World Arthritis Day

Tom Randall Excerpts

Wednesday 25th October 2023 Westminster Hall

[Tom Randall (Gedling) (Con)]

I beg to move,

That this House has considered World Arthritis Day.

It is a pleasure to serve under your chairmanship, Ms McDonagh. This House was in recess on 12 October, but that date has been celebrated—if that is the right word—as World Arthritis Day since it was established by Arthritis and Rheumatism International in 1996. Its aim is to raise awareness across the world of the existence and impact of rheumatic and musculoskeletal diseases, and to educate people about symptoms, preventive measures and treatment options. I thought it might be helpful to bring this debate to the Chamber today—the closest date to World Arthritis Day that we could arrange—to raise awareness, to highlight the extent and impact of arthritis and musculoskeletal conditions in Britain today and to continue the debate on what we can do to mitigate the impact of arthritis.

What is arthritis? Arthritis refers to painful, stiff or restricted joints, which are common symptoms in conditions that cause joint damage or inflammation. They include osteoarthritis, which happens when the body can no longer maintain and repair one or more joints; autoimmune inflammatory arthritis conditions, including axial spondyloarthitis; crystal arthritis such as gout; or symptoms of inflammatory connective tissue diseases, such as lupus. Arthritis is used as an umbrella term for a range of conditions, and that is how I will use it in this debate, although there are certain issues specific to particular conditions that I will mention later.

The subject is worthy of debate for three reasons: first, to recognise the inherent issues in living with arthritis, and how widespread it is; secondly, to highlight the wait for diagnosis and treatment; and thirdly, to understand the economic costs of not dealing with musculoskeletal conditions effectively. We might think that arthritis only affects old ladies, but it is more widespread than that. More than 10 million people in the UK—one in six of our constituents—have arthritis. One in six of our constituents is in pain and experiences fatigue and often restricted mobility.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing forward this debate. In Northern Ireland, where we have a population of 1.95 million, there are 525,000 people living with arthritis or another musculoskeletal condition. That gives some perspective— it is more than one in four. The scale of the issue is massive.

Does the hon. Gentleman agree that for those in the early stages, help in dealing with pain and strengthening the muscles can prevent further untimely deterioration? We should ensure that people stop classifying arthritis as an old person’s disease, so we can allow younger people to determine what they have and how to manage the progression that the hon. Gentleman wishes to achieve.

[Tom Randall]

The hon. Gentleman is absolutely right. When we have debated this subject in the past, he has raised the issue of arthritis in Northern Ireland; I am so pleased to see him raising it again. He is right in the perspective that he takes on the breadth of the issue, which affects a wide variety of people. I will come on to that point shortly.

One of my Gedling constituents puts it this way:

“Living with arthritis changes you and turns your world upside down. Things you took for granted become obstacles and daily challenges to be overcome. On a good day, you might not look like you’re living with a chronic condition but it never goes away. It’s hard to plan ahead because you don’t know if you’ll be up to going out or meeting up. Arthritis doesn’t only affect the person with the condition but their family too. I have watched Rheumatoid arthritis rob my mum of a life and now I have it too. It makes me frightened for my daughter’s future.”

Early diagnosis and prompt treatment can improve the futures of people living with arthritis and musculo- skeletal conditions, but not always. In the case of axial spondyloarthritis, in which I declare an interest as chair of the all-party parliamentary group on axial spondyloarthritis, a key challenge remains timely diagnosis. In this country, the condition currently takes an average of eight and a half years to diagnose, which puts us behind most comparable nations in Europe.

The latest report of the national early inflammatory arthritis audit, which is run by the British Society for Rheumatology, found that patients are experiencing diagnostic and treatment delays, with 44% of patients still not referred within the target of three working days and 48% of patients experiencing symptoms for longer than six months prior to referral. Although the average time to treatment has improved in England, having been reduced by three days, delays are an average of 12 days higher than the quality standard of 42 days.

