Government Policy on Health

Jim Shannon Excerpts

Monday 9th September 2024 Commons Chamber

[Wes Streeting]

I am grateful to my hon. Friend for his question. We know that the NHS is broken, and is going through the worst crisis in history. We will shortly hear from the noble Lord Darzi about the outcome of his investigation into the true state of our national health service, but against that bleak backdrop of political failure are stories across the country of triumph against the odds, and of some outstanding public servants doing extraordinary things, showing what the future of our health and care services could look like with a Government on their side. I am pleased that such a Government is here—this Labour Government—and I would be delighted to hear more about my hon. Friend’s constituency.

[Jim Shannon (Strangford) (DUP)]

I wish the Secretary of State all the best in his new role, and in the task that he has taken on. With great respect to my Conservative colleagues, the downfall of the Tory Government was due in part to the fact that people did not trust the background politics behind closed doors. I want the Government to succeed, as do most people in this House. Stability and direction are much needed, but that can happen only with openness, transparency and a desire to put nation before party. How can the Secretary of State assure us that this Government will do things differently, and that policy will be proposed by those with know-how, and passed with scrutiny in this place, not simply due to pressure from lobby groups?

[Wes Streeting]

I strongly agree with the hon. Member. In the short time that I have been in post, I have been delighted to have had virtual meetings with the current Northern Ireland Minister of Health, as well as with his predecessor, the hon. Member for South Antrim (Robin Swann), who now sits over there on the Opposition Benches—I am delighted to see him in his place.

Ministerial meetings attended by third parties are declared in our quarterly transparency publication. People will want to lobby and influence Government, and Members of Parliament, all the time. Members of Parliament regularly receive correspondence—let alone the deluge of advice that we receive in government. The important thing is that Ministers take decisions on the basis of the best possible advice available, that they weigh up carefully the evidence and arguments in a fair and proper way, and that advisers may advise but Ministers ultimately decide.

This Government are aware of the deep crisis in trust in our politics. That is why, on his very first day, the Prime Minister talked outside Downing Street about restoring Government to service. It is why it should be no surprise whatsoever that many people who have given outstanding public service to this country, such as my right honourable friend Alan Milburn—and the same is true of Patricia Hewitt, Alan Johnson, my noble Friend Lord Reed, the Mayor of Greater Manchester and many more—want to roll up their sleeves and help the Government. They can see the state that the Conservative party left our country in, and are willing once again to roll their sleeves up to get our country back on its feet, turn the situation around and ensure that everyone in our country can look forward to the future with optimism and hope after 14 years of abysmal failure.

Preventable Baby Loss

Jim Shannon Excerpts

Wednesday 4th September 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to follow the hon. Member for Morecambe and Lunesdale (Lizzi Collinge) and to hear her contribution as well. In particular, I thank the hon. Member for Ashfield (Lee Anderson) for setting the scene, as he often does, with a passion and an understanding of his constituents that we all see, and for describing the examples of his constituents who have suffered in this way. He did it with sensitivity, because it is a very sensitive debate. As a father and a grandfather, my thoughts are with those who have faced and are living through baby loss; there are many who have. I say “living through” because I know that it is not something to get over as such.

I could give many examples, but I will give just one. The hon. Member for Ashfield said that every family has been touched, and he was right. My mother has had a number of miscarriages, as has my sister and Naomi in my office, so the issue of baby loss resonates with us all.

There was a lady I greatly admired. Her name was Agnes Thomas. She is dead and gone, but she was 4-foot-nothing. There wasn’t much of her, but she was definitely a whirlwind. I remember her coming to see me. She took care of her 105-year-old mother—and that is the age her mother was when she passed away. Agnes had a very ill husband, and she had minimal help from anyone. Within a few months of her passing away, her mother and her husband died too. She was the centre of that home and one of the strongest women that I have ever known—apart from my own mother, of course, who at 93 is equally strong. However, underneath all that undeniable strength was also a lady that, in her 80s, came to the office to see whether she could find out where her stillborn son—

[Helen Morgan (North Shropshire) (LD)]

The hon. Gentleman is making a powerful speech. It is good to hear the story of Agnes, and I hope that he will agree with me that sympathising with our constituents who have suffered such awful circumstances and telling their stories in Parliament is a good way to ensure that they are heard in the future.

[Jim Shannon]

I thank the hon. Lady for that. The story of Agnes’s son is this: her stillborn son was born sleeping in the early ’70s and was buried. Agnes came to see me over 50 years later.

[Lee Anderson]

The hon. Gentleman is making a very passionate speech, and I think everybody in Westminster Hall can tell how impassioned he is. He tells a very touching story. Does he agree that it does not matter how long ago baby loss occurred—it will always stay with the family?

[Jim Shannon]

I am sorry for being emotional. I know that I should not be. I thank the hon. Gentleman for giving me a chance to recover some of my composure.

Agnes came in tears to ask where the Royal Victoria hospital had buried her son. It meant something to her, even though it was 50 years later—that wee small lady, standing in my office telling me her story, which was breaking her heart 50 years later.

The loss of a baby is life-changing, and my thoughts are with those families who have been mentioned in this debate. There will be others. Other hon. Members will speak, and they will tell the same story with the very same emotion, compassion, understanding and that realness that the hon. Member for Ashfield compounded in such a fantastic way in his introduction.

