Oral Answers to Questions

Steve Baker Excerpts

Tuesday 13th October 2015 Commons Chamber

[Mr Jeremy Hunt]

I will take no lessons on transparency from the Opposition. Professor Sir Brian Jarman said that the Department of Health under Labour was a “denial machine” when it came to the problems of Mid Staffs. We have made the NHS more transparent than ever before, and we will continue to practise transparency.

[Mr Steve Baker (Wycombe) (Con)]

T6. What progress has been made towards the implementation of the Keogh review of urgent and emergency care?

[Mr Hunt]

We are making good progress and we expect to make a substantive announcement on that before the end of the year. That will be about improving the standard and the quality of care in A and E departments, which I know my hon. Friend has a great interest in, and removing the confusion that people feel about what precisely the NHS offer is in their area. It is looking good and I hope to have something to announce to the House before too long.

NHS Reform

Steve Baker Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

Let me tell the hon. Gentleman what the doctors and nurses working in our NHS hospitals see. They see 8,000 more hospital nurses on full-time contracts than when his party was in power, because we are doing something about the scandal of short-staffed wards that was left behind by his Government.

[Mr Steve Baker (Wycombe) (Con)]

Will my right hon. Friend ensure that neither the revalidation regime nor the NHS’s status as a near monopsony employer is allowed to promote anxiety among NHS staff who would otherwise wish to speak up? It is essential that they know they have that freedom and security.

[Mr Hunt]

As ever, my hon. Friend is spot on. At the heart of what I am saying today is creating a new learning culture inside the NHS where people are able to be open. In the airline industry, it is much easier for a junior pilot to talk to a senior pilot about a mistake they think the senior pilot has made without feeling it will impact on their career. We need to break down the barriers, so that when people talk about their concerns—even about what their boss has done, which is never easy—they are listened to and treated seriously, and there are no consequences as a result. We absolutely have to make that change.

Oral Answers to Questions

Steve Baker Excerpts

Tuesday 7th July 2015 Commons Chamber

[Ben Gummer]

I gently remind the hon. Lady that the difference is that changes to services provided at hospitals are now made on the recommendation of clinicians, rather than of bureaucrats and Ministers, as it was under the previous Government, in which she served. In respect of her own hospital, the number of diagnostic tests for cancer are up by 22,000 since 2010, the number of MRI scans by 6,000, the number of CT scans by 7,000 and the number of operations by 1,800. That is a record of which to be proud.

[Mr Steve Baker (Wycombe) (Con)]

Wycombe hospital could benefit from one of the excellent models in the “Five Year Forward View”. Will my hon. Friend make sure these excellent proposals are carried through with energy and alacrity?

[Ben Gummer]

The strength of the NHS forward view is that it is a creation of the NHS itself, and we, as the only party to back it in full with cash, will give it the kind of support it needs to make sure it is delivered.

A&E Services

Steve Baker Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Reed]

I thank my right hon. Friend for that intervention, and may I say what a pleasure it is to see her again in the House of Commons? She is entirely right in what she says. We all remember the pictures, and we remember the Prime Minister’s promises and those from the previous Secretary of State. My right hon. Friend is right to say that nobody should ever take any lessons from Conservative Members or believe what they are being told by them—not one bit.

[Mr Steve Baker (Wycombe) (Con)]

Why is it that when an A&E department is lost from a Labour constituency it is the Government’s fault, but when one was lost in a Conservative constituency under the previous Government that was “clinically led”? Can the hon. Gentleman explain the contradiction?

[Mr Reed]

I am afraid the hon. Gentleman is not listening; the rules have changed. The system whereby these processes are undertaken has comprehensively changed. If he were to draw a golden thread through Conservative health policy over the past five years, it would be that the public do not matter and are not listened to, and that change is driven from the centre, irrespective of what local clinicians say.

Health and Social Care

Steve Baker Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

As this is the first time that I have spoken in this Parliament, may I state for the record that I am married to a full-time NHS consultant forensic psychiatrist who also chairs the Westminster liaison committee for the Royal College of Psychiatrists and will shortly be taking up a role as the registrar of the Royal College of Psychiatrists? I also have a daughter who is a foundation junior doctor and another daughter who is a medical student. The House will be pleased to hear that my son has managed to escape; perhaps his handwriting was not quite bad enough.

I was honoured to have worked as a front-line clinician in the NHS for 24 years, and I wish to start by extending my thanks and paying tribute to all those colleagues who work across the NHS with such professionalism and compassion. In replying to the Gracious Speech, I wish to touch on four areas: the workforce challenge; the financial challenge; volunteering; and issues around prevention.

