Mental Capacity (Amendment) Bill [Lords]

Tanmanjeet Singh Dhesi Excerpts

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Tuesday 18th December 2018 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

I beg to move, That the Bill be now read a Second time.

Every Member of this House will agree that we have a duty of care to the most vulnerable in our society, and that everybody deserves to be treated with dignity and respect, no matter what their physical or mental condition. I hope that the House will also agree that liberty is a fundamental right, and that no decision on the deprivation of liberty can ever be taken lightly. Such decisions can be taken only to protect society or individuals. There are currently 2 million people in this country who have impaired mental capacity. Care homes and hospitals often have to take decisions to restrict people’s movements in order to protect them. That could involve preventing elderly people with dementia from moving, or stopping vulnerable people getting access to things that they could use to self-harm. The present deprivation of liberty safeguards are meant to ensure that people who lack the capacity to make decisions for themselves are not deprived of their liberty unfairly or unnecessarily, but the current system is broken and needs to change.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

What assurances can the Secretary of State give us that local authorities will be given sufficient resources to allow them to process all deprivation of liberty cases?

[Matt Hancock]

The resource question is an important one, and so too is the process. The question of resources and the question of what the process is go hand in hand. There has been an increase in the amount of resources given to local authorities to enable them to deliver in this area, but the question will undoubtedly arise again as we run up to the spending review.

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[Barbara Keeley (Worsley and Eccles South) (Lab)]

I beg to move an amendment, to leave out from “That” to the end of the Question and add:

“this House declines to give a Second Reading to the Mental Capacity (Amendment) Bill, notwithstanding the need for reform to the current system of mental capacity assessments and while acknowledging the improvements made to the Bill by the House of Lords, because the Bill underwent no pre-legislative scrutiny, it does not put the interests of the cared-for person at the heart of the Bill, it enshrines a conflict of interest in relation to independent providers of health and care services, it fails to provide measures to reduce the substantial backlog of Deprivation of Liberty Safeguards Assessments and it fails to recognise explicitly the interface with the Mental Health Act when determining which legislation should be used to authorise care or treatment arrangements.”

The issue before the House today is one of fundamental importance to us all: the individual liberty of vulnerable people. Today, we are being asked under which conditions it is right to deprive vulnerable people of that liberty when they need care and treatment and cannot give their consent, and what protections should be in place when their liberty is taken away.

The proposals in the Bill to replace deprivation of liberty safeguards have the scope to affect the rights of a large portion of the 2 million people in the UK thought to lack capacity to make their own decisions. Among them are people with dementia, learning disabilities, autism and brain injuries. Whether to deprive some of the most vulnerable people in this country of their liberty should be an issue that we treat with the utmost respect, thought and care. However, I am afraid the Government’s approach to this immensely important issue has shown few of those qualities.

The reform of the Mental Capacity Act 2005 requires methodical planning, but the truth is that the Bill has been rushed through without proper scrutiny, despite the best efforts of many people who are concerned about its contents and have been working to change it for the better. The fact that the Bill has less than two hours for Second Reading and was brought forward with just two sitting days’ notice speaks volumes of the speed that the Government are adopting in respect of the Bill, and will raise further concerns among those who care about these matters.

The process of reforming the 2005 Act began when the Law Commission produced a draft framework for new liberty protection safeguards to replace the existing deprivation of liberty safeguards. That came after two years of painstaking work and wide consultation ended last year. The Government accepted the commission’s proposals at the time they were produced, but the Bill that was introduced to the House of Lords has diverged substantially from the original recommendations— an issue on which the Secretary of State answered a question earlier. At the outset of the process, the draft Bill published by the Government was subject to no prelegislative scrutiny whatsoever, meaning that important stakeholders were not consulted about its contents.

During the Bill’s passage through the House of Lords, my colleagues and I heard many concerns about it from interested stakeholders, from charities representing people with dementia, learning disabilities and autistic people through to directors of adult social services, organisations representing social workers, and social work professionals involved with the current system. They have been unanimous in their agreement that the Bill is deeply flawed, that there has not been adequate time for consultation, and that the proposals in the Bill could cause more problems than they solve.