The impact of arthritis is ultimately a human story, but the economic cost is also worth mentioning. According to the Office for National Statistics, 23.3 million working days were lost in 2021 due to musculoskeletal conditions. I have thought about how to put that figure in a way that politicians and politicos can understand. Think back to the winter of discontent in 1979, when 29 million working days were lost due to strike action. That was a politically pivotal year, which was notorious for how many working days were lost, and we are facing the equivalent of 80% of that figure—not just in one year but every year because of musculoskeletal conditions.

People with arthritis are 20% less likely to be in work than people without arthritis. Twelve per cent of sickness absence in the NHS between September 2021 and August 2022 was due to back problems and other MSK conditions. The National Axial Spondyloarthritis Society estimates that

“A patient aged 26 who waits 8.5 years for a diagnosis is likely to lose around £187,000”,

the majority of which derives from a loss of productivity due to reduced employment. The average patient also incurs costs of around £61,000 in out-of-pocket expenses while waiting for a diagnosis. That includes the cost of medication, travelling to appointments and private healthcare appointments, including visits to chiropractors.

I first praise the Government for making musculoskeletal conditions part of the major conditions strategy. Making MSK one of the six major conditions signals the importance of this issue, and I believe that it demonstrates that the Government are serious about tackling it. I hope that it will be understood that there are a range of measures that can be taken to improve matters. The Government have made reducing waiting lists one of their top priorities to improve the lives of those with arthritis and musculoskeletal conditions, including those waiting for joint replacement surgery, but I would welcome clarification that it will remain a key Government priority and clarity on how that will remain the case in the face of likely future winter pressures.

According to the British Society for Rheumatology, growing the rheumatology workforce would reduce the health and societal costs of newly diagnosed rheumatoid arthritis by £50 million, so I welcome clarification from the Minister on plans to grow the rheumatology workforce.

Everyone recognises the valuable role that primary care can play. Raised public awareness can help to encourage early presentation in primary care, but there is also work to be done to help GPs and other healthcare professionals to recognise conditions. I spoke earlier of the delay to the diagnosis of axial spondyloarthritis. Fifty-six per cent. of that delay time occurs in primary care, with GPs often failing to identify the symptoms of axial spondyloarthritis and thinking that the patient may have mechanical back pain or back pain associated with injury. That can lead to repeated primary care visits and causes patients to be bounced around in the system, placing further burdens on the already stretched system. I welcome any opportunity to follow up with the Minister separately on that point, particularly on what can be done to improve public and primary care awareness of these conditions.

World arthritis day only comes once a year, but for those living with arthritis and musculoskeletal conditions it is a constant issue. While they might dream of a world free of pain and discomfort, that is not yet a reality. I am grateful for the opportunity to raise this issue on the Floor of the House today and I look forward to hearing further contributions on how we might make that the case.

Social Care: Nottinghamshire

Tom Randall Excerpts

Monday 21st February 2022 Commons Chamber

[Ben Bradley]

My hon. Friend knows the challenges in Nottinghamshire social care as well as anybody—I am sure they come across his desk in Broxtowe all the time—and he is right that this work has to be locally led. I welcome the opportunity in the White Paper to build from the community upwards through our integrated care strategy and to work together with health partners around the county. In the long term, locally led and community-based provision will help us to tackle the challenges we face.

This debate is on social care in Notts. As the Minister knows, among those in this place I am unique in being responsible for the direct delivery of social care services in my county and in my Mansfield constituency, so this is a unique opportunity for me to raise the key issues that affect those services with her and with the Government—from the coalface, so to speak. That is part of why I have argued that my dual role can benefit my constituents and the Government. I hope that proves to be true.

The Minister will not be surprised to hear that workforce capacity is far and away the biggest challenge that we face in Nottinghamshire. We have seen a further 5% decline in staffing levels in a sector that was already understaffed. I am grateful that a crisis was averted by the revocation of the mandatory vaccination plans, because they would have seen thousands more leave the sector in Notts. That change of policy was absolutely the right decision.

We estimate that the turnover of staff in home care is around 26%, which is a massive and ridiculous proportion. That reflects the fact that there is significant competition for pay; that people can earn more in other sectors locally; that we are struggling to recruit; and that staff who have been through the ringer in recent years in incredibly tough circumstances are increasingly deciding to retire early or take a break because of the pressures.

