Oral Answers to Questions

Tim Farron Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Speaker]

Not only was the hon. Lady present in Speaker’s House this morning, but her sister and distinguished speech and language therapist Rosalind Pow was present as well, so we had two doses of Pow in the course of a breakfast meeting. It was an unforgettable experience for all concerned.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I cannot compete with that, Mr Speaker. Back in November, I wrote to the Secretary of State about the increased service charges on GP practices. Ambleside surgery in my constituency, which serves an increasingly ageing population, faces a huge increase of £25,000—more than double—and the staff there fear they cannot keep the surgery going long term with that kind of increase. A ministerial written response in November did not mention Ambleside once, so will the Secretary of State commit now to intervening directly to guarantee that Ambleside will not have to pay this unjustified additional £25,000 a year?

[Mr Hunt]

I will re-look at the issue and the response that the hon. Gentleman was given. The issue is that there is unevenness and unfairness in the rates charged to GPs whose surgeries belong to NHS Property Services. We are trying to make this fair across the country, but we also want to make sure that no GP surgeries close.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mr Hunt]

We are absolutely going to do that. We have a big programme of expansion in perinatal health support, because there is a lot of evidence that pressures on mothers around the time of birth transmit to their children and can leave lasting damage.

[Tim Farron (Westmorland and Lonsdale) (LD)]

Specialist mental health crisis care for young people in south Cumbria is available only between the hours of 9 and 5 from Monday to Friday. Does the Secretary of State agree that in the light of the Care Quality Commission’s recent damning report of the partnership trust, that is not acceptable? Will he join me in asking the Morecambe Bay CCG to ensure that there is out-of-hours and weekend care for all people?

[Mr Hunt]

I am happy to look into that issue. The hon. Gentleman’s colleague, the right hon. Member for North Norfolk (Norman Lamb), did a huge amount to set up crisis care provision around the country. We need to build on that for the simple reason that, if we are to have parity of esteem, people need to be able to get help in a mental health crisis, just as they are if something goes wrong with their physical health.

Cancer Treatment: Patient Travel Times

Tim Farron Excerpts

Wednesday 10th January 2018 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

I beg to move,

That this House has considered patient travel times for cancer treatment.

It is a great pleasure to serve under your chairmanship, Sir Christopher. I should also like to consider satellite radiotherapies at Westmorland General Hospital.

Almost every story that I have heard or read in recent times about the national health service has been negative. I understand why, given the debate in the main Chamber at this moment, but I sometimes wonder how much this further damages the morale of the thousands of professionals who work in the national health service. So I want to start by paying tribute and saying a massive thank you to those NHS professionals who work tirelessly up and down the country, day in and day out, to look after us and our loved ones when we need it most. I especially want to put on record my appreciation for those who work in cancer care. We have some of the best cancer care in the world. We should all take a moment to recognise the fantastically high standard of treatment that we have in this country, delivered by professionals whose competence and compassion are the hallmark of our NHS.

But here is the problem: yes, we have world-leading treatment, but it is not truly available equally. The availability of care depends hugely on people’s ability to access it. I welcome, and have done so on the record, the £130 million announced by NHS England that is to be invested in improving radiotherapy treatment, and the new service specification, which aims to improve standards across the country. Working in clinical networks and developing specialised services has a strong evidence base, but what is not addressed is the inequality in access to services that already exist. That inequality will only get worse if it is not addressed now by NHS England. I am grateful to the Government that the consultation on allocating that investment has been extended to 24 January, not least because it gives the Minister the chance to amend the criteria and the priorities for allocating services.

I passionately believe that one of the criteria in allocating improved radiotherapy services must be the shortening of the distances that people have to travel, especially for those with more common cancers. My position is backed up by evidence, including a publication in The BMJ in 2016 indicating that outcomes are worse for people who need to travel further. Let me be clear what “worse outcomes” actually means. Worse outcomes can mean patients actively deciding to forgo potentially life-saving or life-lengthening treatment because getting to hospital is just too much of a trauma for them owing to the length and difficulty of the journey that is required. Worse outcomes means choosing forms of treatment that may be less effective than radiotherapy because the nearest unit is too far away. Worse outcomes includes patients failing to complete a vital course of radiotherapy treatment because they simply cannot cope with the gruelling, wearying travelling every single day.

Action Radiotherapy estimates that one in six of us will need radiotherapy to treat cancer at some point in our lives, but easy access to this treatment can depend entirely on a postcode lottery. It is the sad reality that in rural areas of England travel times to cancer treatments can be unbearably long for too many people, and patients are often forced to cover these long distances on public transport. Not everyone has the option of travelling in the relative comfort of a personal car, and even if a person does, driving themselves or being driven, day in and day out for four to six weeks, is a massive challenge. I believe that it is frankly cruel, if we could do otherwise, to force people who are already very poorly to make a two or three-hour round trip every day, for weeks, in order to receive life-saving care.

