importantly, to tackle the variation I mentioned. We will look at that.

Alongside limiting babies’ exposure to smoke during and after pregnancy, we must continue to work to end the cycle of children taking up smoking in the first place. As the percentage of 15-year-olds who regularly smoke has fallen to 8% and continues to fall, we must press our advantage and work towards our first smokeless generation. That would be something that we could genuinely be proud of. Restricting access to tobacco remains key, and we will want to maintain the enforcement of measures mentioned today, such as age of sale laws. Evidence shows that children who have a parent who smokes are two to three times more likely to be smokers themselves. Continuing to support adults to quit is therefore vital to ending the cycle of children taking up smoking and must remain a key part of tobacco control in the future.

In order to achieve our ambitions for the population groups I have mentioned, and to reduce smoking prevalence across all populations to even lower rates, we have to continue to draw on the things that we know work. This is an area in which we have a strong evidence base, and that work will include continuing a programme of evidence-based marketing campaigns such as Stoptober and monitoring the evidence base for e-cigarettes.

Finally, the right hon. Member for North Norfolk is right to say that tobacco use is a global issue and an international priority. Our new tobacco control plan will need to reflect that. As a world leader on tobacco control, the UK will continue to work closely with others to reduce the burden that smoking places on individuals, families and economies across the globe. As he said, we are investing official development assistance funds over five years to strengthen the implementation of the WHO’s framework convention on tobacco control. The project will be delivered by the WHO, and through it, we will share the UK’s experience in tobacco control to support low and middle-income countries to put effective measures in place to stop people using tobacco. That will happen through capacity sharing. We will carefully monitor the progress of that initiative to ensure that it delivers results, using very effective evaluation measures. I am happy to have further discussions about that with the right hon. Gentleman, if he would find that helpful.

We can be proud of the progress that successive Governments have made on helping people to quit smoking, preventing them from starting in the first place and creating an environment that de-normalises smoking. With prevalence rates at an all-time low, there is no question that good work has been done, but as the issues raised in this debate clearly show, there is more work to be done. The Government are committed to doing that work as a matter of urgency. I will take away the comments made today, which are incredibly helpful to me as a new Minister, and I will ensure that as we finalise the new tobacco control plan—

[Mrs Hodgson]

Will the Minister give way?

[Nicola Blackwood]

This is literally my last sentence, but I will.

[Mrs Hodgson]

I am very grateful; I thought I could just catch the Minister before she finishes. Can we expect the tobacco control plan this year or next year?

[Nicola Blackwood]

The hon. Lady will have to wait and see.

In conclusion, the Government recognise this area as a top priority and will continue to work on it as such.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 11th October 2016 Commons Chamber

[Nicola Blackwood]

The hon. Gentleman raises an important issue relating to drug and alcohol misuse. We have prioritised this question as one of the local statutory requirements. We have given £16 billion to local health authorities for public health delivery, and we will expect them to prioritise this issue.

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

Lack of physical activity contributes to obesity. With today’s Health questions falling on World Obesity Day, as I am sure the Minister is aware, it is vital that we recommit our efforts to reversing rising obesity levels in the UK. An opportune moment would have been the childhood obesity strategy—sorry, the plan—that was published over the summer, but sadly it did not go far enough. Therefore, will the Minister commit today to ensuring that the plan is fully realised as a preventive strategy to change behaviours and help to make the next generation healthier than the last?

[Nicola Blackwood]

I congratulate the hon. Lady on her appointment. I am particularly pleased to see her in her place. She has played an important role in the all-party parliamentary group on breast cancer. We are very proud of the childhood obesity plan. It is based on the best available evidence, and it will make a real difference to obesity rates in this country. The Government are also consulting on the soft drinks industry levy, and we have launched a broad sugar reduction strategy. She is absolutely right to say that we must now work hard to ensure that we deliver on that with the NHS, local authorities and other partners as we move into the delivery phase of the plan. We are proud that it is a world-leading plan.

Defending Public Services

Sharon Hodgson Excerpts

Monday 23rd May 2016 Commons Chamber

[Heidi Alexander]

Having had these exchanges over the Dispatch Box for the past nine months, it strikes me that the reality of what people are experiencing in hospitals is sometimes missing from these debates, and that is why I thought it important to quote from those letters.

On workforce challenges, nothing sums up this Government’s failure on the NHS more than the way that they have treated NHS staff. We have had pay freezes, cuts to training places, and the first all-out doctors strike in 40 years—a strike that the Health Secretary did not even try to prevent; in fact he provoked it. He has spoken about seven-day services, but he said little about how he proposes to improve weekend care without the extra resources and staff that the NHS will need. We can only assume that his plan is to spread existing resources more thinly, asking staff to do even more and putting patients at risk during the week.