The fact that baby loss can be preventable makes the outcome that bit more difficult to accept. Sands is a phenomenal charity, and it has given the following statistics. I always give a Northern Ireland perspective simply because I feel it adds to the debate, but it also tells us that the things happening here are no different for us back home. The stillbirth rate declined 17.7% in Northern Ireland between 2010 and 2022. However, comparing the rate over a three-year average shows a smaller reduction of 10.1%. My goodness! Though it is decreasing, it is still there with a vengeance. The neonatal mortality rate has been higher in Northern Ireland than in any other UK nation since 2013. It is equally bad wherever it is, but I am just making the point that Northern Ireland has examples of it that are above the rate anywhere else.

[Carla Lockhart (Upper Bann) (DUP)]

I thank my hon. Friend for his powerful speech. This is certainly a debate that resonates with me on a very personal level, but I want to make mention of a little boy called Teddy from my constituency of Upper Bann, who died from sudden infant death syndrome. He will be forever seven weeks old. Does my hon. Friend agree that we need better wraparound services, particularly in our hospitals, with rooms made available for families who find themselves in these most tragic circumstances? There should be support, counselling and help right through their grief journey.

[Jim Shannon]

I thank my hon. Friend and colleague for that intervention. What she says is absolutely true.

I tend to be emotional at the best of times, but whenever someone loses someone, particularly at that time, it resonates with everyone. It is a time when people want to wrap their arms around them, because it is the right thing to do. At the same time, there has to be someone outside. The hon. Member for Ashfield gave some examples where—with respect—people were just sent home when they needed someone. That is so sad. I feel that there should be a greater role for churches and ministers to help and, as best they can, to give succour and support physically, emotionally and mentally. Those are things that we have probably all tried to do.

Unlike stillbirths and neonatal deaths, the total number of miscarriages and miscarriage rates are not reported in Northern Ireland. That needs to change. It is a matter for us back home and not the Minister’s responsibility, because health is devolved, but I do feel that we need to do better. I still feel that the aims in the mainland should be replicated. I know that the Minister is sitting in for another Minister who cannot be here, but maybe it could be conveyed to the responsible Minister that we should look at an overall strategy for the whole United Kingdom of Great Britain and Northern Ireland.

Although there is an ambition in England to halve the 2010 rates of stillbirth, neonatal death, pre-term birth, maternal death and brain injury by 2025, there is no equivalent ambition in Northern Ireland. There really needs to be one; that is one thing that I would love to see. Sands states:

“The Northern Ireland Executive must commit to reducing pregnancy loss and baby deaths and eliminating inequalities. Any future targets must have a clear and agreed baseline to measure progress against.”

It is not just about having a goal; it is about having a goal that means something. With respect, we can have words until the cows come home, but they mean nothing unless they turn into action. Sands further states:

“These targets should be the driving force behind a programme of policy activity, with funding and resources to meet them.”

I agree. The ambition of this debate is to highlight the need for funding and resources, highlight the issue, make people aware and give an outlet to those who have suffered so painfully and who will carry that burden with them all their life. That is what I too am advocating, not simply for England but throughout the whole United Kingdom.

We have midwives who regularly find themselves staying after handover, as they are understaffed. We find exhausted junior doctors being left with full maternity wards while their SOs catch up on the never-ending paperwork. We have cleaning staff telling us that they do not have time to do all they need to clear rooms of infections. All those things are a matter of funding, and they are all UK-wide.

In all parts of this great nation, these are matters of life and death. The death of just one little baby that did not need to happen—we all have examples in mind today—is a tragedy. The number of babies who have died needlessly is not just a tragedy, but a catastrophe. We need to change it. With that in mind, I congratulate the hon. Member for Ashfield on giving us all an opportunity to participate in this debate in a small way, but with united force. Politics aside, we are here as MPs on behalf of our constituents, and we will all say the same thing: the loss of a baby is devastating to a family. If we can do something, we must. Let us support staff and, by doing so, support the health of our mothers and their children.

Unpaid Carers

Jim Shannon Excerpts

Tuesday 3rd September 2024 Commons Chamber

[Wendy Chamberlain (North East Fife) (LD)]

Thank you, Madam Deputy Speaker. It is great to be back, and to see you in the Chair. I congratulate you on your new position.

Caring or being cared for is an almost universal experience. Almost everybody will find themselves being an unpaid carer for their loved ones at some point in their life, or being cared for by loved ones. Who among us does not know somebody who is helping an elderly parent, or supporting a family member with a long-term illness? As new MPs will come to learn, almost every week here, we have an opportunity to learn about and mark a national awareness day for a different devastating illness. For every person suffering from those illnesses, there will inevitably be a family member—unseen—supporting and caring for them.

According to the recent census, there are 5.7 million unpaid carers in England and Wales, but those are just the people who recognise themselves as such. In 2022, Carers UK research estimated that there were up to 10.6 million unpaid carers. Whichever figure we use, that is a huge number, and the figure is growing. According to very recent research published by the Joseph Rowntree Foundation, by 2035 there will be an 11% increase in the number of unpaid carers, and as degenerative conditions, including chronic degenerative conditions, become more prevalent, the amount of care that carers do is predicted to go up; it is expected that ever more will provide more than 35 hours of care each week.

The Government should care about carers, not just because that is the right thing to do, and not even because unpaid carers are in homes across every constituency in the UK, but because we need them. Unpaid carers are absolutely vital to our economy and our society.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this debate forward. The House is fuller than usual for this Adjournment debate, which indicates the importance of the issue. Every one of us knows people who are carers. I care for my brother, who had a big accident 20 years ago, and I understand what it means to be a carer and to be available at all times, as others do. Does the hon. Lady agree that respite for carers is an essential component of support, and that inability to access respite care will push many into making the unwanted decision to give up caring and instead institutionalise the people they care for, due to the unbearable pressure on their mental health?