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

I congratulate the hon. Gentleman on securing this debate. I am a cancer survivor. I survived stage 4 cancer and I had a month of radiotherapy; I had to get the bus most days to get there, and caught a nasty infection because of the travel time, so I fully appreciate where he is coming from. I would like to highlight the cases of families with children with cancer. According to CLIC Sargent there are fewer than 20 treatment centres nationally, and that makes life extremely difficult for families who are having to travel for treatment. Will he pay tribute to CLIC Sargent for the respite care, finance and accommodation that it provides to families going through this terrible process and journey?

[Tim Farron]

I am grateful to the hon. Gentleman for raising those issues and his own personal experiences. As I will come to in a moment, the issues affecting children and young people are even greater. I am very happy to pay tribute to the work and provision of CLIC Sargent and, in particular, to recognise the impact on people with cancer who have young children themselves. Maintaining an income and maintaining family life is an immense challenge, and the distances involved can make it yet harder, so I thank him for that intervention.

In its 2007 report, the national radiotherapy advisory group recommended that cancer patients should have to travel no more than 45 minutes one way—an hour and a half both ways—to receive radiotherapy treatment. This was adopted in the service specification by NHS England, but has since disappeared. Experts in the field maintain that travelling any longer could have a hugely negative impact on treatment outcomes and patient wellbeing. If preventing unacceptable travelling times became a part of NHS England’s criteria for delivering radiotherapy, it would hugely increase our chances of bringing a radiotherapy satellite unit to Westmorland General Hospital in Kendal.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

I thank the hon. Gentleman for giving way during his important and passionate contribution to this debate. I know that he is focused on England, but may I share with him that in Scotland the issue is the same, if not worse, because of the rurality of Scotland and the distances travelled? I find some of his points very interesting when we have the Ayrshire and Arran health board not closing, but reviewing, a chemotherapy unit, Station 15, at University Hospital Ayr. The closure of that unit would impose a 32-mile round trip on patients who, to exacerbate that, may have travelled a 40 or 50-mile round trip. The issue is UK-wide, so I thank him for securing this debate.

[Tim Farron]

I very much acknowledge the hon. Gentleman’s powerful point. In general, it is important that none of us are misunderstood here: centres of excellence are incredibly important; nevertheless access to treatment is also important. Where we are at the moment means that we are looking at the former to the exclusion of the latter, when both could be considered.

[Chris Davies (Brecon and Radnorshire) (Con)]

If I may, I would like to declare that my wife is a therapeutic radiographer in an NHS cancer trust, and put that on record. I agree with my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant). From a Welsh perspective, we are seeing some people travelling 60, 70 or more miles to get radiotherapy treatment. Does the hon. Gentleman agree that satellite centres from specialist centres are the way forward? My wife works in the Hereford cancer unit, a satellite centre from the specialist centre in Cheltenham, which knocks 40 miles off people’s journeys.

[Tim Farron]

I would like to thank the hon. Gentleman’s wife for her work, but also to say that he is absolutely right. There are great models, including from the Christie in Manchester, where they already operate satellite services. Arguing for rural or any form of standalone cancer services is foolish and is not what I am asking for. I am asking for satellites of existing, established, high-quality cancer units such as the Rosemere in Preston, the Christie or others of that nature. Making sure that we meet those needs by having a satellite unit at the Westmorland General Hospital in Kendal would have a positive impact on the lives of thousands of people in south Cumbria who are living with cancer. That is what I ask the Minister to do.

Radiotherapy treatment at Westmorland General Hospital is long overdue and would mean the world to local people, who now have to make the long journey to Preston for treatment. Let us be clear: the Rosemere unit in Preston is excellent—my own mother received wonderful treatment there, and the quality of the service and care provided by NHS professionals still moves me when I look back today—but for most people in south Cumbria, it is ludicrously distant.

[Julian Sturdy (York Outer) (Con)]

I congratulate the hon. Gentleman on securing the debate. Will he also note the importance of local charities? In my constituency, we have a charity called York Against Cancer, which has raised £15 million over the past three years. That money goes towards running a local minibus from York to Leeds for patients who have to be treated at Leeds in the radiology department.

[Tim Farron]

I am very happy to acknowledge the work of local charities in my area. The Rosemere Cancer Foundation and South Lakes CancerCare do immensely good work, just like the charities in the hon. Gentleman’s constituency.

For some people living in the remotest areas of my part of the world—in south Cumbria—who are eligible for hospital-provided pick-ups, a round trip to access treatment in Preston, including waiting times, could easily surpass six hours. That is on a good day, when all standards are being met.

[Steve Double (St Austell and Newquay) (Con)]

I congratulate the hon. Gentleman on securing a debate on this very important matter. The area of Cornwall that I represent has similar issues to those in Cumbria, and NHS England is consulting on closing our only treatment centre for radiography in Truro. That would mean people from the far west of Cornwall having to travel all the way to Plymouth for treatment. At the height of summer, when the roads are busy, that could easily be a five or six-hour round trip. Does he agree that that is far too long to expect patients to have to travel to receive this essential treatment?

