(4 months ago)
Commons ChamberMy hon. Friend raises an incredibly important point. We know that because all dentists were locked down during covid, the recovery in access to NHS care has not been as fast as we would like. That is why we announced our dentistry recovery plan, including a new patient premium, which, since it was launched on 1 March, has already seen hundreds of thousands of new NHS patients who have not seen a dentist in two years. Some 240 dentists will receive golden hellos to encourage them to work in underserved areas. We also have our new Smile for Life prevention programme, which will ensure that babies receive an early dental check for their milk teeth in family hubs, and that pregnant mums receive better dental care and advice. We are now trying to work with dentists to look at reform of the units of dental activity contract, but following the first meeting of the group yesterday, it seems that dentists feel that all the parameters are in place. What we now need to do is ensure that the incentives are there and that we see things changing rapidly.
My GPs are working extraordinarily hard to increase access in the face of ever increasing public demand. I am alarmed by the Labour party’s talk about scrapping the GP partnership model, as I find in the Stroud district that GP practices are some of the most efficient parts of our NHS services. They need support, the removal of bureaucracy and the opening up of funding pots, rather than dismantling. Will my right hon. Friend explain how access to primary care would not be helped by removing the partnership model, and what are the Government doing to help ICBs create more flexible partnership funding pots?
My hon. Friend makes a fantastic point, and I say again that GPs absolutely underpin our primary care. We all absolutely rely on them, and our measures to create 36,000 additional roles in GP practices will provide them with the additional capacity they need so that they can serve their patients better. That is good for patients, good for primary care and incredibly good value for the taxpayer. It is ludicrous that Labour is proposing to undermine the GP partnership model; that would be a disaster for primary care.
(4 months, 1 week ago)
Commons ChamberThis is quite basic for me. I see the Bill as an opportunity to change the life chances and the life course of thousands of children in the Stroud district, with my two little girls included in the mix. It is not perfect, but it enhances the chance for their little lungs and healthy bodies to grow up to be strong adults.
Like many, I am intuitively against banning things and state interventions. I have concerns about the implementation, practicalities and enforcement of the Bill, but I am less interested in hearing colleagues slagging off each other to help sell books, and more interested in the really spirited debate we have had and in challenges from people such as my right hon. Friend the Member for Norwich North (Chloe Smith), because the amendments that could be tabled for forthcoming debates will help us.
At the heart of this legislation is this great Parliament using the knowledge and evidence that tobacco causes harm, which has built up over decades and decades. When we know that smoking cigarettes is addictive, expensive and limits life chances, particularly for the poorest, why should we accept the status quo and hope for a natural evolution? We know that smoking affects life opportunities and that youngsters are still smoking, despite everything we have done so far and those awful pictures on cigarette packs. When we know all of that, why would we not want to do more?
On the health of the nation, the NHS clearly needs reform. I know that politicians get shot down in flames for saying that, but it is the reality. The combination of an ageing population and the billions of pounds provided year after year in taxpayers’ cash, which is never enough, means that serious change is required. So, notwithstanding my concerns about this legislation, I view the measures in this Bill as part of a genuinely bold and preventive strategy that we have not seen before. This is from a Prime Minister who is known to be characteristically thoughtful and into the detail, the data and the evidence, so I applaud the PM for taking a battering on this in order to try to do the right thing and prevent known harms to children and to young people’s futures. Children in Stroud, in Gloucestershire and beyond will benefit from this Bill as they are growing up.
All six Gloucestershire MPs have the joy and benefit of meeting our health experts on a regular basis. They give us a hard time and we give them a hard time; they are rarely really happy with the Government on all bases, but they have told us that this policy is one of the most important public health interventions that any Government can make. The health experts also wrote to us to say that they wholeheartedly support the plan to create a smoke-free generation. They said:
“The legislation is needed, and proportionate. Smoking is the leading cause of preventable ill health and death and the major driver of differences between rich and poor…In Gloucestershire, the smoking prevalence in the most deprived quintile of the county is 22% and as many as over 30% of those in routine and manual employment”.
That is about 25,000 people in our little county. The doctors went on to say:
“Furthermore, smoking is the leading cause of 10-20 year reduction in life expectancy in people with serious mental illness, of whom 38% of those in our county are addicted to tobacco. Progression towards a smoke free future will significantly improve the health and well being of those currently in the most adverse circumstances, with nearly 26,000 tobacco dependent households in the county”.