[Wendy Chamberlain]

I am grateful to the hon. Member for that intervention. He is absolutely right, and as he and I know, having served in the last Parliament, during covid the lack of respite care was a critical factor for many carers. It is clear that we all need to do more in that area.

We were talking about how vital carers are to our economy and society. The economic value of unpaid care is £162 billion a year in England and Wales, £13.1 billion in Scotland and £5.8 billion in Northern Ireland. We know the country’s finances have been left in a ruinous state by the last Government, and that the social care system is already stretched to breaking point. We must also know that we cannot take the contribution of unpaid carers for granted, so I hope that the Minister will take tonight as an opportunity to show that the Government do care about unpaid carers.

In a debate shortly before the general election was called, the then shadow Minister for care, who is now a Minister, the hon. Member for Gorton and Denton (Andrew Gwynne), committed Labour to developing a new carers strategy if it formed the next Government:

“There will be a carers strategy under the next Labour Government, because we value the vital work our carers do. It will be a cross-Government strategy with the Department for Work and Pensions, Department for Education and the future of work review all feeding into it along with the Department of Health and Social Care. There is a brighter future for those living with dementia and their families and carers. Labour will deliver it.”

Given that promise, I hope that the Minister can understand why I and many whom I have spoken to in the care third sector were disappointed that unpaid carers were not mentioned at all in the Labour manifesto. At the same point in the speech I just referred to, the then shadow Minister said that unpaid carers

“will be at the heart of Labour’s plans in Government.” —[Official Report, 16 May 2024; Vol. 750, c. 228WH.]

I hope the Minister will take tonight’s debate as an opportunity to make that case.

--- Later in debate ---

[Stephen Kinnock]

I thank my hon. Friend for that intervention. She is absolutely right that many such networks, often informal, play a vital role in the community in providing that support and peer-to-peer support. So often unpaid carers can end up feeling quite isolated. Informal networks like the one she describes are vital and I commend the work of that network in achieving the objectives we all want to see.

[Jim Shannon]

The Minister outlines the need for reform. I think many of us in the Chamber would like compassion and understanding to be key to that. Reforms are okay, but they need compassion and understanding to make them work.

[Stephen Kinnock]

I thank the hon. Member for that intervention. He has reminded the House that caring for friends and family is an important part of what it means to be human. It is at the heart of the desire to support one’s community, as well as one’s friends and family.

We must always approach this issue with compassion. We know that we have certain constraints as a Government in terms of what we are able to do, but I can assure the hon. Member that we are absolutely committed to fixing what is, broadly speaking, a broken system; indeed, my right hon. Friend the Secretary of State for Health and Social Care has described the health and social care system as broken. We have to fix the foundations of that system, and unpaid carers are absolutely part of those foundations. We also have to ensure that unpaid carers have a strong voice in the consensus that we want to build around fixing the system. We know that if we are to build a national care service of which our entire country can be proud, we will need those reforms, but they must truly embody person-centred care and the role played by unpaid carers. To achieve that, I will engage with my counterparts across Government, with unpaid carers and with sector partners such as Carers UK and Carers Trust to ensure that their voices are heard.

I know that many of us were profoundly moved by the experiences of caring shared by the right hon. Member for Kingston and Surbiton (Ed Davey) during the general election campaign. As we have heard this evening, this is a subject of great significance for, and close to the heart of, Members on both sides of the House—including, of course, the hon. Member for North East Fife. I look forward to engaging with colleagues throughout the House on a cross-party basis, because we know that the consensus we need to build transcends narrow party political partisan divides. This is about building a system that is truly fit for the future, and fit for the country in which we live. So let us forge ahead together with the promise of that future in which unpaid carers are visible, valued and supported.

Question put and agreed to.

Healthcare Provision: East of England

Jim Shannon Excerpts

Tuesday 3rd September 2024 Westminster Hall

[Clive Lewis]

On the hon. Gentleman’s first point, yes, successive Governments have presided over the NHS, but with differing intentions. Until the mid-1970s, say, there was a broad consensus—I will come on to this—on what the welfare state was and how it operated. That has changed substantially in the past 60 years. The implementation of different policies by different Governments, including Conservative ones, has not always been in the best interests of the NHS. On enterprise, yes, a secure welfare state, good social security and the ability to give people good health—the NHS has been integral to that—have implications for our economy, as I have already pointed out.

I am sure I am not the first or the last to suspect a direct connection between the rise of angry and anti-democratic right-wing politics and the demise of the NHS’s ability to look after us all effectively. The sheer far-reaching impact of the NHS and its crisis cannot be underestimated. One needs only to look at the US, where free universal healthcare does not exist, as the hon. Member for Mid Norfolk (George Freeman) just mentioned, to see the state of politics, crime, drug addiction and social breakdown there. The free market in healthcare provision and medicines has led to a country with one of the least efficient and most high-cost healthcare systems in the western world, and where millions are hooked on drugs that are as heavily advertised as if they were cans of coke. Let us not indulge too much in English exceptionalism, though. We need only to look at dentistry and adult social care in this country to see what happens to healthcare provision that is, to all intents and purposes, privatised or well on its way to being so—the consequences of which I hope colleagues will discuss later in the debate.

The foresight of the 1945 Labour Government cannot be underestimated. When the NHS was launched in 1948, it was done in tandem with the advent of the welfare state, because Beveridge, Keynes and Bevan understood the three pillars necessary for a healthy nation. The first pillar—the NHS—would be there for people if they became sick, but it was the second and third pillars that meant the NHS would not be overburdened. They would work in tandem with it to prevent sickness.