The Secretary of State quoted a smattering of organisations; let me read him this list: the Relatives & Residents Association, Mencap, the National Autistic Society, Mind, Rethink, the Alzheimer’s Society, VoiceAbility, Disability Rights UK, POhWER, the British Institute of Human Rights, Sense, Liberty, Learning Disability England and Inclusion London have all called for the Bill to be paused so that further consultation can take place. But as we can see today, that call has not been heeded.

[Mr Dhesi]

Does my hon. Friend agree that, given that Sir Simon Wessely’s review has only just been published, the Government should consider pausing the Bill to look into the interplay between it and the recommendations on the Mental Health Act? Otherwise, we risk creating legislation that fits together very poorly.

HIV and World AIDS Day

Tanmanjeet Singh Dhesi Excerpts

Thursday 29th November 2018 Commons Chamber

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

On 1 December 1988, we observed the first World AIDS Day. It was created as an international day to raise awareness of the AIDS pandemic caused by the spread of HIV and to mourn those who had died from the disease. In two days’ time, we mark its 30th anniversary, and this event gives us pause to reflect on how far we have come and to remember those we have lost.

Such events are also deeply personal to me, because next year I will be marking an anniversary of my own —10 years since I became HIV-positive. It has been a long journey from the fear of acceptance to today and, hopefully, advocacy, knowing that my treatment keeps me healthy and protects any partner that I may have.

When you are first diagnosed, you get that call from the clinic and they just say, “You need to come in.” They do not tell you the details, and you know immediately that something is wrong. All the different worst-case scenarios flash through your mind, and of course, being a sexually active young man, HIV is one of them. Going in, you kind of know that something is wrong and it might well be serious, but at the same time you are working out all the ways that this is just some joke, some technical error, some tiny thing they are going to tell you that you will be laughing about later. You try to imagine the ways you are going to get out of this, and then in that NHS room, with those cream carpets and the plastic seating we all know, they tell you, and it hits you like a wall. Although you have prepared yourself for it in your mind, nothing quite prepares you for when they say those words. I remember looking up at that ceiling—those false ceilings you get—and wishing that one of the tiles would rip away and it would suck me up, and that I would wake up and it would all be a dream and all be over.

But, of course, the reality is that that is not what happens. Instead, you walk out of that room and, even with all the greatest support and advice that they offer, you feel totally numb. You have a million things running through your mind and, at the same time, a sense of absolute nothingness.

I have decided to make this announcement and speech today, because earlier this year I was at an awards ceremony in Brighton. I had nominated Gary Pargeter, who for a number of years has been running a local club for people living with HIV called Lunch Positive. He had won the award and people were coming up to talk about how important the project was and how brave he had been to talk about his HIV status, and I felt like, “I am watching someone who has done inspiring work, and I am proud to have nominated him, but I have not told anyone else in this room that I am HIV positive, too.” Just like so many who attend Lunch Positive, I am lucky because the medication means I will not get sick and I cannot transmit HIV. I felt that if Gary and so many others can talk openly about it, then so should I.

The second reason I wanted to have this debate today is because we are genuinely on the cusp of eradicating new HIV transmissions in this country. Figures today show that we are already, in parts of this country, halting the rates of HIV diagnosis, but we are at a fork in the road and I worry that we might be starting to head in the wrong direction, with £700 million of cuts to public health having been made between 2014 and 2017. We are not investing in the universal roll-out of PrEP—Pre-exposure prophylaxis—the pill that prevents HIV. So it is important for me politically to speak out.

Finally, I wanted to be able to stand here in this place and say to those who are living with HIV that their status does not define them and we can be whoever we want to be, and to say to those who have not been tested, perhaps out of fear, that it is better to live in knowledge than to die in fear. HIV in this country is no longer the death sentence it once was. A recent study led by the University of Bristol found that due to the advances in HIV treatment, people living with HIV can expect to live a near normal life. The improvement in survival rates for people with HIV is one of the greatest success stories of recent times. What was once considered a terminal disease is now seen as a manageable condition. Yet this information has not changed the narrative, which is still, sadly, framed in those scare campaigns of the tombstones of the 1980s. So much of LGBT culture also is marked by this spectre of HIV, which has led to an incredible sense of fear about the disease.