[Tim Farron]

Yes, I fully agree. That is why the NHS England consultation is the right time to set criteria. If we all say, “We’d rather like it if these issues are addressed,” nothing will happen, but if they are set as firm criteria and priorities as a consequence of the consultation, something should happen. The hon. Gentleman was right to raise that point.

Requiring NHS trusts to make it a priority for investment to ensure that radiotherapy is available more locally—such as by bringing a satellite unit to our local hospital in Kendal—would significantly improve outcomes for patients. That has been the focus of our long-running community campaign. I want to say a massive thank you to the many thousands of people who have been involved in that campaign so far. Just before Christmas, on behalf of our community, I presented a private Member’s Bill that would specify 45 minutes as the maximum time that patients have to travel to access radiotherapy treatment. I urge the Minister to support that Bill and ensure that the Government accept it.

I was asked on the radio this morning why, after nine years of fighting this campaign, I had not just accepted defeat and walked away. The answer is that every week in Westmorland, more families learn that they must fight cancer, and we have no right to turn our backs on them. Sadly, the challenge of cancer renews itself week after week, and so our zeal in fighting for those families must also be renewed week after week.

[Gillian Keegan (Chichester) (Con)]

Some 840,000 people live in West Sussex and yet we are the only county in the whole of England that has no radiotherapy facilities within its boundary. I can also confirm the point made by my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti). I recently visited the Sussex Snowdrop Trust, which looks after desperately ill children. The stories of them traveling up to London or Southampton and having to stop several times along the way were heartbreaking; it is the worst thing to happen when they are facing that kind of trauma. I agree with the hon. Member for Westmorland and Lonsdale (Tim Farron) completely that patient travel times need to be taken into account during the consultation. I hope that they are, and that St Richard’s Hospital in Chichester is considered as a worthwhile investment for LINAC—linear accelerator—machines to help local people in West Sussex.

[Tim Farron]

All the points that the hon. Lady makes are absolutely right and relevant to those of us who are here today—especially so, given the nature of her county.

Our community in south Cumbria remains proud that we won part one of our fight for a cancer centre. When we launched our campaign in 2009, it was for chemotherapy and radiotherapy. In 2011, we cut the ribbon on the Grizedale ward—the chemotherapy unit—and we are determined to win our fight for radiotherapy too. We have had an overwhelming response to the petition we launched again last September, adding to the 10,000 people who signed the original petition. Thousands more have written in and shared their stories with me locally and nationally. They include stories of the pain they went through in travelling hours every day to get the treatment that they desperately needed; stories of families who suffered watching relatives deteriorate as the long days of arduous travel visibly took their toll; and stories of choosing not to proceed with treatment because of the unbearable rigours of travelling huge distances. All those people have told me how a centre at Kendal could have helped them and their loved ones.

Most of us know, and all can imagine, the shock of being diagnosed with cancer. It is a life-shattering blow. Imagine then being faced with weeks of daily, grindingly long and tiring journeys to receive care. The travel can become the biggest part of the problem. One of my constituents, Philip from Grange-over-Sands, gave me this story, and his words speak more powerfully than any I could use. He said:

“At the age of 81 I had to attend 37 visits for treatment between the May and July 2013. The round trip from Grange to Preston Hospital was in excess of 100 miles per day whether by road or by train and then bus to the hospital. The times of my treatment varied day by day from 8am to 6pm. The treatment machine was not always available at the specified time which meant further time added on to the days travelling. All the above resulted in a very stressful time for myself and my wife on top of suffering from prostate cancer.”

Thankfully, Philip has now been discharged following three years of follow-up visits. He added:

“I trust that future patients may get their treatment at Kendal so good luck with your efforts.”

I was also contacted by the parents of Josie from Oxenholme. They told me:

“After a truly horrific chemo-therapy regime, which nearly killed her, Josie was left shattered and we faced the prospect of having to make daily trips for 4 weeks to Preston for Radiotherapy. The round trip typically takes 4-5 hours. She is left tired and with little time in the day to do much else. A unit in Kendal would have transformed this experience and left her with more energy and time to take more care of herself.”

Lastly, the words of Magda from Windermere sum up the problem perfectly:

“The whole idea of ever having to do any of this again would make me think twice about undergoing the treatments I was offered”.

Thousands of residents joined me back in 2009 when we launched a similar campaign to bring chemotherapy treatment to the south Lakes. Back then, patients had to travel many miles for any kind of cancer treatment. Thanks to local support, the chemotherapy ward at Westmorland General Hospital opened in 2011, and since then hundreds of local people have benefited from treatment there. We showed that when a community gets behind a campaign and the Government recognises that there is a real issue, changes can be made, funding can be allocated and problems can be solved.