We are doing a lot locally to try to combat the amount of turnover, including through new apprenticeships and big recruitment campaigns with market providers, and by incentivising collaboration between providers and offering incentives for them to invest in staff wellbeing or training, but more is needed. We need a national workforce strategy and recovery plan with sustainable funding that recognises the disparities in pay and conditions in the sector, and that needs to be part of the “fair price for care” reforms, which is not currently the case.

We need to understand what more can be done to increase the stature and status of care workers and the care profession. The workforce plan needs to include clear and defined pathways into health services, so that people see social care as an entry pathway to wider health and NHS careers, where the range and scale of opportunities for different jobs and long-term careers is massive. Care is often perceived to be a low-skilled, low-paid job with little scope for progress or promotion, but that is absolutely mad when we consider the fact that the skills and qualifications are directly transferable into one of the world’s biggest employers, the NHS, which covers every health role under the sun.

The pathways should be obvious and we need to make them obvious and overtly available to care workers and young people in schools and colleges. I hope we can plan some of this work locally, perhaps through the devolution of skills funding in the coming years. We are already working on some of that with West Nottinghamshire College and Nottingham Trent University, which are trying to build the pathways from school directly into the health services in my Mansfield constituency. A national pathway for integrated health and care careers would be fantastic.

The shortage in home care has meant that an additional 10 people a day are waiting to be discharged from my local hospital and much higher proportions of people end up being discharged to care homes when they could and should have gone to their own home. That is not good for long-term outcomes or those people’s wellbeing and also means that our reablement services—those that support people to get back on their feet and be independent in their own home—are overwhelmed. These are observations from Notts, but the trend is regional and national, not just ours. In fact, we have fared better than many other areas.

I thank the incredibly hard-working and dedicated staff in Nottinghamshire’s social care services for everything they have done to manage incredibly difficult circumstances. I include among them our council’s service director, Melanie Brooks, who directly delivered care packages and was on call over Christmas to try to mitigate the pressure. A huge thank you to her and her teams.

We have a lack of housing stock for care provision, and investment in things such as supported accommodation has slowed down, obstructed by covid, construction and supply chain issues and other factors. It often seems like the link between health and housing is not made clear, and it does not seem to feature much in some of the recent proposed legislation, but good housing can reduce social care needs, prevent hospital admissions and support people to remain active and sociable in their own homes and communities.

Homes England funding could be devolved to support local areas to meet their needs. Housing needs to be a key part of care reform. In our two-tier area we are working hard on collaboration among councils and providers to ensure that housing and health services talk to each other, but that is an option rather than something that is automatically built into the system. That needs to change. Similarly, if we have accountable local leaders—the Government have made clear through the Department for Levelling Up, Housing and Communities their intention to devolve significant powers—could we not have more local control over how powers are managed and delivered? That would help us to integrate our local services. Children’s services are also key to this. I question whether all this needs to be linked to the children’s care work that seems to be in the pipeline, through the Josh MacAlister review and the special educational needs and disability review that is happening in the Department for Education. Children’s care services and adult care services are linked, quite clearly, and they need to be integrated just as health and care do. I know that this is complex as it spans multiple departments, but it is also sensible and it needs to happen.

Our local integrated care systems will seek to draw all these things together to offer the best start in life and the right preventive interventions, just as Nottinghamshire County Council is doing with a significant investment in the transformation of our children’s services. More proactive and preventive services will be announced in our budget on Thursday. That is something of which I am incredibly proud and it will, I think, change lives. If local plans across the country seek to integrate adult care services and children’s care services then, clearly, national ones must do so, too.

Financially, Nottinghamshire has some capacity to use adult social care precepts this year, but continued rises in council tax without major reform are also unsustainable, especially when we consider that some London boroughs pay half the council tax that many people do elsewhere, including in my own constituency. That is not fair, but, as an authority, it means that we do have some funds to draw on this year. Our social care budget for 2022-23 will rise by around £12 million compared with last year. That extra funding is very welcome, but, again, we need to understand that that is not sustainable in the current system. Fairer funding for local government needs to be a priority to make sure that we have that level playing field across the country.