In that hospital room, and in the days and weeks that followed, I had to come to terms with that fear myself. I am a HIV-positive man, but because I have been taking the right medication for several years I am what the NHS calls “HIV-positive undetectable”. That means not only can HIV not be detected in my system and so I do not get sick, but I cannot transmit HIV to someone else. As the virus lie undetectable and dormant in my body, my medication ensures that the virus does not reactivate, does not progress and cannot be passed on. That is why the NHS says “undetectable equals untransmittable”. UNAIDS highlights three large studies conducted between 2007 and 2016 of HIV transmissions among thousands of couples where one partner was positive and the other was negative. In those studies there was not a single case of sexual transmission of HIV from a positive undetectable person to a HIV-negative partner. It is safer to have sex with someone who is HIV-positive undetectable than with someone who does not know their status, because undetectable equals untransmittable.

Understanding that I was unable to transmit HIV sexually has been life-changing, too. I went from thinking that I would never have a HIV-negative partner, or that if I had sex with someone, I could pass this on, to knowing that I can live a normal life and that any partner I have is totally protected. I cannot transmit HIV to my sexual partner, I have a perfectly healthy life, so my announcement here today should go totally unnoticed—

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

My hon. Friend is being immensely courageous in what he is doing today. I, for one, am sure that his bravery will reduce the stigma and the fear of so many living in our country and beyond.

[Lloyd Russell-Moyle]

I thank my hon. Friend for that. He is right to say that my name will help those people, and it might appear in tomorrow’s newspapers as a result of my being the first MP to declare themselves HIV-positive in this Chamber and the second, after only Chris Smith, to openly live with HIV as an MP.

BAME Blood, Stem Cell and Organ Donation

Tanmanjeet Singh Dhesi Excerpts

Wednesday 27th June 2018 Westminster Hall

[Mohammad Yasin]

My hon. Friend makes an important point and I will refer to similar points later in my speech.

Sadly, despite receiving a transplant, Rakesh’s condition, MDS, was so advanced that he died in December 2014, leaving Poonam and their two young children. After Rakesh’s death, Poonam decided to raise funds for Anthony Nolan and raise awareness among people from south Asia and other ethnic minority backgrounds about stem cell donations.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

I thank my hon. Friend for securing this debate. Does he agree that Health Ministers should work more closely with grassroots and community organisations? Currently, donors from Asian or other minority ethnic backgrounds make up just 15% of the stem cell register, but campaigns such as Cure Kaiya, which held an event in my constituency, and Match4Rajie are encouraging more people from BAME backgrounds to become registered donors.

[Mohammad Yasin]

My hon. Friend makes a very important point.

In November, Poonam’s fundraising efforts were recognised when she was awarded individual fundraiser of the year. I was so inspired by her story that I wanted to help raise awareness of the issue in BAME communities, because none of us know whether we or one of our loved ones might be a name on that list in need of a match, desperately waiting for a lifesaving opportunity. The reality is that many patients will not receive the stem cell transplant they need, because either there is no donor available or a donor cannot be found quickly enough. Only 20% of BAME patients receive the best possible match, compared with 69% of white, northern European patients.

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[Jackie Doyle-Price]

The NHSBT strategy has that in mind. Recently, we had a faith summit where we worked with the individuals who are able to go out and give those messages. The approach must be organic. I have also tasked NHSBT to work with me to develop an MP’s toolkit to help us to go out in our constituencies and develop the right networks and links. The hon. Lady is right to say that people from these communities will listen to their elders and other representatives, and that is why we need to work through those people. We are doing that with a number of organisations.

Turning to stem cell donation, all hon. Members articulated beautifully the real disparity of access to appropriate treatment. It is only by building and diversifying the UK stem cell register that we will be able to provide the best match for patients. Hon. Members have raised the issue of an international register; the Department funds Anthony Nolan’s efforts in this area. Members of the World Marrow Donor Association already promote global collaboration. We will continue to support that as best we can, working with Anthony Nolan and NHSBT.

