Lobular Breast Cancer

Valerie Vaz Excerpts

Tuesday 10th December 2024 Westminster Hall

[Helen Hayes]

I thank all hon. Members who have contributed. They have brought their constituents’ stories and their own personal experiences to the debate. We have many issues to work on in this House, but there is a particular responsibility when an issue presents itself in a personal way through a devastating story, whether that is through a constituent, somebody we know or our own personal experience. When we see an opportunity for things to be done, it is imperative for us all to bring that to this place. I am grateful to hon. Members for the spirit in which the debate has been conducted, the high level of consensus and the high level of commitment to see change for patients with lobular cancer.

I am grateful to the Minister for her engagement with the debate. I know she is committed to this area. In closing, I ask that she looks in further detail at two issues. The first is the proportional allocation of the funding available through the NIHR for research into breast cancer. We have heard again and again today that lobular cancer accounts for 15% of all breast cancers, yet currently attracts only a tiny fraction of dedicated research. We know that the improvements we have seen in treatments and outcomes for different types of cancer diagnosis always hinge on the investment put into research to find the cures. There is a disproportionality there that can and must be changed.

The second area I ask the Minister to look at in a little more detail is the advice and guidance given to clinicians in primary care, to make sure that there is a consistent understanding of the symptoms of lobular cancer and its distinctiveness as a disease compared with ductal cancer, and to make sure that every woman presenting to her GP is able to access accurate advice and swift onward referral. It is important across the whole range of women’s health conditions that women are trusted and listened to when they present with symptoms to their GP, and this is an area where I believe primary care can do better, be more consistent and deliver better outcomes as a consequence.

I pay tribute once again to Dr Susan Michaelis and all those who campaign on this issue on the basis of their deeply difficult personal experiences. I give my commitment that for as long as I have a voice in this place, I will continue to work on this issue until we see the changes that are needed.

[Valerie Vaz (in the Chair)]

I thank everyone who took part in and attended this debate.

Question put and agreed to.

Resolved,

That this House has considered the treatment of lobular breast cancer.

NHS Performance: Darzi Investigation

Valerie Vaz Excerpts

Monday 7th October 2024 Commons Chamber

[Valerie Vaz (Walsall and Bloxwich) (Lab)]

It is a pleasure to follow the hon. Member for Hinckley and Bosworth (Dr Evans).

The report is a tour de force from Lord Darzi, and I thank him for his work. The Secretary of State rightly commissioned the report as a benchmark for future improvement. I was a member of the Health Committee from 2010 to 2015. Given the evidence we heard, there was no alternative but to pause the Bill—the Committee played an important role in that. Chapter 10 of the report sets out the structure. Lord Darzi points out that the 2012 Act was three times the size of the original Act setting up the NHS. The 2022 Act moved into integrated care, and in paragraph 15 on page 121, he raises some concerns about how the ICBs—integrated care boards—operate, and their accountability. Could there be a review into how they operate? Paragraph 37 highlights that trust chief executives’ pay is based on the turnover of the organisation, which encourages trusts to

“grow their revenue rather than to improve operational performance.”

Some are even paid more than the Prime Minister.

The flow of patients is important, which is where working with local authorities is so important. We can move planes around the world, but it seems we cannot move people out of hospital. The Select Committee visited Torbay, which was set up in 2009. We followed Mrs Smith from a single point of contact all the way through. As Lord Darzi said on page 77, collaboration is not the same as integration. On page 5, paragraph 13, he points out that too great a share of the money is spent in hospitals rather than in the community. On page 81, he said that “GP…contracts are complex” and doing the right thing for patients is the wrong thing for GP income. He said, “That cannot be right.”

Our mantra should be “prevention, prevention, prevention”. In our report, we said that public health should be moved into local authorities. As Lord Darzi said, health visitors are dropping. He also said that the NHS is missing an opportunity to intervene early. We had Sure Start, which is where health visitors were focused. He talked about clinical negligence. Some £2.9 billion— 1.7%—of the budget is spent on settling claims. Can the Secretary of State pursue the duty of candour and ask each trust to look at whether they can move cases into arbitration?

Sadly, disparities by ethnicity make very grim and sad reading. Paragraph 24 refers to the median age at death as 62 for white people, 40 for black people, 33 for Asian people and 30 for those from a mixed background. There was supposed to be a chart in the report, but it is not there. Will the Secretary of State look at producing it?