I was so pleased to see the Five Year Forward View right at the centre of our commitments in the Gracious Speech. I am talking about the commitment not just to back the Five Year Forward View but to the £8 billion that we will need by 2020. I ask the Government to front-load as much as possible of that £8 billion, because what we see alongside that £8 billion is the need to make £22 billion of efficiency savings. Ministers will know that in the previous Parliament those efficiency savings were largely achieved by pay restraint in the NHS, but in the long term pay restraint will start to have implications for recruitment and retention, which are already major challenges for the NHS.

I welcome today’s announcement because it was unsustainable to continue spending £3.3 billion a year on agency costs. Using agency staff not only leaches money from the NHS that could be better spent elsewhere, but has an undermining effect on permanent staff in the NHS. In fact, it starts to have a domino effect on the ability to retain staff, so it is simply unsustainable. When the Minister responds, I hope she will set out how the caps on those rates, which I welcome, will play in relation to the rates that are paid to NHS bank staff and give us more detail about the arrangements. Where there are crises in staffing, we need to know that safety will be paramount and how those caps will be overruled in emergencies. It is important that that clarity is delivered across the NHS.

Recruitment and retention are about not just pay rates but staff morale and the way that staff feel valued. They are also about the ability of staff to work in teams. We need to consider the effect of increased shift working across the NHS. I am talking about the effect of the structure of the service. There is also the burden of paperwork and administration on NHS staff. All those things are important when we consider how to retain permanent staff in the NHS and to move away from our reliance on agencies.

[Mr Steve Baker (Wycombe) (Con)]

Will my hon. Friend join me in welcoming the work of the Royal College of Emergency Medicine, which is trying to change the way that emergency medicine consultants work in order to retain more of them in their particular specialty? At the moment, far too many of them leave that specialty, creating some of the problems that we see across the country.

[Dr Wollaston]

Absolutely, and I recognise and value the work that has been done. We also need to look at the skill mix across the NHS. It is unsustainable to deliver the commitments to primary care and to improve access to primary care unless we look further at the skill mix across the wider NHS. For example, we talked in Health questions about the use of pharmacists. The one area of the NHS where there is not any kind of workforce shortfall is in pharmacy, and that industry has much to offer to primary care. We also need to consider the role of physician associates and nursing assistants, and look at how we can diversify and provide better continuing professional development across the NHS. All those things will be important as we move forward.

Epilepsy

Steve Baker Excerpts

Thursday 26th February 2015 Commons Chamber

[Mrs Cheryl Gillan (Chesham and Amersham) (Con)]

It is an honour to follow the hon. Member for Vauxhall (Kate Hoey), and I hope that she obtains justice for her constituent. It is also an honour to follow my hon. Friend the Member for South Thanet (Laura Sandys). As I said earlier, she will be a great loss to the House, and I am personally sorry that she is leaving this place because I think she has added a great dimension to it, particularly on the subject of epilepsy.

I declare an interest because the Epilepsy Society is based in my constituency and I am proud to be a vice-president. It has been working with and for people affected by epilepsy for 123 years. Although the detail of its aims and objectives have altered over the years, fundamentally it remains true to the vision set out by the group of philanthropists and neurologists who established it in 1892—to cure, treat and prevent epilepsy. It is unique.

At the Epilepsy Society’s Chalfont centre, groundbreaking epilepsy research laboratories are co-located with England’s only dedicated epilepsy assessment and treatment centre. Led by medical director Professor Ley Sander and head of genetics Professor Sanjay Sisodiya, some of the world’s pre-eminent epilepsy researchers and clinicians undertake research and clinical practice at the Chalfont centre. The Epilepsy Society’s researchers have been central to new scientific discoveries, in particular research that demonstrates the breadth of genetic influences in epilepsy. The society also brings together state-of-the-art diagnostic tools for epilepsy in one place, including the UK’s only dedicated epilepsy MRI scanner and a specialised epilepsy therapeutic drug monitoring service that is provided to hospitals across the UK and Europe.

The Epilepsy Society is also part of a unique three-way partnership with the NHS and with academia—the national hospital for neurology and neurosurgery at University college London—that has the benefit of translating research into clinical practice, providing access to funding, attracting top researchers and clinicians and providing the flexibility to innovate. The partnership has been recognised by the World Health Organisation.

[Steve Baker (Wycombe) (Con)]

My right hon. Friend has taught me something today—I did not know that my constituency was adjacent to such a fantastic centre. Will she confirm that it is a national centre serving a population wider than just our constituencies?

[Mrs Gillan]

That is absolutely right—it is a national centre.