NHSBT continues to grow both its cord blood banks and bone marrow donor registers, with the explicit intent of increasing the number of black and Asian donors. Overall, we have paid more than £20 million to NHSBT and Anthony Nolan specifically for stem cell donation since 2015. So far, we have made some progress in increasing donations from black, Asian and minority ethnic backgrounds, but not nearly enough to address the disparity. We will all continue to make our efforts count in that area.

I pay tribute to the initiative of the Bandhan Bedford Group that the hon. Member for Bedford mentioned. If there is a good local champion that captures local imagination, real progress can be made. We all need to encourage those sorts of activities.

Turning to blood, there is a real need for black donors and donors from the Asian community to increase supplies, not least because they are more likely to suffer from diseases that will require blood transfusions, specifically sickle cell anaemia. We are undertaking initiatives to increase the number of black and Asian blood donors. We are holding “know your type” events in high population areas, where people can learn their blood type with a finger prick test. That will help NHSBT to manage its blood stocks and develop a database of exactly the type of blood that there is a shortage of.

We are supporting others, such as the music of black origin awards, to reach audiences. Those who watch “Britain’s Got Talent”—I watch it—will have seen the B Positive choir, who did so much to raise awareness and were absolutely fantastic.

[Mr Dhesi]

In terms of outreach work, whether with the MOBO awards or otherwise, can the Minister outline the steps that have been taken to reach out via the media? I am not just referring to the national media but the culturally specific and ethnic media, which have a greater outreach in those ethnic minority communities.

[Jackie Doyle-Price]

The hon. Gentleman makes a good point. I could not give him a definitive answer at this moment in time. I would expect NHSBT to be using those outlets to spread the message. If it is not, I will make sure it does, but I will ask that question and I will write to him with a fuller answer.

Turning to organs, we have discussed that there are around 6,000 people waiting for an organ transplant, of whom 34% are from a black or Asian background. That illustrates the disparity, given that only 6% of deceased donors were from those backgrounds. There is a real challenge to ensure that we are able to save all the lives we can through transplant. We have a big campaign designed to improve the rates of organ donation.

We estimate that if the private Member’s Bill from the hon. Member for Coventry North West successfully passes through Parliament, it will save an additional 200 lives a year. That is not to be sniffed at. As a Health Minister, I would be failing in my duty if I did not do everything I possibly could to secure the passage of that Bill, and I will do that. But that does not alter the fact that we still need more black and Asian people to agree to go on the register. We are working on a number of tools to address people’s real concerns, whether they are about faith, belief or heritage. We need to be able to produce materials that attack misconceptions but do so in an extremely sensitive way to those who will react to them.

Again, I encourage all Members to get involved in helping us to develop those tools and in spreading those messages as best they can. We have a library of resources that are specifically tailored to particular communities, but I am always open to any suggestions for what more we can do, because ultimately this is a very serious injustice that we need to tackle. I have a very large black African Christian community in my constituency, so I am used to engaging with them, having these debates and encouraging them to sign up to the register. We can all do that.

I am very grateful to the hon. Member for Bedford and to all hon. Members who have shown support for this debate. I am under no illusion about the challenge here, but I am very heartened to see that so many Members recognise that this is a problem and are taking positive steps to do something about it. Those are the ingredients for success, but I will not be complacent—this is a tough one for us to tackle. I thank all donors, whether of blood, stem cells or organs, for everything that they have done to save people’s lives.

Question put and agreed to.

Cancer Treatment

Tanmanjeet Singh Dhesi Excerpts

Thursday 19th April 2018 Commons Chamber

[Peter Kyle (Hove) (Lab)]

Thank you, Mr Speaker, for being present in the Chamber today. I know that you take the Chair most Thursdays, but I choose to interpret your presence today as a testament to Tessa. He is not in his place at the moment, but it is worth recognising that the Secretary of State was present not just during today’s debate but in the debate in the Lords. That was recognised by many of us and very much appreciated.