It is true that the problem of outrageous travel times thankfully affects a relatively small proportion of the population throughout the UK—evidenced by the fact that although this is a massively important issue, only a few of us are here today—but in the places where access is a problem, it is a dreadful problem. NHS England must address it directly and explicitly in its current consultation on radiotherapy. I ask the Minister to ensure that NHS England does just that.

Solving the problem for south Cumbria would not create an expensive precedent—there are relatively few sizeable communities in this position—but for the people who are affected, living in rural areas makes accessing treatment unbearably difficult and arduous. That was highlighted recently by Age UK’s Painful Journeys campaign. It would cost the Government a relatively small amount to fund a satellite radiotherapy unit in Kendal: a capital cost of about £12 million—a sum that had been earmarked during the coalition Government in early 2015. That investment would lead to important changes. Above all, it would stop local people opting not to take up lifesaving treatment because of the need to travel those distances. In south Lakeland, the number of people aged over 60 is 10% above the national average, so older people and people with disabilities in our area are disproportionately negatively affected by distant access to radiotherapy treatment. That makes it all the more important for us to take advantage of this consultation to tackle the problem.

The Equality Act 2010 was passed by the House to ensure that services are offered to people in such a way as not to discriminate against older and disabled people, among other characteristics. Through those unbearably long travel times, those groups are disproportionately disadvantaged and indirectly discriminated against in breach of that Act.

My request is simple. I want travel times and equality of access, particularly for people who are older or who have disabilities, to be key criteria when allocating cancer services. This NHS England consultation on radiotherapy is the opportunity to ensure that those criteria are set so that access is prioritised. I want the Minister to agree to do that today. An expectation should then be placed on hospital trusts to ensure that satellite units of existing established centres are provided in rural communities such as the south Lakes to meet those criteria. Only then will our community be able to access cancer treatment fairly, equally and safely.

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

It is a pleasure to serve under your chairmanship, Sir Christopher. It is also a pleasure to respond to the hon. Member for Westmorland and Lonsdale (Tim Farron). I wish to associate myself with his opening comments in praise of the NHS. Demand for NHS services is constantly increasing. We always want the best we can possible get, but by making that case, we often sound as if we are talking the NHS down. Nothing could be further from the truth—we have the best national health service in the world. I am glad to see that the hon. Gentleman is nodding his head, and I am grateful for the persuasive way in which he made his case. He can consider that a very good representation in response to the consultation to which he referred. The points he has made will be reflected on keenly.

Improving cancer outcomes remains a priority for the Government. The work under way is making a difference: cancer survival rates in England have never been higher and have increased year-on-year since 2010. The decrease in cancer deaths means that around 7,000 people are alive today who would not have been had things stayed the same.

We are committed to implementing every one of the 96 recommendations in the cancer strategy for England and to making a difference to the millions of people living with the disease and the thousands more diagnosed each year. We are providing the funding to match our commitment. NHS England has confirmed £607 million in funding to support the delivery of the strategy between 2017-18 and 2020-21.

We want our cancer services to be the best in the world, and we want patients to have access to the treatment and services that will give them the best chance of a successful clinical outcome. That includes the time they spend travelling for treatment. We know that cancer treatments can be arduous. Patients often undergo treatment daily and treatments can last several weeks at a time. Ideally, we want patients to have treatments at their local hospital.

However, specialised cancer treatments are not always best delivered locally. We want patients to have the best possible care available, but for certain cancers that sometimes means seeing a specialist multidisciplinary team with a full range of clinical expertise and capability. Although local is good, we clearly cannot always have specialist care provided as locally as we would like.

A perfect example of that is proton beam therapy treatment. Patients with high-priority cancer types requiring that treatment are sent to Florida and Switzerland at great cost to the NHS, because we have been unable to provide it here. In April 2012, the Government announced a £250 million investment to build proton beam therapy treatment facilities at the Christie in Manchester and University College London Hospitals. The Christie’s facilities will become operational later this year and will offer patients access to world-class treatment on the NHS.

Over the last few years, we have seen astounding technological advances. The UK is leading from the front in using cutting-edge technology in the form of whole genome sequencing to transform healthcare and health research. Wherever possible, it is right that patients have easy access to those life-saving treatments.

The same principle applies to radiotherapy. Around four in 10 of all NHS cancer patients are treated using radiotherapy. Recent advances have helped to target radiation doses at cancer cells more precisely, which means far fewer doses, better outcomes and improved quality of life for patients. That is a crucial part of why survival rates have continuously risen in England.

One of the cancer strategy’s key objectives is to deliver a modern, high-quality cancer service. In October 2016, NHS England announced a £130 million fund to modernise radiotherapy across England that will upgrade or replace older treatment devices over two years.

[Tim Farron]

The hon. Lady mentioned proton beam therapy, which is a wonderful treatment. We are grateful for the investment of more than one Government, which has ensured that it is coming to Manchester and London. She also talked about upgrading existing equipment, which is a reminder that 80% of commonly occurring cancers will still be treated by linear accelerators, albeit regularly upgraded. Therefore the delivery of proton beam therapy and other specialist and precise treatments, and the investment in more locally delivered treatment from linear accelerators in places such as Westmorland, are not mutually exclusive. We need to do both.