Lord Darzi’s report gives the Secretary of State and the health team an important opportunity to re-set the NHS. It is the envy of the world and free at the point of use. As Lord Darzi said, we cannot afford not to have an NHS.

[Madam Deputy Speaker]

I call Monica Harding to make her maiden speech.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 5th March 2024 Commons Chamber

[Victoria Atkins]

Again, I very much admire the effort and determination that my hon. Friend is showing to stand up for his constituents. He will know that sadly I am constrained from commenting on individual cases, but what I do know is that the innovation he is showing alongside his parish council—and, indeed, I would hope, his local integrated care board—is the approach we want to adopt across our rural and coastal communities to ensure that they, too, have the access to primary care that we all expect.

[Valerie Vaz (Walsall South) (Lab)]

Equal access to primary care is so important, but the use of physician associates is downright dangerous. Does the Secretary of State agree that patients have the right to see a qualified GP and not be fobbed off with a two-tier primary care system?

[Victoria Atkins]

I understand the concerns—we have seen them in the media—but, please, we in this House have a responsibility to our constituents and to professionals working in healthcare, including our clinicians and physician associates. In fact, physician associates have been working in the NHS for some two decades. They are there to work with doctors to assist them, freeing up doctors’ time to focus on the tasks that only they are qualified to do. We have been very careful to listen to the concerns raised, which is why we recently announced intentions to regulate them. But, please, we must all take that responsibility for ensuring that we are not spreading concern. Actually, these roles can have a very positive effect on healthcare system.

Building an NHS Fit for the Future

Valerie Vaz Excerpts

Monday 13th November 2023 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

Let me start by saying what a pleasure it is to follow the right hon. Member for Gainsborough (Sir Edward Leigh). I also welcome the hon. Member for Uxbridge and South Ruislip (Steve Tuckwell), who will make his maiden speech; he will know that we campaign in slogans but we sometimes have to make difficult decisions when we represent our constituents, as we have seen with the international issues taking place in Israel and Gaza.

I say to the right hon. Member for Gainsborough that we are talking about a ceasefire not only to enable the hostages to be released, but to stop the killing of innocent civilians. When organisations such as the Catholic Agency for Overseas Development cannot even enter Gaza and do the work they need to do, and when 44% of the United Nations workers have been killed, we have to do something. We cannot sit back and do nothing, which is why I will add my voice to the calls for a ceasefire to enable our brilliant diplomats to try to find a solution to this intolerable situation. People may have seen what took place at the weekend, but let me say that I was writing this speech and I just could not carry on, as it was incredibly upsetting to see babies’ bodies lined up—that is just a horrific thing. They have done absolutely nothing; they have just come into this world, and for what—just to be dead? Parents and all sorts of people are facing incredible difficulties, not being able to eat or drink; doctors are even unable to carry out operations.

We have had the first speech of our gracious sovereign and he set out the Government’s business until the next Session, with 21 Bills proposed. They do not represent the urgency of what is needed, and I want to focus on energy and climate change, public services and empowered local government, and keeping us all safe through the criminal justice system. In the gracious sovereign’s speech, the Government say they want to strengthen the UK’s energy security, but there are no measures set out to bring down bills. Onshore wind projects have recently stalled, as there are no new applications, so investment is being driven abroad. However, new licences for oil and gas are set out in the King’s Speech. Despite 13 years of North sea licences, only small amounts of gas have been found—the equivalent of nine weeks of usage; we are talking about 12 fields and nine weeks. Despite six rounds since 2010, only five new fields have been discovered, and the Sillimanite gas field is 30% owned by the Russian gas giant Gazprom. How is that making us secure?

His Majesty’s Opposition’s Gracious Speech, which we hope to produce fairly soon, will include the energy independence Bill. That will include a target to achieve clean power by 2030—we have nothing from this Government on targets. We will bring forward the planning and regulatory reforms for clean power by 2030 and establish “Great British Energy”, a new home-grown publicly owned clean power generation company with a mandate to produce profit-free power for our citizens. All of that will cut energy bills, create good jobs, ensure energy security and protect the planet for future generations.

Our children are choking and dying from inhaling particulate matter. Dr Sarah Moller from the University of York found that the people who experience the highest levels of nitrogen oxide emissions are those who live nearest roads and in areas of higher density—deprived communities—so what did the Government do? They cancelled a major transport project that would have enabled people to use high-speed trains for capacity and connectivity. To make things more difficult, the Government have done a U-turn. Ticket offices are there to help people use trains; the Government want to close them. Accessible train stations should be a right for people with disabilities. That is what I am trying to ensure with Bescot Stadium station. Our next Gracious Speech will have a Bill on energy independence.