The second pillar was, of course, the welfare state, providing a network of social institutions that would protect citizens from the market risks associated with unemployment, accidents and old age. The third pillar was an economic system that prioritised full employment in secure, well-paid, unionised jobs—a system that sought to reduce all forms of inequality, from wealth to health.

Over the last 60 years, the three pillars have been systematically smashed. The second and third pillars are in tatters, while the first—the NHS—is wobbling precariously. It is testament to the enduring nature of the national healthcare system that it has managed to survive as an almost solitary pillar for as long as it has. If a Labour Government are truly to fix the foundations of our broken healthcare system, they must acknowledge the nature of the three-pillar foundation, and acknowledge that the NHS cannot be fixed if we do not rebuild and replace the other two pillars as well.

The situation in the east of England—from dentistry deserts to sky-rocketing rates of mental health referrals and some of the worst ambulance waiting times in the country—is beyond one malfunctioning organisation. Norwich and the wider region are experiencing a systemic crisis that is institutional, social and economic. Healthcare reforms such as devolution to the integrated care boards have become about devolving who gets to wield the axe to make savings—known to many people as cuts. I will give an example. Our ICB in the east of England, part of NHS Norfolk and Waveney, has been told by national health bosses to cut its running costs by 30% by 2026. My first question to the Minister is: how will our Government deliver improved healthcare outcomes while simultaneously implementing the previous Government’s frankly destructive cuts?

We know that vast areas such as dentistry and social care are largely privatised, with spiralling costs, and that undermines the NHS’s central commitment to care being free at the point of use. Tendrils of the crisis extend into social care. It is often said that if social care is cut, the NHS bleeds too. Norfolk county council acknowledges a crisis in social care. With soaring demand and struggles to recruit staff, there is a backlog of hundreds of vulnerable people waiting to get their care needs assessed, and care providers fold on a regular basis. My second question to the Minister, then, is: what news can she give us on the last Government’s unimplemented cap on care costs? Is it being implemented, as the Secretary of State implied during the general election campaign, or being dropped? If it is dropped, what plans are there to help those facing ruin given their complex care needs?

One consequence of the situation in Norfolk is that there are regularly hundreds of hospital patients who are medically fit to leave but unable to be discharged. It is clear that our healthcare system is struggling to respond to today’s crisis, but it is also unprepared for the challenges of the future. East Anglia is the UK region most at risk from early climate impacts, and there is clear evidence of the link between climate breakdown and ill health. For example, from 2022 to 2023 the number of flood reports in Norfolk doubled, and stretches of Norwich are predicted to flood year after year. Victims of flooding in the UK are nine times more likely to experience long-term mental health issues, and flooding is linked to a greater instance of respiratory diseases because of dampness.

Prevention is better than cure—it is about treating the causes, not just symptom alleviation. We know that the Prime Minister is keen on the so-called preventive state and we have seen some early policy announcements, so my third question is: will the Minister elaborate on what that will look like? What does healthcare provision that prioritises prevention look like in the east of England?

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this issue forward. I know the debate is about the issues particular to his constituency, but they are ones apparent to all of us across the United Kingdom of Great Britain and Northern Ireland. First, does he understand and perhaps agree that the Minister and Government could look at pharmacies having a bigger role in treating minor ailments? Secondly, there is the issue of how people, particularly elderly people, can access GP appointments regularly. Thirdly, when it comes to cataract surgery there is a postcode lottery across the whole United Kingdom. If people get the surgery early, it stops them losing their sight. Is the hon. Gentleman experiencing issues in his constituency similar to those in mine?

[Clive Lewis]

I thank the hon. Gentleman for his input, and his points were well made. When researching this debate, I probably spent more time working out what I did not have time to say than what I could actually put into the debate, so I have tried to do a broad overview. Many of the issues the hon. Gentleman raised are also of concern in my Norwich South constituency and across the eastern region. I am sure that during the debate many of those issues will be raised and dealt with in more detail.

Our Government have said they are a Government of service, but a legitimate fourth question that I ask the Minister is: in service of whom and to what end? It is clear to many that the interests of big business, of big tech and data companies and of private finance do not always sit well with the public interest, particularly when it comes to health. There are areas where they do, but there are also areas where they do not. We know with whom the last Government sided; whom will ours back when push comes to shove—big business, big tech, the finance industry or Joe public?

I want to briefly provide a snapshot of the scale of the crisis in the eastern region. Ambulance response times in the east of England are significantly worse than those in the rest of England. In 2023, response times for category 1 cases—that is, severe cases—were nearly 12 minutes in East Anglia, while the national target is seven minutes. They were nearly the worst on record. The Care Quality Commission, now under inquiry and investigation itself for its capability to do its job, has described Norwich university hospital as the

“worst in the East of England”

for ambulance handover times.

Referrals to mental health services increased by 18% between 2018 and 2020. Compared with the rest of England, Norwich and Norfolk have higher rates of self-harm, death by suicide and mental health issues among young people, as well as more self-diagnosed mental health issues generally. Our mental health trust—Norfolk and Suffolk NHS foundation trust—is notorious for being the worst in the country, and I do not think that can be said enough.

Norwich is a dental desert. In July, the Secretary of State branded Norwich North the “Sahara of dental deserts”. That is a rather romantic notion, but it is a desert where people pull their own teeth out in this burgeoning phenomenon of a do-it-yourself dentistry industry. Indeed, some of my Ukrainian constituents have told me that they find it preferable to dodge Russian missiles and artillery to use Ukrainian dentists. Ukraine arguably has a better dental system in the middle of a prolonged war. That is unsurprising given that in the east we have one NHS dentist—no, it is not even one NHS dentist; it is one dentist—per 2,600 people. Just picture that in your head: one dentist with their tools with 2,600 people queued up. That is what it feels like to many of my constituents.