There will be a significant challenge in terms of resources and staffing capacity as we try to tackle both the day-to-day care issues that I have touched on—pressures of services and staffing—as well as delivering the significant reform that we are being asked to deliver. Although it is welcome and right, it will present its own challenges and pressures. The Government must ensure that sufficient capacity exists if they want us to do both at the same time.

[Tom Randall (Gedling) (Con)]

I congratulate my hon. Friend on securing this Adjournment debate; it is on a very important subject. I am sure that most Nottinghamshire MPs have spoken to people such as Terry Galloway who has some very interesting ideas on this subject. I am talking in particular about people who are of working age but who are leaving the care system—reintegrating into life as it were. They face particular challenges that are almost akin to a benefits trap in terms of leaving care and then having to meet certain costs. Does he agree that, when we talk about resources, it is important that we give these people the resources that they need to bridge that gap? In the longer term, that will benefit both them and the wider system as it will help them to get back to a normal life.

[Ben Bradley]

I thank my hon. Friend for that intervention. Terry Galloway is fantastic. He is a real advocate for some of our children’s services—our care leavers’ services in particular—in Nottinghamshire. I am pleased that my hon. Friend has raised his case here today. This is a prime example of where children’s services and adult care services need to talk to each other, and where we need to have those clear pathways into additional support. Some of those children will get support until they are 25 under the current system, but that is not all funded. Equally, we need to do more at a county level to plan for the lifetime of these children. We know that they are there. We know that when they are in children’s services, they are likely to come into adult services, and we need to make sure that we are planning for that in the long term. The same applies to SEND and other local challenges—my hon. Friend is absolutely right about that. We know that the outcomes for care leavers are not great, which is partly why we are investing £14 million over the next three years at County Hall in transforming those proactive and preventive services, starting with our children’s services, making sure that we are delivering the best possible support and offer to them.

I am pleased that the Government are finally grasping the nettle of social care reform and integration, because, just like the never-ending increases in the NHS budget, it is neither right nor affordable for spending to go up and up every year and for that to be accepted by Government or by anyone else. That is not a solution. We must do it differently. If we cannot tackle the growth in cost and demand under the current systems, then those systems need to change—whether they be care services, health services, children’s services, or all of it. In some ways, covid provides us with that opportunity to draw a line, to think again and to reform. I hope Government will take that opportunity, and I look forward to hearing from my hon. Friend the Minister.

Health and Social Care

Tom Randall Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend. This money is being allocated to the regions, then to individual trusts. A large amount of that money has already been allocated to specific projects that have been announced today. The rest of the money, when allocated to local systems, will then be allocated by that local system—the people who know their area best.

[Tom Randall (Gedling) (Con)]

Staff in hospitals in Nottinghamshire are working hard, as we have heard, sometimes in difficult circumstances. Today’s announcement includes an extra £4 million of spending for hospitals in Nottinghamshire. Does my hon. Friend agree that that will make a real difference to patients in Nottinghamshire, and will he join me in thanking staff in Nottinghamshire hospitals for the hard work that they are doing at the moment?

[Edward Argar]

I am happy to join my hon. Friend in paying tribute to the work of the staff in his local hospitals. He is absolutely right to highlight the fact that that money will make a huge and real difference to patient care in his local hospital trust and in his local area.

Down Syndrome Bill

Tom Randall Excerpts

Friday 26th November 2021 Commons Chamber

[Tom Randall (Gedling) (Con)]

Like many others, I speak in support of the Bill. I add my congratulation to those from colleagues of all parties to my right hon. Friend the Member for North Somerset (Dr Fox) on having brought the Bill to the House and his passionate speech in favour of the measures it contains. Down’s syndrome is a visible condition and the name will be familiar to very many people, but my right hon. Friend’s speech raised so much awareness of a condition of which there are so many factors that members of the public or those who have not been directly affected are not aware. This morning’s debate, like those on so many sitting Fridays, has been an educational process. We have learned something about the wider world, which is a good thing for us as politicians to do once in a while.

There are 47,000 people in the UK with Down’s syndrome. I am grateful to my constituents who wrote to me in advance of this debate to tell me about the issues that they and their families have faced and the challenges that the condition can bring. They have told me about how the language and attitude on learning that the baby has Down’s syndrome can often be negative and discriminatory, and that young people with Down’s syndrome are more likely to be hospitalised than those without it, and for longer.