We have seen the recent pronouncement of the Bank of England that the economy is flatlining. Inflation, mortgage costs, and food and energy prices are creating a crisis in every household. There was nothing in the speech to help those on the frontline who are providing statutory services. The Government-funded part of local authority spending has fallen in real terms by 52%. Instead of giving local authorities a grant based on a formula that calculates need and deprivation, the Government have retained funding and purport to dish it out by ensuring that local authorities have to bid against each other for a particular fund. Most local authorities are struggling to provide child protection and other statutory services, but there was nothing in the speech to deal with the issues surrounding vulnerable children, which have increased since the pandemic and have had a major impact on local authority budgets. Local authorities are on the frontline, and they should be in a position to provide these services face to face. They are there to support our constituents, not to close down or turn people away. Again, there was also nothing in the Gracious Speech about NHS waiting times or decent wages for staff.

There was also a lack of clarity in the Gracious Speech regarding the criminal justice system, which is collapsing, Mr Deputy Speaker—and he will know as a former barrister. Some 90% of crimes are going unsolved. Arrests on thefts are down 40% on just a few years ago. Shoplifting has reached record levels. Those who work on the frontline in supermarkets are suffering abuse. The charity Retail Trust found that 40% of workers—two in five—face abuse from customers weekly. Those workers were the ones who helped us through the pandemic. I saw a gang when I was in a local convenience store, looking at the CCTV. I was wondering what the owner of the shop was looking at. Basically, someone had wheeled up a van, and lifted a clothes bank and took it away. That is what is happening now. We still have 10,000 fewer neighbourhood police. In Labour’s first Gracious Speech, His Majesty’s Opposition will put 13,000 more neighbourhood and police community support officers on the street. We want to introduce respect orders, with criminal sanctions for antisocial behaviour.

The Government have not even looked at prisons; there was no mention of those difficulties in the King’s Speech. I asked a prison governor in my constituency, “What’s the capacity in your prison?” He said, “99%.” I said, “What should it be?” and he said, “70%.” That is what is happening, and it has to be dealt with. We need a return to extended court sittings to address the backlog of cases, and we should perhaps bring back Nightingale courts, which we used to have. We need to see respect for the rule of law. The legal system needs proper representation for all, and it is vital, as you will know, Mr Deputy Speaker, that both sides are represented. Judges are having to fill in for claimants and for the defence because they need to explain procedures to people, so that they know exactly what will happen to them.

There was also not a single word in the Gracious Speech—I did check—about public services, apart from a statement that public service estimates will be laid; there was nothing about how to deal with the present crisis. We have a dithering, do-nothing Government. The biggest discussion is whether a Minister or Secretary of State should be sacked. We told the Government about the Northern Ireland protocol. They then had to put it right, and rename it, and that came in only in February this year. We told them about the Horizon programme, and how our brilliant scientists were being prevented from continuing to take part, until finally the Government agreed that we should get involved in the Horizon programme. It is so difficult for scientists because they have to plan ahead and apply for grants. Yet only in September this year did the Government agree on the Horizon programme. They dithered about it, and could have saved everyone time. Some 28% of music industry workers have not had any work in the EU for the last two years.

I know people say, “So what are you going to do?”, so I want to set out what will be in His Majesty’s Opposition’s King’s Speech: breakfast clubs, so all children can benefit from a good start; getting the NHS back on its feet by cutting waiting lists, delivering out-of-hours treatment and doubling the number of scanners to provide faster treatment; and getting Britain building again, with 1.5 million homes built in five years and first-time buyers being allowed to bid for those houses in their local community.

I walked past the flats that were there for the Commonwealth games village. They are lying empty and I would like to know what is happening with them. Homeless people are being put up in hotels, when those flats are lying empty and should be used.

We need to switch on “Great British Energy”, a new British company giving us cheaper bills and new high-paid jobs; and to take back our streets from gangs, drug dealers and fly-tippers, with stronger policing, guaranteed patrols in town centres and more criminals put behind bars. That is what will be in His Majesty’s Opposition’s King’s Speech.

Finally, I know the Prime Minister is very interested in “Star Wars”—he is a “Star Wars” geek—so I say this to him: “Red 326 standing by.”