A note to the self-proclaimed freedom fighters: we all love freedom, but addicts are not free. They have very limited choices. Two thirds of those who try smoking will go on to continue to smoke for the rest of their lives. That was my bit, by the way, about the freedom fighters. It was not our learned doctors who said that. They did, however, say:
“This legislation has the potential to avoid the 4,653 hospital admissions and 690 premature deaths in Gloucestershire which occur as a result of smoking. Whilst this is a novel policy, there is no reason to think it cannot be successfully implemented.”
I do not accept that the UK cannot implement the policy. They went on:
“The legislation will have a profound impact on society, as transformative as smokefree legislation was more than a decade ago. It is possible to conceive of a future where smoking no longer addicts and kills thousands of people every year.”
I would like to thank Dr Charlie Sharp, our former chief exec Deborah Lee, Dr Richard Makins, Sheema Rahman, Professor Mark Pietroni and the many others who gave me the most structured and sensible part of my speech. They know, because they see this stuff every day. My mum is a nurse, and she sees it. We can do this, so let us not talk this Parliament and this country down when it comes to implementing tricky things. I am looking forward to the next stages.
(6 months, 2 weeks ago)
Commons ChamberThe hon. Gentleman articulates the case against Labour-run Wales with great power. There is £200 million on top of the £3 billion that we already spend on NHS dentistry in England
I have raised dentistry a lot, because Stroud constituents and dentists have been really worried, so I welcome the Government’s plans with NHS England. I give credit to Gloucestershire ICB, which recognised the complexity of this issue. Post pandemic, it set about raising provision and we have decent take-up so far. My plea to the Secretary of State and to the Under-Secretary of State for Health and Social Care, my right hon. Friend Member for South Northamptonshire (Dame Andrea Leadsom) is to continue their relentless focus on prioritising children’s appointments, and not to let parents off the hook, because we can all do better even if it is hard to get a toothbrush in a three-year-old’s gob every night. Will the Secretary of State say more about how ICBs will be supported to deliver the plans and integrate the work that they are already doing? The local areas that are prioritising this are making a difference.
My hon. Friend was probably summing up this morning’s toothbrushing ahead of the school run for many mums and dads up and down the country. That is the point—we want to work with parents. We do not want to patronise them. The overwhelming majority of parents do a great job looking after their kids’ teeth. Our plans are to support those who are struggling. The expectation on ICBs is clear. The plan is a document between NHSE and us. We want to deliver this plan at local level. Expectations will be set on ICBs to make sure that they fulfil the potential of this great plan.
(8 months, 3 weeks ago)
Commons ChamberYes, I was. What is more, we looked carefully at the figures in relation to overseas care workers. We are grateful to all international people who work in our NHS and our care system, but we need to tackle the migration rate, which is too high. The package presented yesterday by the Government is a thoughtful and careful one to tackle legal migration.
Stroud Maternity Hospital is doing a great job, but the post-natal beds are still not open. We have been chasing a ministerial meeting about that for some time. Will my hon. Friend meet me and the Gloucestershire NHS scrutiny chair, Andrew Gravells, to discuss the issue? We think that we need some help with the Care Quality Commission.
I am happy to meet my hon. Friend to discuss that specific issue. We are doing a piece of work on a capital survey of all maternity units as well as working with the CQC on how capital infrastructure—beds and so forth—are impacting on maternity performance.
(1 year, 2 months ago)
Commons ChamberI thank the Chair of the Health and Social Care Committee for his question, as he raises an important point. Last year, we asked the Advisory Committee on the Safety of Blood, Tissues and Organs to reconsider this specific issue. It set up a working group in June last year to look at it and we expect its recommendations this month. We will take them seriously and address them swiftly once we have its advice.
So many women’s health issues begin with birth and pregnancy, as health is often dependent on the care and aftercare that women receive. Will my hon. Friend give the House an update on the recruitment of midwives and maternity teams, as Gloucestershire NHS is working so hard on that, in order to fully reopen Stroud Maternity Hospital?
I thank my hon. Friend, who does a huge amount of work supporting her local midwives in Stroud. I can give her encouraging news: not only have we spent £190 million on midwifery services, but we are seeing an increased number of midwives coming through midwifery training. Excitingly, we have a nurse conversion course, which takes 18 months, with NHS England paying the tuition fees for nurses to convert to being midwives. We have had 300 in training this year and we are expanding that to 500 in the next academic year. We have encouraging retention rates too, which show that midwives are not only joining the profession, but staying in it.