From my research in preparation for this debate, I have learned that those with Down’s can have problems with their heart, bowel difficulties, difficulties with hearing and vision and increased risk of infection, so there is possibly an increased requirement for health services. Parents are often discouraged from sending children to mainstream schools because teachers there sometimes lack confidence and the knowledge to include children in classes alongside siblings and neighbours. Post-16 education is often a “one size fits all” approach that sees learning stall. Social care can often be inappropriate. My right hon. Friend gave the example of those in older life, and he was right to say that there is a scandal that we very much need to avoid in terms of possibly putting those with Down’s syndrome in age-inappropriate settings.

The Bill provides the opportunity to make life-changing differences for a condition that affects so many aspects of life across the health, education, housing and social care fields. The Bill is short—only a couple of clauses—and it requires the Secretary of State to create guidance. Various authorities would be required to pay due regard to that guidance. One might argue about whether primary legislation is required for the production of guidance. We ought not to have laws for laws’ sake, but given the wide variety of bodies that the guidance will affect, the argument in favour is strong and has been articulated strongly this morning. The importance of the changes that can be brought about once the guidance is written and implemented has also been highlighted.

There is a precedent for the Bill. We have not spoken yet of the Autism Act 2009, which shares some similarities with this Bill. I was particularly struck by the words of the National Autistic Society:

“The…Act has brought about some great changes to the way that autistic people access support. Because of the Act, almost every council has a diagnosis pathway for adults and a specific Autism Lead. Additionally, it makes sure that every autistic person has the right to a social care assessment, something which was difficult for many autistic people more than10 years ago.”

It appears that that legislation has brought about some positive changes, so I am hopeful that, by supporting this Bill today, we will be able to revisit this situation in 10 years’ time and find that we have seen great strides in the way that the needs of people with Down’s syndrome have been met. The Bill certainly commands my support, as I am sure it does across the House, and I wish it well.

Menopause (Support and Services) Bill

Tom Randall Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Jackie Doyle-Price]

My hon. Friend puts that extremely well. The fact of the matter is that, even as women who are well-informed and interested in this subject, we still do not necessarily know what to expect. It is also the case that boys and men need to understand these things too.

Hon. Members will know that I chair the all-party pharmacy group and I can advise the House that the National Pharmacy Association is fully in support of this Bill. It fully supports the exemption of HRT from prescription charges. It also expressed its willingness to play a much bigger role in terms of the education and support of women going through menopause. We know that, a lot of the time, the conversations that patients can have with their pharmacists are less intimidating and less formal than those they might have with their GP. Again, lots of things are available over the counter that can help alleviate the symptoms of menopause, but also a lot of advice can be given about generally looking after wellbeing. I say to the Minister that I know that pharmaceutical bodies will be very keen to play their role in making sure that there is a much wider understanding and in giving more support to women going through the menopause.

My hon. Friend the Member for Devizes (Danny Kruger) raised the important issue of the half a billion pounds of potential waste of prescriptions. We must make better use of pharmacists to review prescriptions, because they often tend to know more about the drugs that are being dispensed than thfe GPs who are writing the prescriptions. If we can play a better role in enabling pharmacists to review the prescriptions that their patients are presenting to them, we might go a long way to making those savings and getting more bang for our buck from the billions of pounds that we spend on our NHS. I encourage the Minister to look constructively at that suggestion, because the issue of misdiagnosis and the cost of drugs is significant.

The hon. Member for Swansea East has raised the issue of vaginal dryness. That leads me to make the observation that if we had applied as much attention to vaginal atrophy as we had to erectile dysfunction, we would be much better off—wouldn’t we? I cannot help but come to the conclusion that if this were happening to men, we might be in a better place. Look at what happened when Viagra was invented: within a year, it became available over the counter. That really begs the question of whether women are being treated fairly in this context. It does not feel like it to me. Again, I am sure that the Minister will be quite sympathetic to that point.