For the second year running, no dental practices are accepting NHS patients. Norfolk children under five have some of the worst tooth decay in the entire country. Thousands of people have had to go to hospitals in Norwich and Norfolk for abscesses that should have been prevented. The list goes on and on. I am sure that many of my colleagues from the eastern region will also outline some of the issues and stories that they know are taking place on a daily basis, and that have been for many years now.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Karin Smyth]

My hon. Friend is absolutely right that the separation of babies and their parents at that time is not acceptable, and about the shocking state of the estate, as we have just heard. We will look at the findings of the NHS review very quickly, and I will be happy to get back to her on those specific points.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her answer. This issue is clearly not just about accommodation; it is also about providing physical and emotional help for mothers who have been through traumatic circumstances, emotionally and physically. What will be done along those lines to ensure that mothers and babies have all the help they need?

[Karin Smyth]

The hon. Gentleman makes a really important point about mental health support in that critical period. We will absolutely make sure that is looked at.

Health Services: Rural Areas

Jim Shannon Excerpts

Wednesday 17th July 2024 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Let me get my specs on properly, Madam Deputy Speaker. They have a wonky leg that sticks out sideways.

I must say at the outset that I have heard some excellent maiden speeches today. It is a bit worrying to hear such good maiden speeches, because it makes one feel somewhat mundane in comparison. Let me also welcome the Minister to her place: it is a pleasure to see her sitting opposite me.

This Adjournment debate is the first of the new Parliament, and I am grateful to the Speaker for granting it. It concerns a topic that is important not only to my constituents in the highlands, but to constituents in every rural area in the country. I thank the Minister for her attendance, and look forward to hearing what she has to say. I hope that the debate sets the tone for how a Government and an Opposition can work together to meet the needs of every citizen of the United Kingdom, no matter where they live.

I recently had the great honour of being re-elected to represent Caithness, Sutherland and Easter Ross, which is now the largest constituency in the United Kingdom. It measures a staggering 11,798 sq km, more than half the size of Wales. We are here tonight to discuss the adequacy of healthcare services in rural areas, and for fear of being predictable I am afraid to say that the health services in the highlands are not even faintly adequate. I recognise, of course, that health is devolved, but 17 years of centralisation have wreaked havoc on my part of the world. Health services have been stripped back and gutted, leaving my constituents with access to far too few local services.

Let me begin with general practices. In Scotland, we have seen changes in vaccination services because, in an effort to reduce GPs’ workload, GP contract Scotland removed their vaccination capabilities. That is of huge concern to crofters in my constituency who might cut themselves on a piece of barbed wire and need a tetanus vaccination as quickly as possible. The same goes for anyone in need of shingles, flu, covid or travel vaccines. They must travel a staggering 70 miles or more to the nearest A&E, where they will face further waits owing to backlogs resulting from heavy workloads.

[Jim Shannon (Strangford) (DUP)]

I want to keep the tradition alive, Madam Deputy Speaker. This is my first intervention during an Adjournment debate in the new Parliament.

I commend the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for raising an issue that is very important to me and to my constituency. I also congratulate him on his excellent victory in the polls: he has done exceptionally well. I hail from a rural constituency where my own doctor has to service a huge number of people, and the inadequacy of help for rural constituents is abundantly clear to me. Does the hon. Member not agree that the current postcode lottery must end, and that access to GPs, physiotherapists, nutritionists and mental health services for farming and other rural communities must be at least on a par with those in cities and large towns? Why should those in rural communities be second-class citizens in their own country?

[Jamie Stone]

The hon. Member makes his point with his customary charm. It is no wonder that he is so well liked in this place, because he always speaks for his constituents.

I have talked about the delays in vaccinations, which also applies to the lifesaving vaccinations that babies must have. The Scottish Government take a one-size-fits-all approach that, frankly, does not work in remote rural areas such as mine. The retention and recruitment of GPs and other healthcare workers is crucial, but poor wages and terms and conditions, and a lack of proper travel reimbursement, all lead to a general impression that the game is simply not worth the candle. That is why we are missing key workers and doctors, and why we are paying through the nose for locum and temporary staff. Madam Deputy Speaker, can you believe that NHS Highland has spent £21 million on locum staffing in the past year? That is almost 3% of its entire budget—an eye-watering sum. Could that money not have been spent much better, for example on care homes, hospitals or pain clinics that have been forced to close?

--- Later in debate ---

[Karin Smyth]

I am aware of the issues facing the south-west and, when in Opposition, I spoke in the local media about some of the ambulance challenges. I am not aware of those reports, but if the hon. Gentleman writes to me with the details, I will happily look into the issue and get back to him.

We also recognise the additional cost of providing services in rural areas, for example in travel and staff time. That is why the funding formula used by NHS England to allocate funds to integrated care boards includes an element to better reflect needs in some rural, coastal and remote areas.

The NHS faces significant challenges. It needs fundamental reform. The Prime Minister is personally committed to resetting the UK Government’s relationship with devolved Governments in Scotland, Wales and Northern Ireland. I echo the Prime Minister’s words today about our commitment to rural constituencies across the entire country and I hope we can work with hon. Members from across the House, including the hon. Member for Caithness, Sutherland and Easter Ross.