The Health Secretary also failed to say what experts think about his approach. For example, Professor Sir Bruce Keogh said that the NHS was making good progress towards improving weekend care, but that that became “derailed” when the Health Secretary started linking seven-day services to junior doctors. Fiona Godlee, editor of The British Medical Journal, said that, by picking a fight with doctors, the Health Secretary has set back NHS England’s established programme of work on improving services at weekends. Not only does he have no plan to deliver a seven-day NHS, but he has ripped up the plan that was already in place to improve weekend care. You couldn’t make it up, Mr Speaker.

The Health Secretary often reads out his usual list of stats on staff numbers, but to know what is really happening we must look beyond the spin. A recent survey of nurses by Unison found that almost two-thirds believe that staffing levels have got worse in the past year, and 63% said that they felt there were inadequate numbers of staff on the wards to ensure safe and dignified care—that figure was up from 45% the year before. Whether GPs, nurses or midwives, numbers of staff have not kept pace with demand.

Analysis by the House of Commons Library shows that, in the Labour Government’s last year in office, there were 70 GPs per 100,000 of the population, but that figure has now fallen to just 66. In Labour’s last year, there were 679 nurses per 100,000 of the population, but there are now just 665. No wonder that doctors and nurses feel pushed to breaking point. If we do not look after the workforce, patients will suffer. There was nothing in the Queen’s Speech to help the workforce—no U-turn on scrapping NHS bursaries, no plan to train the staff the NHS so desperately needs, and no plan to improve working conditions.

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

My hon. Friend’s point about the workforce is important. Does she share my concern about those attacks on doctors and nurses, and the undermining of numbers? If we break the doctors we will in turn break the NHS, and it is a lot easier to get public support to privatise a broken NHS, than an NHS that is well, healthy and working as it should.

[Heidi Alexander]

My hon. Friend makes a good point, and motivated staff are essential to providing high-quality care.

--- Later in debate ---

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

I was hoping for a lot more from this Queen’s Speech. I hoped that there would be something to address the ever-growing housing crisis in this country. I also hoped that there would be something on the environment or on the long-awaited and much promised Bill on wild animals in circuses. But mainly, I hoped that there would be some hope for my region and my constituency. Yet again, however, we heard only scant warm words with the brief mention of the northern powerhouse—the Chancellor’s pet project—which does not even seem to reach the north-east.

I do not think the Chancellor heeded my words on the lack of measures for the north-east in his ultra-shambolic Budget back in April, when I warned him that, despite his ambition to be king of the north, he needed to recognise that there was a lot more of the north beyond Manchester before he got to the wall. Mercifully, his time as Chancellor is almost up. Who knows where he will be when winter comes, post-referendum: in No. 10 or in the wilderness on the Back Benches? His legacy for the north-east is, sadly, only more pain and hurt.

Today’s debate is all about our public services, and I want to highlight the damage that is being inflicted on them by this Conservative Government, who are continuing to starve them of proper investment while forcing through damaging and unnecessary legislation. The Tories are now trying to dismantle and ruin two of our country’s greatest and most precious institutions: the NHS and the BBC. These are two public services that we probably all use almost every day and both are central to our national way of life. This Government are hellbent on completely changing the culture and ethos of the two institutions. They have already started the process, but we must not let them complete it.

Since the Conservatives came into office in 2010, the NHS has faced crisis after crisis, all of which could have been avoided if it had been given proper investment and support. Instead, we saw an unnecessary top-down reorganisation of the NHS that disjointed funding streams and placed unnecessary burdens on services through cuts that have been detrimental to our constituents’ experiences of using the NHS. This abysmal mismanagement of the NHS by the Health Secretary and his equally appalling predecessor is compounded by the fact that 3.7 million people are currently on waiting lists, by the understaffing of our hospitals and by patients’ struggles to see their GP. The mismanagement has been acutely felt in the north-east, with the prime example being the underperformance of the North East Ambulance Service NHS Trust. That was the subject of a Westminster Hall debate about two weeks ago in which I and a dozen other north-east colleagues raised our numerous concerns. I hope that the Government have listened to those concerns and will act as soon as possible.