NHS Long-term Workforce Plan

Valerie Vaz Excerpts

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

My hon. Friend raises a brilliant point. I do not know if Members know, but there are 350 different types of role in the NHS. It is really important that we get the right information to children whose parents are perhaps not informed about those opportunities. One point on which I slightly take issue with my hon. Friend is that it is not just those at the start of their career who need to be aware of the opportunities. This is about offering opportunities to people throughout their careers to progress and to take on more advanced roles. I strongly believe that we should not define people’s future career by where they are at 21 or 22; they should have the opportunity to progress. That is a key part of the workforce plan, and I think it is a key Conservative principle that they have that ladder of opportunity throughout their time in the NHS.

[Valerie Vaz (Walsall South) (Lab)]

I associate myself with the remarks the Secretary of State made about Bob Kerslake. He was a true public servant, and his death is our loss.

What is the point of a workforce plan if the Secretary of State is not actually talking to the workforce? When will he talk to the junior doctors and the consultants? Can I also ask whether the work on the workforce plan will start forthwith or sometime in the future?

[Steve Barclay]

The fact that we are talking to the workforce is shown by the fact that we have reached agreement with the largest workforce group in the NHS.

[Valerie Vaz]

indicated dissent.

[Steve Barclay]

The right hon. Lady, for whom I have a huge amount of respect, is shaking her head, but it is a fact that the largest workforce group in the NHS are those on “Agenda for Change”, which covers more than 1 million healthcare workers from nurses, midwifes and paramedics through to porters, cleaners and many others. We have reached agreement with the NHS Staff Council, and those sums—the 5%, plus the lump sum in recognition of their tremendous work—is going into pay packets this month. So we have reached agreement, notwithstanding discussions with the junior doctors. They still demand 35%, and that is not affordable.

Patient Choice

Valerie Vaz Excerpts

Thursday 25th May 2023 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

Karen Lumley was indeed a wonderful woman. Our thoughts and prayers are with her family at this difficult time.

The statement is admirable, but how will patients have a choice if the Secretary of State does not address the workforce issue? When will he do that? When will he speak to the junior doctors?

[Steve Barclay]

As I touched on in my statement, the choice is there now; it is available right now, but only about 10% of patients exercise it. There is massive variation in the system now, with the existing workforce. We are increasing the workforce. We have made a commitment to produce a workforce plan, but the point is that there is variation within the system now. What patient choice is about is empowering patients to take advantage of it and to access treatment sooner, for example, by being willing to travel often short distances to access it.

NHS Strikes

Valerie Vaz Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

The hon. Gentleman got a plug in for his policy there, but I am not entirely sure how relevant it is to this statement. On NHS staffing, we have 10,500 more nurses and 4,800 more doctors than last year. But I know adult social care represents one of the biggest challenges for our NHS, and it puts pressure on the rest of the system. That is why in the autumn statement the Chancellor put in place £7.5 billion, the largest ever investment in adult social care.

[Valerie Vaz (Walsall South) (Lab)]

The Minister will know about the ministerial code and about keeping the House updated, so will he tell us when the Secretary of State for Health met Pat Cullen of the RCN? If cannot tell us now, will he write to us and put that letter in the library, please?

[Will Quince]

Of course I am happy to do that, and I think these things are put on the public record in any event. I do not know when the Secretary of State met specifically with the RCN, but I can tell the House that I have met the unions, I believe, on 9, 12, 25 and 31 January.

Urgent and Emergency Care Recovery Plan

Valerie Vaz Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

I could not agree more, which is why this morning the Prime Minister and I were at University Hospital of North Tees, where it is effective on the ground. It is about looking at hospitals where such measures have been effective and are having an effect on the ground, such as in North Tees and at Maidstone Hospital, and how we take best practice from them. We then have to do what has sometimes been more difficult in the NHS, which is to scale those innovations and get them adopted across the piece.

[Valerie Vaz (Walsall South) (Lab)]

There are 165,000 vacancies in social care and there was nothing in the statement about how the Secretary of State will address them. Will he do that through better terms and conditions?

[Steve Barclay]

We are dealing with that through additional funding—the £500 million for this winter. That relates to the point made by my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) about the impact on the ground, which will be to give ICBs and local authorities discretion. Some of that £500 million is being spent on the workforce, including in social care, so there is discretion as to how they spend that. There is also the £2.8 billion of local authority and ICB funding that will be in place next year, and £4.7 billion the following year.