Under our new chair, Helen Pernelet, and the new chief executive, Angela Geer, the Epilepsy Society has an ambitious new vision to leverage its medical research strength to revolutionise how epilepsy is diagnosed and treated. Of course, there are issues facing the society’s specialised medical and research facilities, but sadly, with only eight minutes in which to speak, I might not get through them all. For the Minister, there are co-commissioning concerns. Under the Health and Social Care Act 2012, the responsibility and budget for specialised services were brought together in NHS England as the sole national commissioner of specialised services, but since May 2014, it has U-turned on national commissioning. Instead, the new proposals for co-commissioning would see responsibility for the vast majority of specialised services shared with local clinical commissioning groups.

The Epilepsy Society is opposed to the co-commissioning of specialised epilepsy services for several reasons. NHS England asserts that national service specifications will continue to apply to co-commissioned specialised services, but it is uncertain how that will be achieved, given that CCGs are independent bodies. If CCGs are allowed to reinvest savings from specialised commissioning in other areas of their budget, it might create an incentive to underspend on specialised services, raising questions about the level of investment. There is also evidence that CCGs are not in a position to engage with specialised commissioning in areas such as neurology. For example, the Minister will know that the Neurological Alliance’s recent report, “The Invisible Patients”, found that only 26% of CCGs had assessed the prevalence of neurological conditions locally and that only 14% had assessed the cost of neurological services.

I also wish to highlight the Epilepsy Society’s opposition in principle to the introduction of a marginal rate in specialised commissioning and its concern about the lack of clarity in neuroscience specification. There is an ongoing lack of clarity over the division of responsibility between NHS England and CCGs for commissioning neurological services, and there is continued confusion about precisely which services fall under the scope of specialised commissioning arising from inconsistent statements in the manual for prescribed specialised services and the neurosciences service specification. I hope that the Minister can respond to the society’s calling on NHS England to clarify this important service specification to ensure nationally applied standards for specialised epilepsy services.

I encourage the Minister to improve access to the Government’s flagship 100,000 Genomes Project. It is an exciting development that the Epilepsy Society strongly supports, but the project’s focus is largely on cancer and rare diseases, making it unlikely that more than a handful of epilepsy genomes will be sequenced as part of the groundbreaking initiative, despite the huge potential that genome sequencing has for transforming epilepsy. I would like to see the Government continue to invest in genetics research and its translation into clinical practice and to ensure that it benefits patients with epilepsy, but I would particularly like to see the genome project embrace epilepsy.

The need to reform the current system for accessing effective medicines will become ever more important in the context of increasing the availability of personalised medicines. I have been working locally with Daiichi Sankyo on patient access to novel oral anticoagulants, and there is a gap that the Department of Health needs to address across the board.

In my remaining minutes, I would like to draw attention to the issue of laser ablation surgery. I have recently dealt with a distressing case of a constituent who sadly lost a family member to epilepsy. The constituent expressed great distress that a surgical treatment known as laser ablation therapy had not been made available to her and her child as a treatment option. Laser ablation is a relatively new surgical technique that burns away accurately targeted tissue with a surgical laser. The technique is much less invasive than traditional brain surgery, and enables surgeons to operate deeper in the brain. It is also much more accurate and carries fewer risks of complication. Laser ablation can be a good choice for patients who have few other treatment options either because medication does not control their seizures or because the lesions in their brain that cause their epilepsy are deep and hard to reach using open brain surgery.

A significant minority of epilepsy patients—approximately 12,500 in the UK—would benefit from surgical treatment, including laser-guided surgery. In around 60% of these cases, surgery can be curative. Evidence shows that it also contributes to reducing premature mortality in epilepsy. Sadly, despite these benefits, only around 300 patients a year are currently given this treatment. I think that the Department of Health should urgently review the number of patients with access to neuro-surgery each year, particularly surgery that uses the new and less invasive techniques such as laser ablation.

Finally, I mentioned the connection with autism, to which my hon. Friend the Member for South Thanet responded during her opening speech. It is obvious that although we have made great strides on epilepsy since the days when epileptics were not allowed to marry, we still have a long way to go. I hope that the Minister will respond positively to the questions raised on both sides of the House about the future of epilepsy in the hands of the NHS.

--- Later in debate ---

[Steve Baker (Wycombe) (Con)]

I ask the Government to take a close interest in the case of my constituent Jessica Monks, which I shall relate from the perspective of her parents. I am grateful to my hon. Friend the Member for South Thanet (Laura Sandys) for creating the opportunity for me to do so and for giving me the opportunity to inform myself about this important issue. I have been astonished by what I have learned.