(1 year, 3 months ago)
Commons ChamberI have recognised throughout that demand has increased. Primary care is treating 10% more patients than before the pandemic, with around 1 million appointments a day. There is more demand, not just because of the pandemic but, as I said in my opening remarks, because we have a third more people over the age of 70, and they are five times more likely than younger people to go to their GP. That demographic change, the impact of the pandemic and a change in public expectations of advances in medicine are all creating additional pressure, which is why it is right that we use the full range of additional roles and that we invest in technology, in addition to the 2,000 more doctors in general practice.
GPs, pharmacists and primary care teams do an incredible job for local people in the Stroud district, and I look forward to the funding flowing to our pharmacists, as many of them have made a constructive case for it. A local GP told me that he believes a national education campaign is needed to advise patients of when to access general practice and when to access other services, such as pharmacies. I think this is a good idea, given today’s announcement. Will the Government take it up?
My hon. Friend is absolutely right on this and we plan to have a communications campaign. The front door to the NHS can often be confusing for people—whether they should go to primary care, a pharmacy, accident and emergency or elsewhere. We will have a campaign, not just linked to the opportunity to access care through Pharmacy First, but looking at the technology innovations we are bringing on stream, particularly on the NHS app. We are also making changes to 111. So there will be a communications campaign, on exactly the lines she references.
(1 year, 7 months ago)
Commons ChamberAs we have said previously, we have a process, through the independent pay review body, to look at these issues in the round and, when it comes to the needs of our NHS—my focus, obviously, is on the NHS in England; it is for the Welsh Government to conduct negotiation in Wales—to balance what constitutes the right level of funding for retention and recruitment against the wider issues of affordability for the economy as a whole. However, we are keen to engage with the trade unions, and we had a good discussion with them today. I am pleased that they recognised the progress made in that discussion, and I look forward to further discussions with them.
In recent weeks I have seen a few of my constituents in tears because they have been with loved ones in A&E and seen elderly residents stuck on trolleys. No Member of Parliament wants to deal with that. I know that my right hon. Friend is working hard, and I welcome his announcements, but the public are watching more and more money going into the NHS, and I think we need to hear, very clearly, his assessment of when the further money that has now been announced will lead to meaningful change in Gloucestershire’s A&E departments and elsewhere.
That is a fair challenge. Let me divide it into three sections. First, there is a recognition that the combination of the legacy from the pandemic, the ongoing covid issues and, in particular, the massive spike in flu create an immediate pressure in our A&E departments. The package announced today shows that we have listened to those on the frontline, and have responded.
Secondly, there is a recognition—this is relevant to some of the questions asked today—that the system has been under pressure for some time. Therefore, the second phase looks at innovation, technology, artificial intelligence, virtual wards and ways of doing things differently. To take the example of the frail and elderly, that will address their needs upstream in the care home before they get to the emergency department or release them from hospital quicker, provided they have the safety net of being part of a virtual ward, where they are subject to ongoing clinical supervision. If they need to come back to hospital, they can do so much more easily than would otherwise be the case. That stops the boomerang of patients being released early and then coming back. That second phase includes the modular capacity, because space is needed to streamline and to triage. That compression within the emergency department also drives inefficiency and poor care.
Thirdly, the Government have invested in the life sciences industry. R&D investment of £15 billion to £20 billion is a big marker of that. One of the priorities is to say that we can do certain things at scale with companies such as Moderna that will shift the dial in healthcare. That is a third but significant part of this, particularly in respect of the prevention work that we can do.
(1 year, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate in an important awareness-raising month for pancreatic cancer. I meet hundreds of people each month as Stroud’s MP, and I am asked to take up thousands of issues and causes. Sometimes people demand that I take up causes, and my team get fed up with me, because I want to help everybody, and they say I generate work whenever I leave the house. I know that many MPs across all political parties will share the same experience.
When constituents come with very clear asks and a constructive approach, it makes it easier for us as MPs. I have found over time in my still relatively new role in the past three years that everybody who comes to talk to me about pancreatic cancer comes with that constructive approach and a clear set of asks about what they want to happen. It does not matter how personal it has been for them, or whether they have had loss or are cancer survivors themselves. Pancreatic cancer is something that people want to see changed. They are going about it the right way, by bringing matters to us, so that we can raise issues with Ministers. I thank them for that, as well as the charities, Pancreatic Cancer UK and others.