I want to start by talking about my mum, Joanna Kyle, later Murrell. In 2011, my mum presented to doctors with severe back pain, for which she was given medication but no further tests. In the 18 months that followed that visit, she went to doctors and clinicians and to hospital no more than a dozen times with the back pain, which never went away and only got worse. She was sent for numerous tests on her back, but on her final visit to the GP, when her husband said, “Please run more tests because the pain is not going away,” the GP simply replied, “Why on earth would I do that?” A week later, my mum collapsed. She was taken to hospital and diagnosed with stage 4 lung cancer. Within a month, she had died. Her mother had lung cancer, my mum had been a smoker earlier in her life—one would have thought that those were the sort of things that would have been picked up much earlier.

At the point at which my mum was diagnosed, she had only a 21% chance of living a year. If she had been diagnosed at the point at which she first presented to the doctors, in all statistical likelihood she would have seen me, her son, enter the House of Commons. There would have been a very good chance that she would have been here today or, most likely, outside enjoying the weather at her house in Devon.

My mum was not a complainer. She did not push herself forward, and she did not complain, thrust or make sure she got all the attention she needed. This is a good link from my mum to Tessa. Many people who do not know the relationship I have with Tessa might not see the link between my mother and Tessa, but for me it seems very logical. Tessa has always played a very strong and maternal role in my life, always—always—pushing me forward. For me, the link is an easy one. Tessa, too, is not a complainer, but my God she is a doer. She has always got things done and it is easy to pay tribute to her not just for her stellar career and achieving the Olympics but for her wonderful family. These debates in Parliament are the best testament to her, because amid the anguish of living with cancer, Tessa’s first instinct is to make life better for others.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

Does my hon. Friend agree that although we pay tribute to the incredible bravery and determination of Baroness Tessa Jowell, we also need to pay tribute to the amazing work of Cancer Research UK, which has an impact not just in our country but around the world?

[Peter Kyle]

Of course I do. My hon. Friend makes an important point. Tessa, too, has been linking with many organisations, bringing them together and focusing attention on them but, just because that is so typically Tessa, it does not make it any less remarkable.

For brain cancer to be tackled, three things must happen. We need to sort out funding, innovation and the use of data, and I will speak about the data. The working group set up by the Department of Health and Social Care said that brain tumour patients would like

“their health data to be used for research to speed up development of new treatments. Regulators should respect these wishes.”

Lord Freyberg said in the debate in the other place that Britain has a “globally unique research asset” in the NHS. We have cradle-to-grave records covering millions of people, and examples from those records could revolutionise care and research. Those records need to be much better utilised.

That is the data at the very top, but we now see in America how Apple is revolutionising the use of health data down to the individual. Last month a dozen healthcare providers in the US partnered with Apple to provide health records directly on to patients’ phones via an app. The information is presented in a way that incentivises healthy choices and empowers patients not only to make the right choices but to have a more natural relationship with their health and health information, and with the professionals who provide it. With our NHS, we have infinitely more potential than any other country on earth to revolutionise health research and the way we manage and maintain our own health. We need far more ambition to realise that.

I end with another quick word about Tessa, because I would not be here if not for strong women like Tessa pushing me forward way before I came to this place and way before I got into politics. In all those situations I knew Tessa and felt her guiding hand gently pushing me forward. She gave me the kind of mentorship that people need. I have articulated to her many times that it has always been a source of regret that we were never able to sit on these Benches together, because I believe hers is the sort of mentorship from which somebody like me would really benefit as they enter this place.

Tessa, to be here today in the same Chamber as you, and to be sharing these green Benches with you for these few moments, is something I will remember for the rest of my life.

Austerity: Life Expectancy

Tanmanjeet Singh Dhesi Excerpts

Wednesday 18th April 2018 Westminster Hall

[Louise Haigh]

My hon. Friend is absolutely right. It has particularly hit older women, and I will come on to that disproportionate impact shortly.

Something is adversely affecting the health of our population, and as my hon. Friend has just said, none of it is happening in a vacuum. The observation is unavoidable that these patterns coincide with the era of austerity. It is simply inconceivable that the state of our public realm, welfare system, housing, fuel poverty, child poverty and our NHS have nothing at all to do with it. The number of NHS trusts with budget deficits has increased sharply since 2015, as have waiting periods for elective surgery and waits for urgent care. Hospitals are now warning of an “eternal winter”, as records show the number of patients receiving urgent care within four hours fell to a record low in March 2018. Almost half a million patients waited longer than 18 weeks for planned care.