I ask the Government to look constructively at that issue, because we could liberate some of these drugs and make them more available over the counter. We have recently made the mini-pill available over the counter, which is really important given that one in three pregnancies is unplanned, and increasingly those unplanned pregnancies are women in their 30s, rather than teenagers. We have got to the right place when it comes to making contraception more available over the counter, but it took an awfully long time—much longer than making Viagra available over the counter. We must take these matters seriously.

On the subject of vaginal atrophy, I pay tribute to my constituent Sue Moxley. Sue used to be the beauty editor of The Sun. She is now better known for being the singing partner of her husband, David Van Day. She has spoken very publicly about her issues with vaginal atrophy. Again, she echoed the point that it happened to her completely unexpectedly. She was not prepared for it at all and it was incredibly difficult for her to find out information about what she was going through. In the end, having had a number of referrals, she experienced a direct laser-based treatment from Italy to improve the supply of collagen to the vagina, and it was transformational. I ask the Minister to look at that treatment. It is a direct physical treatment; it will not suit everybody, but neither does HRT. We have to ensure that we have a diverse range of treatments available, depending on people’s conditions, because, as the hon. Lady mentioned, everyone’s experience of menopause is very different.

One other issue that Sue raised with me was that it was suggested to her that women who have not experienced childbirth tend to suffer menopause worse. That raises another question, because if that is true, women should all know about it. There is lots about our life courses and experiences that will impact our health, but I would suggest that not enough research is being done into these things. For 51% of the population, I think we deserve better, so I encourage the Minister to look at that.

I have a few final points. The hon. Lady mentioned that HRT has had a bad press. A study in—I think—2001 suggested an increased risk of breast cancer as a consequence of HRT. In fact, that increase was very small, and the impact that study has had on women’s wellbeing has been far more damaging. Let us look at what goes on further through life. If more women were encouraged to take HRT, there would be massive savings for the Government. When we look at social care and why people go into residential care towards the end of their lives, we see that one of the biggest causes is falls and frailty. If we could encourage more women to take HRT—if it suits them—we would have fewer problems with osteoporosis and the injuries that lead to it. It makes perfect sense—we are spending to save.

[Tom Randall (Gedling) (Con)]

I join my hon. Friend in her congratulations to the hon. Member for Swansea East (Carolyn Harris). It was Teresa Gorman who said:

“HRT keeps you out of hospital, out of an old folks’ home and out of the divorce courts.”

Does she agree that it is surprising that one third of women who visited a GP were not made aware of HRT, and that greater awareness of it will help improve women’s health?

[Jackie Doyle-Price]

My hon. Friend puts the point so well: it is incredible that so long after the former hon. Member for Billericay was making her campaign, we have not moved on—we have almost stalled. However, the hon. Member for Swansea East is turbocharging it so that we can make up for lost time. From a Government perspective, it is frankly a false economy not to make HRT more widely available.

The hon. Lady made the crucial point that there is not enough training of medical professionals about these issues, either. That must be addressed as a matter of urgency. I fully support the Bill and congratulate the hon. Lady and all the campaigners she has worked with to get us to this place. It is clear from the mood in the Chamber that the House is with her, and amen to that! Women are back in charge.

Health Incentives Scheme

Tom Randall Excerpts

Friday 22nd October 2021 Commons Chamber

[Maggie Throup]

Obesity is a top priority for the Government and covid-19 has shown us the necessity of levelling up disparities in health. We know how important it is to update the House first and to allow it a chance to have its say, so I wanted to update it as soon as possible on this important issue.

[Tom Randall (Gedling) (Con)]

I offer my belated congratulations to my hon. Friend on her appointment to her role. In her statement, she mentioned Singapore’s national steps challenge, which has shown how to give small incentives to improve people’s lives. Will she confirm that her Department will draw on the best practice from around the world as it develops and pilots the scheme?

[Maggie Throup]

We have looked at schemes from around the world. Actually, if we get this right, we will be world-leading on this issue, although probably behind Singapore—I will give it some credit for being there first. We have looked at different schemes globally and we feel that this pulls together what has been tried in different areas, as well as having some uniqueness about it, which I am looking forward to developing as the pilot moves forward.