The more I have looked into the subject, the more I have understood why it needs to be addressed. Campaigners and families affected by pancreatic cancer talk about the failure in our NHS medical system. As wonderful as the NHS is, there is a failure to detect this cancer earlier. They raise the failure to get people properly to understand the symptoms of this cancer. One of my constituents says, “The clue is in the loo,” which I like as a slogan. They also raise the failure to prescribe medicine that will help people, which I will come to separately.
If there are clear asks in this area of medicine, people are confused why they are not being met. The medical healthcare system is failing our constituents at the moment on pancreatic cancer. I know that Stroud people, whom I love dearly, will die of this most deadly common cancer, if the health care system does not change.
I want to talk about one of my constituents: a young woman, my age, a mum, businesswoman, super-bright cancer survivor. She is a young woman with what was thought of as an elderly person’s cancer. For about five years, she went to her GP with fatigue, bloating and general lethargy, but a further investigation into cancer was not done. She went backwards and forwards with a list of symptoms, but it was not picked up. Her tumour was the size of a walnut and internal, so that it could not be felt. We have got used to checking our bits and bobbins, as my wonderful hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) tells us to do, but where there is an internal walnut-sized lump—not lumps on breasts or testicles—we are stuck, and people are not detecting it. If our medical system is not detecting it, we are in difficulties.
My constituent’s experience highlights the need for people and health care professionals to be alert to smaller symptoms that could be a sign of pancreatic cancer. We need to talk about poo—the clue is in the loo. We need to raise awareness of this silent cancer. If the general population is not aware of symptoms, we will miss it and will get further into difficulties with that devastating loss.
My constituent also asked me to campaign on the issue of PERT—pancreatic enzyme replacement therapy. There has been a push from cancer charities to try to get PERT prescribed more frequently, because three in four people with pancreatic cancer reported that PERT improved their quality of life. It is about 60 tablets a day and not an easy thing for people to take, but it improves their quality of life. It reduces the weight loss, the appetite loss, the abdominal pain and the bloating or wind. It reduces pale, oily and floating poo, and it reduces diarrhoea. All of that enables patients to regain some normality in their day to day lives, and it helps food to be digested and absorbed by the body. That means they gain strength to undergo potentially life-saving treatment. Given that we know about that treatment, why is it not prescribed as frequently as campaigners suggest it should be?
We understand there is a lack of awareness among healthcare professionals about what PERT can do, and that the levels of nutritional expertise among healthcare professionals are quite low, particularly in general hospitals. We know, as the hon. Member for Strangford has set out, that the stage that people are diagnosed with pancreatic cancer is incredibly late.
I have six key asks: to raise awareness among healthcare professionals; to place PERT at the heart of pancreatic cancer treatment improvements; a top-down prioritisation and approach that tackles the entire pathway of treatment and care; to make PERT a UK-wide priority in pancreatic cancer care; national targets for the use of PERT; and local health bodies to ensure the effective prescription of PERT.
I want to hear from the Minister today in relation to PERT and the prescription—or lack—of it. I also want to draw her attention to a study into pancreatic cancer —there is not enough time to go into it today—by Oxford University and Pancreatic Cancer Action, which was released last week. I read it last night and it is excellent. The founder and CEO, Ali Stunt, is an incredible woman. In fact, we are surrounded by incredible women campaigners, and we should pay homage to the late, great Dame Deborah James. I am sure all of us have been moved by seeing what she managed to achieve on social media. I know her family are continuing with the campaign.
All of my Stroud constituents who brought these issues to me want to see action and they want to hear from the Minister. I am really pleased we are having this debate, and I thank the hon. Member for Strangford for securing it. I hope that we can all come together to reach agreement about what should happen.
(2 years, 4 months ago)
Commons ChamberI congratulate my hon. Friend the Member for Gosport (Dame Caroline Dinenage) on securing this important debate. I thank my constituents who have written to me about the debate to bring it to my attention. It is important that we bring local and personal experiences into this place when we are thinking about policy and legislation. I am grateful to Sophie’s mum, Charlotte, for sending me notes about Sophie and her beautiful picture. It is impossible not to be brought to tears—I am a crier anyway and I am pregnant at the moment, so I hope that hon. Members will forgive me if I go.