[Jackie Doyle-Price]

I absolutely agree—the two are complementary and need to be key ingredients in a successful strategy to combat cancer.

NHS England is not only modernising existing radiotherapy services; it is currently consulting on a new model for them, as the hon. Gentleman said. The aim is to encourage radiotherapy providers to work together in networks to concentrate expertise and improve pathways for patients requiring radical radiotherapy for less common cancers. That will help to improve access to more innovative radiotherapy treatments, increase clinical trial recruitment and ensure that radiotherapy equipment is fully utilised. There is no intention to reduce the number of radiotherapy providers, nor is that considered to be a likely outcome of the proposals being consulted on.

We will continue to ensure that travel times are taken into consideration when looking at cancer treatment in this country. The National Cancer Registration and Analysis Service is evaluating the impact on cancer outcomes of patients living different distances from a cancer centre. Public Health England is also testing travel times from several available datasets, so a programme of work can be established that incorporates data on travel times.

One of the first outputs of that work will be a report on whether there is any demonstrable difference in radiotherapy treatments associated with the time taken to travel to a specialist cancer centre. We expect the first results of that work to be published in the spring. I am sure the hon. Gentleman will have a considerable interest in the outcome.

In the current NHS England consultation, there are proposals that would allow local commissioners and providers to plan, review and redesign services through a joint radiotherapy board. Any case for change would determine the optimum location to achieve the best impact for patients, so it would be possible for patients requiring radiotherapy for common cancers to be treated at a satellite centre. Specialised commissioners will always want to balance patient travel with issues such as the sustainability of the service, whether the service is accessible enough to patients to be financially viable, and ensuring that patients who have to travel are supported in other ways, including through transport and accommodation.

I hope that meets with a positive reaction from the hon. Gentleman. We are consulting on making services more accessible and looking at travel times. I dare say that we will continue to have this debate over the coming months, not least because of his private Member’s Bill.

I understand that the hon. Gentleman recently met his local clinical commissioning group at Morecambe Bay to discuss the accessibility of services. I am encouraged that that dialogue is taking place at a local level.

I hope that what I have set out gives the hon. Gentleman some reassurance. I emphasise that cancer remains a priority for the Government. We remain committed to ensuring the best possible treatment and to achieving easy access in terms of travelling time for all cancer patients, regardless of where they live. I am grateful to the hon. Gentleman for securing this debate.

Question put and agreed to.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

I congratulate my hon. Friend on becoming Chair of the Liaison Committee. Of course, I am always happy to meet her, and the issue that she has raised is very important. Our figures show that the number of nursing home beds, as distinct from the number of nursing homes, is broadly stable. There is real pressure in the market, however, and there are real issues about market failure in some parts of the country, so I am more than happy to talk to her about that.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The south Cumbria area is one of the few places in England where patients who need even the least complex radiotherapy treatment must travel for longer than the maximum 45 minutes recommended by the National Radiotherapy Advisory Group. In NHS England’s consultation, which will close on 18 December, will the Secretary of State make sure that access to radiotherapy within 45 minutes is a key criterion in allocating resources so that Westmorland general can be given its much-needed satellite radiotherapy unit?

[Mr Dunne]

I am grateful to the hon. Gentleman for raising that point. We are absolutely aware of the need to have more radiographers and sonographers available to support facilities around the country, and we have currently some 200 radiographers in training. I would like him to write to me so that we can follow up the specific point he makes about south Cumbria.

Valproate and Foetal Anticonvulsant Syndrome

Tim Farron Excerpts

Thursday 19th October 2017 Commons Chamber

[Norman Lamb]

I thank the hon. Lady for her intervention, and I completely agree with her. Interestingly, the original product licence in March 1974 stated this, way back then:

“In women of child bearing age, it should only be used in severe cases or those resistant to other treatments.”

They knew in the ’70s, yet the appalling scandal is that so many women since then have had their life turned completely upside down, with enormous consequences for their children, because they were not told.

[Tim Farron (Westmorland and Lonsdale) (LD)]

My constituent Nicola took sodium valproate through her pregnancy, and her son has chronic fatigue. The impact on her family is immense and expensive. We have fought for, and managed to secure, medical support for her through hospitals in Manchester, but does my right hon. Friend agree that there needs to be a Government fund to ensure that victims have such support, rather than having to rely on their own means?

[Norman Lamb]

I completely agree. I will make the case a little later, but it seems unanswerable and the Government need to reflect on that.

What happened was worse than just the neglect of not telling women. The minutes from the 18 July 1973 meeting of the sub-committee on adverse reactions, a sub-committee of the Committee on Safety of Medicines, have been uncovered. That document reveals a real outrage, because it talks about keeping the information from women—deliberately withholding it

“especially as it could give rise to fruitless anxiety.”