I am glad to follow the hon. Member for Erith and Thamesmead (Teresa Pearce). As she will learn, I too will talk about issues of consent towards the end of my speech. It was shocking to hear what she set out about consent.

Jessica Monks was not just a cheerful but a positively joyful young woman. Her life and her untimely death are a case study in what can go badly wrong and what ought to be done. Jessica was born on 7 February 1996 and lived in Medmenham in my constituency. She suffered from epilepsy and was under the care of the neurology department of the John Radcliffe hospital in Oxford. I understand that she was learning to live very well with her condition.

Jessica died by suicide on Saturday 24 January 2015 as a result of a psychotic episode related to the epilepsy medication she was taking. She had been taking Zonisamide since about November 2013, but her seizures had not stopped. Her neurologist told her parents to keep an eye on her moods and to make an appointment with him immediately if her moods changed in any way.

Over Christmas 2014, Jessica, usually a joyful young woman, became noticeably low and withdrawn, very unlike her usual buoyant self. As requested, Mr and Mrs Monks attempted to make an appointment for Jessica to see her neurologist about her changing moods in early January, but despite several phone calls they did not receive a response. Her parents were concerned about her deteriorating mood so they made an appointment with her GP, who saw her on 8 January. The GP agreed that her mood had deteriorated but, crucially, felt that it was important to speak to her neurologist before prescribing any medication to help her mood improve.

On Friday 9 January, Jessica was admitted to Wexham Park hospital after taking an overdose of Zonisamide, oxcarbazepine and paracetamol. She was seen by a junior psychiatric nurse, and I am surprised that it was a nurse. I am sure that they do a wonderful job, but I would have thought that in such circumstances a consultant would have been appropriate. However, the nurse deemed her fit for discharge. Following a further attempted suicide on Monday 12 January, Jessica’s parents made another appointment to see her GP who again recommended that Jessica be prescribed an antidepressant but felt unable to do so until she had spoken to her neurologist. The GP did arrange an urgent psychiatric appointment for Jessica and, thankfully, the psychiatrist phoned that evening to make an appointment and offer out-of-hours support.

At the psychiatric appointment on 22 January, Jessica was diagnosed as suffering from a psychotic episode and was instructed to stop taking the anti-depressants immediately. The psychiatrist was concerned that the drug Jessica was taking was causing this psychotic side effect—which is, by the way, well known—and said she would speak to the neurologist that evening to discuss whether Jessica should cease taking the epilepsy drug Zonisamide.

On Saturday 24 January, Jessica died when she stepped in front of an oncoming train.

[Norman Lamb]

My hon. Friend is talking about a tragic case and I cannot begin to imagine what the family have been through. I am very happy to meet him to discuss further what lessons can be learned.

[Steve Baker]

I am extremely grateful to my right hon. Friend.

Mr and Mrs Monks feel that there was a significant breakdown in the care of their daughter, and I certainly agree with them. The speed and severity with which her mental health deteriorated due to her epilepsy medication were not considered a priority—they were not adequately prioritised—and they feel they have been badly let down by the medical professionals they saw in the days leading up to Jessica’s death.

Jessica’s death was apparently avoidable. We need to know why it was not avoided. There are a number of questions to be answered by the NHS and the investigation is ongoing, as, indeed, is the coroner’s inquest. I contacted the coroner before raising this case and they were content for me to do so. I will not run through all the questions, some of which are apparent, but I should like to ask in particular why was the consultant neurologist not more available? Why, when it is well known, as the Library brief explains, that some of this medication can cause these side effects, was more immediate, perhaps telephone, support not available in the event of an episode?

[Mrs Gillan]

Among other things, I sit on the Public Administration Committee and we are responsible for the health ombudsman. Will my hon. Friend make sure that the details of this case are passed to the Committee and to the ombudsman, because we are looking into how complaints are dealt with and how we can learn for the future from such tragic experiences?

[Steve Baker]

I am extremely grateful to my right hon. Friend. I have already passed the details to the Minister. I am aware of the inquest and the NHS investigation, but I will certainly take her advice and give those other bodies the opportunity to investigate.

That brings me on to the specific issue of consent. I have spoken to Mr and Mrs Monks today and they say that at no point was it explained to them that this medication could have these side effects. Jessica was 17 when she started taking it, and I feel that that possibility really should have been explained to her parents. They should have had the opportunity to take very strong action. Of course, they did take very strong action—they took the strongest action they could—and it seems to me, without wishing to pass judgment, that the key problem was that they could not get hold of the neurologist.

[Dr Julian Lewis (New Forest East) (Con)]

I am puzzled that the instructions that came with the medication did not include a warning that if someone had those sorts of side effects, they should cease taking it.