Oral Answers to Questions

Tom Randall Excerpts

Tuesday 13th July 2021 Commons Chamber

[Philip Dunne (Ludlow) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

[Tom Randall (Gedling) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

[The Minister for Health (Edward Argar)]

In our manifesto, we committed to building 40 new hospitals by 2030 and to upgrading another 20 hospitals. We are delivering on this commitment, and we now have plans to build 48 new hospitals this decade. We are also delivering improvements across the country to hospital maintenance, eradicating mental health dormitories and improving A&E capacity. Finally, the Department has received a £9.4 billion capital settlement for 2021-22, including the first year of a £5.4 billion multi-year commitment until 2024-25 for new hospitals and hospital upgrades, and £4.2 billion for NHS trusts’ operational capital.

--- Later in debate ---

[Edward Argar]

NHS E&I and the Department of Health and Social Care wrote to the Shrewsbury and Telford Hospital NHS Trust on 19 November last year confirming we remain committed to supporting the scheme. This letter confirmed the allocation remains at £312 million at this time, and of course my right hon. Friend will recall that I committed to approving the request in principle for £6 million of early funding to continue to develop the scheme. It is an important scheme, we want to see it proceed and I am very happy to meet him and fellow Shropshire colleagues.

[Tom Randall (Gedling) (Con)]

In my role as chair of the all-party group for axial spondyloarthritis I have heard from many about the importance of hydrotherapy pools in supporting those living with the condition, but there has been a concern that the reopening of these pools following the pandemic has been jeopardised by space within hospitals being allocated to other functions and a general low level of prioritisation. Does my hon. Friend agree that it is vital that we have robust plans in place to reopen as many hydrotherapy pools as possible, and will he consider meeting me to discuss this matter in further detail?

[Edward Argar]

I pay tribute to my hon. Friend and the all-party group for their work. He raises an important point: the challenges posed by infection control and the impact of the pandemic on the operation of hospitals. That has had an impact in this space, but I entirely recognise the value and importance of hydrotherapy as a treatment for particular conditions and I will be delighted to meet him.

Oral Answers to Questions

Tom Randall Excerpts

Tuesday 13th April 2021 Commons Chamber

[Matt Hancock]

We are putting a record amount of investment into the infrastructure of the NHS. That is evidenced by the questions that we have had already, with the improvements in Stoke, Scunthorpe and across the rest of the country. It is about not just the physical investment, but making sure that we support staff to be able to deliver and making sure that the NHS gets the support that it needs to tackle this backlog. We have a very significant backlog because of the pandemic and we are working incredibly hard to tackle it.

[Tom Randall (Gedling) (Con)]

What assessment he has made of the progress of covid-19 vaccine roll-out among the UK adult population.

[Elliot Colburn (Carshalton and Wallington) (Con)]

What assessment he has made of the progress of covid-19 vaccine roll-out among the UK adult population.

[The Minister for Covid Vaccine Deployment (Nadhim Zahawi)]

First, I would like to pay tribute to our fantastic NHS and all the frontline vaccinators, our volunteers, armed forces and local authorities and all those working on the vaccine deployment programme. I am very grateful for their tireless efforts in vaccinating those most at risk across the country.

I am absolutely delighted, Mr Speaker—no haircut puns at all here—that another significant milestone has been reached, as we have met our target of offering a vaccine to those in cohorts 1 to 9 ahead of schedule. Over 32 million people have had their first dose and more than 7.6 million have had their second dose. We are making phenomenal progress, but we remain focused on ensuring that no one gets left behind.

[Tom Randall]

Last week I became one of those people who had their first jab, at Boots the chemist in Nottingham. Will my hon. Friend join me in thanking all those in places such as Boots and all those involved in the roll-out of the Pfizer-BioNTech, Oxford-AstraZeneca and Moderna vaccines? Does he agree that the best way out of this situation is to get that jab, and that when the time comes and people get the call, they should take that opportunity as soon as they can?

[Nadhim Zahawi]

I absolutely agree with my hon. Friend, and I thank Boots the chemist not only for its frontline capability but for its distribution arm, which has helped us to distribute Pfizer-BioNTech, Oxford-AstraZeneca and, now, Moderna. I agree that when people get the call, they should come forward and have their jab.