[Jim Shannon]

I welcome the Minister’s clear commitment to England, Scotland, Wales and Northern Ireland—and particularly to Northern Ireland. Let me declare an interest: I am a member of the Ulster Farmers Union. I know that the Ulster Farmers Union back home, in conjunction with the NFU here, has been trying to work with the health service and with all those with responsibility in this area on the issue of suicides. Farmers mostly work on their own and suffer from anxiety and depression. They face pressures from finance and pressures from the bureaucracy that exists in farming. I know the Minister is compassionate and understanding—I mean that honestly. When it comes to addressing that issue, does she think that it must be done in conjunction with the farmers unions? Trying to work together to make things better must be a step in the right direction.

[Karin Smyth]

As ever, the hon. Gentleman makes a valid point. I shall certainly ask my colleagues in the Department for Environment, Food and Rural Affairs about that. His point is extremely well made. I know his constituency in Northern Ireland very well. Let me say that we are very committed to working with hon. Members across the House to share ideas. The hon. Member for Caithness, Sutherland and Easter Ross has put forward more ideas about how that can happen. I do not promise to implement all of those things, but I will certainly look at them. We want to work very closely across all jurisdictions so that we can make progress for all our constituents to improve the health outcomes across the four nations of the United Kingdom.

Question put and agreed to.

NHS

Jim Shannon Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

My hon. Friend has devoted her career in this place not only to representing the steelworkers in her constituency, but to her constituents’ healthcare, and it is thanks to her campaigning, and that of other colleagues, that we have a CDC, and facilities like that, in her local area. She has very tactfully described my position. I, of course, acknowledge my awareness of her campaign, and I really look forward to working with her in the future to see whether we can ensure that the residents of Scunthorpe—and the residents of Grimsby—have those services that we all hold so dear.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State very much for her statement. It is clear that the NHS is, in some cases, in need of critical care. While we all prepare for an election, there are ill and vulnerable people unable to prepare for the surgery and treatment that they so desperately need. How will the Secretary of State ensure that, while this Parliament dissolves, the NHS continues to consolidate and grow, and delivers much-needed diagnoses and operations for its patients—our constituents?

[Victoria Atkins]

I thank the hon. Gentleman. One of the joys of this Parliament has been to have him contributing in every statement and debate. On the particular healthcare needs in Northern Ireland, he will appreciate that healthcare is devolved, and that we are all very mindful of recent history, in terms of the devolution of power in that particular set of circumstances. However, I have very much enjoyed working with the Health Minister, Minister Swann.

Clearly, we value our United Kingdom, and we want to do whatever we can to help all corners of the United Kingdom in healthcare—although, of course, we respect that they are devolved matters. That is why I want to work closely with my counterpart in Northern Ireland, and, as I have indicated—or am indicating now— I would be very happy to work with the Health Ministers in Scotland and Wales to help them with their waiting lists.

International Health Regulations

Jim Shannon Excerpts

Tuesday 14th May 2024 Commons Chamber

[Andrew Stephenson]

I happily reassure my hon. Friend that national sovereignty comes first. We will continue to do everything that we can to ensure that we get an accord that is agreeable, but if the accord would undermine our sovereignty and our ability to act domestically in any way, we will simply not sign it.

[Jim Shannon (Strangford) (DUP)]

I have been contacted by a large number of constituents who have voiced grave concerns about the powers and rights requested and required by this unelected body. While we may support some of the work carried out to help developing countries, I will not sign away the sovereignty of this nation. Our participation in the WHO should not come with a prerequisite of signing up to these demands. Further, if that is the case, we should no longer be a participating member of the WHO.

World ME Day

Jim Shannon Excerpts

Wednesday 1st May 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I certainly will do exactly that; I had planned a five-minute contribution.

I congratulate the right hon. Member for Bromsgrove (Sir Sajid Javid) on highlighting World ME Day. I listened to the right hon. Member for Hayes and Harlington (John McDonnell). When I was first introduced as an elected representative, as a Member of the Assembly at Stormont back in 1998, a person with ME came to me one day. I will be honest: I had no idea what it was. But I knew one thing, which was that that lady was ill. I am no wiser or smarter than anybody else, and I am not a doctor, but I can recognise pain. I can recognise a disability that hurts. It was making her life absolutely unworkable.

I helped her with her benefits; incidentally, we won on appeal. We won because if I could see what that lady was going through, the four people on the panel could see it, too. The right hon. Member for Hayes and Harlington referred to the appeals process. I always ask the person, “How many days a week are you ill?” and the person will tell you. Sometimes they are ill for a week, sometimes they are not ill and sometimes they are ill for three of the seven days. The point I am making is that they are ill, and it is a case of proving that.

The article by Hope 4 ME & Fibro Northern Ireland really summarises how the ME community feels:

“In recent times, the landscape of ME has undergone a transformation, with COVID-19 emerging as the most common trigger for this chronic illness. The intersection of these two health challenges has resulted in a significant increase in the number of people affected by ME. An estimated 55+ million individuals worldwide are living with the debilitating effects of this condition.”

It is an epidemic across the world.

“Amidst these escalating numbers, Hope 4 ME & Fibro Northern Ireland proudly stands alongside World ME Alliance members across the globe. We collectively amplify support for initiatives that seek to address the multifaceted impact of ME on individuals and communities alike.”

As an active Member of Parliament, a former Member of the Northern Ireland Assembly and former councillor—I think this is now my 39th year in elected service—I have seen the debilitating effects suffered by those with ME suffer. One of the harsh realities is that there is no cure. Individuals grappling with ME often endure both the physical toll of the illness and the stigmas that accompany it. It is imperative that we as a global community and in this House come together to address these gaps in understanding, treatment and research. That is where we in this place have a part to play. The right hon. Member for Bromsgrove set the scene well, as did others who have spoken; those who follow will tell it again.