This week, the Royal College of Physicians raised the alarm, writing to hon. Members to tell us that hospitals are “underfunded, underdoctored, overstretched”. That will not be news to anybody who has been anywhere close to the NHS in recent years. However, the shortage of doctors and consultants revealed by the RCP is systematic and shocking; 43% of advertised consultant posts last year in Yorkshire and the Humber were not appointed to. In acute medicine, only five out of 26 posts were successfully appointed to. The RCP concludes that these workforce shortages have direct implications for patient safety. Although our hospitals still provide expert care, relentlessly drawing on the good will of staff—who cannot possibly provide the best possible care when under such pressure—is unsustainable.

Issues within the NHS are being compounded by problems with the provision of adult social care. According to the King’s Fund, in 2016-17 there were 380,000 cases of a delayed transfer of care due to patients’ awaiting a hospital assessment. A similar number were waiting for a place in a nursing home. It is little surprise that the sorry state of our social care system should be linked to a fall in the life expectancy of older women living in the poorest parts of the UK, because that cohort has seen a disproportionate fall in their life expectancy. For the first time, health inequality is rising because the most deprived are suffering with poorer health.

I have often heard it said that the elderly have been protected from the worst ravages of austerity, but the elderly who live in deprived communities have been hit many times over. Relevant to this debate, they have been hit first by the cut in pension credit for lower-income groups and then through the funding pressures on adult social care. Of course, it is in the local authorities serving the most deprived areas that these effects have been felt the most.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

My hon. Friend is making an excellent speech, especially on the impact on the elderly. However, does she agree that more and more children are now being impacted by austerity? Slough Foodbank has noticed an increase in the number of families attending its food bank, saying:

“When we checked the vouchers, we discovered that there had been an increase of 16% in the number of children we helped in 2017 compared to 2016.”

Does my hon. Friend agree that it is important that child poverty is addressed now? There are lifelong implications for those who grow up in poverty, such as poorer academic results, employment prospects and life expectancy.

[Louise Haigh]

I am glad that my hon. Friend raises that important point, because I am not able to address all the factors behind declining life expectancy. The British Medical Association raised that point this week, saying it is very concerned about the 5 million children growing up in poverty and the implications that that will have in the future on life expectancy.

Oral Answers to Questions

Tanmanjeet Singh Dhesi Excerpts

Tuesday 20th March 2018 Commons Chamber

[Caroline Dinenage]

The Secretary of State was with Andrew Dilnot yesterday, and we are looking carefully at his proposals. My right hon. Friend is right: although 81% of adult social care providers are registered as good or outstanding, it is unacceptable for levels of care to fall below the standards that we would expect, and in preparing the Green Paper, we will look closely at how we can improve the system.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

19. According to recent polling by the Alzheimer’s Society, public concern about the social care system is growing, and it is clear that action is needed now to fix the crisis. Why will the Government not heed the will of Parliament and commit themselves to closing the social care funding gap, as agreed in the vote on our Opposition day motion last October?

[Caroline Dinenage]

I do not entirely agree with what the hon. Gentleman has said. We provided an extra £2 billion in last year’s Budget to help councils to commission care services that are sustainable, high-quality and diverse. In the Green Paper, which will be published this summer, we will consider how we can future-proof the system.

Hospital Car Parking Charges

Tanmanjeet Singh Dhesi Excerpts

Thursday 1st February 2018 Commons Chamber

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

First, I wish to thank the right hon. Member for Harlow (Robert Halfon) for having secured and initiated such an important debate, which affects so many in my constituency and across our country. For many, attending a hospital is a vulnerable time, whether we are seeking treatment for ourselves or for a loved one. Our hospitals are indeed underfunded and overstretched, but it is not for sick patients, anxious relatives and already hard-pressed NHS staff to be filling the funding gaps.