NHS: Long-term Strategy

Valerie Vaz Excerpts

Wednesday 11th January 2023 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is a pleasure to follow my friend the hon. Member for Winchester (Steve Brine), the new Chair of the Select Committee. My hon. Friend the Member for Ilford North (Wes Streeting), the shadow Secretary of State, is right about Government mismanagement of the NHS since 2010. As a member of the Health Committee from 2010 to 2015, when it was chaired by the right hon. Stephen Dorrell, the former Health Secretary, I want to set out why this crisis has been brewing since 2010. Incidentally, Stephen Dorrell has noted five mistakes that the Government have made and should look at.

The Health and Social Care Act 2012 prevented integration. It made the NHS not the first and default option, and it was opened up to privatisation, fragmented and destabilised. The reorganisation was described as so big that it could be seen from space, and it was opposed by so many that it had to be paused. Despite the pressures of the pandemic, we had a further reorganisation with the Health and Care Act 2022, under which we will not have CCGs any more, but integrated care boards.

His Majesty’s Opposition have been pushing integrated care since before 2010. Our Select Committee visited Torbay in 2009, during the last Labour Government. We saw the single-point entry of Mrs Smith, who could be tracked from the start—from a single phone call—to hospital and out again, with any of her needs met by an upscaled, co-located team. However, the 2012 Act stopped that pooling of resources. Integrated care can only work if there are adequate resources for local authorities. Austerity measures since 2010 have starved local authorities and other public services of funding. Clinicians should be at the heart of the NHS. People who use it or work in it do not get a say.

In 2016 the then Secretary of State, now Chancellor, picked a fight with the junior doctors. I met them outside Richmond House. We have had more mismanagement, with £347 million for a covid testing contract to Randox, which then had to be recalled because of concerns about contamination. Now we have PPE Medpro, and today the Public Accounts Committee said the Government have mismanaged the economy by losing £42 billion in uncollected taxes. There is money, but not the will to find it.

Nurses went on strike in December, yet in the first statement the Secretary of State has made since—he is not in the Chamber, but he said that we did not mention his statement—he did not mention the workforce at all. In fact, he gave an understatement of the figures for people with delayed discharge. He said that there were just 6,000 cases in June 2020. Last year, there were 12,000 to 13,000 a day. The Government knew the figures, but they did nothing—they had no plan.

Not talking to a workforce who stepped up into the unknown during the pandemic is mismanagement. Stopping nurses’ bursaries was mismanagement. Not holding cross-party talks to solve the care crisis when we urged them to—the Health Committee report was in 2012—was mismanagement. The Government dismantling a health service that had its highest satisfaction levels in 2010, when Labour left office, is mismanagement.

[Tahir Ali (Birmingham, Hall Green) (Lab)]

On the workforce, existing nurses are underpaid, but the serious number of vacancies that existed in September—47,000, as reported by Nursing Times—must also be addressed adequately and immediately. Those vacancies are putting pressure on nurses, on top of the pay awards they are after.

[Valerie Vaz]

My hon. Friend is absolutely right and puts the point perfectly. I have questions to ask the Minister. Are the recommendations on safe staffing levels made by Sir Robert Francis being followed now? Will the Secretary of State consider a patient discharge dashboard so we can see the figures on a weekly basis? Where is the accountability for the £500 million in the discharge fund? Are the 42 NHS system control centres mentioned in the statement just the ICBs by a different name? Our shadow Secretary of State for Health has outlined a plan for training more doctors, paid for by abolishing non-doms, and I am with him on salaried GPs as a step in the right direction.

Nye Bevan heard the cries of his community in the valleys. He said:

“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”

He turned his dream into a wonderful service that is free for all of us. We will not let this flailing and failing Government destroy our NHS.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 14th June 2022 Commons Chamber

[Sajid Javid]

Yes, of course I can give the hon. Lady that commitment. I am very sorry to hear about Joanna; I think of her, her loved ones and her two children. I will absolutely look personally into the case. I hope that the hon. Lady agrees that where we see poor outcomes, it is important to make sure that we have the best possible leadership in place.

[Valerie Vaz (Walsall South) (Lab)]

I have already raised the issue of the governance at Walsall Manor Hospital. I welcome the Messenger-Pollard review—the Secretary of State will know that there is also a report called “The snowy white peaks of the NHS”, which says roughly the same thing—but I have been fobbed off because the leadership at Walsall and Wolverhampton remains the same. Could he look into why Walsall Manor should not have its own chief executive?

[Sajid Javid]

These are important issues, and I have discussed this with the right hon. Lady. I will take another look at the management of Walsall Manor.