I do not believe that we have done more than scratch the surface of fulfilling our obligation to those who are in inexplicable pain daily and who are made to feel as if it is somehow only in their head. It is not. I am not a doctor, but I can see pain; I can see agony; I can see trauma. I can see people who need help. If I can do that, everybody in this room could do the same, because that is what we do every day when we deal with people. They live feeling ashamed of an illness, when most other illnesses are accepted as being out of the victim’s hands. There is work to do in how our health and benefits Departments view ME—there is a big role for them to play—and subsequently treat those who suffer from ME and associated illnesses. Support should be offered not just to them, but also to the families—never forget the families. It is not just that one person suffering; the whole family suffers, because they can see the pain and the agony. Undoubtedly, the burden is often shared with the entire household, emotionally, physically and financially.

On World ME Day, we need to be aware that the people we may see for a brief moment may be fighting a battle with pain that we cannot fully understand. We cannot share that pain, but we can hopefully appreciate what they are saying. It is our job in this place to fight harder for them. For them, this debate is a continuation of that very battle they have fought. We fight today alongside them.

Preventable Sight Loss

Jim Shannon Excerpts

Tuesday 30th April 2024 Westminster Hall

[Margaret Greenwood]

My hon. Friend makes an important point, and I will touch on regional variations later.

A paper published last month by the Centre for Health and the Public Interest reported that in the period 2018-19 to 2022-23, the NHS paid the private sector around £700 million for cataract treatments. While cataract operations are very important and can transform people’s lives, it is crucial that those responsible for health policy consider whether the increase in the number of them being delivered comes at the expense of other sight-saving treatments.

We must ensure that the NHS is comprehensive in the range of treatments that it provides. The Centre for Health and the Public Interest warns that the increase in the percentage of the NHS budget being spent on cataract operations is likely to mean that there are fewer resources available to treat other eye care conditions, such as glaucoma and macular degeneration, which are generally considered more serious and lead to irreversible sight loss. Ophthalmologists have also told me that it is impacting capacity for the treatment of conditions such as cancer care, urgent treatment and the treatment of newborn babies.

Data received by the charity from 13 NHS trusts has shown that waiting times for some irreversible conditions have increased between 2017-18 and 2022-23, including for glaucoma and diabetic retinopathy. Waiting times have also increased for cataract operations. The charity also reports that the rise in expenditure on cataract services has been accompanied by an increase in the number of private, for-profit clinics, which have been established to deliver NHS cataract services. Its paper states that 78 new private, for-profit clinics have opened over the past five years.

It is not surprising that some senior ophthalmologists have raised concerns that the increased expenditure on NHS cataract provision, carried out predominantly by the independent sector, is being driven not by patient need but by the commercial interests of the companies delivering it. Last December, Professor Ben Burton, president of the Royal College of Ophthalmologists, warned that the entire commissioning process needed looking at, with local integrated care systems unable to effectively control their use of resources, resulting in some patients with

“very mild cataracts getting surgery at the expense of other patients going blind”.

He added that the approach of unplanned commissioning means that

“the NHS is losing consultants, money and trainees to the private sector”

and that the profit margin is “too high”, meaning that

“companies can pay three times the NHS overtime rate...So, unsurprisingly, people are dropping sessions in the NHS and doing cataract surgery at private companies.”

Professor Burton further warned that:

“We are trying to train the next generation of cataract surgeons, but they’re not getting any straightforward cases to train them on, because the NHS is being left with the more complex cases, with the less complex ones being outsourced.”

That very much chimes with the arguments raised by the Centre for Health and the Public Interest. In other words, the independent sector is cherry-picking the less complex work.

When he responds on behalf of the Government, will the Minister set out what discussions they have had with NHS England about sorting out the perverse outcomes caused by the unplanned commissioning that Professor Burton has highlighted? Unless we see a change of course by policymakers as a matter of urgency, there are real concerns that we will see the breadth of eye care provided within the NHS diminished to the point where some complex sight-saving treatments are no longer available on the NHS. They might be things such as the treatment people need when they are in urgent care after a road traffic accident, the treatment needed for newborn babies or treatment for cancer.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing forward this debate. First, this is a terrific subject. She will know that this morning I had a debate on optometry care, which is a similar topic, and the issue is clear. In that debate, I said that 22 people weekly lose their sight to preventable loss. The hon. Lady knows that. Does she agree that the annual eye test should be pushed as forcibly as a dental check-up, and that the message should start in schools and resound right through the community? I think she will agree that optometrists and opticians want to be part of that move forward. If that is the case, we need the Minister and his Department to work alongside them to push for appointments from an early age.

[Margaret Greenwood]

I thank the hon. Gentleman for his intervention; it was characteristically appropriate. I particularly welcome his call for the message to start when children are in school because it is massively important.

In the not too distant future, we may face eye care deserts in some parts of the country, in much the same way as has happened with dentistry, with some people missing out on crucial treatment. That is exactly what Professor Burton has warned could happen. He said:

“There is a risk that the NHS loses ophthalmology completely, like it has dentistry, in terms of it being a service which is available free at the point of delivery.”

It is not difficult to see how such a conclusion has been arrived at. The great tragedy we face if that happens is that some people will lose their sight from treatable conditions.

The use of the independent sector for ophthalmology has tended to be more prevalent in some parts of the country than in others, so Members representing constituencies in those areas may be particularly concerned. A regional analysis of trends published by the Royal College of Ophthalmologists in 2022 found that in 2021 the north-west of England had the highest proportion of NHS-funded cataract procedures delivered by independent sector providers, at 61%. The midlands, the north-east, Yorkshire and the south-west of England also had figures over 50%. Those figures have increased greatly since 2016. Although there is regional variation, we should be concerned about that right across the United Kingdom.