We have heard that hospital car parking charges raise funds, but many hospital trusts up and down our country have increased their charges without consulting the public—the very people they are there for. Some trusts allow private contractors to manage car parking sites, which is leading to penalties and fines for patients and visitors, as we have heard in this important debate. At a time when the cost of living is increasing and those who work in the public sector have had their pay capped, the rising cost of hospital car parking only increases the financial burden on many in our constituencies.

It is not just the patients who are deterred by higher charges; families and friends might be discouraged from visiting patients at their bedside, which must surely have a negative impact on the mental wellbeing of patients and lead to increased pressure on nursing staff. From personal experience, I know that many patients rely on relatives and friends to act as interpreters or advocates. Such elements are seemingly overlooked when surveys and reports are undertaken, but patient care can be impacted where higher charges deter people from providing such crucial assistance.

[Andrew Lewer (Northampton South) (Con)]

We have heard a lot about staff and patients and families. My right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) mentioned volunteers earlier, and the hon. Gentleman is talking about the importance of patient support. Does he agree that it is particularly short-sighted of any hospital trust to seek to charge volunteers, who give of their time, for parking?

[Mr Dhesi]

I thank the hon. Gentleman for his excellent intervention, and I could not agree more. We have heard previously about volunteer drivers. It is just not fair. It is nonsensical to ask them to dig further into their pockets. It also places an unfair and unnecessary burden on hard-working staff who have gone for years without a decent pay rise. While some hospitals offer free or discounted parking for specific kinds of treatment or for people in receipt of specific benefits, there are significant variations in fees across trusts in the same region. Wexham Park Hospital in my constituency has some of the highest parking charges in the region: £3.30 after the first 15 minutes and an increase, in stages, to £8 over five hours. That is the situation in my constituency, but that trust is only doing what all other trusts are no doubt doing and it is within Government guidelines. I do not want older and vulnerable patients to be deterred from attending hospital. They should be able to get to their appointments in a comfortable, dignified, affordable manner and within a reasonable time.

Most NHS car parking charges have been abolished in Scotland and Wales, and I know that the Government have issued guidance to NHS trusts on the implementation of car parking charges, including the provision of discounted or free parking. These guidelines are not based in legislation and appear to have had little effect. The Labour Government in 2010 left fully costed plans to phase out charges for in-patients and their visitors, and in 2015 a private Member’s Bill on this subject gained cross-party support but was talked out. Clearly, many across the country and the House want an end to hospital car parking charges. Let us send a clear message today that there is another way forward and that this unfair stealth tax on the vulnerable must end.

Hormone Pregnancy Tests

Tanmanjeet Singh Dhesi Excerpts

Thursday 14th December 2017 Commons Chamber

[Jeff Smith (Manchester, Withington) (Lab)]

I pay tribute to the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for securing the debate and for their work on this issue over the years. I pay tribute to other hon. Members who have doggedly pursued justice for the victims of Primodos over a long period.

I have come relatively late to this issue, but it is very clear to me that, as my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman) said recently at the all-party group, the lesson we have to learn from previous scandals is that any inquiry must have the confidence of the victims. The report of the expert working group has already failed that test.

I am speaking today because constituents of mine have been affected by the tragic events relating to hormone pregnancy tests. They have contacted me to say that they have no confidence in the process or in the conclusions of the report. The Pierce family and the McLellan family have had their lives changed by Primodos. They are convinced that their family’s issues are as a direct result of Primodos use. Louise, the daughter of my constituent Edward, suffered life-changing multiple health issues. They are just one of many thousands of families who need to see justice for the harm caused by this drug. The announcement of the review gave them some hope, but, having been in contact with them in recent weeks, I know they share the disappointment and anger experienced by many following the publication of the report.

There are too many question marks over the process and over the conclusions of the report of the expert working group. The report itself flags up the difficulty of drawing robust conclusions on the analysis of the studies available. It admits that the available evidence was very limited. It then concludes that the body of evidence did not “on balance”—key phrase—support an association between the use of HPTs and congenital anomalies. We need more explanation and more justification of what is meant by the words “on balance” in the light of such limited evidence.