It continued:

“Nevertheless, they thought it would be best if prescribers were all made aware of the nature of the evidence and recommended that a statement similar to that proposed by ICI”—

in respect of another product—

“could be included in all relevant data sheets but not on package inserts so that there would be no danger of patients themselves seeing it.”

That is extraordinary.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 10th October 2017 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I am aware of the report that she talks about. We know that half of mental health conditions become established before the age of 14, which is why early intervention is so important. In July, I announced an expansion in the mental health workforce—another 21,000 posts. A number of those will be in children’s mental health, to address the issues she raises.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The Secretary of State may know that because of a reduction in the number of mental health clinicians in Cumbria, the Cumbria Partnership NHS Foundation Trust has now chosen to end consultant psychiatric call-out care from 8 pm to 9 am. It would have started last week, but it is going to start in the next two or three weeks. That means, as I am sure he is aware, that it will not be possible to section people under the Mental Health Acts between those hours unless they are within an NHS facility. People in police stations, people in care homes and people at A&E departments will not be—

[Mr Speaker]

Order. If the hon. Gentleman wants to make an application for an Adjournment debate, he can do that on a subsequent occasion. I think we have got the gravamen of his question.

[Tim Farron]

The question is: does the Secretary of State agree that that is not an appropriate use of resources, and will he provide the resources that are needed?

[Mr Hunt]

The hon. Gentleman raises a very serious issue. I will not go into it in detail now, but I will certainly look into it closely and get back to him, if I may. Obviously it is very important.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

I was concerned about the general laughter following that comment, Mr Speaker.

I am delighted that my hon. Friend’s father was treated so well, and I very much enjoyed my visit to the hospital recently. She is right: where there are changes in the patterns of training, we need to be very careful to ensure that they do not interrupt the delivery of local services in a disadvantageous way.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The boundaries of the sustainability and transformation partnerships are bound to cause concern about the future of A&E and other acute departments given the nature of them. My area, south Cumbria—relatively sparsely populated and rural—is lumped in with Lancashire, which is largely urban. Will the Secretary of State confirm that the voices of rural communities will not be dwarfed by those of the larger urban ones, and in this week, as we celebrate the 25th anniversary of Westmorland general hospital, will he give guarantees that it will not be closed and will indeed not receive any downgrading as a result of the STP process?

[Mr Hunt]

Westmorland general hospital has a very important future in the NHS and I am happy to give the hon. Gentleman that assurance. I do not think he should be concerned about STP footprints covering both rural and urban areas. However, where there is an issue in his constituency, and many others, it is the response times for ambulances in the most remote areas, and we are looking at that.

Contaminated Blood and Blood Products

Tim Farron Excerpts

Thursday 24th November 2016 Commons Chamber

[Diana Johnson]

Yes. One point I will come to later is the need for some form of inquiry.

To continue my point about why who runs the scheme is so important, a big criticism of the new scheme is the continuation of discretionary payments. Department of Health officials are still not listening to the concerns raised about that. The APPG inquiry uncovered huge issues with the highly conditional and poorly managed discretionary support scheme. One respondent told us:

“The whole system seems designed to make you feel like a beggar”.

I also believe that the trust’s current administrators have not fought hard enough for their beneficiaries, which legally they could have done. Instead, they saw their role as dispassionate managers and conduits to the Department of Health. They left the affected community alone to fight for themselves. If the new support scheme ends up being managed by Atos or Capita it will do nothing to address those fundamental issues, and could even make the situation much worse, adding insult to injury. I call on the Minister to do the right thing and announce that she will scrap plans for a private profit-making scheme administrator, and will replace the current scheme with a more beneficiary run and focused organisation that has no profit motive.

Will the Minister set out exactly what kind of discretionary support the new scheme will provide? It remains unclear whether any or all of the current support will continue. That contrasts starkly with the Scottish scheme, where the financial review group agreed that no one should receive less financial support under the new scheme. Will the Government urgently provide the same guarantee and publish full details of any obligations that the new scheme administrators will be subject to?

There are also issues with the current welfare benefits reassessment regime that many people are having to go through—for example, moving from disability living allowance on to the personal independence payment. Those issues need to be addressed urgently, so that individuals can be passported straightaway on to new benefits. I hope the Minister will agree that that is a sensible way forward for the people affected.

My third concern relates to the families of those affected, who need better support under the scheme. Under the new English proposals, widows and widowers will continue to be eligible for discretionary support—whatever that means; I have raised my concerns about that already—on top of a new £10,000 lump sum, provided their loved ones died at least partially as a result of contracting HIV or hepatitis C. However, many clinicians have already told me that that could mean many people are excluded from assistance simply because their partner’s death certificate does not include mention of HIV or hepatitis C, sometimes at the family’s request. The new proposals could also still be considerably less generous than the support that some widows already receive, because there is a huge question mark hanging over what discretionary help they will get under the reformed scheme.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am grateful to the hon. Lady for leading this debate. Many people around the country are hugely grateful to her, me included. Two of my constituents—Mike Dorricott and Neil Howson—sadly passed away as a consequence of contaminated blood and the diseases that they contracted. Their loved ones have exactly the concern that the hon. Lady indicated: that the dependence on potential discretionary payments is insufficient. The fact that the one-off payment is not backed up by the generosity, regularity and dependability of an annual payment means that such people often have to give up work, lose the ability to have a pension of their own and find themselves in immense hardship.