[Steve Baker]

I am a layman, but one of the things I have learned today is that one cannot simply cease taking medication for epilepsy, so specialist advice is required.

[Laura Sandys]

indicated assent.

[Steve Baker]

I am grateful to my hon. Friend for acknowledging that. Put simply, it seems that the epilepsy medication, which was necessary, caused psychotic side effects, which were exacerbated by anti-depressants that were prescribed with the best intentions. Jessica therefore spiralled into the situation that tragically led to her death.

I would like to finish with a few words from Jessica’s parents, who have written to me:

“The sudden and tragic death of our otherwise healthy and happy teenage daughter has caused devastation throughout our family and local community. We strongly feel that this situation could have been avoided if we were given the correct advice and prompt treatment and are committed to ensuring the same mistake does not happen to another epilepsy patient.”

Susan and Steven Monks have been robbed of their daughter and of all the future opportunities, hopes and dreams for which she stood. They deserve to know why and what will be done about it.

--- Later in debate ---

[Mr George Howarth (Knowsley) (Lab)]

I add my thanks to the hon. Member for South Thanet (Laura Sandys) for giving us the opportunity to debate this important issue. I wholeheartedly endorse hon. Members’ comments that she will be missed in the House. Her speech was not only informative but unique, because in the many years I have been in the House, I have never before heard a Member declare themselves to be both a law-maker and a law-breaker. Even more alarmingly, she declared her intention to become a repeat offender. Her speech was also unique in that it brought before the House the experience of people who suffer this condition, and she gave us the opportunity to understand more about its dimensions.

I need to say a word about the speech made by the hon. Member for Wycombe (Steve Baker), in which he described a tragic case. Anyone who has experienced the loss of a child knows exactly the depths of misery that the people concerned will have experienced. The hon. Gentleman dealt with a difficult subject in not only a suitably moving way, but with great dignity, and I, too, pass on my sincere condolences to the family.

[Steve Baker]

I am extremely grateful for the right hon. Gentleman’s kind words. I know that the family have heard him and will also be grateful.

[Mr Howarth]

The hon. Gentleman’s speech highlighted a more general point about how chronic conditions are dealt with. I have some knowledge of type 1 diabetes. When someone with that condition reaches a crisis, whether that is a psychological crisis or something that should be dealt with by a diabetologist, they cannot always get to see the right people at the right time so that they can get the right support, prescription or advice. Brilliant though our national health service is, that is one aspect that all too often breaks down, so I hope that the Minister will address that problem.

I want to concentrate on a particular issue, which I do not think has been mentioned, about which one of my constituents has contacted me: how the benefits system makes life very difficult indeed for those people who find themselves on benefits. No doubt the Minister will not be able to respond to my points, but I hope that he will pass them on to his colleagues in the relevant Department.

My constituent, who has asked to be named, Mr Adam Lane, who lives in Huyton, said:

“In regard to my DLA claim I had to go through 6 months with no money for myself, my wife and my two-year-old son. At that time we had to live on £50 a week until I went to a tribunal and won. Now I have to go through the whole process again on 13th of March for PIP. I have a letter from my epilepsy doctor stating how bad my epilepsy is. I fall and convulse without warning and have seriously damaged my knee, and have panic attacks throughout the whole experience. My seizures are occurring every week now and are very serious and now I suffer with migraines where I vomit 14 hours a day and I’m confined to bed through the process for 2 weeks at a time. I’m hoping Atos will not brush me off like last time, hoping to appease Government numbers to get people off benefits. I feel I am in need of benefits. I cannot work with my health conditions. My wife is my carer 24/7. My son has been traumatised though watching my seizures. I’m hoping my Atos interviewer sees what is in front of their eyes and not what the Government want them to see and say. Please, for others out there like me, let there be a way for people who do not abuse the system to be given a fairer crack of claiming what is deservedly theirs. Thank you.”

I thought it was worth reading that out in full because it gives a very clear picture of how this man has had to struggle to keep his family together and to support them in extremely difficult circumstances, where the benefits system seems to mount up against him to prevent him having any kind of reasonable life. I hope that such cases—there are many more of them out there—give the Government cause to think again about how people with chronic conditions are dealt with in the benefits system.

Jimmy Savile (NHS Investigations)

Steve Baker Excerpts

Thursday 26th February 2015 Commons Chamber

[Mr Hunt]

The report clearly says that every trust must have a named director who is responsible for safeguarding. One can draw one’s own conclusions about whether senior management knew or not. The report was unable to find evidence that that was the case, but nor did it say that it was not the case. One comes away with the clear suspicion that senior management may not have wanted to hear the things that they were being told because of Savile’s importance in fund raising and possibly his celebrity status. That is what we must make sure never happens again.