In 1977, the medical regulator wrote that there was an association between the tests and birth defects. We must therefore ask what new study or evidence is available to dispute that conclusion. It strikes me that, without new research that tries to establish a new body of evidence, it is not possible to determine whether Primodos is safe. I agree with the suggestion that the Government create a ring-fenced fund to enable new studies, perhaps using imaging analysis and molecular study to try to get to the truth. Even new studies are unlikely to resolve the issue definitively—it is likely to come down to a Government judgment on where the responsibility lies—but they may at least give comfort to the victims that the whole process has been carried out thoroughly.

As we have heard, there are questions about the regulatory regime surrounding hormone pregnancy tests—I do not have the time to get into the details—but the biggest question is surely over whether this product should have been allowed on the market at all without proper testing.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

My hon. Friend is making an excellent speech. I commend the right hon. Member for Hemel Hempstead (Sir Mike Penning) for bringing forward the motion, and other hon. Members. I particularly commend my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for all her work over the years. I think that my hon. Friend the Member for Manchester, Withington (Jeff Smith) will be aware that countries such as Finland, Sweden, Holland and Norway actually banned the use of hormone pregnancy tests between 1970 and 1971. Does he agree that the warning signs were clearly indicated at the time, so action should have been taken then to prevent foetal malformations and all the ensuing heartache?

[Jeff Smith]

My hon. Friend is right and makes an excellent point. We must ask why there was so little regulation for so long, given that it is possible to regulate on a precautionary basis, and whether there is a Government liability under general product law that is meant to protect citizens. Those questions need to be considered in detail.

We heard other questions about the transparency of the report, including that the published report is not the original report that was first presented. A number of inaccuracies were identified and key wording was changed, including the word “definitive”, which was removed. So is this a definitive report? If not, we clearly need a new inquiry. I am running out of time and other people have covered transparency, so I am not going to talk in great detail about it.

There are too many question marks over this issue. In order to regain the trust of the victims, the Government must commit to a judge-led independent public inquiry under the Inquiries Act 2005 to look at the issue again. The inquiry must have all the powers needed to bring to light all available evidence relating to the scandal, including the ability to compel witnesses to give oral evidence. The inquiry must be broad enough to look at the scientific and legal issues in the case, including the allegations of liability. Finally, the victims and their families must be involved in the design and implementation of the inquiry following the Hillsborough inquiry’s families first approach.

As we have heard, there are concerns across the House about this matter. It is not a party political issue. Something is not right and we need to get to the truth. We owe it to the victims and to people who may still be taking products related to these drugs. The only way we will get to the truth is with a judge-led inquiry.

Baby Loss Awareness Week

Tanmanjeet Singh Dhesi Excerpts

Tuesday 10th October 2017 Commons Chamber

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

Following on from the very moving and courageous speeches by hon. Members about Baby Loss Awareness Week, I rise as someone whose own family members have suffered from the trauma of baby loss. Stillbirths and neonatal deaths affect so many in our community, including in my Slough constituency. The son of my very good friend Councillor Madhuri Bedi was born prematurely. He had strep B, which gave him brain damage. The family had to make the harrowing decision to switch off his life support machine only one day into his precious life. As they remarked, there is very little awareness and not enough support. That is something that we all need to work towards.

I commend the excellent work done by so many individuals, campaigners and hon. Members, on a cross-party basis. I also pay tribute to members of the all-party parliamentary group on baby loss.

[Melanie Onn (Great Grimsby) (Lab)]

On that point, will my hon. Friend join me in welcoming the recommendations in the updated clinical guidance from the Royal College of Obstetricians and Gynaecologists, which include the recommendation that all pregnant women should at the very least be provided with an information leaflet on group B strep, as a tool to raise awareness and prevent what he has just described?

[Mr Dhesi]

I fully concur with my hon. Friend and thank her for her intervention. In that regard, I would very much like to pay tribute to hon. Members in the all-party group. I look forward to joining them tomorrow to provide whatever little support I can.

It is wonderful to see the advances made and also the pledges made by the Minister, whether on maternity safety champions, funding for safety and training at hospitals or the national bereavement care pathway. I for one most sincerely hope that he and the Government will continue in this endeavour to ensure that we make further advances and minimise the trauma suffered by so many.