[Diana Johnson]

That leads me to my next point, which is on the Scottish proposals. As we have heard, they offer a better settlement, particularly for the bereaved, who are guaranteed 75% of their partner’s previous entitlement in addition to continued access to the Scottish discretionary scheme. That gives them much-needed security in a way that the proposed English scheme does not. I ask the Minister to look again at adopting the Scottish model and at providing more guarantees on non-discretionary support for widows and widowers.

My fourth point is about support for primary beneficiaries, which was raised in an intervention. The APPG asks the Government to look again at some groups of primary beneficiaries who need better support than is proposed under the English scheme. I received an email this morning from someone who contracted hepatitis B through contaminated blood products. Under the scheme, they are not eligible for any help, but they have obviously suffered and are suffering still. I hope that the Minister is willing to look at a very small group of people who are not covered.

The APPG believes that if more assistance were provided in the form of non-discretionary, ongoing payments, it would reduce the need for discretionary support and allay a great deal of our constituents’ worries. I urge the Department of Health to consider the contrast with the support announced in the Scottish scheme and whether more non-discretionary, ongoing payments could be made.

--- Later in debate ---

[Alistair Burt (North East Bedfordshire) (Con)]

I begin by congratulating my friend, the hon. Member for Kingston upon Hull North (Diana Johnson), on her consistency on this issue and the work that she and the all-party group have done over a long time. I thank the Backbench Business Committee for allowing the debate to be held. I also welcome my hon. Friend the Minister to the Front Bench. We know that this matter is not among her responsibilities—it belongs to our noble Friend Lord Prior—and I know how difficult it is to deal with something that is not in one’s own portfolio, but I am sure that she will communicate faithfully to the Government the points raised in the debate, although she will not be in a position, I think, to answer all our questions. However, the fact that we are again raising these questions in the Chamber is an important point for her to take back to the Secretary of State and other colleagues.

I want to pick up on a couple of points arising from the speech made by the hon. Member for Kingston upon Hull North. I agree with her about who should administer the scheme. This is not an area in which we should be looking to outsource for ideological reasons. There is an important concern at the heart of this issue. Given everything that we have learned from the United States, we know that the profit motive involved in selling the blood in the first place was a primary source of everything that has happened since. It is really important that we recognise that and show some sensitivity to the fact. I actually think that Government can run some things, and it is good to run some things publicly. We have to choose. In our political lives, we have lived through the Government running British Telecom, British Airways and so on. Things have changed, but it is important that some things be publicly owned, run and dealt with, and this is one of them. I therefore join her absolutely in saying that the Government should think again about how the scheme is administered. They should keep it in public hands where there is at least some democratic accountability. Above all, as she said, we need a group that will act on behalf of the beneficiaries, rather than solely in the Government’s interest. It would have to be very carefully put together.

[Tim Farron]

The right hon. Gentleman is making some really important points. Does he agree that one area in which the private sector could and should be playing a part is in contributing to the compensation? Is there not an analogy—an off-the-shelf scheme we could consider—in how the thalidomide victims were supported through a composite of public funding and funding from the drug companies responsible? Like the Scottish scheme, that system has introduced annual payments and allowed people struggling with conditions that they contracted because of thalidomide to have some security throughout their lives. The same could be afforded to the survivors or the loved ones of those who passed away because of contaminated blood.

[Alistair Burt]

I am sure that the hon. Gentleman will develop that point in his own speech. Of course, the thalidomide compensation was based on a clear line of accountability as the company admitted responsibility. The situation has not been quite the same in this case, for reasons that we all know, but perhaps I can come on to financial matters in a second. I will now move on from the speech made by the hon. Member for Kingston upon Hull North, the majority of which I supported wholeheartedly.

It is a matter of some despair that we are here again. I remember those friends who came to the public meetings in the House of Commons a couple of years ago saying they were actually sick of coming here as they had done so so often over the years. I would be grateful if the Minister could relay to the Government—I have not been able to get this point across—that this drip, drip approach over the years is just not working. The Government can find money at various times for some big affairs. If there is a natural disaster, a dramatic crisis or a banking collapse, vast sums suddenly appear. We have not been able to give this issue the same priority, but it cries out for it. That we are here again is proof that these concerns are not going away and cannot be dealt with drip by drip. Somebody has still not grasped the fact that, for the many reasons that I know colleagues will raise, a settlement is of the highest importance.