[Steve Baker (Wycombe) (Con)]

With Stoke Mandeville serving my constituents, I was reassured to hear that in the present culture these appalling circumstances are not likely to be repeated. Can my right hon. Friend reassure me that it is now far more likely that we will see prosecutions within the lifetime of perpetrators rather than this horrific clean-up exercise after a perpetrator’s death?

[Mr Hunt]

I do believe that that is the case. I want to put it on record that Buckinghamshire Healthcare NHS Trust, which includes Stoke Mandeville, has made huge progress in turning round and improving its culture. It came out of special measures last year and the staff and management are to be congratulated. His constituents can be confident that, although things are not perfect, huge progress has been made to improve standards.

Oesophageal Cancer

Steve Baker Excerpts

Monday 23rd February 2015 Commons Chamber

[Jane Ellison]

In a recent Back-Bench debate on cancer, mention was made of the tension that we all feel as constituency Members between the desire to have services nearby and the recognition that the expertise resulting from seeing lots of cancers, particularly the rarer ones, is really important to developing clinical excellence. We have to be clear that there are areas where concentrating excellence and clinical experience will save lives, and my hon. Friend perhaps highlights one such area. We often underestimate just how few cancers of any kind the average GP sees, and that is especially true of rarer cancers.

Let me go back to the different ways of looking at earlier diagnosis. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17. In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support—CDS—tool for GPs to use in their routine practice. It covers lung, colorectal, pancreatic, oesophagus and stomach, and ovarian cancers. Following the pilot, the CDS tool has been refined and is currently installed in more than 1,000 GP practices across the UK. It is designed exactly to deal with the point about helping people who do not see certain things very often with those diagnostics. Macmillan is working with software companies to adapt the CDS for different IT systems and make it available to GPs as part of their standard software offer.

I just wish to mention the Be Clear on Cancer campaign, which I am glad my hon. Friend the Member for Hove mentioned.

[Steve Baker (Wycombe) (Con)]

The Minister has said many things that give me the impression that there is potential for a huge additional demand on consultants. One of the most striking things that my hon. Friend the Member for Hove (Mike Weatherley) said was that a consultant will get only six minutes with a patient. Will the Minister explain what the Government are going to do to make sure that consultants have enough capacity to deal with the extra demand that is likely as a result of these laudable new methods?

[Jane Ellison]

The cancer taskforce is charged with looking at all those challenges and resolving those tensions, but the NHS’s own “Five Year Forward View” considers some of the ways in which it can be innovative about the use of consultants and the interaction between primary and secondary care, and whether we can do more by looking at that differently. If my hon. Friend is interested in that, it is definitely worth looking at. That is very much the sense of direction and we are now looking to the cancer taskforce to examine all those issues. Parliamentary all-party groups have been asked by the cancer taskforce to contribute to its review, and we ascertained that before the Back-Bench debate. He highlights a fair point; all these things bring their challenges, and that is one reason why we put so much effort into testing the Be Clear on Cancer campaign.

I was delighted that the recent pilot of the Be Clear on Cancer campaign for oesophageal and stomach cancer in the north-east and north Cumbria was so successful. We carry out the pilots in order to understand what additional demand they create in the system, so we can model that and cope with it if the campaigns are rolled out. Following the pilot, a national four-week campaign ran from 26 January until yesterday, and was supported with national TV, radio, digital and out-of-home advertising and a public relations campaign. A variety of face-to-face events were held across the country in venues such as shopping centres.

The campaign aimed to raise awareness of the symptoms of oesophageal and stomach cancers and to encourage those with symptoms such as persistent heartburn to visit their GP. The campaign was targeted at men and women aged 50 and over. Of the nearly 13,000 people who are diagnosed with oesophageal or stomach cancer each year in England, more than nine out of 10 are aged 50 and over. The campaign was also aimed at friends and family, who can encourage those with symptoms to make an appointment with their doctor if they are concerned. We are all aware of those times when despite knowing what is good for us, we need a loved one to say, “It is time to go to the doctor.” The campaign takes that into account.

Let me deal with the clear and good points made about endoscopy, including by my hon. Friend the Member for Winchester (Steve Brine). We accept that there are issues to address on endoscopy capacity, which is why we have been working with NHS England and Health Education England to prioritise this area. A joint endoscopy working group, set up by the NHS England’s national clinical director on diagnostics and imaging, has been analysing the latest data, and an action plan has been developed to ensure sufficient capacity in the short and long term.