Coronavirus

Tom Randall Excerpts

Thursday 25th March 2021 Commons Chamber

[Tom Randall (Gedling) (Con) [V]]

I think the day when all the regulations under the Coronavirus Act are lifted will be my highlight in this Parliament. That is a day that cannot come soon enough, but I do accept that today is not that day.

There is a road map and an end in sight, but the events on the continent remind us that we have not reached the end point just yet. Were the measures lifted today, many that have been deemed necessary to curtail the spread of disease and some of the measures that are helpful, such as statutory sick pay, would be removed. Given how far we have come, it is necessary to lift measures gradually to ensure that this is a one-way process, rather than taking too many steps forward now, only to have to revert at a later stage. The vaccination programme is our route out of lockdown and about 30 million jabs done is a fantastic success. I worry that sudden change might undo a lot of that good work.

The road map as it stands will see most restrictions lifted by June, and this House is being asked to renew measures for six months. I understand that that will effectively mean that large parts of the Act will be dormant, but that they can be reactivated if necessary, without primary legislation. I do not support coronavirus legislation with enthusiasm, but I understand its necessity. That is why I will be supporting the Government today.

While covid and the restrictions are on the decline, there is talk of living in a covid-tinged world for some time to come. There is a broader question. If one accepts restrictions on personal liberty to prevent the spread of deadly disease, should they be necessary to prevent its reoccurrence? There has been talk of certification or so-called vaccine passports. Earlier this week, the Public Administration and Constitutional Affairs Committee, on which I sit, heard evidence on that from, among others, my right hon. Friend the Member for Haltemprice and Howden (Mr Davis). We heard questions in that evidence session about the effectiveness of such a scheme. Its introduction, for example, might be not just for a football stadium, but for the train there and back where a virus might be spread. If holding a vaccine passport is likely to affect access to key public services such as public transport, I think it will be necessary to show clearly the effectiveness of such a scheme and the data on which it is based.

That is, perhaps, a debate for another day, but a thorough debate on that subject will be necessary. In the meantime, I look forward to continuing to follow the road map to get us all out of the pandemic.

UK Rare Diseases Framework

Tom Randall Excerpts

Wednesday 24th March 2021 Westminster Hall

[Tom Randall (Gedling) (Con) [V]]

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate the hon. Member for Blaydon (Liz Twist) on securing the debate. It is a welcome debate and an opportunity to discuss those rare diseases that, by their very nature, do not have the large advocacy organisations to speak about them. This week I received a mailshot from one of the UK’s leading cancer charities. While that is a welcome and worthwhile effort, rare diseases—those that affect fewer than one in 2,000 people—do not have those resources and it is important that we speak about them.

I welcome the publication of “The UK Rare Diseases Framework”, which has four priorities. I will speak briefly on priorities 2 and 4. Priority 2 is to increase awareness of rare diseases among healthcare professionals, which I think is crucial. I am co-chair of the all-party parliamentary group on axial spondyloarthritis, which is not a rare disease—it affects one in 200 people—but the eight-year delay in diagnosis has been attributed, in part, to a lack of knowledge by healthcare professionals. I fully support any increased awareness of rare diseases.

Priority 4 is to improve access to specialist care, treatments and drugs. As others have said, I have seen that myself with phenylketonuria, which I had not heard of until I met the parents of Hurley, one of my youngest constituents. They came to see me to discuss Hurley’s condition. PKU affects fewer than one in 10,000 babies. As we have heard, it means that the body cannot process protein, which results in a severely restricted diet.

The drug Kuvan has been available but was not widely licensed despite promising results. I welcome the news that Kuvan is now available, but it is not available for over-18s. That causes understandable concerns not only for adults, but for those in their late teens who are approaching a point when their treatment will become unavailable. I will add my name to those calling for the wider licensing of Kuvan for those with PKU.

This is a welcome debate and there is a responsibility on all MPs to speak up for their constituents who have rare diseases, to make their case heard. I look forward to continuing to do so with colleagues.

[Mrs Maria Miller (in the Chair)]

Order. After the next speaker, I will move to a two-minute time limit, in an attempt to get more speakers in.