Instead of addressing the issues that the NHS is facing on a day-to-day basis, the Health Secretary took it upon himself to enter into a protracted fight with our junior doctors. They do an amazing job of treating patients in difficult circumstances, yet he has battled with them remorselessly over their pay and conditions. It is welcome that a deal has now been struck between the Department of Health and the junior doctors after everyone was at last brought back around the negotiating table. However, this all could have been avoided, including the recent strike action, if only the Health Secretary had meaningfully listened to the junior doctors’ concerns about the impact the proposed changes to their contracts would have on the NHS.

The Health Secretary must rethink his entire strategy for the national health service and ensure that it does what it was created to do. I want to quote from the leaflet that every home received when the NHS was launched in 1948:

“It will provide you with all medical, dental and nursing care. Everyone—rich or poor, man, woman or child—can use it or any part of it.”

It was Nye Bevan who said:

“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community”.

We should have seen something like that in this Queen’s Speech. But wait—no, that only happens in a Labour Queen’s Speech. That is how we got our NHS in the first place.

The BBC is another of our treasured public services that the Government are trying to undermine. The Culture Secretary is using tactics that can only be described as bullying and intimidation to make the BBC accept a new charter—which is in no one’s interests other than those of commercial media moguls—and he has shown his true colours by going on record as saying that the disappearance of the BBC is a “tempting prospect”. Those are the words of the man who is supposed to be in charge of nurturing and championing British culture and talent.

The Government’s proposals aim to hobble the BBC, and they will put its position as an independent public broadcaster in jeopardy by introducing Government appointees to oversee the organisation. That is a clear attack on the BBC’s independence and its ability to hold the Government to account. Putting Government-approved people on the board would threaten the very existence of the BBC as we know it. Peter Kosminsky, the director of “Wolf Hall” and winner of the BAFTA Best Drama award, has said that

“the BBC’s main job is to speak truth to power—to report to the British public without fear or favour, no matter how unpalatable that might be to those in government.”

Those words remind us of exactly why the Government must maintain the integrity that the BBC has come to be respected for, not just in the UK but right across the world.

The BBC is not only one of our main sources of news and information; it also acts as a beacon for British culture and talent and is a true cornerstone of UK plc. From giving that much needed break to up-and-coming artists on BBC radio stations to the many TV programmes that showcase the greatest aspects of British life—commercially successful shows such as “Strictly Come Dancing” and “The Great British Bake-Off”, informative and incredible documentaries such as “South Pacific”, “Frozen Planet” and the many other David Attenborough documentaries that have taken us into some of the most remote and exotic places in the world—the BBC is the very best of British in everything it does, and we get to enjoy all that for the remarkably good-value price of just 40p a day while sitting in the comfort of our own home. However, the Culture Secretary has persistently put the future of commercial BBC programming in jeopardy by saying that the BBC should focus on broadcasting for the public good. He clearly forgets that all shows broadcast by the BBC, whether commercial or informative, are for the public good. The two cannot be separated because commercially successful programmes help to fund world-class documentaries that are viewed across the globe. My Opposition colleagues and I will do everything in our power to ensure that one of our most treasured institutions is protected, continues to drive creativity in the 21st century, and is accessible to all.

Going back to Peter Kosminsky, he also said in his acceptance speech at the BAFTAs:

“It’s not their BBC, it’s your BBC.”

Never have truer words been said about our BBC. We need to defend it at all costs from the damage that this Government wish to inflict upon it. Our NHS and BBC make us proud to be British. When it comes to damaging those two precious public services, the Government will not get an easy ride either from Opposition Members or from the wider public watching today.

[Jake Berry]

Does the hon. Lady agree that the BBC is uniquely able to tackle difficult issues such as controlling abuse? She may have been following the recent story in “The Archers” relating to Helen Titchener, which showcases the BBC at its best. If the hon. Lady goes on to the “Free Helen Titchener” JustGiving page, she will see that the BBC has been involved in helping to raise £130,000 to support women’s refuges across the country.

[Mrs Hodgson]

I am so pleased that I allowed that intervention, because it was excellent. I thank the hon. Gentleman for that, and I do agree with him.

The NHS and the BBC are cherished institutions, providing an essential public good. They are the very best of British. The proposals are a damning indictment of this Government’s attitude towards our country and those two great institutions, of which I believe the whole country is immensely proud. That is why we cannot allow them to be dismantled or diminished in stature or performance. On the day that the NHS was founded, Nye Bevan said:

“The NHS will last as long as there are folk left with the faith to fight for it.”

His words apply equally to the BBC in this context, as much as he intended them for the NHS. We need to have faith now, and we need to fight for both of them before it is too late. Otherwise, the NHS and the BBC, which our grandparents’ generation so proudly created, will no longer be there for our grandchildren, who will never forgive us.