Let me briefly mention treatment. NHS England’s oesophageal and gastric cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective oesophageal cancer services, in line with the National Institute for Health and Care Excellence’s clinical guideline, “Improving Outcomes in Upper Gastro-intestinal Cancers”.

I want to touch on research, because people should understand what we are doing to invest in understanding more about these specialist areas. The National Institute for Health Research has awarded £2 million for a research professorship with a focus on improving outcomes for oesophageal cancer through innovative screening and surveillance tests. It is also funding a £2 million trial of palliative radiotherapy in addition to self-expanding metal stents for improving outcomes of dysphagia and survival from advanced oesophageal cancer. The NIHR clinical research network is currently recruiting for 24 clinical trials and studies in oesophageal cancer.

In conclusion, I thank my hon. Friend the Member for Hove for securing this debate and congratulate him on the way he moved and delivered it. I do not underestimate the challenge of improving outcomes for people with oesophageal cancer. However, I hope that what I have briefly set out here shows that we are committed to improving cancer care through building greater awareness among the public; targeted and high-profile awareness campaigns, such as the Be Clear on Cancer; using technology and innovation to support GPs to better identify symptoms and improve the referral process; and taking action to ensure sufficient capacity in areas such as endoscopy. Things are improving, but there is much work still to be done. We are committed to improving cancer survival rates and building on the improvements we have made so far so that we have the best cancer outcomes in Europe. My hon. Friend’s speech tonight illustrated far more eloquently than I can, with all my facts, figures and statistics, why that is important to our fellow countrymen and women and why it is so important that we continue to make progress, and I thank him for highlighting that this evening.

Question put and agreed to.

Francis Report: Update and Response

Steve Baker Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

That is an interesting point and we should certainly reflect on it in the consultation. I am looking forward to visiting my hon. Friend’s trust in March. On many of the visits I have made to hospitals in special measures, which his hospital is not, I have met union representatives and they have an important contribution to make, because nine times out of 10 the real problem is that the people on the front line feel they are not being listened to, and when that is put right the other things start to be solved as well.

[Steve Baker (Wycombe) (Con)]

As a former airworthiness engineer, may I strongly endorse my right hon. Friend’s direction of travel? Will he confirm that Buckinghamshire Healthcare NHS Trust, having exited special measures after the Keogh review, has enjoyed a fantastic transformation, which I believe he saw when he visited Wycombe hospital?

[Mr Hunt]

I had a fantastic visit there. This was a hospital that, putting it bluntly, was one of the worst in the country, and it is now on its way to becoming one of the best. The motivation and excitement not just of the management team but also the staff there, were palpable, and I think a huge number of good things are happening. What has worked there is the sense that what we are asking of the hospital is the same thing that they want to deliver for their patients—safe, compassionate care—and that must remain the focus.

Human Fertilisation and Embryology

Steve Baker Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Jane Ellison]

No, I cannot accept that description. I recognise that my hon. Friend has objections to the procedure, but I do not recognise his description. Nuclear DNA is not affected; mitochondrial DNA is different.

As well as paying tribute to the scientists at Newcastle university, I want to pay tribute to the Lily Foundation, a charity founded by families who have lost their children to serious mitochondrial disease, and who have shown us the human suffering behind this scientific advance. Many right hon. and hon. Members, like me, have constituents who are affected, and I am sure that some Members will talk about such families in their own speeches.

[Steve Baker (Wycombe) (Con)]

Does the Minister accept that a person born as a result of a mitochondrial replacement would not pass on mitochondrial disease to their successors? In other words, the germ line would have been modified so that the mitochondrial disease had stopped with their parents. It seems to me that if she accepts that the germ line has been modified, what she said a few moments ago cannot possibly be right.

[Jane Ellison]

We have made it clear that the removal of the faulty mitochondria will be passed on to the next generation. That is exactly what we have been describing, but I do not accept my hon. Friend’s description of it as genetic modification. It has to be said that there is no universally agreed definition of genetic modification, but for the purposes of these regulations, we have used a working definition and it involves not altering the nuclear DNA.

--- Later in debate ---

[Andrew Miller]

The ethical basis on which science is conducted in this country is world leading. The hon. Gentleman is right to say that we should be immensely proud of the successes—again—of our scientific community in a range of life science disciplines. This one affects a very small group of the population but does so in such a profound way. Although there are issues that need properly regulating, the regulatory structure that we have created does that properly. The Minister was asked about, and indeed mentioned, the issues associated with designer babies. Of course this House would want to impose limits, but we are considering a specific set of regulations about dealing with mitochondrial disease—they do nothing else. I, for one, would not stand here to defend the concept of designer babies and people choosing eye colour and so on. Today, we are dealing purely with those terrible illnesses.