The theme running through many of the examples that we have heard today, and the correspondence that I have received, is a plea for the Government, MPs and policy makers not to misunderstand childhood cancer and not to write it off as rare, because so much flows from that label in terms of funding, attention and even time in this place. I understand that with 80-odd types of childhood cancer, it is complicated, but that is absolutely no excuse. We have already heard that it is the biggest killer of children under 14. I have not done the maths, but I know that that is many, many devastated families, even in the Stroud district, whom we cannot overlook.
One constituent wrote to tell me that the death of a friend when they were in their teens still plays on their mind. The GPs and out-of-hours services that he accessed did not have the training to identify that his symptoms were due to bone cancer and, as a result, after 13 gruelling months—we have heard time and again the horror of the treatment that the children go through—he died from the disease. Had his diagnosis been made sooner, my constituent is absolutely clear that his chances of survival would have been greatly increased.
We hear comments about mystery viruses and mystery symptoms. One of my greatest concerns is listening to the reality of pushed GPs, who are busy people and who are not equipped or trained enough to be able to spot some of the signs soon enough.
Is that because there is not enough research? I was surprised to learn that only 4% of funds raised for cancer research and treatment are directed towards childhood cancer and that children, unfortunately, are receiving treatment for adult bodies. It all requires greater investment, which is obviously something that the Minister can respond to. As my hon. Friend has, I have had many cases in my constituency, particularly in Crowborough, Mayfield and Forest Row.
I thank my hon. Friend for that intervention. What I will say is that that is certainly not due to lack of care and love, because GPs absolutely want to do the best for their patients. Whether it is research, whether it is training, whatever it is, we have to fix this, so I support the calls for a children’s cancer mission, and urgently so. I want to bring everybody together for research and awareness raising.
I am very lucky that Meningitis Now—that fantastic charity, which has been mentioned—has absolutely turned around understanding and knowledge about meningitis in my constituency. It is a small charity, but it packs a punch. Why can we not do that for childhood cancer research and sufferers?
Post-pandemic parents, as I have just said about GPs, will look to call 111 for advice. We told parents and we told the whole country, “Don’t go to the A&E. Don’t go out to your NHS. Call 111.” So this is also about training that is really focused on that service.
Listen, the Minister is a fantastic Minister. I am bothering her all the time about lots of things, so I know her intellect and her care for people up and down the country. The Government have already committed to improving cancer outcomes, and the 10-year plan is absolutely an opportunity to make changes for the hundreds of families who are affected and desperately need our help.
(2 years, 4 months ago)
Commons ChamberIf I may, I will write to the hon. Lady about the national clinical audit. As for her important point about boards, the report refers to their importance and the importance of ensuring that the people on them are vetted, understand their responsibilities, and have the information that they need in order to fulfil those responsibilities. In, I think, 2014 or thereabouts, the Care Quality Commission changed the rules relating to NHS trust board members, requiring them to meet a new “fit and proper” test.
It is impossible to think about these lost babies, lost lives, and damaged families without becoming very upset and then very, very angry. However, I know from the work I have been doing with midwives and families, mums and dads, in the last six months or so that this does not involve just one trust. We have thousands of midwives marching on the streets. During the pandemic, mums were taking to social media, feeling that they were being marginalised and their voices were not being heard. Midwives tell me that they did not want to speak out before because they did not want to frighten the mums and dads in their charge, and that is why they often feel that they are not heard themselves. So we have to help them. How will the NHS and the Government reassure pregnant women and help the midwives to reassure them, given that all this is in the news at the moment, and how can we prevent other maternity services from failing?
My hon. Friend has raised a very important point. Hundreds of thousands of births are delivered through the NHS each year, and the vast majority are completely safe, as I myself have found and as many other Members have found, including my hon. Friend. What we have heard about today is what happens when it goes wrong, and goes tragically wrong, but especially when that was avoidable.
My hon. Friend was right to talk about the importance of considering other trusts. This report focuses on one trust, but we know that there was a problem in Morecambe Bay and that an independent investigation is taking place in East Kent. There is action to be taken by all trusts. That is why I think it is so important for the NHS to act on the recommendations for the wider NHS, and for me to act on the recommendations for my Department. We will certainly be taking action and so will the NHS.