I will not rehearse the history, because colleagues indulged me when I raised it in a Back-Bench debate a couple of years ago, so I will not go into it at such great length again. Neither will I cite the accounts of individuals who have come to us because, frankly, I find it too difficult to read them into the record. I have done that before, but I am not able to do so again. Instead, I want to make a couple of personal points and three comments about where we might go from here.

I campaigned on this issue for many years—in government and in opposition; and when I was a Minister and not a Minister. I was pleased that the hon. Lady mentioned David Cameron, because his response to my contribution at Prime Minister’s questions in October 2013 began the current chain of events and continued the progress made over many years. I was grateful that he met me, a constituent and a dear friend of ours. He seemed to understand where we were going, and more money has come into the scheme, which I appreciate.

In June 2015, I was re-invited by the then Prime Minister to join the Government in the Department of Health, at which point I went quiet on campaigning as far as the public were concerned. I know that some people misinterpreted that. My position in the Department of Health was not conditional on the fact that I had been involved with contaminated blood, and neither was my positon in the Foreign Office or my decision to leave the Department of Health of my own accord earlier this year. However, the ministerial convention is clear: Ministers say only what the Government’s position is. We cannot have two colleagues firing away on the same issues, so I did indeed go quiet publicly for a period. Inside the Department, I made my representations to the then responsible Minister, and I want to put on record my appreciation for what my hon. Friend the Member for Battersea (Jane Ellison) sought to do with the scheme. She worked extremely hard, saw a lot of people and tried to do her best.

I think that I made a mistake when the original proposals that the current scheme is based on came forward in January this year. I sat beside my hon. Friend on the Front Bench and while I understood the general thrust, I had not fully grasped the detail, which became clear only in the consultation. My mistake was to think at that time that we had solved the problem—we clearly had not. I got that wrong, but I hope that I have tried to contribute to the debate since, both inside and now outside the Department, as we try to deal with the present proposals. As the hon. Member for Kingston upon Hull North said, they move us on from where we were, but we are not yet there, so perhaps I could say a couple of things about where I think we might go.

First, we got the issue of discretionary payments wrong in the original proposals. A number of discretionary payments have effectively become fixed and people have become dependent on them. That should have been known to the Department, but clearly it was not known in enough detail, which has accordingly led to uncertainty and to people feeling that they might not be financially compensated to the extent that they are at present. That cannot be the case, and I am certainly not prepared to support anything that will make my constituents worse off than they are at present. That was not the intention, so we must make sure that those discretionary payments are included in the new scheme.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 15th November 2016 Commons Chamber

[David Mowat]

My hon. Friend is quite right: research, in the end, is the way we will beat cancer. This country is ahead of all countries in the world in terms of the number of trials going on, including the US. The voluntary sector, including the charity to which he refers, makes a big impact and I congratulate it.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I lost my mum to ovarian cancer just a few years ago. She received outstanding treatment at the Rosemere centre in Preston. That is the centre that my constituents need to travel to for radiotherapy for all forms of cancer, but an average round trip to receive treatment takes about two hours. Does the Minister agree that that is not acceptable, and will he support the Rosemere centre in setting up a satellite unit at Kendal hospital, so that people in south Cumbria can get treatment quickly?

[David Mowat]

I certainly agree with the hon. Gentleman that two hours is a long time. His is a large constituency and I am very happy to look at his specific point and to revert to the House.

Community Pharmacies

Tim Farron Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Norman Lamb (North Norfolk) (LD)]

My central argument is that this is a cut to preventive healthcare and as such is completely irrational, makes no sense and will be a false economy. It will end up with fewer people accessing pharmacies than at the moment, resulting in more pressure on GPs and A&E departments.

I have made the point to the Government before that, by all means, they should do more to get more bang for their buck, to ensure that money is working effectively and that people get good preventive care in their communities, but they should not cut the budget for preventive care. In response to my earlier intervention, the Minister said that the cut was compensated for by the extra investment in GP practices, but that is misleading because the total investment in GP practices for pharmacies will be £112 million between now and 2020, yet in one year, by 2017-18, this budget will be down by £208 million. It is a massive cut to preventive care. It makes no sense at all and is the precise opposite of what the Government claim they seek to do on shifting resources within the NHS.

[Tim Farron (Westmorland and Lonsdale) (LD)]

When I surveyed pharmacists in my community, they told me, among other things, that in what is probably England’s most rural county, more than 80% of pharmacies do not qualify for the rural pharmacy access scheme, and for those that do, that money will be blown away by the larger cuts. Given that staff are already being laid off, does my right hon. Friend agree that one of the greatest areas of damage will be to small, rural pharmacies in areas such as ours?

[Norman Lamb]

I thank my hon. Friend for making that point; it was the second one that I was going to make. As the hon. Member for Central Ayrshire (Dr Whitford) made clear earlier, the impact will be arbitrary, and disadvantaged communities and rural areas will feel it most. Only four of the 15 pharmacists in my community will benefit from the pharmacy access scheme; all the others will not, yet they are needed by their local community.