[Steve Baker]

Will the hon. Gentleman give way?

[Andrew Miller]

No, as it would not be fair on other people. In case colleagues have not seen them, let me commend the e-mails sent to all Members by the Muscular Dystrophy Campaign; Jonathan Kingsley wrote to us all, and the Lily Foundation has written to us all in very powerful language. Those people who have sat and listened to some of the families will understand, and colleagues who have constituents affected by mitochondrial disease will understand the message.

We are in a society where people are entitled to have their beliefs, and I respect those beliefs; everyone should be entitled to express their opinion. But this is about focusing on the needs of that small part of the population that I mentioned. I urge the House, in coming to a conclusion this afternoon, to think about those families, to focus on their needs and to set aside general beliefs in the overwhelming interest of that small part of the population who have suffered immensely and who have an opportunity at their disposal because of the extraordinary science that has been advanced.

[Steve Baker (Wycombe) (Con)]

I approach this subject with a considerable degree of humility, for two reasons. First, I will never forget meeting a family in my constituency whose child suffers from mitochondrial disease; there was both a haunting sorrow in that family and the hope that if these regulations are passed they will be able to have a child without this problem. Secondly, I am very aware of my own shortcomings in relation to biological science. As a chartered engineer, I am perhaps more competent in the physical sciences, and I do not mind admitting that I had to look up at least a few of the words in the regulations in order to understand them.

As I have listened to this debate, not only today but previously, I have wondered whether we have really reflected on how science proceeds, because scientific truth is not established by authority or by democratic vote; it is established, as Karl Popper put it, through “conjecture and refutation”—trial and error. Someone who reads Thomas Kuhn’s “The Structure of Scientific Revolutions” will discover that it is possible for quite large bodies of knowledge to be developed with errors in them. When those errors are corrected, the paradigm shifts—that is a term we have all heard. That is how science proceeds, through trial and error. The reality is that there will always be uncertainty in any scientific procedure.

When the Commons Library summarised the Nuffield Council on Bioethics’ review, the second point mentioned was this:

“The knowledge about these techniques is uncertain and could remain so for several generations—their use could potentially harm future persons.”

The hon. Member for Liverpool, Wavertree (Luciana Berger), speaking from the Front Bench, made the point that, broadly, the question before us was whether there was a reason to withhold these techniques from people. If there is a reason, it is that they may do harm to future persons. I will not support the measure because this is inherently uncertain. That uncertainty is an inherent part of science, and it is no good appealing to authority to try to resolve the question, because different authorities will disagree and there is no way to resolve those disagreements apart from through empirical evidence, which we can obtain only by experimenting on humans.

[Graham Stringer (Blackley and Broughton) (Lab)]

The hon. Gentleman is making a typically thoughtful contribution to this important debate. Does he not have to balance that uncertainty, which he points out fairly, with the 100% certainty that the children of mothers with mitochondrial disease will suffer?

[Steve Baker]

The hon. Gentleman is absolutely right, which is why I began by expressing the humility I feel on this subject as a result of meeting and having had a lengthy conversation with a family who face just that issue. I remind myself, however, that we are dealing here not with a cure for those who have already been born, but with ensuring that those who are subsequently born do not suffer from that disease. If we were discussing a cure for those already living, perhaps the circumstances might be different.

[Angela Smith]

Is prevention not better than cure?

[Steve Baker]

Prevention certainly is better than cure, but the question is: at what risk? I simply accept that on the earliest stages of human life there is a space for conscience; we will have different beliefs, some of which will be religious, and it is a matter of conscience. There are noble reasons for disagreeing about that stage and about what is and is not legitimate risk taking with human beings.

The second point I wish to make is that in the course of this conversation there seems to have been what, at best, I could describe as semantic sophistry as to whether or not this process is genetic modification. As always, there is space for debate about the definition of terms, but the germ line is to be modified if these techniques go ahead. The Minister has stated that plainly—

[Jane Ellison]

indicated assent.

[Steve Baker]

She nods, and I am grateful. If the germ line is to be modified, to me this is genetic modification. I heard the hon. Member for Cambridge (Dr Huppert) give a clear explanation of the separate origins, and he understands the science better than I do. But for me the key thing is not so much where these parts of the DNA identity of a person came from, but where they are now. Each one of us has our own particular DNA identity. This procedure changes only a tiny part of it, but, having changed it, we cannot know what the consequences will be. I know that families will be affected by the decision, but I have to say, with great sorrow, that, when it comes to human beings, this degree of uncertainty cannot be borne by my conscience and I shall be voting against the regulations.