NHS staffing levels for ophthalmology are also a matter of extreme concern. As I said earlier, NHS ophthalmology departments are worried about training opportunities for junior doctors and the available workforce. In response to a recent written parliamentary question, the Under-Secretary of State for Health and Social Care, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), failed to provide clear information about the Government’s plans for specialty training places for ophthalmology. She said:

“A decision regarding which specialties these places will be allocated to will be made nearer the time that the places are required for the expanded workforce. NHS England will work with stakeholders to ensure this growth is sustainable and focused in the service areas where need is greatest.”

Will the Minister clarify that? When Under-Secretary of State for Health and Social Care spoke of stakeholders in that context, was she talking about the independent sector as well as the NHS? If so, will the Minister ask NHS England what progress it is making towards meeting its commitment, set out in the 2023 elective recovery taskforce implementation plan, to

“track, monitor and evaluate independent sector’s impact on the long-term NHS capacity landscape”?

That is an incredibly important matter, and if the Minister is not able to reply today, I would welcome it if he can write to me on that point.

How confident is the Minister that the full breadth of ophthalmology expertise will be there in the NHS for any one of us in five or 10 years? Data from the most recent workforce census from the Royal College of Ophthalmologists shows that there is real cause for concern, given that 76% of NHS ophthalmology departments report not having enough consultants to meet patient need. In reality, NHS ophthalmology departments are increasingly relying on costly locums to cover workforce gaps, and nearly two thirds—65%—use locums to fill consultant vacancies.

Typically, UK-trained ophthalmologists will have undertaken the vast majority of their training in the NHS, including those now working for independent sector providers. There are concerns that the increase in NHS staff working in the independent sector on cataract provision is reducing the availability of training opportunities that enable NHS staff to train in more complex areas. That is potentially a time bomb for the future, and could mean that we will not have anywhere near enough staff trained to carry out work on treatment for conditions such as glaucoma and wet macular degeneration.

It is clear that we are facing a sight loss health emergency, and there is an urgent need for a national eye health strategy. The RNIB has suggested that the goal of such a strategy should be to establish eye health as a public health priority, and it should aim to prevent irreversible sight loss.

As the Royal College of Ophthalmologists pointed out, it is imperative that NHS ophthalmology departments across the UK are supported to deliver high-quality and timely care for all patients, regardless of their condition and where they live. Among other things, it is calling on policymakers to support the development of a multi-disciplinary eye care workforce fit for the future. That should include delivering an additional 285 ophthalmology training places in England by 2031 and boosting investment in the ophthalmic practitioner training programme so that more eye care professionals can work to the top of their licence.

The royal college is also calling for better integrated eye care through investment in digital solutions such as interoperable electronic patient records between optometry and ophthalmology, and a further development of integrated pathways for optometry so that patients receive the most appropriate and accessible care and are prioritised based on clinical need. It is calling for the reform of commissioning, tariff and data reporting systems, which it believes will ultimately help the NHS ophthalmology services. All those things should be part of a national eye health strategy.

The strategy must be inclusive and must address the needs of everybody. The charity SeeAbility has pointed out that people with learning difficulties are 10 times more likely to have a serious sight problem than other people, but are far less likely to have a sight test. What is happening to ophthalmology services in the NHS is clearly a matter of extreme concern and is one example of just how damaging the privatisation of NHS services is to the delivery of a universal and comprehensive national health service.

The increasing use of the independent sector to treat NHS patients leaves us vulnerable to the vagaries of the market. Under this Government, the use of private-sector companies in health has increased. Indeed, the Health Service Journal reported last December that the amount spent by NHS trusts on outsourcing activities to other providers has almost doubled from £2.4 billion in 2019-20 to £4.7 billion in 2022-23. The HSJ stated that independent providers are

“likely to make up the bulk of the spend”.

The Minister will say that the Government are not privatising the NHS, but that is smoke and mirrors. The World Health Organisation defines privatisation as

“a process in which non-government actors become increasingly involved in the financing and/or provision of health care services”.

We have seen that in ophthalmology, with the commercial interests of private companies driving the increased expenditure on NHS cataract provision. That is the view of ophthalmologists. No doubt the Minister will say that the Government are providing the national health service with record levels of funding—again, smoke and mirrors. The fact is that, as pointed out in the 2023 report “The Rational Policy-Maker’s Guide to the NHS”, NHS spending has not been enough to keep pace with need when we factor in and combine the effects of inflation, population growth, population ageing and increased morbidity.

I ask Members to think about the questions I raised at the beginning of the debate. How would you feel if you lost your sight, how would it impact your life, and how would you feel if you then found out that the loss of your eyesight could have been prevented? How would you feel if you found that you could not get the treatment you need because less serious conditions were being treated as a priority in the independent sector by specialists who were lured there, away from the NHS, due to how commissioning works and because the market is increasingly influencing what is and is not treated?

RNIB figures show that every day, 250 people in the UK start to lose their sight. We need the national eye health strategy, the goal of which should be to preserve vision and prevent irreversible sight loss. I call on the Government to address those issues as a matter of urgency. The Government must invest in the national health service and strengthen it as a public service to ensure that it is universal and comprehensive. For that, they must build the capacity of expertise within the NHS so that we can be confident that the service is there to treat all eye conditions. In the words of Professor Ben Burton, the chief executive of the Royal College of Ophthalmologists,

“the key to ensuring long term capacity to deliver patient care is to invest in comprehensive NHS services, workforce and infrastructure.”